Allergy and Molecular Immunology Laboratory, Lee Hiok Kwee Functional Genomics Laboratories, Department of Biological Sciences, National University of Singapore, Block S2, Level 5, 14 Science Drive 4, off Lower Kent Ridge Road, 117543, Singapore, Singapore.
J Physiol Anthropol. 2021 Dec 9;40(1):22. doi: 10.1186/s40101-021-00273-x.
An increasing trend of asthma prevalence was observed in Asia; however, contributions of environmental and host-related risk factors to the development of this disease remain uncertain. This study aimed to perform a systematic review and meta-analysis for asthma-associated risk factors reported in Asia.
We systematically searched three public databases (Web of Science, PubMed, and Scopus) in Feb 2021. We only included articles that reported environmental and host-related risk factors associated with asthma in the Asian population. Random-effect meta-analyses were conducted for frequently reported asthma-associated risk factors to provide an overall risk estimate of asthma development.
Of 4030 records obtained from public databases, 289 articles were selected for review. The most frequently reported asthma-associated risk factor was the family history of allergy-related conditions. The random-effect asthma risk estimates (pooled odds ratio, OR) were 4.66 (95% confidence interval (CI): 3.73-5.82) for the family history of asthma, 3.50 (95% CI: 2.62-4.67) for the family history of atopy, 3.57 (95% CI: 3.03-4.22) for the family history of any allergic diseases, 1.96 (95% CI: 1.47-2.61) for the family history of allergic rhinitis, and 2.75 (95% CI: 1.12-6.76) for the family history of atopic dermatitis. For housing-related factors, including the presence of mold, mold spots, mold odor, cockroach, water damage, and incense burning, the random-effect pooled OR ranged from 1.43 to 1.73. Other risk factors with significant pooled OR for asthma development included male gender (1.30, 95% CI: 1.23-1.38), cigarette smoke exposure (1.44, 95% CI: 1.30-1.60), cigarette smoking (1.66, 95% CI: 1.44-1.90), body mass index (BMI)-related parameters (pooled OR ranged from 1.06 to 2.02), various types of air pollution (NO, PM10, and O; pooled OR ranged from 1.03 to 1.22), and pre- and perinatal factors (low birth weight, preterm birth, and cesarean section; pooled OR ranged from 1.14 to 1.32).
The family history of asthma was the most frequently reported risk factor for asthma development in Asia with the highest risk estimate for asthma development. This suggests a major role of the genetic component in asthma pathogenesis. Further study on asthma genetics is required to improve the current understanding of asthma etiology.
亚洲的哮喘发病率呈上升趋势；然而，环境和宿主相关危险因素对疾病发展的贡献仍不确定。本研究旨在对亚洲报道的哮喘相关危险因素进行系统评价和荟萃分析。
我们于 2021 年 2 月系统地检索了三个公共数据库（Web of Science、PubMed 和 Scopus）。我们仅纳入了报道亚洲人群中与哮喘相关的环境和宿主相关危险因素的文章。对经常报道的哮喘相关危险因素进行随机效应荟萃分析，以提供哮喘发展的总体风险估计。
从公共数据库中获得了 4030 条记录，其中有 289 篇文章被选入进行综述。最常报道的哮喘相关危险因素是过敏相关疾病的家族史。哮喘的随机效应风险估计（合并优势比，OR）为哮喘家族史 4.66（95%置信区间（CI）：3.73-5.82），特应性家族史 3.50（95%CI：2.62-4.67），任何过敏疾病的家族史 3.57（95%CI：3.03-4.22），过敏性鼻炎家族史 1.96（95%CI：1.47-2.61），特应性皮炎家族史 2.75（95%CI：1.12-6.76）。与住房相关的因素，包括霉菌、霉菌斑、霉菌气味、蟑螂、水损坏和焚香，随机效应合并 OR 范围为 1.43-1.73。其他对哮喘发展具有显著合并 OR 的危险因素包括男性（1.30，95%CI：1.23-1.38）、接触香烟烟雾（1.44，95%CI：1.30-1.60）、吸烟（1.66，95%CI：1.44-1.90）、体重指数（BMI）相关参数（合并 OR 范围为 1.06-2.02）、各种类型的空气污染（NO、PM10 和 O；合并 OR 范围为 1.03-1.22）以及产前和围产期因素（低出生体重、早产和剖宫产；合并 OR 范围为 1.14-1.32）。
哮喘家族史是亚洲报道的哮喘发病的最常见危险因素，其哮喘发病的风险估计最高。这表明遗传因素在哮喘发病机制中起主要作用。需要进一步研究哮喘遗传学，以提高对哮喘病因的认识。
