Non-atopic males with adult onset asthma are at risk of persistent airflow limitation
Marijke Amelink, Department of Respiratory Medicine, F5-260, Academic Medical Centre, University of Amsterdam, P.O. Box 22700, Amsterdam, NL-1100 DE, The Netherlands.
Patients with asthma have on average a more rapid decline in FEV 1 as compared with the general population. Recent cluster analysis has revealed different asthma phenotypes that can be distinguished by age of onset and reversibility of airflow limitation.
This study aimed at detecting risk factors associated with persistent airflow limitation in patients with the adult onset asthma phenotype.
We recruited 88 patients with adult onset (≥ 18 years) asthma from an academic pulmonary outpatient clinic in the Netherlands. The associations of age, age of asthma onset, asthma duration, gender, race, atopy, smoking packyears, BMI, use of oral corticosteroids with post-bronchodilator FEV 1/FVC were investigated.
Multiple linear regression analysis showed an association of absence of atopy (r = −0.27, B = −0.26, P = 0.01) and male gender (r = 0.31, B = 0.30, P = 0.004) with post-bronchodilator FEV 1/FVC. Multiple logistic regression analysis showed that male patients were 10.8 (CI: 2.6–45.2) times the odds than women to have an FEV 1/FVC < 0.7, and non-atopic patients were 5.2 (CI: 1.3–20.3) times the odds to have an FEV 1/FVC < 0.7 than atopic patients.
Conclusions and Clinical Relevance
We conclude that in patients with adult onset asthma, male gender and absence of atopy are associated with persistent airflow limitation. This might suggest that amongst patients with adult onset asthma, non-atopic male patients are at increased risk of accelerated decline in lung function.