Small airway dysfunction links asthma exacerbations with asthma control and health-related quality of life

IF 4.7 2区医学 Q1 RESPIRATORY SYSTEM

Respiratory Research Pub Date : 2024-08-12 DOI:10.1186/s12931-024-02937-5

Fan Gao, Jiahui Lei, He Zhu, Limin Zhao

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Abstract

Small airway dysfunction not only affects asthma control, but also has adverse effects on the psychological and/or social activities of asthma patients. However, few long-term observational studies have explored the complex relationship between small airway dysfunction and asthma control and health-related quality of life in patients with asthma exacerbations. The study recruited 223 patients with exacerbations of asthma (i.e. those with at least one asthma attack over the past year) and 228 patients without exacerbations of asthma (i.e. those without asthma attacks over the past year). We evaluated SAD in patients with asthma exacerbations using impulse oscillometry method. At each evaluation time point within one year of follow-up, the attending physician conducts a case investigation of the patients. We analyzed the correlation between SAD and general characteristics (age, obesity, smoking history), type 2 inflammation (blood eosinophils, exhaled nitric oxide), FEV1, as well as asthma control (ACT) and health-related quality of life (mini-AQLQ) in patients with asthma exacerbations, and constructed a structural equation model to evaluate the causality of these clinical variables. The SAD prevalence in patients with asthma exacerbation is as high as 75%. SAD is connected with poor asthma control and poor health-related quality of life. The structural equation model indicates that age, obesity, FeNO, and FEV1 are independent predictive factors of SAD. SAD is the main determinant factor of asthma control, which in turn affected health-related quality of life. FEV1 and age directly affect asthma control and affect health-related quality of life through asthma control. In addition, there is a bidirectional relationship between FEV1 and small airway dysfunction and between asthma control and health-related quality of life. Small airways are involved from an early stage in asthma. Abnormal function of the small airways can significantly increase airway resistance in asthma patients, while worsening their clinical symptoms. In addition, aging is also a key risk factor for asthma control. Especially, small airway dysfunction links asthma control with health-related quality of life.

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小气道功能障碍将哮喘恶化与哮喘控制和健康相关生活质量联系起来

小气道功能障碍不仅会影响哮喘控制，还会对哮喘患者的心理和/或社交活动产生不利影响。然而，很少有长期观察性研究探讨哮喘加重患者小气道功能障碍与哮喘控制和健康相关生活质量之间的复杂关系。这项研究招募了 223 名哮喘加重患者（即在过去一年中至少发作过一次哮喘的患者）和 228 名无哮喘加重患者（即在过去一年中未发作过哮喘的患者）。我们采用脉冲振荡法对哮喘加重患者的 SAD 进行了评估。在随访一年内的每个评估时间点，主治医生都会对患者进行病例调查。我们分析了哮喘加重患者的 SAD 与一般特征（年龄、肥胖、吸烟史）、2 型炎症（血液嗜酸性粒细胞、呼出一氧化氮）、FEV1 以及哮喘控制（ACT）和健康相关生活质量（mini-AQLQ）之间的相关性，并构建了一个结构方程模型来评估这些临床变量的因果关系。哮喘加重患者的 SAD 患病率高达 75%。SAD 与哮喘控制不佳和健康相关生活质量低下有关。结构方程模型表明，年龄、肥胖、 FeNO 和 FEV1 是 SAD 的独立预测因素。SAD 是哮喘控制的主要决定因素，而哮喘控制反过来又会影响与健康相关的生活质量。FEV1 和年龄直接影响哮喘控制，并通过哮喘控制影响与健康相关的生活质量。此外，FEV1 与小气道功能障碍之间以及哮喘控制与健康相关生活质量之间存在双向关系。小气道在哮喘的早期阶段就受到了影响。小气道功能异常可显著增加哮喘患者的气道阻力，同时加重其临床症状。此外，衰老也是影响哮喘控制的一个关键风险因素。特别是，小气道功能障碍将哮喘控制与健康相关的生活质量联系在一起。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Respiratory Research 医学-呼吸系统

自引率

1.70%

发文量

314

期刊介绍： Respiratory Research publishes high-quality clinical and basic research, review and commentary articles on all aspects of respiratory medicine and related diseases. As the leading fully open access journal in the field, Respiratory Research provides an essential resource for pulmonologists, allergists, immunologists and other physicians, researchers, healthcare workers and medical students with worldwide dissemination of articles resulting in high visibility and generating international discussion. Topics of specific interest include asthma, chronic obstructive pulmonary disease, cystic fibrosis, genetics, infectious diseases, interstitial lung diseases, lung development, lung tumors, occupational and environmental factors, pulmonary circulation, pulmonary pharmacology and therapeutics, respiratory immunology, respiratory physiology, and sleep-related respiratory problems.