Aeroallergen Sensitization Patterns in a Lake-Influenced Region of Eastern Anatolia and Their Association with Pediatric Airway Physiology

Öz

Objective: To characterize regional aeroallergen sensitization patterns in Eastern Anatolia and assess their association with spirometrically defined airway outcomes among children with asthma from lake-adjacent districts of Van Province and inland districts in other Eastern Anatolian provinces. Methods: In this retrospective cross-sectional study, 235 children aged 6–18 years were stratified by residence (lake-adjacent districts of Van Province vs inland districts in other Eastern Anatolian provinces). Sensitization burden was defined as the number of positive aeroallergen groups. Spirometry was available for 137 children with physician-diagnosed asthma. Multivariable logistic regression was used to identify independent predictors of airway obstruction (FEV₁/FVC < 0.80), adjusting for age, sex, eosinophilia, and log-transformed IgE. Results: Sensitization profiles differed by region: house dust mite sensitization was more prevalent in lake-adjacent districts, whereas sensitization to grass and weed pollen was more frequent in inland districts. Among children who underwent spirometry, 22.6% had airway obstruction. Obstruction prevalence increased across sensitization burden categories (0, 1, and ≥2 aeroallergen groups) (8.5%, 20.0%, and 35.0%; p = 0.033). FEV₁/FVC and FEF₂₅-₇₅ declined with increasing sensitization burden (p = 0.007 and p = 0.012, respectively). In adjusted analysis, sensitization burden was independently associated with airway obstruction (adjusted OR 1.88, 95% CI 1.24–2.85; p = 0.003). Model discrimination was modest (AUC 0.68, 95% CI 0.59–0.77). Conclusion: Regional ecological context was associated with distinct patterns of aeroallergen sensitization and clinically relevant differences in airway function. Cumulative sensitization burden was independently associated with spirometrically defined airway obstruction in this pediatric cohort.

Anahtar Kelimeler

• Asthma
• Bronchodilator reversibility
• Eastern Anatolia;
• Polysensitization

Doğu Anadolu’da Göl Etkisindeki Bir Bölgede Aeroalerjen Duyarlanma Paternleri ve Bunların Çocuklarda Havayolu Fizyolojisi ile İlişkisi

Öz

Amaç: Doğu Anadolu’da bölgesel aeroalerjen duyarlanma paternlerini tanımlamak, bu paternlerin Van ilinin göl kıyısındaki ilçelerinde ve diğer Doğu Anadolu illerinin iç kesimlerinde yaşayan astımlı çocuklarda spirometrik olarak tanımlanan havayolu sonuçlarıyla ilişkisini değerlendirmek. Yöntemler: Bu retrospektif kesitsel çalışmada, 6–18 yaş aralığındaki 235 çocuk ikamet yerine göre (Van ili göl kıyısındaki ilçeler ve diğer Doğu Anadolu illerinin iç kesimleri) sınıflandırıldı. Duyarlanma yükü, pozitif aeroalerjen grup sayısı olarak tanımlandı. Astımı olan 137 çocukta spirometri verisi mevcuttu. Havayolu obstrüksiyonunun (FEV₁/FVC < 0,80) bağımsız belirleyicilerini saptamak amacıyla yaş, cinsiyet, eozinofili ve log-dönüştürülmüş IgE için düzeltme yapılarak çok değişkenli lojistik regresyon analizi uygulandı. Bulgular: Duyarlanma paternleri bölgeye göre farklılık gösterdi: ev tozu akarı duyarlanması göl kıyısındaki ilçelerde daha sık görülürken, çimen ve yabani ot poleni duyarlanması iç kesimlerde daha yaygındı. Spirometri uygulanan çocukların %22,6’sında havayolu obstrüksiyonu saptandı. Obstrüksiyon prevalansı, duyarlanma yükü kategorileri arttıkça yükseldi (%8,5; %20,0; %35,0; p = 0,033). Duyarlanma yükü arttıkça FEV₁/FVC ve FEF₂₅–₇₅ değerlerinde azalma gözlendi (sırasıyla p = 0,007 ve p = 0,012). Düzeltilmiş analizde duyarlanma yükü, havayolu obstrüksiyonu ile bağımsız olarak ilişkili bulundu (düzeltilmiş OR 1,88; %95 GA 1,24–2,85; p = 0,003). Modelin ayırt ediciliği orta düzeydeydi (AUC 0,68; %95 GA 0,59–0,77). Sonuç: Bölgesel ekolojik bağlam, farklı aeroalerjen duyarlanma paternleri ve klinik olarak anlamlı havayolu fonksiyonu farklılıkları ile ilişkili bulundu. Bu pediatrik kohortta kümülatif duyarlanma yükü, spirometri ile tanımlanan havayolu obstrüksiyonu ile bağımsız olarak ilişkiliydi.

Anahtar Kelimeler

• Aeroalerjen
• Astım
• Bronkodilatör yanıt
• Doğu Anadolu
• Polisensitizasyon.

Kaynakça

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