Litonjua A A, Carey V J, Burge H A, Weiss S T, Gold D R
Channing Laboratory, Department of Medicine, Brigham and Women's Hospital, and Department of Environmental Health, Harvard School of Public Health, Boston, Massachusetts, USA.
Am J Respir Crit Care Med. 1998 Jul;158(1):176-81. doi: 10.1164/ajrccm.158.1.9710014.
Although heredity plays a major role in asthma and in other allergic diseases, mechanisms underlying the inheritance of these disorders are poorly understood, as is the relative contribution of maternal and paternal conditions to risk of disease. We investigated doctor-diagnosed maternal and paternal asthma, eczema, and hay fever as cross-sectional predictors of childhood asthma and allergic disease in 306 children with a median age of 3.5 yr from families in which at least one parent had a history of either asthma or other allergic conditions. For both childhood asthma and eczema, the strongest parental predictors were the same conditions in the parents. For asthma in particular, maternal asthma was most strongly associated with asthma in the child over all ages in both univariate (OR = 3.2, 95% CI = 1.5 to 6.7) and multivariable (OR = 4.1, 95% CI = 1.7 to 10.1) models. Paternal asthma was weakly associated with childhood asthma in the univariate model (OR = 1.4, 95% CI = 0.6 to 3.2), but this association increased in magnitude in the multivariable model (OR = 2.7, 95% CI = 1.0 to 7.2). Among the children < 5 yr of age, the risk for childhood asthma associated with maternal asthma (OR = 5.0, 95% CI = 1.7 to 14.9) was greater than the risk associated with paternal asthma (OR = 1.6, 95% CI = 0. 5 to 5.9), whereas both maternal asthma and paternal asthma were associated with similar risks among children >= 5 yr of age (OR = 4. 6, 95% CI = 1.1 to 19.0 and OR = 4.1, 95% CI = 1.0 to 16.0, respectively). The odds of having a child with asthma were three times greater in families with one asthmatic parent and six times greater in families with two asthmatic parents than in families where only one parent had inhalant allergy without asthma; furthermore, inhalant allergy in one parent also conferred additional risk in the presence of asthma in the other parent. Further investigation is needed into the relative importance of genetic factors and in utero and postnatal exposures in determining the differential effects of maternal and paternal asthma on the development of childhood asthma.
虽然遗传在哮喘及其他过敏性疾病中起主要作用，但这些疾病的遗传机制仍知之甚少，父母状况对疾病风险的相对影响也不清楚。我们调查了医生诊断的父母哮喘、湿疹和花粉热，将其作为306名年龄中位数为3.5岁儿童患儿童哮喘和过敏性疾病的横断面预测因素，这些儿童来自至少有一方父母有哮喘或其他过敏病史的家庭。对于儿童哮喘和湿疹，最强的父母预测因素是父母自身患同样的疾病。特别是对于哮喘，在单变量模型（OR = 3.2，95% CI = 1.5至6.7）和多变量模型（OR = 4.1，95% CI = 1.7至10.1）中，母亲哮喘与各年龄段儿童哮喘的关联最为强烈。在单变量模型中，父亲哮喘与儿童哮喘的关联较弱（OR = 1.4，95% CI = 0.6至3.2），但在多变量模型中这种关联强度增加（OR = 2.7，95% CI = 1.0至7.2）。在年龄小于5岁的儿童中，与母亲哮喘相关的儿童哮喘风险（OR = 5.0，95% CI = 1.7至14.9）大于与父亲哮喘相关的风险（OR = 1.6，95% CI = 0.5至5.9），而在年龄大于等于5岁的儿童中，母亲哮喘和父亲哮喘的风险相似（分别为OR = 4.6，95% CI = 1.1至19.0和OR = 4.1，95% CI = 1.0至16.0）。与只有一方父母有吸入性过敏但无哮喘的家庭相比，有一方哮喘父母的家庭生出患哮喘孩子的几率高出三倍，有两方哮喘父母的家庭则高出六倍；此外，一方父母有吸入性过敏在另一方父母有哮喘的情况下也会带来额外风险。需要进一步研究遗传因素以及子宫内和出生后暴露在确定父母哮喘对儿童哮喘发展的不同影响方面的相对重要性。
