Atopy in people aged 40 years and over: Relation to airflow limitation

作者：Guevara-Rattray, E. M.^*; Garden, F. L.; James, A. L.; Wood-Baker, R.; Abramson, M. J.; Johns, D. P.; Buist, A. Sonia; Burney, P. G. J.; Walters, E. Haydn; Toelle, B. G.; Marks, G. B.

来源：Clinical and Experimental Allergy, 2017, 47(12): 1625-1630.

DOI：10.1111/cea.13038

• airflow limitation
• allergic sensitization
• asthma
• atopy
• COPD
• epidemiology
• population health

Background: Previous studies have reached conflicting conclusions about the role of atopy as a risk factor for COPD. In part, this is attributable to variation in the definitions of airflow limitation and the treatment of people with asthma.
Objective: To establish whether there is any independent association between atopy and post-bronchodilator airflow limitation in the general population aged 40 years and over.
Methods: A cross-sectional survey was conducted in a general population sample of 2415 people aged 40 years and over in Australia. A history of ever being diagnosed with asthma was elicited by questionnaire. Atopy was defined as any skin prick test weal to common aeroallergens >= 4 mm. Airflow limitation was defined as post-bronchodilator spirometric (FEV1/FVC) ratio < lower limit of normal. Analyses were adjusted for potential confounding due to age, sex, smoking, race and socioeconomic status.
Results: The prevalence of atopy, ever diagnosed asthma and post-bronchodilator airflow obstruction was 44.8%, 19.3% and 7.5%, respectively. In the population as a whole, atopy was associated with lower FEV1 (adjusted difference -0.068L, 95% confidence interval (CI) -0.104 to -0.032), FVC (adj. difference -0.043L, 95% CI -0.086 to -0.0009) and post-bronchodilator FEV1/FVC ratio (adj. difference -0.011, 95% CI -0.017 to -0.0055). The effect of atopy on lung function was no longer apparent when participants who reported ever diagnosed asthma were excluded (FEV1 -0.011L, [95% CI -0.05 to 0.028L], FVC -0.012L [95% CI -0.060 to 0.036] and FEV1/FVC ratio -0.0012 [95% CI -0.0072 to 0.0047L]).
Conclusion and Clinical Relevance: The apparent association between atopy and post-bronchodilator airflow limitation in the general population appears to be explained by the association between atopy and having ever diagnosed asthma and the effect of asthma on lung function.

• 出版日期2017-12
• 单位河北医科大学