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최길순,신유섭,김주희,최선윤,이수걸,남영희,이영목,박해심,PRANA Study Group 대한의학회 2014 Journal of Korean medical science Vol.12 No.12
Depression is an important comorbidity of asthma. However, little information is availableabout depression and its potential impact on asthma control in Korean adult asthmapatients. We aimed to estimate the prevalence and risk factors for depression in Koreanadults with persistent asthma. The 127 non-elderly (20-64 yr) and 75 elderly ( ≥ 65 yr)patients with asthma were recruited. Demographic and clinical data were extracted, andthe patients completed the Asthma Specific Quality of Life (AQOL) questionnaire andasthma control test (ACT). Depression status was defined using the Korean version of thePatient Health Questionnaire-9 (PHQ-9). Depression was more prevalent in non-elderly(18.9%) than in elderly patients with asthma (13.3%). Patients with depression weresignificantly younger, had lower economic status, shorter disease duration, poorer asthmacontrol, and worse AQOL scores (P < 0.05). Within the non-elderly group, younger ageand shorter disease duration were significantly associated with depression (P < 0.05). Within the elderly group, a higher body mass index and current smoking status weresignificantly associated with depression (P < 0.05). The PHQ-9 score was significantlycorrelated with worse ACT and AQOL scores in both groups. In conclusion, depression isstrongly associated with poor asthma control and quality of life in Korean adult asthmapatients. Our results provide important clues that used to target modifiable factors whichcontribute to development of depression in asthma patients.
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반가영,예영민,김상하,허규영,김주희,심재정,조금선,조주연,박해심,PRANA group 대한천식알레르기학회 2017 Allergy, Asthma & Immunology Research Vol.9 No.4
The tools for asthma control assessment recommended by the current guideline are cognitive function- and effort-dependent, which is substantially impaired in the elderly. The aim of this study is to investigate objective assessment tools of asthma control status and previous asthma exacerbation (AE) in elderly subjects. Asthmatics aged >60 years who were treated with step 2 or 3 by the Global Initiative for Asthma (GINA) guideline were enrolled. During the 12-week study period, the subjects used either 400 μg of budesonide plus 10 mg of montelukast or 800 μg of inhaled budesonide. The occurrence of AE during the 4-week run-in and 12-week treatment period was monitored. After 12-week of treatment, sputum eosinophil count, peripheral eosinophil count, the plasma leukotriene E4 (LTE4), and prostaglandin F2α (PGF2α) metabolite levels were measured using the UHPLC/Q-ToF MS system. The study subjects were divided into group 1 (asthmatics who experienced AE during the study period) and group 2 (those who did not). A total of 101 patients aged 60-85 years were enrolled. Twenty-three patients (22.8%) had experienced AE. The plasma LTE4 level, LTE4/PGF2α ratio, and peripheral eosinophil count were significantly higher in group 1 than in group 2 (P=0.023, P=0.010, P=0.033, respectively). The plasma LTE4/PGF2α ratio and peripheral eosinophil count at week 12 were significantly associated with previous AE (odds ratio [OR]=1.748, P=0.013; OR=1.256, P=0.027). Receiver operating characteristic (ROC) curves to discriminate the subjects with previous AE, including these 2 parameters, showed that the area under the curve was 0.700 (P=0.004), with 73.9% sensitivity and 47.9% specificity. In conclusion, a combination of plasma LTE4/PGF2α ratio and peripheral eosinophil count can be an objective assessment tool which is significantly associated with asthma control status in elderly asthmatics.
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