成人哮喘发作的风险随着过敏性多发性疾病的数量增加而增加，随着年龄的增长而降低
2019/07/11
背景：本研究的目的是考虑到过敏性疾病的数量和年龄效应，研究过敏性共患病与成人哮喘发病率之间的关系。
方法：使用芬兰国家登记的基于人群的数据，包括1205名30岁以上新近诊断为哮喘的成年人（年龄范围：30-93岁），与一个或两个性别、年龄和生活区域相匹配的对照组（n=2050）。变应性鼻炎（AR）、变应性结膜炎（AC）和变应性皮炎（AD）由自编问卷确定。对潜在的混杂因素（吸烟、在农村生长、儿童住院感染/肺炎、父母哮喘/过敏、父母吸烟、教育水平、专业培训、兄弟姐妹人数和出生顺序）进行条件logistic回归，以评估哮喘与过敏性共患病相关的风险。
结果：1118例哮喘患者和1772例配对对照组[平均值（标准差，最小值-最大值）53（11，31-71）岁，37%男性]。哮喘受试者的AR、AC或AD分别为50.2%、39.6%、33.8%，对照组为26.1%、20.0%、23.5%。与非过敏性患者相比，成人哮喘发病率随过敏性疾病的数量增加而增加；与1、2和3种过敏性疾病相关的哮喘调整后OR值分别为1.95[1.52-2.49]、2.87[2.19-3.77]和4.26[3.07-5.90]。成人哮喘发作与≥1种过敏性性共患病率之间的相关性随着年龄的增长而降低（50岁、50-62岁和>62岁的受试者分别为3.52[2.51-4.94]、2.44[1.74-3.42]和1.68[1.04-2.71]）（P代表年龄*≥1种过敏性共患病相互作用，0.002）。
结论：成人哮喘发作与过敏性疾病的数量呈正相关，且这种相关性随年龄的增长而降低。
Risk of adult-onset asthma increases with the number of allergic multimorbidities and decreases with age
Toppila-Salmi S, Chanoine S, Karjalainen J, Pekkanen J, Bousquet J, Siroux V
Abstract
BACKGROUND: The aim was to study the association between allergic multimorbidity and adult-onset asthma considering the number of allergic diseases and the age effect.
METHODS: We used population-based data from Finnish national registers including 1205 adults over 30 years of age with recently diagnosed asthma (age range: 30-93), matched for gender, age, and living region with one or two controls (n=2050). Allergic rhinitis (AR), allergic conjunctivitis (AC) and allergic dermatitis (AD), was defined from self-completed questionnaire. Conditional logistic regression adjusted on potential confounders (smoking, growing in countryside, childhood hospitalized infection/pneumonia, parental asthma/allergy, parental smoking, education level, professional training, number of siblings, and birth order) was applied to estimate the asthma risk associated with allergic multimorbidity.
RESULTS: 1118 cases with asthma and 1772 matched controls were included [mean (sd, min-max) 53 (11, 31-71) years, 37% men)]. AR, AC or AD were reported by 50.2%, 39.6%, 33.8%, respectively among subjects with asthma and 26.1%, 20.0%, 23.5%, among controls. Compared to non-atopics, adult-onset asthma increased with the number of allergic diseases; adjusted OR for asthma [CI95%] associated with 1, 2, and 3 allergic diseases were 1.95 [1.52-2.49], 2.87 [2.19-3.77], and 4.26 [3.07-5.90], respectively. The association between adult-onset asthma and ≥1 allergic multimorbidity decreased with increasing age (3.52 [2.51-4.94], 2.44 [1.74-3.42] and 1.68 [1.04-2.71]) in subjects <50 years, 50-62 years and >62 years, respectively (p for age*≥1 allergic multimorbidity interaction, .002).
CONCLUSIONS: Adult-onset asthma was positively associated with the number of allergic diseases and this association decreases with age. This article is protected by copyright. All rights reserved.
方法：使用芬兰国家登记的基于人群的数据，包括1205名30岁以上新近诊断为哮喘的成年人（年龄范围：30-93岁），与一个或两个性别、年龄和生活区域相匹配的对照组（n=2050）。变应性鼻炎（AR）、变应性结膜炎（AC）和变应性皮炎（AD）由自编问卷确定。对潜在的混杂因素（吸烟、在农村生长、儿童住院感染/肺炎、父母哮喘/过敏、父母吸烟、教育水平、专业培训、兄弟姐妹人数和出生顺序）进行条件logistic回归，以评估哮喘与过敏性共患病相关的风险。
结果：1118例哮喘患者和1772例配对对照组[平均值（标准差，最小值-最大值）53（11，31-71）岁，37%男性]。哮喘受试者的AR、AC或AD分别为50.2%、39.6%、33.8%，对照组为26.1%、20.0%、23.5%。与非过敏性患者相比，成人哮喘发病率随过敏性疾病的数量增加而增加；与1、2和3种过敏性疾病相关的哮喘调整后OR值分别为1.95[1.52-2.49]、2.87[2.19-3.77]和4.26[3.07-5.90]。成人哮喘发作与≥1种过敏性性共患病率之间的相关性随着年龄的增长而降低（50岁、50-62岁和>62岁的受试者分别为3.52[2.51-4.94]、2.44[1.74-3.42]和1.68[1.04-2.71]）（P代表年龄*≥1种过敏性共患病相互作用，0.002）。
结论：成人哮喘发作与过敏性疾病的数量呈正相关，且这种相关性随年龄的增长而降低。
(中日友好医院呼吸与危重症医学科 李红雯 摘译 林江涛 审校)
(Allergy. 2019 Jul 3. doi: 10.1111/all.13971)
(Allergy. 2019 Jul 3. doi: 10.1111/all.13971)
Risk of adult-onset asthma increases with the number of allergic multimorbidities and decreases with age
Toppila-Salmi S, Chanoine S, Karjalainen J, Pekkanen J, Bousquet J, Siroux V
Abstract
BACKGROUND: The aim was to study the association between allergic multimorbidity and adult-onset asthma considering the number of allergic diseases and the age effect.
METHODS: We used population-based data from Finnish national registers including 1205 adults over 30 years of age with recently diagnosed asthma (age range: 30-93), matched for gender, age, and living region with one or two controls (n=2050). Allergic rhinitis (AR), allergic conjunctivitis (AC) and allergic dermatitis (AD), was defined from self-completed questionnaire. Conditional logistic regression adjusted on potential confounders (smoking, growing in countryside, childhood hospitalized infection/pneumonia, parental asthma/allergy, parental smoking, education level, professional training, number of siblings, and birth order) was applied to estimate the asthma risk associated with allergic multimorbidity.
RESULTS: 1118 cases with asthma and 1772 matched controls were included [mean (sd, min-max) 53 (11, 31-71) years, 37% men)]. AR, AC or AD were reported by 50.2%, 39.6%, 33.8%, respectively among subjects with asthma and 26.1%, 20.0%, 23.5%, among controls. Compared to non-atopics, adult-onset asthma increased with the number of allergic diseases; adjusted OR for asthma [CI95%] associated with 1, 2, and 3 allergic diseases were 1.95 [1.52-2.49], 2.87 [2.19-3.77], and 4.26 [3.07-5.90], respectively. The association between adult-onset asthma and ≥1 allergic multimorbidity decreased with increasing age (3.52 [2.51-4.94], 2.44 [1.74-3.42] and 1.68 [1.04-2.71]) in subjects <50 years, 50-62 years and >62 years, respectively (p for age*≥1 allergic multimorbidity interaction, .002).
CONCLUSIONS: Adult-onset asthma was positively associated with the number of allergic diseases and this association decreases with age. This article is protected by copyright. All rights reserved.
