Carey O J, Cookson J B, Britton J, Tattersfield A E
Department of Medicine, Glenfield General Hospital, Leicester, United Kingdom.
Am J Respir Crit Care Med. 1996 Aug;154(2 Pt 1):537-40. doi: 10.1164/ajrccm.154.2.8756835.
There is increasing evidence linking Western culture to increasing prevalence of asthma. We have measured the prevalence of symptoms of asthma, bronchial hyperreactivity, and atopy in a sample of white and Asian inner city schoolchildren aged 8-11 yr in the U.K. and assessed the influence of certain aspects of western culture on these variables. Bronchial reactivity was measured by methacholine challenge, atopy by allergen skin prick tests, and symptoms of asthma and aspects of lifestyle by questionnaire. Degree of Westernization was assessed from dietary habit categorized as exclusively Asian, mostly Asian, mixed, or exclusively English. The questionnaire was completed by 92% of children. The 308 white and 539 Asian children were of similar age (mean 9.3 yr versus 9.4 yr) with slightly more girls in the Asian group (52.6% versus 47.4%). The white children reported more wheeze within the past year (14.2% versus 8.8%, p = 0.01) but less were atopic (29.5% versus 38.4%, p = 0.01) with no significant difference in the prevalence of hyperreactivity (31.5% versus 29.6%, p = 0.57). Most Asians (97%) included Asian food in their diet; 35% ate a mostly Asian diet, 45% ate a mixed English and Asian diet, and 17% ate an exclusively Asian diet. After controlling for confounding factors whites were at higher risk of hyperreactivity and lower risk of atopy, and the risk of hyperreactivity and to a lesser extent atopy among Asian children was related to diet in a dose response fashion. The relative odds for hyperreactivity with an exclusively Asian, mostly Asian, or a mixed diet relative to an English diet were 0.31 (95% CI 0.15 to 0.62), 0.88 (0.56 to 1.37), and 0.99 (0.65 to 1.49), and for atopy were 1.22 (0.72 to 2.06), 1.47 (0.99 to 2.19), and 1.78 (1.23 to 2.58). These results suggest that diet or other closely related factors associated with Westernization are involved in the etiology of atopy and hyperreactivity.
越来越多的证据表明，西方文化与哮喘患病率的上升有关。我们在英国对一组年龄在8至11岁的白人及亚裔内城学童进行了哮喘症状、支气管高反应性和特应性的患病率测量，并评估了西方文化的某些方面对这些变量的影响。通过乙酰甲胆碱激发试验测量支气管反应性，通过变应原皮肤点刺试验检测特应性，通过问卷调查了解哮喘症状和生活方式的各个方面。根据饮食习惯将西化程度分为纯亚洲饮食、主要为亚洲饮食、混合饮食或纯英国饮食。92%的儿童完成了问卷调查。308名白人儿童和539名亚裔儿童年龄相仿（平均分别为9.3岁和9.4岁），亚裔组女孩略多（分别为52.6%和47.4%）。白人儿童报告过去一年喘息较多（分别为14.2%和8.8%，p = 0.01），但特应性较少（分别为29.5%和38.4%，p = 0.01），高反应性患病率无显著差异（分别为31.5%和29.6%，p = 0.57）。大多数亚洲人（97%）的饮食中包含亚洲食物；35%主要吃亚洲饮食，45%吃英国和亚洲混合饮食，17%吃纯亚洲饮食。在控制混杂因素后，白人高反应性风险较高，特应性风险较低，亚洲儿童的高反应性风险以及在较小程度上的特应性风险与饮食呈剂量反应关系。相对于英国饮食，纯亚洲饮食、主要为亚洲饮食或混合饮食的高反应性相对比值分别为0.31（95%可信区间0.15至0.62）、0.88（0.56至1.37）和0.99（0.65至1.49），特应性相对比值分别为1.22（0.72至2.06）、1.47（0.99至2.19）和1.78（1.23至2.58）。这些结果表明，与西化相关的饮食或其他密切相关因素参与了特应性和高反应性的病因学。
