Sears M R, Burrows B, Flannery E M, Herbison G P, Holdaway M D
Department of Medicine, McMaster University, Hamilton, Ontario, Canada.
Clin Exp Allergy. 1993 Nov;23(11):941-8. doi: 10.1111/j.1365-2222.1993.tb00279.x.
Reasons for the gender differences in prevalence rates for asthma remain unclear. We have examined the relationships between allergen skin-test reactions and diagnoses of hay fever and asthma in New Zealand boys and girls examined at the age of 13 years. Information on current and past wheezing, diagnosed asthma, and hay fever was obtained for 662 subjects (341 boys) of a birth cohort followed longitudinally to the age of 13 years, using a physician-administered questionnaire. Atopic status was determined by skin-prick tests to 11 common allergens. The proportion of 13-year-old boys with current asthma was 1.6 times higher and of ever-diagnosed asthma 1.4 times higher than in girls, but the prevalence of recurrent wheeze (> or = three episodes per year) not diagnosed as asthma, or of hay fever, was not significantly different between the sexes. The prevalence of diagnosed asthma increased with increasing numbers of positive skin tests, but hay fever without asthma was little affected above one positive skin-test. Boys had a greater prevalence of any positive skin-test (50.1% vs 37.1%), two or more positive tests (29.3% vs 21.8%), and responses to house dust mite (34.0% vs 23.1%) and cat (14.7% vs 11.2%). Gender differences for asthma became insignificant when adjusted for skin-test responsiveness to house dust mite and/or cat. The proportion of children with diagnosed asthma increased with increasing size of weals to house dust mite and cat dander. Gender differences in allergen sensitivities partly explain the gender differences in diagnosed asthma in children. In both sexes, risk of asthma was primarily associated with sensitization to indoor allergens (house dust mite and cat), and was related to the magnitude of the skin-test response, while the risk of hay fever was primarily associated with grass pollen sensitivity.
哮喘患病率存在性别差异的原因尚不清楚。我们研究了新西兰13岁男孩和女孩的变应原皮肤试验反应与花粉症和哮喘诊断之间的关系。通过医生发放的问卷，获取了662名（341名男孩）出生队列中一直随访到13岁的受试者当前和过去喘息、确诊哮喘及花粉症的信息。通过对11种常见变应原进行皮肤点刺试验确定特应性状态。13岁男孩中当前哮喘的比例比女孩高1.6倍，曾被诊断为哮喘的比例比女孩高1.4倍，但未被诊断为哮喘的反复喘息（每年≥3次发作）或花粉症的患病率在两性之间无显著差异。确诊哮喘的患病率随皮肤试验阳性数量的增加而升高，但无哮喘的花粉症在一个皮肤试验阳性以上时受影响较小。男孩任何皮肤试验阳性（50.1%对37.1%）、两个或更多阳性试验（29.3%对21.8%）以及对屋尘螨（34.0%对23.1%）和猫（14.7%对11.2%）的反应的患病率更高。当根据对屋尘螨和/或猫的皮肤试验反应性进行调整后，哮喘的性别差异变得不显著。确诊哮喘的儿童比例随对屋尘螨和猫皮屑风团大小的增加而升高。变应原敏感性的性别差异部分解释了儿童确诊哮喘的性别差异。在两性中，哮喘风险主要与对室内变应原（屋尘螨和猫）致敏有关，且与皮肤试验反应的强度有关，而花粉症风险主要与草花粉敏感性有关。
