Mario H Vargas1, Martín Becerril-Ángeles2, Ismael Seth Medina-Reyes3, Ramón Alberto Rascón-Pacheco3. 1. Unidad de Investigación Médica en Enfermedades Respiratorias, Hospital de Pediatría, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Mexico City, Mexico; Departamento de Investigación en Hiperreactividad Bronquial, Instituto Nacional de Enfermedades Respiratorias Ismael Cosío Villegas, Mexico City, Mexico. 2. Departamento de Alergia e Inmunología Clínica, Hospital de Especialidades, Centro Médico Nacional La Raza, Instituto Mexicano del Seguro Social, Mexico City, Mexico. Electronic address: mbecer5@gmail.com. 3. División de Información Epidemiológica, Coordinación de Vigilancia Epidemiológica y Apoyo en Contingencias, Instituto Mexicano del Seguro Social, Mexico City, Mexico.
Abstract
BACKGROUND: Previous studies suggest an inverse correlation between asthma and altitude. In the present work, we performed an in-depth analysis of asthma incidence in the 758 Mexican counties covered by the largest medical institution in the country (∼37.5 million insured subjects), and evaluated its relationships with altitude and other factors. METHODS: Asthma incidence in each county was calculated from new cases diagnosed by family physicians. Other variables in the same counties, including selected diseases, geographical variables, and socioeconomic factors, were also obtained and their association with asthma was evaluated through bivariate and multivariate analyses. RESULTS: Median asthma incidence was 296.2 × 100,000 insured subjects, but tended to be higher in those counties located on or near the coast. When asthma incidence was plotted against altitude, a two-stage pattern was evident: asthma rates were relatively stable in counties located below an altitude of ∼1500 m, while these rates progressively decreased as altitude increased beyond this level (rS = -0.51, p < .001). Multivariate analysis showed that, once each variable was adjusted by the potential influence of the others, asthma incidence was inversely correlated with altitude (standardized β coefficient, -0.577), helminthiasis (-0.173), pulmonary tuberculosis (-0.130), and latitude (-0.126), and was positively correlated with acute respiratory tract infection (0.382), pneumonia (0.289), type 2 diabetes (0.138), population (0.108), and pharyngotonsillitis (0.088), all with a p ≤ .001. CONCLUSION: Our study showed that altitude higher than ∼1500 m comprises a major factor in determining asthma incidence, with the risk of new-onset asthma decreasing as altitude increases. Other less influential conditions were also identified.
BACKGROUND: Previous studies suggest an inverse correlation between asthma and altitude. In the present work, we performed an in-depth analysis of asthma incidence in the 758 Mexican counties covered by the largest medical institution in the country (∼37.5 million insured subjects), and evaluated its relationships with altitude and other factors. METHODS:Asthma incidence in each county was calculated from new cases diagnosed by family physicians. Other variables in the same counties, including selected diseases, geographical variables, and socioeconomic factors, were also obtained and their association with asthma was evaluated through bivariate and multivariate analyses. RESULTS: Median asthma incidence was 296.2 × 100,000 insured subjects, but tended to be higher in those counties located on or near the coast. When asthma incidence was plotted against altitude, a two-stage pattern was evident: asthma rates were relatively stable in counties located below an altitude of ∼1500 m, while these rates progressively decreased as altitude increased beyond this level (rS = -0.51, p < .001). Multivariate analysis showed that, once each variable was adjusted by the potential influence of the others, asthma incidence was inversely correlated with altitude (standardized β coefficient, -0.577), helminthiasis (-0.173), pulmonary tuberculosis (-0.130), and latitude (-0.126), and was positively correlated with acute respiratory tract infection (0.382), pneumonia (0.289), type 2 diabetes (0.138), population (0.108), and pharyngotonsillitis (0.088), all with a p ≤ .001. CONCLUSION: Our study showed that altitude higher than ∼1500 m comprises a major factor in determining asthma incidence, with the risk of new-onset asthma decreasing as altitude increases. Other less influential conditions were also identified.
Authors: Blanca Estela Del-Río-Navarro; Arturo Berber; Nayely Reyes-Noriega; Elsy Maureen Navarrete-Rodríguez; Roberto García-Almaraz; Philippa Ellwood; Luis Garcia-Marcos; Omar Josué Saucedo-Ramírez; Valente Juan Mérida-Palacio; Beatriz Del Carmen Ramos-García; Alberto José Escalante-Domínguez; Francisco Javier Linares-Zapién; Héctor Leonardo Moreno-Gardea; Georgina Ochoa-López; Luis Octavio Hernández-Mondragón; José Santos Lozano-Sáenz; José Antonio Sacre-Hazouri; Ángeles Juan-Pineda; Ma Guadalupe Sánchez-Coronel; Noel Rodríguez-Pérez; María de Jesús Ambriz-Moreno Journal: BMJ Open Respir Res Date: 2020-12
Authors: Karin B Fieten; Marieke T Drijver-Messelink; Annalisa Cogo; Denis Charpin; Milena Sokolowska; Ioana Agache; Luís Manuel Taborda-Barata; Ibon Eguiluz-Gracia; Gerrit J Braunstahl; Sven F Seys; Maarten van den Berge; Konrad E Bloch; Silvia Ulrich; Carlos Cardoso-Vigueros; Jasper H Kappen; Anneke Ten Brinke; Markus Koch; Claudia Traidl-Hoffmann; Pedro da Mata; David J Prins; Suzanne G M A Pasmans; Sarah Bendien; Maia Rukhadze; Mohamed H Shamji; Mariana Couto; Hanneke Oude Elberink; Diego G Peroni; Giorgio Piacentini; Els J M Weersink; Matteo Bonini; Lucia H M Rijssenbeek-Nouwens; Cezmi A Akdis Journal: Allergy Date: 2022-02-15 Impact factor: 14.710