TY - JOUR
T1 - Asthma severity according to global initiative for asthma and its determinants
T2 - An international study
AU - Cazzoletti, Lucia
AU - Marcon, Alessandro
AU - Corsico, Angelo
AU - Janson, Christer
AU - Jarvis, Deborah
AU - Pin, Isabelle
AU - Accordini, Simone
AU - Bugiani, Massimiliano
AU - Cerveri, Isa
AU - Gislason, David
AU - Gulsvik, Amund
AU - De Marco, Roberto
PY - 2009/1
Y1 - 2009/1
N2 - Background: The identification of the factors associated with severe asthma may shed some light on its etiology and on the mechanisms of its development. We aimed to describe asthma severity using the Global Initiative for Asthma (GINA) classification and to investigate its determinants in a cross-sectional, population-based sample in Europe. Methods: In the European Community Respiratory Health Survey II (1999-2002), 1,241 adults with asthma were identified. Severity was assessed using the 2002 GINA classification (intermittent, mild persistent, moderate persistent, severe persistent) and it was related to potential determinants by a multinomial logistic model, using the intermittent group as the reference category for relative risk ratios. Results: About 30% of asthmatic subjects were affected by moderate-to-severe asthma. Sensitization to Cladosporium was associated with a more than 5-fold greater risk of having (mild, moderate or severe) persistent asthma than intermittent asthma. Persistent asthma was positively associated with sensitization to house dust mite, nonseasonal asthma, an older age at asthma onset, and chronic cough and phlegm. Sensitization to cat increased the risk of severe asthma only. Smoking was more strongly associated with asthma severity in men, while rhinitis was more strongly associated with asthma severity in women. Conclusions: One third of the asthmatic population have moderate-to-severe asthma. Sensitization to perennial indoor allergens, particularly Cladosporium, is strongly associated with asthma severity. The role of smoking and rhinitis in determining asthma severity may differ between the sexes, and it should be further investigated.
AB - Background: The identification of the factors associated with severe asthma may shed some light on its etiology and on the mechanisms of its development. We aimed to describe asthma severity using the Global Initiative for Asthma (GINA) classification and to investigate its determinants in a cross-sectional, population-based sample in Europe. Methods: In the European Community Respiratory Health Survey II (1999-2002), 1,241 adults with asthma were identified. Severity was assessed using the 2002 GINA classification (intermittent, mild persistent, moderate persistent, severe persistent) and it was related to potential determinants by a multinomial logistic model, using the intermittent group as the reference category for relative risk ratios. Results: About 30% of asthmatic subjects were affected by moderate-to-severe asthma. Sensitization to Cladosporium was associated with a more than 5-fold greater risk of having (mild, moderate or severe) persistent asthma than intermittent asthma. Persistent asthma was positively associated with sensitization to house dust mite, nonseasonal asthma, an older age at asthma onset, and chronic cough and phlegm. Sensitization to cat increased the risk of severe asthma only. Smoking was more strongly associated with asthma severity in men, while rhinitis was more strongly associated with asthma severity in women. Conclusions: One third of the asthmatic population have moderate-to-severe asthma. Sensitization to perennial indoor allergens, particularly Cladosporium, is strongly associated with asthma severity. The role of smoking and rhinitis in determining asthma severity may differ between the sexes, and it should be further investigated.
KW - Allergen sensitization
KW - Asthma control
KW - Asthma severity
KW - Cat
KW - Cladosporium
KW - Global Initiative for Asthma
KW - House dust mite
KW - Perennial allergens
UR - http://www.scopus.com/inward/record.url?scp=68349101969&partnerID=8YFLogxK
U2 - 10.1159/000232572
DO - 10.1159/000232572
M3 - Article
C2 - 19672098
AN - SCOPUS:68349101969
SN - 1018-2438
VL - 151
SP - 70
EP - 79
JO - International Archives of Allergy and Immunology
JF - International Archives of Allergy and Immunology
IS - 1
ER -