Respiratory Medicine ( IF 4.3 ) Pub Date : 2020-09-17 , DOI: 10.1016/j.rmed.2020.106160 Paul G. Lassmann-Klee , Päivi L. Piirilä , Ben Brumpton , Matz Larsson , Britt-Marie Sundblad , Jaak Põlluste , Maria Juusela , Annamari Rouhos , Mari Meren , Ari Lindqvist , Hannu Kankaanranta , Helena Backman , Arnulf Langhammer , Eva Rönmark , Bo Lundbäck , Anssi R.A. Sovijärvi
The prevalence of asthma is higher in Sweden and Finland than in neighbouring eastern countries including Estonia. Corresponding difference in bronchial eosinophilic inflammation could be studied by FENO measurements. We aimed to compare FENO in adult general populations of Sweden, Finland, and Estonia, to test the plausibility of the west-east disparity hypothesis of allergic diseases.
We conducted clinical interviews (N = 2658) with participants randomly selected from the general populations in Sweden (Stockholm and Örebro), Finland (Helsinki), and Estonia (Narva and Saaremaa), and performed FENO (n = 1498) and skin prick tests (SPT) in 1997–2003.
The median (interquartile range) of FENO (ppb) was 15.5 (9.3) in Sweden, 15.4 (13.6) in Finland and 12.5 (9.6) in Estonia. We found the lowest median FENO values in the Estonian centres Saaremaa 13.1 (9.5) and Narva 11.8 (8.6). In the pooled population, asthma was associated with FENO ≥25 ppb, odds ratio (OR) 3.91 (95% confidence intervals: 2.29–6.32) after adjusting for SPT result, smoking, gender and study centre. A positive SPT test increased the likelihood of asthma OR 3.19 (2.02–5.11). Compared to Saaremaa, the likelihood of having asthma was higher in Helsinki OR 2.40 (1.04–6.02), Narva OR 2.45 (1.05–6.19), Örebro OR 3.38 (1.59–8.09), and Stockholm OR 5.54 (2.18–14.79).
There was a higher prevalence of asthma and allergic airway inflammation in adult general populations of Sweden and Finland compared to those of Estonia. Atopy and elevated FENO level were independently associated with an increased risk of asthma. In conclusion, the findings support the earlier west-east disparity hypothesis of allergic diseases.
中文翻译：
瑞典，芬兰和爱沙尼亚成年人口的F ENO以及哮喘和特应性流行的平行梯度—北欧EpiLung研究
瑞典和芬兰的哮喘患病率高于包括爱沙尼亚在内的邻国。支气管嗜酸性粒细胞炎症的相应差异可以通过F ENO测量来研究。我们旨在比较瑞典，芬兰和爱沙尼亚的成年人口中的F ENO，以检验过敏性疾病的东西方差异假设的合理性。
我们进行了临床访谈（N = 2658），从瑞典（斯德哥尔摩和厄勒布鲁），芬兰（赫尔辛基）和爱沙尼亚（纳尔瓦和萨列马岛）的一般人群中随机选择参与者，并进行了F ENO（n = 1498）和皮肤刺测试（SPT）在1997-2003年。
F ENO（ppb）的中位数（四分位数范围）在瑞典为15.5（9.3），在芬兰为15.4（13.6），在爱沙尼亚为12.5（9.6）。我们在爱沙尼亚中部萨列马岛13.1（9.5）和纳尔瓦11.8（8.6）中找到最低的中位数F ENO值。在集合群体，哮喘与相关联˚F ENO调整SPT结果，吸烟，性别和研究中心后：比值比（OR）3.91（2.29-6.32 95％置信区间）≥25PPB，。SPT测试阳性会增加患哮喘的可能性，即OR值为3.19（2.02-5.11）。与萨列马岛相比，赫尔辛基的OR为2.40（1.04–6.02），纳尔瓦为OR 2.45（1.05–6.19），厄勒布鲁或OR 3.38（1.59–8.09）和斯德哥尔摩为OR 5.54（2.18-14.79）的可能性更高。
与爱沙尼亚相比，瑞典和芬兰的成年人口中哮喘和过敏性气道炎症的患病率更高。特应性疾病和F ENO水平升高与哮喘风险增加独立相关。总之，这些发现支持了早期的过敏性疾病的东西方差异假说。
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