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A meta-analysis of the effect of high weight on asthma.

机译:对肥胖对哮喘影响的荟萃分析。

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BACKGROUND: Prevalence rates for both overweight and asthma have been increasing among children in developed countries over the past two decades. Some recent studies have postulated a causal relation between these but have lacked power to form a definitive conclusion. AIM: To estimate the effect of high body weight in childhood on the future risk of asthma. METHODS: Medline search (1966 to October 2004), supplemented by manual search of reference lists and grey literature. Cohort studies that examined high body weight at birth or during childhood and future outcome of asthma were included. Data from each study were extracted on exposure status, clinical outcome, and study characteristics. RESULTS: A total of 402 studies were initially identified, of which 12 met the inclusion criteria. The combined results from four studies that examined the effect of high body weight during middle childhood on the outcome of subsequent asthma showed a 50% increase in relative risk (RR 1.5, 95% CI 1.2 to 1.8). The combined results from nine studies that examined the effect of high birth weight on subsequent asthma had a pooled RR of 1.2 (95% CI 1.1 to 1.3). There was consistency among the results in sensitivity analyses examining studies containing only estimates of odds ratios, studies containing only the outcome of physician diagnosis of asthma, and studies including all definitions of high body weight. CONCLUSIONS: Children with high body weight, either at birth or later in childhood, are at increased risk for future asthma. Potential biological mechanisms include diet, gastro-oesophageal reflux, mechanical effects of obesity, atopy, and hormonal influences. Further research might elucidate the causal pathway, which could improve our understanding of the pathophysiology of asthma and perhaps lead to knowledge of potential preventive interventions.
机译:背景:过去二十年来,发达国家儿童中超重和哮喘的患病率一直在上升。最近的一些研究假设它们之间存在因果关系,但缺乏形成明确结论的能力。目的:评估儿童高体重对未来哮喘风险的影响。方法:Medline搜索(1966年至2004年10月),辅以手工搜索参考文献列表和灰色文献。队列研究检查了出生时或儿童时期的高体重以及哮喘的未来结局。从每项研究中提取有关接触状况,临床结果和研究特征的数据。结果:最初确定了402项研究,其中12项符合纳入标准。来自四项研究的综合结果,这些研究检查了中年期高体重对随后哮喘的预后的影响,相对风险增加了50%(RR 1.5,95%CI 1.2至1.8)。来自九项研究的综合结果,这些研究检查了高出生体重对随后哮喘的影响,合并的RR为1.2(95%CI为1.1至1.3)。在敏感性分析中,仅包含比值比估计值的研究,仅包含医师诊断为哮喘的结果的研究以及包括高体重的所有定义的研究,结果之间存在一致性。结论:体重高的儿童,无论是在出生时还是在儿童期后期,都有增加患上未来哮喘的风险。潜在的生物学机制包括饮食,胃食管反流,肥胖症的机械作用,特应性和激素影响。进一步的研究可能会阐明病因途径,这可能会增进我们对哮喘的病理生理学的了解,并可能导致人们了解潜在的预防性干预措施。

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