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首页> 外文期刊>Allergy >Airway inflammation in obese and nonobese patients with difficult-to-treat asthma.
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Airway inflammation in obese and nonobese patients with difficult-to-treat asthma.

机译：肥胖和非肥胖难治性哮喘患者的气道炎症。

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BACKGROUND: Asthma and obesity are associated disorders, but the contribution of obesity to difficult-to-treat asthma as well as the mechanisms responsible for this relationship are unclear. The aim of this study was to investigate the relationship between obesity (body mass index >/= 30) and factors related with asthma severity in patients with difficult-to-treat asthma. METHODS: One hundred and thirty-six nonsmoking asthmatic adults with persistent symptoms despite high doses of inhaled or oral corticosteroids and long-acting bronchodilators were studied [70% female, median (range) age 44.6 (18-75) years, 32% on daily oral corticosteroids]. The association between obesity, lung function parameters [forced expiratory volume in 1 s (FEV(1)), functional residual capacity/total lung capacity (FRC/TLC)], inflammatory markers [blood eosinophils, sputum eosinophils and neutrophils, exhaled nitric oxide (FE(NO)), airway hyperresponsiveness, C-reactive protein (CRP)] and aggravating co-morbid factors (severe chronic sinus disease, gastro-esophageal reflux, recurrent respiratory infections, psychopathology and obstructive sleep apnea) was investigated. RESULTS: Obese patients (n = 29) had a higher FEV(1)%pred (P = 0.05) and a lower FRC/TLC%pred (P < 0.01) compared with nonobese patients (n = 107). Body mass index was inversely related with sputum eosinophils (r = -0.36, P < 0.01) and FE(NO) (r = -0.30, P < 0.01). Obese patients had an increased risk for gastro-esophageal reflux (OR = 2.3) and sleep apnea (OR = 3.1). CONCLUSION: Obesity in patients with difficult-to-treat asthma is inversely related with sputum eosinophils and FE(NO), and positively associated with the presence of co-morbid factors and reduced lung volumes. This suggests that other factors than airway inflammation alone explain the relationship between obesity and asthma severity.
机译：背景：哮喘和肥胖是相关疾病，但是肥胖对难治性哮喘的贡献以及导致这种关系的机制尚不清楚。这项研究的目的是研究肥胖（体重指数> / = 30）与难治性哮喘患者的哮喘严重程度相关因素之间的关系。方法：研究了一百三十六名非吸烟哮喘成人，尽管吸入或口服皮质类固醇和长效支气管扩张剂的剂量较高，但仍存在持续症状[70％女性，中位（范围）年龄44.6（18-75）岁，32％每日口服糖皮质激素]。肥胖，肺功能参数[1秒钟呼气量（FEV（1）），功能残余容量/肺总容量（FRC / TLC）]，炎症标志物[血液嗜酸性粒细胞，痰嗜酸性粒细胞和嗜中性粒细胞，呼出一氧化氮]之间的关联（FE（NO）），气道高反应性，C反应蛋白（CRP）]和加重的合并症因素（严重的慢性鼻窦疾病，胃食管反流，反复呼吸道感染，精神病理学和阻塞性睡眠呼吸暂停）。结果：与非肥胖患者（n = 107）相比，肥胖患者（n = 29）的FEV（1）％pred较高（P = 0.05），而FRC / TLC％pred较低（P <0.01）。体重指数与痰中嗜酸性粒细胞（r = -0.36，P <0.01）和FE（NO）（r = -0.30，P <0.01）呈负相关。肥胖患者胃食管反流（OR = 2.3）和睡眠呼吸暂停（OR = 3.1）的风险增加。结论：难治性哮喘患者的肥胖与痰嗜酸性粒细胞和FE（NO）呈负相关，与共病因素和肺容量减少呈正相关。这表明除了气道炎症以外的其他因素也可以解释肥胖与哮喘严重程度之间的关系。

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