BACKGROUND: Little is known about the risk factors for atopic and nonatopic asthma among children in Puerto Rico. We aimed to identify modifiable risk factors for atopic and nonatopic asthma in this vulnerable population. METHODS: Case-control study of children with (n = 305) and without (n = 327) asthma in San Juan (Puerto Rico). Asthma was defined as physician-diagnosed asthma and wheeze in the previous year. Atopic asthma (n = 210) was defined as asthma and greater than or equal to one positive IgE to aero-allergens. Nonatopic asthma (n = 95) was defined as asthma and no positive IgE to the allergens tested. Logistic regression was used for the multivariable analysis of atopic and nonatopic asthma. RESULTS: In a multivariable analysis, body mass index (BMI) z score, prematurity, parental asthma, lifetime exposure to gun violence, and having a bird in the child's home were associated with increased odds of atopic asthma, while each one-point increment in a dietary score (range: -2 [least healthy diet] to +2 [healthiest diet]) was associated with 37% reduced odds of atopic asthma (95% confidence interval [CI] = 0.48-0.81; P < .01). In a separate multivariable analysis, parental asthma, early-life second-hand smoke (SHS) exposure, and daycare attendance in the first year of life were significantly associated with increased odds of nonatopic asthma, while each one-point increment in the dietary score was associated with 42% reduced odds of nonatopic asthma (95% CI = 0.45-0.76; P < .01). CONCLUSIONS: We have identified potentially modifiable risk factors for atopic asthma (eg, BMI and gun violence), nonatopic asthma (eg, early-life SHS and daycare attendance), or both (eg, an unhealthy diet) in Puerto Rican children.
BACKGROUND: Little is known about the risk factors for atopic and nonatopic asthma among children in Puerto Rico. We aimed to identify modifiable risk factors for atopic and nonatopic asthma in this vulnerable population. METHODS: Case-control study of children with (n = 305) and without (n = 327) asthma in San Juan (Puerto Rico). Asthma was defined as physician-diagnosed asthma and wheeze in the previous year. Atopic asthma (n = 210) was defined as asthma and greater than or equal to one positive IgE to aero-allergens. Nonatopic asthma (n = 95) was defined as asthma and no positive IgE to the allergens tested. Logistic regression was used for the multivariable analysis of atopic and nonatopic asthma. RESULTS: In a multivariable analysis, body mass index (BMI) z score, prematurity, parental asthma, lifetime exposure to gun violence, and having a bird in the child's home were associated with increased odds of atopic asthma, while each one-point increment in a dietary score (range: -2 [least healthy diet] to +2 [healthiest diet]) was associated with 37% reduced odds of atopic asthma (95% confidence interval [CI] = 0.48-0.81; P < .01). In a separate multivariable analysis, parental asthma, early-life second-hand smoke (SHS) exposure, and daycare attendance in the first year of life were significantly associated with increased odds of nonatopic asthma, while each one-point increment in the dietary score was associated with 42% reduced odds of nonatopic asthma (95% CI = 0.45-0.76; P < .01). CONCLUSIONS: We have identified potentially modifiable risk factors for atopic asthma (eg, BMI and gun violence), nonatopic asthma (eg, early-life SHS and daycare attendance), or both (eg, an unhealthy diet) in Puerto Rican children.
Authors: Jose A Castro-Rodriguez; Ana M Ramirez; Paola Toche; Dolores Pavon; Maria A Perez; Guido Girardi; Luis Garcia-Marcos Journal: Ann Allergy Asthma Immunol Date: 2007-03 Impact factor: 6.347
Authors: Gudrun Weinmayr; Stephan K Weiland; Bengt Björkstén; Bert Brunekreef; Gisela Büchele; William O C Cookson; Luis Garcia-Marcos; Maia Gotua; Christina Gratziou; Marianne van Hage; Erika von Mutius; Mall-Anne Riikjärv; Peter Rzehak; Renato T Stein; David P Strachan; John Tsanakas; Kristin Wickens; Gary W Wong Journal: Am J Respir Crit Care Med Date: 2007-06-15 Impact factor: 21.405
Authors: Franziska Rosser; Erick Forno; John Brehm; Yueh-Ying Han; Nadia Boutaoui; Angel Colón-Semidey; María Alvarez; Edna Acosta-Pérez; Kristen S Kurland; John F Alcorn; Glorisa Canino; Juan C Celedón Journal: Pediatr Allergy Immunol Pulmonol Date: 2016-09-01 Impact factor: 1.349