Risk factors for the development of asthma symptoms in children with allergic rhinitis

Abstract

Purpose: Both allergic rhinitis and asthma are considered one airway disease, which interacts with each other in disease onset and symptom worsening. We evaluated factors developing new or persistent asthma symptoms in elementary school children with al lergic rhinitis. Methods: We selected 343 children aged 6 to 7 years who had rhinitis symptoms within 12 months and allergic sensitization on skin prick tests among 2,491 elementary school children. The questionnaires on symptoms, medical history and environments, blood eosinophils, serum total IgE, pulmonary function test, and bronchial provocation tests were obtained. Using multiple regression analysis, we evaluated factors for later asthma symptoms during a follow-up period of 4 years. Results: The independent risk factors for later asthma symptoms among children with allergic rhinitis were higher body mass index (adjusted odds ratio [aOR], 1.29; 95% confidence interval [CI], 1.06-1.56; P=0.012), a parental diagnosis of asthma (aOR, 6.19; 95% CI, 1.59-24.06; P=0.008), residence in the rural area (aOR, 5.37; 95% CI, 1.34-21.42; P=0.017), and a history of bronchiolitis in the first 2 years (aOR, 5.82; 95% CI, 1.42-23.80; P=0.014). However, pulmonary functions, the levels of bronchial hyper-responsiveness, and the patterns of sensitization showed not significant factors. Children whose allergic rhinitis was treated in the follow-up period were less likely to have asthma symptoms later (aOR, 0.30; 95% CI, 0.10-0.93; P=0.036). Conclusion: In the school-aged children with allergic rhinitis, body mass index and asthma-related risk factors are crucial for devel oping asthma symptoms. The appropriate treatment of rhinitis may decrease asthma symptoms. (Allergy Asthma Respir Dis 2020;8:191-198)