Gender differences in prevalence, diagnosis and incidence of allergic and non-allergic asthma: a population-based cohort
Gender differences in prevalence, diagnosis and incidence of allergic and non-allergic asthma: a population-based cohort
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DOI：
10.1136/thoraxjnl-2011-201249
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发表时间：
2012-07-01
期刊：
影响因子：
10
通讯作者：
Neukirch, Francoise
中科院分区：
文献类型：
--
作者：
Leynaert, Benedicte;Sunyer, Jordi;Neukirch, Francoise
背景：虽然在临床实践中，女性严重非过敏性哮喘可能在成人哮喘患者中占相当大的比例，但在普通人群中过敏性和非过敏性哮喘发病率的性别差异研究很少。方法从普通人群中随机抽取9091名男性和女性，作为欧洲共同体呼吸健康调查的一部分，调查哮喘患病率、报告诊断和发病率的性别差异。该方案包括评估支气管反应性、对4种常见过敏原的特异性IgE和对9种过敏原的皮试。结果35岁以上女性哮喘的发生率比男性高20%。哮喘可能的漏诊似乎在非特应性个体中尤其常见，但在女性中的发生率与男性一样高。基线时无哮喘受试者的随访显示，女性哮喘发病率高于男性(HR 1.94；95%CI 1.40至2.68)，这不能用吸烟、肥胖或肺功能的差异来解释。超过60%的女性和30%的男性新发哮喘是非特应性的。女性非过敏性哮喘的发病率高于男性(HR 3.51；95%CI 2.21~5.58)，而过敏性哮喘的发病率无性别差异。结论女性是非过敏性哮喘的独立危险因素，在临床实践中需要对男性和女性中可能的非过敏性哮喘进行更仔细的评估。
Background Although women with severe non-allergic asthma may represent a substantial proportion of adults with asthma in clinical practice, gender differences in the incidence of allergic and non-allergic asthma have been little investigated in the general population.Methods Gender differences in asthma prevalence, reported diagnosis and incidence were investigated in 9091 men and women randomly selected from the general population and followed up after 8-10 years as part of the European Community Respiratory Health Survey. The protocol included assessment of bronchial responsiveness, IgE specific to four common allergens and skin tests to nine allergens.Results Asthma was 20% more frequent in women than in men over the age of 35 years. Possible under-diagnosis of asthma appeared to be particularly frequent among non-atopic individuals, but was as frequent in women as in men. The follow-up of subjects without asthma at baseline showed a higher incidence of asthma in women than in men (HR 1.94; 95% CI 1.40 to 2.68), which was not explained by differences in smoking, obesity or lung function. More than 60% of women and 30% of men with new-onset asthma were non-atopic. The incidence of non-allergic asthma was higher in women than in men throughout all the reproductive years (HR 3.51; 95% CI 2.21 to 5.58), whereas no gender difference was observed for the incidence of allergic asthma.Conclusions This study shows that female sex is an independent risk factor for non-allergic asthma, and stresses the need for more careful assessment of possible non-allergic asthma in clinical practice, in men and women.