Are Environmental Factors for Atopic Eczema in ISAAC Phase Three due to Reverse Causation?
Are Environmental Factors for Atopic Eczema in ISAAC Phase Three due to Reverse Causation?
复制标题
ISAAC 第三阶段中特应性湿疹的环境因素是否是反向因果关系？
DOI：
10.1016/j.jid.2018.08.035
复制
发表时间：
2019
期刊：
影响因子：
--
通讯作者：
Rutter CE
中科院分区：
文献类型：
--
作者：
Rutter CE
一些先前描述的特应性湿疹的环境关联可能是由于反向因果关系。我们通过比较个人和学校水平的多个特应性湿疹危险因素的结果，探讨了反向因果关系的作用。儿童哮喘和过敏症国际研究（即ISAAC）第三阶段调查了学校（抽样单位）的儿童特应性湿疹症状和潜在的危险因素。我们使用混合效应logistic回归模型评估这些危险因素对特应性湿疹症状的影响，首先是个人水平的暴露数据，其次是学校水平的暴露患病率。共有来自53个国家的546，348名儿童参加。在6-7岁时，最强的个体水平关联与当前使用扑热息痛有关（比值比[OR] = 1.45，95%置信区间[CI] = 1.37-1.54），在学校水平持续存在（OR = 1.55，95%CI = 1.10-2.21），早期抗生素（OR = 1.41，95% CI = 1.34-1.48），以及早期使用扑热息痛（OR = 1.28，95%CI = 1.21-1.36），前者在学校水平持续存在，后者则不再观察到OR = 1.35，95%CI = 1.00-1.82; OR = 0.94，95%CI = 0.69-1.28。在13-14岁年龄段，个体水平上最强的相关性与当前使用扑热息痛有关（OR = 1.57，95%CI = 1.51-1.63）和明火烹饪（OR = 1.46，95%CI = 1.33-1.62）;在学校水平两者均较强（OR = 2.57，95%CI = 1.84-3.59和OR = 2.38，95%CI = 1.52-3.73）。在学校水平（OR = 1.40，95%CI = 1.07 -1.82），与交通繁忙（OR = 1.31，95%CI = 1.27 -1.36）的相关性也持续存在。大多数个人和学校一级的影响是一致的，往往排除反向因果关系。
Some previously described environmental associations for atopic eczema may be due to reverse causation. We explored the role of reverse causation by comparing individual- and school-level results for multiple atopic eczema risk factors. The International Study of Asthma and Allergies in Childhood (i.e, ISAAC) Phase Three surveyed children in schools (the sampling unit) regarding atopic eczema symptoms and potential risk factors. We assessed the effect of these risk factors on atopic eczema symptoms using mixed-effect logistic regression models, first with individual-level exposure data and second with school-level exposure prevalence. Overall, 546,348 children from 53 countries were included. At ages 6–7 years, the strongest individual-level associations were with current paracetamol use (odds ratio [OR] = 1.45, 95% confidence interval [CI] = 1.37–1.54), which persisted at school-level (OR = 1.55, 95% CI = 1.10–2.21), early-life antibiotics (OR = 1.41, 95% CI = 1.34–1.48), and early-life paracetamol use (OR = 1.28, 95% CI = 1.21–1.36), with the former persisting at the school level, whereas the latter was no longer observed (OR = 1.35, 95% CI = 1.00–1.82 and OR = 0.94, 95% CI = 0.69–1.28, respectively). At ages 13–14 years, the strongest associations at the individual level were with current paracetamol use (OR = 1.57, 95% CI = 1.51–1.63) and open-fire cooking (OR = 1.46, 95% CI = 1.33–1.62); both were stronger at the school level (OR = 2.57, 95% CI = 1.84–3.59 and OR = 2.38, 95% CI = 1.52–3.73, respectively). Association with exposure to heavy traffic (OR = 1.31, 95% CI = 1.27–1.36) also persisted at the school level (OR = 1.40, 95% CI = 1.07–1.82). Most individual- and school-level effects were consistent, tending to exclude reverse causation.
登录
查看更多内容
坏死性小肠结肠炎的治疗
影响因子：
5.2
作者：
R. Balkrishnan;T. S. Housman;Christie L. Carroll;S. Feldman;A. Fleischer
通讯作者：
A. Fleischer
出生体重和特应性疾病的风险：ISAAC III 期研究
影响因子：
4.4
作者：
E. Mitchell;T. Clayton;L. García‐Marcos;N. Pearce;S. Foliaki;G. Wong
通讯作者：
G. Wong
DOI：
10.1016/s2213-2600(13)70073-0
发表时间：
2013-07
期刊：
The Lancet. Respiratory medicine
影响因子：
--
作者：
G. Wong;Bert Brunekreef;P. Ellwood;Ross Anderson;Innes Asher;J. Crane;C. Lai;I. EllwoodMPHProfM;Asher MBChB;Prof Gary;WK Wong
通讯作者：
G. Wong;Bert Brunekreef;P. Ellwood;Ross Anderson;Innes Asher;J. Crane;C. Lai;I. EllwoodMPHProfM;Asher MBChB;Prof Gary;WK Wong
影响因子：
14.2
作者：
Odhiambo, Joseph A.;Williams, Hywel C.;Asher, M. Innes
通讯作者：
Asher, M. Innes
DOI：
10.1111/cea.12349
发表时间：
2015-01
期刊：
Clinical and experimental allergy : journal of the British Society for Allergy and Clinical Immunology
影响因子：
--
作者：
Strachan DP;Aït-Khaled N;Foliaki S;Mallol J;Odhiambo J;Pearce N;Williams HC;ISAAC Phase Three Study Group
通讯作者：
ISAAC Phase Three Study Group