Poole Jill A, Barriga Kathy, Leung Donald Y M, Hoffman Michelle, Eisenbarth George S, Rewers Marian, Norris Jill M
Division of Allergy and Clinical Immunology, Department of Medicine and Pediatrics, National Jewish Medical and Research Center, Denver, Colorado, USA.
Pediatrics. 2006 Jun;117(6):2175-82. doi: 10.1542/peds.2005-1803.
Early exposure to solid foods in infancy has been associated with the development of allergy. The aim of this study was to examine the association between cereal-grain exposures (wheat, barley, rye, oats) in the infant diet and development of wheat allergy.
A total of 1612 children were enrolled at birth and followed to the mean age of 4.7 years. Questionnaire data and dietary exposures were obtained at 3, 6, 9, 15, and 24 months and annually thereafter. The main outcome measure was parent report of wheat allergy. Children with celiac disease autoimmunity detected by tissue transglutaminase autoantibodies were excluded. Wheat-specific immunoglobulin E levels on children reported to have wheat allergy were obtained.
Sixteen children (1%) reported wheat allergy. Children who were first exposed to cereals after 6 months of age had an increased risk of wheat allergy compared with children first exposed to cereals before 6 months of age (after controlling for confounders including a family history of allergic disorders and history of food allergy before 6 months of age). All 4 children with detectable wheat-specific immunoglobulin E were first exposed to cereal grains after 6 months. A first-degree relative with asthma, eczema, or hives was also independently associated with an increased risk of wheat-allergy development.
Delaying initial exposure to cereal grains until after 6 months may increase the risk of developing wheat allergy. These results do not support delaying introduction of cereal grains for the protection of food allergy.
婴儿期过早接触固体食物与过敏的发生有关。本研究的目的是探讨婴儿饮食中谷物（小麦、大麦、黑麦、燕麦）接触与小麦过敏发生之间的关联。
共有1612名儿童在出生时入组，并随访至平均年龄4.7岁。在3、6、9、15和24个月以及此后每年获取问卷数据和饮食接触情况。主要结局指标是家长报告的小麦过敏情况。排除通过组织转谷氨酰胺酶自身抗体检测出患有乳糜泻自身免疫性疾病的儿童。获取报告有小麦过敏的儿童的小麦特异性免疫球蛋白E水平。
16名儿童（1%）报告有小麦过敏。与6个月龄前首次接触谷物的儿童相比，6个月龄后首次接触谷物的儿童发生小麦过敏的风险增加（在控制了包括过敏性疾病家族史和6个月龄前食物过敏史等混杂因素后）。所有4名可检测到小麦特异性免疫球蛋白E的儿童均在6个月后首次接触谷物。患有哮喘、湿疹或荨麻疹的一级亲属也与小麦过敏发生风险增加独立相关。
将首次接触谷物推迟至6个月后可能会增加发生小麦过敏的风险。这些结果不支持为预防食物过敏而推迟引入谷物。
