Unit for Occupational and Environmental Epidemiology and Net Teaching, Institute and Outpatient Clinic for Occupational, Social and Environmental Medicine, University Hospital of Munich LMU, Munich, Germany.
J Allergy Clin Immunol. 2010 Sep;126(3):590-5.e1-3. doi: 10.1016/j.jaci.2010.06.020.
Although it is known that atopic dermatitis (AD) can develop during adolescence, research on its course and predictors in this age group is thus far limited.
We aimed to describe the course of AD over puberty and prospectively determine risk factors for the incidence, recurrence, and persistence of AD until adolescence in a population-based cohort study.
German participants of the International Study of Asthma and Allergies in Childhood Phase II were followed prospectively. The final dataset comprised 2857 adolescents, of whom 2433 were unaffected by AD at baseline. Bivariate and multivariate prediction models for the incidence, recurrence, and persistence of AD using early-life factors, family history of atopic diseases, and job history as predictors were developed.
The incidence of AD between ages 9 to 11 and 16 to 20 years was 1.7%, and recurrence was 2.4%. AD persisted in 47.6% of adolescents with AD symptoms at baseline (n = 424). High socioeconomic status, female sex, asthma symptoms and a positive skin prick test response at baseline, parental history of rhinitis/AD, and having worked in a high-risk job were significant predictors for the course of disease. With all the factors present, the probability of the incidence of AD was 21.4% (95% CI, 1.8% to 80.2%) and increased up to 81.7% (95% CI, 47.0% to 95.8%) for recurrence of AD and 87.6% (95% CI, 63.4% to 96.6%) for persistence of AD among those affected by AD. Early-life exposures did not predict the course of AD over puberty.
Genetic factors, early allergen sensitization, and having worked in a high-risk job seem to be more important for disease development in late adolescence than other early-life exposures.
尽管已知特应性皮炎（AD）可在青春期发生，但目前针对该年龄段 AD 病程及其预测因素的研究仍十分有限。
我们旨在描述青春期 AD 的病程，并在一项基于人群的队列研究中前瞻性确定 AD 在青春期前发病、复发和持续的风险因素。
德国国际儿童哮喘和过敏研究 II 期参与者进行前瞻性随访。最终数据集包含 2857 名青少年，其中 2433 名基线时无 AD。采用生命早期因素、特应性疾病家族史和职业史作为预测因素，建立用于预测 AD 发病、复发和持续的双变量和多变量预测模型。
9 至 11 岁和 16 至 20 岁之间 AD 的发病率为 1.7%，复发率为 2.4%。在基线时有 AD 症状的青少年中，47.6%（n=424）AD 持续存在。高社会经济地位、女性、哮喘症状和基线时皮肤点刺试验阳性反应、父母有鼻炎/AD 病史以及从事高风险职业，是疾病病程的显著预测因素。在所有因素存在的情况下，AD 发病的概率为 21.4%（95%CI，1.8%至 80.2%），AD 复发的概率增加至 81.7%（95%CI，47.0%至 95.8%），AD 持续的概率增加至 87.6%（95%CI，63.4%至 96.6%）。生命早期暴露因素不能预测青春期 AD 的病程。
遗传因素、早期变应原致敏和从事高风险职业，似乎比其他生命早期暴露因素对青少年晚期疾病的发生发展更为重要。
