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Association between menarche and increased bronchial hyper‐responsiveness during puberty in female children and adolescents
Author(s) -
Kim YoungHo,
Lee Eun,
Cho HyunJu,
Yang SongI,
Jung YoungHo,
Kim Hyung Young,
Seo JuHee,
Kim HyoBin,
Lee SoYeon,
Song DaeJin,
Kim WooKyung,
Jang GwangCheon,
Shim JungYeon,
Kim EunJin,
Lee JooShil,
Kwon JiWon,
Hong SooJong
Publication year - 2016
Publication title -
pediatric pulmonology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.866
H-Index - 106
eISSN - 1099-0496
pISSN - 8755-6863
DOI - 10.1002/ppul.23433
Subject(s) - medicine , asthma , bronchial hyperresponsiveness , menarche , atopy , pediatrics , population , logistic regression , demography , respiratory disease , lung , environmental health , sociology
Summary Purpose Bronchial hyper‐responsiveness (BHR) is a key feature of asthma. The degree of BHR in children may be altered by several factors. We evaluated the prevalence of BHR according to age and gender in pediatric and adolescent population and analyzed the associated factors for gender differences. Methods Among the 2,067 subjects, methacholine challenge tests were performed in 1,820 children from one elementary and one middle school in Seoul, Korea. A total of 1,725 subjects between 6 and 14 years old were included in the analysis. The prevalence of BHR, defined as a provocative concentration that induced a 20% reduction of FEV 1 (PC 20 ) that was less than 8 mg/ml, was evaluated according to age and gender. Gender differences associated with BHR prevalence at each age were calculated and multiple logistic regression analyses were performed to identify factors associated with BHR by gender. Results The prevalence of BHR (PC 20 ≤ 8 mg/ml) for each gender decreased with age ( P < 0.001). Although the prevalence of BHR linearly decreased in males with age, females showed an increase after 11 years of age. BHR in males was associated with a younger age (aOR, 0.797; 95%CI, 0.678–0.925), a higher blood eosinophil counts (%) (aOR, 1.160; 95%CI, 1.047–1.284), atopy (aOR, 2.091; 95%CI, 1.003–4.359), and a lower FEV 1 /FVC ratio (aOR, 0.947; 95%CI, 0.901–0.995), and FEF 25–75% (aOR, 0.980; 95%CI, 0.961–0.999). In females, BHR was significantly associated with a younger age (aOR, 0.845; 95%CI, 0.747–0.957), lower FEV 1 (%) (aOR, 0.961; 95%CI, 0.938–0.984), and menarche (aOR, 3.674; 95%CI, 1.226–11.012). Conclusion BHR declined with age in the Korean pediatric population. A younger age and reduced lung function were common factors related to BHR in both genders. Additionally, atopy was related to BHR in males, whereas sexual maturation was related to BHR in females. These findings have important clinical implications for evaluating of childhood BHR and asthma related to gender. Pediatr Pulmonol. 2016;51:1040–1047. © 2016 Wiley Periodicals, Inc.