Publication date: Available online 14 September 2018
Source: Annals of Allergy, Asthma & Immunology
Author(s): Miceline Mésidor, Andrea Benedetti, Mariam El-Zein, Dick Menzies, Marie-Élise Parent, Marie-Claude Rousseau
Abstract
Background
Previous studies on asthma phenotypes were often conducted in selected clinical populations and overlooked changes over the life course.
Objective
In a population-based cohort, we identified asthma phenotypes based on utilization of health services for allergic diseases in three life periods and documented transitions between phenotypes across life periods.
Methods
In a cohort of 78,211 individuals born in 1974 in the province of Québec (Canada), we documented medical visits and hospitalizations for asthma and other allergic diseases until 1994. Phenotypes based on clusters of health services utilization in childhood (8-12 years), adolescence (13-17 years), and young adulthood (18-20 years) were identified using Ward's method among 9,989 (12.8%) subjects who had at least one health encounter for asthma during follow-up. Population level probabilities of transitioning between phenotypes were estimated in the full study population.
Results
In the subset with asthma, six phenotypes were identified during both childhood and young adulthood, and seven during adolescence. The most common phenotype was "no asthma or allergic diseases": 58% in childhood, 42% in adolescence, and 54% in adulthood. Second most common was the "mild asthma/no allergic diseases" phenotype, representing respectively 36%, 31%, and 21% in these three periods. In the study population, 87% of the subjects remained in the "no asthma" phenotype over the follow-up. The vast majority of subjects in the asthma phenotypes transitioned over time.
Conclusion
Our study uniquely contributes to a better understanding, at the population level, of the manifestations and transitions in asthma phenotypes over the life course.
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