Pakkasela Johanna, Salmela Petri, Juntunen Pekka, Karjalainen Jussi, Lehtimäki Lauri
Department of Respiratory Medicine, Tampere University Hospital, Tampere, Finland.
Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland.
Eur Clin Respir J. 2023 Oct 18;10(1):2269653. doi: 10.1080/20018525.2023.2269653. eCollection 2023.
Childhood-onset allergic asthma is the best-known phenotype of asthma. Adult-onset asthma, also an important entity, is instead often shown to be more non-allergic. There is still a lack of studies concerning the association of allergies and age at asthma onset from childhood to late adulthood. The aim of the study was to assess the age at onset of asthma symptoms and age at asthma diagnosis among adults with allergic and non-allergic asthma.
Questionnaires were sent to 2000 randomly selected Finnish adults aged 18-80 years who were dispensed medication for obstructive airway diseases during the previous year. The corrected sample size was 1978 subjects after exclusion of non-analysable data. The response rate was 40.6%. Self-reported doctor-diagnosed asthma was considered allergic if a concomitant self-reported doctor-diagnosed pollen and/or animal allergy was reported with asthma symptoms upon allergen exposure.
Of the 496 participants with asthma, 42.7% were considered to have allergic asthma. The median ages at asthma diagnosis and onset of asthma symptoms were 31 (IQR 17-46) and 20 (9.25-40) years in participants with allergic asthma and 49 (37.75-58) and 40.5 (30-50) years in participants with non-allergic asthma ( < 0.001), respectively. Of the participants with asthma diagnosed at ≥30 years of age, 18% of allergic and 7% of non-allergic participants reported having had asthma symptoms under 20 years of age.
Both the onset of symptoms and diagnosis occurred at a younger age among adults with allergic asthma than among those with non-allergic asthma. Only a minority of adults with non-allergic asthma had already had symptoms in younghood.
儿童期起病的过敏性哮喘是哮喘最广为人知的表型。而成人期起病的哮喘虽然也是一个重要类型，但往往表现为更多的非过敏性。从儿童期到成年后期，关于过敏与哮喘起病年龄之间关联的研究仍然不足。本研究的目的是评估过敏性哮喘和非过敏性哮喘成人患者的哮喘症状起病年龄及哮喘诊断年龄。
向前一年接受过阻塞性气道疾病药物治疗的2000名年龄在18 - 80岁之间的芬兰成年人随机发放问卷。排除不可分析的数据后，校正后的样本量为1978名受试者。应答率为40.6%。如果在接触过敏原时伴有自我报告的医生诊断的花粉和/或动物过敏以及哮喘症状，则自我报告的医生诊断的哮喘被视为过敏性哮喘。
在496名哮喘患者中，42.7%被认为患有过敏性哮喘。过敏性哮喘患者的哮喘诊断年龄中位数和哮喘症状起病年龄中位数分别为31岁（四分位间距17 - 46岁）和20岁（9.25 - 40岁），非过敏性哮喘患者分别为49岁（37.75 - 58岁）和40.5岁（30 - 50岁）（<0.001）。在30岁及以上被诊断为哮喘的患者中，18%的过敏性患者和7%的非过敏性患者报告在20岁之前有哮喘症状。
过敏性哮喘成人患者的症状起病和诊断年龄均比非过敏性哮喘成人患者年轻。只有少数非过敏性哮喘成人在年轻时就已经出现症状。
