Patterns of Atopic Eczema Disease Activity From Birth Through Midlife in 2 British Birth Cohorts.
Patterns of Atopic Eczema Disease Activity From Birth Through Midlife in 2 British Birth Cohorts.
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DOI：
10.1001/jamadermatol.2021.2489
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发表时间：
2021-10-01
期刊：
影响因子：
10.9
通讯作者：
Langan SM
中科院分区：
文献类型：
--
作者：
Abuabara K;Ye M;Margolis DJ;McCulloch CE;Mulick AR;Silverwood RJ;Sullivan A;Williams HC;Langan SM
特应性湿疹的特点是病程呈异质性的起伏变化，发病年龄和症状持续时间各不相同。在整个儿童时期已确定了不同的疾病活动模式，如早发/缓解型和持续型疾病；对于成年期的模式知之甚少。
基于成年中期的疾病活动模式确定特应性湿疹的亚型，检验早期生活风险因素和参与者特征是否能预测这些亚型，并确定这些亚型是否与成年中期的其他特应性疾病和总体健康状况相关。
两项基于人群的出生队列研究。
英国，1958 - 2016年。
1958年全国儿童发展研究（NCDS）和1970年英国队列研究（BCS70）的成员。
根据多次自我报告的特应性湿疹期间患病率确定特应性湿疹模式的亚型。这些亚型是早期生活特征模型中的结果，也是中年健康模型中的暴露变量。
潜在类别分析在NCDS的15939人和BCS70的14966人中确定了四种具有不同疾病活动模式的亚型：“罕见/无”特应性湿疹（88% - 91%）、“减轻”型（4%）、“加重”型（2% - 6%）以及随着年龄增长报告患特应性湿疹的概率持续“高”（2% - 3%）。早期生活因素，包括出生时性别、社会阶层、居住地区、烟草烟雾暴露和母乳喂养，预测了三种特应性湿疹亚型与不常发/无特应性湿疹组之间的差异，但只有女性性别区分了高概率和概率降低的亚型。高概率亚型的个体最有可能患哮喘和鼻炎，而加重型亚型的个体在中年时自我报告总体健康状况不佳（比值比1.29，95%置信区间1.09 - 1.53）和心理健康状况不佳（比值比1.45，95%置信区间1.23 - 1.72）的风险更高。
将观察窗口延伸到儿童期之后，我们根据疾病活动模式观察到了特应性湿疹的明确亚型。一种新确定的在成年期活动概率增加的亚型，鉴于其与中年时自我报告健康状况不佳的关联，值得进一步关注。
Atopic eczema is characterized by a heterogenous waxing and waning course, with variable age of onset and persistence of symptoms. Distinct patterns of disease activity such as early-onset/resolving and persistent disease have been identified throughout childhood; little is known about patterns into adulthood. To identify subtypes of atopic eczema based on patterns of disease activity through mid-adulthood, to examine whether early life risk factors and participant characteristics predict these subtypes, and to determine whether subtypes are associated with other atopic diseases and general health in mid-adulthood. Two population-based birth cohort studies. United Kingdom, 1958-2016. Members of the 1958 National Childhood Development Study (NCDS) and the 1970 British Cohort Study (BCS70). Subtypes of atopic eczema patterns were identified based on self-reported atopic eczema period prevalence at multiple occasions. These subtypes were the outcome in models of early life characteristics and an exposure variable in models of mid-life health. Latent class analysis identified four subtypes with distinct patterns of disease activity among 15,939 individuals from the NCDS and 14,966 individuals from the BCS70: ‘rare/no’ atopic eczema (88-91%), ‘decreasing’ (4%), ‘increasing’ (2-6%), and persistently ‘high’ (2-3%) probability of reporting prevalent atopic eczema with age. Early life factors, including sex at birth, social class, region of residence, tobacco smoke exposure, and breastfeeding, predicted differences between the three atopic eczema subtypes and the infrequent/no atopic eczema group, but only female sex differentiated the high and decreasing probability subtypes. Individuals in the high subtype were most likely to experience asthma and rhinitis, and those in the increasing subtype were at higher risk of poor self-reported general (OR 1.29, 95%CI 1.09 to 1.53) and mental (OR 1.45, 95%CI 1.23 to 1.72) health in mid-life. Extending the window of observation beyond childhood, we observed clear subtypes of atopic eczema based on patterns of disease activity. A newly identified subtype with increasing probability of activity in adulthood warrants additional attention given observed associations with poor self-reported health in mid-life.
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DOI：
10.1016/j.jaci.2017.09.044
发表时间：
2018-03
期刊：
The Journal of allergy and clinical immunology
影响因子：
--
作者：
Paternoster L;Savenije OEM;Heron J;Evans DM;Vonk JM;Brunekreef B;Wijga AH;Henderson AJ;Koppelman GH;Brown SJ
通讯作者：
Brown SJ
影响因子：
14.2
作者：
Abuabara, Katrina;Ye, Morgan;Langan, Sinead M.
通讯作者：
Langan, Sinead M.
影响因子：
14.2
作者：
Odhiambo, Joseph A.;Williams, Hywel C.;Asher, M. Innes
通讯作者：
Asher, M. Innes
影响因子：
6.5
作者：
Fuxench, Zelma C. Chiesa;Block, Julie K.;Ong, Peck Y.
通讯作者：
Ong, Peck Y.
DOI：
10.1080/10705510701575396
发表时间：
2007-01-01
影响因子：
6
作者：
Nylund, Karen L.;Asparoutiov, Tihomir;Muthen, Bengt O.
通讯作者：
Muthen, Bengt O.