Tohidinik Hamid Reza, Mallah Narmeen, Takkouche Bahi
HIV/STI Surveillance Research Center, WHO Collaborating Center for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran.
Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.
World Allergy Organ J. 2019 Oct 17;12(10):100069. doi: 10.1016/j.waojou.2019.100069. eCollection 2019 Oct.
Allergic rhinitis has been suspected to be a risk factor for asthma in several studies but this association is not firmly established. The objective of this study was to synthesize the evidence of the association between allergic rhinitis and the risk of asthma through a systematic review and meta-analysis.
We performed a search in Medline, Scopus, ISI Proceedings databases and other databases from inception until February 2019, followed by manual search to identify potentially relevant case-control and cohort studies that reported relative risk estimates and confidence intervals of the association between allergic rhinitis and asthma. Cross-sectional studies were excluded. Pooled odds ratios (ORs) and 95% confidence intervals (CIs) were calculated using fixed and random effects models and quality of studies was assessed through a modified version of the Newcastle-Ottawa scale.
Twenty-nine eligible studies, 22 cohort and 7 case-control studies, with a total of 274489 subjects, were included in the meta-analysis. The results show that history of allergic rhinitis is significantly associated with the occurrence of asthma (OR = 3.82; 95% CI: 2.92-4.99). European studies showed a stronger association (OR = 4.35; (95% CI: 3.12-6.06) than non-European studies (OR = 2.75; 95% CI: 2.16-3.50), and case-control studies showed a stronger association (OR = 4.71; 95% CI: 3.58-6.17) than cohort studies (OR = 3.42; 95% CI: 2.60-4.50).
This meta-analysis shows that allergic rhinitis is strongly associated with asthma. Further prospective studies on the effect of treatment of allergic rhinitis on the development of asthma are needed. Relief of airway allergic manifestations may need dual control of allergic rhinitis and asthma.
PROSPERO database with registration number CRD42017055156.
多项研究怀疑变应性鼻炎是哮喘的一个危险因素，但这种关联尚未完全确立。本研究的目的是通过系统评价和荟萃分析综合变应性鼻炎与哮喘风险之间关联的证据。
我们在Medline、Scopus、ISI Proceedings数据库及其他数据库中进行检索，检索时间从建库至2019年2月，随后进行手动检索，以识别报告变应性鼻炎与哮喘之间关联的相对风险估计值和置信区间的潜在相关病例对照研究和队列研究。横断面研究被排除。使用固定效应模型和随机效应模型计算合并比值比（OR）和95%置信区间（CI），并通过纽卡斯尔-渥太华量表的修订版评估研究质量。
荟萃分析纳入了29项符合条件的研究，其中22项队列研究和7项病例对照研究，共274489名受试者。结果显示，变应性鼻炎病史与哮喘的发生显著相关（OR = 3.82；95% CI：2.92 - 4.99）。欧洲的研究显示出比非欧洲研究更强的关联（OR = 4.35；95% CI：3.12 - 6.06），病例对照研究显示出比队列研究更强的关联（OR = 4.71；95% CI：3.58 - 6.17）（队列研究OR = 3.42；95% CI：2.60 - 4.50）。
这项荟萃分析表明变应性鼻炎与哮喘密切相关。需要进一步开展关于变应性鼻炎治疗对哮喘发展影响的前瞻性研究。气道变应性表现的缓解可能需要对变应性鼻炎和哮喘进行双重控制。
PROSPERO数据库，注册号CRD42017055156。
