早年生活环境与2岁时患湿疹的风险——对六个芬兰出生队列的荟萃分析

Early-life environment and the risk of eczema at 2 years-Meta-analyses of six Finnish birth cohorts.

作者信息

Lukkarinen Minna, Kirjavainen Pirkka V, Backman Katri, Gonzales-Inca Carlos, Hickman Brandon, Kallio Sampo, Karlsson Hasse, Karlsson Linnea, Keski-Nisula Leea, Korhonen Laura S, Korpela Katri, Kuitunen Mikael, Kukkonen Anna Kaarina, Käyhkö Niina, Lagström Hanna, Lukkarinen Heikki, Peltola Ville, Pentti Jaana, Salonen Anne, Savilahti Erkki, Tuoresmäki Pauli, Täubel Martin, Vahtera Jussi, de Vos Willem M, Pekkanen Juha, Karvonen Anne M

机构信息

FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Department of Clinical Medicine, University of Turku, Turku, Finland.

Department of Paediatrics and Adolescent Medicine, University of Turku and Turku University Hospital, Turku, Finland.

出版信息

Pediatr Allergy Immunol. 2023 Apr;34(4):e13945. doi: 10.1111/pai.13945.

DOI:10.1111/pai.13945

PMID:37102387

Abstract

BACKGROUND

Urban-related nature exposures are suggested to contribute to the rising prevalence of allergic diseases despite little supporting evidence. Our aim was to evaluate the impact of 12 land cover classes and two greenness indices around homes at birth on the development of doctor-diagnosed eczema by the age of 2 years, and the influence of birth season.

METHODS

Data from 5085 children were obtained from six Finnish birth cohorts. Exposures were provided by the Coordination of Information on the Environment in three predefined grid sizes. Adjusted logistic regression was run in each cohort, and pooled effects across cohorts were estimated using fixed or random effect meta-analyses.

RESULTS

In meta-analyses, neither greenness indices (NDVI or VCDI, 250 m × 250 m grid size) nor residential or industrial/commercial areas were associated with eczema by age of 2 years. Coniferous forest (adjusted odds ratio 1.19; 95% confidence interval 1.01-1.39 for the middle and 1.16; 0.98-1.28 for the highest vs. lowest tertile) and mixed forest (1.21; 1.02-1.42 middle vs. lowest tertile) were associated with elevated eczema risk. Higher coverage with agricultural areas tended to associate with elevated eczema risk (1.20; 0.98-1.48 vs. none). In contrast, transport infrastructure was inversely associated with eczema (0.77; 0.65-0.91 highest vs. lowest tertile).

CONCLUSION

Greenness around the home during early childhood does not seem to protect from eczema. In contrast, nearby coniferous and mixed forests may increase eczema risk, as well as being born in spring close to forest or high-green areas.

摘要

背景

尽管几乎没有支持性证据，但与城市相关的自然接触被认为是导致过敏性疾病患病率上升的原因。我们的目的是评估出生时家庭周围12种土地覆盖类型和两种绿化指数对2岁时医生诊断的湿疹发展的影响，以及出生季节的影响。

方法

从芬兰的六个出生队列中获取了5085名儿童的数据。环境信息协调组织以三种预定义的网格大小提供接触情况。在每个队列中进行调整后的逻辑回归，并使用固定效应或随机效应荟萃分析估计各队列之间的综合效应。

结果

在荟萃分析中，绿化指数（归一化植被指数或植被连续变化检测指数，250米×250米网格大小）以及住宅区或工业/商业区与2岁时的湿疹均无关联。针叶林（调整后的优势比为1.19；中间三分位数与最低三分位数相比，95%置信区间为1.01-1.39，最高三分位数与最低三分位数相比为1.16；0.98-1.28）和混交林（中间三分位数与最低三分位数相比为1.21；1.02-1.42）与湿疹风险升高相关。农业区域覆盖率较高往往与湿疹风险升高相关（与无农业区域相比为1.20；0.98-1.48）。相比之下，交通基础设施与湿疹呈负相关（最高三分位数与最低三分位数相比为0.77；0.65-0.91）。