Bidirectional association between asthma and chronic rhinosinusitis: Two longitudinal follow-up studies using a national sample cohort

Gwanghui Ryu,Ji-Hun Mo,Bumjung Park,Chanyang Min,Hyo Geun Choi

doi:10.1038/s41598-020-66479-8

Gwanghui Ryu, Ji-Hun Mo + Show 3 more

Open Access

https://doi.org/10.1038/s41598-020-66479-8

Copy DOI

Abstract

The aim of this study was to evaluate an epidemiologic association of asthma and chronic rhinosinusitis (CRS) using a national sample cohort of the Korean population. We collected data from the Korean Health Insurance Review and Assessment Service-National Sample Cohort between 2002 and 2013, and two different case-control cohorts were designed (1st: asthmatic patients matched in a 1:1 ratio with 204,119 non-asthmatics as control I, 2nd: CRS patients matched in a 1:4 ratio with 124,020 non-CRS patients as control II). Bidirectional association was examined using Cox proportional hazard models stratified by age, sex, income, and region of residence. Patients with asthma had an increased risk of developing CRS [adjusted hazard ratio (95% confidence interval) = 1.74 (1.67–1.80)], both with nasal polyps [1.55 (1.36–1.78)], without nasal polyps [1.74 (1.67–1.81)]. In the second cohort, patients with CRS had increased risk of developing asthma [1.85 (1.80–1.91)] with similar results for those with and without nasal polyps. The strongest association for risk of CRS was in 20–39 years old men with asthma [2.41 (1.97–2.96)], while the strongest association for increased risk of asthma in those with CRS group was also seen in this same subgroup [2.40 (2.18–2.63)]. CRS and asthma had a bidirectional influence on each other. CRS increased the risk of asthma, and asthma increased the risk of CRS, especially in young men.

Highlights

The aim of this study was to evaluate an epidemiologic association of asthma and chronic rhinosinusitis (CRS) using a national sample cohort of the Korean population
The characteristics of two groups were exactly the same due to the matching (P = 1.000), while the rates of comorbid atopic dermatitis, chronic obstructive pulmonary disease (COPD), and Charlson comorbidity index (CCI) score ≥ 2 were higher in the asthma group compared to the control I
In all subjects with CRS in study I, the distribution of CRS with nasal polyp (CRSwNP) and CRSsNP was similar in both asthma patients (0.3% vs. 3.6%) and control I (0.2% and 1.9%) groups, still the prevalence of CRSwNP and CRSsNP were higher in asthma group than control I (Table S1)

Summary

Introduction

The aim of this study was to evaluate an epidemiologic association of asthma and chronic rhinosinusitis (CRS) using a national sample cohort of the Korean population. Patients with CRS had increased risk of developing asthma [1.85 (1.80–1.91)] with similar results for those with and without nasal polyps. 41–51% had CRS in a large cohort study in United States[17]. The interaction between the two conditions is not clearly understood, and a recent study suggests that increased periostin levels may predispose patients with CRSwNP to comorbid asthma[18]. The association of asthma and CRS in a large epidemiologic study has not been investigated. We investigated the bidirectional association between CRS and asthma using a national sample cohort

Objectives

Methods

Results

Conclusion