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农村生活与儿童至青年期变应性鼻炎的前瞻性研究:GABRIEL 研究结果

Farm living and allergic rhinitis from childhood to young adulthood: Prospective results of the GABRIEL study.

机构信息

Institute and Clinic for Occupational, Social and Environmental Medicine, University Hospital. Ludwig Maximilian University of Munich, Munich, Germany; Comprehensive Pneumology Center Munich, German Center for Lung Research, Munich, Germany.

Institute and Clinic for Occupational, Social and Environmental Medicine, University Hospital. Ludwig Maximilian University of Munich, Munich, Germany; Comprehensive Pneumology Center Munich, German Center for Lung Research, Munich, Germany; Munich Centre of Health Sciences, Munich, Germany.

出版信息

J Allergy Clin Immunol. 2022 Nov;150(5):1209-1215.e2. doi: 10.1016/j.jaci.2022.05.027. Epub 2022 Jun 29.

Abstract

BACKGROUND

Growing up on a farm is associated with a reduced prevalence of respiratory allergies in childhood. Whether this protective effect remains into adulthood is unknown.

OBJECTIVES

We aimed to prospectively investigate the relationship between farm exposure and prevalence of allergic rhinitis and wheeze from childhood to early adulthood.

METHODS

Participants from phase 2 of the Multidisciplinary Study to Identify the Genetic and Environmental Causes of Asthma in the European Community (GABRIEL) who were living in southern Germany (aged 6-11 years at baseline and 20-25 years at follow-up) were invited to complete a questionnaire on sociodemographic data, farm contact, respiratory symptoms, and potential confounders. Odds ratios (ORs) with 95% CIs were modeled by using generalized estimating equations.

RESULTS

Of the 2276 phase 2 participants, 1501 (66%) answered the follow-up questionnaire, of whom 1333 could be included in the analyses. Living on a farm was associated with reduced prevalence of allergic rhinitis (OR with persistent farm living = 0.4 [95% CI = 0.2-0.6]; OR with farm living at baseline only = 0.4 [95% CI = 0.2-0.8]). The OR for development of symptoms from baseline to follow-up was almost 3 (OR = 2.7 [95% CI = 2.1-3.3]) irrespective of farm living. For symptoms of wheeze, no statistically significant association with farm living was observed.

CONCLUSIONS

The protective effect of farm living on allergic rhinitis persists from childhood to early adulthood. Continuing exposure over puberty does not add to the effect. This confirms that the window of opportunity for a protective effect might be found in childhood.

摘要

背景

在农场长大与儿童时期呼吸道过敏的患病率降低有关。这种保护作用是否会持续到成年期尚不清楚。

目的

我们旨在前瞻性研究农场暴露与儿童期至成年早期变应性鼻炎和喘息患病率之间的关系。

方法

邀请参加欧洲社区多学科研究以确定哮喘的遗传和环境原因(GABRIEL)第 2 阶段的参与者居住在德国南部(基线时年龄为 6-11 岁,随访时为 20-25 岁)完成一份关于社会人口统计学数据、农场接触、呼吸道症状和潜在混杂因素的问卷。使用广义估计方程对比值比(OR)及其 95%置信区间进行建模。

结果

在 2276 名第 2 阶段参与者中,有 1501 名(66%)回答了随访问卷,其中 1333 名可纳入分析。居住在农场与变应性鼻炎患病率降低相关(持续居住在农场的 OR = 0.4 [95%CI 0.2-0.6];仅基线时居住在农场的 OR = 0.4 [95%CI 0.2-0.8])。从基线到随访的症状发展的 OR 几乎为 3(OR = 2.7 [95%CI 2.1-3.3]),无论农场生活如何。对于喘息症状,与农场生活没有观察到统计学上显著的关联。

结论

从儿童期到成年早期,农场生活对变应性鼻炎的保护作用持续存在。青春期后持续暴露不会增加这种效果。这证实了保护作用的机会之窗可能在儿童期。

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