期刊
CHEST
卷 143, 期 4, 页码 984-992出版社
ELSEVIER
DOI: 10.1378/chest.12-0973
关键词
-
资金
- National Institutes of Health [HL69116, HL69130, HL69155, HL69167, HL69170, HL69174, HL69349, HL091762, KL2RR025009, M01 RR02635, M01 RR03186, M01 RR007122-14, 1UL1RR024153, 1UL1RR024989, 1UL1RR024992, 1UL1RR025008, 1UL1RR025011]
- National Institute of Allergy and Infectious Diseases
- National Heart, Lung, and Blood Institute
- NIH
- Alcon Laboratories, Inc
- Amgen Inc
- Asthmatic/Boston Scientific Corporation
- Ception Therapeutics, Inc/Cephalon, Inc
- Genentech, Inc
- GlaxoSmithKline plc
- MedImmune, LLC
- Merck Co, Inc
- Novartis AG
- sanofi-aventis US LLC
- American Lung Association
- Wellcome Trust
- Medical Research Council, Asthma UK
- National Environmental Research Council (UK)
- Medical Research Council [G0801056B] Funding Source: researchfish
Background: Although perimenstrual asthma (PMA) has been associated with severe and difficult-to-control asthma, it remains poorly characterized and understood. The objectives of this study were to identify clinical, demographic, and inflammatory factors associated with PMA and to assess the association of PMA with asthma severity and control. Methods: Women with asthma recruited to the National Heart, Lung, and Blood Institute Severe Asthma Research Program who reported PMA symptoms on a screening questionnaire were analyzed in relation to basic demographics, clinical questionnaire data, immunoinflammatory markers, and physiologic parameters. Univariate comparisons between PMA and non-PMA groups were performed. A severity-adjusted model predicting PMA was created. Additional models addressed the role of PMA in asthma control. Results: Self-identified PMA was reported in 17% of the subjects (n = 92) and associated with higher BMI, lower FVC% predicted, and higher gastroesophageal reflux disease rates. Fifty-two percent of the PMA group met criteria for severe asthma compared with 30% of the non-PMA group. In multivariable analyses controlling for severity, aspirin sensitivity and lower FVC% predicted were associated with the presence of PMA. Furthermore, after controlling for severity and confounders, PMA remained associated with more asthma symptoms and urgent health-care utilization. Conclusions: PMA is common in women with severe asthma and associated with poorly controlled disease. Aspirin sensitivity and lower FVC% predicted are associated with PMA after adjusting for multiple factors, suggesting that alterations in prostaglandins may contribute to this phenotype. CHEST 2013; 143(4):984-992
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