Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, 90033, USA.
Am J Respir Crit Care Med. 2011 Mar 1;183(5):596-603. doi: 10.1164/rccm.200912-1863OC. Epub 2010 Oct 1.
The impact of asthma on chronic lung function deficits is well known. However, there has been little study of ethnic differences in these asthma-associated deficits.
To examine whether there are ethnic differences in the effects of asthma on children's lung function.
We evaluated the impact of asthma on lung function in 3,245 Hispanic and non-Hispanic white school children (age 10-18 yr) in a longitudinal analysis of the Southern California Children's Health Study. Sex-specific mixed-effects regression spline models were fitted separately for each ethnic group.
Large deficits in flows were observed among children with asthma diagnosed before age 4 years regardless of ethnicity. Hispanic girls with asthma had greater deficits in flows than non-Hispanic girls and were largest for maximal midexpiratory flow (-5.13% compared with -0.58%, respectively). A bigger impact of asthma in Hispanic girls was also found for FEV(1), FEF(75), and PEF (P value 0.04, 0.07, and 0.005, respectively). These ethnic differences were limited to girls diagnosed after age 4 years. In boys, asthma was also associated with greater deficits in flows among Hispanic than in non-Hispanic white children (differences that were not statistically significant). Ethnic differences in prevalence of pets and pests in the home, health insurance coverage, parental education, and smoking did not explain the pattern of lung function differences.
Larger asthma-associated lung function deficits in Hispanics, especially among girls, merit further investigation to determine public health implications and to identify causes amenable to intervention.
哮喘对慢性肺功能损害的影响是众所周知的。然而,对于哮喘相关损害在不同种族人群中的差异,研究甚少。
探讨哮喘对儿童肺功能的影响是否存在种族差异。
我们对参加南加州儿童健康研究的 3245 名西班牙裔和非西班牙裔白人学龄儿童(10-18 岁)进行了纵向分析,评估了哮喘对儿童肺功能的影响。对每个种族群体分别采用性别特异性混合效应回归样条模型进行分析。
无论种族如何,在 4 岁前被诊断为哮喘的儿童中,其流量均存在明显的较大损害。患有哮喘的西班牙裔女孩比非西班牙裔女孩的流量损害更大,最大中期呼气流量的损害最大(-5.13%比-0.58%)。在 FEV1、FEF75 和 PEF 方面,哮喘对西班牙裔女孩的影响也更大(P 值分别为 0.04、0.07 和 0.005)。这些种族差异仅局限于 4 岁后被诊断为哮喘的女孩。在男孩中,与非西班牙裔白人儿童相比,患有哮喘的西班牙裔男孩的流量也有更大的损害(差异无统计学意义)。家庭中宠物和害虫的存在、健康保险的覆盖范围、父母的教育程度和吸烟情况等因素的差异并不能解释肺功能差异的模式。
西班牙裔人群中,尤其是女孩,哮喘相关的肺功能损害更大,需要进一步调查以确定其对公共卫生的影响,并确定可干预的病因。