Patel Bhavisha, Wi Chung-Il, Hasassri M Earth, Divekar Rohit, Absah Imad, Almallouhi Eyad, Ryu Euijung, King Katherine, Juhn Young J
Allergy Asthma Proc. 2018 Jan 1;39(1):51-58. doi: 10.2500/aap.2018.39.4100.
Although human leukocyte antigen (HLA)-DR and HLA-DQ genes and gluten play crucial roles in developing celiac disease (CD), most patients with these risk factors still do not develop CD, which indicates additional unrecognized risk factors.
To determine the association between asthma and the risk of CD in children.
We conducted a population-based retrospective case-control study in children who resided in Olmsted County, Minnesota. We identified children with CD (cases) between January 1, 1997, and December 31, 2014, and compared these with children without CD (controls) (1:2 matching). Asthma status was ascertained by using the predetermined asthma criteria (PAC) and the asthma predictive index (API). Data analysis included conditional logistic regression models and an unsupervised network analysis by using an independent phenome-wide association scan (PheWAS) data set.
Although asthma status as determined by using PAC was not associated with the risk of CD (odds ratio [OR] 1.4 [95% confidence interval {CI}, 0.8-2.5]; p = 0.2), asthma status by using the API was significantly associated (OR 2.8 [95% CI, 1.3-6.0]; p = 0.008). A subgroup analysis indicated that children with both asthma as determined by using PAC and a family history of asthma had an increased risk of CD compared with those without asthma (OR 2.28 [95% CI, 1.11-4.67]; p = 0.024). PheWAS data showed a cluster of asthma single nucleotide polymorphisms and patients with CD.
A subgroup of children with asthma who also had a family history of asthma seemed to be at an increased risk of CD, and, thus, the third factor that underlies the risk of CD might be related to genetic factors for asthma. Heterogeneity of asthma plays a role in determining the risk of asthma-related comorbidity.
尽管人类白细胞抗原（HLA）-DR和HLA-DQ基因以及麸质在乳糜泻（CD）的发生发展中起关键作用，但大多数具有这些风险因素的患者仍未患上CD，这表明存在其他未被认识到的风险因素。
确定儿童哮喘与CD风险之间的关联。
我们在明尼苏达州奥尔姆斯特德县居住的儿童中进行了一项基于人群的回顾性病例对照研究。我们确定了1997年1月1日至2014年12月31日期间患有CD的儿童（病例），并将其与未患CD的儿童（对照）进行比较（1:2匹配）。通过使用预先确定的哮喘标准（PAC）和哮喘预测指数（API）来确定哮喘状态。数据分析包括条件逻辑回归模型和使用独立的全表型关联扫描（PheWAS）数据集进行的无监督网络分析。
尽管使用PAC确定的哮喘状态与CD风险无关（优势比[OR]为1.4[95%置信区间{CI}，0.8-2.5]；p = 0.2），但使用API确定的哮喘状态与CD显著相关（OR为2.8[95%CI，1.3-6.0]；p = 0.008）。亚组分析表明，与没有哮喘的儿童相比，使用PAC确定患有哮喘且有哮喘家族史的儿童患CD的风险增加（OR为2.28[95%CI，1.11-4.67]；p = 0.024）。PheWAS数据显示哮喘单核苷酸多态性与CD患者存在聚集。
有哮喘家族史的哮喘儿童亚组似乎患CD的风险增加，因此，CD风险的第三个潜在因素可能与哮喘的遗传因素有关。哮喘的异质性在确定哮喘相关合并症的风险中起作用。
