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. 2022 Sep 7;22(1):338.
doi: 10.1186/s12890-022-02138-0.

Risk factors associated with comorbid asthma in patients with chronic rhinosinusitis with nasal polyps: a cross-sectional study

Fangyuan Li #  1 , Xuechen Wang #  1 , Shen Shen  2   3 , Kai Huang  1 , Ming Wang  2   3 , Xiaofang Liu  1 , Chengshuo Wang  2   3 , Jianmin Jin #  1   3 , Luo Zhang #  4   5   6   7
Affiliations

Risk factors associated with comorbid asthma in patients with chronic rhinosinusitis with nasal polyps: a cross-sectional study

Fangyuan Li et al. BMC Pulm Med. .

Abstract

Background: Although 20-60% of patients with chronic rhinosinusitis with nasal polyps (CRSwNP) have asthma, the risk factors associated with comorbid asthma are not clear. The aim of the study was to investigate the factors associated with asthma, and develop a practical scoring system to screen asthma comorbidity in CRSwNP patients.

Methods: This report describes a cross-sectional study with consecutive CRSwNP patients. Two cohorts of CRSwNP patients named "modelling" group and "validation" group were investigated respectively. Logistic regression analysis was performed based on demographic and clinical data collected from patients in the modelling group to determine the risk factors associated with asthma, and establish a scoring system for screening comorbid asthma. Receiver operating characteristic curve was constructed to evaluate the screening system; the optimal cut-off point was established by means of the Yoden Index. The consistency between the diagnosis of asthma by the Global Initiative for Asthma (GINA) criteria and by the screening system was assessed by Kappa value in the validation group.

Results: Totally 150 patients in modelling group and 78 patients in validation group were enrolled. Female gender (odds ratio [OR] = 6.4; P < 0.001), allergic rhinitis (OR = 2.9; P = 0.021), serum total (T)-immunoglobulin (Ig) E ≥ 69.0kU/L (OR = 12.0; P < 0.001), and blood eosinophil count ≥ 0.35 × 109/L (OR = 4.0; P = 0.001) were shown to be independent risk factors for asthma in patients with CRSwNP. Based on these variables, a scoring system (FAIE) ranging from 0(no risk) to 6(high risk); was developed. The area under the receiver operating characteristic curve of the system was 0.823, and the optimal cut-off value was 3 points, with sensitivity 83.8% and specificity 68.6% for screening asthma. The asthma comorbidity determined with FAIE score ≥ 3 points in the validation group, was moderately consistent with that defined by GINA (Kappa = 0.513, P < 0.001), with sensitivity 76.9% and specificity 74.4%.

Conclusions: Female gender, allergic rhinitis, serum T-IgE level, and blood eosinophil count are independent risk factors for asthma comorbidity in patients with CRSwNP, and the FAIE system may be practical for screening comorbid asthma in these patients.

Keywords: Asthma screening system; Chronic rhinosinusitis; Comorbid-asthma; Nasal polyps; Risk factors.

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Conflict of interest statement

The authors declare that they have no conflicts of interest.

Figures

Fig. 1
Fig. 1
Study Flowchart. CRSwNP, chronic rhinosinusitis with nasal polyps; EPOS, European Position Paper on Rhinosinusitis and Nasal Polyps; GINA, Global Initiative for Asthma
Fig. 2
Fig. 2
ROC curves of T-IgE, eosinophil count and FAIE screening system for assessing comorbid asthma. ROC, receiver operating characteristic; T-IgE, total immunoglobulin E; FAIE, Female gender, Allergic rhinitis, IgE, and Eosinophils as asthma risk factors
Fig. 3
Fig. 3
Factors associated with asthma in CRSwNP patients after conversion of quantitative variables into dichotomic variables. CRSwNP, chronic rhinosinusitis with nasal polyps; T-IgE, total immunoglobulin E; CI, confidence interval
See this image and copyright information in PMC

References

    1. Fokkens WJ, Lund VJ, Mullol J, Bachert C, Alobid I, Baroody F, et al. European position paper on rhinosinusitis and nasal polyps 2012. Rhinology. 2012;50(supplement 23):1–298. - PubMed
    1. Jarvis D, Newson R, Lotvall J, Hastan D, Tomassen P, Keil T, et al. Asthma in adults and its association with chronic rhinosinusitis: the GA2LEN survey in Europe. Allergy. 2012;67(1):91–98. doi: 10.1111/j.1398-9995.2011.02709.x. - DOI - PubMed
    1. Langdon C, Mullol J. Nasal polyps in patients with asthma: prevalence, impact, and management challenges. J Asthma Allergy. 2016;9:45–53. - PMC - PubMed
    1. Zhang N, Van Zele T, Perez-Novo C, Van Bruaene N, Holtappels G, DeRuyck N, et al. Different types of T-effector cells orchestrate mucosal inflammation in chronic sinus disease. J Allergy Clin Immunol. 2008;122(5):961–968. doi: 10.1016/j.jaci.2008.07.008. - DOI - PubMed
    1. Klossek JM, Neukirch F, Pribil C, Jankowski R, Serrano E, Chanal I, et al. Prevalence of nasal polyposis in France: a cross-sectional, case-control study. Allergy. 2005;60(2):233–237. doi: 10.1111/j.1398-9995.2005.00688.x. - DOI - PubMed