哮喘联盟

   摘要
   背景：先前研究已经发现出生地与哮喘患病率之间的相关性。
   目的：旨在研究出生地、美国患病率、发病年龄和成人哮喘疾病进程之间的相关性。
   方法：评估数据来自1997年到2011年国家卫生服务调查中447801例成人。采用Rao-Scott χ2、logistic分析、倾向评分和回归分析比较哮喘病史与出生地间的差异。采用logistic回归分析评估哮喘流行趋势。通过多变量模型控制社会人口、卫生服务使用、吸烟史和身体质量指数。
   结果：出生于美国国外的成人具有较低的曾患哮喘(校正比值比[OR] 0.52, 95%置信区间[CI] 0.49-0.55)或现患哮喘(OR 0.50, 95% CI, 0.46-0.54)几率。在所有出生地中，国外出生与哮喘流行呈显著负相关(P < .0001)。美国国外出生但居住在美国超过10年与仅居住0-4年的成人比，具有较高的曾患哮喘(OR 1.28, 95% CI, 1.18-1.38)和现患哮喘(OR 1.70, 95% CI, .31-2.19)几率。国外出生与美国出生的成人比，同样哮喘发病较晚(校正风险比0.27, 95% CI, 0.27-0.28)。美国哮喘的患病率从1997年(9.1%, 8.77%-9.37%)到2011年(12.5%, 12.1%-12.8%, P < .0001)，呈线性增长，与美国出生的成年人趋势平行。然而，国外出生的成年人的哮喘患病率一致性较低，且增长程度较小 (P < .0001)。
   结论：在所有出生地中，国外出生的美国人具有较低的哮喘患病率，随着其在美国长期居住后有增长。国外出生的美国人可能具有较高的成人哮喘发病风险。
 

（林江涛 审校）
AnnAllergyAsthmaImmunol.2014Aug19.pii:S1081-1206(14)00464-5.doi:10.1016/j.anai.2014.07.006. [Epub ahead of print]

 

Association between birthplace, prevalence, and age of asthma onset in adults: a United States population-based study.
 

Silverberg JI1, Durkin HG2, Joks R3.
 

ABSTRACT
BACKGROUND: Previous studies have found associations between region of birth and asthma prevalence.
OBJECTIVE: To study the association among birthplace, US prevalence, age of onset, and disease course of adult asthma.
METHODS: Data from 447,801 adults from the 1997 to 2011 National Health Interview Survey were reviewed. History of asthma was compared with birthplace using Rao-Scott χ2 tests, survey logistic, propensity score, and Cox regression. Trends of asthma prevalence were analyzed using logistic regression. Multivariate models controlled for sociodemographics, health care access, smoking history, and body mass index.
RESULTS: Adults born outside the United States had lower odds of ever asthma (adjusted odds ratio [OR] 0.52, 95% confidence interval [CI] 0.49-0.55) or current asthma (OR 0.50, 95% CI, 0.46-0.54). The inverse association between foreign birthplace and asthma prevalence was significant in all regions of birth (P < .0001). Adults born outside the United States who resided in the United States for longer than 10 years compared with only 0 to 4 years had higher odds of ever asthma (OR 1.28, 95% CI, 1.18-1.38) and current asthma (OR 1.70, 95% CI, .31-2.19). Foreign-born compared with US-born adults also had delayed onset of asthma (adjusted hazard ratio 0.27, 95% CI, 0.27-0.28). The US prevalence of asthma increased in a linear manner from 1997 (9.1%, 8.77%-9.37%) to 2011 (12.5%, 12.1%-12.8%, P < .0001), which ralleled the trend for US-born adults. However, the prevalence of asthma in foreign-born adults was consistently lower and increased to a lesser extent (P < .0001).
CONCLUSION: Foreign-born American adults from all regions of birth have a lower prevalence of asthma, which increases after prolonged US residency. Foreign-born Americans may have a higher risk of adult-onset asthma.
 

AnnAllergyAsthmaImmunol.2014Aug19.pii:S1081-1206(14)00464-5.doi:10.1016/j.anai.2014.07.006. [Epub ahead of print]