Rönmark Erik P, Ekerljung Linda, Mincheva Roxana, Sjölander Sigrid, Hagstad Stig, Wennergren Göran, Rönmark Eva, Lötvall Jan, Lundbäck Bo
Department of Internal Medicine, Krefting Research Centre, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Box 424, 405 30 Gothenburg, Sweden.
ThermoFisher Scientific, Uppsala, Sweden.
Clin Transl Allergy. 2016 Aug 4;6:28. doi: 10.1186/s13601-016-0112-0. eCollection 2016.
Atopic diseases including asthma, rhinitis and eczema have increased in the second half of the past century. This has been well studied among children and adolescents but with the exception of asthma to a much lesser extent in adults. The adult risk factor pattern of atopic diseases, in particular of eczema, and their relation to allergic sensitization are yet to be fully elucidated. Studies among adults that have compared the risk factor pattern for these conditions in the same material are very few. The objective of this study was to compare the risk factor patterns for asthma, rhinitis and eczema in a randomly selected adult population.
A questionnaire survey on atopic diseases was dispatched by mail to 30,000 randomly selected individuals in West Sweden aged 16-75 years and 62 % participated. A subgroup of 2000 individuals was selected for clinical examinations including blood sampling for specific serum Immunoglobulin E to common airborne allergens and 1172 attended.
The prevalence of current asthma was 11.8 %, current rhinitis 42.8 %, current eczema 13.5 and 2.3 % had all three conditions while 13.9 % had at least two conditions. No mutual risk factor was identified for all three conditions. Allergic sensitization was a strong risk factor for current asthma (OR 4.1 CI 2.7-6.3) and current rhinitis (OR 5.1 CI 3.8-6.9) but not so for current eczema. Obesity was a risk factor for current asthma and current rhinitis, while farm childhood decreased the risk for current asthma and current rhinitis. Occupational exposure to gas dust or fumes and female sex was associated with an increased risk of current asthma and current eczema.
There are different risk factor patterns for asthma, rhinitis and eczema in adults but some risk factors are overlapping between some of the conditions. The effect of mutable risk factors should be assessed further in longitudinal studies.
包括哮喘、鼻炎和湿疹在内的特应性疾病在过去世纪后半叶有所增加。这在儿童和青少年中已有充分研究，但除哮喘外，在成人中的研究程度要低得多。特应性疾病，尤其是湿疹的成人风险因素模式及其与过敏致敏的关系尚待充分阐明。在成人中，对这些疾病的风险因素模式进行相同材料比较的研究非常少。本研究的目的是比较随机选择的成年人群中哮喘、鼻炎和湿疹的风险因素模式。
通过邮件向瑞典西部30000名年龄在16 - 75岁的随机选择个体发放关于特应性疾病的问卷调查，62%的人参与了调查。从2000名个体中选取一个亚组进行临床检查，包括采集血液样本检测针对常见空气传播过敏原的特异性血清免疫球蛋白E，1172人参加了检查。
当前哮喘的患病率为11.8%，当前鼻炎为42.8%，当前湿疹为13.5%，2.3%的人三种疾病都有，而13.9%的人至少有两种疾病。未发现所有三种疾病的共同风险因素。过敏致敏是当前哮喘（比值比4.1，可信区间2.7 - 6.3）和当前鼻炎（比值比5.1，可信区间3.8 - 6.9）的强风险因素，但对当前湿疹并非如此。肥胖是当前哮喘和当前鼻炎的风险因素，而童年时期在农场生活可降低当前哮喘和当前鼻炎的风险。职业性接触气体、粉尘或烟雾以及女性性别与当前哮喘和当前湿疹的风险增加有关。
成人哮喘、鼻炎和湿疹存在不同的风险因素模式，但某些风险因素在部分疾病之间存在重叠。可变风险因素的影响应在纵向研究中进一步评估。
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