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2020 (English)In: Respiratory Medicine, ISSN 0954-6111, E-ISSN 1532-3064, Vol. 173, article id 106160Article in journal (Refereed) Published
Abstract [en]
The prevalence of asthma is higher in Sweden and Finland than in neighbouring eastern countries including Estonia. Corresponding difference in bronchial eosinophilic inflammation could be studied by FENO measurements. We aimed to compare FENO in adult general populations of Sweden, Finland, and Estonia, to test the plausibility of the west-east disparity hypothesis of allergic diseases.
We conducted clinical interviews (N = 2658) with participants randomly selected from the general populations in Sweden (Stockholm and dOrebro), Finland (Helsinki), and Estonia (Narva and Saaremaa), and performed FENO (n = 1498) and skin prick tests (SPT) in 1997-2003.
The median (interquartile range) of FENO (ppb) was 15.5 (9.3) in Sweden, 15.4 (13.6) in Finland and 12.5 (9.6) in Estonia. We found the lowest median FENO values in the Estonian centres Saaremaa 13.1 (9.5) and Narva 11.8 (8.6). In the pooled population, asthma was associated with FENO >= 25 ppb, odds ratio (OR) 3.91 (95% confidence intervals: 2.29-6.32) after adjusting for SPT result, smoking, gender and study centre. A positive SPT test increased the likelihood of asthma OR 3.19 (2.02-5.11). Compared to Saaremaa, the likelihood of having asthma was higher in Helsinki OR 2.40 (1.04-6.02), Narva OR 2.45 (1.05-6.19), dOrebro OR 3.38 (1.59-8.09), and Stockholm OR 5.54 (2.18-14.79).
There was a higher prevalence of asthma and allergic airway inflammation in adult general populations of Sweden and Finland compared to those of Estonia. Atopy and elevated FEND level were independently associated with an increased risk of asthma. In conclusion, the findings support the earlier west-east disparity hypothesis of allergic diseases.
Place, publisher, year, edition, pages
Elsevier, 2020
Keywords
Asthma, FENO, Atopy, Skin prick test
National Category
Respiratory Medicine and Allergy
Identifiers
urn:nbn:se:oru:diva-88363 (URN)10.1016/j.rmed.2020.106160 (DOI)000589916300001 ()33011446 (PubMedID)2-s2.0-85091985606 (Scopus ID)
Note
Funding Agencies:
Foundation of the Finnish Anti Tuberculosis Association, Finland
Research Foundation of the Pulmonary Diseases, Finland
Tampere Tuberculosis Foundation: Eero Hamalainen, Finland
VainO and Laina Kivi Foundation, Finland
Ida Montin Foundation, Finland
Estonian Science Foundation, Estonia
Nummela Sanatorium Foundation, Finland
University of Helsinki, Finland
Nordic Council of Ministers: NordForsk (Nordic EpiLung Study), Norway
2021-01-132021-01-132021-01-13Bibliographically approved