Haartman Institute, Medicum, University of Helsinki, Helsinki, Finland.
Skin and Allergy Hospital, Helsinki University Hospital and University of Helsinki, Helsinki, Finland.
Allergy. 2019 Dec;74(12):2406-2416. doi: 10.1111/all.13971. Epub 2019 Jul 24.
The aim was to study the association between allergic multimorbidity and adult-onset asthma considering the number of allergic diseases and the age effect.
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.
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).
Adult-onset asthma was positively associated with the number of allergic diseases, and this association decreases with age.
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。
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。
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)。
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。