Body mass index, weight gain, and other determinants of lung function decline in adult asthma

JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY

卷:123

Article

Marcon, Alessandro¹  Corsico, Angelo²  Bugiani, Massimiliano³  Almar, Enrique⁴  Cerveri, Isa²  Gislason, David⁵  Gulsvik, Amund⁶  Janson, Christer⁷  Jarvis, Deborah⁸  Martinez-Moratalia, Jesus⁹  Pin, Isabelle^10,11 

[1] Univ Verona, Unit Epidemiol & Med Stat, Dept Med & Publ Hlth, Ist Biol 2, I-37134 Verona, Italy

[2] Univ Pavia, Fdn Ist Ricovero & Cura Carattere Sci San Matteo, Div Resp Dis, I-27100 Pavia, Italy

[3] Azienda Sanitaria Locale 4 Torino 2 Piemonte, Unit Pneumol, Turin, Italy

[4] Junta Comunidades Castilla La Mancha, Dept Publ Hlth, Epidemiol Unit, Albacete, Spain

[5] Landspitali Univ Hosp, Dept Allergy Resp Med & Sleep, Reykjavik, Iceland

[6] Univ Bergen, Dept Thorac Med, Haukeland Univ Hosp, Bergen, Norway

[7] Uppsala Univ, Dept Med Sci Resp Med & Allergol, Uppsala, Sweden

[8] Univ London Imperial Coll Sci Technol & Med, Natl Heart & Lung Inst, Resp Epidemiol & Publ Hlth Grp, London, England

[9] Univ Albacete, Gen Hosp, Ser Neumol, Albacete, Spain

[10] CHU Grenoble, F-38043 Grenoble, France

[11] Inst Albert Bonniot, INSERM, U823, Grenoble, France

关键词: Asthma;    lung function decline;    airflow obstruction;    body mass index;    weight gain;    obesity;    FEV1;    allergen sensitization;    prospective cohort study;    predictors;   

DOI  :  10.1016/j.jaci.2009.01.040

来源: Elsevier

【 摘 要 】

Background: Little is known about factors associated with lung function decline in asthma. Objective: To identify the determinants of FEV1 decline in adults with asthma with and without airflow obstruction at baseline. Methods: An international cohort of 638 subjects with asthma (20-44 years old) was identified in the European Community Respiratory Health Survey (1991-1993) and followed up from 1998 to 2002. Spirometry was performed on both occasions. FEV1 decline was related to potential determinants evaluated at baseline and during the follow-up by random intercept linear regression models. The analyses were stratified by the presence of airflow obstruction (FEV1/forced vital capacity < 0.70) at baseline. Results: In the group of individuals without airflow obstruction (n = 544), a faster FEV1 decline was observed for subjects with intermediate body mass index (BMI) than for lean and obese subjects. FEV1 decline was associated with weight gain independently of baseline BMI, and this association was stronger in men (20; 95% CI, 10-30, mL/y/kg gained) than in women (6; 95% CI, 1-1.1, mL/y). In the group of individuals with airflow obstruction (n = 94), the absence of allergen sensitization and a low BMI at baseline were associated with a faster FEV1 decline, whereas weight gain was not associated with decline. Conclusions: The detrimental effect of weight gain on FEV1 decline is particularly relevant in subjects with asthma who still do not have an established airflow obstruction. Our findings support the importance of weight management in asthma and recommend weight loss in overweight or obese individuals with asthma. (J Allergy Clin Immunol 2009;123:1069-74.)

【 授权许可】

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