Henry Ford Health System, Detroit, Mich.
Henry Ford Health System, Detroit, Mich.
J Allergy Clin Immunol. 2021 Nov;148(5):1270-1280. doi: 10.1016/j.jaci.2021.04.027. Epub 2021 May 6.
Few studies have examined longitudinal asthma incidence rates (IRs) from a public health surveillance perspective.
Our aim was to calculate descriptive asthma IRs in children over time with consideration for demographics and parental asthma history.
Data from 9 US birth cohorts were pooled into 1 population covering the period from 1980 to 2017. The outcome was earliest parental report of a doctor diagnosis of asthma. IRs per 1,000 person-years were calculated.
The racial/ethnic backgrounds of the 6,283 children studied were as follows: 55% European American (EA), 25.5% African American (AA), 9.5% Mexican-Hispanic American (MA) and 8.5% Caribbean-Hispanic American (CA). The average follow-up was 10.4 years (SD = 8.5 years; median = 8.4 years), totaling 65,291 person-years, with 1789 asthma diagnoses yielding a crude IR of 27.5 per 1,000 person-years (95% CI = 26.3-28.8). Age-specific rates were highest among children aged 0 to 4 years, notably from 1995 to 1999, with a decline in EA and MA children in 2000 to 2004 followed by a decline in AA and CA children in 2010 to 2014. Parental asthma history was associated with statistically significantly increased rates. IRs were similar and higher in AA and CA children versus lower but similar in EA and MA children. The differential rates by sex from birth through adolescence principally resulted from a decline in rates among males but relatively stable rates among females.
US childhood asthma IRs varied dramatically by age, sex, parental asthma history, race/ethnicity, and calendar year. Higher rates in the 0- to 4-year-olds group, particularly among AA/CA males with a parental history of asthma, as well as changes in rates over time and by demographic factors, suggest that asthma is driven by complex interactions between genetic susceptibility and variation in time-dependent environmental and social factors.
从公共卫生监测的角度来看，很少有研究检查纵向哮喘发病率（IR）。
我们的目的是随着时间的推移计算儿童哮喘发病率（IR）的描述性数据，同时考虑人口统计学和父母哮喘史。
将来自 9 个美国出生队列的数据合并为 1 个人群，涵盖 1980 年至 2017 年的时间段。结果是最早由父母报告的医生诊断为哮喘。每 1000 人年计算 IR。
研究的 6283 名儿童的种族/民族背景如下：55%为欧洲裔美国人（EA），25.5%为非裔美国人（AA），9.5%为墨西哥裔西班牙裔美国人（MA），8.5%为加勒比裔西班牙裔美国人（CA）。平均随访时间为 10.4 年（SD=8.5 年；中位数=8.4 年），共 65291 人年，1789 例哮喘诊断，粗发病率为 27.5/1000 人年（95%CI=26.3-28.8）。年龄特定的发病率在 0 至 4 岁的儿童中最高，特别是在 1995 年至 1999 年期间，EA 和 MA 儿童的发病率在 2000 年至 2004 年期间下降，随后 AA 和 CA 儿童的发病率在 2010 年至 2014 年期间下降。父母哮喘史与发病率显著增加相关。IR 在 AA 和 CA 儿童中相似且较高，而在 EA 和 MA 儿童中则较低但相似。从出生到青春期，男女发病率的差异主要是由于男性发病率下降，但女性发病率相对稳定所致。
美国儿童哮喘发病率（IR）因年龄、性别、父母哮喘史、种族/民族以及年份而异。0 至 4 岁儿童组的发病率较高，特别是有父母哮喘史的 AA/CA 男性，以及随着时间的推移和人口统计学因素的变化而变化的发病率，表明哮喘是由遗传易感性与时间相关的环境和社会因素之间的复杂相互作用驱动的。
