Natural progression of childhood asthma symptoms and strong influence of sex and puberty.
Natural progression of childhood asthma symptoms and strong influence of sex and puberty.
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DOI：
10.1513/annalsats.201402-084oc
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发表时间：
2014-07-01
影响因子：
8.3
通讯作者：
Wang, Zuyi
中科院分区：
文献类型：
--
作者：
Fu, Liang;Freishtat, Robert J;Wang, Zuyi
依据：已经对哮喘的患病率、发作、缓解和复发以及医疗保健使用进行了深入研究。然而，哮喘症状在儿童期和青少年期的进展尚未得到充分研究，部分原因是在获得大量哮喘受试者的一致和可靠的长期随访数据方面存在挑战。使用儿童哮喘管理计划安慰剂组的哮喘日记症状数据（5年，418名受试者，共564,518条记录），以建立性别特异性的高分辨率时间进程的哮喘症状的自然进展，通过childhood和adolescence.METHODS：我们使用哮喘日记症状代码作为每日疾病严重程度的措施。每年记录坦纳阶段被用来确定青春期对严重程度的影响。数据对齐技术被用来获得平均症状和平均坦纳stage.MEASUREMENTS和主要结果的13年的时间进程：数据分析显示三个年龄和性别相关的哮喘症状进展阶段：阶段1（5岁和6岁）-男孩的严重程度更高; 2期（7至9岁）-严重程度无性别差异; 3期（10至17岁）-女孩的严重程度更高。在青春期开始时，男性和女性哮喘症状的持续下降会突然停止。结论：哮喘症状的严重程度在儿童期和青春期各不相同，并且模式因性别而异。青春期对两性的症状进展有很大影响。症状进展是哮喘流行病学的一个独特方面。
RATIONALE: Asthma prevalence, onset, remission and relapse, and healthcare use have been intensively studied. However, asthma symptom progression through childhood and adolescence has not been well studied, in part due to the challenges in obtaining consistent and robust long-term follow-up data on a large series of subjects with asthma.OBJECTIVES: To use the asthma diary symptom data of the Childhood Asthma Management Program placebo group (5 yr, 418 subjects, and total 564,518 records) to establish sex-specific high-resolution time courses of the natural progression of asthma symptoms through childhood and adolescence.METHODS: We used the asthma diary symptom code as a measure of daily disease severity. Annual records of Tanner stage were used to determine the influence of puberty on severity. A data alignment technique was used to derive 13-year time courses of mean symptoms and mean Tanner stage.MEASUREMENTS AND MAIN RESULTS: Data analyses showed three age- and sex-related phases of asthma symptom progression: Phase 1 (ages 5 and 6 yr)-greater severity in boys; Phase 2 (ages 7 to 9 yr)-no sex difference in severity; and Phase 3 (age 10-17 yr)-greater severity in girls. The continuous decline of symptoms in both sexes stops abruptly at the onset of puberty.CONCLUSIONS: The severity of asthma symptoms varies through childhood and adolescence, and patterns differ by sex. Puberty has a strong influence on symptom progression in both sexes. Progression of symptoms is a distinct aspect of asthma epidemiology.