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by Zhen Li
Institution: | Paris Saclay |
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Year: | 2017 |
Keywords: | Epidmiologie; Charcuterie; Qualit de l'alimentation; Asthme; Obsit; Analyses de mdiation; Epidemiology; Processed meat; Diet quality; Asthma; Obesity; Mediation analysis |
Posted: | 02/01/2018 |
Record ID: | 2153860 |
Full text PDF: | http://www.theses.fr/2017SACLS087 |
Lobjectif principal de la thse tait dtudier les effets de lalimentation et de lobsit sur lasthme et son volution, en prenant en compte des facteurs de mdiations spcifiques.La premire partie de la thse visait tudier le rle de lalimentation dans l'asthme, en prenant en compte lindice de masse corporelle (IMC) comme un mdiateur potentiel, et en valuant leffet modificateur du tabac dans ces associations. Ce travail a dabord port sur le rle de la consommation de charcuterie, rcemment classe cancrogne. Parmi 971 adultes de ltude des facteurs gntiques et environnementaux de lasthme (EGEA), nous avons montr quune consommation leve de charcuterie (au moins 4 fois par semaine) tait associe de faon directe laggravation des symptmes de lasthme, et que seulement 14% de lassociation entre la consommation de charcuterie et lasthme tait expliqu par lIMC (effet indirect). Ce travail a ensuite port sur le rle de la qualit globale de lalimentation, value par le score alimentaire Alternate Healthy Eating Index 2010. Parmi 969 participants dEGEA, nous avons montr quune alimentation de qualit tait associe de faon directe une amlioration des symptmes de lasthme chez les non-fumeurs. Leffet indirect li lIMC ntait pas significatif. La deuxime partie de la thse visait mieux comprendre l'association entre l'obsit et l'activit de lasthme, en prenant en compte la leptine, une adipokine pro-inflammatoire, comme un mdiateur potentiel. Parmi 331 adultes dEGEA avec un asthme actif linclusion, les analyses ont montr que diffrentes mesures leves de la composition corporelle taient associes une activit persistante de lasthme, avec un effet indirect trs fort de la leptine dans ces associations. The general aim of the thesis was to study the role of diet and obesity in asthma, while accounting for potential mediators in these analyses.The first part of the thesis aimed to investigate the role of dietary factors in asthma at a macro-level, considering body mass index (BMI) as a potential mediator, and to evaluate effect modification by smoking. We first focused on processed meat intake, a recent carcinogen. Among 971 participants from the Epidemiological study on the Genetics and Environment of Asthma, bronchial hyperresponsiveness and atopy (EGEA), analysis showed that high processed meat intake (at least 4 servings/week) was associated with worsening asthma symptoms over time, through a direct effect and to a lesser extent an effect mediated by BMI. We then focused on the overall diet quality assessed by the Alternate Healthy Eating Index 2010. Among 969 participants from the EGEA study, the analyses showed that a greater adherence to a better diet quality was associated with improved asthma symptoms over time in never smokers only and was not mediated through BMI. The second part of the thesis aimed to better understand the association between obesity and asthma at a micro-level, considering leptin, an inflammatory biological marker related toAdvisors/Committee Members: Varraso, Raphalle (thesis director), Nadif, Rachel (thesis director).
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