Asma em adolescentes: o que o estudo ERICA nos mostrou?
Asthma in adolescents: what did ERICA study show us?
Mara Morelo Rocha Felix; Fábio Chigres Kuschnir; Érica Azevedo de Oliveira Costa Jordão; Maria Cristina Caetano Kuschnir; Katia Vergetti Bloch
Resumo
A asma é uma doença heterogênea caracterizada pela história de sintomas respiratórios que variam de intensidade e ao longo do tempo. Devido à sua alta prevalência, constitui um problema mundial de saúde pública, atingindo todas as faixas etárias, em especial crianças e adolescentes. O objetivo deste artigo foi analisar as produções científicas sobre asma baseadas no Estudo de Riscos Cardiovasculares em Adolescentes (ERICA). Trata-se de uma revisão narrativa incluindo os artigos originais sobre asma baseados nos dados do ERICA, publicados em periódicos indexados em inglês e português. O ERICA foi um estudo multicêntrico nacional realizado em 2013 e 2014, que investigou a prevalência de asma e fatores de risco cardiovascular, incluindo obesidade, diabetes mellitus, hipertensão arterial sistêmica, dislipidemia, tabagismo, sedentarismo, hábitos alimentares inadequados, e a associação entre esses fatores, em adolescentes de 12 a 17 anos, estudantes de escolas públicas e privadas de municípios brasileiros com mais de 100.000 habitantes. Nos cinco estudos selecionados, foi possível demonstrar que a prevalência de asma foi significativamente maior entre adolescentes do sexo feminino em todas as capitais e macrorregiões do Brasil, com predomínio da doença na região Sudeste do nosso país. Além disso, a asma esteve fortemente associada ao tabagismo (passivo e ativo) e foi associada à duração curta do sono. Por outro lado, não esteve associada com os níveis séricos de vitamina D. Em relação aos parâmetros metabólicos, foi observado que a síndrome metabólica e alguns de seus componentes, como a circunferência abdominal, estiveram significativamente associados à asma grave em adolescentes brasileiros.
Palavras-chave
Abstract
Asthma is a heterogeneous disease characterized by a history of respiratory symptoms that vary in intensity and over time. Due to its high prevalence, asthma is considered a global public health problem affecting all age groups, especially children and adolescents. This study aimed to analyze scientific papers on asthma based on the Study of Cardiovascular Risks in Adolescents (ERICA). We provide a narrative review of original articles on asthma based on ERICA data published in indexed journals in English and Portuguese. ERICA was a national multicenter study conducted in 2013 and 2014 that investigated the prevalence of asthma and cardiovascular risk factors, including obesity, diabetes mellitus, systemic arterial hypertension, dyslipidemia, smoking, sedentary lifestyle, and inadequate eating habits, and the association between these factors in adolescents aged 12 to 17 years, students from public and private schools in Brazilian cities of more than 100,000 population. In the 5 selected studies, the prevalence of asthma was significantly higher in female adolescents in all capitals and macro-regions of Brazil, occurring predominantly in the southeast region of the country. In addition, asthma was strongly associated with smoking (passive and active) as well as with short sleep duration, but not with serum vitamin D levels. Regarding metabolic parameters, metabolic syndrome and some of its components, such as waist circumference, were significantly associated with severe asthma in Brazilian adolescents.
Keywords
Referências
1. ReddelHK,Bacharier LB, BatemanED,BrightlingCE,Brusselle GG, Buhl R, et al. Global Initiative for Asthma Strategy 2021: executive summary and rationale for key changes. Eur Respir J. 2021 Dec 31;59(1):2102730.
2. Asher MI, García-Marcos L, Pearce NE, Strachan DP. Trends in worldwide asthma prevalence. Eur Respir J. 2020 Dec 24;56(6):2002094.
3. Ding G, Ji R, Bao Y.Risk and protective factors for the development of childhood asthma. Paediatr Respir Rev. 2015 Mar;16(2):133-9.
4. Mortimer K, Reddel HK, Pitrez PM, Bateman ED. Asthma management in low and middle-income countries:case for change. Eur Respir J. 2022 Sep 15;60(3):2103179.
5. Bloch KV, Szklo M, Kuschnir MC, Abreu Gde A, Barufaldi LA, Klein CH, et al.The Study of Cardiovascular Risk in Adolescents--ERICA: rationale, design and sample characteristics of a national survey examining cardiovascular risk factor profile in Brazilian adolescents. BMC Public Health. 2015 Feb 7;15:94. Erratum in: BMC Public Health. 2015;15:850.
6. Asher MI, Keil U, Anderson HR, Beasley R, Crane J, Martinez F, et al.International Study of Asthma and Allergies in Childhood (ISAAC): rationale and methods. Eur Respir J. 1995 Mar;8(3):483-91.
7. Solé D, Vanna AT, Yamada E, Rizzo MC, Naspitz CK. International Study of Asthma and Allergies in Childhood (ISAAC) written questionnaire: validation of the asthma component among Brazilian children. J Investig Allergol Clin Immunol. 1998 NovDec;8(6):376-82.
8. Kuschnir FC, Gurgel RQ, Solé D, Costa E, Felix MM, de Oliveira CL, et al. ERICA: prevalence of asthma in Brazilian adolescents. Rev Saude Publica. 2016 Feb;50 Suppl 1(Suppl 1):13s. Erratum in: Rev Saude Publica. 2016;50:13serr.
9. Kuschnir FC, Felix MMR, Caetano Kuschnir MC, Bloch KV, Jordão EAOC, Solé D, et al. Severe asthma is associated with metabolic syndrome in Brazilian adolescents. J Allergy Clin Immunol. 2018 May;141(5):1947-1949.e4.
10. Jordão EAOC, Kuschnir FC, Figueiredo VC, Félix MMR, Silva TLND, Kuschnir MCC, et al. ERICA: smoking is associated with more severe asthma in Brazilian adolescents. J Pediatr (Rio J). 2019 Sep-Oct;95(5):538-44.
11. Estanislau NRDA, Jordão EAOC, Abreu GA, Bloch KV, Kuschnir MCC, Felix MMR, et al. Association between asthma and sleep hours in Brazilian adolescents: ERICA. J Pediatr (Rio J). 2021 JulAug;97(4):396-401.
12. Amaral CSFD, Jordão ÉAOC, Oliveira CL, Felix MMR, Kuschnir MCC, Kuschnir FC.Asthma and vitamin D in Brazilian adolescents: Study of Cardiovascular Risks in Adolescents (ERICA). J Bras Pneumol. 2021 Dec 15;47(6):e20210281.
13. Mitchell EA, Beasley R, Keil U, Montefort S, Odhiambo J; ISAAC Phase Three Study Group. The association between tobacco and the risk of asthma, rhinoconjunctivitis and eczema in children and adolescents:analyses from Phase Three of the ISAAC programme. Thorax. 2012 Nov;67(11):941-9.
14. The International Study of Asthma and Allergies in Childhood (ISAAC) Steering Committee. Worldwide variation in prevalence of symptoms of asthma, allergic rhinoconjunctivitis, and atopic eczema: ISAAC. Lancet. 1998 Apr 25;351(9111):1225-32.
15. Pearce N, Aït-Khaled N, Beasley R, Mallol J, Keil U, Mitchell E;ISAAC Phase Three Study Group. Worldwide trends in the prevalence of asthma symptoms:phase III of the International Study of Asthma and Allergies in Childhood (ISAAC). Thorax. 2007 Sep;62(9):758-66.
16. Lai CK, Beasley R, Crane J, Foliaki S, Shah J, Weiland S;International Study of Asthma and Allergies in Childhood Phase Three Study Group. Global variation in the prevalence and severity of asthma symptoms: phase three of the International Study of Asthma and Allergies in Childhood (ISAAC). Thorax. 2009 Jun;64(6):476-83.
17. Barreto ML, Ribeiro-Silva R de C, Malta DC, Oliveira-Campos M, Andreazzi MA, Cruz AA. Prevalence of asthma symptoms among adolescents in Brazil: National Adolescent School-based Health Survey (PeNSE 2012). Rev Bras Epidemiol. 2014;17 Suppl 1:106-15.
18. Solé D, Rosário Filho NA, Sarinho ES, Camelo-Nunes IC, Barreto BA, Medeiros ML, et al.Prevalence of asthma and allergic diseases in adolescents: nine-year follow-up study (2003-2012). J Pediatr (Rio J). 2015 Jan-Feb;91(1):30-5.
19. Fenger RV, Gonzalez-Quintela A, Linneberg A, Husemoen LL, Thuesen BH, Aadahl M, et al.The relationship of serum triglycerides, serum HDL, and obesity to the risk of wheezing in 85,555 adults. Respir Med. 2013 Jun;107(6):816-24.
20. Leone N, Courbon D, Thomas F, Bean K, Jégo B, Leynaert B, et al. Lung function impairment and metabolic syndrome: the critical role of abdominal obesity. Am J Respir Crit Care Med. 2009 Mar 15;179(6):509-16.
21. Forno E, Han YY, Muzumdar RH, Celedón JC. Insulin resistance, metabolic syndrome, and lung function in US adolescents with and without asthma. J Allergy Clin Immunol. 2015 Aug;136(2):304-11. e8.
22. Luzak A, Fuertes E, Flexeder C, Standl M, von Berg A, Berdel D, et al. Which early life events or current environmental and lifestyle factors influence lung function in adolescents? - Results from the GINIplus & LISAplus studies. Respir Res. 2017 Jul 12;18(1):138.
23. Ribeiro-Silva RC, Malta DC, Rodrigues LC, Ramos DO, Fiaccone RL, Machado DB, et al. Social, Environmental and Behavioral Determinants of Asthma Symptoms in Brazilian Middle School Students-A National School Health Survey (Pense 2012). Int J Environ Res Public Health. 2018 Dec 19;15(12):2904.
24. Elias BC, Silva JB, Mais LA, Warkentin S, Konstantyner T, Solé D. Factors associated with asthma in brazilian adolescents: national adolescent school-based health survey (PENSE-2012). Rev Paul Pediatr. 2019 Jul 18;37(4):406-13.
Submetido em:
21/06/2023
Aceito em:
22/07/2023
Facebook
Google+
Twitter
LinkedIn
Mendeley
StumbleUpon
CiteULike
Reddit
Email