Asthma control in normal weight and overweight/obese asthmatic children following adenotonsillectomy.

IF 17.7 1区化学 Q1 CHEMISTRY, MULTIDISCIPLINARY

Accounts of Chemical Research Pub Date : 2025-09-01 Epub Date: 2022-12-01 DOI:10.1177/01455613221101085

Gary D Josephson, Joshua B Bradshaw, Cheyenne Roohani, Jobayer Hossain, Steven M Andreoli, Jason E Lang

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引用次数: 0

Abstract

ObjectivesChildhood adenotonsillar hypertrophy (ATH) with sleep-disordered breathing (SDB) frequently occurs concomitant with asthma. Adenotonsillectomy and reduction in asthma severity association has been reported. We describe changes in asthma control in nonobese or normal weight and obese/overweight children undergoing adenotonsillectomy for SDB.MethodsThis prospective, nonrandomized cohort trial with 6-month follow-up at a tertiary children's hospital enrolled 41 children with persistent asthma undergoing adenotonsillectomy for SDB. Children with significant chronic medical conditions, premature birth (< 28 weeks), or recent respiratory infection were excluded. Patients were stratified by baseline BMI into nonobese or normal weight (BMI < 85 percentile) and obese/overweight (BMI > 85%). The primary outcome was change in Childhood Asthma Control Test (cACT) scores 3 and 6 months following adenotonsillectomy. Secondary outcome examined improvement in Pediatric Asthma Caregiver's Quality of Life Questionnaire (PACQLQ) 3 and 6 months following adenotonsillectomy.ResultsBaseline characteristics were similar except for anthropometric measures and mean PACQLQ (P = .03). Children with nonobese or normal weight (n = 26) had statistically significant improvement in change in cACT at 3 (22.80 ± 2.33 vs. 17.86 ± 3.53, P < .001) and 6 (20.71±3.29 vs. 18.24 ± 4.16, P = .044) months compared with baseline. PACQLQ scores also improved at 3 (6.20 ± 0.87 vs. 4.56 ± 1.12, P < .001) and 6 (6.36 ± 0.72 vs. 4.93 ± 0.96, P < .001) months. Obese/overweight children (n = 10) had significant improvement in cACT scores at 6 months (20.00 ± 3.90 vs. 15.00 ± 6.90, P = .048). Change of cACT scores at 3 months (17.86 ± 3.53 vs. 14.86 ± 6.31, P = .272) was not significantly different. PACQLQ scores improved at 3 (5.47 ± 1.09 vs. 3.70 ± 0.85, P < .001) and 6 (5.75 ± 2.19 vs. 3.67 ± 1.04, P = .016) months.ConclusionNonobese or normal-weight children undergoing adenotonsillectomy demonstrated significant improvement in asthma control scores at 3 and 6 and obese/overweight children at 6 months. Using the PACQLQ, caregiver quality of life improved for all children at 3 and 6 months. Surgical management of ATH in children with comorbid SBD and asthma is a good treatment option.

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腺扁桃体切除术后体重正常和超重/肥胖哮喘儿童的哮喘控制情况。

目的：儿童腺扁桃体肥大（ATH）和睡眠呼吸障碍（SDB）经常与哮喘同时发生。腺扁桃体切除术与减轻哮喘严重程度的关系已有报道。我们描述了因 SDB 而接受腺样体扁桃体切除术的非肥胖或正常体重和肥胖/超重儿童的哮喘控制变化：这项前瞻性、非随机队列试验在一家三级儿童医院进行，随访 6 个月，共招募了 41 名因 SDB 而接受腺样体切除术的持续性哮喘患儿。排除了患有严重慢性疾病、早产（小于 28 周）或近期有呼吸道感染的儿童。患者按基线体重指数分为非肥胖或正常体重（体重指数 85 百分位数）和肥胖/超重（体重指数大于 85%）两类。主要结果是腺扁桃体切除术后3个月和6个月儿童哮喘控制测试（cACT）评分的变化。次要结果是腺扁桃体切除术后3个月和6个月儿童哮喘护理者生活质量问卷（PACQLQ）的改善情况：结果：除人体测量指标和平均 PACQLQ 外，基线特征相似（P = 0.03）。与基线相比，非肥胖或体重正常的儿童（n = 26）在 3 个月（22.80 ± 2.33 vs. 17.86 ± 3.53，P < .001）和 6 个月（20.71±3.29 vs. 18.24 ± 4.16，P = .044）的 cACT 变化有显著的统计学改善。PACQLQ评分在3个月（6.20 ± 0.87 vs. 4.56 ± 1.12，P < .001）和6个月（6.36 ± 0.72 vs. 4.93 ± 0.96，P < .001）时也有所提高。肥胖/超重儿童（10 人）的 cACT 评分在 6 个月时有明显改善（20.00 ± 3.90 vs. 15.00 ± 6.90，P = .048）。3 个月时的 cACT 分数变化（17.86 ± 3.53 vs. 14.86 ± 6.31，P = .272）无明显差异。PACQLQ评分在3个月（5.47 ± 1.09 vs. 3.70 ± 0.85，P < .001）和6个月（5.75 ± 2.19 vs. 3.67 ± 1.04，P = .016）时有所改善：结论：接受腺样体切除术的非肥胖或正常体重儿童在3个月和6个月时的哮喘控制评分有明显改善，而肥胖/超重儿童在6个月时的哮喘控制评分有明显改善。通过使用 PACQLQ，所有儿童在 3 个月和 6 个月时的照顾者生活质量均有所改善。对于合并 SBD 和哮喘的儿童，手术治疗 ATH 是一种很好的治疗选择。

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来源期刊

Accounts of Chemical Research 化学-化学综合

CiteScore

31.40

自引率

1.10%

发文量

312

审稿时长

2 months

期刊介绍： Accounts of Chemical Research presents short, concise and critical articles offering easy-to-read overviews of basic research and applications in all areas of chemistry and biochemistry. These short reviews focus on research from the author’s own laboratory and are designed to teach the reader about a research project. In addition, Accounts of Chemical Research publishes commentaries that give an informed opinion on a current research problem. Special Issues online are devoted to a single topic of unusual activity and significance. Accounts of Chemical Research replaces the traditional article abstract with an article "Conspectus." These entries synopsize the research affording the reader a closer look at the content and significance of an article. Through this provision of a more detailed description of the article contents, the Conspectus enhances the article's discoverability by search engines and the exposure for the research.