Atopy and pulmonary function among healthy-weight and overweight/obese children with asthma.
Atopy and pulmonary function among healthy-weight and overweight/obese children with asthma.
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DOI：
10.1002/ppul.25005
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发表时间：
2021-01
影响因子：
3.1
通讯作者：
Rastogi D
中科院分区：
文献类型：
--
作者：
Farhat L;de Vos G;De A;Lee DS;Rastogi D
流行病学研究发现，在肥胖哮喘儿童中，特应性低/无特应性，但肥胖性哮喘中特应性与包括肺功能在内的疾病发病率之间的关联或缺乏尚不清楚。我们试图确定在患有哮喘的超重/肥胖少数民族儿童中，特应性与肺功能的相关性。在一家学术儿科哮喘中心5年来对200名以少数民族为主的儿童的回顾图表中，我们比较了过敏症(定义为≥-1皮肤点刺试验阳性或血清特异性Ig E定量与环境过敏原)的患病率及其与超重/肥胖者(体重指数和GT；85%)(n=99)和正常体重儿童(BMI 5-85%)(n=101)的肺功能的关系。在一个由47.5%的西班牙裔和39.5%的非裔美国人组成的队列中，81%的超重/肥胖儿童和74%的健康体重儿童患有特应症。与非特应性肥胖儿童相比，特应性健康体重儿童的FEV1预测百分比(93±13.6比107%±33.2，p=0.03)和FVC预测百分比(93%±12.2比104%±16.1，p=0.01)低，而超重/肥胖儿童特应性与FEV1(p=0.7)和FVC(p=0.17)无关。调整人口学和临床变量后，特应性是健康体重儿童第一秒用力肺活量和用力肺活量的独立预测因子(β=−2.4，p=0.0 7和β=−1.7，p=0.0 4)，但在超重/肥胖儿童中不是(β=0.6，p=0.5和β=0.8，p=0.3)。在正常体重的哮喘患者中，特应性与肺功能低下有关，而在超重/肥胖哮喘患者中则不相关，这支持了非过敏机制在儿童肥胖相关哮喘的疾病负担中的作用。
Epidemiologic studies have found low/ absence of atopy in obese asthmatic children, but the association or lack thereof of atopy with disease morbidity, including pulmonary function, in obese asthma is not well understood. We sought to define the association of atopy with pulmonary function in overweight/obese minority children with asthma. In a retrospective chart review of 200 predominantly minority children evaluated at an academic Pediatric Asthma Center over 5 years, we compared the prevalence of atopy, defined as ≥1 positive skin prick test or serum-specific IgE quantification to environmental allergens, and its association with pulmonary function in overweight/obese (body mass index (BMI) >85%) (n=99) to healthy-weight children (BMI 5–85% for age) (n=101). In a cohort comprised of 47.5% Hispanics and 39.5% African Americans, 81% of overweight/obese and 74% of healthy-weight children were atopic. While atopic healthy-weight children had lower percent-predicted FEV1 (93±13.6 vs. 107%±33.2, p =0.03) and lower percent-predicted FVC (93%± 12.2 vs 104%±16.1, p=0.01) as compared to non-atopic children, atopy was not associated with FEV1 (p=0.7) or FVC (p=0.17) in overweight/obese children. Adjusting for demographic and clinical variables, atopy was found to be an independent predictor of FEV1 and FVC in healthy-weight (β=−2.4, p=0.07 and β= −1.7, p=0.04, respectively) but not in overweight/obese children (β=0.6, p=0.5 and β= 0.8, p=0.3). Atopy is associated with lower lung function in healthy-weight asthmatics but not in overweight/obese asthmatics, supporting the role of non-allergic mechanisms in disease burden in pediatric obesity-related asthma.
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DOI：
10.1016/j.jaci.2016.06.060
发表时间：
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期刊：
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