Prevalence and risk factors of allergic rhinitis among Chinese adults: A nationwide representative cross-sectional study

Xiao Zhang; Mei Zhang; Haijing Sui; Chun Li; Zhengjing Huang; Bo Liu; Xiaoting Song; Shuanglu Liao; Miao Yu; Tingting Luan; Torsten Zuberbier; Limin Wang; Zuotao Zhao; Jing Wu

doi:10.1016/j.waojou.2023.100744

Prevalence and risk factors of allergic rhinitis among Chinese adults: A nationwide representative cross-sectional study

World Allergy Organ J. 2023 Mar 26;16(3):100744. doi: 10.1016/j.waojou.2023.100744. eCollection 2023 Mar.

Authors

Xiao Zhang¹, Mei Zhang¹, Haijing Sui², Chun Li¹, Zhengjing Huang¹, Bo Liu³, Xiaoting Song³, Shuanglu Liao³, Miao Yu³, Tingting Luan³, Torsten Zuberbier⁴, Limin Wang¹, Zuotao Zhao³, Jing Wu¹

Affiliations

¹ National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China.
² Department of Otorhinolaryngology Head and Neck Surgery, Peking University First Hospital, Beijing, China.
³ Department of Dermatology and Venerology, Peking University First Hospital, Beijing, China.
⁴ Dermatological Allergology, Allergie-Centrum-Charité, Department of Dermatology, Venereology and Allergy, Charité - Universitätsmedizin Berlin, Germany.

Abstract

Background: The prevalence of allergic rhinitis (AR) has been increasing steadily worldwide, especially in countries with increasing industrialization such as China. However, available evidence regarding AR prevalence among Chinese adults is scarce and limited to regional data collected in earlier years. We therefore aimed to provide a more recent and robust estimate of AR prevalence using a nationwide representative cross-sectional study in China.

Methods: Data of 184 326 participants aged 18 years or older were obtained from the China Chronic Disease and Risk Factor Surveillance conducted in 2018-2019. AR was determined by self-reported sneezing, nasal itching, obstruction, or rhinorrhea symptoms for at least 1 h in the absence of a cold or flu within the last 12 months. Multivariable logistic model was used to examine the risk factors of AR, and a possible non-linear relationship was further tested by restricted cubic spline. Potential additive interactions of risk factors with sex, residence, and geographic region were assessed by relative excess risk due to interaction (RERI).

Results: The weighted prevalence of AR was 8.1% (95% confidence interval [CI], 7.4%-8.7%), of whom 23.7% (95% CI, 21.3%-26.0%) were aware of their diagnosis. Increased odds of AR were associated with younger age, men, living in urban area or north region, more education, smoking, underweight, and higher income. Despite the nonsignificant linear trend, the spline regression demonstrated a non-linear association between AR and sleep duration, with higher odds at both ends. Additionally, the observed associations were generally stronger among men and people living in urban area and north region, with significant RERI ranging from 0.07 (95% CI, 0.00-0.14) to 0.40 (95% CI, 0.12-0.67).

Conclusions: AR is prevalent in China and the associated factors and interactions are helpful to design targeted preventive strategies towards certain subpopulations. The low awareness of AR calls for a national effort on AR screening.

Keywords: Additive interaction; Allergic rhinitis; Chinese adults; Nationwide representative; Risk factors.