Obesity and respiratory hospitalizations during influenza seasons in Ontario, Canada: a cohort study.
Obesity and respiratory hospitalizations during influenza seasons in Ontario, Canada: a cohort study.
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DOI：
10.1093/cid/cir442
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发表时间：
2011-09
期刊：
影响因子：
--
通讯作者：
Rosella LC
中科院分区：
文献类型：
--
作者：
Kwong JC;Campitelli MA;Rosella LC
2009年甲型H1N1流感大流行的证据表明，严重肥胖是流感感染严重并发症的风险因素。我们的研究确定，在季节性流感流行期间，严重肥胖是呼吸道住院的一个危险因素。(见第页上贾恩和查维斯的社论。)背景： 先前的研究表明，肥胖可能是甲型H1N1流感大流行感染并发症的危险因素。我们的目的是研究季节性流感流行期间肥胖和呼吸道住院之间的联系，并确定在没有确定流感感染严重并发症危险因素的个人中这种联系的程度。方法： 我们对加拿大安大略省人口健康调查的82545名受访者进行了一项队列研究，时间跨度为12个流感季节(1996年至1997年至2007年至2008年)。我们纳入了在流感季节开始前5年内对一项调查做出答复的18-岁的个人。我们使用Logistic回归来检验在整个队列中和按慢性病状况分层的选定呼吸系统疾病(肺炎和流感、急性呼吸系统疾病和慢性肺部疾病)的住院治疗与自我报告的身体质量指数(BMI)之间的关系。结果：在流感季节， 肥胖I级(体重指数，30-34.9)(优势比[OR]，1.45[95%可信区间，1.0 3-2.0 5])和肥胖II级或III级(≥35)个体(OR，2.12[95%CI，1.45-3.10])比正常体重个体更有可能在流感季节发生呼吸道住院。在II级或III级肥胖者中，既存在那些没有先前确定的危险因素的人(OR，5.10[95%CI，2.53-10.24])，也存在那些有1个危险因素的人(OR，2.11[95%CI，1.10-4.06])。结论：在流感季节，患有和不患有慢性病的 严重肥胖患者呼吸系统住院的风险增加。他们应被视为预防流感措施的优先群体，例如接种疫苗和用抗病毒药物治疗。
Evidence from the 2009 H1N1 pandemic suggests that severe obesity was a risk factor for serious complications from influenza infection. Our study identifies severe obesity as a risk factor for respiratory hospitalizations during seasonal influenza epidemics. (See the Editorial Commentary by Jain and Chaves, on pages .) Background. Previous studies suggest that obesity may be a risk factor for complications from pandemic influenza A(H1N1) infection. We aimed to examine the association between obesity and respiratory hospitalizations during seasonal influenza epidemics and to determine the extent of this association among individuals without established risk factors for serious complications due to influenza infection. Methods. We conducted a cohort study over 12 influenza seasons (1996–1997 through 2007–2008) of 82545 respondents to population health surveys in Ontario, Canada. We included individuals aged 18–64 years who had responded to a survey within 5 years prior to the start of an influenza season. We used logistic regression to examine the association between self-reported body mass index (BMI) and hospitalization for selected respiratory diseases (pneumonia and influenza, acute respiratory diseases, and chronic lung diseases), both in the entire cohort and stratified by chronic condition status. Results. Obese class I (BMI, 30–34.9) (odds ratio [OR], 1.45 [95% confidence interval {CI}, 1.03–2.05]) and obese class II or III (BMI, ≥35) individuals (OR, 2.12 [95% CI, 1.45–3.10]) were more likely than normal weight individuals to have a respiratory hospitalization during influenza seasons. Among obese class II or III individuals, the association was present both for those without previously identified risk factors (OR, 5.10 [95% CI, 2.53–10.24]) and for those with 1 risk factor (OR, 2.11 [95% CI, 1.10–4.06]). Conclusions. Severely obese individuals with and without chronic conditions are at increased risk for respiratory hospitalizations during influenza seasons. They should be considered a priority group for preventive influenza measures, such as vaccination and treatment with antiviral medications.
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