title: Risk factors for onset and remission of atopy, wheeze, and airway hyperresponsiveness.
abstract: BACKGROUND
  Although many children with asthma may have a remission as they grow and other children who did not have asthma may develop asthma in adult life, knowledge about the factors that influence the onset and prognosis of asthma during adolescence and young adulthood is very limited.
  
  
  METHODS
  A cohort of 8-10 year old children (n=718) living in Belmont, New South Wales, Australia were surveyed six times at 2 yearly intervals from 1982 to 1992, and then again 5 years later in 1997. From this cohort, 498 subjects had between three and seven assessments and were included in the analysis. Atopy, airway hyperresponsiveness (AHR), and wheeze in the last 12 months were measured at each survey. Late onset, remission, and persistence were defined based on characteristics at the initial survey and the changes in characteristics at the follow up surveys.
  
  
  RESULTS
  The proportion of subjects with late onset atopy (13.7%) and wheeze (12.4%) was greater than the proportion with remission of atopy (3.2%) and wheeze (5.6%). Having atopy at age 8-12 years (OR 2.8, 95% CI 1.5 to 5.1) and having a parental history of asthma (OR 2.0, 95% CI 1.02 to 4.13) were significant risk factors for the onset of wheeze. Having AHR at age 8-12 years was a significant risk factor for the persistence of wheeze (OR 4.3, 95% CI 1.3 to 15.0). Female sex (OR 1.9, 95% CI 1.01 to 3.60) was a significant risk factor for late onset AHR whereas male sex (OR 1.9, 95% CI 1.1 to 2.8) was a significant risk factor for late onset atopy.
  
  
  CONCLUSIONS
  The onset of AHR is uncommon during adolescence, but the risk of acquiring atopy and recent wheeze for the first time continues during this period. Atopy, particularly present at the age of 8-10 years, predicts the subsequent onset of wheeze.
authors.affiliation: Institute of Respiratory Medicine, University of Sydney, P O Box M77, Camperdown, NSW 2050, Australia. wx@mail.med.usyd.edu.au
authors.forename: W
authors.initials: W
authors.lastname: Xuan
authors.forename: G B
authors.initials: GB
authors.lastname: Marks
authors.forename: B G
authors.initials: BG
authors.lastname: Toelle
authors.forename: E
authors.initials: E
authors.lastname: Belousova
authors.forename: J K
authors.initials: JK
authors.lastname: Peat
authors.forename: G
authors.initials: G
authors.lastname: Berry
authors.forename: A J
authors.initials: AJ
authors.lastname: Woolcock
mesh_terms: D017668:Age of Onset; D016535:Bronchial Hyperreactivity / Q000209:etiology*; D002648:Child; D015331:Cohort Studies; D005260:Female; D006801:Humans; D006969:Hypersensitivity, Immediate / Q000209:etiology*; D008297:Male; D012135:Respiratory Sounds / Q000209:etiology*; D012307:Risk Factors; D012737:Sex Factors