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Risk factors for bronchial hyperresponsiveness in late childhood and early adolescence

The Respiratory Epidemiology Unit, Dept of Epidemiology and Biostatistics, McGill University, Montreal, Canada

CORRESPONDENCE: M.R. Becklake, Respiratory Epidemiology Unit, McGill University, 1110 Pine avenue West, Montréal, Québec, Canada, H3A 1A3. Fax: 514 3988981. E-mail: margaret.becklake@mcgill.ca

Keywords: allergy skin test, asthma, exercise-induced bronchospasm, gas cooking, methacholine challenge test, puberty

Received: February 5, 2002
Accepted April 6, 2002

This work was supported by the Respiratory Health Network of Centres of Excellence (P.T. Macklem) and the Montreal Chest Research Institute.

The prevalence of asthma and bronchial hyperresponsiveness (BHR) tends to decrease in male children but increase in female children in the transition from childhood to adolescence. Hormonal factors may be involved in the natural history of asthma during this period.

In a prospective study of Montreal school children, the authors examined the determinants of BHR according to the child's pubertal status; 156 male children and 168 female children without a prior diagnosis of asthma were followed for an average of 4.6 yrs.

Average age at follow-up was 13.4 yrs and 59% had reached puberty. The prevalence of BHR at follow-up was similar among pre- and postpubertal male children (25.0% versus 29.2%),while BHR was more common among post- compared with prepubertal female children (33.1% versus 14.2%). There were no differences in the determinants (measured in childhood) of BHR at follow-up according to pubertal status. The major determinant of BHR was a positive skin test to dust-mite antigen. BHR was also linked to exposure to gas cooking and the presence of exercise-induced bronchospasm.

In conclusion, the results of this study do not support a change in asthma phenotype with the onset of puberty. Pre- and postpuberty, the major determinant of bronchial hyperresponsiveness was skin sensitivity to mite allergen.

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