Overweight/Obesity and Risk of Seasonal Asthma Exacerbations
Overweight/Obesity and Risk of Seasonal Asthma Exacerbations
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DOI：
10.1016/j.jaip.2013.07.009
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发表时间：
2013-11-01
影响因子：
9.4
通讯作者：
Camargo, Carlos A., Jr.
中科院分区：
文献类型：
--
作者：
Schatz, Michael;Zeiger, Robert S.;Camargo, Carlos A., Jr.
背景：肥胖与哮喘发作风险增加有关，但这种风险是否与发作季节有关尚不清楚。目的：探讨体重指数（BMI）升高与哮喘加重季节的关系。方法：研究对象为2008年有BMI测量的持续性哮喘健康计划成员中的成人（18-65岁）和儿童（5-17岁）。BMI分类正常（= 30 kg/m(2)）。急性发作被定义为与2009年春、夏、秋或冬哮喘发作相关的口服皮质类固醇配剂。结果：该队列包括17,316名成人和10,700名儿童。成人各季节加重比例及儿童秋季和冬季加重比例随BMI类别呈显著线性增加（P < 0.05）。超重或肥胖（相对于正常体重）与秋季和冬季加重的关系在调整性别和教育后的成人和儿童中仍然显著。在广义估计方程模型中，BMI状态和季节（春季、秋季和冬季）都与病情恶化有关。此外，我们注意到在不同季节（秋冬vs春夏），成人（P = .03）和儿童（P = .97）的bmi -加重关联有显著的相互作用。结论：较高的BMI值增加了成人和儿童持续性哮喘发作的风险，尤其是成人秋冬季发作。这些发现的潜在机制，包括维生素D状态、病毒感染和皮质类固醇反应性，值得进一步研究。(C) 2013年美国过敏、哮喘与免疫学学会
BACKGROUND: Obesity is associated with an increased risk for asthma exacerbations, but whether this risk is related to the season of exacerbation is not known.OBJECTIVE: To determine the relationship of increased body mass index (BMI) to the season of asthma exacerbation.METHODS: Study subjects were adult (aged 18-65 years) and children (aged 5-17 years) health plan members with persistent asthma in 2008 for whom a BMI measurement was available. BMI categories were normal (= 30 kg/m(2)). Exacerbations were defined as oral corticosteroid dispensings linked to an asthma encounter in the spring, summer, fall, or winter of 2009.RESULTS: The cohort included 17,316 adults and 10,700 children. There was a significant (P < .05) linear increase with BMI category in the proportion of adults with exacerbations in every season and in the proportion of children with exacerbations during fall and winter. Relationships of overweight or obesity (vs normal weight) to fall and winter exacerbations remained significant in both adults and children after adjustment for sex and education. In a generalized estimating equation model, both BMI status and season (spring, fall, and winter) were related to exacerbations. Moreover, we noted a significant interaction in adults (P = .03) but not children (P = .97) of the BMI-exacerbation association by season (fall-winter vs spring-summer).CONCLUSION: Higher BMI values increased the risk for asthma exacerbations in adults and children with persistent asthma, particularly for fall-winter exacerbations in adults. Potential mechanisms for these findings, including vitamin D status, viral infections, and corticosteroid responsiveness, merit further study. (C) 2013 American Academy of Allergy, Asthma & Immunology