Comment le trouble du spectre de l'autisme affecte-t-il le risque et la gravité de l'asthme chez l'enfant?

Aperçu: G.M.

Chez les enfants souffrant d'asthme, la TSA concomitante est associée à de meilleurs résultats liés à l'asthme, mais à un taux de traitement plus élevé. En outre, les données ne supportent pas les TSA comme facteur de risque d'asthme incident.

Ann Allergy Asthma Immunol. 2017 May;118(5):570-576. doi: 10.1016/j.anai.2017.02.020.

How does autism spectrum disorder affect the risk and severity of childhood asthma?

Jónsdóttir U¹, Lang JE².

Author information

1

Faculty of Medicine, University of Iceland, Reykjavík, Iceland.

2

Division of Pulmonary and Sleep Medicine, Nemours Children's Hospital, Orlando, Florida; Division of Allergy/Immunology and Pulmonary Medicine, Duke University School of Medicine, Durham, North Carolina. Electronic address: Jason.Lang@Duke.edu.

Abstract

BACKGROUND:

Autism spectrum disorder (ASD) and asthma are among the most common chronic disorders in childhood. Both are associated with altered immune regulation and share several risk factors. The effects of ASD on risk for later asthma and asthma severity remain unclear.

OBJECTIVE:

To determine whether ASD in children increases the risk of incident asthma and worsens asthma severity.

METHODS:

We performed 2 distinct analytic designs (case-control and retrospective longitudinal cohort) using a multistate electronic health records database to assess the odds of new asthma and asthma severity among children with ASD. In both designs, children with ASD were matched with children without ASD according to sex, age, race, ethnicity, location, and insurance status. Pulmonary function, controller medication prescriptions, asthma exacerbations, and asthma-related hospitalizations were collected. The effects of ASD on asthma risk and severity were assessed using multivariable linear and logistic regression.

RESULTS:

Among children with asthma, ASD was associated with reduced exacerbations (odds ratio [OR], 0.71; 95% confidence interval [CI], 0.54-0.92), better forced expiratory volume in 1 second/forced vital capacity ratio (0.876 vs 0.841, P < .001), and lower odds of airflow obstruction (OR, 0.53; 95% CI, 0.31-0.90) but had higher odds of asthma controller prescription (OR, 2.18; 95% CI, 1.62-2.93). In a longitudinal analysis of children without asthma, ASD was found to be protective for new asthma (OR, 0.44; 95% CI, 0.26-0.74).

CONCLUSION:

Among children with asthma, concomitant ASD is associated with better asthma-related outcomes but a higher controller treatment burden. In addition, our data did not support ASD as a risk factor for incident asthma.

Copyright © 2017 American College of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

PMID:28477788

DOI:10.1016/j.anai.2017.02.020