哮喘联盟

   摘要
   背景：城市化是世界范围内哮喘流行的一个重要因素。在中低收入的正经历快速工业化的国家，该效应的负担似乎正日益严重。我们试图描述秘鲁四个不同地区的成人哮喘患病率特征和找出与成人哮喘相关的个体和环境危险因素。
   方法：我们搜集了35岁以上成年人的社会人口学资料、病史和肺功能数据。满足以下三个标准之一，我们定义为哮喘：内科医生的诊断、自我报告的喘息或哮喘药物的使用。我们使用多变量逻辑回归来评价与成人哮喘相关的个体和环境因素。
   结果：我们对2953名参与者（平均55岁，男性占49%）的数据进行了分析。哮喘的总患病率是7.1%，各地区的患病率因城市化的不同而有所差异：利马最高(14.5%)、普诺市居次(4.0%)、其次为半城市化的通贝斯(3.8%)、普诺乡村最低(1.8%)。多变量分析表明：男性(OR=0.60, 95% CI 0.39-0.93)和高海拔地区生活(OR=0.26, 95% CI 0.16-0.42)与哮喘的低发病率相关，城市生活(OR=4.72, 95% CI 3.15 to 7.23)和哮喘家族史(OR=1.83, 95% CI 1.19-2.73)与哮喘的高发病率相关。当前的日常生物燃料烟雾暴露(OR=1.18, 95% CI 0.70-1.91)和抽烟(OR=0.99, 95% CI 0.73-1.22)与哮喘无关。
   结论：这些发现证明城市化是哮喘的一个环境危险因素，质疑将生物燃料烟雾暴露作为哮喘的一个重要危险因素，提出将高海拔作为哮喘发展的一个可能性保护因素。
 

（苏欣 审校）
Thorax.2015 Dec 23.pii:thoraxjnl-2015-207584.doi:10.1136/thoraxjnl-2015-207584. [Epub ahead of print]

 

Urbanisation but not biomass fuel smoke exposure is associated with asthma prevalence in four resource-limited settings.
 

Gaviola C1, Miele CH1, Wise RA1, Gilman RH2, Jaganath D1, Miranda JJ3, Bernabe-Ortiz A3, Hansel NN1, Checkley W4; CRONICAS Cohort Study Group.
 

Abstract
BACKGROUND:Urbanisation is an important contributor to the prevalence of asthma worldwide, and the burden of this effect in low-income and middle-income countries undergoing rapid industrialisation appears to be growing. We sought to characterise adult asthma prevalence across four geographically diverse settings in Peru and identify both individual and environmental risk factors associated with adult asthma.
METHODS:We collected sociodemographics, clinical history and spirometry in adults aged ≥35 years. We defined asthma as meeting one of the three criteria: physician diagnosis, self-report of wheezing attack or use of asthma medications. We used multivariable logistic regression to assess individual and environmental factors associated with adult asthma.
RESULTS:We analysed data from 2953 participants (mean age 55 years; 49% male). Overall asthma prevalence was 7.1%, which varied with urbanisation: highest in Lima (14.5%), followed by urban Puno (4.0%), semiurban Tumbes (3.8%) and rural Puno (1.8%). In multivariable analysis, being male (OR=0.60, 95% CI 0.39 to 0.93) and living at high altitude (OR=0.26, 95% CI 0.16 to 0.42) were associated with lower odds of having asthma, whereas living in an urban setting (OR=4.72, 95% CI 3.15 to 7.23) and family history of asthma (OR=1.83, 95% CI 1.19 to 2.73) were associated with higher odds. Current daily exposure to biomass fuel smoke (OR=1.18, 95% CI 0.70 to 1.91) and smoking (OR=0.99, 95% CI 0.73 to 1.22) were not associated with asthma.
CONCLUSIONS:These findings confirm that urbanisation is an environmental risk factor of asthma, questions biomass fuel smoke exposure as an important risk factor and proposes high altitude as possibly protective against the development of asthma.
 

Thorax.2015 Dec 23.pii:thoraxjnl-2015-207584.doi:10.1136/thoraxjnl-2015-207584. [Epub ahead of print]