Lack of association between indoor allergen sensitization and asthma morbidity in inner-city adults
Lack of association between indoor allergen sensitization and asthma morbidity in inner-city adults
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DOI：
10.1016/j.jaci.2007.03.044
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发表时间：
2007-07-01
影响因子：
14.2
通讯作者：
Halm, Ethan A.
中科院分区：
文献类型：
--
作者：
Wisnivesky, Juan P.;Sampson, Hugh;Halm, Ethan A.
背景：对室内过敏原的敏感性和暴露与市中心儿童哮喘发病率的增加有关。然而，它是未知的，是否与过敏性哮喘恶化的成人。目的：评估过敏性和哮喘发病率在城市成人之间的关系。方法：我们前瞻性研究了245名从市中心诊所招募的持续性哮喘成人。通过招募时测量的特异性IgE抗体评价对室内过敏原的致敏性。在基线、1个月和3个月随访时收集哮喘控制、哮喘相关急诊就诊、住院和口服类固醇使用的数据。单变量，分层和多元回归分析被用来比较哮喘发病率在致敏和非致敏患者控制后，自我报告的暴露和其他潜在的confersider.Results：研究队列主要包括低收入，少数民族患者的资源利用率高。对蟑螂、尘螨、猫、霉菌和小鼠的致敏率分别为60%、43%、41%、21%和14%。在单变量分析中，与非致敏个体相比，对每种变应原致敏的患者并没有更差的哮喘控制或更高的资源利用。分层和多变量分析也表明，即使在控制了自我报告的室内过敏原暴露和其他潜在的混杂因素后，致敏和哮喘发病率的几个指标之间也没有关联。这些研究结果表明，改善城市人群哮喘控制的努力应集中在其他可改变的发病风险因素上。
Background: Sensitivity and exposure to indoor allergens is associated with increased asthma morbidity in inner-city children. However, it is unknown whether sensitization is associated with worse asthma in adults.Objective: To evaluate the relationship between sensitization and asthma morbidity in urban adults. Methods: We prospectively studied 245 adults with persistent asthma recruited from an inner-city clinic. Sensitization to indoor allergens was evaluated by specific IgE antibodies measured at enrollment. Data on asthma control, asthma-related emergency department visits, hospitalizations, and oral steroid use were collected at baseline and at 1-month and 3-month follow-up contacts. Univariate, stratified, and multiple regression analyses were used to compare asthma morbidity in sensitized and nonsensitized patients after controlling for self-reported exposure and other potential confounders.Results: The study cohort consisted predominantly of low income, minority patients with high rates of resource utilization. The prevalences of sensitization to cockroach, dust mite, cat, mold, and mouse were 60%, 43%, 41%, 21%, and 14%. On univariate analyses, patients sensitized to each allergen did not have worse asthma control or higher resource utilization compared with nonsensitized individuals. Stratified and multivariate analyses also showed no association between sensitization and several measures of asthma morbidity even after controlling for self-reported exposure to indoor allergens and other potential confounders.Conclusion: Sensitization to indoor allergens does not appear to he associated with increased asthma morbidity in inner-city adults.Clinical implications: These findings suggest that efforts to improve asthma control among urban populations should focus on other modifiable risk factors for morbidity.