儿童和青少年过敏性共病表型模式及相关健康结局：一项基于人群的潜在类别研究。
Phenotypic patterns of allergic comorbidity and associated health outcomes in children and adolescents: A population-based latent class study.
文献信息
| PMID | 42834764 |
|---|---|
| 原文 | 在 PubMed 查看原文 ↗ |
| 发表日期 | 2026 |
| 作者 | Wenqian Zhang |
| 作者单位 | Center for Evidence-Based Medicine, Capital Center for Children's Health, Capital Institute of Pediatrics, Capital Medical University, Beijing, China. |
| 期刊 | Pediatric allergy and immunology : official publication of the European Society of Pediatric Allergy and Immunology |
| SCI 分区 | Q1 |
| IF | 4.3 |
| 研究类型 | 临床研究 · 临床 |
| 所属专科 | 鼻科 |
中文摘要
目的： 儿童过敏性疾病常共存，但纳入食物和药物过敏的基于表型的证据仍有限。本研究旨在对五种过敏性疾病（湿疹、鼻炎、哮喘、食物过敏和药物过敏）推导潜在的过敏性共病表型，并检验所识别表型聚类与儿童和青少年相关健康结局之间的关联。
方法： 在这项基于人群的横断面研究中，从北京和唐山招募了18,371名3-14岁儿童和青少年。对家长报告的医生诊断的湿疹、鼻炎和哮喘，以及基于问卷的食物和药物过敏，采用潜在类别分析（LCA）进行分析。分别使用多项和二元logistic回归模型识别与过敏性表型归属相关的因素，并评估表型归属与相关健康结局之间的关联。
结果： 通过LCA识别出三种表型：低过敏型（13,505，73.5%）、鼻炎主导型（3147，17.1%）和多过敏型（1719，9.4%）。女性、母亲教育程度较高、中等家庭收入和户外时间较短与鼻炎主导型和多过敏型表型的显著更高比值比相关。生命早期因素主要与鼻炎主导型表型相关。较长的久坐时间和每周1-2次快餐摄入与多过敏型表型相关。与低过敏型表型相比，鼻炎主导型和多过敏型表型显示上呼吸道感染（调整比值比：4.40和3.48）和下呼吸道感染（2.49和2.57）的比值比更高。与龋齿的关联相对较弱。敏感性分析支持呼吸道感染的发现。
结论： 在中国3-14岁儿童中识别出三种不同的过敏性共病表型，其中两种不良表型（鼻炎主导型和多过敏型）共享生活方式相关因素，但在生命早期暴露关联方面存在差异。重要的是，两种表型均与呼吸道感染可能性更高独立相关。
英文摘要
PURPOSE: Childhood allergic diseases often coexist, but phenotype-based evidence that includes food and drug allergy remains limited. The study aimed to derive potential allergic comorbidity phenotypes across five allergic diseases (eczema, rhinitis, asthma, food allergy, and drug allergy) and examine associations between identified phenotypic clusters and associated health outcomes in children and adolescents.
METHODS: In this population-based cross-sectional study, 18,371 children and adolescents aged 3-14 years were enrolled from Beijing and Tangshan. Parent-reported physician diagnoses of eczema, rhinitis, and asthma, together with questionnaire-based food and drug allergy, were analyzed using latent class analysis (LCA). Multinomial and binary logistic regression models were used to identify factors associated with allergic phenotype membership and to assess associations between phenotype membership and related health outcomes, respectively.
RESULTS: Three phenotypes were identified via LCA: low-allergy (13,505, 73.5%), rhinitis-dominant (3147, 17.1%), and multi-allergic (1719, 9.4%). Female sex, higher maternal education, middle household income, and shorter outdoor time were associated with significantly higher odds of both rhinitis-dominant and multi-allergic phenotypes. Early-life factors were mainly associated with the rhinitis-dominant phenotype. Longer sitting time and 1-2/week fast-food intake were associated with the multi-allergic phenotype. Compared with the low-allergy phenotype, rhinitis-dominant and multi-allergic phenotypes showed higher odds of upper respiratory infections (adjusted odds ratio: 4.40 and 3.48) and lower respiratory infections (2.49 and 2.57). Associations with dental caries were relatively weak. Sensitivity analyses supported the respiratory infection findings.
CONCLUSIONS: Three distinct allergic comorbidity phenotypes were identified in Chinese children aged 3-14 years, with two adverse phenotypes (rhinitis-dominant and multi-allergic) sharing lifestyle correlates yet differing in early-life exposure associations. Importantly, both phenotypes were independently associated with a higher likelihood of respiratory infections.