| 1. |
- de Marco, Roberto, et al.
(författare)
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Risk Factors for Chronic Obstructive Pulmonary Disease in a European Cohort of Young Adults
- 2011
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Ingår i: American Journal of Respiratory and Critical Care Medicine. - 1073-449X .- 1535-4970. ; 183:7, s. 891-897
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Tidskriftsartikel (refereegranskat)abstract
- Rationale: Few studies have investigated the factors associated with the early inception of chronic obstructive pulmonary disease (COPD). Objectives: We investigated COPD risk factors in an international cohort of young adults using different spirometric definitions of the disease. Methods. We studied 4,636 subjects without asthma who had prebronchodilator FEV1/FVC measured in the European Community Respiratory Health Survey both in 1991 to 1993 (when they were 20-44 yr old) and in 1999 to 2002. COPD was defined according to the Global Initiative for Chronic Obstructive Lung Disease fixed cut-off criterion (FEV1/FVC < 0.70), and two criteria based on the Quanjer and LuftiBus reference equations (FEV1/FVC less than lower limit of normal). COPD determinants were studied using two-level Poisson regression models. Measurements and Main Results: COPD incidence ranged from 1.85 (lower limit of normal [Quanjer]) to 2.88 (Global Initiative for Chronic Obstructive Lung Disease) cases/1,000/yr. Although about half of the cases had smoked less than 20 pack-years, smoking was the main risk factor for COPD, and it accounted for 29 to 39% of the new cases during the follow-up. Airway hyperresponsiveness was the second strongest risk factor (15-17% of new cases). Other determinants were respiratory infections in childhood and a family history of asthma, whereas the role of sex, age, and of being underweight largely depended on the definition of COPD used. Conclusions: COPD may start early in life. Smoking prevention should be given the highest priority to reduce COPD occurrence. Airway hyperresponsiveness, a family history of asthma, and respiratory infections in childhood are other important determinants of COPD. We suggest the need for a definition of COPD that is not exclusively based on spirometry.
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| 2. |
- Olivieri, Mario, et al.
(författare)
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Risk factors for new-onset cat sensitization among adults : A population-based international cohort study
- 2012
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Ingår i: Journal of Allergy and Clinical Immunology. - : Elsevier BV. - 0091-6749 .- 1097-6825. ; 129:2, s. 420-425
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Cat exposure during childhood has been shown to increase the risk of developing cat sensitization, while the effect of cat exposure in adulthood has not yet been established. OBJECTIVE: To evaluate new-onset sensitization to cat in adulthood in relation to changes in cat keeping. METHODS: A total of 6292 European Community Respiratory Health Survey I (ECRHS I) participants aged 20 to 44 years from 28 European centers, who were not sensitized to cat, were reevaluated 9 years later in ECRHS II. Present and past cat ownership and total and specific IgE levels were assessed in both surveys. Allergen-specific sensitization was defined as a specific serum IgE level of 0.35 kU/L or more. RESULTS: A total of 4468 subjects did not have a cat in ECRHS I or ECRHS II, 473 had a cat only at baseline, 651 acquired a cat during the follow-up, and 700 had a cat at both evaluations. Two hundred thirty-one subjects (3.7%) became sensitized to cat. In a 2-level multivariable Poisson regression model, cat acquisition during follow-up was significantly associated with new-onset cat sensitization (relative risk = 1.85, 95% CI 1.23-2.78) when compared with those without a cat at both surveys. Preexisting sensitization to other allergens, a history of asthma, nasal allergies and eczema, and high total IgE level were also significant risk factors for developing cat sensitization, while cat ownership in childhood was a significant protective factor. CONCLUSION: Our data support that acquiring a cat in adulthood nearly doubles the risk of developing cat sensitization. Hence, cat avoidance should be considered in adults, especially in those sensitized to other allergens and reporting a history of allergic diseases.
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