The sex‐shift in single disease and multimorbid asthma and rhinitis during puberty ‐ a study by MeDALL

  • T. Keller
    Institute of Social Medicine, Epidemiology and Health Economics Charité – Universitätsmedizin Berlin Berlin Germany
  • C. Hohmann
    Institute of Social Medicine, Epidemiology and Health Economics Charité – Universitätsmedizin Berlin Berlin Germany
  • M. Standl
    Institute of Epidemiology I Helmholtz Zentrum München ‐ German Research Center for Environmental Health Neuherberg Germany
  • A. H. Wijga
    Center for Nutrition, Prevention, and Health Services National Institute for Public Health and the Environment Bilthoven The Netherlands
  • U. Gehring
    Division of Environmental Epidemiology Institute for Risk Assessment Sciences Utrecht University Utrecht The Netherlands
  • E. Melén
    Department of Medical Epidemiology and Biostatistics Karolinska Institutet Solna Sweden
  • C. Almqvist
    Department of Medical Epidemiology and Biostatistics Karolinska Institutet Solna Sweden
  • S. Lau
    Department of Paediatric Pneumology & Immunology Charité‐Universitätsmedizin Berlin Berlin Germany
  • E. Eller
    Department of Dermatology and Allergy Center Odense Research Center for Anaphylaxis (ORCA) Odense University Hospital Odense Denmark
  • U. Wahn
    Department of Paediatric Pneumology & Immunology Charité‐Universitätsmedizin Berlin Berlin Germany
  • E. S. Christiansen
    Department of Dermatology and Allergy Center Odense Research Center for Anaphylaxis (ORCA) Odense University Hospital Odense Denmark
  • A. von Berg
    Department of Pediatrics Research Institute Marien‐Hospital Wesel Wesel Germany
  • J. Heinrich
    Institute of Epidemiology I Helmholtz Zentrum München ‐ German Research Center for Environmental Health Neuherberg Germany
  • I. Lehmann
    Department of Environmental Immunology/Core Facility Studies Helmholtz Centre for Environmental Research – UFZ Leipzig Germany
  • D. Maier
    Biomax Informatics AG Munich Germany
  • D. S. Postma
    Department of Pulmonology University Medical Center Groningen University of Groningen Groningen The Netherlands
  • J. M. Antó
    Centre for Research in Environmental Epidemiology (CREAL) ISGlobal Barcelona Spain
  • J. Bousquet
    Universitat Popmpeu Fabra (UPF) Barcelona Spain
  • T. Keil
    Institute of Social Medicine, Epidemiology and Health Economics Charité – Universitätsmedizin Berlin Berlin Germany
  • S. Roll
    Institute of Social Medicine, Epidemiology and Health Economics Charité – Universitätsmedizin Berlin Berlin Germany

抄録

<jats:title>Abstract</jats:title><jats:sec><jats:title>Background</jats:title><jats:p>Cross‐sectional studies suggested that allergy prevalence in childhood is higher in boys compared to girls, but it remains unclear whether this inequality changes after puberty. We examined the sex‐specific prevalence of asthma and rhinitis as single and as multimorbid diseases before and after puberty onset in longitudinal cohort data.</jats:p></jats:sec><jats:sec><jats:title>Methods</jats:title><jats:p>In six European population‐based birth cohorts of MeDALL, we assessed the outcomes: current rhinitis, current asthma, current allergic multimorbidity (ie, concurrent asthma and rhinitis), puberty status and allergic sensitization by specific serum antibodies (immunoglobulin E) against aero‐allergens. With generalized estimating equations, we analysed the effects of sex, age, puberty (yes/no) and possible confounders on the prevalence of asthma and rhinitis, and allergic multimorbidity in each cohort separately and performed individual participant data meta‐analysis.</jats:p></jats:sec><jats:sec><jats:title>Findings</jats:title><jats:p>We included data from 19 013 participants from birth to age 14‐20 years. Current rhinitis only affected girls less often than boys before and after puberty onset: adjusted odds ratio for females vs males 0.79 (95%‐confidence interval 0.73‐0.86) and 0.86 (0.79‐0.94), respectively (sex‐puberty interaction <jats:italic>P</jats:italic> = .089). Similarly, for current asthma only, females were less often affected than boys both before and after puberty onset: 0.71, 0.63‐0.81 and 0.81, 0.64‐1.02, respectively (sex‐puberty interaction <jats:italic>P</jats:italic> = .327). The prevalence of allergic multimorbidity showed the strongest sex effect before puberty onset (female‐male‐OR 0.55, 0.46‐0.64) and a considerable shift towards a sex‐balanced prevalence after puberty onset (0.89, 0.74‐1.04); sex‐puberty interaction: <jats:italic>P</jats:italic> < .001.</jats:p></jats:sec><jats:sec><jats:title>Interpretation</jats:title><jats:p>The male predominance in prevalence before puberty and the “sex‐shift” towards females after puberty onset were strongest in multimorbid patients who had asthma and rhinitis concurrently.</jats:p></jats:sec>

収録刊行物

  • Allergy

    Allergy 73 (3), 602-614, 2017-11-07

    Wiley

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