Kwon Shin Young, Lim Ji Eun, Jung Hae-Un, Baek Eun Ju, Jung Hyein, Kang Ji-One, Kim Tae-Bum, Oh Bermseok
Department of Biomedical Science, Graduate School, Kyung Hee University, Seoul, Republic of Korea.
Joint first authorship.
J Glob Health. 2025 Jun 6;15:04147. doi: 10.7189/jogh.15.04147.
Asthma is a heterogeneous disease influenced by genetic and environmental factors. Identifying high-risk individuals for developing asthma is a major goal of primary prevention. Recent studies have reported that genetic factors can predict high-risk groups for various diseases. However, the understanding of genetically high-risk individuals for adult-onset asthma, which could be potential targets for preventive interventions, remains limited. Using a polygenic risk score (PRS), we identified a group of individuals at a genetically high risk for adult-onset asthma and examined their characteristics, as well as the degree of risk reduction through lifestyle factors.
Using the asthma PRS provided by the UK Biobank, we identified a genetically high-risk group among unrelated White British individuals, including those with adult-onset asthma and a control group. We analysed the association between asthma-related lifestyle factors and adult-onset asthma in the high-risk group. Additionally, we conducted Kaplan-Meier analysis to investigate the cumulative incidence of adult-onset asthma by age of onset according to genetic risk and lifestyle status.
The high-risk group for adult-onset asthma had a 2.26 times higher risk of developing asthma compared to the average-risk group. Within the high-risk group, lifestyle factors, such as obesity-related traits, stress, insomnia, and snoring, were significantly associated with adult-onset asthma. Among individuals in the high-risk group, adhering to a favourable lifestyle can reduce the lifetime risk of adult-onset asthma by up to 40% compared to those with an unfavourable lifestyle.
Based on this study, we suggest that the PRS can identify individuals at high risk of developing adult-onset asthma. Furthermore, our findings indicate that individuals with a genetically high risk may reduce their disease risk through appropriate lifestyle modifications, emphasising their potential to benefit significantly from primary prevention strategies. However, as this study is cross-sectional and assumes that lifestyle factors have remained unchanged, further prospective studies are required to validate these findings.
哮喘是一种受遗传和环境因素影响的异质性疾病。识别哮喘发病的高危个体是一级预防的主要目标。最近的研究报告称，遗传因素可以预测各种疾病的高危人群。然而，对于成年期哮喘的遗传高危个体（可能是预防性干预的潜在目标）的了解仍然有限。我们使用多基因风险评分（PRS）识别出一组成年期哮喘遗传高危个体，并研究了他们的特征，以及通过生活方式因素降低风险的程度。
利用英国生物银行提供的哮喘PRS，我们在不相关的英国白人个体中识别出一个遗传高危组，包括成年期哮喘患者和一个对照组。我们分析了高危组中与哮喘相关的生活方式因素与成年期哮喘之间的关联。此外，我们进行了Kaplan-Meier分析，以根据遗传风险和生活方式状态调查成年期哮喘按发病年龄的累积发病率。
成年期哮喘高危组患哮喘的风险是平均风险组的2.26倍。在高危组中，与肥胖相关的特征、压力、失眠和打鼾等生活方式因素与成年期哮喘显著相关。在高危组个体中，与生活方式不良的个体相比，坚持良好的生活方式可将成年期哮喘的终生风险降低多达40%。
基于这项研究，我们建议PRS可以识别成年期哮喘发病的高危个体。此外，我们的研究结果表明，遗传高危个体可能通过适当的生活方式改变来降低疾病风险，这强调了他们从一级预防策略中显著获益的潜力。然而，由于这项研究是横断面研究，且假设生活方式因素保持不变，因此需要进一步的前瞻性研究来验证这些发现。
