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Ann Allergy Asthma Immunol. 2018 Sep 14. pii: S1081-1206(18)31199-2. doi: 10.1016/j.anai.2018.09.453. [Epub ahead of print]

Asthma phenotypes based on health services utilization for allergic diseases in a province-wide birth cohort.

Author information

1
Epidemiology and Biostatistics Unit, INRS-Institut Armand-Frappier, Université du Québec, 531 boul. des Prairies, Laval, QC, Canada, H7V 1B7.
2
Respiratory Epidemiology and Clinical Research Unit, Research Institute of the McGill University Health Centre, 5252 boul. De Maisonneuve, Montreal, QC, Canada, H4A 3S5; Department of Epidemiology, Biostatistics and Occupational Health, Faculty of Medicine, McGill University, 1020 Pine Ave. West, Montreal, QC, Canada, H3A 1A2.
3
Epidemiology and Biostatistics Unit, INRS-Institut Armand-Frappier, Université du Québec, 531 boul. des Prairies, Laval, QC, Canada, H7V 1B7. Electronic address: marie-claude.rousseau@iaf.inrs.ca.

Abstract

BACKGROUND:

Previous studies on asthma phenotypes were often conducted in selected clinical populations and overlooked changes over the life course.

OBJECTIVE:

In a population-based cohort, we identified asthma phenotypes based on utilization of health services for allergic diseases in three life periods and documented transitions between phenotypes across life periods.

METHODS:

In a cohort of 78,211 individuals born in 1974 in the province of Québec (Canada), we documented medical visits and hospitalizations for asthma and other allergic diseases until 1994. Phenotypes based on clusters of health services utilization in childhood (8-12 years), adolescence (13-17 years), and young adulthood (18-20 years) were identified using Ward's method among 9,989 (12.8%) subjects who had at least one health encounter for asthma during follow-up. Population level probabilities of transitioning between phenotypes were estimated in the full study population.

RESULTS:

In the subset with asthma, six phenotypes were identified during both childhood and young adulthood, and seven during adolescence. The most common phenotype was "no asthma or allergic diseases": 58% in childhood, 42% in adolescence, and 54% in adulthood. Second most common was the "mild asthma/no allergic diseases" phenotype, representing respectively 36%, 31%, and 21% in these three periods. In the study population, 87% of the subjects remained in the "no asthma" phenotype over the follow-up. The vast majority of subjects in the asthma phenotypes transitioned over time.

CONCLUSION:

Our study uniquely contributes to a better understanding, at the population level, of the manifestations and transitions in asthma phenotypes over the life course.

KEYWORDS:

Administrative health databases; Allergic diseases; Asthma; Birth Cohort; Phenotypes

PMID:
30223115
DOI:
10.1016/j.anai.2018.09.453

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