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婴儿期接触霉菌作为潜在哮喘发展的预测指标。

Mold exposure during infancy as a predictor of potential asthma development.

作者信息

Iossifova Yulia Y, Reponen Tiina, Ryan Patrick H, Levin Linda, Bernstein David I, Lockey James E, Hershey Gurjit K Khurana, Villareal Manuel, LeMasters Grace

机构信息

Department of Environmental Health, University of Cincinnati, Cincinnati, Ohio 45267-0056, USA.

出版信息

Ann Allergy Asthma Immunol. 2009 Feb;102(2):131-7. doi: 10.1016/S1081-1206(10)60243-8.

Abstract

BACKGROUND

Exposure to mold has been associated with exacerbation of asthma symptoms in children.

OBJECTIVE

To report how the presence of visible mold and exposure to (1-3)-beta-D-glucan in infancy affects the risk of asthma at the age of 3 years as defined by an Asthma Predictive Index (API).

METHODS

Visible mold was evaluated by means of home inspection. (1-3)-beta-D-glucan levels were measured in settled dust. Children were considered to be at high risk for asthma at later ages if they reported recurrent wheezing at the age of 3 years and met at least 1 of 3 major or 2 of 3 minor API criteria.

RESULTS

Children aged 3 years with high visible mold in the home during infancy were 7 times more likely to have a positive API than were those with no visible mold (adjusted odds ratio [aOR], 7.1; 95% confidence interval [CI], 2.2-12.6). In contrast, at low (1-3)-beta-D-glucan levels (< 22 microg/g), children were at increased risk of a positive API (aOR, 3.4; 95% CI, 0.5-23.5), whereas those with high (1-3)-beta-D-glucan levels (> 133 microg/g) were at decreased risk (aOR, 0.6; 95% CI, 0.2-1.6). Of the other covariates, mother's smoking was the strongest significant risk factor for the future development of asthma based on a positive API (aOR, 4.4; 95% CI, 1.7-11.6).

CONCLUSIONS

The presence of high visible mold and mother's smoking during infancy were the strongest risk factors for a positive API at the age of 3 years, suggesting an increased risk of asthma. High (1-3)-beta-D-glucan exposure seems to have an opposite effect on API than does visible mold.

摘要

背景

接触霉菌与儿童哮喘症状加重有关。

目的

报告婴儿期可见霉菌的存在以及接触(1-3)-β-D-葡聚糖如何影响3岁时根据哮喘预测指数(API)定义的哮喘风险。

方法

通过家庭检查评估可见霉菌。测量沉降灰尘中的(1-3)-β-D-葡聚糖水平。如果儿童在3岁时报告反复喘息且符合3项主要API标准中的至少1项或3项次要标准中的2项,则被认为在以后患哮喘的风险较高。

结果

婴儿期家中可见霉菌多的3岁儿童API呈阳性的可能性是家中无可见霉菌儿童的7倍(调整后的优势比[aOR],7.1;95%置信区间[CI],2.2-12.6)。相比之下,(1-3)-β-D-葡聚糖水平低(<22微克/克)的儿童API呈阳性的风险增加(aOR,3.4;95%CI,0.5-23.5),而(1-3)-β-D-葡聚糖水平高(>133微克/克)的儿童风险降低(aOR,0.6;95%CI,0.2-1.6)。在其他协变量中,基于API呈阳性,母亲吸烟是哮喘未来发展的最强显著风险因素(aOR,4.4;95%CI,1.7-11.6)。

结论

婴儿期可见霉菌多和母亲吸烟是3岁时API呈阳性的最强风险因素,提示哮喘风险增加。高(1-3)-β-D-葡聚糖暴露对API的影响似乎与可见霉菌相反。

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