Are risk factors of childhood asthma predicting disease persistence in early adulthood different in the developing world?
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.
Sekerel
B E
BE
Pediatric Allergy and Asthma Unit, Faculty of Medicine, Hacettepe University, Ankara, Turkey.
Civelek
E
E
Karabulut
E
E
Yildirim
S
S
Tuncer
A
A
Adalioglu
G
G
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
D016085:Bronchoconstrictor Agents; D016210:Methacholine Chloride; D007073:Immunoglobulin E