Wong Qi Yi Ambrose, Lim Jun Jie, Ng Jun Yan, Malipeddi Praneeth, Lim Yi Ying Eliza, Sio Yang Yie, Chew Fook Tim
Department of Biological Sciences, Faculty of Science, National University of Singapore, 117543, Singapore.
World Allergy Organ J. 2023 Mar 20;16(3):100757. doi: 10.1016/j.waojou.2023.100757. eCollection 2023 Mar.
Asthma is a chronic inflammatory disease of the airway characterized by respiratory symptoms: wheezing, shortness of breath, coughing, and chest tightness. Globally, asthma affects over 300 million individuals and carries high morbidity and mortality burden. Previous studies have estimated the prevalence of asthma; however, prevalence estimates have been changing over time. Here, in a population of young Chinese adults from Singapore, we aimed to obtain an updated prevalence of asthma and its phenotypes, and identify potential associated risk factors.
The Singapore/Malaysia Cross-Sectional Genetics Epidemiology Study (SMCGES) is an ongoing study which uses established ISAAC guidelines to collect epidemiological data and information pertaining to allergic diseases such as asthma. Responses from young Chinese adults recruited in the National University of Singapore were analyzed.
Lifetime asthma prevalence rate was estimated at 19.1% (2049/10,736), while current asthma prevalence rate was estimated at 6.3% (679/10,736). For ever asthma, the most important risk factor was a parental history of asthma. Increased consumption of pulses (aOR: 0.822, 95% CI: 0.706-0.958) was associated with a lowered odds of ever asthma, but cereals (aOR: 1.256, 95% CI: 1.006-1.580), pasta (aOR: 1.265, 95% CI: 1.027-1.553), butter (aOR: 1.350, 95% CI: 1.113-1.632), and margarine (aOR: 1.343, 95% CI: 1.081-1.660) were associated with a higher risk of ever asthma. Increased television/computer usage was associated with a decreased risk of ever asthma (aOR: 0.448, 95% CI: 0.367-0.545). Conversely, genetic factors had a lower strength of effect on current asthma (parental history of asthma - OR: 1.465, 95% CI: 1.135-1.888) as compared to ever asthma. Only increased potato consumption was significantly associated with an increased risk of current asthma (most or all days per week vs never or only occasionally - aOR: 1.577, 95% CI: 1.145-2.180). Physical activity (aOR: 0.693, 95% CI: 0.542-0.885) was associated with a lower odds of asthma, while second-hand smoke exposure was associated with an increased risk for current asthma (aOR: 1.435, 95% CI: 1.001-2.047).
Overall, the prevalence of lifetime asthma and current asthma among young Chinese adults was 19.1% and 6.3%, higher than that of previous studies. Our results suggested a stronger association between genetic factors and ever asthma as compared to current asthma. Parental asthma was the most important intrinsic epidemiological factor for asthma manifestation, while various foods, physical activity levels, and television or computer usage were also significantly associated with asthma. Future studies should consider risk factors in conjunction with other accompanying variables given the potential interactions between them, to discern the effects of environment and lifestyle on asthma more distinctly.
哮喘是一种气道慢性炎症性疾病,其特征为呼吸道症状,如喘息、气短、咳嗽和胸闷。在全球范围内,哮喘影响着超过3亿人,带来了很高的发病率和死亡率负担。以往的研究对哮喘的患病率进行了估计;然而,患病率估计值随时间不断变化。在此,我们针对来自新加坡的年轻中国成年人,旨在获取哮喘及其表型的最新患病率,并确定潜在的相关危险因素。
新加坡/马来西亚横断面遗传流行病学研究(SMCGES)是一项正在进行的研究,该研究采用既定的国际儿童哮喘和过敏研究(ISAAC)指南来收集与哮喘等过敏性疾病相关的流行病学数据和信息。对在新加坡国立大学招募的年轻中国成年人的回答进行了分析。
终生哮喘患病率估计为19.1%(2049/10736),而当前哮喘患病率估计为6.3%(679/10736)。对于曾患哮喘者,最重要的危险因素是父母有哮喘病史。豆类摄入量增加(调整后比值比:0.822,95%置信区间:0.706 - 0.958)与曾患哮喘的几率降低相关,但谷类(调整后比值比:1.256,95%置信区间:1.006 - 1.580)、面食(调整后比值比:1.265,95%置信区间:1.027 - 1.553)、黄油(调整后比值比:1.350,95%置信区间:1.113 - 1.632)和人造黄油(调整后比值比:1.343,95%置信区间:1.081 - 1.660)与曾患哮喘的风险较高相关。电视/电脑使用时间增加与曾患哮喘的风险降低相关(调整后比值比:0.448,95%置信区间:0.367 - 0.545)。相反,与曾患哮喘相比,遗传因素对当前哮喘的影响强度较低(父母有哮喘病史 - 比值比:1.465,95%置信区间:1.135 - 1.888)。仅土豆摄入量增加与当前哮喘风险增加显著相关(每周大部分或所有天数与从不或仅偶尔食用相比 - 调整后比值比:1.577,95%置信区间:1.145 - 2.180)。体育活动(调整后比值比:0.693,95%置信区间:0.542 - 0.885)与哮喘几率较低相关,而二手烟暴露与当前哮喘风险增加相关(调整后比值比:1.435,95%置信区间:1.001 - 2.047)。
总体而言,年轻中国成年人中终生哮喘和当前哮喘的患病率分别为19.1%和6.3%,高于以往研究。我们的结果表明,与当前哮喘相比,遗传因素与曾患哮喘之间的关联更强。父母患哮喘是哮喘表现最重要的内在流行病学因素,而各种食物、体育活动水平以及电视或电脑使用情况也与哮喘显著相关。鉴于它们之间可能存在的相互作用,未来的研究应结合其他伴随变量考虑危险因素,以便更清晰地辨别环境和生活方式对哮喘的影响。