Risk factors of new-onset asthma in adults: a population-based international cohort study
Risk factors of new-onset asthma in adults: a population-based international cohort study
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DOI：
10.1111/j.1398-9995.2009.02301.x
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发表时间：
2010-08-01
期刊：
影响因子：
12.4
通讯作者：
Burney, P.
中科院分区：
文献类型：
--
作者：
Anto, J. M.;Sunyer, J.;Burney, P.
研究背景：成年期新发哮喘的发生是常见的，但对其决定因素包括特应性的作用了解不足。目的：评估中年人新发哮喘的危险因素，并根据特应性进行比较。方法：对9175名参加欧洲共同体呼吸健康调查（ECRHS）的两项调查的年轻人进行纵向分析，调查间隔9年。结果：我们观察到4588名参与者中有179例新发哮喘，他们没有哮喘，并在随访开始时报告他们从未患过哮喘（4.5/1000人-年）。在逻辑回归分析中，发现以下危险因素会增加新发哮喘的风险：女性（OR：1.97; 95%可信区间（CI）：1.38，2.81），支气管高反应性（3.25; 2.19，4.83）、特应性（1.55; 1.08，2.21）、FEV 1 <100%预计值（1.87; 1.34，2.62）、鼻过敏（1.98; 1.39，2.84）和母亲哮喘（1.91;1.13;3.21）。肥胖、早期呼吸道感染和高风险职业增加了新发哮喘的风险，尽管我们的能力有限，无法证实它们的作用。在特应性哮喘患者中，总IgE和对猫的致敏性与新发哮喘的风险独立相关。结论：未患哮喘的成年人，由于肺功能等多个独立危险因素的影响，其新发哮喘的风险很大。特应性解释了一小部分新发成人哮喘。
P>Background:The occurrence of new-onset asthma during adulthood is common, but there is insufficient understanding of its determinants including the role of atopy.Objective:To assess the risk factors for the development of new-onset asthma in middle-aged adults and to compare them according to atopy.Methods:A longitudinal analysis of 9175 young adults who participated in two surveys of the European Community Respiratory Health Survey (ECRHS) conducted 9 years apart.Findings:We observed 179 cases of new-onset asthma among 4588 participants who were free of asthma and reported at the beginning of the follow-up that they had never had asthma (4.5 per 1000 person-years). In a logistic regression, the following risk factors were found to increase the risk of new-onset asthma: female gender (OR: 1.97; 95% confidence interval (CI): 1.38,2.81), bronchial hyperresponsiveness (3.25; 2.19,4.83), atopy (1.55;1.08,2.21), FEV1 < 100 % predicted (1.87;1.34,2.62), nasal allergy (1.98;1.39,2.84) and maternal asthma (1.91;1.13;3.21). Obesity, respiratory infections in early life and high-risk occupations increased the risk of new-onset asthma although we had limited power to confirm their role. Among the atopics, total IgE and sensitization to cat were independently related to the risk of new-onset asthma. The proportion of new-onset asthma attributable to atopy varied from 12% to 21%.Conclusion:Adults reporting that they had never had asthma were at a substantial risk of new-onset asthma as a result of multiple independent risk factors including lung function. Atopy explains a small proportion of new-onset adult asthma.