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在缺乏资源的儿童中,体重,喘负担和2型炎症之间的关联
David Thompson1, Cynthia M Visness2, Robert A Wood3
1Division of Respiratory and Sleep Medicine, Department of Pediatrics, Albert Einstein College of Medicine, New York, New York.
概括
超重/肥胖和2型 (T2) 炎症独立增加儿童的喘负担. T2炎症,而不是肥胖,与喘控制不良和住院病例有关,突出了不同的风险因素.
科学领域:
- 儿科过敏和免疫学
- 呼吸系统医学 呼吸系统医学
- 公共卫生 公共卫生
背景情况:
- 超重/肥胖是贫困儿童喘的重要危险因素,加剧了疾病负担.
- 2型 (T2) 炎症,其特点是IgE升高,好色素和过敏原敏感性,与与肥胖相关的喘严重程度有不一致的关联.
- T2特征之间有限的重叠可能解释了先前研究中观察到的不一致的关联.
研究的目的:
- 检查2型 (T2) 炎症特征如何影响贫困儿童中超重/肥胖和喘负担之间的关系.
- 为了区分T2炎症和超重/肥胖对各种喘结果的影响.
主要方法:
- 分析了来自内城喘联盟四个队伍的2160名儿童 (年龄在6-20岁).
- 调查过重/肥胖和喘负担指标之间的关联:非预定的访问,住院治疗,恶化,喘控制和肺功能.
- 评估了T2特征 (总IgE升高,好色素 >300细胞/μL,或对≥2种过敏原的敏感性) 对这些关联的修饰作用.
主要成果:
- 超重/肥胖和过敏原敏感性与非计划性访问的可能性增加有关.
- 增加的总IgE和eosinophilia与更高的住院率相关.
- 增加的总IgE与较差的喘控制有关.
- 超重/肥胖以及所有T2特征都与1秒/强迫生命能力比率的强迫呼气体积减少有关.
- 没有发现T2特征对超重/肥胖-喘负担联系产生协同或显著的调解效应.
结论:
- 在缺乏资源的患有喘的儿童中,超重/肥胖和T2炎症在很大程度上是无计划访问和肺功能受损的独立贡献者.
- 2型炎症,而不是超重/肥胖,与喘控制不良和住院病例有显著的关联.
- 研究结果表明,T2炎症和肥胖会通过不同的途径影响儿童喘.
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