{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,15]],"date-time":"2026-01-15T02:34:03Z","timestamp":1768444443506,"version":"3.49.0"},"reference-count":19,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2016,8,9]],"date-time":"2016-08-09T00:00:00Z","timestamp":1470700800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000943","name":"Albert and Margaret Alkek Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000943","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000055","name":"National Institute on Deafness and Other Communication Disorders","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000055","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["R01 DC011651"],"award-info":[{"award-number":["R01 DC011651"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["R01 DC003594"],"award-info":[{"award-number":["R01 DC003594"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["R01 DC015004"],"award-info":[{"award-number":["R01 DC015004"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100002249","name":"National Organization for Hearing Research Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100002249","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["aao-hnsfjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Otolaryngol.--head neck surg."],"published-print":{"date-parts":[[2016,11]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>To identify genetic and environmental risk factors for otitis media in an indigenous Filipino population.<\/jats:p><\/jats:sec><jats:sec><jats:title>Study Design<\/jats:title><jats:p>Cross\u2010sectional study.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>Indigenous Filipino community.<\/jats:p><\/jats:sec><jats:sec><jats:title>Subjects and Methods<\/jats:title><jats:p>Clinical history and information on breastfeeding, tobacco smoke exposure, and swimming were obtained from community members. Heads of households were interviewed for family history and personal beliefs on ear health. Height and weight were measured. Otoscopic findings were described for the presence and character of perforation or discharge. An <jats:italic>A2ML1<\/jats:italic> duplication variant that confers otitis media susceptibility was Sanger sequenced in all DNA samples. Co\u2010occurrence of middle ear bacteria detected by 16S rRNA gene sequencing was determined according to <jats:italic>A2ML1<\/jats:italic> genotype and social cluster.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The indigenous Filipino population has a ~50% prevalence of otitis media. Young age was associated with otitis media (4 age strata; <jats:italic>P<\/jats:italic> =. 004); however, age was nonsignificant as a bistratal or continuous variable. There was no association between otitis media and sex, body mass index, breastfeeding, tobacco exposure, or deep swimming. In multivariate analyses, <jats:italic>A2ML1<\/jats:italic> genotype is the strongest predictor of otitis media, with an odds ratio of 3.7 (95% confidence interval: 1.3\u201010.8; <jats:italic>P<\/jats:italic> =. 005). When otitis media diagnoses were plotted across ages, otitis media was observed within the first year of life, and chronic otitis media persisted up to adulthood, particularly in <jats:italic>A2ML1<\/jats:italic>\u2010variant carriers.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Among indigenous Filipinos, <jats:italic>A2ML1<\/jats:italic> genotype is the primary risk factor for otitis media and main determinant of disease progression, although age, the middle ear microbiome, and social clusters might modulate the effect of the <jats:italic>A2ML1<\/jats:italic> genotype.<\/jats:p><\/jats:sec>","DOI":"10.1177\/0194599816661703","type":"journal-article","created":{"date-parts":[[2016,8,2]],"date-time":"2016-08-02T21:33:29Z","timestamp":1470173609000},"page":"856-862","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":21,"title":["Genetic and Environmental Determinants of Otitis Media in an Indigenous Filipino Population"],"prefix":"10.1002","volume":"155","author":[{"given":"Regie Lyn P.","family":"Santos\u2010Cortez","sequence":"first","affiliation":[{"name":"Center for Statistical Genetics Department of Molecular and Human Genetics Baylor College of Medicine Houston Texas USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ma. Rina T.","family":"Reyes\u2010Quintos","sequence":"additional","affiliation":[{"name":"Philippine National Ear Institute University of the Philippines Manila\u2013National Institutes of Health Manila Philippines"},{"name":"Department of Otorhinolaryngology University of the Philippines College of Medicine\u2013Philippine General Hospital Manila Philippines"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ma. Leah C.","family":"Tantoco","sequence":"additional","affiliation":[{"name":"Philippine National Ear Institute University of the Philippines Manila\u2013National Institutes of Health Manila Philippines"},{"name":"Department of Otorhinolaryngology University of the Philippines College of Medicine\u2013Philippine General Hospital Manila Philippines"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Izoduwa","family":"Abbe","sequence":"additional","affiliation":[{"name":"Center for Statistical Genetics Department of Molecular and Human Genetics Baylor College of Medicine Houston Texas USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Erasmo Gonzalo d.V.","family":"Llanes","sequence":"additional","affiliation":[{"name":"Philippine National Ear Institute University of the Philippines Manila\u2013National Institutes of Health Manila Philippines"},{"name":"Department of Otorhinolaryngology University of the Philippines College of Medicine\u2013Philippine General Hospital Manila Philippines"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nadim J.","family":"Ajami","sequence":"additional","affiliation":[{"name":"Alkek Center for Metagenomics and Microbiome Research (CMMR) Department of Molecular Virology and Microbiology Baylor College of Medicine Houston Texas USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Diane S.","family":"Hutchinson","sequence":"additional","affiliation":[{"name":"Alkek Center for Metagenomics and Microbiome Research (CMMR) Department of Molecular Virology and Microbiology Baylor College of Medicine Houston Texas USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joseph F.","family":"Petrosino","sequence":"additional","affiliation":[{"name":"Alkek Center for Metagenomics and Microbiome Research (CMMR) Department of Molecular Virology and Microbiology Baylor College of Medicine Houston Texas USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carmencita D.","family":"Padilla","sequence":"additional","affiliation":[{"name":"Institute of Human Genetics University of the Philippines Manila\u2013National Institutes of Health Manila Philippines"},{"name":"Department of Pediatrics University of the Philippines College of Medicine\u2013Philippine General Hospital Manila Philippines"},{"name":"Philippine Genome Center University of the Philippines Diliman Quezon City Philippines"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"suffix":"Jr","given":"Romeo L.","family":"Villarta","sequence":"additional","affiliation":[{"name":"Philippine National Ear Institute University of the Philippines Manila\u2013National Institutes of Health Manila Philippines"},{"name":"Department of Otorhinolaryngology University of the Philippines College of Medicine\u2013Philippine General Hospital Manila Philippines"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Teresa Luisa","family":"Gloria\u2010Cruz","sequence":"additional","affiliation":[{"name":"Philippine National Ear Institute University of the Philippines Manila\u2013National Institutes of Health Manila Philippines"},{"name":"Department of Otorhinolaryngology University of the Philippines College of Medicine\u2013Philippine General Hospital Manila Philippines"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Abner L.","family":"Chan","sequence":"additional","affiliation":[{"name":"Philippine National Ear Institute University of the Philippines Manila\u2013National Institutes of Health Manila Philippines"},{"name":"Department of Otorhinolaryngology University of the Philippines College of Medicine\u2013Philippine General Hospital Manila Philippines"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eva Maria","family":"Cutiongco\u2010de la Paz","sequence":"additional","affiliation":[{"name":"Institute of Human Genetics University of the Philippines Manila\u2013National Institutes of Health Manila Philippines"},{"name":"Department of Pediatrics University of the Philippines College of Medicine\u2013Philippine General Hospital Manila Philippines"},{"name":"Philippine Genome Center University of the Philippines Diliman Quezon City Philippines"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Charlotte M.","family":"Chiong","sequence":"additional","affiliation":[{"name":"Philippine National Ear Institute University of the Philippines Manila\u2013National Institutes of Health Manila Philippines"},{"name":"Department of Otorhinolaryngology University of the Philippines College of Medicine\u2013Philippine General Hospital Manila Philippines"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Suzanne M.","family":"Leal","sequence":"additional","affiliation":[{"name":"Center for Statistical Genetics 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