PREDICTORS OF ASTHMA AND PERSISTENT WHEEZE IN A NATIONAL SAMPLE OF CHILDREN IN THE UNITED-STATES - ASSOCIATION WITH SOCIAL-CLASS, PERINATAL EVENTS, AND RACE
PREDICTORS OF ASTHMA AND PERSISTENT WHEEZE IN A NATIONAL SAMPLE OF CHILDREN IN THE UNITED-STATES - ASSOCIATION WITH SOCIAL-CLASS, PERINATAL EVENTS, AND RACE
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DOI：
10.1164/ajrccm/142.3.555
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发表时间：
1990-09-01
期刊：
影响因子：
--
通讯作者：
SPEIZER, FE
中科院分区：
文献类型：
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作者：
SCHWARTZ, J;GOLD, D;SPEIZER, FE
这项研究分析了第二次全国健康和营养检查调查的数据，以确定黑人儿童是否更容易患哮喘或喘息，即使在对环境和社会经济暴露进行调整后也是如此。对于 6 个月至 11 岁的儿童，未经调整的哮喘患病率在白人儿童中为 3.0%，在黑人儿童中为 7.2%；频繁喘息的患病率在白人中为 6.2%，在黑人中为 9.3%。在包含种族、年龄和性别的逻辑回归模型中，黑人儿童与白人儿童相比，患哮喘的相对几率 (RO) 为 2.5（95% 置信区间 [Cl]，1.9 至 3.4）。逐步逻辑回归中哮喘的其他预测因素包括年龄、性别（男孩与女孩，RO = 1.4）、母亲年龄较小（年龄下降 2 个标准差 [SD]，RO = 1.4）、居住在中心城市（RO = 1.6）和家庭收入（最低三分位数与最高三分位数的 RO，RO = 1.7）。在调整了这些危险因素、年龄和性别后，黑人儿童患哮喘的 RO 仍然为 1.7（95% Cl，1.2 至 2.1）。频繁喘息与种族（黑人与白人，RO = 1.6）、性别（男孩与女孩，RO = 1.3）、出生体重（出生体重 2 SD 不足，RO = 1.4）和三头肌皮褶厚度（皮褶增加 2 SD 增加哮喘几率增加，RO = 1.6）有关。调整其他混杂变量后，母亲年龄和出生体重的显着影响表明，子宫内环境可能是哮喘的重要决定因素。黑人患哮喘和频繁喘息的风险增加可能部分归因于环境暴露，其中许多与贫困有关，但在调整这些环境因素后，黑人的风险仍然明显较高。
This study analyzes data from the Second National Health and Nutritional Examination Survey to determine whether black children are more likely to have asthma or wheeze, even after adujusting for environmental and socioeconomic exposures. For children 6 months to 11 yr of age, the unadjusted prevalence for asthma was 3.0% among white children and 7.2% among blacks; prevalence of frequent wheeze was 6.2% among whites and 9.3% among blacks. In a logistic regression model including race, age, and sex, the relative odds (RO) of asthma for black children as compared to white were 2.5 (95% confidence interval [Cl], 1.9 to 3.4). Other predictors of asthma in a stepwise logistic regression included age, sex (boys versus girls, RO = 1.4), younger maternal age (2 standard deviation [SD] drop in age, RO = 1.4), residence in the central city (RO = 1.6), and family income (RO for the lowest versus highest tertile, RO = 1.7). After adjusting for these risk factors, age and sex, black children still had a 1.7 RO (95% Cl, 1.2 to 2.1) of having asthma. Frequent wheeze was associated with race (black versus white, RO = 1.6), sex (boys versus girls, RO = 1.3), birth weight (2 SD deficit in birth weight, RO = 1.4), and triceps skinfold thickness (increase in odds of asthma for 2 SD increase in skinfold, RO = 1.6). The significant effect of maternal age and birth weight after adjusting for other confounding variables suggests that the in utero environment may be an important determinant of asthma. The increased risk for asthma and frequent wheeze among blacks may be due in part to environmental exposures, many of which are associated with poverty, but after adjusting for these environmental factors, blacks were still at a significantly higher risk.