{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T15:03:31Z","timestamp":1790262211859,"version":"4.1.0"},"reference-count":43,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2017,11,7]],"date-time":"2017-11-07T00:00:00Z","timestamp":1510012800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"name":"European Union under the Health Cooperation Work Programme of the 7th Framework Programme","award":["261357"],"award-info":[{"award-number":["261357"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Allergy"],"published-print":{"date-parts":[[2018,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Cross\u2010sectional studies suggested that allergy prevalence in childhood is higher in boys compared to girls, but it remains unclear whether this inequality changes after puberty. We examined the sex\u2010specific prevalence of asthma and rhinitis as single and as multimorbid diseases before and after puberty onset in longitudinal cohort data.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>In six European population\u2010based birth cohorts of MeDALL, we assessed the outcomes: current rhinitis, current asthma, current allergic multimorbidity (ie, concurrent asthma and rhinitis), puberty status and allergic sensitization by specific serum antibodies (immunoglobulin E) against aero\u2010allergens. With generalized estimating equations, we analysed the effects of sex, age, puberty (yes\/no) and possible confounders on the prevalence of asthma and rhinitis, and allergic multimorbidity in each cohort separately and performed individual participant data meta\u2010analysis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Findings<\/jats:title><jats:p>We included data from 19\u00a0013 participants from birth to age 14\u201020\u00a0years. Current rhinitis only affected girls less often than boys before and after puberty onset: adjusted odds ratio for females vs males 0.79 (95%\u2010confidence interval 0.73\u20100.86) and 0.86 (0.79\u20100.94), respectively (sex\u2010puberty interaction <jats:italic>P<\/jats:italic>\u00a0=\u00a0.089). Similarly, for current asthma only, females were less often affected than boys both before and after puberty onset: 0.71, 0.63\u20100.81 and 0.81, 0.64\u20101.02, respectively (sex\u2010puberty interaction <jats:italic>P<\/jats:italic>\u00a0=\u00a0.327). The prevalence of allergic multimorbidity showed the strongest sex effect before puberty onset (female\u2010male\u2010OR 0.55, 0.46\u20100.64) and a considerable shift towards a sex\u2010balanced prevalence after puberty onset (0.89, 0.74\u20101.04); sex\u2010puberty interaction: <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a0.001.<\/jats:p><\/jats:sec><jats:sec><jats:title>Interpretation<\/jats:title><jats:p>The male predominance in prevalence before puberty and the \u201csex\u2010shift\u201d towards females after puberty onset were strongest in multimorbid patients who had asthma and rhinitis concurrently.<\/jats:p><\/jats:sec>","DOI":"10.1111\/all.13312","type":"journal-article","created":{"date-parts":[[2017,9,28]],"date-time":"2017-09-28T15:45:56Z","timestamp":1506613556000},"page":"602-614","source":"Crossref","is-referenced-by-count":62,"title":["The sex\u2010shift in single disease and multimorbid asthma and rhinitis during puberty \u2010 a study by MeDALL"],"prefix":"10.1111","volume":"73","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3603-534X","authenticated-orcid":false,"given":"T.","family":"Keller","sequence":"first","affiliation":[{"name":"Institute of Social Medicine, Epidemiology and Health Economics Charit\u00e9 \u2013 Universit\u00e4tsmedizin Berlin Berlin Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C.","family":"Hohmann","sequence":"additional","affiliation":[{"name":"Institute of Social Medicine, Epidemiology and Health Economics Charit\u00e9 \u2013 Universit\u00e4tsmedizin Berlin Berlin Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M.","family":"Standl","sequence":"additional","affiliation":[{"name":"Institute of Epidemiology I Helmholtz Zentrum M\u00fcnchen \u2010 German Research Center for Environmental Health Neuherberg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A. H.","family":"Wijga","sequence":"additional","affiliation":[{"name":"Center for Nutrition, Prevention, and Health Services National Institute for Public Health and the Environment Bilthoven The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"U.","family":"Gehring","sequence":"additional","affiliation":[{"name":"Division of Environmental Epidemiology Institute for Risk Assessment Sciences Utrecht University Utrecht The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"E.","family":"Mel\u00e9n","sequence":"additional","affiliation":[{"name":"Department of Medical Epidemiology and Biostatistics Karolinska Institutet Solna Sweden"},{"name":"Sachs\u2019 Children's Hospital Stockholm Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1045-1898","authenticated-orcid":false,"given":"C.","family":"Almqvist","sequence":"additional","affiliation":[{"name":"Department of Medical Epidemiology and Biostatistics Karolinska Institutet Solna Sweden"},{"name":"Pediatric Allergy and Pulmonology Unit at Astrid Lindgren Children's Hospital Karolinska University Hospital Stockholm Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S.","family":"Lau","sequence":"additional","affiliation":[{"name":"Department of Paediatric Pneumology &amp; Immunology Charit\u00e9\u2010Universit\u00e4tsmedizin Berlin Berlin Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3322-3046","authenticated-orcid":false,"given":"E.","family":"Eller","sequence":"additional","affiliation":[{"name":"Department of Dermatology and Allergy Center Odense Research Center for Anaphylaxis (ORCA) Odense University Hospital Odense Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"U.","family":"Wahn","sequence":"additional","affiliation":[{"name":"Department of Paediatric Pneumology &amp; Immunology Charit\u00e9\u2010Universit\u00e4tsmedizin Berlin Berlin Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"E. S.","family":"Christiansen","sequence":"additional","affiliation":[{"name":"Department of Dermatology and Allergy Center Odense Research Center for Anaphylaxis (ORCA) Odense University Hospital Odense Denmark"},{"name":"Hans Christian Andersen Children Hospital Odense Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A.","family":"von Berg","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Research Institute Marien\u2010Hospital Wesel Wesel Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J.","family":"Heinrich","sequence":"additional","affiliation":[{"name":"Institute of Epidemiology I Helmholtz Zentrum M\u00fcnchen \u2010 German Research Center for Environmental Health Neuherberg Germany"},{"name":"Inner City Clinic Institute and Outpatient Clinic for Occupational, Social and Environmental Medicine University Hospital of Munich (LMU) Munich Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8875-5587","authenticated-orcid":false,"given":"I.","family":"Lehmann","sequence":"additional","affiliation":[{"name":"Department of Environmental Immunology\/Core Facility Studies Helmholtz Centre for Environmental Research \u2013 UFZ Leipzig Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"D.","family":"Maier","sequence":"additional","affiliation":[{"name":"Biomax Informatics AG Munich Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"D. 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