Department of Public Health Sciences, Henry Ford Hospital, Detroit, MI 48202, USA.
J Allergy Clin Immunol. 2012 Sep;130(3):657-662.e2. doi: 10.1016/j.jaci.2012.06.024. Epub 2012 Jul 31.
Racial differences in allergic diseases have been reported, with black subjects suffering disproportionately compared with white subjects, although such studies have been more commonly done in pediatric populations.
We sought to determine whether there are differences in rates of allergic sensitization or prior diagnoses of asthma, hay fever, or eczema in black and white pregnant women.
Women were recruited during pregnancy (regardless of allergic history) as part of a birth cohort study in the Detroit metropolitan area and were interviewed about prior doctors' diagnoses of asthma, hay fever/nasal allergies/allergic rhinitis, and eczema. Blood samples were collected, total IgE levels were determined, and specific IgE levels were measured for Alternaria alternata, cat, cockroach, dog, Dermatophagoides farinae, short ragweed, timothy grass, and egg.
Black women (n = 563) were more likely than white women (n = 219) to have had at least 1 specific IgE level of 0.35 IU/mL or greater (62.5% vs 40.2%, P < .001). Black women had higher total IgE levels (geometric mean, 47.8 IU/mL [95% CI, 42.5-53.8 IU/mL] vs 20.0 IU/mL [95% CI, 16.2-24.6 IU/mL]; P < .001, Wilcoxon rank sum test). Black women were more likely to have had a prior doctor's diagnosis of asthma (22.7% vs 16.0%, P = .04) and eczema (21.9% vs 14.8%) but not hay fever (white women: 17.5% vs black women: 15.7%, P = .55). Associations persisted for total IgE levels, having 1 or more positive allergen-specific IgE levels, and eczema after adjusting for common socioeconomic or environmental variables.
Racial differences in allergic sensitization and diagnoses were present, even after controlling for various factors. Future research should focus on prevention to ameliorate these disparities.
已报道了过敏疾病的种族差异,黑人患者的发病比例明显高于白人患者,尽管此类研究更常见于儿科人群。
我们旨在确定黑人与白人孕妇在过敏致敏或哮喘、花粉症或湿疹既往诊断方面是否存在差异。
在底特律大都市区进行的一项出生队列研究中,孕妇(无论有无过敏史)在妊娠期间被招募,并接受有关哮喘、花粉症/鼻过敏/过敏性鼻炎和湿疹既往医生诊断的访谈。采集血样,测定总 IgE 水平,并针对Alternaria alternata、猫、蟑螂、狗、屋尘螨、豚草、梯牧草和鸡蛋进行特定 IgE 水平检测。
黑人女性(n=563)比白人女性(n=219)更有可能至少有 1 项特定 IgE 水平≥0.35 IU/mL(62.5% vs 40.2%,P<0.001)。黑人女性的总 IgE 水平更高(几何均数,47.8 IU/mL[95%CI,42.5-53.8 IU/mL] vs 20.0 IU/mL[95%CI,16.2-24.6 IU/mL];P<0.001,Wilcoxon 秩和检验)。黑人女性更有可能有哮喘(22.7% vs 16.0%,P=0.04)和湿疹(21.9% vs 14.8%)的既往医生诊断,但花粉症无差异(白人女性:17.5% vs 黑人女性:15.7%,P=0.55)。在校正常见的社会经济或环境变量后,总 IgE 水平、有 1 项或多项阳性过敏原特异性 IgE 水平和湿疹的关联仍然存在。
即使在控制了各种因素后,过敏致敏和诊断方面仍存在种族差异。未来的研究应集中于预防,以减轻这些差异。