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特应性皮炎婴儿食物过敏的危险因素。

The risk factors for food allergy in infants with atopic dermatitis.

作者信息

Akelma Zülfikar, Köse Seda Şirin, Özmen Serap

机构信息

Pediatric Allergy and Immunology Clinic, Dr. Sami Ulus Maternity and Children's Research and Training Hospital, Ankara.

出版信息

Turk J Pediatr. 2023;65(2):235-244. doi: 10.24953/turkjped.2022.656.

Abstract

BACKGROUND

There is a lack of information about which risk factors accompany food allergy (FA) in infants with atopic dermatitis (AD). We hypothesized that we would be able to predict FA through risk factors in infants with AD.

METHODS

This prospective descriptive cross-sectional study was performed with infants aged 1-12 months with newly diagnosed AD. The SCORing Atopic Dermatitis (SCORAD) and Eczema Area and Severity Index (EASI), Infants` Dermatitis Quality Of Life (IDQOL), and Family Dermatological Life Quality (FDLQ) index scores were calculated at first admission. We developed a new tool, Sites of Eczema (SoE), to score sites of eczema on the body.

RESULTS

A total of 279 infants with AD were included. FA was found in 166 (59.5%) infants with AD, of whom 112 had single and 54 had multiple FAs. The SCORAD index, EASI scores, IDQOL1, IDQOL2, and FDQL, and SoE scores were higher in the subgroup with FA compared to that without FA (p < 0.001). In the multivariate regression model, eosinophil count (odds ratio [OR]=1.00, 95% confidence interval: [CI, 1.00-1.00]; p=0.008), serum total IgE level (OR=1.02, 95% CI: [1.00-1.03]; p=0.002), pruritus score (OR=0.87, 95% CI: [0.77-0.97]; p=0.019), SCORAD index (OR=1.04, 95% CI: [1.01-1.08]; p=0.008), FDQL index (OR=1.09, 95% CI: [1.01-1.18]; p=0.014), and SoE score (OR=1.48, 95% CI: [1.00-2.19]; p=0.046) were identified as the highest risk factors for FA in infants with AD.

CONCLUSIONS

Serum total IgE levels, eosinophil counts and ratio, SCORAD index and EASI scores, IDQOL and FDLQ index, pruritus and sleep disturbance scores, and SoE scores were identified as risk factors for FA in infants with AD in this study. The SoE score is an important risk factor for FA in infants with AD. We recommend that the risk factors for FA in patients with AD guide the management of these patients.

摘要

背景

关于特应性皮炎(AD)婴儿中哪些风险因素与食物过敏(FA)相关的信息匮乏。我们假设能够通过AD婴儿的风险因素预测FA。

方法

对1至12个月新诊断为AD的婴儿进行了这项前瞻性描述性横断面研究。首次入院时计算特应性皮炎评分(SCORAD)、湿疹面积和严重程度指数(EASI)、婴儿皮炎生活质量(IDQOL)以及家庭皮肤病生活质量(FDLQ)指数评分。我们开发了一种新工具,即湿疹部位(SoE),用于对身体上的湿疹部位进行评分。

结果

共纳入279例AD婴儿。166例(59.5%)AD婴儿被发现患有FA,其中112例为单一FA,54例为多种FA。与无FA的亚组相比,有FA的亚组中SCORAD指数、EASI评分、IDQOL1、IDQOL2和FDQL以及SoE评分更高(p<0.001)。在多变量回归模型中,嗜酸性粒细胞计数(比值比[OR]=1.00,95%置信区间:[CI,1.00 - 1.00];p=0.008)、血清总IgE水平(OR=1.0, 95% CI: [1.00 - 1.03];p=0.002)、瘙痒评分(OR=0.87,95% CI: [0.77 - 0.97];p=0.019)、SCORAD指数(OR=1.04,95% CI: [1.01 - 1.08];p=0.008)、FDQL指数(OR=1.09,95% CI: [1.01 - 1.18];p=0.014)以及SoE评分(OR=1.48,95% CI: [1.00 - 2.19];p=0.046)被确定为AD婴儿FA的最高风险因素。

结论

本研究中血清总IgE水平、嗜酸性粒细胞计数及比例、SCORAD指数和EASI评分、IDQOL和FDLQ指数、瘙痒和睡眠障碍评分以及SoE评分被确定为AD婴儿FA的风险因素。SoE评分是AD婴儿FA的重要风险因素。我们建议AD患者FA的风险因素可指导这些患者的管理。

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