Chong Kok Wee, Wright Karen, Goh Anne, Meyer Rosan, Rao Rajeshwar
Allergy Service, Department of Paediatric Medicine, KK Women's and Children's Hospital, Singapore 229899.
Department of Paediatrics, Imperial College, London, United Kingdom.
Asia Pac Allergy. 2018 Oct 11;8(4):e34. doi: 10.5415/apallergy.2018.8.e34. eCollection 2018 Oct.
Although it is known that children with food allergies are at risk of impaired growth, this has not been well studied in South-East Asia.
The aim of this cross-sectional study is to survey the growth of children with food allergies in Singapore and the factors impacting it.
Anthropometric data, demographic data, type of food allergy, foods eliminated, and atopic comorbidities were recorded. Malnutrition was defined using World Health Organization standards (≤-2 -score for weight-for-height [WH], weight-for-age [WA], and height-for-age [HA]).
Seventy-four patients (51% male) were recruited over 1 month, with median age at diagnosis of 8 months (interquartile range [IQR], 4-13 months) and at data collection of 25 months (IQR, 14-48 months). Sixty-two (84%) had IgE-mediated allergy, 8 (11%) mixed IgE and non-IgE, and 4 (5%) non-IgE-mediated allergy. Food exclusions: 55% one food, 27% two foods, 8% three to four foods, and 10% ≥5 foods. Only 1% were underweight (WA ≤ -2 -score) and 3% had WA ≥ +2 -score. Having a mixed type food allergy significantly reduced WA ( = 0.023). WA was significantly lower for those referred to the dietitian ( = 0.027). 5.4% were stunted (HA ≤ -2 -score). Factors significantly associated with stunting were underlying eczema ( = 0.03) and having an IgE-mediated ( = 0.03) or mixed type food allergy ( = 0.002). One point four percent (1.4%) were undernourished (WH ≤ -2 -score) and 1.4% were overweight (WH ≥ +2 -score). Multivariate regression analysis found that children with mixed type food allergies were significantly shorter (-score -1 lower). Children had a lower WA if they had skin involvement as part of their symptom presentation.
This is the first survey documenting growth in children with food allergy in Singapore. Eczema, IgE-mediated and mixed type allergies are associated with poorer growth rates in these children. Early, individualised nutritional intervention is recommended for all children with food allergy.
尽管已知食物过敏儿童存在生长发育受损的风险，但在东南亚地区对此尚未进行充分研究。
这项横断面研究的目的是调查新加坡食物过敏儿童的生长情况及其影响因素。
记录人体测量数据、人口统计学数据、食物过敏类型、排除的食物以及特应性合并症。采用世界卫生组织标准（身高别体重[WH]、年龄别体重[WA]和年龄别身高[HA]的z评分≤-2）定义营养不良。
在1个月内招募了74例患者（51%为男性），诊断时的中位年龄为8个月（四分位间距[IQR]，4 - 13个月），数据收集时的年龄为25个月（IQR，14 - 48个月）。62例（84%）为IgE介导的过敏，8例（11%）为IgE和非IgE混合型，4例（5%）为非IgE介导的过敏。食物排除情况：55%排除一种食物，27%排除两种食物，8%排除三至四种食物，10%排除≥5种食物。只有1%体重过低（WA≤-2 z评分），3%的WA≥+2 z评分。混合型食物过敏显著降低了WA（P = 0.023）。转诊至营养师处的儿童WA显著更低（P = 0.027）。5.4%发育迟缓（HA≤-2 z评分）。与发育迟缓显著相关的因素是潜在的湿疹（P = 0.03）以及患有IgE介导的（P = 0.03）或混合型食物过敏（P = 0.002）。1.4%营养不良（WH≤-2 z评分），1.4%超重（WH≥+2 z评分）。多因素回归分析发现，混合型食物过敏的儿童显著更矮（z评分低1分）。如果儿童的症状表现包括皮肤受累，则其WA更低。
这是首项记录新加坡食物过敏儿童生长情况的调查。湿疹、IgE介导的和混合型过敏与这些儿童较差的生长速度相关。建议对所有食物过敏儿童进行早期个体化营养干预。
