Lin Ting-Yu, Lin Horng-Chyuan, Liu Yun-Sheng, Lo Yu-Lun, Wang Chun-Hua, Chang Po-Jui, Lo Chun-Yu, Lin Shu-Min
Department of Thoracic Medicine, Chang Gung Memorial Hospital, Taipei, Taiwan.
College of Medicine, Chang Gung University, Taoyuan, Taiwan.
Front Med (Lausanne). 2021 Dec 16;8:783720. doi: 10.3389/fmed.2021.783720. eCollection 2021.
Traffic-related pollution is associated with the onset of asthma and the development of different phenotypes of asthma. Few studies have investigated the association between traffic proximity and late-onset of asthma (LOA) and early-onset asthma (EOA). This study was conducted to investigate the associations of LOA phenotypes with a function of the distance between residence and heavy traffic roads (HTRs). The study group consisted of 280 patients who were (LOA: 78.4%) recruited consecutively from a pay-for-performance asthma program to clarify the patient characteristics and proximity to HTRs within 1,000 m from their residences between EOA and LOA in three urban centers in Taiwan. The subsequent analysis focused on patients with LOA ( = 210) linking phenotypes and distance to HTRs. Subjects with LOA tended to be older than those with EOA and had shorter asthma duration, poorer lung function, lower atopy, and less exposure to fumes or dust at home. Patients with LOA were more likely than those with EOA to live within 900 m of two or more HTRs (14.3 vs. 3.4%, = 0.02). Among patients with LOA, minimum distance to an HTR was negatively associated with numbers of specific IgE as well as positively associated with the age of onset and body weight significantly. A higher proportion of patients with atopy (26.3 vs. 20.6%, = 0.001. odds ratio [OR]: 2.82) and anxiety/depression (21.0 vs. 18.1%, = 0.047. OR: 1.81) and a trend of lower proportion of patients with obese (5.7 vs. 12.4%, = 0.075) were found to be living within 900 m from HTRs. Late-onset of asthma (LOA) tended to live in areas of higher HTR density compared to EOAs. Among patients with LOA living close to HTRs, the interaction between traffic-related pollution, allergy sensitization, and mood status were the factors associated with asthma onset early. Obesity may be the factor for later onset who live far from HTRs.
交通相关污染与哮喘的发病及不同哮喘表型的发展有关。很少有研究调查居住距离交通要道与迟发性哮喘(LOA)和早发性哮喘(EOA)之间的关联。本研究旨在调查LOA表型与居住距离繁忙交通道路(HTRs)之间的关系。研究组由280名患者组成(LOA:78.4%),这些患者是从一个按绩效付费的哮喘项目中连续招募的,以阐明台湾三个城市中心EOA和LOA患者的特征以及他们住所1000米范围内与HTRs的距离。后续分析集中在LOA患者(n = 210),将表型与到HTRs的距离联系起来。LOA患者往往比EOA患者年龄更大,哮喘病程更短,肺功能更差,特应性更低,在家中接触烟雾或灰尘更少。与EOA患者相比,LOA患者更有可能居住在距离两条或更多HTRs 900米以内(14.3%对3.4%,P = 0.02)。在LOA患者中,到HTRs的最小距离与特异性IgE数量呈负相关,与发病年龄和体重呈正相关。居住在距离HTRs 900米以内的患者中,特应性比例更高(26.3%对20.6%,P = 0.001,比值比[OR]:2.82)、焦虑/抑郁比例更高(21.0%对18.1%,P = 0.047,OR:1.81),肥胖患者比例有降低趋势(5.7%对12.4%,P = 0.075)。与EOA相比,迟发性哮喘(LOA)患者倾向于居住在HTR密度更高的地区。在居住在HTRs附近的LOA患者中,交通相关污染、过敏致敏和情绪状态之间的相互作用是与哮喘早期发病相关的因素。肥胖可能是居住在远离HTRs地区患者发病较晚的因素。