哮喘联盟

   摘要
   背景：目前全球儿童肥胖和哮喘的数量与日俱增，假设这两者之间可能存在关联。
   方法：采用ISAAC第二阶段的标准方法学对8－12岁儿童（共10652例）（16个发达地区中心和8个非发达中心）进行分层随机样本的横断面研究。通过父母的调查问卷确定患儿呼吸和过敏症状。进行过敏性疾病的诊断试验。测量身高和体重，依据国际标准判定超重和肥胖。计算患病率和优势比。
   结果：超重（OR=1.14，95%可信区间：0.98；1.33）和肥胖（OR=1.67，95%可信区间：1.25; 2.21）与喘息相关。在发达地区医疗中心比在非发达地区中心间的相关性更强。超重和肥胖与咳嗽痰液、鼻炎、湿疹等症状间也有相似的相关性，但该相关性主要与喘息相关。超重和肥胖与气道阻塞间具有明确的相关性（超重儿童FEV1/FVC的变化值为-0.90%，95%置信区间：-1.33%－-0.47%；肥胖儿童FEV1/FVC的变化值为-2.46%，95%可信区间：-3.84%－-1.07%），但与其他指标，包括特应性无相关性。
   结论：从一个大样本国际儿童群体的研究数据表明，体重指数与喘息间存在很强的相关性，尤其是在发达地区。另外，体重指数与气道阻塞客观指标（FEV1/FVC）相关，但与呼吸和过敏性疾病的其它客观指标无关。
 

（杨冬 审校）
PLoS One. 2014 Dec 4;9(12):e113996. doi: 10.1371/journal.pone.0113996. eCollection 2014.


 

Overweight/Obesity and Respiratory and Allergic Disease in Children: International Study of Asthma and Allergies in Childhood (ISAAC) Phase Two.
 

Weinmayr G1, Forastiere F2, Büchele G1, Jaensch A1, Strachan DP3, Nagel G1; ISAAC Phase Two Study Group.
 

ABSTRACT
BACKGROUND: Childhood obesity and asthma are increasing worldwide. A possible link between the two conditions has been postulated.
METHODS: Cross-sectional studies of stratified random samples of 8-12-year-old children (n = 10 652) (16 centres in affluent and 8 centres in non-affluent countries) used the standardized methodology of ISAAC Phase Two. Respiratory and allergic symptoms were ascertained by parental questionnaires. Tests for allergic disease were performed. Height and weight were measured, and overweight and obesity were defined according to international definitions. Prevalence rates and prevalence odds ratios were calculated.
RESULTS: Overweight (odds ratio = 1.14, 95%-confidence interval: 0.98; 1.33) and obesity (odds ratio = 1.67, 95%-confidence interval: 1.25; 2.21) were related to wheeze. The relationship was stronger in affluent than in non-affluent centres. Similar results were found for cough and phlegm, rhinitis and eczema but the associations were mostly driven by children with wheeze. There was a clear association of overweight and obesity with airways obstruction (change in FEV1/FVC, -0.90, 95%-confidence interval: -1.33%; -0.47%, for overweight and -2.46%, 95%-confidence interval: -3.84%; -1.07%, for obesity) whereas the results for the other objective markers, including atopy, were null.
CONCLUSIONS: Our data from a large international child population confirm that there is a strong relation of body mass index with wheeze especially in affluent countries. Moreover, body mass index is associated with an objective marker of airways obstruction (FEV1/FVC) but no other objective markers of respiratory and allergic disorders.

PLoS One. 2014 Dec 4;9(12):e113996. doi: 10.1371/journal.pone.0113996. eCollection 2014.