Norbäck D, Zhao Z-H, Wang Z-H, Wieslander G, Mi Y-H, Zhang Z
Department of Medical Sciences, Uppsala University and University Hospital, 751 85 Uppsala, Sweden.
Int Arch Occup Environ Health. 2007 Jan;80(3):207-16. doi: 10.1007/s00420-006-0123-6. Epub 2006 Jul 5.
To study self-reported asthma, eczema, and pollen and furry pet allergy among pupils (9-20 years) in Shanxi province, China, in relation to dietary and environmental factors.
A standardised questionnaire was distributed to pupils in two primary and two secondary schools, one in Taiyuan city (3.0 milj. inhabitants), the others in Qingxu county, a rural area 30 km outside Taiyuan. Totally, 2,116 pupils (90%) participated.
Fifty percent were girls, 61% had been growing up on the countryside, 18% lived in Taiyuan now, 1.7% had ever had asthma, 0.8% had doctor's diagnosed asthma, 1.4% pollen allergy, 1.7% cat allergy, and 0% had dog allergy. Multiple logistic regression was applied, controlling for age, gender, diet, indoor exposures, rural childhood, and current urban residency. Girls had less eczema (OR = 0.51; 95%CI 0.28-0.92). Pupils in the city had more eczema (OR = 5.05; 95% CI 1.11-23.3). Those with a rural childhood had less asthma (OR = 0.17; 95% CI 0.05-0.60), eczema (OR = 0.15; 95% CI 0.13-0.66) and pollen/cat allergy (OR = 0.50; 95%CI 0.25-0.99). None of the indoor variables was related to asthma or allergy. Children with frequent fruit consumption had less asthma (OR = 0.40; 95% CI 0.19-0.82) and pollen/cat allergy (OR = 0.49; 95% CI 0.29-0.84). Those with frequent fish consumption had less asthma (OR = 0.32; 95% CI 0.11-0.97). Those with frequent hamburgers consumption had more asthma (OR = 2.05; 95% CI 1.09-3.87) and eczema (OR = 1.85; 95% CI 1.12-3.04).
Asthma, eczema, and pollen or pet allergy was uncommon, compared with western countries and other areas in China. Pupils with a rural childhood had less asthma and allergy, which is consistent with the "hygiene hypothesis". Fruit and fish consumption may reduce, and fast food consumption may increase the risk for asthma. Finally, the higher prevalence of asthma and eczema among younger children, born in the 1990s, indicates a cohort effect similar to that observed in western countries.
研究中国山西省9至20岁学生自我报告的哮喘、湿疹、花粉和对带毛宠物的过敏情况,并分析其与饮食和环境因素的关系。
向两所小学和两所中学的学生发放标准化问卷,一所小学和一所中学位于太原市(300万人口),另外一所小学和一所中学位于清徐县,即距离太原30公里的农村地区。共有2116名学生(90%)参与调查。
50%为女生,61%在农村长大,18%现居住在太原,1.7%曾患哮喘,0.8%经医生诊断患有哮喘,1.4%对花粉过敏,1.7%对猫过敏,0%对狗过敏。采用多因素logistic回归分析,对年龄、性别、饮食、室内暴露因素、农村童年经历和当前城市居住情况进行校正。女生患湿疹的比例较低(比值比[OR]=0.51;95%置信区间[CI]为0.28 - 0.92)。城市学生患湿疹的比例较高(OR = 5.05;95% CI为1.11 - 23.3)。有农村童年经历的学生患哮喘(OR = 0.17;95% CI为0.05 - 0.60)、湿疹(OR = 0.15;95% CI为0.13 - 0.66)以及花粉/猫过敏(OR = 0.50;95% CI为0.25 - 0.99)的比例较低。室内变量与哮喘或过敏均无关联。经常食用水果的儿童患哮喘(OR = 0.40;95% CI为0.19 - 0.82)和花粉/猫过敏(OR = 0.49;95% CI为0.29 - 0.84)的比例较低。经常食用鱼类的儿童患哮喘的比例较低(OR = 0.32;95% CI为0.11 - 0.97)。经常食用汉堡的儿童患哮喘(OR = 2.05;95% CI为1.09 - 3.87)和湿疹(OR = 1.85;95% CI为1.12 - 3.04)的比例较高。
与西方国家及中国其他地区相比,哮喘、湿疹、花粉或宠物过敏并不常见。有农村童年经历的学生哮喘和过敏患病率较低,这与“卫生假说”一致。食用水果和鱼类可能降低哮喘风险,而食用快餐可能增加哮喘风险。最后,20世纪90年代出生的年幼儿童哮喘和湿疹患病率较高,提示存在与西方国家类似的队列效应。