种族多元化群体中采用哮喘表型模式评估出生体重与青春期后哮喘发生率间的关系
2016/02/23
摘要
目的：低出生体重(LBW)被认为是哮喘的独立危险因素。我们假设LBW可能对早发性疾病的影响最大。
方法：1983年-1985年间在同一地区两家医院（一家市区，一家郊区）出生的体重≤2500 g的多种族儿童纳入研究，在他们6岁及以后的时间进行定期随访。在17岁进行随访时，受试者及他们的父母/监护人分别进行面对面随访，内容包括采用标准ISAAC调查问卷询问受试者的哮喘史。我们通过诊断年龄和持续/间歇评估了从出生到青春期的哮喘累计发生率。
结果：共680位（占最初人数的82.6%）受试者纳入分析，378位为LBW儿童，293位为正常出生体重儿童。内科医师诊断的“目前哮喘”患病率与LBW相关(p = 0.003)，且在男性和白人相关性更大。LBW与迟发持续性哮喘（8岁后诊断为目前哮喘）最相关，p值为0.032。这种趋势也是在男性和白人中最明显。没有定义为“间歇性”的哮喘分类与LBW相关。
结论：LBW与17岁前间歇性发作的哮喘不相关。LBW与童年中期持续到青春期的哮喘相关，提示LBW的致气喘效应在童年早期到成年期逐渐明显。
（苏欣 审校）
J Asthma. 2015 Dec;52(10):1006-12. doi: 10.3109/02770903.2015.1054405. Epub 2015 Sep 16.
Birth weight and asthma incidence by asthma phenotype pattern in a racially diverse cohort followed through adolescence.
Johnson CC1, Peterson EL1, Joseph CL1, Ownby DR2, Breslau N3.
Abstract
OBJECTIVE:Low birth weight (LBW) has been shown to be an independent risk factor for asthma. We hypothesized that LBW would have its greatest impact on early onset disease.
METHODS:A racially diverse cohort of children born from 1983 to 1985 at two hospitals, one urban and one suburban in the same metropolitan area, and oversampled for babies weighing ≤2500 g, was identified retrospectively when the children were 6 years of age and followed periodically. At the age 17 years study visit, cohort members and their parent/guardians were separately interviewed face-to-face regarding the subject's history of asthma using the standardized ISAAC questionnaire. We measured the cumulative incidence of asthma from birth through adolescence defined by age of diagnosis and persistence/remittance.
RESULTS:Six-hundred and eighty teens (82.6% of the original cohort) were included in the analyses, 387 with LBW and 293 of normal birth weight. The prevalence of physician-diagnosed "Current Asthma" was associated with LBW (p = 0.003 for trend), with patterns stronger in males and whites. LBW was associated most strongly with Late Onset Persistent asthma (current asthma that was diagnosed after 8 years); p for trend 0.032. This trend was again most evident in males and whites. None of the asthma categories classified as "remittent" were statistically associated with LBW.
CONCLUSIONS:LBW was not associated with diagnosed asthma that remitted before age 17 years. LBW was associated with asthma diagnosis in mid-childhood that persisted through adolescence, suggesting that the asthmagenic effects of LBW can become evident post the early years of childhood and persist into adulthood.
J Asthma. 2015 Dec;52(10):1006-12. doi: 10.3109/02770903.2015.1054405. Epub 2015 Sep 16.
