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Phenotyping asthma, rhinitis and eczema in MeDALL population-based birth cohorts: an allergic comorbidity cluster
J Garcia-Aymerich1,2,3, M Benet1,2,3, Y Saeys4
1Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain.
Insights
Childhood asthma, rhinitis, and eczema frequently co-occur and can be identified as a single allergic comorbidity cluster at ages 4 and 8. This finding aids in understanding the relationship between these common allergic conditions in children.
Area of Science:
- Pediatric Allergy and Immunology
- Epidemiology
- Computational Biology
Background:
- Asthma, rhinitis, and eczema commonly co-occur in children, but their population-level interrelationships are not well understood.
- Previous research has not fully addressed the clustering of these conditions using statistical methods.
Purpose of the Study:
- To investigate the co-occurrence patterns of childhood asthma, rhinitis, and eczema.
- To identify distinct clusters of children based on these allergic conditions using unsupervised statistical techniques.
Main Methods:
- Utilized partitioning cluster analysis on data from 17,209 children at age 4 and 14,585 at age 8 from seven European birth cohorts (MeDALL project).
- Analyzed 23 variables including symptoms, doctor diagnoses, treatment, age of onset, immunoglobulin E sensitization, weight, and height.
- Performed sensitivity analyses using latent class analysis and self-organizing maps to validate findings.
Main Results:
- Two distinct groups were consistently identified at both ages: a reference group with low symptom prevalence and sensitization, and a symptomatic group with higher prevalence.
- The symptomatic group encompassed 99% of children with co-occurring asthma, rhinitis, and/or eczema (comorbidities) at both 4 and 8 years of age.
- Clustering results remained consistent across all sensitivity analyses, confirming the robustness of the identified groups.
Conclusions:
- At the population level, asthma, rhinitis, and eczema can be classified as a single allergic comorbidity cluster in children aged 4 and 8.
- Further research incorporating longitudinal data and biological markers is recommended to elucidate the complex interrelationships between these allergic diseases.
Background:
Asthma, rhinitis and eczema often co-occur in children, but their interrelationships at the population level have been poorly addressed. We assessed co-occurrence of childhood asthma, rhinitis and eczema using unsupervised statistical techniques.
Methods:
We included 17 209 children at 4 years and 14 585 at 8 years from seven European population-based birth cohorts (MeDALL project). At each age period, children were grouped, using partitioning cluster analysis, according to the distribution of 23 variables covering symptoms 'ever' and 'in the last 12 months', doctor diagnosis, age of onset and treatments of asthma, rhinitis and eczema; immunoglobulin E sensitization; weight; and height. We tested the sensitivity of our estimates to subject and variable selections, and to different statistical approaches, including latent class analysis and self-organizing maps.
Results:
Two groups were identified as the optimal way to cluster the data at both age periods and in all sensitivity analyses. The first (reference) group at 4 and 8 years (including 70% and 79% of children, respectively) was characterized by a low prevalence of symptoms and sensitization, whereas the second (symptomatic) group exhibited more frequent symptoms and sensitization. Ninety-nine percentage of children with comorbidities (co-occurrence of asthma, rhinitis and/or eczema) were included in the symptomatic group at both ages. The children's characteristics in both groups were consistent in all sensitivity analyses.
Conclusion:
At 4 and 8 years, at the population level, asthma, rhinitis and eczema can be classified together as an allergic comorbidity cluster. Future research including time-repeated assessments and biological data will help understanding the interrelationships between these diseases.
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