哮喘联盟

   摘要 
   背景：在富裕国家，家庭人口多与花粉症、湿疹、哮喘和变异性过敏症客观指标发生率低相关，但我们对此相关性在不富裕国家的状况知之甚少。
   方法：国际儿童哮喘和过敏性疾病研究（ISAAC）第三阶段共收集来自31个国家的210200例6-7岁儿童和来自52个国家的337226例13-14岁儿童的问卷数据。分别根据总同胞数目以及年长和年幼的同胞数目分析疾病症状和哮喘、鼻炎、湿疹特征的相关性，采用混合（多级）逻辑回归模型校正个体协变量和所在地区的中心程度、语言和国家富裕程度。
   结果：在两个年龄组，花粉过敏症和湿疹报告例数与总同胞数目、特别是年长兄弟姐妹数目的增加呈负相关(P<0.0001)。在富裕国家这种负相关更显著(P<0.005)。相反，在两个年龄组人群中，严重哮喘和严重湿疹的症状与总兄弟姐妹数目呈正相关(P<0.0001)。这种与症状严重程度的相关性在很大程度上与兄弟姐妹们所处的地区和人均国民收入无关。
   结论：这些关于同胞数目和儿童哮喘、鼻炎和湿疹相关性的全球性发现提示，至少存在两个截然不同的趋势。年长的兄弟姐妹数目与过敏性疾病发生率的负相关现象主要存在于富裕国家中（引起过敏性疾病“卫生假说”的观察）；而在全球范围内，家庭人口多与症状严重程度正相关。本文章受版权保护。
 

（苏楠 审校）
Clin Exp Allergy.2014 Jun 10.doi: 10.1111/cea.12349. [Epub ahead of print]

 

Siblings, Asthma, RhinoconjunctivitisAnd Eczema: A Worldwide Perspective From The International Study Of Asthma And Allergies In Childhood.
 

Strachan DP1, Aït-Khaled N, Foliaki S, Mallol J, Odhiambo J, Pearce N, Williams HC; The ISAAC Phase Three Study Group.
 

ABSTRACT
BACKGROUND: Associations of larger families with lower prevalences of hay fever, eczema and objective markers of allergic sensitization have been found fairly consistently in affluent countries, but little is known about these relationships in less affluent countries.
METHODS: Questionnaire data for 210200 children aged 6-7 years from 31 countries, and 337226 children aged 13-14 years from 52 countries, were collected by Phase Three of the International Study of Asthma and Allergies in Childhood (ISAAC). Associations of disease symptoms and labels of asthma, rhinoconjunctivitis and eczema were analysed by numbers of total, older and younger siblings, using mixed (multi-level) logistic regression models to adjust for individual covariates and at the centre level for region, language and national affluence.
RESULTS: In both age groups, inverse trends (P<0.0001) were observed for reported "hay fever ever" and "eczema ever" with increasing numbers of total siblings, and more specifically older siblings. These inverse associations were significantly (P<0.005) stronger in more affluent countries. In contrast, symptoms of severe asthma and severe eczema were positively associated (P<0.0001) with total sibship size in both age groups. These associations with disease severity were largely independent of position within the sibship and national GNI per capita.
CONCLUSIONS: These global findings on sibship size and childhood asthma, rhinoconjunctivitis and eczema suggest at least two distinct trends. Inverse associations with older siblings (observations which prompted the "hygiene hypothesis" for allergic disease) are mainly a phenomenon of more affluent countries, whereas greater severity of symptoms in larger families is globally more widespread. This article is protected by copyright. All rights reserved.
 

Clin Exp Allergy.2014 Jun 10.doi: 10.1111/cea.12349. [Epub ahead of print]