Kim Hye Young, Choi Jaehee, Ahn Kangmo, Hahm Myung Il, Lee So Yeon, Kim Woo Kyung, Chae Yoomi, Park Yong Mean, Han Man Yong, Lee Kee Jae, Kwon Ho Jang, Kim Seonwoo, Yoo Heejin, Kim Jihyun
Department of Pediatrics, Medical Research Institute of Pusan National University Hospital, Pusan National University School of Medicine, Busan, Korea.
Department of Pediatrics, Samyook Medical Center, Seoul, Korea.
J Korean Med Sci. 2017 May;32(5):803-809. doi: 10.3346/jkms.2017.32.5.803.
The present study aimed to investigate the distribution of total serum immunoglobulin E (IgE) levels in Korean schoolchildren and to evaluate its utility in the prediction of atopy and allergic diseases. A nationwide, cross-sectional survey was conducted in first grade students from randomly selected elementary and middle schools. Total IgE levels were measured by ImmunoCAP. Skin prick tests were performed for 18 common inhalant allergens to determine the presence of atopy. Children aged 12-13 years and parents of children aged 6-7 years were asked to complete questionnaire assessing allergic diseases. The cut-off levels of total IgE were determined by analyzing receiver operating characteristic curves. The median total IgE level was 86.7 kU/L (range: 1.5-4,523.1) in 3,753 children aged 6-7 years and 94.7 kU/L (range: 1.5-3,000.0) in 3,930 children aged 12-13 years. Total IgE concentrations were higher in children with atopy or allergic diseases than in those without (all P < 0.001). At the cut-off value of 127.7 kU/L, sensitivity, specificity, and positive and negative predictive values (PPV and NPV) were 67.1%, 75.4%, 65.4%, and 76.7%, respectively, in elementary schoolchildren. At the cut-off value of 63.0 kU/L, sensitivity, specificity, PPV, and NPV were 81.9%, 66.6%, 75.0%, and 75.1%, respectively, in middle schoolchildren. PPV and NPV were ≥ 70% when cut-offs of 258.8 kU/L and 38.4 kU/L were used for the diagnosis of atopy in 6-7 year-olds and 12-13 year-olds, respectively. This nationwide population-based study provided the first normal reference ranges of total IgE in Korean schoolchildren.
本研究旨在调查韩国学童血清总免疫球蛋白E（IgE）水平的分布情况，并评估其在预测特应性和过敏性疾病方面的效用。在随机抽取的小学和初中一年级学生中进行了一项全国性横断面调查。采用免疫化学发光法测定总IgE水平。对18种常见吸入性变应原进行皮肤点刺试验以确定是否存在特应性。要求12 - 13岁的儿童和6 - 7岁儿童的家长填写评估过敏性疾病的问卷。通过分析受试者工作特征曲线确定总IgE的临界值。3753名6 - 7岁儿童的总IgE水平中位数为86.7 kU/L（范围：1.5 - 4523.1），3930名12 - 13岁儿童的总IgE水平中位数为94.7 kU/L（范围：1.5 - 3000.0）。有特应性或过敏性疾病的儿童总IgE浓度高于无此类疾病的儿童（所有P < 0.001）。在小学儿童中，临界值为127.7 kU/L时，敏感性、特异性、阳性预测值和阴性预测值（PPV和NPV）分别为67.1%、75.4%、65.4%和76.7%。在初中儿童中，临界值为63.0 kU/L时，敏感性、特异性、PPV和NPV分别为81.9%、66.6%、75.0%和75.1%。当分别使用258.8 kU/L和38.4 kU/L的临界值诊断6 - 7岁和12 - 13岁儿童的特应性时，PPV和NPV均≥70%。这项基于全国人群的研究提供了韩国学童总IgE的首个正常参考范围。
