Effect of body mass on exercise-induced bronchospasm and atopy in African children
Effect of body mass on exercise-induced bronchospasm and atopy in African children
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DOI：
10.1016/j.jaci.2005.05.025
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发表时间：
2005-10-01
影响因子：
14.2
通讯作者：
Burney, P
中科院分区：
文献类型：
--
作者：
Calvert, J;Burney, P
背景：对过敏原的致敏在较不富裕国家的农村人口中很常见，但特应性疾病的发生率低于较富裕国家。解释这种二分法的变量可能为了解哮喘等特应性疾病的潜在机制提供见解。目的：测试非洲城市化人群中运动诱发支气管痉挛（EIB）的风险是否与皮肤敏感性或体重增加有关。方法：共有3322名儿童参加了南非城市和农村的EIB患病率调查。对运动挑战反应积极的儿童和反应消极的随机儿童样本被纳入病例对照研究（393例对照，380例病例）。研究对象采用变应原皮肤点刺试验、人体测量和IgE测定。分析粪便中是否有寄生虫感染。结果：城市地区EIB患病率（14.9%）高于农村地区（8.9%）（P < 0.0001）。城市和农村受试者之间EIB风险的差异与特应性（皮肤轮直径上分位数的比值比[OR]为2.65；95% CI为1.43-4.89;P < 0.0001）、体重增加（体重指数[BMI]上分位数的比值比[OR]为2.17；95% CI为1.45-3.26;P = .001）和富裕程度有关。BMI增加还与特异性IgE与相应皮肤试验之间的相关性增强相关（皮肤试验结果呈特异性IgE阳性的翼状螨，OR：较重的受试者，OR为34.6；95% CI为0.9-109.3;P < 0.0001；较轻的受试者，OR为8.05；95% CI为2.74-23.6;P < .001）。结论：自给经济农村儿童BMI升高可能导致特应性疾病患病率升高。这一观察值得在前瞻性研究中进一步调查。
Background: Sensitization to allergen is common in rural populations in less affluent countries, but atopic disease is less frequent than in richer countries. Variables explaining this dichotomy may provide insight into underlying mechanisms of atopic diseases like asthma.Objective: To test whether risk of exercise-induced bronchospasm (EIB) in urbanized African populations is increased in association with greater skin sensitivity or increased body mass.Methods: A total of 3322 children were enrolled in a prevalence survey of EIB in urban and rural South Africa. Children responding positively to an exercise challenge and a random sample of children responding negatively were recruited into a case-control study (393 controls, 380 cases). Subjects were investigated by using allergen skin prick testing, anthropometry, and assay of IgE. Stools were analyzed for parasite infestation.Results: The prevalence of EIB was higher in urban (14.9%) than rural (8.9%) areas (P < .0001). The difference in risk of EIB between urban and rural subjects was associated with atopy (odds ratio [OR] for upper tertile of skin wheal diameter, 2.65; 95% CI, 1.43-4.89; P < .0001), increasing weight (OR for upper tertile of body mass index [BMI], 2.17; 95% CI, 1.45-3.26; P = .001), and affluence. Increasing BMI was also associated with a greater strength of association between specific IgE and the corresponding skin test (Dermatophagoides pteronyssinus, OR for a positive skin test result in presence of specific IgE: heavier subjects, OR, 34.6; 95% CI, 0.9-109.3; P < .0001; lighter subjects, OR, 8.05; 95% CI, 2.74-23.6; P < .001).Conclusion: Increases in BMI of rural children in subsistence economies may lead to an increased prevalence of atopic disease. This observation merits further investigation in prospective studies.