Disease modifiers for Latino asthmatics are not well-characterized. Objective: Identify predictors of asthma severity among Latinos.
Hispanic youth with or without asthma were recruited from five cities in the mainland United States and Puerto Rico for the GALA-II Study during 2008-2011. Procedures included questionnaire, aeroallergen skin test (MultiTest, 14 allergens), venipuncture, and lung function. We used logistic regression to investigate potential predictors of severity among asthmatic subjects, adjusting for demographics, ethnicity, income, recruitment site, body mass index, smoking history, and asthma duration.
Of 2020 asthmatic subjects, 1431 had skin test results. Mean+SD age was 12.7+/-3.3 years, 54% male, FEV1= 92.6+/-15.8% predicted (NHANES). 42.4% (n=607) had severe asthma; 26.6% (n=380), 14.0% (n=200), and 17.1% (n=244) had moderate, mild persistent, and mild intermittent asthma, respectively. 17.6% (n=252) took >=2 asthma controllers, 20.3% (n=291) took one controller, and 43.2% (n=619) used SABA PRN only. Compared to subjects with mild and moderate asthma, severe asthmatics had higher serum total IgE (p<0.001) and were more likely to be sensitized to any allergen (OR=1.85, 95%CI=1.34-2.57). Indoor allergens were more likely to be associated with severe asthma (Dermatophagoides pteronyssinus OR=1.44, 95%CI=1.07-1.92; cat OR=1.51, 95%CI=1.08-2.10; cockroach OR=1.56, 95%CI=1.12-2.19; Aspergillus spp. OR=2.00, 95%CI=1.05-3.81); Cladosporium spp. was also associated with severity (OR=1.77, 95%CI=1.03-3.04). Similarly, compared to subjects taking none to one controller, those using two or more controllers were more often sensitized to D. pteronyssinus, cat, cockroach, Cladosporium spp., Olea europaea, and ragweed (all p<0.01).
Aeroallergen sensitization, especially to indoor allergens, is associated with more severe asthma in Latino children.
Journal of Allergy and Clinical Immunology, Vol. 131, Issue 2, AB51
- AAAAI 2013 (69th)