Siblings, asthma, rhinoconjunctivitis and eczema: a worldwide perspective from the International Study of Asthma and Allergies in Childhood.
Siblings, asthma, rhinoconjunctivitis and eczema: a worldwide perspective from the International Study of Asthma and Allergies in Childhood.
复制标题
DOI：
10.1111/cea.12349
复制
发表时间：
2015-01
期刊：
影响因子：
--
通讯作者：
ISAAC Phase Three Study Group
中科院分区：
文献类型：
--
作者：
Strachan DP;Aït-Khaled N;Foliaki S;Mallol J;Odhiambo J;Pearce N;Williams HC;ISAAC Phase Three Study Group
在富裕的国家中，发现较大的家庭与花粉热、湿疹和过敏性致敏的客观标志物的较低患病率之间的关系相当一致，但在不太富裕的国家中，对这些关系知之甚少。来自31个国家的210200名6-7岁儿童和来自52个国家的337226名13-14岁儿童的问卷数据由儿童哮喘和过敏国际研究（ISAAC）第三阶段收集。哮喘，鼻结膜炎和湿疹的疾病症状和标签的关联进行了分析的总数，年长和年幼的兄弟姐妹，使用混合（多层次）逻辑回归模型调整个别协变量和中心水平的地区，语言和国家的富裕。在这两个年龄组中，随着兄弟姐妹总数的增加，特别是年长的兄弟姐妹，观察到报告的“花粉热”和“湿疹"呈相反趋势（P < 0.0001）。这些反向关联在更富裕的国家中显著更强（P < 0.005）。相反，在两个年龄组中，严重哮喘和严重湿疹的症状与总同胞数呈正相关（P < 0.0001）。这些与疾病严重程度的关联在很大程度上独立于兄弟姐妹内的位置和人均国民总收入。这些关于兄弟姐妹人数与儿童哮喘、鼻结膜炎和湿疹的全球研究结果表明，至少有两种不同的趋势。与年长的兄弟姐妹的反向关联（促使过敏性疾病的“卫生假说”的观察结果）主要是一种更富裕国家的现象，而在大家庭中症状的严重程度更高则在全球范围内更为普遍。
Associations of larger families with lower prevalences of hay fever, eczema and objective markers of allergic sensitization have been found fairly consistently in affluent countries, but little is known about these relationships in less affluent countries. Questionnaire data for 210 200 children aged 6–7 years from 31 countries, and 337 226 children aged 13–14 years from 52 countries, were collected by Phase Three of the International Study of Asthma and Allergies in Childhood (ISAAC). Associations of disease symptoms and labels of asthma, rhinoconjunctivitis and eczema were analysed by numbers of total, older and younger siblings, using mixed (multi-level) logistic regression models to adjust for individual covariates and at the centre level for region, language and national affluence. In both age groups, inverse trends (P < 0.0001) were observed for reported ‘hay fever ever’ and ‘eczema ever’ with increasing numbers of total siblings, and more specifically older siblings. These inverse associations were significantly (P < 0.005) stronger in more affluent countries. In contrast, symptoms of severe asthma and severe eczema were positively associated (P < 0.0001) with total sibship size in both age groups. These associations with disease severity were largely independent of position within the sibship and national GNI per capita. These global findings on sibship size and childhood asthma, rhinoconjunctivitis and eczema suggest at least two distinct trends. Inverse associations with older siblings (observations which prompted the ‘hygiene hypothesis’ for allergic disease) are mainly a phenomenon of more affluent countries, whereas greater severity of symptoms in larger families is globally more widespread.
登录
查看更多内容
影响因子：
9.6
作者：
Goldberg, Shmuel;Israeli, Eran;Picard, Elie
通讯作者：
Picard, Elie
影响因子：
10
作者：
Bodner, C;Godden, D;Seaton, A
通讯作者：
Seaton, A
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：
--
作者：
STRACHAN, DP
通讯作者：
STRACHAN, DP
影响因子：
5
作者：
Infante-Rivard, C;Amre, D;Malo, JL
通讯作者：
Malo, JL