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Chung, Park, Lee, Choi, Hong, and Park: Risk factors, lung function and bronchial hyperresponsiveness in current dust mite-induced allergic rhinitis
Original Article

Allergy, Asthma & Respiratory Disease 2016; 4(1): 49-54.

Published online: 29 January 2016

DOI: https://doi.org/10.4168/aard.2016.4.1.49

Risk factors, lung function and bronchial hyperresponsiveness in current dust mite-induced allergic rhinitis

Euncho Chung1, Jeewon Park1, So-Yeon Lee2, Yean Jung Choi3, Soo-Jong Hong3, Kang Seo Park1

1Department of Pediatrics, Presbyterian Medical Center, Jeonju, Korea.

2Department of Pediatrics, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, Korea.

3Department of Pediatrics, Childhood Asthma Atopy Center, Environmental Health Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.

Correspondence to: Kang Seo Park. Department of Pediatrics, Presbyterian Medical Center, 365 Seowon-ro, Wansan-gu, Jeonju 54987, Korea. Tel: +82-63-230-0390, Fax: +82-63-230-8129, hardypar@hanmail.net

Received 27 July 2015       Revised 28 September 2015       Accepted 1 October 2015

© 2016 The Korean Academy of Pediatric Allergy and Respiratory Disease; The Korean Academy of Asthma, Allergy and Clinical Immunology

(open-access):

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/).

Abstract

Purpose

We analyzed the pulmonary function and risk factors of allergic rhinitis (AR) in dust mite-sensitized children with current AR and no history of asthma.

Methods

In this cross-sectional study, demographic and disease-related information was obtained from 1,792 Korean children aged 9–12 years using a questionnaire, skin-prick testing, spirometric analysis, and methacholine challenge testing.

Results

A total of 672 children were analyzed. The control group consisted of 583 children without any allergic diseases who were not sensitized to 16 common allergens. The group with current AR and dust mite sensitization consisted of 89 children. Binary logistic regression analysis showed that helminth infection (adjusted odds ratio [aOR], 2.88; 95% confidence interval [CI], 1.23–6.77) and antibiotic use during infancy (aOR, 1.89; 95% CI, 1.10–3.25) were the risk factors. Pet ownership (aOR, 0.32; 95% CI, 0.15–0.69) and older siblings (aOR, 0.58; 95% CI, 0.35–0.96) were protective factors. Spirometry results did not differ between the control and dust mite-induced AR groups. None of the children showed a bronchodilator response. However, 8.5%, 7.1%, and 2.1% of the control-group children and 28.7%, 23.0%, and 8.0% of the dust mite-induced AR-group children showed methacholine PC20 (provocative concentration of methacholine causing a 20% fall in forced expiratory volume in 1 second) values of ≤25 mg/mL, ≤16 mg/mL, and ≤8 mg/mL, respectively (P<0.01).

Conclusion

The prevalence of current dust mite-induced AR may be reduced by controlling environmental factors. Even though the spirometry results seemed to be normal, bronchial hyperresponsiveness occurred more frequently in children with dust mite-induced AR than in normal children.

Keywords: Allergic rhinitis, Risk factor, Spirometry, Bronchial hyperreactivity, Child

Figures and Tables

Table 1

Demographics with control group vs. current allergic rhinitis with dust mite sensitization group

aard-4-49-i001
Variable Controls (n = 583) Current allergic rhinitis (n = 89) P-value
Age (yr), range 9–12 9–12 -
Male sex 262/583 (44.9) 51/89 (57.3) 0.03
Urban/rural < 0.01
 Seoul 175/583 (30.0) 51/89 (57.3)
 Jeongeup 408/583 (70.0) 38/89 (42.7)
Agricultural or livestock farming parents 139/542 (25.6) 12/78 (15.4) 0.05
Farm animal* contact
 During pregnancy 13/448 (2.9) 1/71 (1.4) 0.47
 Now 13/543 (2.4) 3/78 (3.8) 0.45
Stable ownership 67/529 (12.7) 7/77 (9.1) 0.37
Pet ownership 179/498 (35.9) 11/71 (15.5) < 0.01
Breast-feeding 357/576 (62.0) 47/88 (53.4) 0.13
Birth by C-section 185/573 (32.3) 30/87 (34.5) 0.68
Older siblings 385/579 (66.5) 47/88 (53.4) 0.02
Antibiotics use during infancy 107/563 (19.0) 31/89 (34.8) < 0.01
Helminth infection 29/442 (6.6) 9/67 (13.4) 0.05
Income (KRW/mon) 0.01
 High ( ≥ 5,000,000) 29/533 (5.4) 9/85 (10.6)
 Middle ( ≥ 2,000,000, < 5,000,000) 339/533 (63.3) 62/85 (72.9)
 Low ( < 2,000,000) 165/533 (31.3) 14/85 (16.5)

Values are presented as number (%). Statistical analysis was performed using the chi-square test.

KRW, Korean won (the currency of South Korea).

*Farm animal: cattle, pig, poultry, goat, and rabbit.

Table 2

Binary logistic regression analysis of risk factors (adjusted OR, 95% CI) for current allergic rhinitis with dust mite sensitization group

aard-4-49-i002
Variable aOR 95% CI P-value
Agricultural or livestock farming parents 0.72 0.36–1.48 0.37
Farm animal* contact
 During pregnancy 0.40 0.05–3.35 0.40
 Now 3.32 0.85–13.01 0.09
Stable ownership 1.06 0.44–2.55 0.89
Pet ownership 0.32 0.15–0.69 < 0.01
Breast-feeding 0.80 0.48–1.32 0.38
Birth by C-section 0.99 0.58–1.69 0.96
Older siblings 0.58 0.35–0.96 0.03
Antibiotics use during infancy 1.89 1.10–3.25 0.02
Helminth infection 2.88 1.23–6.77 0.02
Income (KRW/mon)
 High ( ≥ 5,000,000) Reference Reference Reference
 Middle ( ≥ 2,000,000, < 5,000,000) 0.76 0.30–1.89 0.55
 Low ( < 2,000,000) 0.47 0.16–1.38 0.17

Statistical analysis was performed using the t-test. Adjusted for age, sex, parental history of allergic diseases, and body mass index.

aOR, adjusted odd ratio; CI, confidence interval; KRW, Korean won (the currency of South Korea).

*Farm animal: cattle, pig, poultry, goat, and rabbit.

Table 3

Pulmonary function of control and current allergic rhinitis with dust mite sensitization group

aard-4-49-i003
Variable Control Current allergic rhinitis P-value
FEV1 (%) 99.28 ± 10.76 99.18 ± 10.34 0.83
FVC (%) 92.14 ± 10.49 91.42 ± 10.08 0.88
FEF25%-75% (%) 97.70 ± 19.85 99.92 ± 21.36 0.41
FEV1/FVC (%) 91.54 ± 5.16 91.82 ± 5.41 0.45
BDR - - -

FEV1, forced expiratory volume in one second; FVC, forced vital capacity; FEF25%–75%, forced expiratory flow between 25% and 75% of vital capacity; BDR, bronchodilator response, defined as a 12% increase in either FEV1 or FVC.

Table 4

Methacholine PC20 of control and current allergic rhinitis with dust mite sensitization group

aard-4-49-i004
Variable Control
(n=567)		 Current allergic rhinitis
(n=87)		 P-value
Log PC20 mg/mL 3.77±0.50 3.44±0.82 <0.01
PC20 ≤25 mg/mL (%) 48 (8.5) 25 (28.7) <0.01
PC20 ≤16 mg/mL (%) 40 (7.1) 20 (23.0) <0.01
PC20 ≤8 mg/mL (%) 12 (2.1) 7 (8.0) <0.01

Values are presented as mean±standard deviation or number (%). Statistical analysis was performed using chi-square.

PC20, provocative concentration causing a 20% decrease in forced expiratory volume in 1 second.

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ORCID iDs

Kang Seo Park
https://orcid.org/http://orcid.org/0000-0003-3983-9770

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