Rhinitis as an independent risk factor for adult-onset asthma
Rhinitis as an independent risk factor for adult-onset asthma
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DOI：
10.1067/mai.2002.121701
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发表时间：
2002-03-01
影响因子：
14.2
通讯作者：
Barbee, RA
中科院分区：
文献类型：
--
作者：
Guerra, S;Sherrill, DL;Barbee, RA
背景：多年来，哮喘和鼻炎之间的联系主要归因于共同的过敏背景。最近，有研究表明哮喘和鼻炎在没有特应性的情况下是相关的。这种联系的性质尚不清楚。目的：本研究在一个大型的、纵向的社区人群中进行，目的是确定鼻炎在多大程度上是成人发作哮喘的独立危险因素。方法：我们从图森阻塞性肺病流行病学研究的纵向队列中进行巢式病例对照研究。173例经医生证实的哮喘患者与2177例无哮喘或呼吸短促伴喘息的受试者进行了比较。潜在的危险因素，包括鼻炎的存在，在哮喘发作之前（患者）或在最后一次完成调查之前（对照组）进行评估。结果：鼻炎是哮喘的重要危险因素（粗优势比为4.13；95%可信区间为2.88-5.92）。在对随访年数、年龄、性别、特应性状态、吸烟状况和是否患有慢性阻塞性肺疾病进行校正后，相关性程度有所降低，但仍然非常显著（校正优势比为3.21,95%可信区间为2.19-4.71）。分层后，鼻炎使特应性和非特应性患者发生哮喘的风险增加了约3倍，在IgE水平最高的患者中增加了5倍以上。伴有持续和严重鼻部症状的鼻炎患者，以及医生确诊的个人鼻窦炎病史，哮喘发展的风险增加。结论：我们认为鼻炎是成人哮喘的重要危险因素，无论是特应性还是非特应性。鼻炎和哮喘之间关系的性质有待解释。
Background: For many years, the association between asthma and rhinitis has primarily been attributed to a common allergic background. Recently, it has been suggested that asthma and rhinitis are associated in the absence of atopy. The nature of this association is not well known.Objective: The purpose of this study, which was performed in a large, longitudinal community population, was to determine the extent to which rhinitis is an independent risk factor for adult-onset asthma.Methods: We carried out a nested case-control study from the longitudinal cohort of the Tucson Epidemiologic Study of Obstructive Lung Diseases. One hundred seventy-three incident patients with physician-confirmed asthma were compared with 2177 subjects who reported no asthma or shortness of breath with wheezing. Potential risk factors, including the presence of rhinitis, were assessed before the onset of asthma (patients) or before the last completed survey (control subjects).Results: Rhinitis was a significant risk factor for asthma (crude odds ratio, 4.13; 95% confidence interval, 2.88-5.92). After adjustment for years of follow-up, age, sex, atopic status, smoking status, and presence of chronic obstructive pulmonary disease, the magnitude of the association was reduced but still highly significant (adjusted odds ratio, 3.21, 95% confidence interval, 2.19-4.71). After stratification, rhinitis increased the risk of development of asthma by about 3 times both among atopic and nonatopic patients and by more than 5 times among patients in the highest IgE tertile. Patients with rhinitis with persistent and severe nasal symptoms and a personal history of physician-confirmed sinusitis had an additional increased risk of asthma development.Conclusion: We conclude that rhinitis is a significant risk factor for adult-onset asthma in both atopic and nonatopic subjects. The nature of the association between rhinitis and asthma is open to interpretation.