성인 천식 환자에서 체질량지수와 기도과민성 및 폐기능의 연관성
Association of body mass index with airway hyperresponsiveness and lung function in adult asthmatics
2
조회
0
다운로드
4
인용
0
참고문헌
키워드
초록
Purpose: Obesity is commonly regarded as a risk factor for asthma development, poor asthma control, and poor response to asthma therapy. However, its relationships are not always consistent. Gender difference has been reported to influence asthma severity and asthma control. We investigated the contribution of obesity to airway hyperresponsiveness (AHR) and lung function before and after treatment in adult asthmatics. Methods: The medical records of a total of 323 adult asthmatics were analyzed retrospectively. Asthma was diagnosed based on the positive result of methacholine bronchial provocation test (PC20≤25 mg/mL) or bronchodilator test (≥12% and 200-mL improvement in forced expiratory volume in 1 second after inhalation of a bronchodilator). Follow-up spirometry was performed in 113 patients after at least 3 months of asthma treatment with controller medication. Percent change between spirometry before and after treatment was defined as {[(value after treatment–value before treatment)/value before treatment]×100}. Body mass index (BMI, weight [kg]/height [m2]) was categorized into underweight (<18.5), normal weight (18.5–24.9), overweight (25.0–29.9), and obese (>30) according to the world health organization classification. Results: BMI did not show any significant correlation with PC20 value of methacholine provocation test and each lung function parameter before and after treatment. When we divided the study subjects according to gender and age, BMI was negatively correlated with PC20 value only in female adult asthmatics under 65 years old (r=–0.024, P=0.036). Conclusion: Obesity is positively correlated with the intensity of AHR in female adult asthmatics. Gender seems to differentially contribute to the relationship between BMI and AHR
Abstract
Purpose: Obesity is commonly regarded as a risk factor for asthma development, poor asthma control, and poor response to asthma therapy. However, its relationships are not always consistent. Gender difference has been reported to influence asthma severity and asthma control. We investigated the contribution of obesity to airway hyperresponsiveness (AHR) and lung function before and after treatment in adult asthmatics. Methods: The medical records of a total of 323 adult asthmatics were analyzed retrospectively. Asthma was diagnosed based on the positive result of methacholine bronchial provocation test (PC20≤25 mg/mL) or bronchodilator test (≥12% and 200-mL improvement in forced expiratory volume in 1 second after inhalation of a bronchodilator). Follow-up spirometry was performed in 113 patients after at least 3 months of asthma treatment with controller medication. Percent change between spirometry before and after treatment was defined as {[(value after treatment–value before treatment)/value before treatment]×100}. Body mass index (BMI, weight [kg]/height [m2]) was categorized into underweight (<18.5), normal weight (18.5–24.9), overweight (25.0–29.9), and obese (>30) according to the world health organization classification. Results: BMI did not show any significant correlation with PC20 value of methacholine provocation test and each lung function parameter before and after treatment. When we divided the study subjects according to gender and age, BMI was negatively correlated with PC20 value only in female adult asthmatics under 65 years old (r=–0.024, P=0.036). Conclusion: Obesity is positively correlated with the intensity of AHR in female adult asthmatics. Gender seems to differentially contribute to the relationship between BMI and AHR
참고문헌 (28)
- Ford ES, "The epidemiology of obesity and asthma", J Allergy Clin Immunol, 115, pp.897~909 (2005)
- Masoli M, "Global Initiative for Asthma (GINA) Program. The global burden of asthma: executive summary of the GINA Dissemination Committee report", Allergy, 59, pp.469~478 (2004)
- Shore SA, "Obesity and asthma", Pharmacol Ther, 110, pp.83~102 (2006)
- Juel CT, "Obesity and asthma: impact on severity, asthma control, and response to therapy", Respir Care, 58, pp.867~873 (2013)
- Shore SA, "Obesity, airway hyperresponsiveness, and inflammation. J Appl Physiol (1985)", J Appl Physiol, 108, pp.735~743 (2010)
- Schachter LM, "Obesity is a risk for asthma and wheeze but not airway hyperresponsiveness", Thorax, 56, pp.4~8 (2001)
- Kwon JW, "Airway hyperresponsiveness is negatively associated with obesity or overweight status in patients with asthma", Int Arch Allergy Immunol, 159, pp.187~193 (2012)
- Varraso R, "Epidemiological Study on the Genetics and Environment of Asthma. Asthma severity is associated with body mass index and early menarche in women", Am J Respir Crit Care Med, 171, pp.334~339 (2005)
- Kattan M, "Asthma control, adiposity, and adipokines among inner-city adolescents", J Allergy Clin Immunol, 125, pp.584~592 (2010)
- James PT, "Obesity: the worldwide epidemic", Clin Dermatol, 22, pp.276~280 (2004)
- Celedon JC, "Body mass index and asthma in adults in families of subjects with asthma in Anqing, China", Am J Respir Crit Care Med, 164(10 Pt 1), pp.1835~1840 (2001)
- Chinn S, "European Community Respiratory Health Survey. Relation of bronchial responsiveness to body mass index in the ECRHS. European Community Respiratory Health Survey", Thorax, 57, pp.1028~1033 (2002)
- Maffei M, "Leptin levels in human and rodent: measurement of plasma leptin and ob RNA in obese and weight-reduced subjects", Nat Med, 1, pp.1155~1161 (1995)
- Litonjua AA, "Association of body mass index with the development of methacholine airway hyperresponsiveness in men: the Normative Aging Study", Thorax, 57, pp.581~585 (2002)
- Shore SA, "Obesity and asthma: lessons from animal models", J Appl Physiol (1985), 102, pp.516~528 (2007)
- Shore SA, "Obesity and asthma: possible mechanisms", J Allergy Clin Immunol, 121, pp.1087~1093 (2008)
- van Veen IH, "Airway inflammation in obese and nonobese patients with difficult-to-treat asthma", Allergy, 63, pp.570~574 (2008)
- Lavoie KL, "Higher BMI is associated with worse asthma control and quality of life but not asthma severity", Respir Med, 100, pp.648~657 (2006)
- 장규진, "국민건강영양조사 자료를 통한 천식과 비만의 상관성 연구", 천식 및 알레르기, 25(4), pp.262~268 (2005), 대한천식알레르기학회
- Kanner RE, "Gender difference in airway hyperresponsiveness in smokers with mild COPD. The Lung Health Study", Am J Respir Crit Care Med, 150, pp.956~961 (1994)
- Castro-Rodriguez JA, "Increased incidence of asthmalike symptoms in girls who become overweight or obese during the school years", Am J Respir Crit Care Med, 163, pp.1344~1349 (2001)
- Foster PS, "Effect of steroids on beta-adrenoceptor-mediated relaxation of pig bronchus", Br J Pharmacol, 78, pp.441~445 (1983)
- Hernandez Garcia IA, "Effect of weight reduction on the clinical and hormonal condition of obese anovulatory women", Ginecol Obstet Mex, 67, pp.433~437 (1999)
- Takeda M, "Gender difference in allergic airway remodelling and immunoglobulin production in mouse model of asthma", Respirology, 18, pp.797~806 (2013)
- Riffo-Vasquez Y, "Role of sex hormones in allergic inflammation in mice", Clin Exp Allergy, 37, pp.459~470 (2007)
- Cai Y, "Estrogen stimulates Th2 cytokine production and regulates the compartmentalisation of eosinophils during allergen challenge in a mouse model of asthma", Int Arch Allergy Immunol, 158, pp.252~260 (2012)
- Clerisme-Beaty EM, "Does higher body mass index contribute to worse asthma control in an urban population?", J Allergy Clin Immunol, 124, pp.207~212 (2009)
- Peters-Golden M, "Influence of body mass index on the response to asthma controller agents", Eur Respir J, 27, pp.495~503 (2006)
