Regional variation in epinephrine autoinjector prescriptions in Australia: more evidence for the vitamin D-anaphylaxis hypothesis
Regional variation in epinephrine autoinjector prescriptions in Australia: more evidence for the vitamin D-anaphylaxis hypothesis
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DOI：
10.1016/s1081-1206(10)60265-7
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发表时间：
2009-12-01
影响因子：
5.9
通讯作者：
Camargo, Carlos A., Jr.
中科院分区：
文献类型：
--
作者：
Mullins, Raymond James;Clark, Sunday;Camargo, Carlos A., Jr.
背景资料：关于澳大利亚过敏反应的地区分布的信息很少。目的：研究纬度对过敏反应的影响（阳光/维生素D状态的标志物）作为澳大利亚过敏反应的一个促成因素，重点是从出生到4岁的儿童。方法：肾上腺素自动注射器（EpiPen）处方（2006-2007年）和过敏症住院率（2002-2007年）作为过敏反应的替代指标。从出生到4岁的儿童（平均951）的EpiPen处方率（每年每10万人）高于总人口（平均324）。在一个未调整的儿童从出生到4岁的模型中，绝对纬度的下降与EpiPen处方率的下降有关，因此澳大利亚南部地区的处方率高于北方地区（β，-44.4; 95%置信区间）。-57.0至-31.8，P < .001）。调整饲料。性别、种族、富裕指数、受教育程度或获得医疗护理的机会（一般、专科过敏或儿科）并没有削弱这一发现（β，-51.9; 95%置信区间）。-71.0至-32.9; P < .001）。虽然统计功效有限，但过敏反应入院率（0-4岁儿童中最突出）显示出类似的南北梯度。因此，与澳大利亚的北方地区相比，南方地区的入院率更高。结论：EptPen处方率类过敏反应入院在澳大利亚的南方地区更常见。这些数据为维生素D在过敏性反应发病机制中的可能作用提供了额外的支持。《过敏性哮喘免疫学杂志》2009：103 488-495
Background: There is little information on the regional distribution of anaphylaxis in Australia.Objective: To examine the influence of latitude (a marker of sunlight/vitamin D status) as a contributor to anaphylaxis in Australia, with a focus on children from birth to the age of 4 years.Methods: Epinephrine autoinjector (EpiPen) prescriptions (2006-2007) in 59 statistical divisions and anaphylaxis hospital admission rates (2002-2007) in 10 regions were used as surrogate markers of anaphylaxis.Results: EpiPen prescription rates (per 100,000 population per year) were higher in children from birth to the age of 4 years (mean, 951) than in the overall population (mean, 324). In an unadjusted model of children from birth to the age of 4 years, decreasing, absolute latitude was associated with a decrease in EpiPen prescription rates, such that rates were higher in southern compared with northern regions of Australia (beta, -44.4; 95% confidence interval. -57.0 to -31.8, P < .001). Adjusting forage. sex, ethnicity, indexes of affluence, education, or access to medical care (general, specialist allergy, or pediatric) did not attenuate the finding (beta, -51.9; 95% confidence interval. -71.0 to -32.9; P < .001). Although statistical power was limited, anaphylaxis admission rates (most prominent in children aged 0-4 years) showed a similar south-north gradient. such that admission rates were hi-her in Southern compared with northern regions of AustraliaConclusions: EptPen prescription rates kind anaphylaxis admissions are more common in southern regions of Australia. These data provide additional support for a possible role of vitamin D in the pathogenesis of anaphylaxis. Ann Allergy Asthma Immunol. 2009:103 488-495