From the PreventADALL birth cohort, we included 1233 children with EDN analysed using ImmunoCAP at 1 and/or 3 years. Non-atopic children had no history of wheeze, asthma, allergic sensitization or atopic dermatitis. Preschool asthma was defined as having ≥3 episodes of bronchial obstruction between 2 and 3 years, plus doctor diagnosed asthma and/or asthma medication use by 3 years. The upper limit of normal (ULN) of EDN was defined as the 95th percentile. With Youden Index we calculated EDN cut-off levels for risk of preschool asthma.
The overall median (ULN) EDN levels were 27.4 (121) μg/L at 1 year (n = 787), and 20.1 (87.8) μg/L at 3 years (n = 857). Non-atopic children had EDN levels of 24.0 (107) μg/L at 1 year (n = 147), and 17.3 (84.6) μg/L at 3 years (n = 173). EDN levels were higher in boys compared to girls; 32.0 (133) versus 24.5 (97.0) μg/L at 1 year, and 20.9 (96.3) versus 19.0 (72.4) μg/L at 3 years. Preschool asthma was observed in 109/892 (12.2%) children. Higher EDN levels at 1 (>26.7 μg/L) and 3 (≥20.5 μg/L) years were associated with preschool asthma; adjusted OR (95% CI) 2.20 (1.09, 4.41) and 4.68 (2.29, 9.55), respectively.
We report EDN values in early childhood, demonstrating higher levels at 1 compared to 3 years and in boys compared to girls at both ages. Higher EDN levels at both ages were associated with preschool asthma. However, EDN cut-off levels for preschool asthma were overall lower than the ULN of non-atopic children, limiting translation into clinical practice.
方法:从PreventADALL出生队列中,我们纳入了1233名在1年和/或3年时使用ImmunoCAP分析的EDN患儿.非特应性儿童没有喘息史,哮喘,过敏性致敏或特应性皮炎。学龄前哮喘被定义为在2至3年之间有≥3次支气管阻塞发作,加上医生诊断为哮喘和/或哮喘药物使用3年。EDN的正常上限(ULN)定义为第95百分位数。通过YoudenIndex,我们计算了学龄前哮喘风险的EDN临界值。
结果:1年时(n=787)的总中位数(ULN)EDN水平为27.4(121)μg/L,3年为20.1(87.8)μg/L(n=857)。非特应性儿童在1年时EDN水平为24.0(107)μg/L(n=147),和17.3(84.6)μg/L在3年(n=173)。与女孩相比,男孩的EDN水平更高;1年时32.0(133)对24.5(97.0)μg/L,3年时分别为20.9(96.3)和19.0(72.4)μg/L。在109/892(12.2%)儿童中观察到学龄前哮喘。1年(>26.7μg/L)和3年(≥20.5μg/L)较高的EDN水平与学龄前哮喘相关;校正OR(95%CI)2.20(1.09,4.41)和4.68(2.29,9.55),分别。
结论:我们报告了儿童早期的EDN值,与3岁相比,1岁和男孩在两个年龄段都比女孩表现出更高的水平。两个年龄段的较高EDN水平与学龄前哮喘有关。然而,学龄前哮喘的EDN截止水平总体低于非特应性儿童的ULN,限制转化为临床实践。