Severe asthma is increasingly being recognized as an important public health issue. Obesity has been identified as a risk factor for poor asthma control and for worsening of asthma severity. However, most studies investigating obese patients with asthma have been performed in Western countries. Reports on the characteristics of obese Japanese individuals with severe asthma are lacking. Herein, we investigated the clinical characteristics of patients with obesity-associated severe asthma in a Japanese population and the association between obesity and poor asthma control.
Methods
We conducted a retrospective observational study of adult patients with severe asthma. Patients were classified into two groups based on the definition of obesity recommended by the Japan Society for the Study of Obesity: obese (OB) group (body mass index [BMI] ≥25?kg/m2) and non-obese (NOB) group (BMI <25?kg/m2). The two groups were compared. The characteristics of obesity and the metabolic functions are known to differ between males and females; therefore, we analyzed male-only and female-only cohorts separately.
Results
A total of 492 patients were enrolled. Age, smoking history in terms of number of pack-years, daily controller medications use, and spirometric data were not significantly different between the OB and NOB groups in either cohort. In the female cohort, the annual exacerbation ratio and the percentage of frequent exacerbators were significantly higher in the OB group compared to the NOB group. A multivariate logistic regression analysis showed that obesity was independently associated with frequent asthma exacerbations in the female cohort.
Conclusions
Our study revealed that obesity, defined as a BMI ≥25?kg/m2, was independently associated with poor asthma control (including acute exacerbations) in adult Japanese females with severe asthma. 相似文献
Poly(ethylene 2,5‐furandicarboxylate) (PEF) is an emergent biobased polyester whose chemical structure is analogous to poly(ethylene terephthalate). Pilot‐scale PEF is synthesized through the direct esterification process from 2,5‐furandicarboxylic acid and bio‐ethylene glycol. Wide‐angle X‐ray diffraction (WAXD) measurements reveal similar crystallinities and unit cell structures for melt‐crystallized and glass‐crystallized samples. The non‐isothermal crystallization of PEF sample is investigated by means of DSC experiments both from the glass and the melt. The temperature dependence of the effective activation energy of the growth rate is obtained from these data, and the results show that the glass and early stage of the melt crystallization share common dynamics. Hoffman–Lauritzen parameters and the temperature at maximum crystallization rate are evaluated. It is found that the melt‐crystallization kinetics undergo a transition from regime I to II; however, the crystal growth rate from the melt shows an atypical depression at T < 171 °C compared with the predicted Hoffman–Lauritzen theory.
The relationship between airborne particulate matter (PM) and pulmonary function in children has not been consistent among studies, potentially owing to differences in the inflammatory response to PM, based on PM types and sources. The objective of this study was to investigate the effect of airborne PM on pulmonary function in schoolchildren and its potential for an inflammatory response.
Methods
Daily morning peak expiratory flow (PEF) was measured in 339 schoolchildren in February 2015. Interleukin (IL)-8 production was assessed in THP1 cells stimulated by airborne PM collected every day during the study period, and these IL-8 concentrations are described as the daily IL-8 levels. A linear mixed model was used to estimate the association between PEF values and the daily levels of suspended PM (SPM), PM diameters smaller than 2.5 μm (PM2.5), and IL-8.
Results
The daily IL-8 levels were significantly associated with those of SPM and PM2.5. A 0.83 μg/mL increase in IL-8 levels was significantly associated with a ?1.07 L/min (95% confidence interval, ?2.05 to ?0.08) decrease in PEF. A 12.0 μg/m3 increase in SPM and a 10.0 μg/m3 increase in PM2.5 were associated with a ?1.36 L/min (?2.93 to 0.22) and ?1.72 L/min (?3.82 to 0.36) decreases in PEF, respectively. There were no significant relationships between PEF, SPM, and PM2.5.
Conclusions
These findings suggest that the effects of airborne PM on pulmonary function in schoolchildren might depend more on the pro-inflammatory response than the mass concentration of the PM. 相似文献
BACKGROUND: In the original 32-item Asthma Quality of Life Questionnaire (AQLQ), five activity questions are selected by patients themselves. However, for long-term studies and large clinical trials, generic activities may be more appropriate. METHODS: For the standardized version of the AQLQ, the AQLQ(S), we formulated five generic activities (strenuous exercise, moderate exercise, work-related activities, social activities, and sleep) to replace the five patient-specific activities in the AQLQ. In a 9-week observational study, we compared the AQLQ with the AQLQ(S) and examined their measurement properties. Forty symptomatic adult asthma patients completed the AQLQ(S), the AQLQ, the Medical Outcomes Survey Short Form 36, the Asthma Control Questionnaire, and spirometry at baseline, 1, 5, and 9 weeks. RESULTS: Activity domain scores (mean +/- SD) were lower with the AQLQ (5.7 +/- 0.9) than with the AQLQ(S) (5.9 +/- 0.8; p = 0.0003) and correlation between the two was moderate (r = 0.77). However, for overall scores, there was minimal difference (AQLQ, 5.4 +/- 0.8; AQLQ(S), 5.5 +/- 0.8; r = 0.99). Reliability (AQLQ intraclass correlation coefficient, 0.95; AQLQ(S) intraclass correlation coefficient, 0.96) and responsiveness (AQLQ, p < 0.0001; AQLQ(S), p < 0.0001) were similar for the two instruments. Construct validity (correlation with other measures of health status and clinical asthma) was also similar for the two instruments. CONCLUSIONS: The AQLQ(S) has strong measurement properties and is valid for measuring health-related quality of life in asthma. The choice of instrument should depend on the task at hand. 相似文献
