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Combined effects of multiple risk factors on asthma in school-aged children.
Szentpetery, Sylvia S; Gruzieva, Olena; Forno, Erick; Han, Yueh-Ying; Bergström, Anna; Kull, Inger; Acosta-Pérez, Edna; Colón-Semidey, Angel; Alvarez, Maria; Canino, Glorisa J; Melén, Erik; Celedón, Juan C.
Afiliação
  • Szentpetery SS; Division of Pulmonary Medicine, Allergy, and Immunology, Department of Pediatrics, Children's Hospital of Pittsburgh of UPMC, University of Pittsburgh, Pittsburgh, PA, United States.
  • Gruzieva O; Institute of Environmental Medicine, Karolinska Institute, Stockholm, Sweden.
  • Forno E; Division of Pulmonary Medicine, Allergy, and Immunology, Department of Pediatrics, Children's Hospital of Pittsburgh of UPMC, University of Pittsburgh, Pittsburgh, PA, United States.
  • Han YY; Division of Pulmonary Medicine, Allergy, and Immunology, Department of Pediatrics, Children's Hospital of Pittsburgh of UPMC, University of Pittsburgh, Pittsburgh, PA, United States.
  • Bergström A; Institute of Environmental Medicine, Karolinska Institute, Stockholm, Sweden; Centre for Occupational and Environmental Medicine, Stockholm County Council, Sweden.
  • Kull I; Sachs' Children's Hospital, Södersjukhuset and the Department of Clinical Science and Education, Karolinska Institutet, Stockholm, Sweden.
  • Acosta-Pérez E; Behavioral Sciences Research Institute, University of Puerto Rico, San Juan, Puerto Rico.
  • Colón-Semidey A; Behavioral Sciences Research Institute, University of Puerto Rico, San Juan, Puerto Rico.
  • Alvarez M; Centre for Occupational and Environmental Medicine, Stockholm County Council, Sweden.
  • Canino GJ; Behavioral Sciences Research Institute, University of Puerto Rico, San Juan, Puerto Rico.
  • Melén E; Institute of Environmental Medicine, Karolinska Institute, Stockholm, Sweden; Sachs' Children's Hospital, Södersjukhuset and the Department of Clinical Science and Education, Karolinska Institutet, Stockholm, Sweden.
  • Celedón JC; Division of Pulmonary Medicine, Allergy, and Immunology, Department of Pediatrics, Children's Hospital of Pittsburgh of UPMC, University of Pittsburgh, Pittsburgh, PA, United States. Electronic address: juan.celedon@chp.edu.
Respir Med ; 133: 16-21, 2017 12.
Article em En | MEDLINE | ID: mdl-29173444
BACKGROUND: Little is known about synergistic effects of several risk factors on asthma. We developed a risk score in Puerto Rican children, and then used this score to estimate the combined effects of multiple risk factors on asthma at school age in Puerto Rican and Swedish children. METHODS: Case-control study in 609 Puerto Rican children (aged 6-14 years) and longitudinal birth cohort study of 2290 Swedish children followed up to age 12 years (The Children, Allergy, Milieu, Stockholm, Epidemiological Survey [BAMSE] Study). In both cohorts, there was data on parental asthma, sex, obesity, allergic rhinitis, and early-life second-hand smoke (SHS); data on diet and (in children ≥9 years) lifetime exposure to gun violence were also available in the Puerto Rico study. Asthma was defined as physician-diagnosed asthma and ≥1 episode of wheeze in the previous year. RESULTS: In a multivariable analysis in Puerto Rican children, male sex, parental asthma, allergic rhinitis, early-life SHS, an unhealthy diet and (in children ≥9 years) gun violence were each significantly associated with asthma. We next created a risk score using these variables (range, 0 to 5-6 in Puerto Rico and 0 to 4 in BAMSE). Compared with Puerto Rican children without any risk factors (i.e. a score of 0), Puerto Rican children with 2, 3, and at least 4 risk factors had 3.6 times (95% CI = 1.4-9.2), 10.4 times (95% CI = 4.0-27.0), and 21.6 times (95% CI = 7.2-64.9) significantly higher odds of asthma, respectively. In BAMSE, the presence of 2, 3, and at least 4 risk factors was significantly associated with 4.1 times (95% CI = 2.3-7.4), 6.3 times (95% CI = 3.0-13.3), and 17.2 times (95% CI = 4.1-73.2) increased odds of asthma at age 12 years. CONCLUSIONS: Our findings emphasize the multifactorial etiology of asthma, and suggest that concurrent eradication or reduction of several modifiable risk factors may better prevent or reduce the burden of childhood asthma.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Asma / Instituições Acadêmicas / Poluição por Fumaça de Tabaco / Rinite Alérgica / Obesidade Tipo de estudo: Etiology_studies / Observational_studies / Risk_factors_studies Aspecto: Determinantes_sociais_saude Limite: Adolescent / Child / Female / Humans / Male País/Região como assunto: Caribe / Europa / Puerto rico Idioma: En Revista: Respir Med Ano de publicação: 2017 Tipo de documento: Article País de afiliação: Estados Unidos País de publicação: Reino Unido

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Asma / Instituições Acadêmicas / Poluição por Fumaça de Tabaco / Rinite Alérgica / Obesidade Tipo de estudo: Etiology_studies / Observational_studies / Risk_factors_studies Aspecto: Determinantes_sociais_saude Limite: Adolescent / Child / Female / Humans / Male País/Região como assunto: Caribe / Europa / Puerto rico Idioma: En Revista: Respir Med Ano de publicação: 2017 Tipo de documento: Article País de afiliação: Estados Unidos País de publicação: Reino Unido