Qianqian Xu, Qingmei Zhang, Jin Jia, Yalin Chen, Chenyu He, Huaiwen Zhang, Jie Chen
Department of Gynecology, Affiliated Provincial People's Hospital of Fujian University of Traditional Chinese Medicine, 602, 817 Zhong Road, Fuzhou City, Fujian Province, China.
Fujian University of Traditional Chinese Medicine, Qiyang West Road, Flag Mountain Campus, Shangjie Town, Minhou County, Fuzhou City, Fujian Province, China.
BMC Pulm Med. 2025 Aug 21;25(1):399. doi: 10.1186/s12890-025-03885-6.
This study used data from the 2009–2018 National Health and Nutrition Examination Survey (NHANES) to examine the associations between obesity indicators (body mass index [BMI] and body roundness index [BRI]), the inflammatory marker white blood cell count (WBC), and asthma in women. Furthermore, it explored the potential mediating role of WBC in the relationships between BMI, BRI, and asthma.
This cross-sectional study included 3,792 eligible female participants. Logistic regression, restricted cubic spline (RCS), nonlinear curve fitting, threshold effect analysis, and mediation analysis were applied to evaluate the associations of BMI, BRI, and WBC with asthma.
Weighted analyses showed that women with asthma had significantly higher BMI, BRI, and WBC levels compared to those without asthma (all < 0.001). After adjusting for all potential confounders, these indicators remained significantly associated with asthma risk. Quartile-based analysis indicated that women in the highest quartile (Q4) of BMI, BRI, and WBC had a significantly higher risk of asthma. RCS and nonlinear curve fitting analyses supported nonlinear associations between these indicators and asthma, suggesting potential threshold effects. Mediation analysis demonstrated that WBC partially mediated the associations between BMI, BRI, and asthma risk.
This study identified significant and nonlinear associations between BMI, BRI, WBC, and asthma risk in women. WBC was shown to play a partial mediating role in these relationships, providing new evidence for understanding the inflammatory mechanisms underlying obesity-related asthma.
The online version contains supplementary material available at 10.1186/s12890-025-03885-6.
本研究使用2009 - 2018年美国国家健康与营养检查调查（NHANES）的数据，来研究肥胖指标（体重指数[BMI]和体圆度指数[BRI]）、炎症标志物白细胞计数（WBC）与女性哮喘之间的关联。此外，还探讨了WBC在BMI、BRI与哮喘关系中的潜在中介作用。
这项横断面研究纳入了3792名符合条件的女性参与者。应用逻辑回归、受限立方样条（RCS）、非线性曲线拟合、阈值效应分析和中介分析来评估BMI、BRI和WBC与哮喘的关联。
加权分析显示，与无哮喘的女性相比，患有哮喘的女性BMI、BRI和WBC水平显著更高（均P < 0.001）。在调整所有潜在混杂因素后，这些指标仍与哮喘风险显著相关。基于四分位数的分析表明，BMI、BRI和WBC最高四分位数（Q4）的女性患哮喘的风险显著更高。RCS和非线性曲线拟合分析支持这些指标与哮喘之间存在非线性关联，提示潜在的阈值效应。中介分析表明，WBC部分介导了BMI、BRI与哮喘风险之间的关联。
本研究确定了BMI、BRI、WBC与女性哮喘风险之间存在显著的非线性关联。WBC在这些关系中发挥了部分中介作用，为理解肥胖相关哮喘的炎症机制提供了新证据。
在线版本包含可在10.1186/s12890 - 025 - 03885 - 6获取的补充材料。
