Childhood eczema and rhinitis predict atopic but not nonatopic adult asthma: A prospective cohort study over 4 decades

Martin, Pamela E.; Matheson, Melanie C.; Gurrin, Lyle C.; Burgess, John A.; Osborne, Nicholas J.; Lowe, Adrian J.; Morrison, Stephen; Mészáros, D; Giles, Graham G.; Abramson, Michael J.; Walters, E. Haydn; Allen, Katrina J.; Dharmage, Shyamali C.

doi:10.1016/j.jaci.2011.02.041

Cited by 94 publications

(79 citation statements)

References 30 publications

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“…However, 2 longitudinal studies showed that childhood allergic rhinitis is associated with asthma persistence [28] and atopic asthma, but not nonatopic asthma in adulthood [29]. Atopy is preponderant in childhood asthma and could account for 60% of children with persistent wheezing at ages of 3 and 6 years [30].…”

Section: Discussionmentioning

confidence: 99%

Different Severity and Severity Predictors in Early-Onset and Late-Onset Asthma: A Taiwanese Population-Based Study

Chen

Lee

et al. 2015

Respiration

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Background: Late-onset asthma has been shown to be more severe than early-onset asthma in clinic-based studies. However, population-based studies are scarce, and the predictors of severity have been less studied. Objectives: To determine asthma severity and severity predictors regarding age at onset. Methods: A cross-sectional questionnaire survey was conducted among parents of children from 94 schools in Taiwan in 2004. Asthma severity was defined as short-acting β₂-agonist (SABA), inhaled corticosteroid (ICS) and health care use in the last year. Information on age at onset, demographics, heredity and home exposure was collected. Ordered logistic or logistic regression was used for determining the associations between risk factors and severity. Results: Participants aged 26-50 years were included, resulting in 21,057 (67.8%) participants. Among them, 449 reported ever having had physician-diagnosed asthma, and 381 of those subjects answered the question on age at asthma onset. The risks of rescue SABA, ICS and health care use were generally higher among late-onset (13-50 years) than early-onset (0-12 years) asthmatics. Use of SABA and health care increased from childhood-onset, adolescent- or young adult-onset to adult-onset asthma. Allergic rhinitis was positively associated with SABA use (OR, 9.08; 95% CI, 1.06-77.99) and ICS use (OR, 5.08; 95% CI, 1.47-17.52) in early-onset asthma. Dehumidifier use was negatively associated with SABA use (OR, 0.50; 95% CI, 0.29-0.87) and ICS use (OR, 0.38; 95% CI, 0.19-0.78) in late-onset asthma. Conclusions: In adults, late-onset asthma was more severe than early-onset asthma. Severity, as indicated by SABA and ICS use, was positively associated with allergic rhinitis in early-onset asthma and negatively associated with dehumidifier use in late-onset asthma.

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Section: Discussionmentioning

confidence: 99%

Different Severity and Severity Predictors in Early-Onset and Late-Onset Asthma: A Taiwanese Population-Based Study

Chen

Lee

et al. 2015

Respiration

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“…This is true both for epidemiological studies (e.g. [3][4][5][6]) and for intensive clinical investigations (e.g. [7][8][9]).…”

Section: Introductionmentioning

confidence: 99%

Analyzing atopic and non-atopic asthma

et al. 2012

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There is a need to better define phenotypes of asthma. However, many studies have data available only on asthma and atopy, so they are often used to define ‘atopic’ and ‘non-atopic’ asthma. We discuss and illustrate the problems of analyzing such outcomes. We used the 31 year follow-up of the Northern Finland Birth Cohort 1966 (n=5,429). ‘Atopic asthma’ and ‘non-atopic asthma’ were defined based on presence or absence of atopy (any skin prick test ≥3 mm) at age 31. Gender and ownership of cat in childhood were used as risk factors. Simple calculations on hypothetical datasets were used to support the conclusions. ‘Atopic asthma’ and ‘non-atopic asthma’, are not well separated disease entities. The association of a risk factor with ‘atopic asthma’ and ‘non-atopic asthma’ is determined both by its association with asthma and with atopy. E.g. if a risk factor is not associated with asthma, but is protective for atopy, this will produce a protective association with ‘atopic asthma’, but an opposite association with ‘non-atopic asthma’. This is the result from the typical analysis, which uses all non-asthmatics as the comparison group. Valid results, unconfounded by atopy, can be gained by comparing asthmatics to nonasthmatics separately among atopics and non-atopics, i.e. by doing the analysis stratified by atopy. If data only on asthma and atopy are available, asthma and atopy should be analyzed at first as separate outcomes. If atopic and nonatopic asthma are used as additional outcomes, valid results can be gained by stratifying the analysis by atopy.

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“…The Tasmanian Longitudinal Health Study followed a cohort of 8,583 Australian 7-year-old children from 1968 until 2004 and found that childhood eczema was associated with significantly increased incidence of asthma in childhood, preadolescence, adolescence, and adult life [35]. A subsequent study from this cohort found that childhood eczema predicts atopic but not nonatopic asthma in adulthood [36].…”

Section: Asthmamentioning

confidence: 99%

Atopic Dermatitis: Update on Pathogenesis and Comorbidities

Silverberg

2012

Curr Derm Rep

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Atopic dermatitis (AD) is a significant cause of morbidity and healthcare costs in the United States and worldwide. The prevalence of AD in childhood is rising in the United States and other developed countries for reasons that are not well understood. Similarly, the prevalences of obesity and diabetes are on the rise, which might be contributing toward increased AD. This article reviews the association between AD and other atopic disorders with obesity and diabetes. Furthermore, recently recognized AD comorbidities, including fatty liver disease and erectile dysfunction, are reviewed. Potential mechanisms for the association between AD and metabolic disorders are discussed.

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Childhood eczema and rhinitis predict atopic but not nonatopic adult asthma: A prospective cohort study over 4 decades

Cited by 94 publications

References 30 publications

Different Severity and Severity Predictors in Early-Onset and Late-Onset Asthma: A Taiwanese Population-Based Study

Different Severity and Severity Predictors in Early-Onset and Late-Onset Asthma: A Taiwanese Population-Based Study

Analyzing atopic and non-atopic asthma

Atopic Dermatitis: Update on Pathogenesis and Comorbidities

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