Centre for Research in Environmental Epidemiology (CREAL), Barcelona.
Allergy. 2010 Aug;65(8):1021-30. doi: 10.1111/j.1398-9995.2009.02301.x. Epub 2010 Feb 4.
The occurrence of new-onset asthma during adulthood is common, but there is insufficient understanding of its determinants including the role of atopy.
To assess the risk factors for the development of new-onset asthma in middle-aged adults and to compare them according to atopy.
A longitudinal analysis of 9175 young adults who participated in two surveys of the European Community Respiratory Health Survey (ECRHS) conducted 9 years apart.
We observed 179 cases of new-onset asthma among 4588 participants who were free of asthma and reported at the beginning of the follow-up that they had never had asthma (4.5 per 1000 person-years). In a logistic regression, the following risk factors were found to increase the risk of new-onset asthma: female gender (OR: 1.97; 95% confidence interval (CI): 1.38, 2.81), bronchial hyperresponsiveness (3.25; 2.19, 4.83), atopy (1.55; 1.08, 2.21), FEV(1) < 100 % predicted (1.87; 1.34, 2.62), nasal allergy (1.98;1.39,2.84) and maternal asthma (1.91; 1.13; 3.21). Obesity, respiratory infections in early life and high-risk occupations increased the risk of new-onset asthma although we had limited power to confirm their role. Among the atopics, total IgE and sensitization to cat were independently related to the risk of new-onset asthma. The proportion of new-onset asthma attributable to atopy varied from 12% to 21%.
Adults reporting that they had never had asthma were at a substantial risk of new-onset asthma as a result of multiple independent risk factors including lung function. Atopy explains a small proportion of new-onset adult asthma.
成年人新发生哮喘较为常见，但对其决定因素（包括特应性的作用）的了解不足。
评估中年成人新发哮喘的危险因素，并根据特应性对其进行比较。
对参加欧洲社区呼吸健康调查（ECRHS）的 9175 名年轻人进行的一项纵向分析，该调查在 9 年中进行了两次。
在随访开始时报告从未患过哮喘且无哮喘的 4588 名参与者中，我们观察到 179 例新发生的哮喘（每 1000 人年 4.5 例）。在逻辑回归中，发现以下危险因素会增加新发生哮喘的风险：女性（OR：1.97；95%置信区间（CI）：1.38，2.81）、支气管高反应性（3.25；2.19，4.83）、特应性（1.55；1.08，2.21）、FEV1<100%预计值（1.87；1.34，2.62）、鼻过敏（1.98；1.39，2.84）和母亲哮喘（1.91；1.13；3.21）。肥胖、生命早期呼吸道感染和高危职业虽然我们没有足够的能力证实其作用，但增加了新发生哮喘的风险。在特应性患者中，总 IgE 和对猫的过敏与新发哮喘的风险独立相关。特应性导致新发生成人哮喘的比例为 12%至 21%。
报告从未患过哮喘的成年人由于多种独立的危险因素（包括肺功能）而存在发生新发生哮喘的较大风险。特应性解释了一小部分新发生的成人哮喘。
