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[城市儿童支气管哮喘的加重因素(II)——特应性和血清脂肪酸的影响及其与城市生活环境的相互作用]

[Factors aggravating bronchial asthma in urban children (II)--The involvement of atopy and serum fatty acids, and their interaction with urban living environment].

作者信息

Nakajima T, Azuma E, Hashimoto M, Toyoshima K, Hayashida M, Komachi Y

机构信息

Osaka Prefectural Institute of Public Health.

出版信息

Nihon Koshu Eisei Zasshi. 1998 May;45(5):423-36.

PMID:9739595
Abstract

The aggravation of bronchial asthma in today's urban child population was studied by an epidemiological study in order to elucidate the involvement of food habits as well as individual factors such as age, sex, and history of atopic dermatitis, and the interaction with urban living environments. The asthma group consisted of 202 children under 12 years old who had been recently diagnosed as having bronchial asthma and under the care of Osaka Prefectural Habikino Hospital. The non-asthma group consisted of 81 children under 12 years old who had been under care at Osaka Prefectural Hospital but had no present history of allergic symptom. The individual factors and the urban living environments (atmospheric environment, housing style) were surveyed by questionnaire. Also, the mite (Dp: Dermatophagoides pteronyssinus, Df: Dermatophagoides farinae) specific immunoglobulin E (Dp-IgE, Df-IgE) and the composition of serum fatty acid were examined as objective indicators for atopy and dietary habits, respectively. In this study, bronchial asthma was classified into two types: atopic/non-atopic, according to whether Dp-IgE was present/absent (positive/negative). Thus, for the risk factors given above, their involvement in each type of asthma was examined. As atopy is an important factor of child asthma, the relative risk (odds ratio) of Dp-IgE increase (atopy) was also examined by logistic regression analysis in each of the asthma and non-asthma groups. The results are as follows: 1. As age increased, the risk of atopy increased but the risk of asthma decreased. 2. The risk of asthma increased as Dp-IgE rather than Df-IgE increased. 3. For the composition of serum fatty acid, the lower quartile ranking (LQR) group for a saturated fatty acid, stearic acid, and the upper quartile ranking (UQR) group for a mono-unsaturated fatty acid, oleic acid, had a higher risk of nonatopic asthma. 4. The LQR group for omega 6-poly-unsaturated fatty acid such as linoleic acid, had a lower risk of atopy. 5. The UQR group for a omega 3-poly-unsaturated fatty acid, eicosapentaenoic acid, had a higher risk of nonatopic asthma. The UQR of eicosapentaenoic acid and living environments within 25 m from a major road or housing of reinforced concrete structure showed involvement in synergistic increase in the risk of non-atopic asthma.

摘要

为了阐明饮食习惯以及年龄、性别和特应性皮炎病史等个体因素与城市生活环境的相互作用对当今城市儿童支气管哮喘病情加重的影响,开展了一项流行病学研究。哮喘组由202名12岁以下近期被诊断为支气管哮喘且在大阪府羽曳野医院接受治疗的儿童组成。非哮喘组由81名12岁以下在大阪府立医院接受治疗但目前无过敏症状病史的儿童组成。通过问卷调查对个体因素和城市生活环境(大气环境、住房类型)进行了调查。此外,分别检测了螨(Dp:屋尘螨,Df:粉尘螨)特异性免疫球蛋白E(Dp-IgE、Df-IgE)以及血清脂肪酸组成,作为特应性和饮食习惯的客观指标。在本研究中,根据Dp-IgE是否存在(阳性/阴性),将支气管哮喘分为两种类型:特应性/非特应性。因此,针对上述危险因素,研究了它们在每种哮喘类型中的作用。由于特应性是儿童哮喘的一个重要因素,还通过逻辑回归分析在哮喘组和非哮喘组中分别研究了Dp-IgE升高(特应性)的相对风险(优势比)。结果如下:1. 随着年龄增长,特应性风险增加但哮喘风险降低。2. 随着Dp-IgE而非Df-IgE升高,哮喘风险增加。3. 对于血清脂肪酸组成,饱和脂肪酸硬脂酸的下四分位数排名(LQR)组和单不饱和脂肪酸油酸的上四分位数排名(UQR)组患非特应性哮喘的风险较高。4. 亚油酸等ω-6多不饱和脂肪酸的LQR组患特应性的风险较低。5. ω-3多不饱和脂肪酸二十碳五烯酸的UQR组患非特应性哮喘的风险较高。二十碳五烯酸的UQR与距离主干道25米以内的生活环境或钢筋混凝土结构住房显示出与非特应性哮喘风险协同增加有关。

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