Heterogeneity of Childhood Asthma in Korea: Cluster Analysis of the Korean Childhood Asthma Study Cohort
윤지선, 엄은진, 김진택, 임대현, 김우경, 송대진, 유영, 서동인, 백혜성, 신미용, 권지원, 장광천, 양현종, 이은, 김환수, 서주희, 우성일, 김형영, 신윤호, 이주석, 정성수, 한민규, 유진호,
소속 상세정보
윤지선 ( Yoon Ji-Sun ) - Mediplex Sejong Hospital Department of Pediatrics
엄은진 ( Eom Eun-Jin ) - University of Ulsan College of Medicine Asan Institute for Life Sciences
김진택 ( Kim Jin-Tack ) - Catholic University College of Medicine Uijeongbu St. Mary’s Hospital Department of Pediatrics
임대현 ( Lim Dae-Hyun ) - Inha University College of Medicine Department of Pediatrics
김우경 ( Kim Woo-Kyung ) - Inje University Seoul Paik Hospital Department of Pediatrics
송대진 ( Song Dae-Jin ) - Korea University Guro Hospital Department of Pediatrics
유영 ( Yoo Young ) - Korea University Anam Hospital Department of Pediatrics
서동인 ( Suh Dong-In ) - Seoul National University College of Medicine Department of Pediatrics
백혜성 ( Baek Hey-Sung ) - Hallym University Kangdong Sacred Heart Hospital Department of Pediatrics
신미용 ( Shin Mee-Yong ) - Soonchunhyang University School of Medicine Department of Pediatrics
권지원 ( Kwon Ji-Won ) - Seoul National University College of Medicine Seoul National University Bundang Hospital Department of Pediatrics
장광천 ( Jang Gwang-Cheon ) - National Health Insurance Service Ilsan Hospital Department of Pediatrics
양현종 ( Yang Hyeon-Jong ) - Soonchunhyang University College of Medicine Department of Pediatrics
이은 ( Lee Eun ) - Chonnam National University Medical School Chonnam National University Hospital Department of Pediatrics
김환수 ( Kim Hwan-Soo ) - Catholic University College of Medicine Bucheon St. Mary’s Hospital Department of Pediatrics
서주희 ( Seo Ju-Hee ) - Dankook University Hospital Department of Pediatrics
우성일 ( Woo Sung-Il ) - Chungbuk National University College of Medicine Department of Pediatrics
김형영 ( Kim Hyung-Young ) - Pusan National University Yangsan Hospital Department of Pediatrics
신윤호 ( Shin Youn-Ho ) - CHA University School of Medicine CHA Gangnam Medical Center Department of Pediatrics
이주석 ( Lee Ju-Suk ) - Sungkyunkwan University School of Medicine Samsung Changwon Hospital Department of Pediatrics
정성수 ( Jung Sung-Su ) - Pusan National University Yangsan Hospital Department of Pediatrics
한민규 ( Han Min-Kyu ) - Asan Medical Center Department of Clinical Epidemiology and Biostatistics
유진호 ( Yu Jin-Ho ) - University of Ulsan College of Medicine Asan Medical Center Department of Pediatrics
Abstract
Purpose: Asthma is a heterogeneous airway disease occurring in children, and it has various clinical phenotypes. A clear differentiation of the clinical phenotypes can provide better asthma management and prediction of asthma prognosis. Little is currently known about asthma phenotypes in Korean children. This study was designed to identify asthma phenotypes in school-aged Korean children.
Methods: This study enrolled 674 children with physician-diagnosed asthma from the Korean childhood Asthma Study (KAS) cohort. The physicians verified the relevant histories of asthma and comorbid diseases, as well as airway lability and hyper-responsiveness from the results of pulmonary function tests and bronchial provocation tests. Questionnaires regarding the participants' baseline characteristics, their environment and self-rating of asthma control were collected at the time of enrollment. Laboratory tests were performed to assess allergy and airway inflammation. Children with asthma were classified by hierarchical cluster analysis.
Results: Of the 674 patients enrolled from the KAS cohort, 447 were included in the cluster analysis. Cluster analysis of these 447 children revealed 4 asthma phenotypes: cluster 1 (n = 216, 48.3%) which was characterized by male-dominant atopic asthma; cluster 2 (n = 79, 17.7%) which was characterized by early-onset atopic asthma with atopic dermatitis; cluster 3 (n = 47, 10.5%) which was characterized by puberty-onset, female-dominant atopic asthma with the low lung function; and cluster 4 (n = 105, 23.5%) which was characterized by early-onset, non-atopic dominant asthma.
Conclusions: The asthma phenotypes among Korean children can be classified into 4 distinct clusters. Long-term follow-up with these phenotypes will be needed to define their prognosis and response to treatment.
키워드
Asthma; childhood; phenotype; cluster analysis
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