Asthma cases attributable to atopy: Results from the third national health and nutrition examination survey
Asthma cases attributable to atopy: Results from the third national health and nutrition examination survey
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DOI：
10.1016/j.jaci.2007.07.056
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发表时间：
2007-11-01
影响因子：
14.2
通讯作者：
Zeldin, Darryl C.
中科院分区：
文献类型：
--
作者：
Arbes, Samuel J., Jr.;Gergen, Peter J.;Zeldin, Darryl C.
背景：特应性导致哮喘病例的百分比是一个有争议的话题。
目的：目的是估计美国人群中特应性导致的哮喘病例百分比，并研究过敏原特异性皮肤试验与哮喘之间的关联。
方法：数据来自第三次全国健康和营养检查调查，其中6至59岁的受试者用10种过敏原进行皮肤试验。特应性定义为至少1种过敏原特异性试验呈阳性。通过问卷调查评估医生诊断的当前哮喘情况。
结果：在美国，56.3%的哮喘病例可归因于特应性，男性的这一比例高于女性，最高教育类别人群高于较低教育类别人群，居住在人口密集的大都市地区的人群高于所有其他地区。在调整前，每种过敏原特异性试验都与哮喘密切相关（优势比从2.1到4.5不等）；然而，在对所有过敏原进行调整后，只有对猫、链格孢菌、白橡木和多年生黑麦的试验与哮喘独立相关。多年生黑麦与哮喘呈负相关。在10种过敏原中，对猫的阳性反应导致的哮喘病例百分比最高（29.3%）。
结论：第三次全国健康和营养检查调查所代表的美国人群中，约一半的当前哮喘病例可归因于特应性。一些过敏原特异性皮肤试验与哮喘并非独立相关。
临床意义：如果能够预防或逆转特应性，或者阻断其对哮喘的影响，那么美国人群中很大比例的哮喘病例是可以预防的。
Background: The percentage of asthma cases attributable to atopy is the subject of debate.Objectives: The objectives were to estimate the percentage of asthma cases in the US population attributable to atopy and to examine associations between allergen-specific skin tests and asthma.Methods: Data were obtained from the Third National Health and Nutrition Examination Survey, in which subjects age 6 to 59 years were skin tested with 10 allergens. Atopy was defined as at least 1 positive allergen-specific test. Doctor-diagnosed current asthma was assessed by questionnaire.Results: In the United States, 56.3% of the asthma cases were attributable to atopy, and that percentage was greater among males than females, among persons in the highest education category than in lower education categories, and among persons living in highly populated metropolitan areas than in all other areas. Each allergen-specific test was strongly associated with asthma before adjustment (odds ratios varied from 2.1 to 4.5); however, after adjustment by all the allergens, only tests to cat, Alternaria, white oak, and perennial rye were independently associated with asthma. Perennial rye was inversely associated with asthma. Of the 10 allergens, a positive response to cat accounted for the highest percentage of asthma cases (29.3%).Conclusion: About half of the current asthma cases in the US population represented by the Third National Health and Nutrition Examination Survey were attributable to atopy. Some allergen-specific skin tests were not independently associated with asthma.Clinical implications: If atopy could be prevented or reversed, or its effect on asthma blocked, then a large percentage of asthma cases in the US population could be prevented.