兒童氣喘與肥胖之關連性研究

Abstract

背景：近年來兒童氣喘與兒童肥胖的盛行率節節高升，因此有越來越多的研究者開始試圖找出兩者之關連。雖然已經有相當數量的研究證實兩者之關連性，但是對於兩者關係之間的潛在機制仍未有充分的解答。國內相關的研究尚在起步的階段，但本國兒童氣喘與肥胖的盛行率仍未有減緩的趨勢，因此，需要更多本土的研究來定位出此高風險族群，以及辨識出可能危害兒童氣喘控制程度與肥胖程度的危險因子。 目的：本研究旨在驗證氣喘兒童的氣喘控制程度與肥胖程度之間的關連性，並探討可能同時影響兩者的重要共通因素。 研究方法：本研究採取橫斷式研究法，於台大醫院小兒過敏免疫科門診選取氣喘兒童，作為研究個案。主要使用的研究工具為自擬基本資料問卷、飲食頻率問卷、身體活動程度問卷，身高體重計以及肺活量功能計，來蒐集重要的研究變項，包括兒童個人及家庭的基本資料，兒童目前的氣喘控制程度、肺功能指數、身高與體重及所計算的BMI數值，以及其身體活動程度與飲食型態。再將藉由描述性統計、Kruskal-Wallis test、Linear regression、Logistic regression等統計方法，來探討兒童氣喘控制程度與肥胖程度之間的關係，以及辨識出對它們個別或共同產生影響的重要共通因素。 研究結果: 本研究共招募97位氣喘的兒童，其中男童共67位(69.1%)、女童共30位 (30.9%)，收案期間為2009年12月至2011年9月。本研究中，氣喘兒童的氣喘控制程度與以兒童身體質量指數(BMI)所定義的兒童肥胖程度具有相關性(OR:1.19, 95% CI: 1.02~1.41)。兒童的人口學特性、飲食型態與身體活動程度相關的變項，均會同時影響氣喘兒童的氣喘控制程度與肥胖程度。家庭的低社經地位、攝取較高頻率的高油高糖飲食，與較差的氣喘控制及兒童肥胖相關；醫師鼓勵氣喘兒童多運動則顯著地可以同時降低氣喘控制不佳、及兒童肥胖的風險。另外，平日充足的睡眠也可能與較佳的氣喘控制及肥胖風險的降低相關。 結論: 本研究的研究結果不僅驗證了兒童氣喘與肥胖之關連性，並定位出具備某些特徵(人口學、飲食型態與身體活動程度相關)的氣喘兒童，同時也可能成為兒童肥胖的高風險族群。

Backgrounds: The concurrence of children obesity and asthma has been noticed during the past two decades. Thus, there is an increasing number of studies focusing on the relationship between these two health issues and the scientists continue on exploring the underlying mechanism connecting children asthma to obesity. Though the number of children suffering from obesity and/or asthma is also elevating in Taiwan, related studies focusing on Taiwanese children are lacking. There is a need to construct more localized studies to explore the relationship between childhood asthma and obesity in Taiwan’s pediatric population, also those important factors contributing to both health burden. Purpose: The main purpose of this study is to clarify the relationship between childhood asthma and obesity and to identy the important and risk factor that may have impact on the both health issues. Methods: This was a cross-sectional research. The research sample recruited from Pediatric Immunology clinic in National Taiwan University Hospital in Taipei. Questionnaires were adopted to collect children’s demographic variables and physical activities levels; and also Food Frequency Questionnare to explore the dietary pattern of recruited children. A weight/height scale was utilized to calculate children’s BMI and the the pulmonary function test was performed by using the spirometry. All those data were analyzed through statistics method such as descriptive analysis, Kruskal-Wallis test, linear or/and logistic regression to verify the relationships between research variables. Results: 97 children with asthma were recruited. 67 (69.1%) of them were boys while 30 (30.9%) of them were girls. The data collecting period was between Dec. in 2009 till Sep. in 2011. There is a positive association between children’s asthma control level and their obesity status (OR: 1.19, 95% CI: 1.02~1.41). Several factors may both contribute to a worsen asthma control level and obesity including low SES status and a dietary pattern of a frequent intake of oily and hight-sugar food. Doctor’s education was significantly related to decrease the risk of a worsen asthma control and obesity. Finally, the sleep hours during the weekdays were somehow inversely associated with the risk of worse asthma control and obesity. Conclusions: This study not only found some evidence of the positive relationship between childhood asthma and obesity, but also able to identify high-risk gourps by locating the risk demographic and behavioral factors contributing to both health burdens.