哮喘联盟

   摘要
   背景：肥胖与哮喘控制恶化有关。抑郁也被证明在哮喘患者和肥胖者中流行率不一致。但是，还没有研究评估抑郁在肥胖-哮喘关系中的中介效应。本研究在某种程度上评估抑郁症状可能在成人哮喘患者中调节肥胖-哮喘的关系。
   方法：从蒙特利尔圣心医院哮喘门诊患者中总共纳入经医生确诊的798例哮喘患者。患者提供人口统计学资料、病史资料并完成一系列的问卷包括贝克抑郁量表第2版（BDI-II）和哮喘控制问卷（ACQ）。从患者自我报告的身高和体重中计算出BMI。
   结果：校正年龄、性别、受教育年限、同居关系和ICS剂量后的分析表明，BMI和ACQ（β = .017，p = .026）、 BMI 和BDI-II （β = .189， p = .002）、 BDI-II 和 ACQ（β = .044，p=.001）之间存在关系。但是，当BDI-II和BMI都使用相同的模型时，只有BDI-II（β=.044，p=.001)而不是BMI（β=.009，p = .226）仍然与ACQ显著相关。
   结论：抑郁症状严重与BMI高水平均与哮喘控制恶化有关。但是，在BMI和哮喘控制恶化之间的关系是通过抑郁症状调节的，与我们的假设一致。未来的研究应该评估抑郁症状对体重控制和哮喘控制的明确作用。
 

（林江涛 审校）
Chest. 2014 Mar 27. doi: 10.1378/chest.13-1796. [Epub ahead of print]

 

Mediator effect of depressive symptoms on the association between body mass index and asthma control in adult asthmatics.

Boudreau M, Bacon SL, Ouellet K, Jacob A, Lavoie KL.

ABSTRACT
BACKGROUND: Obesity has been associated with worse asthma control. Depression has also been shown to be disproportionally prevalent among both asthma patients and among the obese. However, no studies have examined the mediating effect of depression on the obesity-asthma relationship. This study examined the extent to which depressive symptoms may mediate the obesity-asthma relationship in a sample of adult asthmatics.
METHODS: A total of 798 patients with physician-diagnosed asthma were recruited from the outpatient asthma clinic at Hôpital du Sacré-Coeur de Montréal. Patients provided demographic and medical history information, and completed a battery of questionnaires including the Beck Depression Inventory-II (BDI-II) and the Asthma Control Questionnaire (ACQ). BMI was calculated from patient's self-reported height and weight.
RESULTS: Analyses, adjusted for age, sex, years of education, cohabitation, and ICS dose revealed an association between BMI and ACQ (β = .017, p = .026), between BMI and BDI-II (β = .189, p = .002), and between BDI-II and ACQ (β = .044, p < .001). However, when both BDI-II and BMI were entered into the same model, only BDI-II (β = .044, p < .001), and not BMI (β = .009, p = .226), remained significantly associated with ACQ.
CONCLUSIONS: Results indicate that having high depressive symptoms and high BMI are both associated with worse asthma control. However, consistent with our hypotheses, the relationship between BMI and worse asthma control was mediated by depressive symptoms. Future studies should examine the precise role of depressive symptoms in both weight control and asthma control.
 

Chest. 2014 Mar 27. doi: 10.1378/chest.13-1796. [Epub ahead of print]