Sex-specific and long-term trends of asthma, allergic rhinitis, and atopic dermatitis in South Korea, 2007-2022: a nationwide representative study

Introduction: Although sex differences in allergic diseases such as atopic dermatitis (AD), allergic rhinitis (AR), and asthma are considered important, a limited number of studies during the COVID-19 pandemic investigated this aspect. Therefore, this study aimed to analyze sex-specific and long-term trends and risk factors for allergic diseases before and during the pandemic.

Methods: This study utilized data from the Korea National Health and Nutrition Examination Survey, 2007–2022, including 92,135 participants aged 19 years and older. This study used weighted multivariate regression analysis to examine the estimates of related factors and assessed weighted odds ratios or β-coefficients for these factors across multiple categories.

Results: During the study period (2007–2022), the prevalence of AR was more common in females than in males. Particularly in 2022, the prevalence among females was 19.3% (95% confidence interval, 17.3–21.3), while among males, it was 15.6% (13.8–17.4). The prevalence of AD and asthma showed a slight disparity between males and females. Before and during the pandemic, the prevalence of AD and AR showed a continuous increase (AD: from 2.8% [2.5–3.2] in 2007–2009 to 4.7% [3.9–5.4] in 2022; AR: from 11.7% [11.1–12.4] in 2007–2009 to 17.4% [16.0–18.9] in 2022), while asthma maintained a relatively stable trend. Moreover, this study identified several sexspecific factors that seem to be associated with a higher prevalence of allergic diseases in females, such as high household income, smoking, and being overweight or obese.

Conclusions: Throughout all the periods examined, females consistently exhibited a higher prevalence of AR compared to males. Moreover, the risk factors for males and females varied depending on the disease, with females generally facing a greater number of risk factors. Consequently, this study highlights the necessity for sex-specific health interventions and further research to comprehend the complex influence of socioeconomic factors and lifestyle choices on the prevalence and risk of AD, AR, and asthma.