Division of Allergy, Department of Medical Subspecialties, National Center for Child Health and Development, Tokyo, Japan.
Medical Support Center for Japan Environment and Children's Study (JECS), National Center for Child Health and Development, Tokyo, Japan.
Pediatr Allergy Immunol. 2018 Sep;29(6):606-611. doi: 10.1111/pai.12917. Epub 2018 Jun 5.
Exploring patterns of childhood wheeze may help to clarify the etiology and prognosis of respiratory diseases. The purpose of this study was to classify phenotypes of wheezing in children up to 9 years of age in Japan and to evaluate the individual and environmental risk factors for these phenotypes.
Wheeze was evaluated at approximately 1-year intervals based on the mothers' recollection of their child's wheezing or whistling in the chest during the preceding 12 months. The children were aged 1-9 years. In total, 1116 children who had at least five measures of wheezing at all nine time points were used for identifying trajectories. Trajectories were identified with group-based trajectory analysis. A multinomial logit model was built to evaluate the relationships between phenotypes and risk factors.
Five typical trajectories were identified. The probability of group membership was 43.7%, 32.2%, 6.2%, 8.6%, and 9.2% for the never/infrequent wheeze, transient early wheeze, school-age-onset wheeze, early-childhood-onset remitting wheeze, and persistent wheeze trajectories, respectively. Infant tobacco exposure increased the odds of membership in the transient early wheeze trajectory compared to the never/infrequent wheeze trajectory.
Using the group-based trajectory modeling approach, we identified five trajectories of childhood wheeze development in a Japanese population. The trajectories shown here are based on formal statistical modeling rather than on subjective classification, and an assessment of its precision suggested that the model has high assignment accuracy.
探索儿童喘息模式有助于阐明呼吸道疾病的病因和预后。本研究的目的是对日本 1 至 9 岁儿童喘息的表型进行分类，并评估这些表型的个体和环境危险因素。
根据母亲回忆孩子在过去 12 个月中胸部是否有喘息或哮鸣，在大约 1 年的时间间隔内评估喘息。儿童年龄在 1 至 9 岁之间。共有 1116 名儿童在所有 9 个时间点至少有 5 次喘息测量，用于识别轨迹。使用基于群组的轨迹分析识别轨迹。建立多变量逻辑回归模型来评估表型与危险因素之间的关系。
确定了 5 种典型的轨迹。从未/偶发喘息、短暂性早期喘息、学龄期喘息、儿童早期缓解性喘息和持续性喘息轨迹的分组概率分别为 43.7%、32.2%、6.2%、8.6%和 9.2%。婴儿期烟草暴露使进入短暂性早期喘息轨迹的几率与从未/偶发喘息轨迹相比增加。
使用基于群组的轨迹建模方法，我们在日本人群中确定了 5 种儿童喘息发展轨迹。这里显示的轨迹是基于正式的统计建模，而不是基于主观分类，对其精度的评估表明该模型具有较高的分配准确性。
