Association between menarche and increased bronchial hyper-responsiveness during puberty in female children and adolescents.
Bronchial hyper-responsiveness (BHR) is a key feature of asthma. The degree of BHR in children may be altered by several factors. We evaluated the prevalence of BHR according to age and gender in pediatric and adolescent population and analyzed the associated factors for gender differences.



Among the 2,067 subjects, methacholine challenge tests were performed in 1,820 children from one elementary and one middle school in Seoul, Korea. A total of 1,725 subjects between 6 and 14 years old were included in the analysis. The prevalence of BHR, defined as a provocative concentration that induced a 20% reduction of FEV1(PC20) that was less than 8 mg/ml, was evaluated according to age and gender. Gender differences associated with BHR prevalence at each age were calculated and multiple logistic regression analyses were performed to identify factors associated with BHR by gender.



The prevalence of BHR (PC20≤ 8 mg/ml) for each gender decreased with age (P < 0.001). Although the prevalence of BHR linearly decreased in males with age, females showed an increase after 11 years of age. BHR in males was associated with a younger age (aOR, 0.797; 95%CI, 0.678-0.925), a higher blood eosinophil counts (%) (aOR, 1.160; 95%CI, 1.047-1.284), atopy (aOR, 2.091; 95%CI, 1.003-4.359), and a lower FEV1/FVC ratio (aOR, 0.947; 95%CI, 0.901-0.995), and FEF25-75%(aOR, 0.980; 95%CI, 0.961-0.999). In females, BHR was significantly associated with a younger age (aOR, 0.845; 95%CI, 0.747-0.957), lower FEV1(%) (aOR, 0.961; 95%CI, 0.938-0.984), and menarche (aOR, 3.674; 95%CI, 1.226-11.012).



BHR declined with age in the Korean pediatric population. A younger age and reduced lung function were common factors related to BHR in both genders. Additionally, atopy was related to BHR in males, whereas sexual maturation was related to BHR in females. These findings have important clinical implications for evaluating of childhood BHR and asthma related to gender. Pediatr Pulmonol. 2016;51:1040-1047. © 2016 Wiley Periodicals, Inc.
Department of Pediatrics, Gyeongsang National University Changwon Hospital, Changwon, Korea.
Young-Ho
YH
Kim
Department of Pediatrics, Inje University Haeundae Paik Hospital, Busan, Korea.
Eun
E
Lee
Department of Pediatrics, Childhood Asthma Atopy Center, Environmental Health Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
Hyun-Ju
HJ
Cho
Department of Pediatrics, Hallym University Sacred Heart Hospital, Anyang, Korea.
Song-I
SI
Yang
Department of Pediatrics, CHA University School of Medicine, Seongnam, Korea.
Young-Ho
YH
Jung
Department of Pediatrics, Pusan National University Yangsan Hospital, Yangsan, Korea.
Hyung Young
HY
Kim
Department of Pediatrics, Dankuk University Hospital, Cheonan, Korea.
Ju-Hee
JH
Seo
Department of Pediatrics, Sanggye Paik Hospital, Inje University College of Medicine, Seoul, Korea.
Hyo-Bin
HB
Kim
Department of Pediatrics, Hallym University Sacred Heart Hospital, Anyang, Korea.
So-Yeon
SY
Lee
Department of Pediatrics, Korea University Guro Hospital, Seoul, Korea.
Dae-Jin
DJ
Song
Department of Pediatrics, Seoul Paik Hospital, Inje University College of Medicine, Seoul, Korea.
Woo-Kyung
WK
Kim
Department of Pediatrics, National Health Insurance Corporation Ilsan Hospital, Goyang, Korea.
Gwang-Cheon
GC
Jang
Department of Pediatrics, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea.
Jung-Yeon
JY
Shim
Division of Allergy and Respiratory Diseases, National Institute of Health, Korea Center for Disease Control and Prevention, Cheongju, Korea.
Eun-Jin
EJ
Kim
National Institute of Health, Korea Center for Disease Control and Prevention, Cheongju, Korea.
Joo-Shil
JS
Lee
Department of Pediatrics, Seoul National University Bundang Hospital, Seongnam, Korea. pedas@snubh.org.
Ji-Won
JW
Kwon
Department of Pediatrics, Childhood Asthma Atopy Center, Environmental Health Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea. sjhong@amc.seoul.kr.
Soo-Jong
SJ
Hong
D000293:Adolescent; D001249:Asthma / Q000503:physiopathology*; D016535:Bronchial Hyperreactivity / Q000503:physiopathology*; D001985:Bronchial Provocation Tests; D002648:Child; D005260:Female; D006801:Humans; D006969:Hypersensitivity, Immediate / Q000503:physiopathology; D008297:Male; D008572:Menarche / Q000502:physiology*; D016210:Methacholine Chloride; D056910:Republic of Korea
D016210:Methacholine Chloride
atopy; bronchial hyper-responsiveness; child; gender; menarche