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Gender differences in asthma prevalence may depend on how asthma is defined
A H Henriksen1, T L Holmen, L Bjermer
1Department of Lung Medicine, University Hospital of Trondheim, Norwegian University of Science and Technology, Trondheim, Norway. anne.h.henriksen@medisin.ntnu.no
Respiratory Medicine
|May 9, 2003
Summary
Doctor-diagnosed asthma (DDA) may underestimate prevalence, particularly in girls. Objective measures like exhaled nitric oxide (ENO) are key to understanding asthma in adolescents.
Area of Science:
- Pediatric Pulmonology
- Epidemiology
- Allergy and Immunology
Background:
- Asthma diagnosis can be based on current wheeze, doctor-diagnosed asthma (DDA), or current wheeze with airway hyperresponsiveness (AHR).
- Adolescent asthma prevalence varies based on diagnostic criteria used.
Purpose of the Study:
- To estimate asthma prevalence in adolescents using different diagnostic criteria.
- To investigate gender differences in asthma symptoms and diagnosis.
- To correlate asthma findings with objective measures like AHR, exhaled nitric oxide (ENO), and IgE.
Main Methods:
- A health survey (HUNT) involved 8571 adolescents (13-19 years) reporting respiratory symptoms.
- A subset of 401 with current wheeze and 213 controls underwent allergy screening, methacholine challenge, and ENO measurements.
Main Results:
- Current wheeze prevalence was 26% (30% girls, 23% boys). Doctor-diagnosed asthma (DDA) prevalence was 10.8%.
- Girls with current wheeze were less likely to have DDA than boys.
- More girls than boys with current wheeze had AHR, but more boys reported DDA; elevated ENO strongly predicted DDA.
Conclusions:
- Defining asthma solely by DDA risks underestimating its prevalence, especially in adolescent girls.
- Objective measures like ENO are crucial for accurate asthma assessment in this population.