Pénard-Morand C, Raherison C, Kopferschmitt C, Caillaud D, Lavaud F, Charpin D, Bousquet J, Annesi-Maesano I
INSERM U472, Epidemiology of Allergic and Respiratory Diseases, Villejuif, France.
Allergy. 2005 Sep;60(9):1165-71. doi: 10.1111/j.1398-9995.2005.00860.x.
Food allergy (FA) is an important health problem. However, epidemiological studies at the population level are scarce. We assessed the prevalence of FA and its associations with respiratory manifestations among schoolchildren.
A total of 6672 schoolchildren aged 9-11 years recruited from 108 randomly chosen schools in six French cities underwent a clinical examination including skin prick test (SPT) to common food and aeroallergens and the standardized protocol of the run test to assess exercise-induced bronchial hyper-responsiveness (EIB). Asthma, allergic rhinitis (AR) and clinical symptoms of FA were determined using a standardized questionnaire completed by parents.
About 2.1% of the children reported symptoms of FA, 1.9% were sensitized to food allergens, and 0.1% had SP-tested FA. The AR was more prevalent than asthma (20.0% lifetime, 11.9% past year vs 9.8%, 8.7% respectively). Reported FA, food sensitization and SP-tested FA were all positively associated with asthma and AR (P < 0.001). These associations persisted also for FA not manifesting as respiratory symptoms (P < 0.001). Asthma and AR remained significantly associated with reported symptoms of FA and allergic sensitization to food allergens after adjustment for confounders as well as for sensitization to aeroallergens. No relationship existed between EIB (9.0%) and FA.
The relationships between FA and asthma and AR could be totally explained neither by the existence of respiratory manifestations of FA nor by sensitization to aeroallergens. The FA might intervene differently in asthma and AR.
食物过敏（FA）是一个重要的健康问题。然而，针对人群层面的流行病学研究较少。我们评估了学童中食物过敏的患病率及其与呼吸道表现的关联。
从法国六个城市的108所随机选取的学校招募了6672名9至11岁的学童，对其进行了临床检查，包括针对常见食物和空气过敏原的皮肤点刺试验（SPT）以及用于评估运动诱发支气管高反应性（EIB）的运动激发试验的标准化方案。哮喘、过敏性鼻炎（AR）和食物过敏的临床症状通过家长填写的标准化问卷来确定。
约2.1%的儿童报告有食物过敏症状，1.9%对食物过敏原致敏，0.1%经皮肤点刺试验确诊为食物过敏。过敏性鼻炎的患病率高于哮喘（终生患病率分别为20.0%和9.8%，过去一年患病率分别为11.9%和8.7%）。报告的食物过敏、食物致敏和经皮肤点刺试验确诊的食物过敏均与哮喘和过敏性鼻炎呈正相关（P<0.001）。这些关联在未表现为呼吸道症状的食物过敏中也持续存在（P<0.001）。在对混杂因素以及对空气过敏原致敏进行调整后，哮喘和过敏性鼻炎与报告的食物过敏症状以及对食物过敏原的过敏致敏仍显著相关。运动诱发支气管高反应性（9.0%）与食物过敏之间不存在关联。
食物过敏与哮喘和过敏性鼻炎之间的关系既不能完全由食物过敏的呼吸道表现的存在来解释，也不能由对空气过敏原的致敏来解释。食物过敏在哮喘和过敏性鼻炎中的作用可能不同。
