The diversity of young adult wheeze: a cluster analysis in a longitudinal birth cohort.
The diversity of young adult wheeze: a cluster analysis in a longitudinal birth cohort.
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DOI：
10.1111/cea.12306
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发表时间：
2014
期刊：
影响因子：
--
通讯作者：
Arshad SH
中科院分区：
文献类型：
--
作者：
Kurukulaaratchy RJ;Zhang H;Raza A;Patil V;Karmaus W;Ewart S;Arshad SH
聚类分析增强了对儿童和成人喘息异质性的理解。然而，虽然青春期代表了一个重要的过渡阶段，年轻人喘息的性质尚未明确表征。使用聚类分析来定义，首次，在纵向出生队列临床相关的年轻人喘息集群。k -均值聚类分析对309名18岁的怀特岛出生队列患者（N=1456）进行了分析。在18岁时使用了13种疾病特征聚类变量。由此产生的群集，然后通过严重程度指数和喘息发展的潜在风险因素进一步表征整个生命的前18年。确定了6个喘息集群。第1组（12.3%）男性-儿童早期发病-特应性喘息-肺功能正常，男性占优势，肺活量正常，低BDR（支气管扩张剂可逆性），中等BHR（支气管高反应性），高特应性患病率，更多入院。第2组（24.2%）儿童早期发病-喘息伴中度肺功能无特定的性别关联，中度肺活量、BDR、BHR、BTS步骤治疗和入院率更显著。第3组（9.7%）女性-儿童早期发病-特应性喘息-肺功能受损，女性为主，过敏性疾病合并症高，BDR和BHR更严重，气流阻塞最大，吸烟患病率高，症状严重程度和入院率更高。第4组（19.4%）未确诊的女性喘息患者为青春期发病的非特应性喘息，低BDR和BHR，肺功能受损但未受阻，症状频率高，吸烟率最高。第5组（24.6%）女性-儿童期晚期发病-喘息-肺功能正常，无特异性特应性关联，肺活量正常，BDR、BHR低，症状严重程度低。第6组（9.7%）男性儿童期晚期发病-特应性喘息-肺功能受损，特应性和鼻炎患病率高，BDR和BHR升高，肺功能中度受损，症状严重程度高，BTS步骤治疗较高。青少年喘息是多种多样的，可以分为不同的集群。更严重的群集值得注意，并与儿童期发病、特应性反应、肺功能受损以及在某些情况下吸烟有关。与吸烟有关的未确诊的喘息也值得重视。更好地了解年轻人的喘息可以促进更好的以后成人呼吸健康。
Cluster analyses have enhanced understanding of the heterogeneity of both paediatric and adult wheezing. However while adolescence represents an important transitional phase, the nature of young adult wheeze has yet to be clearly characterised. To use cluster analysis to define, for the first time, clinically relevant young adult wheeze clusters in a longitudinal birth cohort. K-Means Cluster analysis was undertaken among 309 currently wheezing subjects at 18-years in the Isle of Wight Birth Cohort ( N=1456). Thirteen disease characterising clustering variables at 18-years were used. Resulting clusters were then further characterised by severity indices plus potential risk factors for wheeze development throughout the 1st 18-years of life. Six wheeze clusters were identified. Cluster 1 (12.3%) male-early-childhood-onset-atopicwheeze-with-normal-lung function had male predominance, normal spirometry, low BDR (bronchodilator reversibility), intermediate BHR (bronchial hyper-responsiveness), high atopy prevalence, and more admissions. Cluster 2 (24.2%) early-childhood-onset-wheeze-with-intermediate-lung-function had no specific sex association, intermediate spirometry, BDR, BHR, more significant BTS step therapy and admissions. Cluster 3 (9.7%) female-early-childhood-onset-atopic-wheeze-with-impaired-lung-function showed female predominance, high allergic disease comorbidity, more severe BDR and BHR, greatest airflow obstruction, high smoking prevalence, higher symptom severity and admissions. Cluster 4 (19.4%) female-undiagnosed-wheezers had adolescent onset non-atopic wheeze, low BDR and BHR, impaired but non-obstructed spirometry, high symptom frequency and highest smoking prevalence. Cluster 5 (24.6%) female-late-childhood-onset-wheeze-with-normal-lung-function showed no specific atopy association, normal spirometry, low BDR, BHR, and symptom severity. Cluster 6 (9.7%) male-late-childhood-onset-atopic-wheeze-with-impaired-lung-function had high atopy and rhinitis prevalence, elevated BDR and BHR, moderately impaired spirometry, high symptom severity and higher BTS step therapy. Young adult wheeze is diverse and can be classified into distinct clusters. More severe clusters merit attention and are associated with childhood onset, atopy, impaired lung function and in some, smoking. Smoking associated undiagnosed-wheezers also merit recognition. Better understanding of young adult wheeze could facilitate better later adult respiratory health.
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影响因子：
24.3
作者：
Just, Jocelyne;Gouvis-Echraghi, Rahele;Annesi-Maesano, Isabella
通讯作者：
Annesi-Maesano, Isabella
DOI：
10.1164/rccm.200402-230oc
发表时间：
2005-01-15
影响因子：
24.7
作者：
James, AL;Palmer, LJ;Musk, AW
通讯作者：
Musk, AW
影响因子：
2
作者：
Gelman, Andrew
通讯作者：
Gelman, Andrew
影响因子：
158.5
作者：
Bouzigon, Emmanuelle;Corda, Eve;Demenais, Florence
通讯作者：
Demenais, Florence
影响因子：
4.2
作者：
Brook, Judith S.;Saar, Naomi S.;Brook, David W.
通讯作者：
Brook, David W.