Risk factors for severe adult-onset asthma: a multi-factor approach.

Autor: Toppila-Salmi S; Haartman Institute, Medicum, University of Helsinki, Haartmaninkatu 3, PO Box 21, 00014, Helsinki, Finland. sanna.salmi@helsinki.fi.; Skin and Allergy Hospital, Hospital District of Helsinki and Uusimaa, Helsinki University Hospital and University of Helsinki (HUS), Meilahdentie 2, PO Box 160, 00029, Helsinki, Finland. sanna.salmi@helsinki.fi., Lemmetyinen R; Haartman Institute, Medicum, University of Helsinki, Haartmaninkatu 3, PO Box 21, 00014, Helsinki, Finland.; Skin and Allergy Hospital, Hospital District of Helsinki and Uusimaa, Helsinki University Hospital and University of Helsinki (HUS), Meilahdentie 2, PO Box 160, 00029, Helsinki, Finland., Chanoine S; UGA/Inserm U 1209/CNRS UMR 5309 Joint Research Centre Team of Environmental Epidemiology Applied To Reproduction and Respiratory Health, Institute for Advanced Biosciences, Site Santé - Allée Des Alpes, 38700, La Tronche, France.; Pôle Pharmacie, CHU Grenoble Alpes, 38000, Grenoble, France.; Université Grenoble Alpes, 38000, Grenoble, France., Karjalainen J; Allergy Centre, Tampere University Hospital, Teiskontie 35, PO Box 2000, 33521, Tampere, Finland.; Faculty of Medicine and Health Technology, Tampere University, Tampere University, 33014, Tampere, Finland., Pekkanen J; Department of Public Health, University of Helsinki, Tukholmankatu 8 B, PO Box 20, 00014, Helsinki, Finland.; Environmental Health, National Institute for Health and Welfare, PO Box 95, 70701, Kuopio, Finland., Bousquet J; Humboldt-Universität Zu Berlin, and Berlin Institute of Health, Comprehensive Allergy Center, Department of Dermatology and Allergy, Charité, Universitätsmedizin Berlin, Berlin, Germany.; University Hospital Montpellier, MACVIA-France, Montpellier, France., Siroux V; UGA/Inserm U 1209/CNRS UMR 5309 Joint Research Centre Team of Environmental Epidemiology Applied To Reproduction and Respiratory Health, Institute for Advanced Biosciences, Site Santé - Allée Des Alpes, 38700, La Tronche, France.
Jazyk: angličtina
Zdroj: BMC pulmonary medicine [BMC Pulm Med] 2021 Jul 08; Vol. 21 (1), pp. 214. Date of Electronic Publication: 2021 Jul 08.
DOI: 10.1186/s12890-021-01578-4
Abstrakt: Background: The aim was to identify risk factors for severe adult-onset asthma.
Methods: We used data from a population-based sample (Adult Asthma in Finland) of 1350 patients with adult-onset asthma (age range 31-93 years) from Finnish national registers. Severe asthma was defined as self-reported severe asthma and asthma symptoms causing much harm and regular impairment and ≥ 1 oral corticosteroid course/year or regular oral corticosteroids or waking up in the night due to asthma symptoms/wheezing ≥ a few times/month. Sixteen covariates covering several domains (personal characteristics, education, lifestyle, early-life factors, asthma characteristics and multiple morbidities) were selected based on the literature and were studied in association with severe asthma using logistic regressions.
Results: The study population included 100 (7.4%) individuals with severe asthma. In a univariate analysis, severe asthma was associated with male sex, age, a low education level, no professional training, ever smoking, ≥ 2 siblings, ≥ 1 chronic comorbidity and non-steroidal anti-inflammatory drug (NSAID)-exacerbated respiratory disease (NERD) (p < 0.05), and trends for association (p < 0.2) were observed for severe childhood infection, the presence of chronic rhinosinusitis with nasal polyps, and being the 1st child. The 10 variables (being a 1st child was removed due to multicollinearity) were thus entered in a multivariate regression model, and severe asthma was significantly associated with male sex (OR [95% CI] = 1.96 [1.16-3.30]), ever smoking (1.98 [1.11-3.52]), chronic comorbidities (2.68 [1.35-5.31]), NERD (3.29 [1.75-6.19]), and ≥ 2 siblings (2.51 [1.17-5.41]). There was a dose-response effect of the total sum of these five factors on severe asthma (OR [95% CI] = 2.30 [1.81-2.93] for each one-unit increase in the score).
Conclusions: Male sex, smoking, NERD, comorbidities, and ≥ 2 siblings were independent risk factors for self-reported severe asthma. The effects of these factors seem to be cumulative; each additional risk factor gradually increases the risk of severe asthma.
Databáze: MEDLINE
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