BACKGROUND This study investigated the sex-specific incidence of asthma and the effects of modifiable risk factors, particularly obesity, on asthma incidence among middle-aged and older individuals in Korea. METHODS We used data from the National Health Insurance Service-Health Screening Cohort (NHIS-HEALS), which includes health examinees aged 40-79 years in 2002-2003. In total, 459,529 participants with baseline anthropometric measurements were followed-up for 10 years and the development of asthma was evaluated (2004-2013). For subgroup analysis, 246,019 participants who had body mass index (BMI) and waist circumference (WC) measurements taken in 2008-2009 were included in the analysis of the asthma incidence for 2010-2013. Factors associated with asthma were analysed using Cox proportional hazard models. RESULTS The cohort comprised 4,248,813 (men, 2,358,541; women, 1,890,272) person-years of follow-up for 2004-2013. The asthma incidence was 10.58 and 15.03 per 1000 person-years for men and women, respectively. Asthma incidence increased with age, notably so in men. Obesity based on the baseline BMI was significantly associated with asthma development in both sexes (men, HR = 1.23, 95% confidence interval (CI) = 1.13-1.34; women, HR = 1.40 95% CI = 1.32-1.48). High WC was also related to asthma incidence in both sexes with statistical significance (men, HR = 1.34, 95% CI = 1.16-1.57; women, HR = 1.19 95% CI = 1.03-1.37). Analysis of the combined effects of BMI and WC showed that men had a higher asthma risk in the group with both general obesity and abdominal obesity than in the group with non-abdominal obesity and normal BMI. However, obese women had a higher risk of asthma regardless of abdominal obesity. Similarly, smoking was associated with asthma in both sexes but drinking and physical activity showed different associations between the sexes. CONCLUSIONS Our results revealed that asthma incidence was substantially high at old age and lifestyle factors were associated with asthma development. Practical strategies including weight control and healthy lifestyle modification are required to prevent asthma in older people.

中文翻译：

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韩国中老年人哮喘发病率与可改变的危险因素之间的关联中的性别差异：NHIS-HEALS 10岁队列。

背景技术这项研究调查了韩国中老年人哮喘的性别特异性发病率以及可改变的危险因素（尤其是肥胖症）对哮喘发病率的影响。方法我们使用了来自美国国家健康保险服务部健康检查队列（NHIS-HEALS）的数据，其中包括2002-2003年40-79岁的健康检查者。总共对459,529名基线人体测量学参与者进行了为期10年的随访，并评估了哮喘的发展（2004-2013年）。对于亚组分析，在2008-2009年进行的哮喘发病率分析中包括246,019名在2008-2009年进行体重指数（BMI）和腰围（WC）测量的参与者。使用Cox比例风险模型分析了与哮喘相关的因素。结果该队列包括4,248名，2004-2013年的随访时间为813（男性，2,358,541;妇女，1,890,272）人年。男性和女性的哮喘发病率分别是每1000人年10.58和15.03。哮喘的发病率随年龄增长而增加，尤其是男性。男性和女性的基线BMI肥胖均与哮喘的发展显着相关（男性，HR = 1.23，95％置信区间（CI）= 1.13-1.34；女性，HR = 1.40，95％CI = 1.32-1.48）。WC的高高也与男女的哮喘发病率相关，具有统计学意义（男性，HR = 1.34，95％CI = 1.16-1.57；女性，HR = 1.19 95％CI = 1.03-1.37）。对BMI和WC联合作用的分析表明，与普通和非BMI正常组相比，普通肥胖和腹部肥胖组的男性患哮喘的风险更高。然而，肥胖的妇女无论腹部肥胖如何，都有较高的哮喘风险。同样，吸烟与哮喘均与性别有关，但饮酒和体育锻炼表明性别之间存在不同的关联。结论我们的结果表明，老年时哮喘的发病率很高，生活方式因素与哮喘的发展有关。需要采取控制体重和健康生活方式等实用策略来预防老年人哮喘。