Familial Risk of Asthma Among Adolescents and Their Relatives in Taiwan

Abstract

Although family studies have established that asthma has a hereditary basis, little evidence has been presented about the family risk of simple asthma (AS or nonatopic asthma) and asthma with other atopic diseases (AWAD or atopic asthma) after adjusting for potential risk factors. In this study, data were collected on demographic variables and a wide range of known risk factors for asthma. Study participants were asthmatic adolescents and controls, and their relatives. The role of a familial history of asthma and atopic diseases in predicting asthma risk among asthmatic adolescents and their relatives was evaluated in a population-based family study conducted in southern Taiwan. Asthma risk factor data were collected through telephone interviews with students' parents for 207 asthmatic adolescents 11-16 years of age, their 1600 relatives, and 207 nonasthmatic adolescents in the control group and their 1638 relatives. The results show (after adjusting potential confounders) that a family history of asthma is highly associated with asthma in adolescents. Having two or more family members with asthma was associated with a 3.4-fold (95% confidence interval [CI] = 1.0-12.0) increased risk of asthma among adolescents. Logistic regression was used to assess the effects of having an asthmatic relative and the effect of atopic diseases among relatives of cases. Having a family history of asthma and other atopic conditions, such as rhinitis and atopic dermatitis (adjusted odds ratio [AOR] = 3.64, 95% CI = 2.29-5.74 and AOR = 1.94, 95% CI = 1.53-2.46, respectively), was found to be a significant predictor of asthma in children. Along with a history of allergic rhinitis or atopic dermatitis, familial risks of asthma occurring in adolescents with and without other atopic diseases will be analyzed separately. A critical finding was the significant difference in a risk of asthma and atopic diseases among the relatives of asthma cases with atopic diseases and controls. However, for relatives of asthma cases without atopic diseases compared to control probands, AORs were highly significant for family history of asthma, but not for the family history of atopic diseases. These findings suggest that both forms of asthma may be hereditary, but there are differences in their modes of inheritance. Atopic status itself did not predispose a child to AS. A concomitant inheritance of a predisposition to asthma and atopic condition for AWAD cases was suggested.

Risk factors of asthma in the Asian population: a systematic review and meta-analysis

“…Overall, 91 studies in Asia investigated the associations between the family history of various allergy-related diseases and the risk of asthma development [ 20 , 22 , 23 , 25 – 27 , 31 , 32 , 34 – 36 , 42 , 44 – 46 , 51 , 52 , 57 , 59 , 62 , 65 – 68 , 70 – 73 , 76 – 79 , 82 – 140 ]. Among these, the family medical history of asthma (any family members) was most frequently studied and significantly associated with an increased risk of asthma (36 studies) [ 20 , 25 – 27 , 32 , 34 , 35 , 44 – 46 , 51 , 57 , 59 , 76 , 77 , 79 , 82 , 83 , 86 , 95 , 101 , 102 , 104 – 106 , 108 – 110 , 112 , 116 , 123 , 128 , 129 , 133 , 137 , 140 , 141 ]. In the random-effect meta-analysis performed for the family history of asthma (any family members) based on these 36 studies, the combined risk estimate for asthma development was increased significantly (pooled OR = 4.66, 95% CI : 3.73–5.82, I 2 = 90.2%, heterogeneity p value < 0.001; Fig.…”

“…S 1 ). Further, we also performed meta-analyses for the family medical history of asthma in specific family groups separately, including paternal asthma (11 studies) [ 26 , 27 , 62 , 68 , 92 , 113 , 114 , 117 , 119 , 120 , 138 ], maternal asthma (15 studies) [ 26 , 27 , 62 , 68 , 73 , 84 , 89 , 92 , 113 , 117 , 119 , 120 , 123 , 134 , 138 ], parental asthma (9 studies) [ 26 , 66 , 72 , 78 , 88 , 93 , 118 , 121 , 122 ], and sibling’s asthma (4 studies) [ 26 , 65 , 123 , 138 ]. The combined risk estimates for asthma were also significantly increased in these four meta-analyses (pooled OR ranged between 3.22 and 4; Fig.…”

“…Overall, the family medical history of various allergy-related conditions was most frequently studied and reported to be significantly associated with the risk of asthma development. Of these family medical conditions, frequently reported was the family history of asthma, which was found to significantly associate with asthma development in 37 studies performed in Asia (Table S 5 ) [ 20 , 25 – 27 , 32 , 34 , 35 , 44 – 46 , 51 , 57 , 59 , 76 , 77 , 79 , 82 , 83 , 86 , 95 , 101 , 102 , 104 – 106 , 108 – 110 , 112 , 116 , 123 , 125 , 128 , 129 , 133 , 137 , 140 , 141 ]. Our findings are in concordance with the meta-analysis result performed previously using 6 independent studies, which showed an overall increase in asthma risk for preschool children with a family history of asthma (pooled OR = 2.20, 95% CI : 1.54–3.14) [ 12 ].…”

Risk for Asthma in Offspring of Asthmatic Mothers versus Fathers: A Meta-Analysis

“…In 18 studies, asthma was physician diagnosed based on questionnaire [8], [11], [14], [15], [18], [19], [21]–[24], [26], [28], [29], [34], [35], [37]–[39]. In 7 studies asthma diagnosis was based on questionnaire, but not specifically physician diagnosed [12], [13], [16], [17], [25], [27], [40].…”

“…Of the 33 studies used in this meta-analysis, 8 included patients less than 5 years of age at time of the study [11], [15], [19], [20], [26], [32], [33], [40]. Of the 33 studies used in the meta-analysis, 25 were population based [8]–[11], [13]–[20], [23]–[25], [27], [30]–[35], [39], [40], [86] and 8 were case-control studies [12], [21], [22], [26], [28], [29], [37], [38].…”