Faculty of Medicine, Hacettepe University, Ankara, Turkey.
Pediatr Pulmonol. 2011 Feb;46(2):166-74. doi: 10.1002/ppul.21346. Epub 2010 Nov 23.
Accumulating evidence suggests, asthma includes many phenotypes with varying clinical and prognostic features. Epidemiological surveys documented a number of environmental risk factors for the development of asthma and interestingly these differ between and within countries, suggesting that the differences may be related with the different distribution of asthma phenotypes. This study aimed to investigate risk factors of current wheezing (CW) and different wheezing phenotypes in elementary school children.
Six thousand nine hundred sixty-three 9- to 11-year-old children of a previous multicenter survey where the methodology of the International Study of Asthma and Allergies in Childhood (ISAAC) Phase-II was used were analyzed. Wheezing phenotypes were defined as wheezing with rhinitis (RW), wheezing with rhinoconjunctivitis (RCW), atopic wheezing (AW), non-atopic wheezing (NAW), and frequent wheezing (FW) (≥4/year wheezing episodes).
The prevalence of CW was 15.8% and among these, 22.4%, 67.3%, 45.9%, 20.5%, and 79.5% were classified as FW, RW, RCW, AW, and NAW, respectively. History of parental asthma/allergic rhinitis, coexistence of other allergic diseases, presence of mold and dampness in the house lived during the first year of life and maternal smoking in pregnancy were found to be risk factors for most phenotypes (odds ratio (OR) ranged from 1.43 to 3.56). Number of household in the last year (OR = 1.14), prematurity (OR = 2.08), and duration of breastfeeding (OR = 1.02) per additional month were found to be risk factor for FW, AW, and RCW, respectively.
Beside common risk factors for the development of asthma and its phenotypes, certain risk factors appeared to play a role in the development of phenotypic characteristics of asthma. These findings support our hypothesis that each phenotype has not only different clinical characteristics but also has different roots.
越来越多的证据表明，哮喘包括许多具有不同临床和预后特征的表型。流行病学调查记录了许多哮喘发展的环境危险因素，有趣的是，这些危险因素在国家之间和国家内部都有所不同，这表明差异可能与哮喘表型的不同分布有关。本研究旨在探讨小学生当前喘息（CW）和不同喘息表型的危险因素。
对先前多中心调查的 6963 名 9-11 岁儿童进行分析，该调查采用了国际儿童哮喘和过敏研究（ISAAC）第二期的方法。喘息表型定义为伴有鼻炎的喘息（RW）、伴有鼻结膜炎的喘息（RCW）、特应性喘息（AW）、非特应性喘息（NAW）和频繁喘息（FW）（≥4/年喘息发作）。
CW 的患病率为 15.8%，其中 22.4%、67.3%、45.9%、20.5%和 79.5%分别归类为 FW、RW、RCW、AW 和 NAW。父母哮喘/过敏性鼻炎史、其他过敏性疾病共存、生命第一年居住房屋存在霉菌和潮湿以及孕期母亲吸烟被认为是大多数表型的危险因素（比值比（OR）范围为 1.43 至 3.56）。过去一年家庭数量（OR=1.14）、早产（OR=2.08）和母乳喂养时间（OR=1.02）每增加一个月分别被认为是 FW、AW 和 RCW 的危险因素。
除了哮喘及其表型发展的常见危险因素外，某些危险因素似乎在哮喘表型特征的发展中发挥作用。这些发现支持我们的假设，即每种表型不仅具有不同的临床特征，而且具有不同的根源。
