Ozoh Obianuju B, Aderibigbe Sunday A, Ayuk Adaeze C, Dede Sandra K, Egbagbe Eruke, Babashani Musa
Department of Medicine, College of Medicine, University of Lagos, Lagos, Nigeria.
Department of Medicine, Lagos University Teaching Hospital, Lagos, Nigeria.
Clin Respir J. 2025 Mar;19(3):e13608. doi: 10.1111/crj.13608. Epub 2023 Apr 4.
The impact of allergic rhinitis (AR), a common comorbidity in asthma, on global quality of life (QoL) using generic QoL questionnaires has not been extensively evaluated.
This was a cross-sectional population-based study among adults ≥18 years old. Generic QoL was measured using the World Health Organization (WHO) questionnaire (WHOQOL-BREF), and asthma control was assessed using the Asthma Control Test. Participants were categorized into four groups: Group 1 (No asthma, no AR), Group 2 (Asthma only), Group 3 (AR only) and Group 4 (Concomitant asthma and AR). The student t-test or the ANOVA was used for comparison between groups and based on the level of asthma control. Linear regression was used to assess the association between the level of asthma control and QoL scores, adjusted for age and sex. A p-value of less than 0.05 was considered significant for all associations.
There were 9115 participants; 906 (9.9%) had asthma, and 1998 (21.9%) had AR. The lowest QoL scores were in the environment domain. Mean QoL scores were significantly lower in asthma compared to 'no asthma' and in AR compared to 'no AR'. Either asthma or rhinitis (Group 2 or 3) had significantly lower scores compared to no disease (Group 1) only in the environment domain, but the concomitant disease (Group 4) had lower scores across all categories and domains. Scores were significantly lower for uncontrolled asthma compared to controlled asthma and for 'concomitant asthma and AR' compared to 'asthma only'. Increasing age and uncontrolled asthma predicted worse health-related quality of life (HRQoL) consistently.
Although asthma and AR negatively impact HRQoL independently, concomitant asthma and AR are worse. Uncontrolled asthma underpins poor QoL in asthma because QoL is not impaired in controlled disease. This underscores the need for recognition and treatment of AR in asthma and reinforces the benefits of achieving asthma control as a priority in asthma treatment.
变应性鼻炎（AR）作为哮喘常见的合并症，使用通用生活质量问卷对其对全球生活质量（QoL）的影响尚未进行广泛评估。
这是一项针对18岁及以上成年人的基于人群的横断面研究。使用世界卫生组织（WHO）问卷（WHOQOL - BREF）测量通用生活质量，并使用哮喘控制测试评估哮喘控制情况。参与者分为四组：第1组（无哮喘，无AR）、第2组（仅哮喘）、第3组（仅AR）和第4组（哮喘合并AR）。采用学生t检验或方差分析在组间以及根据哮喘控制水平进行比较。使用线性回归评估哮喘控制水平与生活质量得分之间的关联，并对年龄和性别进行校正。所有关联的p值小于0.05被认为具有统计学意义。
共有9115名参与者；906人（9.9%）患有哮喘，1998人（21.9%）患有AR。生活质量得分最低的是环境领域。与“无哮喘”相比，哮喘患者的平均生活质量得分显著更低；与“无AR”相比，AR患者的平均生活质量得分显著更低。仅哮喘或鼻炎（第2组或第3组）仅在环境领域的得分显著低于无疾病组（第1组），但合并疾病组（第4组）在所有类别和领域的得分均更低。与哮喘控制良好相比，哮喘未控制时得分显著更低；与“仅哮喘”相比，“哮喘合并AR”得分显著更低。年龄增加和哮喘未控制始终预示着健康相关生活质量（HRQoL）更差。
虽然哮喘和AR分别对HRQoL有负面影响，但哮喘合并AR的情况更糟。哮喘未控制是导致哮喘患者生活质量差的原因，因为在疾病得到控制时生活质量并未受损。这突出了在哮喘患者中识别和治疗AR的必要性，并强化了将实现哮喘控制作为哮喘治疗首要目标的益处。
