Obesity, tidal volume, and pulmonary deposition of fine particulate matter in children with asthma.
Obesity, tidal volume, and pulmonary deposition of fine particulate matter in children with asthma.
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DOI：
10.1183/13993003.00209-2021
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发表时间：
2022-03
期刊：
影响因子：
--
通讯作者：
McCormack MC
中科院分区：
文献类型：
--
作者：
Afshar-Mohajer N;Wu TD;Shade R;Brigham E;Woo H;Wood M;Koehl R;Koehler K;Kirkness J;Hansel NN;Ramchandran G;McCormack MC
患有哮喘的肥胖儿童更容易受到空气污染的影响，尤其是细颗粒物（PM2.5），但原因尚不清楚。我们假设，由于身体质量指数（BMI）升高而导致的呼吸模式（潮气量、呼吸频率和分钟通气量）的差异可能有助于这一发现。探讨BMI与呼吸方式和吸入PM2.5沉积的关系。对一项前瞻性哮喘儿童研究的基线数据进行分析（n=174）。用皮托管流量计测量潮汐呼吸，得到潮汐量、呼吸频率和分气量。BMI z-score与呼吸模式的关联是在一个调整了年龄、身高、种族、性别和哮喘严重程度的多变量模型中估计的。颗粒剂量学模型基于bmi相关的呼吸模式变化模拟PM2.5肺沉积。较高的BMI与较高的潮气量（肥胖与正常范围BMI之间的调整平均差[aMD]为25 mL， 95%可信区间[CI] 5-45 mL）和分钟通气量（aMD 453 mL/min, 95%CI 123-784 mL/min）相关。较高的潮气量导致肺中PM2.5的分数沉积更高，这是由更大的肺泡沉积驱动的。这转化为肥胖参与者吸入PM2.5的每次呼吸潴留更大（肺泡沉积分数aMD为3.4%；95%CI为1.3-5.5%），导致PM2.5沉积率更差。患有哮喘的肥胖儿童以较高的潮气量呼吸，这可能会增加PM2.5在肺部沉积的效率。这一发现可以部分解释为什么患有哮喘的肥胖儿童对空气污染更敏感。
Obese children with asthma are more vulnerable to air pollution, especially fine particulate matter (PM2.5), but reasons are poorly understood. We hypothesized that differences in breathing patterns (tidal volume, respiratory rate, and minute ventilation) due to elevated body mass index (BMI) may contribute to this finding. To investigate the association of BMI with breathing patterns and deposition of inhaled PM2.5. Baseline data from a prospective study of children with asthma was analyzed (n=174). Tidal breathing was measured by a pitot-tube flowmeter, from which tidal volume, respiratory rate, and minute ventilation were obtained. The association of BMI z-score with breathing patterns was estimated in a multivariable model adjusted for age, height, race, sex, and asthma severity. A particle dosimetry model simulated PM2.5 lung deposition based on BMI-associated changes in breathing patterns. Higher BMI was associated with higher tidal volume (adjusted mean difference [aMD] between obese and normal-range BMI of 25 mL, 95% confidence interval [CI] 5–45 mL) and minute ventilation (aMD 453 mL/min, 95%CI 123–784 mL/min). Higher tidal volumes caused higher fractional deposition of PM2.5 in the lung, driven by greater alveolar deposition. This translated into obese participants having greater per-breath retention of inhaled PM2.5 (aMD in alveolar deposition fraction of 3.4%; 95%CI 1.3—5.5%), leading to worse PM2.5 deposition rates. Obese children with asthma breathe at higher tidal volumes that may increase the efficiency of PM2.5 deposition in the lung. This finding may partially explain why obese children with asthma exhibit greater sensitivity to air pollution.
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影响因子：
5.9
作者：
McCormack, Meredith C.;Breysse, Patrick N.;Matsui, Elizabeth C.;Hansel, Nadia N.;Peng, Roger D.;Curtin-Brosnan, Jean;Williams, D'Ann L.;Wills-Karp, Marsha;Diette, Gregory B.
通讯作者：
Diette, Gregory B.
影响因子：
2
作者：
COLE, TJ;GREEN, PJ
通讯作者：
GREEN, PJ
影响因子：
3.2
作者：
Kirkness, J. P.;Verma, M.;Schneider, H.
通讯作者：
Schneider, H.
影响因子：
4.9
作者：
Dong, G. H.;Qian, Z.;Trevathan, E.
通讯作者：
Trevathan, E.
影响因子：
5.9
作者：
Epstein, Tolly G.;Ryan, Patrick H.;Bernstein, David I.
通讯作者：
Bernstein, David I.