文化适应与拉丁裔青年的哮喘负担和肺功能相关：GALA II研究
2019/02/19
摘要
背景：文化适应是拉丁裔青年，特别是墨西哥裔美国人哮喘的重要预测指标。关于文化适应和肺功能测量的认识较少。
目的：评估拉丁美洲青年的文化适应措施与哮喘和肺功能的关系，并确定拉丁裔亚组的这种关联是否不同。
方法：我们纳入了来自美国4个城市地区的1,849名拉丁裔（302加勒比西班牙人，193名墨西哥裔美国人，1,136名墨西哥裔美国人，218名其他拉丁裔儿童），年龄为8-21岁。文化适应措施包括出生状况，移民年龄，偏好语言，在美国出生代数。我们使用多变量逻辑和线性回归模型来量化文化适应因素与哮喘（病例对照研究）和肺功能（仅病例研究）之间的关联，人口统计学、社会环境和临床变量因素已调整。
结果：对于所有文化适应措施（出生率状况，移民年龄，偏好语言和美国出生代数），更高水平的文化适应与哮喘发生几率相关性更大。在这些病例中，与低（西班牙语偏好）水平文化适应相比，语言文化适应的高（英语偏好）和中等（西班牙语和英语的同等好）水平与支气管扩张剂反应降低相关（分别为P = 0.009和0.02）。同样，与低语言文化适应相比，高语言文化适应与FEV1增加相关（P = 0.02）。拉丁裔亚组之间的关联性异质性证据不足。
结论：文化适应与拉丁裔儿童的哮喘诊断和肺功能相关，是拉丁裔青年哮喘患者管理中需要考虑的重要因素。
Acculturation is Associated with Asthma Burden and Pulmonary Function in Latino Youth: The GALA II Study.
Thakur N, Borrell LN, Ye M, Oh SS, Eng C, Meade K, Avila PC, Farber HJ, Serebrisky D, Brigino-Buenaventura E, Rodriguez-Cintron W, Kumar R, Bibbins-Domingo K, Thyne S, Sen S, Rodriguez-Santana JR, Burchard EG.
Abstract
BACKGROUND:Acculturation is an important predictor of asthma in Latino youth, specifically, Mexican Americans. Less is known about acculturation and pulmonary function measures.
OBJECTIVE:To estimate the association of acculturation measures with asthma and pulmonary function in Latino youth and determine whether this association varies across Latino subgroups.
METHODS:We included 1,849 Latinos (302 Caribbean Spanish, 193 Central or South Americans, 1,136 Mexican Americans, 218 other Latino children) aged 8-21 years old from 4 urban regions in the U.S. Acculturation measures include nativity status, age of immigration, language of preference, and generation in the U.S. We used multivariable logistic and linear regression models to quantify the association of acculturation factors with the presence of asthma (case-control study) and pulmonary function (case-only study) adjusting for demographic, socio-environmental, and clinical variables.
RESULTS:For all acculturation measures (nativity status, age of immigration, language of preference, and generation in the U.S.), higher levels of acculturation were associated with greater odds of asthma. Among cases, high (English preference) and medium (equal preference for Spanish and English) levels of language acculturation were associated with decreased bronchodilator response compared with low (Spanish preference) levels (p=0.009 and 0.02, respectively). Similarly, high language acculturation was associated with increased FEV1 compared with low language acculturation (p=0.02). There was insufficient evidence of heterogeneity for associations across Latino subgroups.
CONCLUSIONS:Acculturation was associated with diagnosed asthma and pulmonary function in Latino children and is important factor to consider in the management of Latino youth with asthma.
背景：文化适应是拉丁裔青年，特别是墨西哥裔美国人哮喘的重要预测指标。关于文化适应和肺功能测量的认识较少。
目的：评估拉丁美洲青年的文化适应措施与哮喘和肺功能的关系，并确定拉丁裔亚组的这种关联是否不同。
方法：我们纳入了来自美国4个城市地区的1,849名拉丁裔（302加勒比西班牙人，193名墨西哥裔美国人，1,136名墨西哥裔美国人，218名其他拉丁裔儿童），年龄为8-21岁。文化适应措施包括出生状况，移民年龄，偏好语言，在美国出生代数。我们使用多变量逻辑和线性回归模型来量化文化适应因素与哮喘（病例对照研究）和肺功能（仅病例研究）之间的关联，人口统计学、社会环境和临床变量因素已调整。
结果：对于所有文化适应措施（出生率状况，移民年龄，偏好语言和美国出生代数），更高水平的文化适应与哮喘发生几率相关性更大。在这些病例中，与低（西班牙语偏好）水平文化适应相比，语言文化适应的高（英语偏好）和中等（西班牙语和英语的同等好）水平与支气管扩张剂反应降低相关（分别为P = 0.009和0.02）。同样，与低语言文化适应相比，高语言文化适应与FEV1增加相关（P = 0.02）。拉丁裔亚组之间的关联性异质性证据不足。
结论：文化适应与拉丁裔儿童的哮喘诊断和肺功能相关，是拉丁裔青年哮喘患者管理中需要考虑的重要因素。
(中日友好医院呼吸与危重症医学科 顾宪民 摘译 林江涛 审校)
(J Allergy Clin Immunol. 2019 Jan 22. pii: S0091-6749(19)30083-1. doi: 10.1016/j.jaci.2018.12.1015.)
(J Allergy Clin Immunol. 2019 Jan 22. pii: S0091-6749(19)30083-1. doi: 10.1016/j.jaci.2018.12.1015.)
Acculturation is Associated with Asthma Burden and Pulmonary Function in Latino Youth: The GALA II Study.
Thakur N, Borrell LN, Ye M, Oh SS, Eng C, Meade K, Avila PC, Farber HJ, Serebrisky D, Brigino-Buenaventura E, Rodriguez-Cintron W, Kumar R, Bibbins-Domingo K, Thyne S, Sen S, Rodriguez-Santana JR, Burchard EG.
Abstract
BACKGROUND:Acculturation is an important predictor of asthma in Latino youth, specifically, Mexican Americans. Less is known about acculturation and pulmonary function measures.
OBJECTIVE:To estimate the association of acculturation measures with asthma and pulmonary function in Latino youth and determine whether this association varies across Latino subgroups.
METHODS:We included 1,849 Latinos (302 Caribbean Spanish, 193 Central or South Americans, 1,136 Mexican Americans, 218 other Latino children) aged 8-21 years old from 4 urban regions in the U.S. Acculturation measures include nativity status, age of immigration, language of preference, and generation in the U.S. We used multivariable logistic and linear regression models to quantify the association of acculturation factors with the presence of asthma (case-control study) and pulmonary function (case-only study) adjusting for demographic, socio-environmental, and clinical variables.
RESULTS:For all acculturation measures (nativity status, age of immigration, language of preference, and generation in the U.S.), higher levels of acculturation were associated with greater odds of asthma. Among cases, high (English preference) and medium (equal preference for Spanish and English) levels of language acculturation were associated with decreased bronchodilator response compared with low (Spanish preference) levels (p=0.009 and 0.02, respectively). Similarly, high language acculturation was associated with increased FEV1 compared with low language acculturation (p=0.02). There was insufficient evidence of heterogeneity for associations across Latino subgroups.
CONCLUSIONS:Acculturation was associated with diagnosed asthma and pulmonary function in Latino children and is important factor to consider in the management of Latino youth with asthma.
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在严重哮喘治疗的试验中，对维持药物的依从性评估不足会导致效能损失和成本增加，系统的文献回顾和模型研究的结果
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检测重症哮喘患者气道骨膜素：是否有助于T2内型的聚类？
