MEGA Epidemiology, University of Melbourne, Melbourne, Australia.
J Allergy Clin Immunol. 2011 Oct;128(4):816-823.e5. doi: 10.1016/j.jaci.2011.05.039. Epub 2011 Jul 12.
Rhinitis is an increasingly common condition with a heavy health care burden, but relatively little is known about its risk factors.
To examine the association between early-life factors and the development of rhinitis in the European Community Respiratory Health Study (ECRHS).
In 1992-1994, community-based samples of 20-44-year-old people were recruited from 48 centers in 22 countries. On average, 8.9 years later, 28 centers reinvestigated their samples. Onset of rhinitis was reported by 8486 participants in interviewer-led questionnaires. Cox regression was used to assess independent predictors of rhinitis at ages ≤5, 6-10, 11-20, and ≥21 years.
The crude lifelong incidence of rhinitis was 7.00/1000/year (men) and 7.95/1000/year (women) (P = .002). Women developed less rhinitis in later childhood (hazard ratios [HR], 0.63; 95% CI, 0.47-0.85) and more rhinitis in adulthood (HR, 1.36; 95% CI, 1.11-1.66) than did men. In atopic subjects, siblings were associated with lower risk of rhinitis throughout life (pooled HR, 0.94; 95% CI, 0.91-0.98 per 1 sibling). Early contact with children in the family or day care was associated with less incidence of rhinitis, predominantly before age 5 years (HR, 0.84; 95% CI, 0.72-0.99). Early childhood pets or growing up on a farm was associated with less incidence of rhinitis in adolescence (HR, 0.50; 95% CI, 0.37-0.68). Combining these factors showed evidence of a dose-response relationship (trend P = .0001).
Gender is a strong risk factor for rhinitis, with age patterns varying according to atopic status. Protective effects of early contact with children and animals were suggested for incident rhinitis, with risk patterns varying by age window and atopic status.
鼻炎是一种越来越常见的疾病，给医疗保健带来了沉重的负担，但人们对其危险因素知之甚少。
在欧洲社区呼吸健康研究（ECRHS）中研究生命早期因素与鼻炎发展之间的关系。
1992-1994 年，在 22 个国家的 48 个中心招募了 20-44 岁的社区样本。平均 8.9 年后，28 个中心对其样本进行了重新调查。在采访者主导的问卷中，8486 名参与者报告了鼻炎的发病情况。Cox 回归用于评估≤5 岁、6-10 岁、11-20 岁和≥21 岁时鼻炎的独立预测因素。
鼻炎的终生粗发生率为 7.00/1000/年（男性）和 7.95/1000/年（女性）（P<.002）。女性在童年后期患鼻炎的几率较低（危险比[HR]，0.63；95%可信区间，0.47-0.85），成年后患鼻炎的几率较高（HR，1.36；95%可信区间，1.11-1.66）。在特应性患者中，兄弟姐妹的存在与终生患鼻炎的风险较低有关（汇总 HR，每增加 1 个兄弟姐妹，0.94；95%可信区间，0.91-0.98）。家庭或日托中与儿童的早期接触与鼻炎发病率较低有关，主要是在 5 岁之前（HR，0.84；95%可信区间，0.72-0.99）。儿童早期宠物或在农场长大与青春期鼻炎发病率较低有关（HR，0.50；95%可信区间，0.37-0.68）。综合这些因素表明存在剂量反应关系（趋势 P<.0001）。
性别是鼻炎的一个强烈危险因素，其发病模式因特应性状态而异。早期与儿童和动物接触的保护作用被认为可预防鼻炎的发生，其风险模式因年龄窗和特应性状态而异。
