Asthma phenotypes in a multi-ethnic Asian cohort.
Asthma phenotypes in a multi-ethnic Asian cohort.
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DOI：
10.1016/j.rmed.2019.08.016
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发表时间：
2019-10
影响因子：
4.3
通讯作者：
T. Tay;X. Choo;A. Yii;K. Chung;Y. Chan;H. Wong;A. Chan;Augustine Tee;M. Koh
中科院分区：
文献类型：
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作者：
T. Tay;X. Choo;A. Yii;K. Chung;Y. Chan;H. Wong;A. Chan;Augustine Tee;M. Koh
背景哮喘表型的识别有助于我们对哮喘病理的理解。在同质亚洲队列中观察到的表型与在高加索队列中观察到的表型有明显差异，这表明种族可能影响表型表达。在多民族东南亚队列中，表型集群以前没有被描述过，在一项研究中对这些集群进行直接比较可能揭示种族如何影响表型表达。方法将来自新加坡两家医疗机构的630名成年哮喘患者按2:1的比例随机分配到一个测试和验证队列中。使用哮喘发病年龄、性别、种族、吸烟状况、体重指数、肺功能、血嗜酸性粒细胞计数、哮喘控制测试得分和发作频率作为输入变量，对两个队列进行潜在分类分析。比较检验队列和验证队列之间的表型群。结果在检验队列和验证队列中均鉴定出3个表型群，每个队列对应的表型群具有相似的特征。族群代表性和哮喘控制在组间有显著差异。聚类一为迟发性哮喘及哮喘控制效果最好的中国女性。第二组为非华裔女性，肥胖且哮喘控制最差。聚类3为多民族，特应性患者比例最大。结论：我们在东南亚多民族人群中发现了三个表型集群，这些集群在种族上存在明显差异，这可能归因于种族群体之间基线特征的固有差异。
BackgroundIdentification of asthma phenotypes facilitates our understanding of asthma pathobiologies. Phenotypes observed in homogenous Asian cohorts have distinct differences from those described in Caucasian cohorts, suggesting that ethnicity may influence phenotypic expression. Phenotypic clusters in a multi-ethnic Southeast Asian cohort have not been described before, and direct comparisons of these clusters within a single study may reveal how ethnicity affects phenotypic expression.MethodsSix hundred and thirty adult asthma patients from two healthcare institutions in Singapore were randomly assigned in a 2:1 fashion to a test and validation cohort. Latent class analysis was performed on both cohorts using age of asthma onset, sex, ethnicity, smoking status, body mass index, lung function, blood eosinophil count, asthma control test score, and exacerbation frequency as input variables. Phenotypic clusters between the test and validation cohorts were comparedResultsThree clusters were identified in both the test and validation cohorts, with corresponding clusters of each cohort sharing similar characteristics. Ethnic representation and asthma control were significantly different between clusters. Cluster one comprised Chinese females with late-onset asthma and the best asthma control. Cluster two comprised non-Chinese females with obesity and the worst asthma control. Cluster three was multi-ethnic with the greatest proportion of atopic patients.ConclusionWe identified three phenotypic clusters in our multi-ethnic Southeast Asian population, with distinct differences in ethnicity which may be attributable to inherent differences in baseline characteristics among ethnic groups.