Instituto de Saúde Coletiva, Universidade Federal da Bahia, Salvador, Brazil.
Respir Res. 2010 Dec 1;11(1):167. doi: 10.1186/1465-9921-11-167.
The causation of asthma is poorly understood. Risk factors for atopic and non-atopic asthma may be different. This study aimed to analyze the associations between markers of poverty, dirt and infections and wheezing in atopic and non-atopic children.
1445 children were recruited from a population-based cohort in Salvador, Brazil. Wheezing was assessed using the ISAAC questionnaire and atopy defined as allergen-specific IgE ≥ 0.70 kU/L. Relevant social factors, environmental exposures and serological markers for childhood infections were investigated as risk factors using multivariate multinomial logistic regression.
Common risk factors for wheezing in atopic and non-atopic children, respectively, were parental asthma and respiratory infection in early childhood. No other factor was associated with wheezing in atopic children. Factors associated with wheezing in non-atopics were low maternal educational level (OR 1.49, 95% CI 0.98-2.38), low frequency of room cleaning (OR 2.49, 95% CI 1.27-4.90), presence of rodents in the house (OR 1.48, 95% CI 1.06-2.09), and day care attendance (OR 1.52, 95% CI 1.01-2.29).
Non-atopic wheezing was associated with risk factors indicative of poverty, dirt and infections. Further research is required to more precisely define the mediating exposures and the mechanisms by which they may cause non-atopic wheeze.
哮喘的病因尚不清楚。特应性和非特应性哮喘的危险因素可能不同。本研究旨在分析贫困、污垢和感染标志物与特应性和非特应性儿童喘息之间的关系。
本研究从巴西萨尔瓦多的一项基于人群的队列中招募了 1445 名儿童。使用 ISAAC 问卷评估喘息情况，特应性定义为过敏原特异性 IgE≥0.70 kU/L。使用多变量多项逻辑回归分析了相关社会因素、环境暴露和儿童期感染的血清学标志物作为危险因素。
特应性和非特应性儿童喘息的共同危险因素分别为父母哮喘和幼儿期呼吸道感染。没有其他因素与特应性儿童的喘息有关。与非特应性喘息相关的因素包括母亲教育水平低（OR 1.49，95%CI 0.98-2.38）、房间清洁频率低（OR 2.49，95%CI 1.27-4.90）、家中有啮齿动物（OR 1.48，95%CI 1.06-2.09）和日托出勤率高（OR 1.52，95%CI 1.01-2.29）。
非特应性喘息与贫困、污垢和感染的危险因素有关。需要进一步研究以更准确地定义介导因素及其引起非特应性喘息的机制。
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