Pinart Mariona, Keller Theresa, Reich Andreas, Fröhlich Matthias, Cabieses Báltica, Hohmann Cynthia, Postma Dirkje S, Bousquet Jean, Antó Josep M, Keil Thomas
ISGlobal, Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain.
Int Arch Allergy Immunol. 2017;172(4):224-235. doi: 10.1159/000464324. Epub 2017 Apr 29.
A sex-related switch in the prevalence of asthma from childhood (male predominance) to adulthood (female predominance) has been described, but for allergic rhinitis this remains unclear. We aimed to examine sex- and age-group-specific differences in allergic rhinitis prevalence by systematically evaluating studies from across the globe.
A systematic search of MEDLINE and Embase for population-based cross-sectional studies was performed regardless of the language of publication. The search was restricted to the present millennium (2000 to June 2014). Study quality was defined by the sampling method, response rate, sample size, and data collection method. To assess sex differences in the prevalence of self- or parent-reported symptoms of rhinitis, calculated pooled estimates of the male-female ratio (MFR) were obtained using random-effects model meta-analyses due to heterogeneity. A meta-regression analysis was also performed.
Out of 6,539 publications identified, 67 cross-sectional population-based studies (291,726 males and 301,781 females) were included in our meta-analysis. In children (<11 years of age) significantly more boys than girls had rhinitis symptoms (MFR 1.21, 95% CI 1.17-1.25), whereas in adolescents (11 to <18 years of age) males were significantly less often affected than females (MFR 0.90, 95% CI 0.85-0.95). No sex-specific prevalence difference was observed in adults (MFR 0.96, 95% CI 0.83-1.17). These findings were consistent in all continents except in Asia, where the male predominance remained beyond childhood.
The male predominance of rhinitis prevalence in childhood changed towards a female predominance in adolescence across the globe, except in Asia. Longitudinal studies are needed to confirm these cross-sectional data and examine possible determinants and underlying mechanisms.
已有研究描述了哮喘患病率从儿童期（男性居多）到成年期（女性居多）的性别相关转变，但过敏性鼻炎的情况仍不清楚。我们旨在通过系统评估全球范围内的研究，探讨过敏性鼻炎患病率的性别和年龄组特异性差异。
对MEDLINE和Embase进行系统检索，查找基于人群的横断面研究，不限出版物语言。检索限于当前千年（2000年至2014年6月）。研究质量由抽样方法、应答率、样本量和数据收集方法定义。为评估自我报告或家长报告的鼻炎症状患病率的性别差异，由于存在异质性，使用随机效应模型荟萃分析获得男性与女性比例（MFR）的合并估计值。还进行了荟萃回归分析。
在识别出的6539篇出版物中，67项基于人群的横断面研究（291726名男性和301781名女性）纳入我们的荟萃分析。在儿童（<11岁）中，患鼻炎症状的男孩显著多于女孩（MFR 1.21，95%CI 1.17 - 1.25），而在青少年（11至<18岁）中，男性受影响的频率显著低于女性（MFR 0.90，95%CI 0.85 - 0.95）。在成年人中未观察到性别特异性患病率差异（MFR 0.96，95%CI 0.83 - 1.17）。除亚洲外，所有大陆的这些结果均一致，在亚洲，男性优势在儿童期之后仍然存在。
除亚洲外，全球范围内儿童期鼻炎患病率的男性优势在青少年期转变为女性优势。需要进行纵向研究以证实这些横断面数据，并研究可能的决定因素和潜在机制。
