University of Oulu

Mäkikyrö EMS, Jaakkola MS, Lajunen TK, Malmberg LP, Jaakkola JJK. Subtypes of Adult-Onset Asthma at the Time of Diagnosis: A Latent Class Analysis. International Journal of Environmental Research and Public Health. 2023; 20(4):3072.

Subtypes of adult-onset asthma at the time of diagnosis : a latent class analysis

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Author: Mäkikyrö, Elina M. S.1,2,3; Jaakkola, Maritta S.1,2,3; Lajunen, Taina K.1,2,3;
Organizations: 1Center for Environmental and Respiratory Health Research, Research Unit of Population Health, University of Oulu, FI-90014 Oulu, Finland
2Biocenter Oulu, University of Oulu, FI-90014 Oulu, Finland
3Medical Research Center Oulu, Oulu University Hospital, FI-90220 Oulu, Finland
4Skin and Allergy Hospital, Helsinki University Hospital, University of Helsinki, FI-00280 Helsinki, Finland
Format: article
Version: published version
Access: open
Online Access: PDF Full Text (PDF, 1.9 MB)
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Language: English
Published: Multidisciplinary Digital Publishing Institute, 2023
Publish Date: 2023-05-09


Introduction: Only a few previous studies have investigated the subtypes of adult-onset asthma. No previous study has assessed whether these subtypes are different between men and women, or whether these subtypes have different risk factors.

Methods: We applied latent class analyses to the Finnish Environment and Asthma Study population, including 520 new cases of adult-onset asthma. We formed subtypes separately between women and men and analyzed the following determinants as potential predictors for these subtypes: age, body mass index, smoking, and parental asthma.

Results: Among women, the subtypes identified were: 1. Moderate asthma, 2. Cough-variant asthma, 3. Eosinophilic asthma, 4. Allergic asthma, and 5. Difficult asthma. Among men, the subtypes were: 1. Mild asthma, 2. Moderate asthma, 3. Allergic asthma, and 4. Difficult asthma. Three of the subtypes were similar among women and men: Moderate, Allergic, and Difficult asthma. In addition, women had two distinct subtypes: Cough-variant asthma, and Eosinophilic asthma. These subtypes had different risk factor profiles, e.g., heredity was important for Eosinophilic and Allergic asthma (RR for Both parents having asthma in Eosinophilic 3.55 (1.09 to 11.62)). Furthermore, smoking increased the risk of Moderate asthma among women (RR for former smoking 2.21 (1.19 to 4.11)) and Difficult asthma among men but had little influence on Allergic or Cough-variant asthma.

Conclusion: This is an original investigation of the subtypes of adult-onset asthma identified at the time of diagnosis. These subtypes differ between women and men, and these subtypes have different risk factor profiles. These findings have both clinical and public health importance for the etiology, prognosis, and treatment of adult-onset asthma.

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Series: International journal of environmental research and public health
ISSN: 1661-7827
ISSN-E: 1660-4601
ISSN-L: 1661-7827
Volume: 20
Issue: 4
Article number: 3072
DOI: 10.3390/ijerph20043072
Type of Publication: A1 Journal article – refereed
Field of Science: 3121 General medicine, internal medicine and other clinical medicine
Funding: This study was funded by the Academy of Finland (grants no. 138691 and no. 266314, and grant no. 310372 of GLORIA consortium), the Ministry of Social Affairs and Health of Finland (grant no. STM/1523/2012), the Emil Aaltonen foundation, the Research Foundation of the Pulmonary diseases, the Finnish Anti-Tuberculosis Association, Ella and Georg Ehrnrooth Foundation and Jenny and Antti Wihuri Foundation.
Academy of Finland Grant Number: 138691
Detailed Information: 138691 (Academy of Finland Funding decision)
266314 (Academy of Finland Funding decision)
310372 (Academy of Finland Funding decision)
Copyright information: © 2023 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (