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Determinant of persistent asthma and new asthma onset in a longitudinal study with special reference to atopic sensitization
Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Arbets- och miljömedicin.ORCID-id: 0000-0001-9412-6242
Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Arbets- och miljömedicin.
Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Arbets- och miljömedicin.
Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Lungmedicin och allergologi.
2011 (Engelska)Ingår i: American Journal of Respiratory and Critical Care Medicine, ISSN 1073-449X, E-ISSN 1535-4970, Vol. 183, s. A4307-Artikel i tidskrift, Meeting abstract (Övrigt vetenskapligt) Published
Abstract [en]

Our knowledge about atopy as a longitudinal predictor of asthma is limited. The purpose of this study was to investigate the prognosis of asthma and risk factors for asthma onset, especially sensitization of specific allergens in a population sample.

A cohort responded to a respiratory questionnaire in 1990 and 2003. At baseline, 1851 subjects who, in the screening questionnaire, reported respiratory symptoms and 447 controls were investigated with interviews, spirometry and skin prick test. A total of 721 asthmatics and 976 subjects without respiratory disease were clinically verified. At follow-up in 2003, 340 subjects with persistent asthma and 186 subjects with asthma remission were identified while 76 subjects reported new asthma onset.

Sensitisation to pets and a high symptom score were significant determinants of persistent asthma (Odds Ratio [ORs] 3.2 [95% CI 1.9-5.6], and 5.7 [2.5-13.3] respectively), and onset of asthma, (ORs 2.6 [1.1-6.0], and 1.7 [1.2-2.3], respectively). A high self-reported responsiveness to airway irritants (OR 1.6 [1.1-2.2]), and more asthma medications (OR 2.0 [1.3-2.9]) were additional risk factors for persistent asthma at the follow-up. Belonging to the older age group decreased the risk both of having persistent asthma and asthma onset.

In conclusion, asthmatics sensitised to pets have a more severe outcome than asthmatics not sensitised to pets. Sensitisation to pets was also a strong predictor for onset of asthma. Our study also indicates that special attention should be given to asthmatics that report having severe symptoms and problems with airway irritants as such patients are more likely to have persistent problems.

Ort, förlag, år, upplaga, sidor
2011. Vol. 183, s. A4307-
Nyckelord [en]
asthma, longitudinal study, allergens, allergy tests, skin prick test, prognosis
Nationell ämneskategori
Lungmedicin och allergi
Forskningsämne
Arbets- och miljömedicin
Identifikatorer
URN: urn:nbn:se:uu:diva-133142OAI: oai:DiVA.org:uu-133142DiVA, id: diva2:360223
Tillgänglig från: 2010-11-02 Skapad: 2010-11-02 Senast uppdaterad: 2017-12-12Bibliografiskt granskad
Ingår i avhandling
1. A Longitudinal Study of Asthma: Risk Factors and Prognosis
Öppna denna publikation i ny flik eller fönster >>A Longitudinal Study of Asthma: Risk Factors and Prognosis
2010 (Engelska)Doktorsavhandling, sammanläggning (Övrigt vetenskapligt)
Abstract [en]

The aim of this thesis was to identify risk factors for the onset of adult asthma. Other objectives were to study determinants of smoking habits and the association between sensitization and outcome of asthma.

In 1990, a questionnaire was distributed to 12,732 individuals from three age groups (16, 30-39 and 60-69 years) in two counties of Sweden. In a second phase, 2538 subjects who had reported respiratory symptoms and 600 controls were invited to clinical investigations, 81% participated. At the follow-up in 2003 subjects of the remaining cohort (11,282) were re-invited. Analyses are based on the 67% (n=7563) who responded to both questionnaires 1990 and 2003.

In 2003, 17.2% of the young adults, 11.4% of the middle-aged and 10.3% of the elderly reported having, or having had, asthma. A total of 791 subjects reported onset of asthma during the 13-year study period. Lifestyle factors such as smoking, obesity, hard physical training and a low consumption of fruit and fish were constant risk factors for onset of asthma after adjusting for socioeconomic group. A smoker’s risk of asthma onset was increased by 37%. The impact of risk factors differed between the age-groups. BMI had a significantly higher impact in the middle-aged and elderly.

In subjects participating in the clinical investigations in 1990, sensitization to pets, were determinants of both persistent asthma and onset of asthma in 2003. The risk for persistent asthma was threefold. The risk for onset of asthma was more than doubled.

Smoking at baseline in 1990 was the strongest determinant of being a smoker in 2003. Allergic sensitization and clinically verified asthma were not associated with smoking habits in 2003. No differences in changing smoking habits could be identified between smokers with or without asthma.

In conclusion, modifiable lifestyle factors are important risk factors for adult onset asthma. The co-occurrence and interplay between asthma and cigarette smoking is still puzzling.

 

Ort, förlag, år, upplaga, sidor
Uppsala: Acta Universitatis Upsaliensis, 2010. s. 52
Serie
Digital Comprehensive Summaries of Uppsala Dissertations from the Faculty of Medicine, ISSN 1651-6206 ; 622
Nyckelord
asthma epidemiology, longitudinal studies, obstructive airway symptoms, risk factors, BMI, diet, smoking, allergic sensitization, atopy
Nationell ämneskategori
Medicin och hälsovetenskap
Identifikatorer
urn:nbn:se:uu:diva-133218 (URN)978-91-554-7948-0 (ISBN)
Disputation
2010-12-16, Enghoffsalen, Ing 50, Akademiska Sjukhuset, Uppsala, 13:15 (Svenska)
Opponent
Handledare
Tillgänglig från: 2010-11-24 Skapad: 2010-11-03 Senast uppdaterad: 2011-01-13Bibliografiskt granskad

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http://ajrccm.atsjournals.org/cgi/reprint/183/1_MeetingAbstracts/A4307?sid=acfb8378-28dd-4761-a3ad-c2ce30c8e60a

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Rask-Andersen, AnnaUddenfeldt, Monica

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