TY - JOUR
T1 - Risk factors for severe adult-onset asthma
T2 - a multi-factor approach
AU - Toppila-Salmi, Sanna
AU - Lemmetyinen, Riikka
AU - Chanoine, Sebastien
AU - Karjalainen, Jussi
AU - Pekkanen, Juha
AU - Bousquet, Jean
AU - Siroux, Valérie
N1 - Funding Information:
The study was supported in part by research grants from the Finnish Medical Foundation, the Finnish Society of Allergology and Immunology, the Jane and Aatos Erkko Foundation, the Paulo Foundation, State funding for university-level health research (TYH2019322), the Tampere Tuberculosis Foundation, the Väinö and Laina Kivi Foundation, and the Yrjö Jahnsson Foundation.
Funding Information:
We thank the following people for their valuable contributions: Professor Arpo Aromaa from the National Institute for Health and Welfare, MSc Heini Huhtala and Professor Markku M. Nieminen from the University of Tampere, and Professor Timo Klaukka? from the National Health Insurance Institute.
Publisher Copyright:
© 2021, The Author(s).
PY - 2021
Y1 - 2021
N2 - Background: The aim was to identify risk factors for severe adult-onset asthma. Methods: We used data from a population-based sample (Adult Asthma in Finland) of 1350 patients with adult-onset asthma (age range 31–93 years) from Finnish national registers. Severe asthma was defined as self-reported severe asthma and asthma symptoms causing much harm and regular impairment and ≥ 1 oral corticosteroid course/year or regular oral corticosteroids or waking up in the night due to asthma symptoms/wheezing ≥ a few times/month. Sixteen covariates covering several domains (personal characteristics, education, lifestyle, early-life factors, asthma characteristics and multiple morbidities) were selected based on the literature and were studied in association with severe asthma using logistic regressions. Results: The study population included 100 (7.4%) individuals with severe asthma. In a univariate analysis, severe asthma was associated with male sex, age, a low education level, no professional training, ever smoking, ≥ 2 siblings, ≥ 1 chronic comorbidity and non-steroidal anti-inflammatory drug (NSAID)-exacerbated respiratory disease (NERD) (p < 0.05), and trends for association (p < 0.2) were observed for severe childhood infection, the presence of chronic rhinosinusitis with nasal polyps, and being the 1st child. The 10 variables (being a 1st child was removed due to multicollinearity) were thus entered in a multivariate regression model, and severe asthma was significantly associated with male sex (OR [95% CI] = 1.96 [1.16–3.30]), ever smoking (1.98 [1.11–3.52]), chronic comorbidities (2.68 [1.35–5.31]), NERD (3.29 [1.75–6.19]), and ≥ 2 siblings (2.51 [1.17–5.41]). There was a dose–response effect of the total sum of these five factors on severe asthma (OR [95% CI] = 2.30 [1.81–2.93] for each one-unit increase in the score). Conclusions: Male sex, smoking, NERD, comorbidities, and ≥ 2 siblings were independent risk factors for self-reported severe asthma. The effects of these factors seem to be cumulative; each additional risk factor gradually increases the risk of severe asthma.
AB - Background: The aim was to identify risk factors for severe adult-onset asthma. Methods: We used data from a population-based sample (Adult Asthma in Finland) of 1350 patients with adult-onset asthma (age range 31–93 years) from Finnish national registers. Severe asthma was defined as self-reported severe asthma and asthma symptoms causing much harm and regular impairment and ≥ 1 oral corticosteroid course/year or regular oral corticosteroids or waking up in the night due to asthma symptoms/wheezing ≥ a few times/month. Sixteen covariates covering several domains (personal characteristics, education, lifestyle, early-life factors, asthma characteristics and multiple morbidities) were selected based on the literature and were studied in association with severe asthma using logistic regressions. Results: The study population included 100 (7.4%) individuals with severe asthma. In a univariate analysis, severe asthma was associated with male sex, age, a low education level, no professional training, ever smoking, ≥ 2 siblings, ≥ 1 chronic comorbidity and non-steroidal anti-inflammatory drug (NSAID)-exacerbated respiratory disease (NERD) (p < 0.05), and trends for association (p < 0.2) were observed for severe childhood infection, the presence of chronic rhinosinusitis with nasal polyps, and being the 1st child. The 10 variables (being a 1st child was removed due to multicollinearity) were thus entered in a multivariate regression model, and severe asthma was significantly associated with male sex (OR [95% CI] = 1.96 [1.16–3.30]), ever smoking (1.98 [1.11–3.52]), chronic comorbidities (2.68 [1.35–5.31]), NERD (3.29 [1.75–6.19]), and ≥ 2 siblings (2.51 [1.17–5.41]). There was a dose–response effect of the total sum of these five factors on severe asthma (OR [95% CI] = 2.30 [1.81–2.93] for each one-unit increase in the score). Conclusions: Male sex, smoking, NERD, comorbidities, and ≥ 2 siblings were independent risk factors for self-reported severe asthma. The effects of these factors seem to be cumulative; each additional risk factor gradually increases the risk of severe asthma.
KW - Acetylsalicylic acid
KW - Allergy
KW - Asthma
KW - Epidemiology
KW - Sinusitis
U2 - 10.1186/s12890-021-01578-4
DO - 10.1186/s12890-021-01578-4
M3 - Article
AN - SCOPUS:85109614771
SN - 1471-2466
VL - 21
JO - Bmc Pulmonary Medicine
JF - Bmc Pulmonary Medicine
IS - 1
M1 - 214
ER -