Low socioeconomic status as a risk factor for asthma, rhinitis and sensitization at 4 years in a birth cohort
Low socioeconomic status as a risk factor for asthma, rhinitis and sensitization at 4 years in a birth cohort
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DOI：
10.1111/j.1365-2222.2005.02243.x
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发表时间：
2005-05-01
影响因子：
6.1
通讯作者：
Wickman, M
中科院分区：
文献类型：
--
作者：
Almqvist, C;Pershagen, G;Wickman, M
背景社会经济地位与儿童过敏性疾病之间的关系存在争议。有研究表明，儿童哮喘在社会经济地位低的家庭中更常见，而在儿童时期，社会经济地位高的个体对空气中过敏原的敏感性似乎更高。目的评估社会经济地位与哮喘的关系。在一项前瞻性的出生队列研究中，研究对象为4089个1994- 2009年出生儿童的家庭。1996年在预先定义的领域斯德哥尔摩回答问卷的环境因素，社会经济地位（父母职业），过敏性疾病的症状在出生时，1，2和4岁。从2614名儿童4年的血液样本进行了分析特异性IgE常见的空气和食物过敏原。与社会经济地位的各种结果的比值比（OR）和95%置信区间（CI）进行了估计与多元Logistic回归模型，调整潜在的混杂因素，如遗传过敏性疾病，母亲吸烟，母乳喂养时间短，房子building.Results有一个降低的风险，哮喘和鼻炎的社会经济地位。比较最高和最低社会经济群体，哮喘的OR为0.33（95%CI 0.17-0.66），鼻炎的OR为0.50（0.32-0.79），在遗传过敏性疾病的人群中有更强的影响趋势。食物过敏原致敏的风险也随着社会经济地位的提高而降低; OR 0.65（0.41-1.02）在最高的社会经济地位组（P趋势=0.03），这是不清楚地看到空气中的过敏原。这可能与群体之间生活方式和环境暴露的额外不受控制的差异有关，需要进一步研究。
Background The relation between socioeconomic status and allergic diseases in childhood is controversial. Some studies have proposed childhood asthma to be more common in families with low socioeconomic status, while sensitization to airborne allergens seems to be more frequent in individuals with higher socioeconomic status in childhood.Objective To assess the relation between socioeconomic status and asthma, rhinitis and sensitization in an unselected prospective birth cohort.Methods Four thousand and eighty-nine families with children born 1994-1996 in predefined areas of Stockholm answered questionnaires on environmental factors, socioeconomic status (parental occupation), and symptoms of allergic disease at birth, 1, 2 and 4 years of age. Blood samples taken at 4 years from 2614 children were analysed for specific IgE to common airborne and food allergens. Odds ratios (OR) and 95% confidence intervals (CI) for various outcomes in relation to socioeconomic status were estimated with a multiple logistic regression model, adjusting for potential confounders such as heredity for allergic diseases, maternal smoking, short duration of breastfeeding and house construction.Results There was a decreasing risk of asthma and rhinitis with increasing socioeconomic status. The OR for asthma was 0.33 (95% CI 0.17-0.66) and for rhinitis 0.50 (0.32-0.79) comparing the highest and the lowest socioeconomic groups, with a tendency to stronger effects in those with heredity for allergic disease. The risk of sensitization to food allergens also decreased with increasing socioeconomic status; OR 0.65 (0.41-1.02) in the highest socioeconomic group (P-trend=0.03), which was not clearly seen for airborne allergens.Conclusion Asthma, rhinitis and sensitization is more common in lower than in higher socioeconomic groups after adjustment for traditional risk factors. This may be related to additional uncontrolled differences in life style and environmental exposures between the groups, and calls for further studies.