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Obesity is associated with increased asthma severity and exacerbations, and increased serum immunoglobulin E in inner-city adults

机译：肥胖与内城区成年人的哮喘严重程度和恶化加剧以及血清免疫球蛋白E升高有关

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Background: Obesity is associated with increased asthma and atopy. Objective: To determine whether or not obesity in inner-city adults is associated with increased asthma prevalence, severity and exacerbations and IgE responses. Methods: This retrospective study involved 246 adults with asthma and other atopic disorders who were seen at an asthma clinic in New York City between 1997 and 2010. Height, weight, asthma diagnosis and symptoms, peak flow (PF), spirometry, serum IgE levels and white blood cell differentials were recorded. Results: Asthmatic patients had higher body mass index than non-asthmatics (median, interquartile range: 30.5, 10.2 vs. 27.8, 8.8; Mann-Whitney U-test, P = 0.0006). Class I and II/III obesity were associated with increased asthma (I: OR: 2.35, 95% CI: 1.04-5.34, P = 0.04; II/III: OR: 3.25, 95% CI: 1.36-7.74, P = 0.008). Class I and II/III obesity were associated with worsened asthma severity (ordinal logistic regression; I: OR: 4.23, 95% CI: 1.61-11.06, P = 0.003; II/III: OR: 2.76, 95% CI: 1.08-7.09, P = 0.03). Class II/III obesity was associated with increased asthma exacerbations requiring oral corticosteroids (repeated measures logistic regression, OR: 1.13, 95% CI: 1.03-1.25; P = 0.01) and increased requirement of inhaled corticosteroid for long-term asthma management (OR: 1.45, 95% CI: 1.29-1.62; P < 0.0001). In asthmatics, class II/III obesity was associated with decreased PF (general linear model, least squares mean ± SEM: 333.8 ± 37.4 vs. 396.2 ± 32.1 L/min; P = 0.007), forced expiratory volume in 1 s (75.2 ± 4.6 vs. 88.4 ± 5.6%; P = 0.03) and forced vital capacity (83.2 ± 4.7 vs. 109.2 ± 6.0%; P = 0.0002) and increased serum IgE (480.2 ± 88.3 vs. 269.0 ± 66.6 IU/mL; P = 0.04) and neutrophils (66.6 ± 3.7 vs. 60.1 ± 3.8%; P = 0.02). Class I obesity was also associated with increased serum IgE (458.7 ± 68.9, P = 0.03). Conclusion and clinical relevance: Obesity in inner-city adults may be both a risk and exacerbating factor for atopic asthma.
机译：背景：肥胖与哮喘和特应性增高相关。目的：确定市区内成年人的肥胖症是否与哮喘患病率，严重程度和加重以及IgE反应增加有关。方法：这项回顾性研究涉及1997年至2010年在纽约市一家哮喘门诊就诊的246名患有哮喘和其他特应性疾病的成年人。身高，体重，哮喘诊断和症状，峰值流量（PF），肺活量测定，血清IgE水平并记录白细胞差异。结果：哮喘患者的体重指数高于非哮喘患者（中位数，四分位数范围：30.5、10.2与27.8、8.8; Mann-Whitney U检验，P = 0.0006）。 I级和II / III级肥胖与哮喘增加有关（I：OR：2.35，95％CI：1.04-5.34，P = 0.04; II / III：OR：3.25，95％CI：1.36-7.74，P = 0.008 ）。 I级和II / III级肥胖与哮喘严重程度加重相关（常规逻辑回归; I：OR：4.23，95％CI：1.61-11.06，P = 0.003; II / III：OR：2.76，95％CI：1.08- 7.09，P = 0.03）。 II / III类肥胖与需要口服糖皮质激素的哮喘加重加剧有关（重复对数回归，或：1.13，95％CI：1.03-1.25; P = 0.01），以及长期哮喘治疗中吸入糖皮质激素的需求增加（OR ：1.45，95％CI：1.29-1.62; P <0.0001）。在哮喘患者中，II / III级肥胖与PF降低有关（一般线性模型，最小二乘均值±SEM：333.8±37.4 vs. 396.2±32.1 L / min; P = 0.007），强迫呼气量在1 s（75.2± 4.6 vs. 88.4±5.6％; P = 0.03）和强制肺活量（83.2±4.7 vs. 109.2±6.0％; P = 0.0002）和血清IgE升高（480.2±88.3 vs.269.0±66.6 IU / mL; P = 0.04）和中性粒细胞（66.6±3.7对60.1±3.8％; P = 0.02）。 I类肥胖也与血清IgE升高有关（458.7±68.9，P = 0.03）。结论和临床意义：内城区成年人肥胖可能是特应性哮喘的危险因素和加剧因素。

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