title: The influence of gender and atopy on the natural history of rhinitis in the first 18 years of life.
abstract: BACKGROUND
  Longitudinal studies of the natural history of childhood and adolescent rhinitis are lacking.
  
  
  OBJECTIVE
  To investigate the natural history of rhinitis up to 18 years of age, and how that is influenced by gender and atopy.
  
  
  METHODS
  The Isle of Wight birth cohort was recruited in 1989 (n=1456). Questionnaire data on nasal symptoms (rhinitis) were collected at 1, 2, 4, 10 and 18 years of age. To define atopy, skin prick tests were conducted at 4, 10 and 18 years. The 12-month period prevalence plus positive and negative transitions (defined as change in disease status in two consecutive study assessments) were stratified by gender and atopic status.
  
  
  RESULTS
  Overall rhinitis prevalence increased from 5.4% at 4 years to 35.8% at 18 years (P<0.001), without gender difference. Atopic rhinitis prevalence increased steadily from 3.4% at 4 years to 27.3% at 18 years (P<0.001), was commoner in boys at 18 years (P=0.02) and associated with greater positive transition in boys from 10 to 18 years (P=0.01). Prevalence of non-atopic rhinitis also increased from 4 to 18 years (P=0.003) and was greater in girls at 18 years (P<0.001) reflecting higher female positive transition from 10 to 18 years (P<0.001). Non-atopic rhinitis negative transition (remission) was highest in early life and reduced in later childhood/adolescence.
  
  
  CONCLUSIONS
  Atopic rhinitis becomes increasingly common as children grow into adolescents, with stronger associations to male gender. Non-atopic rhinitis shows a female predominance at 18 years as girls 'grow into' it more during adolescence. Our findings suggest differential gender effects on the increasing prevalence of both atopic and non-atopic rhinitis in adolescence.
  
  
  CONCLUSIONS
  A better understanding of how gender and atopic status influence rhinitis during adolescence emerges from this study. Application of such knowledge could help to improve clinical recognition, judge prognosis and ultimately improve management of this common condition.
authors.affiliation: The David Hide Asthma and Allergy Research Centre, St Mary's Hospital, Newport, Isle of Wight, UK.
authors.forename: R J
authors.initials: RJ
authors.lastname: Kurukulaaratchy
authors.forename: W
authors.initials: W
authors.lastname: Karmaus
authors.forename: A
authors.initials: A
authors.lastname: Raza
authors.forename: S
authors.initials: S
authors.lastname: Matthews
authors.forename: G
authors.initials: G
authors.lastname: Roberts
authors.forename: S H
authors.initials: SH
authors.lastname: Arshad
mesh_terms: D000293:Adolescent; D000367:Age Factors; D001249:Asthma / Q000150:complications / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D018450:Disease Progression; D004485:Eczema / Q000150:complications / Q000453:epidemiology; D005260:Female; D006801:Humans; D015994:Incidence; D007223:Infant; D008137:Longitudinal Studies; D008297:Male; D015995:Prevalence; D012220:Rhinitis / Q000150:complications / Q000453:epidemiology* / Q000276:immunology*; D012737:Sex Factors