Obesity and asthma: an association modified by age of asthma onset.
Obesity and asthma: an association modified by age of asthma onset.
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DOI：
10.1016/j.jaci.2011.03.036
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发表时间：
2011-06
期刊：
影响因子：
--
通讯作者：
Wenzel SE
中科院分区：
文献类型：
--
作者：
Holguin F;Bleecker ER;Busse WW;Calhoun WJ;Castro M;Erzurum SC;Fitzpatrick AM;Gaston B;Israel E;Jarjour NN;Moore WC;Peters SP;Yonas M;Teague WG;Wenzel SE
对哮喘表型的研究已经确定肥胖是成人发病哮喘患者比例高的一个组成部分。然而，哮喘发病年龄是否会改变肥胖与哮喘之间的关系尚不清楚。根据严重哮喘项目（SARP），我们将哮喘发病年龄定义为早发（12岁之前）和晚发（12岁及以上）。在发病年龄组内比较了身体质量指数（BMI）类别，并比较了这些组之间的肥胖情况。采用多变量logistic回归分析评估BMI类别与医疗保健利用和呼吸道症状之间的关系，并采用多变量线性回归分析评估哮喘持续时间与体重增加（BMI变化/年）之间的关系。多变量分析包括肥胖和哮喘发病年龄之间的相互作用。研究人群包括1049名受试者，其中哮喘发病的中位年龄为10岁（IQR 4 - 25）；48%为迟发性（≥12），52%为早发性（<12）。与迟发性肥胖哮喘患者相比，早发性肥胖哮喘患者有更多的气道阻塞、支气管高反应性，并且在前一年或前一年因哮喘而入院的3次或以上口服类固醇药物的OR更高（肥胖与哮喘发病年龄之间的相互作用分别为p=0.055和p=0.02）。在早发性哮喘患者中，但在晚发性哮喘患者中，在调整混杂因素后，BMI增加与哮喘持续时间之间存在显著关联。哮喘病程与哮喘发病年龄的交互作用为p < 0.01。肥胖对哮喘患者的影响是不同的，这取决于他们是在生命早期（<12岁）还是在生命后期患上哮喘。这些结果强调需要理解肥胖是一种影响特定临床表型的合并症，而不是所有哮喘患者都一样。
Studies of asthma phenotypes have identified obesity as a component of a group characterized by a high proportion of adult-onset asthmatics. However, whether age of asthma onset modifies the association between obesity and asthma is unknown. From the Severe Asthma Project (SARP), we defined age of asthma onset as early (before 12 years of age) and late-onset (12 and higher). Comparisons of body mass index (BMI) categories were done within age of onset groups and obesity was also compared across these groups. Multivariable logistic regression analysis was done to evaluate the association between BMI categories with healthcare utilization and respiratory symptoms and multivariable linear regression for the association between duration of asthma and weight gain (BMI change/yr). An interaction between obesity and age of asthma onset was included in the multivariable analyses. The study population consisted on 1,049 subjects of which the median age for asthma onset was 10 years (IQR 4 – 25); 48% were late-onset (≥ 12) and 52% were early-onset (<12). Compared to late-onset obese asthmatics, early-onset obese asthmatics had more airway obstruction, bronchial hyperresponsiveness, and higher OR of ever having 3 or more oral steroid tapers preceding/year or ICU admissions for asthma/preceding year (Interactions between obesity and age of asthma onset were respectively p=0.055 and p=0.02). In early-onset, but not in late-onset asthmatics, there was a significant association between increasing BMI and duration of asthma, after adjusting for confounders. The interaction between asthma duration and age of asthma onset was p < 0.01. Asthmatics are differentially affected by obesity, based on whether they developed asthma early (<12 years) or later in life. These results highlight the need to understand obesity as a comorbidity that affects specific clinical phenotypes and not all asthma subjects alike.
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影响因子：
12.4
作者：
van Veen, I. H.;ten Brinke, A.;Bel, E. H.
通讯作者：
Bel, E. H.
DOI：
10.1164/rccm.200406-710st
发表时间：
2005-04-15
影响因子：
24.7
作者：
American Thoracic Society;European Respiratory Society
通讯作者：
European Respiratory Society
影响因子：
10
作者：
Taylor, B.;Mannino, D.;Holguin, F.
通讯作者：
Holguin, F.
影响因子：
14.2
作者：
Miranda, C;Busacker, A;Wenzel, SE
通讯作者：
Wenzel, SE
影响因子：
5.2
作者：
Dizier, MH;Besse-Schmittler, C;Demenais, F
通讯作者：
Demenais, F