Body mass index’s effect on CRSwNP extends to pathological endotype and recurrence

作者：Wen Chen, Y Bai, Pihua Fang, Jun Chen, Xiaoyang Wang, Yinghui Li, Luo Xu, Jun Chen, Z Xiao, Radhika Iyer, Fei Shan, Tao Yuan, Maoxiong Wu, Xiaoling Huang, D Fang, Qiong Yang, Yong Zhang · 发表于：Rhinology Journal · 年份：2024 · DOI：10.4193/rhin23.402 · 被引用次数：8 · 研究领域：Sinusitis and nasal conditions、Asthma and respiratory diseases、Olfactory and Sensory Function Studies

BACKGROUND: Elevated body mass index (BMI) has been recognized as an important contributor to corticosteroid insensitivity in chronic rhinosinusitis with nasal polyps (CRSwNP). We aimed to delineate the effects of elevated BMI on immunological endotype and recurrence in CRSwNP individuals. METHODOLOGY: A total of 325 patients with CRSwNP undergoing FESS were recruited and stratified by BMI. H&E staining was employed for histological evaluation. Characteristics of inflammatory patterns were identified by immunohistochemical staining. The predictive factors for recurrence were determined and evaluated by multivariable logistic regression analysis and the receiver operating characteristic (ROC) curves across all subjects and by weight group. RESULTS: In all patients with CRSwNP, 26.15% subjects were classified as overweight/obese group across BMI categories and exhibited a higher symptom burden. The upregulated eosinophil/neutrophil-dominant cellular endotype and amplified type 2/ type 3 coexisting inflammation was present in overweight/obese compared to underweight/normal weight controls. Additionally, a higher recurrent proportion was shown in overweight/obese patients than that in underweight/normal weight cohorts. Multivariable logistic regression analysis identified BMI as an independent predictor for recurrence. The predictive capacity of each conventional parameter (tissue eosinophil and CLCs count, and blood eosinophil percentage) alone or in combination was poor in over...