Immediate and long term effects of weight reduction in obese people with asthma:: randomised controlled study
Immediate and long term effects of weight reduction in obese people with asthma:: randomised controlled study
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DOI：
10.1136/bmj.320.7238.827
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发表时间：
2000-03-25
影响因子：
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通讯作者：
Mustajoki, P
中科院分区：
文献类型：
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作者：
Stenius-Aarniala, B;Poussa, T;Mustajoki, P
目的探讨减肥对肥胖哮喘患者的影响。设计开放研究两个随机平行组。设置私人门诊中心，赫尔辛基，芬兰。参与者通过报纸广告招募两组19例肥胖哮喘患者（体重指数（kg/m(2)） 30 ~ 42）。干预监督减肥计划，包括8周极低能量饮食。主要观察指标：体重晨起呼气峰流量（PEF）、用力肺活量（FVC）、用力呼气量（FEV1）；还有哮喘症状，急性发作次数，口服类固醇疗程，健康状况（生活质量）。结果：在减肥计划结束时，治疗组的参与者平均减轻了前体重的14.5%，对照组减轻了0.3%。1耳后相应数据为11.3%，增重2.2%。8周节食期后，治疗组和对照组预测FEV1的变化百分比与基线的差异为7.2%（95%置信区间为1.9%至12.5%,P = 0.009）。FVC变化的相应差异为8.6% （4.8% ~ 12.5%,P < 0.0001）。在一次学习后，两组的变化差异仍然显著：FEV1为7.6%(1.5%至13.8%,P = 0.02)， FVC为7.6%（3.5%至11.8%,P = 0.001）。到减肥计划结束时，治疗组呼吸困难减轻13毫米（以视觉模拟量表0毫米至100毫米），对照组减轻1毫米（P = 0.02）。减少抢救用药分别为1.2、0.1剂（P = 0.03）。一年后，两组患者的症状评分差异为- 12（范围- 1至- 22，P = 0.04），总分差异为- 10（范围- 18至- 1，P = 0.02）。治疗组中位加重次数为1次（0 ~ 4次），对照组中位加重次数为4次（0 ~ 7次），P = 0.001。结论肥胖哮喘患者减重可改善肺功能、症状、发病率和健康状况。
Objective To investigate the influence of weight reduction on obese patients with asthma.Design Open study two randomised parallel groups.Setting Private outpatients centre, Helsinki, Finland.Participants Two groups of 19 obese patients with asthma (body mass index (kg/m(2)) 30 to 42) recruited through newspaper advertisements.Intervention Supervised weight reduction programme including 8 week very low energy diet.Main outcome measures Body weight morning peak expiratory flow (PEF), forced vital capacity (FVC), forced expiratory volume in one second (FEV1); and also asthma symptoms, number of acute episodes, courses of oral steroids, health status (quality of life).Results At the end of the weight reducing programme, the participants in the treatment group had lost a mean of 14.5% of their pretreatment weight, the controls 0.3%. The corresponding figures after one) ear were 11.3% and a weight gain of 2.2%. After the 8 week dieting period the difference in changes in percentage of predicted FEV1 from baseline in the treatment and control groups was 7.2% (95% confidence interval 1.9% to 12.5%, P = 0.009). The corresponding difference in the changes in FVC was 8.6% (4.8% to 12.5%, P < 0.0001). After one lear the differences in the changes in the two groups were still significant: 7.6% for FEV1 (1.5% to 13.8%, P = 0.02) and 7.6% for FVC (3.5% to 11.8%, P = 0.001). By the end of the weight reduction programme, reduction in dyspnoea was 13 mm (on a visual analogue scale 0 mm to 100 mm) in the treatment group and 1 mm in the control group (P = 0.02). The reduction of rescue medication was 1.2 and 0.1 doses respectively (P = 0.03). After one year the differences in the changes between the two groups were - 12 for symptom scores (range - 1 to - 22, P = 0.04) and - 10 for total scores (- 18 to - 1, P = 0.02). The median number of exacerbations in the treatment group was 1 (0-4) and in the controls 4 (0-7), P = 0.001.Conclusion Weight reduction in obese patients with asthma improves lung function, symptoms, morbidity and health status.