Department of Family Medicine, Taipei Medical University Hospital, Taipei, Taiwan.
School of Nutrition and Health Sciences, College of Nutrition, Taipei Medical University, Taipei, Taiwan.
Allergy. 2020 Apr;75(4):892-900. doi: 10.1111/all.14009. Epub 2019 Aug 27.
Studies on early puberty and incident asthma have reported inconsistent results and are mainly performed in females. In this longitudinal study, we investigated the causal relationship between pubertal maturation and asthma through Mendelian randomization (MR) and explored the joint effect of overweightness and early pubertal maturation on asthma.
We used data from the Taiwan Children Health Study with longitudinal follow-ups of 2991 children aged 11-17 years. Six puberty-related single-nucleotide polymorphisms (combined into a weighted allelic score) were used to yield genetic instrumental variables for early puberty. Early pubertal maturation was defined as reaching a certain pubertal stage earlier than the median age for that stage. Incident asthma cases were calculated by excluding children with a history of asthma prior to that age.
The results of MR analysis revealed that early pubertal maturation was associated with active asthma (OR = 1.18; 95% CI: 1.08-1.28); this effect was significant in male children. Early pubertal maturation significantly increased the risk of incident asthma outcomes at 12 and 17 years of age in both sexes (hazard ratio = 2.15; 95% CI: 1.21-3.84). Taking non-overweight and non-early puberty children as the reference group, we observed a synergistic effect of overweightness and early pubertal maturation on asthma risk (OR = 1.08; 95% CI: 1.04-1.11) in children of both sexes.
Early screening and intervention for obesity are recommended to prevent future early pubertal onset and asthma occurrence.
关于青春期提前和哮喘发病的研究结果并不一致，且主要在女性中进行。在这项纵向研究中，我们通过孟德尔随机化（MR）研究了青春期提前与哮喘之间的因果关系，并探讨了超重和青春期提前对哮喘的共同作用。
我们使用了台湾儿童健康研究的数据，对 2991 名 11-17 岁的儿童进行了纵向随访。使用 6 个与青春期相关的单核苷酸多态性（组合成加权等位基因评分）作为青春期提前的遗传工具变量。青春期提前被定义为达到特定的青春期阶段早于该阶段的中位数年龄。通过排除在该年龄之前患有哮喘的儿童，计算哮喘发病的病例。
MR 分析结果表明，青春期提前与活跃性哮喘有关（OR=1.18；95%CI：1.08-1.28）；这种影响在男性儿童中更为显著。青春期提前显著增加了男女儿童在 12 岁和 17 岁时哮喘发病的风险（危险比=2.15；95%CI：1.21-3.84）。以非超重和非青春期提前的儿童为参照组，我们观察到超重和青春期提前对哮喘风险的协同作用（OR=1.08；95%CI：1.04-1.11）在男女儿童中均存在。
建议对肥胖症进行早期筛查和干预，以预防未来青春期提前和哮喘的发生。
