Jacobson J S, Mellins R B, Garfinkel R, Rundle A G, Perzanowski M S, Chew G L, Andrews H F, Goldstein I F
Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY 10032, USA.
Allergy. 2008 Jan;63(1):87-94. doi: 10.1111/j.1398-9995.2007.01529.x.
Striking differences in asthma prevalence have been reported among Hispanic adults and children living in different cities of the USA. Prevalence is highest among those of Puerto Rican and lowest among those of Mexican origin. We hypothesized that body size would mediate this association.
Parents of children in New York City Head Start programs completed a questionnaire including demographic factors, health history, a detailed history of respiratory conditions, lifestyle, and home environment. Children's height and weight were measured in home visits. Logistic regression was used to model the association of asthma with body mass index percentile (<85th percentile, gender/age specific vs>or=85th percentile, gender/age specific), national origin, and other factors.
Of 517 children at mean age of 4.0 +/- 0.6 years, 34% met the study criteria for asthma, and 43% were above the 85th percentile. Asthma was strongly associated with non-Mexican national origin, male gender, allergy symptoms, and maternal asthma, and marginally with body size. The odds of asthma among boys of non-Mexican origin was 5.9 times that among boys of Mexican origin [95% confidence interval (CI): 2.9-12.2]; the comparable odds ratio (OR) among girls was 1.8 (95% CI: 0.9-3.6). Body mass was associated with asthma among girls [OR = 2.0 (95% CI: 1.1-3.7)], but not boys [OR = 1.4 (95% CI: 0.8-2.6)].
The association of asthma with both body mass and national origin was gender-specific among the children in our study. Ours is one of the first studies to report on pediatric asthma in different Hispanic populations in the same city, by gender.
据报道,居住在美国不同城市的西班牙裔成年人和儿童的哮喘患病率存在显著差异。波多黎各裔的患病率最高,而墨西哥裔的患病率最低。我们推测体型可能介导了这种关联。
纽约市“启智计划”项目中儿童的家长完成了一份问卷,内容包括人口统计学因素、健康史、详细的呼吸道疾病史、生活方式和家庭环境。在家庭访视中测量了儿童的身高和体重。采用逻辑回归模型分析哮喘与体重指数百分位数(<第85百分位数,按性别/年龄划分vs≥第85百分位数,按性别/年龄划分)、国籍以及其他因素之间的关联。
在517名平均年龄为4.0±0.6岁的儿童中,34%符合哮喘研究标准,43%高于第85百分位数。哮喘与非墨西哥国籍、男性性别、过敏症状和母亲哮喘密切相关,与体型的关联较弱。非墨西哥裔男孩患哮喘的几率是墨西哥裔男孩的5.9倍[95%置信区间(CI):2.9 - 12.2];女孩中的可比优势比(OR)为1.8(95% CI:0.9 - 3.6)。体重与女孩哮喘相关[OR = 2.0(95% CI:1.1 - 3.7)],但与男孩哮喘无关[OR = 1.4(95% CI:0.8 - 2.6)]。
在我们的研究中,哮喘与体重和国籍之间的关联在不同性别儿童中具有性别特异性。我们的研究是首批按性别报告同一城市不同西班牙裔人群儿童哮喘情况的研究之一。