Zusammenfassung
Die Häufigkeit von Adipositas steigt seit einer Generation in der Bevölkerung ebenso an wie die Häufigkeit von Asthma bronchiale. Epidemiologische Untersuchungen lassen vermuten, dass es kausale Verknüpfungen zwischen diesen beiden Krankheitsbildern gibt.
Die Einschränkungen der Lungenfunktion von Adipositas Betroffener lassen jedoch auch einen anderen Schluss zu: Verminderte Flussraten in der Spirometrie sind in Relation zur gleichsinnig verminderten Vitalkapazität zu sehen, ein pathologischer Ausfall in Hyperreagibilitätstests auf eine funktionelle Veränderung der glatten Muskulatur in den Atemwegen adipöser Patienten zurückzuführen („Bronchial Latching”).
Diese Adipositas-induzierte bronchiale Dysfunktion, die durch erhebliche subjektive Beschwerden (vor allem Belastungsdyspnoe) beeindrucken kann, ist demnach nicht auf eine asthmatypische Veränderung an den Atemwegen zurückzuführen und bedarf keiner antiinflammatorischen oder bronchospasmolytischen Therapie. Körperliches Training und Gewichtsreduktion sind dagegen ein kausaler Behandlungsansatz.
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Dr. Josef Lecheler
CJD Asthmazentrum Berchtesgaden
83471 Berchtesgaden
Telefon: 08652/6000-111
Fax: 08652/6000-273
eMail: Josef.Lecheler@cjd.de
