Abstract：
BACKGROUND: Evidence on the early life risk factors of adult CRS, and the history of asthma and allergies across the life course, is limited.
OBJECTIVE: To investigate relationships between respiratory infective/allergic conditions in childhood, and asthma and allergies across the life course and CRS in middle age.
METHODS: Data were from the population-based Tasmanian Longitudinal Health Study (TAHS) cohort, first studied in 1968 when aged 6-7 years (n = 8583) and serially followed into middle age (n = 3609). Using a well-accepted epidemiological definition, participants were assigned a CRS-severity subtype at age 53: no sinusitis/CRS (reference); past doctor diagnosis only; current symptoms without doctor diagnosis; and doctor-diagnosed CRS with current symptoms. Relationships with infective/allergic respiratory illnesses at age 7, and previously published asthma-allergy trajectories from 7 to 53 years, were examined using multinominal regression.
RESULTS: In middle age, 5.8% reported current CRS symptoms with 2.5% doctor-diagnosed. Childhood conditions associated with symptomatic doctor-diagnosed CRS included frequent head colds (multinomial odds ratio [mOR] = 2.04 (95% confidence interval [95% CI]: 1.24, 3.37)), frequent tonsillitis (mOR = 1.61 [95% CI: 1.00, 2.59]) and current childhood asthma (mOR = 2.23 [95% CI: 1.25, 3.98]). Life course trajectories that featured late-onset or persistent asthma and allergies were associated with all CRS subtypes in middle age; early-onset persistent asthma and allergies (mOR = 6.74, 95% CI: 2.76, 16.4); late-onset asthma allergies (mOR = 15.9, 95% CI: 8.06, 31.4), and late-onset hayfever (mOR = 3.02, 95% CI: 1.51, 6.06) were associated with symptomatic doctor-diagnosed CRS.
CONCLUSIONS: Current asthma, frequent head colds and tonsillitis at age 7 could signal a susceptible child who is at higher risk for CRS in mid-adult life and who might benefit from closer monitoring and/or proactive management. Concurrent asthma and allergies were strongly associated and are potential treatable traits of adult CRS.
OBJECTIVE: To investigate relationships between respiratory infective/allergic conditions in childhood, and asthma and allergies across the life course and CRS in middle age.
METHODS: Data were from the population-based Tasmanian Longitudinal Health Study (TAHS) cohort, first studied in 1968 when aged 6-7 years (n = 8583) and serially followed into middle age (n = 3609). Using a well-accepted epidemiological definition, participants were assigned a CRS-severity subtype at age 53: no sinusitis/CRS (reference); past doctor diagnosis only; current symptoms without doctor diagnosis; and doctor-diagnosed CRS with current symptoms. Relationships with infective/allergic respiratory illnesses at age 7, and previously published asthma-allergy trajectories from 7 to 53 years, were examined using multinominal regression.
RESULTS: In middle age, 5.8% reported current CRS symptoms with 2.5% doctor-diagnosed. Childhood conditions associated with symptomatic doctor-diagnosed CRS included frequent head colds (multinomial odds ratio [mOR] = 2.04 (95% confidence interval [95% CI]: 1.24, 3.37)), frequent tonsillitis (mOR = 1.61 [95% CI: 1.00, 2.59]) and current childhood asthma (mOR = 2.23 [95% CI: 1.25, 3.98]). Life course trajectories that featured late-onset or persistent asthma and allergies were associated with all CRS subtypes in middle age; early-onset persistent asthma and allergies (mOR = 6.74, 95% CI: 2.76, 16.4); late-onset asthma allergies (mOR = 15.9, 95% CI: 8.06, 31.4), and late-onset hayfever (mOR = 3.02, 95% CI: 1.51, 6.06) were associated with symptomatic doctor-diagnosed CRS.
CONCLUSIONS: Current asthma, frequent head colds and tonsillitis at age 7 could signal a susceptible child who is at higher risk for CRS in mid-adult life and who might benefit from closer monitoring and/or proactive management. Concurrent asthma and allergies were strongly associated and are potential treatable traits of adult CRS.
摘要：
背景：关于成人CRS早期危险因素的证据，以及整个生命过程中的哮喘和过敏史，是有限的。
目的：研究儿童呼吸道感染/过敏性疾病之间的关系，以及整个生命过程中的哮喘和过敏以及中年时的CRS。
方法：数据来自基于人群的塔斯马尼亚纵向健康研究（TAHS）队列，首次研究于1968年，年龄在6-7岁（n=8583），并连续进入中年（n=3609）。使用公认的流行病学定义，参与者在53岁时被分配了CRS严重程度亚型:无鼻窦炎/CRS(参考);仅过去的医生诊断;没有医生诊断的当前症状;以及有当前症状的医生诊断的CRS.与7岁时的感染性/过敏性呼吸道疾病的关系，以及以前发表的7至53岁的哮喘过敏轨迹，使用多变量回归进行检查。
结果：在中年，5.8%报告了目前的CRS症状，2.5%的医生诊断。与有症状的医生诊断的CRS相关的儿童状况包括频繁的头部感冒（多项比值比[mOR]=2.04（95％置信区间[95％CI]：1.24，3.37）），频发扁桃体炎(mOR=1.61[95%CI:1.00,2.59])和当前儿童哮喘(mOR=2.23[95%CI:1.25,3.98])。以晚发性或持续性哮喘和过敏为特征的生命过程轨迹与中年的所有CRS亚型有关；早发性持续性哮喘和过敏（mOR=6.74，95％CI：2.76，16.4）；晚发性哮喘过敏（mOR=15.9，95％CI：8.06，31.4），晚发性花粉热（mOR=3.02，95％CI：1.51，6.06）与有症状的医生诊断的CRS相关。
结论：目前的哮喘，7岁时频繁的头部感冒和扁桃体炎可能预示着一个易感儿童,他在中年时患有CRS的风险较高,并且可能从更密切的监测和/或积极的管理中受益.并发哮喘和过敏密切相关，是成人CRS的潜在可治疗特征。
目的：研究儿童呼吸道感染/过敏性疾病之间的关系，以及整个生命过程中的哮喘和过敏以及中年时的CRS。
方法：数据来自基于人群的塔斯马尼亚纵向健康研究（TAHS）队列，首次研究于1968年，年龄在6-7岁（n=8583），并连续进入中年（n=3609）。使用公认的流行病学定义，参与者在53岁时被分配了CRS严重程度亚型:无鼻窦炎/CRS(参考);仅过去的医生诊断;没有医生诊断的当前症状;以及有当前症状的医生诊断的CRS.与7岁时的感染性/过敏性呼吸道疾病的关系，以及以前发表的7至53岁的哮喘过敏轨迹，使用多变量回归进行检查。
结果：在中年，5.8%报告了目前的CRS症状，2.5%的医生诊断。与有症状的医生诊断的CRS相关的儿童状况包括频繁的头部感冒（多项比值比[mOR]=2.04（95％置信区间[95％CI]：1.24，3.37）），频发扁桃体炎(mOR=1.61[95%CI:1.00,2.59])和当前儿童哮喘(mOR=2.23[95%CI:1.25,3.98])。以晚发性或持续性哮喘和过敏为特征的生命过程轨迹与中年的所有CRS亚型有关；早发性持续性哮喘和过敏（mOR=6.74，95％CI：2.76，16.4）；晚发性哮喘过敏（mOR=15.9，95％CI：8.06，31.4），晚发性花粉热（mOR=3.02，95％CI：1.51，6.06）与有症状的医生诊断的CRS相关。
结论：目前的哮喘，7岁时频繁的头部感冒和扁桃体炎可能预示着一个易感儿童,他在中年时患有CRS的风险较高,并且可能从更密切的监测和/或积极的管理中受益.并发哮喘和过敏密切相关，是成人CRS的潜在可治疗特征。
