title: Are risk factors of childhood asthma predicting disease persistence in early adulthood different in the developing world?
abstract: BACKGROUND
  Predictive factors of childhood asthma for favorable prognosis may differ between populations where a variety of genetic and environmental factors are present.
  
  
  OBJECTIVE
  To document the factors predicting disease persistence in early adulthood in Turkey.
  
  
  METHODS
  An outpatient cohort (n = 115) with a mean follow-up duration of 11.4 +/- 0.2 years was evaluated. Complete remission was defined as no asthma symptoms, no use of controller medication, no airflow limitation and no airway hyper-responsiveness, and clinical remission as no symptoms and no use of controller medication, within the past year.
  
  
  RESULTS
  The mean ages during referral and at the final visit were 5.8 +/- 0.2 and 17.1 +/- 0.2 years, respectively. Thirty-one (27%) were in complete remission, and a further 30 (26%) in clinical remission. In multivariate logistic models, diminished airflow [forced expiratory volume in 1 s (FEV1) < 80% vs > or = 80%] at the initial lung function test predicted current diminished airflow (8.422; 2.202-32.206) (odds ratio; 95% confidence interval), and presence of obstructive pattern (FEV1/forced vital capacity (FVC) < 80% vs > or = 80%) predicted current obstructive pattern (29.333; 3.022-284.724). Furthermore, female gender appeared to predict persistence of asthma symptoms (3.330; 1.250-8.333) and absence of clinical remission (2.398; 1.038-5.254); eosinophilia predicted persistence of symptoms (4.271; 1.080-16.889) and presence of airway hyper-responsiveness (3.723; 1.129-12.278).
  
  
  CONCLUSIONS
  Diminished airflow, female gender and eosinophilia appear to predict an adverse outcome of childhood asthma, supporting the concept that variability may exist between populations.
authors.affiliation: Pediatric Allergy and Asthma Unit, Faculty of Medicine, Hacettepe University, Ankara, Turkey.
authors.forename: B E
authors.initials: BE
authors.lastname: Sekerel
authors.forename: E
authors.initials: E
authors.lastname: Civelek
authors.forename: E
authors.initials: E
authors.lastname: Karabulut
authors.forename: S
authors.initials: S
authors.lastname: Yildirim
authors.forename: A
authors.initials: A
authors.lastname: Tuncer
authors.forename: G
authors.initials: G
authors.lastname: Adalioglu
mesh_terms: D000293:Adolescent; D001249:Asthma / Q000453:epidemiology* / Q000209:etiology* / Q000503:physiopathology; D016535:Bronchial Hyperreactivity / Q000175:diagnosis; D016085:Bronchoconstrictor Agents / Q000494:pharmacology; D002648:Child; D003906:Developing Countries; D004804:Eosinophils / Q000276:immunology; D005260:Female; D005541:Forced Expiratory Volume; D006801:Humans; D007073:Immunoglobulin E / Q000097:blood; D007958:Leukocyte Count; D008297:Male; D016210:Methacholine Chloride / Q000494:pharmacology; D012189:Retrospective Studies; D012307:Risk Factors; D012737:Sex Factors; D012882:Skin Tests; D013147:Spirometry; D014421:Turkey; D014797:Vital Capacity
chemical_list: D016085:Bronchoconstrictor Agents; D016210:Methacholine Chloride; D007073:Immunoglobulin E