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成年起病哮喘的风险随过敏多种共病的数量增加而升高,随年龄增长而降低。

Risk of adult-onset asthma increases with the number of allergic multimorbidities and decreases with age.

机构信息

Haartman Institute, Medicum, University of Helsinki, Helsinki, Finland.

Skin and Allergy Hospital, Helsinki University Hospital and University of Helsinki, Helsinki, Finland.

出版信息

Allergy. 2019 Dec;74(12):2406-2416. doi: 10.1111/all.13971. Epub 2019 Jul 24.

Abstract

BACKGROUND

The aim was to study the association between allergic multimorbidity and adult-onset asthma considering the number of allergic diseases and the age effect.

METHODS

We used population-based data from Finnish national registers including 1205 adults over 30 years of age with recently diagnosed asthma (age range: 30-93), matched for gender, age, and living region with one or two controls (n = 2050). Allergic rhinitis (AR), allergic conjunctivitis (AC), and allergic dermatitis (AD) were defined from self-completed questionnaire. Conditional logistic regression adjusted on potential confounders (smoking, growing in countryside, childhood hospitalized infection/pneumonia, parental asthma/allergy, parental smoking, education level, professional training, number of siblings, and birth order) was applied to estimate the asthma risk associated with allergic multimorbidity.

RESULTS

A total of 1118 cases with asthma and 1772 matched controls were included [mean (SD, min-max) 53 (11, 31-71) years, 37% men)]. AR, AC, and AD were reported by 50.2%, 39.6%, and 33.8%, respectively, among subjects with asthma and 26.1%, 20.0%, and 23.5%, respectively, among controls. Compared to nonatopics, adult-onset asthma increased with the number of allergic diseases; adjusted OR for asthma [95% CI] associated with 1, 2, and 3 allergic diseases was 1.95 [1.52-2.49], 2.87 [2.19-3.77], and 4.26 [3.07-5.90], respectively. The association between adult-onset asthma and ≥ 1 allergic multimorbidity decreased with increasing age (3.52 [2.51-4.94], 2.44 [1.74-3.42], and 1.68 [1.04-2.71]) in subjects < 50 years, 50-62 years, and > 62 years, respectively (p for age*≥1 allergic multimorbidity interaction, 0.002).

CONCLUSIONS

Adult-onset asthma was positively associated with the number of allergic diseases, and this association decreases with age.

摘要

背景

本研究旨在探讨考虑到过敏疾病数量和年龄效应时,过敏多种疾病与成人发病哮喘之间的关联。

方法

我们使用来自芬兰国家登记处的基于人群的数据,该数据包括 1205 名年龄在 30 岁以上(年龄范围:30-93 岁)的近期诊断为哮喘的成年人(n=1205),并按性别、年龄和居住地区与一名或两名对照者相匹配(n=2050)。过敏性鼻炎(AR)、过敏性结膜炎(AC)和过敏性皮炎(AD)通过自填问卷确定。在调整了潜在混杂因素(吸烟、在农村长大、儿童期住院感染/肺炎、父母哮喘/过敏、父母吸烟、教育程度、职业培训、兄弟姐妹数量和出生顺序)后,应用条件逻辑回归来估计与过敏多种疾病相关的哮喘风险。

结果

共纳入 1118 例哮喘病例和 1772 名匹配对照者[平均(SD,最小-最大)53(11,31-71)岁,37%为男性]。哮喘患者中分别有 50.2%、39.6%和 33.8%报告有 AR、AC 和 AD,而对照者中分别有 26.1%、20.0%和 23.5%。与非特应性者相比,成人发病哮喘随过敏疾病数量的增加而增加;与无过敏疾病者相比,与 1、2 和 3 种过敏疾病相关的哮喘的调整 OR(95%CI)分别为 1.95(1.52-2.49)、2.87(2.19-3.77)和 4.26(3.07-5.90)。在年龄<50 岁、50-62 岁和>62 岁的患者中,成人发病哮喘与≥1 种过敏多种疾病之间的关联随着年龄的增长而降低(分别为 3.52[2.51-4.94]、2.44[1.74-3.42]和 1.68[1.04-2.71])(p 值为年龄*≥1 种过敏多种疾病交互作用,0.002)。

结论

成人发病哮喘与过敏疾病数量呈正相关,且该关联随年龄增长而降低。

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