Sadeghnejad A, Karmaus W, Davis S, Kurukulaaratchy R J, Matthews S, Arshad S H
Department of Epidemiology, Michigan State University, East Lansing, Michigan, USA.
Thorax. 2004 Nov;59(11):936-42. doi: 10.1136/thx.2004.024224.
Evidence suggests that a raised level of cord serum IgE (CS-IgE) is a risk factor for allergic sensitisation. However, whether CS-IgE is a risk for asthma is controversial. A study was undertaken to investigate the association between CS-IgE levels and allergic sensitisation at 4 and 10 years of age and asthma at ages 1-2, 4 and 10.
CS-IgE was available for 1358 of 1456 children born between 1989 and 1990. The cohort was evaluated for allergic diseases at ages 1, 2, 4 and 10 years. Skin prick tests for six allergens were performed on 981 children at age 4 and 1036 at age 10. Asthma was defined based on a physician's diagnosis. Using logistic regression analysis, the risk of asthma and allergic sensitisation for raised levels of CS-IgE (> or =0.5 kU/l) was estimated.
At ages 4 and 10 years 20.2% and 27.0% of children, respectively, had allergic sensitisation. The risk of allergic sensitisation was significantly associated with raised CS-IgE levels at ages 4 (OR 2.29) and 10 years (OR 1.73). The prevalence of asthma was 10.3% at age 1-2, 15.2% at age 4, and 12.8% at age 10. CS-IgE was not associated with asthma at age 1-2 and 4 but showed an increased relative risk at age 10 (OR 1.66, 95% CI 1.05 to 2.62). The association was stronger in children who did not develop allergic sensitisation at age 4 or 10 (OR 3.35, 95% CI 1.41 to 7.93).
Raised cord serum IgE is a risk factor for allergic sensitisation at ages 4 and 10 years. This is the second study suggesting that CS-IgE is also a risk factor for asthma at age 10, probably related to the late onset of asthma. This association is not necessarily mediated by allergic sensitisation.
有证据表明，脐血血清IgE（CS-IgE）水平升高是过敏致敏的一个危险因素。然而，CS-IgE是否为哮喘的危险因素仍存在争议。开展了一项研究，以调查CS-IgE水平与4岁和10岁时的过敏致敏以及1至2岁、4岁和10岁时的哮喘之间的关联。
1989年至1990年间出生的1456名儿童中，有1358名儿童的CS-IgE数据可用。对该队列在1岁、2岁、4岁和10岁时进行了过敏性疾病评估。对981名4岁儿童和1036名10岁儿童进行了六种变应原的皮肤点刺试验。哮喘根据医生的诊断来定义。使用逻辑回归分析，估计了CS-IgE水平升高（≥0.5 kU/l）时哮喘和过敏致敏的风险。
在4岁和10岁时，分别有20.2%和27.0%的儿童发生过敏致敏。4岁（比值比2.29）和10岁（比值比1.73）时，过敏致敏风险与CS-IgE水平升高显著相关。1至2岁时哮喘患病率为10.3%，4岁时为15.2%，10岁时为12.8%。CS-IgE在1至2岁和4岁时与哮喘无关，但在10岁时显示相对风险增加（比值比1.66，95%置信区间1.05至2.62）。在4岁或10岁时未发生过敏致敏的儿童中，这种关联更强（比值比3.35，95%置信区间1.41至7.93）。
脐血血清IgE升高是4岁和10岁时过敏致敏的危险因素。这是第二项表明CS-IgE也是10岁时哮喘危险因素的研究，这可能与哮喘的迟发性有关。这种关联不一定由过敏致敏介导。
