Winberg Anna, West Christina E, Strinnholm Åsa, Nordström Lisbeth, Hedman Linnea, 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.
Acta Paediatr. 2016 Feb;105(2):206-14. doi: 10.1111/apa.13253. Epub 2015 Dec 3.
We investigated phenotypes of milk hypersensitivity among schoolchildren aged 11-12 in Northern Sweden.
In a population-based cohort, 1824 (98%) children aged 11-12 participated in a questionnaire survey, skin prick testing, interviews on food hypersensitivity and assessment of body mass index (BMI). Of the 265 children reporting milk hypersensitivity, milk avoidance and no coeliac disease, 236 (89%) participated in a structured interview and blood samples for analyses of milk-specific Immunoglobulin E. The children were then categorised into milk hypersensitivity phenotypes according to preset criteria.
In all, 14.5% reported milk hypersensitivity. Of these, 3% were categorised as current milk allergy, 23% as outgrown milk allergy, 40% as probable lactose intolerance and 11% as nondefinable. Furthermore, 23% had discontinued their elimination diet. Milk allergy was associated with other atopic disorders and lower BMI, with an odds ratio of 0.82 and 95% confidence interval of 0.80-0.98. Only 2% had previously undergone an oral challenge.
The most common symptom phenotypes among Swedish children aged 11-12 with self-reported milk hypersensitivity and milk avoidance were probable intolerance and outgrown milk allergy, while current milk allergy was uncommon. Children with milk allergy had a lower BMI and most lacked a challenge-proven diagnosis.
我们调查了瑞典北部11至12岁学童的牛奶过敏表型。
在一项基于人群的队列研究中,1824名(98%)11至12岁的儿童参与了问卷调查、皮肤点刺试验、食物过敏访谈以及体重指数(BMI)评估。在265名报告有牛奶过敏、已避免食用牛奶且无乳糜泻的儿童中,236名(89%)参与了结构化访谈并提供了血液样本以分析牛奶特异性免疫球蛋白E。然后根据预设标准将这些儿童分类为牛奶过敏表型。
总体而言,14.5%的儿童报告有牛奶过敏。其中,3%被归类为当前牛奶过敏,23%为已不再过敏的牛奶过敏,40%为可能的乳糖不耐受,11%为无法明确分类。此外,23%的儿童已停止了饮食排除法。牛奶过敏与其他特应性疾病以及较低的BMI相关,优势比为0.82,95%置信区间为0.80 - 0.98。只有2%的儿童之前接受过口服激发试验。
在自我报告有牛奶过敏且已避免食用牛奶的瑞典11至12岁儿童中,最常见的症状表型是可能的不耐受和已不再过敏的牛奶过敏,而当前牛奶过敏并不常见。牛奶过敏的儿童BMI较低,且大多数缺乏经激发试验证实的诊断。