Increase in the prevalence of allergen skin sensitization in successive birth cohorts
Increase in the prevalence of allergen skin sensitization in successive birth cohorts
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DOI：
10.1067/mai.2002.124772
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发表时间：
2002-06-01
影响因子：
14.2
通讯作者：
Britton, J
中科院分区：
文献类型：
--
作者：
Broadfield, E;McKeever, TM;Britton, J
背景：对于普通人群中过敏原皮肤致敏的纵向流行趋势知之甚少。
目的：我们试图测量一组成年人在9年期间过敏原皮肤致敏流行率的变化，从而确定年龄组之间流行率的横断面差异是由于衰老还是队列效应所致。
方法：在1991年和2000年，我们对来自诺丁汉的1339名1991年年龄在18至71岁之间的成年人队列，测量了对屋尘螨、猫毛、混合草、烟曲霉和枝孢霉的皮肤致敏情况，将皮肤致敏定义为风团直径比生理盐水对照所引发的风团直径大3毫米或更多。受试者被分为六个连续的9年出生队列，并在广义估计方程logit模型中分析出生队列的影响以及1991年至2000年受试者自身的变化。
结果：1991年对任何过敏原致敏的未调整流行率为30.5%，2000年为31.8%。在横断面分析中，两次调查中致敏的流行率均随年龄增长而降低（1991年调查中，18 - 26岁患者相对于63 - 70岁患者的风险比为2.15；95%置信区间[CI]为1.45 - 3.17）。在纵向分析中，1991年至2000年受试者自身的致敏情况没有变化（调整后的比值比为1.07；95%CI为0.97 - 1.19），但存在显著的队列效应（每个连续9年队列的调整后比值比为1.27；95%CI为1.18 - 1.37）。
结论：普通人群中过敏原致敏随年龄的横断面下降主要是由于连续出生队列中致敏流行率的长期增加，而非受试者随时间推移致敏的丧失。由于这种队列效应，在这个普通成年人群样本中，过敏性致敏的流行率有所增加。
Background: Little is known about longitudinal trends in the prevalence of allergen skin sensitization in the general population.Objective: We sought to measure the change in prevalence of allergen skin sensitization over a 9-year period in a cohort of adults and hence to determine whether cross-sectional differences in prevalence between age groups are due to an aging or cohort effect.Methods: In 1991 and 2000, we measured skin sensitization, defined its a wheal diameter of 3 mm or larger than that elicited by a saline control, to Dermatophagoides pteronyssinus, cat fur, mixed grass, Aspergillus funtigatus, and Cladosporium herbarum in a cohort of 1339 adults from Nottingham aged between 18 and 71 years in 1991. Subjects were divided into six 9-year successive birth cohorts, and the effects of birth cohort and the within-subject change from 1991 to 2000 were analyzed in a generalized estimating equation logit model.Results: The unadjusted prevalence of sensitization to any allergen was 30.5% in 1991 and 31.8% in 2000. In cross-sectional analyses the prevalence of sensitization decreased with increasing age at both surveys (risk ratio, 2.15; 95% confidence interval [CI], 1.45-3.17 for 18- to 26-year-old patients relative to 63- to 70-year-old patients in the 1991 survey). In longitudinal analysis there was no within-subject change in sensitization from 1991 to 2000 (adjusted odds ratio, 1.07; 95% Cl, 0.97-1.19), but there was a significant cohort effect (adjusted odds ratio per successive 9 year cohort, 1.27; 95% CI, 1.18-1.37).Conclusion: The cross-sectional decrease in allergen sensitization with age in the general population arises predominantly from a secular increase in sensitization prevalence with successive birth cohorts and not to a loss of sensitization within subjects over time. As a result of this cohort effect, the prevalence of allergic sensitization has increased in this general adult population sample.