Université Paris-Saclay, UVSQ, Univ. Paris-Sud, Inserm, Equipe d'Epidémiologie Respiratoire Intégrative, CESP, 94807, Villejuif, France
French Environment and Energy Management Agency, 49004, Angers, France.
Eur Respir J. 2023 Feb 9;61(2). doi: 10.1183/13993003.00943-2022. Print 2023 Feb.
Scarce epidemiological studies have characterised allergic rhinitis (AR) and non-allergic rhinitis (NAR) in adults. In a population-based cohort, our aims were to 1) describe rhinitis, AR and NAR, and 2) explore how asthma and conjunctivitis may lead to the identification of novel rhinitis phenotypes.
In this cross-sectional analysis, current rhinitis was defined as present in the last 12 months using a questionnaire from the French CONSTANCES cohort. Participants with current rhinitis reporting nasal allergies were considered as AR, otherwise as NAR. We described AR and NAR phenotypes, and their phenotypes including co-occurrence with ever-asthma and ever-conjunctivitis.
Among the 20 772 participants included in this analysis (mean±sd age 52.6±12.6 years; 55.2% female), crude prevalences of AR and NAR were 28.0% and 10.9%. AR participants more frequently reported persistent rhinitis (31.6% 25.1%) and moderate-to-severe rhinitis (40.1% 24.2%) than NAR participants. Among AR or NAR participants, those with ever-asthma reported more moderate-to-severe rhinitis. Participants with AR, ever-asthma and ever-conjunctivitis had an earlier age of rhinitis onset, more severe rhinitis and higher eosinophil counts than participants in other groups. Results were replicated in another cohort.
In this large population-based cohort, 40% reported current rhinitis, with a lower prevalence of moderate-to-severe rhinitis than in clinical practice. For the first time in a general adult population, we showed that AR and NAR alone or in combination with asthma or in combination with asthma and conjunctivitis are different phenotypes. These results provide new insights on how best to manage rhinitis and its multimorbidities.
仅有少数流行病学研究对成人变应性鼻炎（AR）和非变应性鼻炎（NAR）进行了描述。在一项基于人群的队列研究中，我们的目的是：1）描述鼻炎、AR 和 NAR；2）探讨哮喘和结膜炎如何导致新型鼻炎表型的识别。
在这项横断面分析中，使用法国 CONSTANCES 队列的问卷，将过去 12 个月中存在的鼻炎定义为当前鼻炎。报告有鼻部过敏的当前鼻炎患者被认为是 AR，否则为 NAR。我们描述了 AR 和 NAR 的表型，以及包括与既往哮喘和既往结膜炎同时存在的表型。
在本分析纳入的 20772 名参与者中（平均年龄 52.6±12.6 岁，55.2%为女性），AR 和 NAR 的粗患病率分别为 28.0%和 10.9%。与 NAR 患者相比，AR 患者更常报告持续性鼻炎（31.6% vs. 25.1%）和中重度鼻炎（40.1% vs. 24.2%）。在 AR 或 NAR 患者中，既往有哮喘的患者报告中重度鼻炎的比例更高。患有 AR、既往哮喘和既往结膜炎的患者鼻炎发病年龄更早，鼻炎更严重，嗜酸性粒细胞计数更高，而其他组患者则没有。在另一项队列研究中也得到了类似的结果。
在这项大型基于人群的队列研究中，40%的参与者报告有当前鼻炎，中重度鼻炎的患病率低于临床实践。在一般成年人群中，我们首次表明，AR 和 NAR 单独或与哮喘或与哮喘和结膜炎同时存在时，是不同的表型。这些结果为如何更好地管理鼻炎及其多种共病提供了新的见解。
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