RATIONALE Although endotoxin is a recognized cause of environmental lung disease, how its relationship with respiratory outcomes varies with climate is unknown. OBJECTIVE To examine the endotoxin predictors as well as endotoxin association with asthma, wheeze, and sensitization to inhalant allergens in various US climate regions. METHODS We analyzed data on 6963 participants in the National Health and Nutrition Examination Survey. Endotoxin measurements of house dust from bedroom floor and bedding were performed at the University of Iowa. Linear and logistic regression analyses were used to identify endotoxin predictors and assess endotoxin association with health outcomes. RESULTS The overall median house dust endotoxin was 16.2 EU/mg; it was higher in mixed-dry/hot-dry regions (19.7 EU/mg) and lower in mixed-humid/marine areas (14.8 EU/mg). Endotoxin predictors and endotoxin association with health outcomes significantly differed across climate regions. In subarctic/very cold/cold regions, log10-endotoxin was significantly associated with higher prevalence of wheeze outcomes (OR:1.48, 95% CI:1.19-1.85 for any wheeze, OR:1.48, 95% CI:1.22-1.80 for exercise-induced wheeze, OR:1.50, 95% CI:1.13-1.98 for prescription medication for wheeze, and OR:1.95, 95% CI:1.50-2.54 for doctor/ER visit for wheeze). In hot-humid regions, log10-endotoxin was positively associated with any wheeze (OR:1.66, 95% CI:1.04-2.65) and current asthma (OR:1.56, 95% CI:1.11-2.18), but negatively with sensitization to any inhalant allergens (OR:0.83, 95% CI:0.74-0.92). CONCLUSION Endotoxin predictors and endotoxin association with asthma and wheeze differ across U.S. climate regions. Endotoxin is associated positively with wheeze or asthma in cold and hot-humid regions, but negatively with sensitization to inhalant allergens in hot-humid climates.

中文翻译：

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内毒素预测因子和相关呼吸系统结果因美国气候区域的不同而不同


基本原理 虽然内毒素是环境性肺部疾病的公认原因，但其与呼吸系统结果的关系如何随气候变化而变化尚不清楚。目的 研究美国不同气候地区的内毒素预测因子以及内毒素与哮喘、喘息和吸入性过敏原敏感性的关联。方法 我们分析了 6963 名全国健康和营养检查调查参与者的数据。爱荷华大学对卧室地板和床上用品的室内灰尘进行了内毒素测量。使用线性和逻辑回归分析来识别内毒素预测因子并评估内毒素与健康结果的关联。结果 室内灰尘内毒素总体中位数为 16.2 EU/mg；干燥/热干混合地区较高（19.7 EU/mg），湿润/海洋混合地区较低（14.8 EU/mg）。不同气候区域的内毒素预测因子以及内毒素与健康结果的关联存在显着差异。在亚北极/极冷/寒冷地区，log10-内毒素与较高的喘息结果发生率显着相关（对于任何喘息，OR：1.48，95% CI：1.19-1.85；对于运动，OR：1.48，95% CI：1.22-1.80）诱发喘息，对于喘息处方药，OR：1.50，95% CI：1.13-1.98；对于喘息医生/急诊室就诊，OR：1.95，95% CI：1.50-2.54）。在湿热地区，log10-内毒素与任何喘息（OR：1.66，95％CI：1.04-2.65）和当前哮喘（OR：1.56，95％CI：1.11-2.18）呈正相关，但与过敏反应呈负相关。任何吸入性过敏原（OR：0.83，95% CI：0.74-0.92）。结论 内毒素预测因子以及内毒素与哮喘和喘息的关联在美国不同的气候地区有所不同。 在寒冷和湿热地区，内毒素与喘息或哮喘呈正相关，但在热湿气候下，与吸入性过敏原的敏感性呈负相关。