从儿童到成人的哮喘和过敏症状轨迹
2021/09/24
摘要
背景：哮喘和过敏性疾病的表型研究大多是在儿童或成人中进行的。为了探讨青少年期和青年期的作用，我们调查了从儿童期向成年期过渡时的症状轨迹。
方法：潜在类别分析（LCA）用于人群研究，研究人群招募最初为儿童哮喘和过敏国际研究的第二期德国组，它们对这些儿童有三次随访，直到30出头（N=2267）。LCA中包括的指标是12个月内喘息、鼻结膜炎和湿疹症状的患病率。关于重要的特征，如皮肤点刺试验，潜在类别得到进一步描述。Logistic回归模型用于调查吸烟和职业暴露等环境决定因素的相关性。
结果：研究确定了六种潜在类型：一种无症状，三种为单一症状，两种为合并症状。所有轨迹基本上是在10年左右的基线评估和17年左右的首次随访之间确定的。从儿童期到青少年期，症状出现的概率增加，尤其是与喘息相关的潜在类别，而在成年期，症状发生的概率保持不变。喘息相关的潜在类别也与青少年期的暴露（如主动吸烟）呈正相关。
结论：哮喘和过敏症状的不同轨迹从儿童期到青少年期逐渐形成，并在成年早期趋于稳定。这种模式在喘息相关的潜在类别中最为显著，在青少年期/青年期，这些类别也与环境暴露表现出最强的正相关性。因此，儿童期和青少年期都与疾病的发展有关，这为预防和促进健康提供了巨大的潜力。
Trajectories of asthma and allergy symptoms from childhood to adulthood
Felix Forster, Markus Johannes Ege, Jessica Gerlich, Tobias Weinmann, Sylvia Kreißl, Gudrun Weinmayr, Jon Genuneit, Dennis Nowak, Erika von Mutius, Christian Vogelberg, Katja Radon
Abstract
BACKGROUND:Phenotypes of asthma and allergic diseases are mainly studied separately for children and adults. To explore the role of adolescence and young adulthood, we investigated symptom trajectories at the transition from childhood into adulthood.
METHODS:Latent class analysis (LCA) was conducted in a population initially recruited for the German arm of Phase II of the International Study of Asthma and Allergies in Childhood and followed-up three times until their early 30s (N=2267). Indicators included in LCA were 12-month prevalences of symptoms of wheeze, rhinoconjunctivitis, and eczema. Latent classes were further characterised regarding important traits such as skin prick tests. Logistic regression models were used to investigate associations with environmental determinants such as smoking and occupational exposures.
RESULTS:Six latent classes were identified: an asymptomatic one as well as three with single and two with co-occurring symptoms. All trajectories essentially established between baseline assessment at around 10 years and the first follow-up at around 17 years. Probabilities for symptoms increased from childhood to adolescence, especially for wheeze-related latent classes, while they remained constant in adulthood. Wheeze-related latent classes were also positively associated with exposures during adolescence (e.g. active smoking).
CONCLUSION:Distinct trajectories of asthma and allergy symptoms establish from childhood through adolescence and stabilize during early adulthood. This pattern was most notable in wheeze-related latent classes which also showed the strongest positive associations with environmental exposures in adolescence/young adulthood. Therefore, not only childhood but also adolescence is relevant for disease development and offers considerable potential for prevention and health promotion.
背景：哮喘和过敏性疾病的表型研究大多是在儿童或成人中进行的。为了探讨青少年期和青年期的作用，我们调查了从儿童期向成年期过渡时的症状轨迹。
方法：潜在类别分析（LCA）用于人群研究，研究人群招募最初为儿童哮喘和过敏国际研究的第二期德国组，它们对这些儿童有三次随访，直到30出头（N=2267）。LCA中包括的指标是12个月内喘息、鼻结膜炎和湿疹症状的患病率。关于重要的特征，如皮肤点刺试验，潜在类别得到进一步描述。Logistic回归模型用于调查吸烟和职业暴露等环境决定因素的相关性。
结果：研究确定了六种潜在类型：一种无症状，三种为单一症状，两种为合并症状。所有轨迹基本上是在10年左右的基线评估和17年左右的首次随访之间确定的。从儿童期到青少年期，症状出现的概率增加，尤其是与喘息相关的潜在类别，而在成年期，症状发生的概率保持不变。喘息相关的潜在类别也与青少年期的暴露（如主动吸烟）呈正相关。
结论：哮喘和过敏症状的不同轨迹从儿童期到青少年期逐渐形成，并在成年早期趋于稳定。这种模式在喘息相关的潜在类别中最为显著，在青少年期/青年期，这些类别也与环境暴露表现出最强的正相关性。因此，儿童期和青少年期都与疾病的发展有关，这为预防和促进健康提供了巨大的潜力。
(中日友好医院呼吸与危重症医学科 顾宪民 摘译 林江涛 审校)
(Allergy.2021 Sep 2.doi: 10.1111/all.15075.)
(Allergy.2021 Sep 2.doi: 10.1111/all.15075.)
Trajectories of asthma and allergy symptoms from childhood to adulthood
Felix Forster, Markus Johannes Ege, Jessica Gerlich, Tobias Weinmann, Sylvia Kreißl, Gudrun Weinmayr, Jon Genuneit, Dennis Nowak, Erika von Mutius, Christian Vogelberg, Katja Radon
Abstract
BACKGROUND:Phenotypes of asthma and allergic diseases are mainly studied separately for children and adults. To explore the role of adolescence and young adulthood, we investigated symptom trajectories at the transition from childhood into adulthood.
METHODS:Latent class analysis (LCA) was conducted in a population initially recruited for the German arm of Phase II of the International Study of Asthma and Allergies in Childhood and followed-up three times until their early 30s (N=2267). Indicators included in LCA were 12-month prevalences of symptoms of wheeze, rhinoconjunctivitis, and eczema. Latent classes were further characterised regarding important traits such as skin prick tests. Logistic regression models were used to investigate associations with environmental determinants such as smoking and occupational exposures.
RESULTS:Six latent classes were identified: an asymptomatic one as well as three with single and two with co-occurring symptoms. All trajectories essentially established between baseline assessment at around 10 years and the first follow-up at around 17 years. Probabilities for symptoms increased from childhood to adolescence, especially for wheeze-related latent classes, while they remained constant in adulthood. Wheeze-related latent classes were also positively associated with exposures during adolescence (e.g. active smoking).
CONCLUSION:Distinct trajectories of asthma and allergy symptoms establish from childhood through adolescence and stabilize during early adulthood. This pattern was most notable in wheeze-related latent classes which also showed the strongest positive associations with environmental exposures in adolescence/young adulthood. Therefore, not only childhood but also adolescence is relevant for disease development and offers considerable potential for prevention and health promotion.
上一篇：
哮喘与COVID-19风险：一项系统综述和荟萃分析
下一篇：
儿童早期环境空气污染暴露与儿童哮喘风险增加相关：来自瑞典斯德哥尔摩的一项队列研究
