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【medical-news】肥胖哮喘病人住院的危险性更高
September 4, 2008 — Obese patients with asthma may have a nearly 5 times greater risk for hospitalization than nonobese patients with asthma, according to the results of a cross-sectional study reported in the September issue of the Journal of Allergy and Clinical Immunology.
"The big finding here is that even after adjusting for risk factors, obese adults were nearly 5 times more likely to be hospitalized for their asthma," lead author David M. Mosen, PhD, MPH, from the Kaiser Permanente Center for Health Research in Portland, Oregon, said in a news release. "Given that nearly 30% of our country is obese, this study is yet another example of the long-term dangers of obesity, along with heart disease, diabetes, stroke, and dementia."
The study goal was to evaluate the association of obesity (body mass index [BMI] > 30 kg/m2), with quality-of-life scores, problems with asthma control, and asthma-related hospitalizations.
A random sample of 1113 members of a large integrated healthcare organization who were at least 35 years old and who had healthcare utilization suggestive of active asthma completed questionnaires at home. Study endpoints included the mini-Asthma Quality of Life Questionnaire, the Asthma Therapy Assessment Questionnaire, and self-reported asthma hospitalization.
The investigators also analyzed data concerning other variables known to affect asthma outcomes, including demographic factors, smoking status, use of oral corticosteroids or inhaled corticosteroid (ICS) in the past month, and evidence of gastroesophageal reflux disease (GERD). The association of BMI status with outcomes was determined using multiple logistic regression models.
Compared with adults with normal BMIs (<25 kg/m2), obese adults were more likely to report poor asthma-specific quality of life (odds ratio [OR], 2.8; 95% confidence interval [CI], 1.6 – 4.9), poor asthma control (OR, 2.7; 95% CI, 1.7 – 4.3), and a history of asthma-related hospitalizations (OR, 4.6; 95% CI, 1.4 – 14.4), even after adjustment for demographics, smoking status, oral corticosteroid use, evidence of GERD and ICS use.
On the basis of these findings, the study authors concluded that obesity is associated with worse asthma outcomes — especially an increased risk for asthma hospitalizations — even after accounting for other patient characteristics and treatment.
Limitations of this study include cross-sectional design, self-reported height and weight, lack of spirometry measurements, data not available regarding nonrespondents, and possible lack of generalizability to obese adults with asthma in other health delivery systems. The study authors recommend future research to develop, implement, and evaluate interventions to promote weight loss within the obese asthmatic population and to then determine the efficacy of such interventions regarding asthma-specific outcome measures.
"The take-home message of this study for clinicians is that obese people with asthma need to be followed more carefully because it's harder to control their asthma, so they are more likely to end up in the hospital," said study coauthor Michael Schatz, MD, chief of allergy at Kaiser Permanente San Diego Medical Center, California. "My advice for obese asthmatics is: be vigilant to keep your asthma symptoms in check, make sure you know what to do when your symptoms worsen, and do whatever you can to lose weight."
The Centers for Disease Control and Prevention supported this study.
J Allergy Clin Immunol. 2008;00:000-000.
肥胖哮喘病人住院的危险性更高
9. 4, 2008 —据变态反应与临床免疫杂志第9期一项横向研究报道，肥胖哮喘病人较非肥胖病人住院的危险性几乎高5 倍.
来自Kaiser Permanente 健康研究中心 in Portland, Oregon的通信作者David M. Mosen博士在新闻稿中说："本研究的重要发现是即使经过调整危险因子，成人肥胖患者因哮喘而住院的机率几乎高 5 倍" “鉴于几乎30%国人肥胖，本研究提示哮喘与心脏病、糖尿病、中风及痴呆一样成为肥胖的长期危险疾病“
该研究随机抽样调查一家大型综合医疗机构至少35岁并且医疗资料提示有效的完整的家庭哮喘调查表的1113名成员，研究终点包括哮喘生活质量小型问卷、哮喘治疗评定问卷及住院情况；目的在于评估肥胖(体重指数[BMI] > 30 kg/m2)与生活质量评分、哮喘控制问题和哮喘相关的住院间的关联性.
调查者还分析了其它可能影响哮喘结果的有关变量资料包括统计学、吸烟状态、上月使用口服或吸入激素情况及胃食管返流疾病(GERD)证据，使用多重逻辑回归模型确定BMI 状况与哮喘结果的相关性。
与正常BMIs (<25 kg/m2)成人比较，即使排除统计学、吸烟状态、口服或吸入激素使用情况及胃食管返流疾病(GERD)证据的影响后，肥胖患者更可能报告哮喘有关的生活质量差(优势比[OR], 2.8; 95%可信区间[CI], 1.6 – 4.9)、控制不良 (OR, 2.7; 95% CI, 1.7 – 4.3)、哮喘相关的住院(OR, 4.6; 95% CI, 1.4 – 14.4)。
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作者:admin@医学,生命科学 2010-11-25 17:11
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