Obesity-Associated Severe Asthma Represents a Distinct Clinical Phenotype Analysis of the British Thoracic Society Difficult Asthma Registry Patient Cohort According to BMI
Obesity-Associated Severe Asthma Represents a Distinct Clinical Phenotype Analysis of the British Thoracic Society Difficult Asthma Registry Patient Cohort According to BMI
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DOI：
10.1378/chest.12-0872
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发表时间：
2013-02-01
期刊：
影响因子：
9.6
通讯作者：
Menzies-Gow, Andrew
中科院分区：
文献类型：
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作者：
Gibeon, David;Batuwita, Kannangara;Menzies-Gow, Andrew
背景：肥胖已成为哮喘发生的危险因素，也可能影响哮喘控制和气道炎症。然而，肥胖在严重哮喘中的作用仍不清楚。因此，我们的目标是探索肥胖与方法：来自英国胸科协会困难哮喘登记处的数据被用来比较三种BMI类别的患者人口统计学、疾病特征和卫生保健利用（正常体重：18.5-24.99;超重：25-29.99;肥胖：>= 30）。该组的中位BMI为29.8（四分位数范围，22.5-34.0）。肥胖组在维持皮质类固醇治疗（超重组和正常体重组分别为48.9% vs 40.4%和34.5%）、类固醇爆发治疗和短效β 2受体激动剂每日使用方面表现出更高的哮喘药物需求。在胃食管反流病（超重组和正常体重组分别为53.9% vs 48.1%和39.7%）和质子泵抑制剂使用方面存在显著差异。肥胖组的骨密度评分较高，而肺功能检查显示FVC降低和一氧化碳转移系数升高。血清IgE水平随着BMI的增加而降低，肥胖组更容易报告湿疹，但不太可能有鼻息肉的病史。结论：严重哮喘患者显示特定的特征，根据BMI支持肥胖相关的严重哮喘可能代表一种独特的临床表型。胸部2013; 143（2）：406-414
Background: Obesity has emerged as a risk factor for the development of asthma and it may also influence asthma control and airway inflammation. However, the role of obesity in severe asthma remains unclear. Thus, our objective was to explore the association between obesity (defined by BMI) and severe asthma.Methods: Data from the British Thoracic Society Difficult Asthma Registry were used to compare patient demographics, disease characteristics, and health-care utilization among three BMI categories (normal weight: 18.5-24.99; overweight: 25-29.99; obese: >= 30) in a well-characterized group of adults with severe asthma.Results: The study population consisted of 666 patients with severe asthma; the group had a median BMI of 29.8 (interquartile range, 22.5-34.0). The obese group exhibited greater asthma medication requirements in terms of maintenance corticosteroid therapy (48.9% vs 40.4% and 34.5% in the overweight and normal-weight groups, respectively), steroid burst therapy, and short-acting (beta(2)-agonist use per day. Significant differences were seen with gastroesophageal reflux disease (53.9% vs 48.1% and 39.7% in the overweight and normal weight groups, respectively) and proton pump inhibitor use. Bone density scores were higher in the obese group, while pulmonary function testing revealed a reduced FVC and elevated carbon monoxide transfer coefficient. Serum IgE levels decreased with increasing BMI and the obese group was more likely to report eczema, but less likely to have a history of nasal polyps.Conclusions: Patients with severe asthma display particular characteristics according to BMI that support the view that obesity-associated severe asthma may represent a distinct clinical phenotype. CHEST 2013; 143(2):406-414