Effects of weight loss on asthma control in obese patients with severe asthma
Effects of weight loss on asthma control in obese patients with severe asthma
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DOI：
10.1183/09031936.00053413
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发表时间：
2014-05-01
影响因子：
24.3
通讯作者：
Cukier, Alberto
中科院分区：
文献类型：
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作者：
Dias-Junior, Servulo Azevedo;Reis, Monica;Cukier, Alberto
关于减轻体重对哮喘患者影响的研究很少。没有对严重哮喘患者进行研究。因此，本研究的目的是评估体重减轻对伴有肥胖的严重哮喘患者的影响。这是一项开放的、前瞻性的、随机的研究，在两个平行组中，在患有严重不受控制的哮喘和中度肥胖的患者中。主要终点是开始减肥计划后6个月的哮喘控制水平，使用哮喘控制问卷（ACQ）进行量化。我们评估了临床参数、肺功能、气道炎症标志物和循环细胞因子。22名患者被随机分为肥胖治疗组和11名对照组。减肥计划与哮喘控制的显著改善相关（治疗组的平均+/- SE ACQ评分为3.02 +/- 0.19至2.25 +/- 0.28，对照组为2.91 +/- 0.25至2.90 +/- 0.16,p=0.001）。这种改善并没有伴随着气道炎症或支气管反应性指标的改变，而是伴随着用力肺活量的增加。我们的研究结果表明，肥胖严重哮喘患者的体重减轻通过与气道炎症无关的机制改善哮喘结局。
Studies on the effects of weight loss in patients with asthma are scarce. No studies have been performed in patients with severe asthma. Therefore, the aim of the present study was to assess the impact of weight loss in patients with severe asthma associated with obesity.This was an open, prospective, randomised study of two parallel groups, in patients with severe uncontrolled asthma and moderate obesity. The primary outcome was the level of asthma control 6 months after initiation of the weight reduction programme, quantified using the Asthma Control Questionnaire (ACQ). We evaluated clinical parameters, lung function, markers of airway inflammation and circulating cytokines.22 patients were randomised to undergo treatment for obesity and 11 to the control group. The weight reduction programme was associated with significant improvements in asthma control (mean +/- SE ACQ score 3.02 +/- 0.19 to 2.25 +/- 0.28 in the treatment group versus 2.91 +/- 0.25 to 2.90 +/- 0.16 in the controls, p=0.001). This improvement was not accompanied by changes in markers of airway inflammation or bronchial reactivity, but by an increase in forced vital capacity.Our results suggest that weight reduction in obese patients with severe asthma improves asthma outcomes by mechanisms not related to airway inflammation.