Zusammenfassung
Background: For many years, the association between asthma
and rhinitis has primarily been attributed to a common allergic
background. Recently, it has been suggested that asthma
and rhinitis are associated in the absence of atopy. The nature
of this association is not well known.
Objective: The purpose of this study, which was performed in
a large, longitudinal community population, was to determine
the extent to which rhinitis is an independent risk factor for
adult-onset asthma.
Methods:We carried out a nested case-control study from the
longitudinal cohort of the Tucson Epidemiologic Study of
Obstructive Lung Diseases. One hundred seventy-three incident
patients with physician-confirmed asthma were compared with
2177 subjects who reported no asthma or shortness of breath
with wheezing. Potential risk factors, including the presence of
rhinitis, were assessed before the onset of asthma (patients) or
before the last completed survey (control subjects).
Results: Rhinitis was a significant risk factor for asthma
(crude odds ratio, 4.13; 95\% confidence interval, 2.88-5.92).
After adjustment for years of follow-up, age, sex, atopic status,
smoking status, and presence of chronic obstructive pulmonary
disease, the magnitude of the association was reduced
but still highly significant (adjusted odds ratio, 3.21; 95\% confidence
interval, 2.19-4.71). After stratification, rhinitis
increased the risk of development of asthma by about 3 times
both among atopic and nonatopic patients and by more than 5
times among patients in the highest IgE tertile. Patients with
rhinitis with persistent and severe nasal symptoms and a personal
history of physician-confirmed sinusitis had an additional
increased risk of asthma development.
Conclusion:We conclude that rhinitis is a significant risk factor
for adult-onset asthma in both atopic and nonatopic subjects.
The nature of the association between rhinitis and asthma
is open to interpretation.
Nutzer