Winberg Anna, Strinnholm Åsa, Hedman Linnea, West Christina E, Perzanowski Matthew S, Rönmark Eva
Department of Clinical Sciences, Pediatrics, UmeÅ University, UmeÅ, Sweden.
Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine, The OLIN Unit, UmeÅ University, UmeÅ, Sweden.
Clin Transl Allergy. 2014 Oct 13;4:32. doi: 10.1186/2045-7022-4-32. eCollection 2014.
Few population-based cohort studies have examined reported food hypersensitivity longitudinally. We investigated prevalence, incidence and remission of perceived food hypersensitivity among schoolchildren from 8 to 12 years of age, and risk factors associated with incidence and remission.
A population-based cohort including all 7-8 year-old children in three Swedish towns was recruited in 2006. A total of 2,585 (96% of invited) children participated in a parental questionnaire. The children in two of the towns, n = 1,700 (90% of invited) also participated in skin-prick-testing with airborne allergens. The cohort was followed using the same methods at 11-12 years of age. At study follow up, specific IgE to foods was analyzed in a randomized subset of children (n = 652).
The prevalence of perceived food hypersensitivity increased from 21% at 8 years to 26% at 12 years of age. During this four-year-period, the cumulative incidence of food hypersensitivity was high (15%), as was remission (33%). This pattern was particularly evident for hypersensitivity to cow´s milk, while the incidence of hypersensitivity to other foods was lower. Female sex, allergic heredity, current rhinitis and allergic sensitization were associated with the incidence of food hypersensitivity and allergic sensitization was negatively associated with remission. Risk-factor-patterns for both incidence and remission were different for hypersensitivity to milk compared with hypersensitivity to other foods. Generally, the agreement between reported food hypersensitivity and IgE-sensitization to the implicated food was poor.
In this longitudinal, population-based cohort-study perceived food hypersensitivity was common among children between ages 8 and 12, often transient and not well correlated with food-specific IgE. While these findings suggest an overestimated prevalence of food hypersensitivity, the public-health-significance remains high as they reflect the perceived reality to which the children adapt their life and food intakes.
很少有基于人群的队列研究对报告的食物过敏进行纵向研究。我们调查了8至12岁学童中感知到的食物过敏的患病率、发病率和缓解情况，以及与发病率和缓解相关的危险因素。
2006年招募了一个基于人群的队列，包括瑞典三个城镇所有7至8岁的儿童。共有2585名（受邀者的96%）儿童参与了家长问卷调查。其中两个城镇的1700名（受邀者的90%）儿童还参与了空气中过敏原的皮肤点刺试验。该队列在11至12岁时采用相同方法进行随访。在研究随访时，对随机抽取的一部分儿童（n = 652）分析了食物特异性IgE。
感知到的食物过敏患病率从8岁时的21%上升到12岁时的26%。在这四年期间，食物过敏的累积发病率很高（15%），缓解率也很高（33%）。这种模式在牛奶过敏方面尤为明显，而对其他食物过敏的发病率较低。女性、过敏遗传史、当前鼻炎和过敏致敏与食物过敏的发病率相关，过敏致敏与缓解呈负相关。牛奶过敏与其他食物过敏在发病率和缓解方面的危险因素模式不同。一般来说，报告的食物过敏与对相关食物的IgE致敏之间的一致性较差。
在这项基于人群的纵向队列研究中，8至12岁儿童中感知到的食物过敏很常见，通常是短暂的，且与食物特异性IgE相关性不佳。虽然这些发现表明食物过敏的患病率被高估，但由于它们反映了儿童在生活和食物摄入方面所适应的感知现实，其公共卫生意义仍然很高。
