美国人群中哮喘和喘息与血清胆固醇之间的新关系
2009/12/15
背景：胆固醇对于炎症具有多种作用。有关血清胆固醇水平是否与哮喘（一种气道炎症性疾病，对公众健康具有较大影响）有关的研究较少。
目的：本试验在美国典型人群中研究血清三种胆固醇（总胆固醇[TC]，高密度脂蛋白胆固醇[HDL-C]和非HDL-C）水平与哮喘/喘息之间的关系。
方法：对2005-2006年国家健康与营养调查研究中的7005名年龄≥6岁的受试者进行横断面分析。
结果：在总体人群中，当前哮喘患者血清TC和非HDL-C水平低于无哮喘患者（TC, 188.5 vs 192.2 mg/dL; non-HDL-C, 133.9 vs 137.7 mg/dL; 两者P < .05），而两者HDL-C未见显著性差异。对于当前哮喘患者，多元logistic回归分析中TC和非HDL-C每增加1-SD的校正OR分别为0.92 (95% CI, 0.86-0.98)和0.91 (95% CI, 0.85-0.98)。对研究对象进行种族分层后，结果显示，该相关性在墨西哥裔美国人（MA）中更明显（TC, 171.4 vs 189.3 mg/dL; P < .001; OR, 0.62; 95% CI, 0.48-0.80; non-HDL-C, 119.8 vs 137.9 mg/dL; P < .001; OR, 0.62; 95% CI, 0.48-0.79）。在MA人群中，需要治疗的喘息的校正后OR为0.57 (TC：95% CI, 0.43-0.75)和0.53 (非HDL-C：95% CI, 0.33-0.85)。胆固醇与哮喘/喘息间的相关性独立于体重指数、血清C反应蛋白，该相关性在特应性患者和非特应性参与者中类似。
结论： 结论美国人群中血清TC和非HDL-C水平与哮喘呈负相关，该关系在墨西哥裔美国人中较为明显。
（苏楠 审校）
J Allergy Clin Immunol. 2009 Oct 2.
Novel relationship of serum cholesterol with asthma and wheeze in the United States.
Fessler MB, Massing MW, Spruell B, Jaramillo R, Draper DW, Madenspacher JH, Arbes SJ, Calatroni A, Zeldin DC.
BACKGROUND: Cholesterol exerts complex effects on inflammation. There has been little investigation of whether serum cholesterol is associated with asthma, an inflammatory airways disease with great public health impact.
OBJECTIVE: To determine relationships between levels of 3 serum cholesterol measures (total cholesterol [TC], high-density lipoprotein cholesterol [HDL-C], and non-HDL-C) and asthma/wheeze in a sample representative of the US population.
METHODS: Cross-sectional study of 7005 participants age >/=6 years from the 2005 to 2006 National Health and Nutrition Examination Survey.
RESULTS: Serum TC and non-HDL-C were lower in patients with current asthma than in subjects without current asthma in the overall population (TC, 188.5 vs 192.2 mg/dL; non-HDL-C, 133.9 vs 137.7 mg/dL; P < .05 for both), whereas HDL-C was not different. Adjusted odds ratios (ORs) from multivariate logistic regression per 1-SD increase of TC and non-HDL-C for current asthma were 0.92 (95% CI, 0.86-0.98) and 0.91 (95% CI, 0.85-0.98), respectively. On racial/ethnic stratification, these relationships reflect marked reductions unique to Mexican Americans (MAs; TC, 171.4 vs 189.3 mg/dL; P < .001; OR, 0.62; 95% CI, 0.48-0.80; non-HDL-C, 119.8 vs 137.9 mg/dL; P < .001; OR, 0.62; 95% CI, 0.48-0.79). Among MAs, the adjusted OR for wheeze requiring medical attention was 0.57 (95% CI, 0.43-0.75) for TC and 0.53 (95% CI, 0.33-0.85) for non-HDL-C. Relationships between cholesterol and asthma/wheeze were independent of body mass index and serum C-reactive protein, and similar between atopic and nonatopic participants.
CONCLUSION: Serum TC and non-HDL-C are inversely related to asthma in the US population, chiefly reflecting a relationship among MAs.
J Allergy Clin Immunol. 2009 Oct 2.
目的：本试验在美国典型人群中研究血清三种胆固醇（总胆固醇[TC]，高密度脂蛋白胆固醇[HDL-C]和非HDL-C）水平与哮喘/喘息之间的关系。
方法：对2005-2006年国家健康与营养调查研究中的7005名年龄≥6岁的受试者进行横断面分析。
结果：在总体人群中，当前哮喘患者血清TC和非HDL-C水平低于无哮喘患者（TC, 188.5 vs 192.2 mg/dL; non-HDL-C, 133.9 vs 137.7 mg/dL; 两者P < .05），而两者HDL-C未见显著性差异。对于当前哮喘患者，多元logistic回归分析中TC和非HDL-C每增加1-SD的校正OR分别为0.92 (95% CI, 0.86-0.98)和0.91 (95% CI, 0.85-0.98)。对研究对象进行种族分层后，结果显示，该相关性在墨西哥裔美国人（MA）中更明显（TC, 171.4 vs 189.3 mg/dL; P < .001; OR, 0.62; 95% CI, 0.48-0.80; non-HDL-C, 119.8 vs 137.9 mg/dL; P < .001; OR, 0.62; 95% CI, 0.48-0.79）。在MA人群中，需要治疗的喘息的校正后OR为0.57 (TC：95% CI, 0.43-0.75)和0.53 (非HDL-C：95% CI, 0.33-0.85)。胆固醇与哮喘/喘息间的相关性独立于体重指数、血清C反应蛋白，该相关性在特应性患者和非特应性参与者中类似。
结论： 结论美国人群中血清TC和非HDL-C水平与哮喘呈负相关，该关系在墨西哥裔美国人中较为明显。
（苏楠 审校）
J Allergy Clin Immunol. 2009 Oct 2.
Novel relationship of serum cholesterol with asthma and wheeze in the United States.
Fessler MB, Massing MW, Spruell B, Jaramillo R, Draper DW, Madenspacher JH, Arbes SJ, Calatroni A, Zeldin DC.
BACKGROUND: Cholesterol exerts complex effects on inflammation. There has been little investigation of whether serum cholesterol is associated with asthma, an inflammatory airways disease with great public health impact.
OBJECTIVE: To determine relationships between levels of 3 serum cholesterol measures (total cholesterol [TC], high-density lipoprotein cholesterol [HDL-C], and non-HDL-C) and asthma/wheeze in a sample representative of the US population.
METHODS: Cross-sectional study of 7005 participants age >/=6 years from the 2005 to 2006 National Health and Nutrition Examination Survey.
RESULTS: Serum TC and non-HDL-C were lower in patients with current asthma than in subjects without current asthma in the overall population (TC, 188.5 vs 192.2 mg/dL; non-HDL-C, 133.9 vs 137.7 mg/dL; P < .05 for both), whereas HDL-C was not different. Adjusted odds ratios (ORs) from multivariate logistic regression per 1-SD increase of TC and non-HDL-C for current asthma were 0.92 (95% CI, 0.86-0.98) and 0.91 (95% CI, 0.85-0.98), respectively. On racial/ethnic stratification, these relationships reflect marked reductions unique to Mexican Americans (MAs; TC, 171.4 vs 189.3 mg/dL; P < .001; OR, 0.62; 95% CI, 0.48-0.80; non-HDL-C, 119.8 vs 137.9 mg/dL; P < .001; OR, 0.62; 95% CI, 0.48-0.79). Among MAs, the adjusted OR for wheeze requiring medical attention was 0.57 (95% CI, 0.43-0.75) for TC and 0.53 (95% CI, 0.33-0.85) for non-HDL-C. Relationships between cholesterol and asthma/wheeze were independent of body mass index and serum C-reactive protein, and similar between atopic and nonatopic participants.
CONCLUSION: Serum TC and non-HDL-C are inversely related to asthma in the US population, chiefly reflecting a relationship among MAs.
J Allergy Clin Immunol. 2009 Oct 2.
上一篇：
ISAAC（儿童哮喘和变态反应性疾病全球研究）的第三阶段总结：有关哮喘患病率和严重程度全球性调查
下一篇：
在哮喘流行情况及自然史研究中，哮喘控制始终不佳（符合专家小组报告3指南中疾病受损领域）的患者，未来哮
