期刊
JOURNAL OF ASTHMA AND ALLERGY
卷 15, 期 -, 页码 1429-1439出版社
DOVE MEDICAL PRESS LTD
DOI: 10.2147/JAA.S376806
关键词
epidemiology; phenotype; precision medicine; prognosis; risk factors
资金
- The Swedish Heart & Lung Foundation
- The Swedish Research Council
- Umea University
- Vaesterbotten County Council (ALF)
- Norrbotten County Council
- Swedish Asthma-Allergy Foundation
- VISARE NORR Fund: Northern county councils Regional federation
- Thermo Fisher, Uppsala, Sweden
Adult-onset asthma and obesity are associated with severe asthma at follow-up. Sensitization to mites and molds, as well as NSAID-related respiratory symptoms, are more common in severe asthma. Participants with severe asthma at follow-up had more severe respiratory symptoms at study entry.
Background: Risk factors for severe asthma are not well described. The aim was to identify clinical characteristics and risk factors at study entry that are associated with severe asthma at follow-up in a long-term prospective population-based cohort study of adults with asthma. Methods: Between 1986 and 2001, 2055 adults with asthma were identified by clinical examinations of population-based samples in northern Sweden. During 2012-2014, n = 1006 (71% of invited) were still alive, residing in the study area and participated in a followup, of which 40 were identified as having severe asthma according to ERS/ATS, 131 according to GINA, while 875 had other asthma. The mean follow-up time was 18.7 years. Results: Obesity at study entry and adult-onset asthma were associated with severe asthma at follow-up. While severe asthma was more common in those with adult-onset asthma in both men and women, the association with obesity was observed in women only. Sensitization to mites and moulds, but not to other allergens, as well as NSAID-related respiratory symptoms was more common in severe asthma than in other asthma. Participants with severe asthma at follow-up had lower FEV1, more pronounced FEV1 reversibility, and more wheeze, dyspnea and nighttime awakenings already at study entry than those with other asthma. Conclusion: Adult-onset asthma is an important risk factor for development of severe asthma in adults, and obesity increased the risk among women. The high burden of respiratory symptoms already at study entry also indicate long-term associations with development of severe asthma.
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