Background

Asthma affects more than 6.2 million children in the United States and is a major source of chronic disease burden. Concurrent food allergy (FA) may be a risk factor for worse asthma outcomes.

Objective

To estimate the prevalence of FA among a cohort of adolescents with persistent asthma and assess whether FA is an independent risk factor for asthma morbidity.

Methods

We included 342 adolescents aged 12 to 16 years with persistent asthma from the Rochester city school district who participated in the School-Based Asthma Care for Teens trial between 2014 and 2018. Multivariable models were used to estimate the association between FA and asthma morbidity.

Results

Overall, 29% of adolescents with asthma reported having a FA. Although there were no statistically significant differences in daytime asthma symptoms, teens with FA had higher fractional exhaled nitric oxide (47.5 vs 33.9 P = .002) and reported more days with activity limitation owing to asthma (3.1 vs 2.3 days/2 weeks, P = .03) compared with teens without FA. Less than half (42%) of adolescents with FA had an epinephrine autoinjector.

Conclusion

This study found FA to be common among this cohort of adolescents with asthma. Although FA was not related to asthma symptom severity, adolescents with FA had higher fractional exhaled nitric oxide and more activity limitation, and most did not have epinephrine autoinjectors. A history of FA and lack of epinephrine autoinjector may increase near-fatal outcomes in adolescents with asthma. Preventive measures in addition to standard asthma treatments are warranted for these teens.

中文翻译：

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患有哮喘的高危青少年的食物过敏：一个需要重点关注的领域。

背景

哮喘影响着美国超过 620 万儿童，是慢性病负担的主要来源。并发食物过敏 (FA) 可能是导致哮喘预后更差的危险因素。

客观的

评估持续性哮喘青少年队列中 FA 的患病率，并评估 FA 是否是哮喘发病的独立危险因素。

方法

我们纳入了来自罗切斯特市学区的 342 名 12 至 16 岁患有持续性哮喘的青少年，他们在 2014 年至 2018 年期间参加了以学校为基础的青少年哮喘护理试验。使用多变量模型来估计 FA 与哮喘发病率之间的关联。

结果

总体而言，29% 的哮喘青少年报告患有 FA。尽管日间哮喘症状没有统计学显着差异，但患有 FA 的青少年呼出一氧化氮分数更高（47.5 对 33.9 P  = .002），并且报告因哮喘导致活动受限的天数更多（3.1 对 2.3 天/2 周，P  = .03) 与没有 FA 的青少年相比。不到一半 (42%) 的 FA 青少年有肾上腺素自动注射器。

结论

这项研究发现 FA 在这组患有哮喘的青少年中很常见。尽管 FA 与哮喘症状严重程度无关，但患有 FA 的青少年呼出一氧化氮分数更高，活动受限更多，而且大多数人没有肾上腺素自动注射器。FA 病史和缺乏肾上腺素自动注射器可能会增加青少年哮喘患者的近乎致命的结局。这些青少年除了标准的哮喘治疗外，还需要采取预防措施。