非裔美国人的过敏结果存在种族差异，这种差异早在 2 岁时就出现了。
Racial disparities in allergic outcomes in African Americans emerge as early as age 2 years.
机构信息
Department of Public Health Sciences, Henry Ford Hospital, Detroit, MI, USA.
出版信息
Clin Exp Allergy. 2012 Jun;42(6):909-17. doi: 10.1111/j.1365-2222.2011.03946.x.
BACKGROUND
Racial disparities in allergic disease outcomes have been reported with African Americans suffering disproportionately compared to White individuals.
OBJECTIVE
To examine whether or not racial disparities are present as early as age 2 years in a racially diverse birth cohort in the Detroit metropolitan area.
METHODS
All children who were participants in a birth cohort study in the Detroit metropolitan area were invited for a standardized physician exam with skin prick testing and parental interview at age 2 years. Physicians made inquiries regarding wheezing and allergy symptoms and inspected for and graded any atopic dermatitis (AD). Skin testing was performed for Alternaria, cat, cockroach, dog, Dermatophagoides farinae (Der F), Short Ragweed, Timothy grass, egg, milk and peanut. Specific IgE was measured for these same allergens and total IgE was determined.
RESULTS
African American children (n = 466) were more likely than White children (n = 223) to have experienced any of the outcomes examined: at least 1 positive skin prick test from the panel of 10 allergens (21.7% vs. 11.0%, P = 0.001); at least one specific IgE ≥ 0.35 IU/mL (out of a panel of 10 allergens) (54.0% vs. 42.9%, P = 0.02); had AD (27.0% vs. 13.5%, Chi-square P < 0.001); and to ever have wheezed (44.9% vs. 36.0%, P = 0.03). African American children also tended to have higher total IgE (geometric means 23.4 IU/mL (95%CI 20.8, 27.6) vs. 16.7 IU/mL (95%CI 13.6, 20.6 IU/mL), Wilcoxon Rank Sum P = 0.004). With the exception of wheezing, the associations did not vary after adjusting for common social economic status variables (e.g. household income), environmental variables (endotoxin; dog, cat and cockroach allergen in house dust) or variables that differed between the racial groups (e.g. breastfeeding). After adjustment, the wheeze difference was ameliorated.
CONCLUSIONS
With disparities emerging as early as age 2 years, investigations into sources of the disparities should include the prenatal period and early life.
背景
已有研究报告称，非裔美国人的过敏疾病结局存在种族差异，与白人相比，非裔美国人的情况更为严重。
目的
在底特律大都市区的一个多种族出生队列中，研究 2 岁时是否已经存在种族差异。
方法
所有参加底特律大都市区出生队列研究的儿童都被邀请参加标准化的医生检查，包括皮肤点刺试验和父母访谈，检查时间为 2 岁。医生询问了喘息和过敏症状，并检查和分级任何特应性皮炎（AD）。对Alternaria、猫、蟑螂、狗、Dermatophagoides farinae（Der F）、短豚草、Timothy 草、鸡蛋、牛奶和花生进行皮肤测试。对这些相同的过敏原进行特异性 IgE 测量，并确定总 IgE。
结果
非裔美国儿童（n=466）比白人儿童（n=223）更有可能经历以下任何一种检查结果：至少有 1 项对 10 种过敏原面板中的 1 种呈阳性皮肤点刺试验（21.7%比 11.0%，P=0.001）；至少有 1 种特异性 IgE≥0.35 IU/mL（10 种过敏原中的 1 种）（54.0%比 42.9%，P=0.02）；有 AD（27.0%比 13.5%，卡方 P<0.001）；且曾有喘息（44.9%比 36.0%，P=0.03）。非裔美国儿童的总 IgE 也往往较高（几何平均值 23.4 IU/mL（95%CI 20.8, 27.6）比 16.7 IU/mL（95%CI 13.6, 20.6 IU/mL），Wilcoxon 秩和 P=0.004）。调整常见社会经济地位变量（如家庭收入）、环境变量（内毒素；室内灰尘中的狗、猫和蟑螂过敏原）或两组之间存在差异的变量（如母乳喂养）后，除了喘息外，其他关联均无差异。调整后，喘息差异得到改善。
结论
早在 2 岁时就出现了差异，因此，对差异来源的调查应该包括产前和生命早期。
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