Racial disparities in allergic outcomes in African Americans emerge as early as age 2 years.
Racial disparities in allergic outcomes in African Americans emerge as early as age 2 years.
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DOI：
10.1111/j.1365-2222.2011.03946.x
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发表时间：
2012-06
期刊：
影响因子：
--
通讯作者：
Johnson CC
中科院分区：
文献类型：
--
作者：
Wegienka G;Havstad S;Joseph CL;Zoratti E;Ownby D;Woodcroft K;Johnson CC
据报道，过敏性疾病的结果存在种族差异，与白人相比，非洲裔美国人遭受的痛苦不成比例。检查种族差异是否早在两岁时就出现在底特律大都会地区的种族多样性出生队列中。所有参加底特律大都会地区出生队列研究的儿童在2岁时被邀请参加标准化的医生检查，包括皮肤点刺试验和父母访谈。医生询问有关喘息和过敏症状，并检查和分级任何特应性皮炎（AD）。皮试动物包括：猫、蜚蠊、狗、稻瘟螨、短豚草、提莫草、鸡蛋、牛奶和花生。测定这些过敏原的特异性IgE，并测定总IgE。非裔美国儿童（n=466）比白人儿童（n=223）更有可能经历任何一种检查结果：从10个过敏原组中至少有1个皮肤点刺试验阳性（21.7%对11.0%,p=0.001）；至少有一个特异性IgE≥0.35 IU/mL（在10个过敏原中）（54.0%对42.9%,p=0.02）；AD患者（27.0% vs 13.5%, χ 2 p<0.001）；曾经喘息过（44.9%对36.0%,p=0.03）。非裔美国儿童也倾向于有更高的总IgE(几何平均值23.4 IU/mL （95%CI 20.8, 27.6) vs . 16.7 IU/mL (95%CI 13.6, 20.6 IU/mL)， Wilcoxon秩和p=0.004）。除喘息外，在调整了常见的社会经济地位变量（如家庭收入）、环境变量（内毒素；室内灰尘中的狗、猫和蟑螂过敏原）或不同种族群体之间的变量（如母乳喂养）后，这些关联没有变化。调整后，喘息差异得到改善。由于差异早在两岁时就出现了，对差异来源的调查应包括产前和早期生活。
Racial disparities in allergic disease outcomes have been reported with African Americans suffering disproportionately compared to White individuals. Examine whether racial disparities are present as early as age 2 years in a racially diverse birth cohort in the Detroit metropolitan area. All children who were participants in a birth cohort study in the Detroit metropolitan area were invited for a standardized physician exam with skin prick testing and parental interview at age 2 years. Physicians made inquiries regarding wheezing and allergy symptoms and inspected for and graded any atopic dermatitis (AD). Skin testing was performed for Alternaria, cat, cockroach, dog, Dermatophagoides farinae (Der F), Short Ragweed, Timothy grass, egg, milk and peanut. Specific IgE was measured for these same allergens and total IgE was determined. African American children (n=466) were more likely than White children (n=223) to have experienced any of the outcomes examined: at least 1 positive skin prick test from the panel of 10 allergens (21.7% versus 11.0%, p=0.001); at least one specific IgE ≥0.35 IU/mL (out of a panel of 10 allergens) (54.0% versus 42.9%, p=0.02); had AD (27.0% versus 13.5%, Chi-square p<0.001); and to ever have wheezed (44.9% versus 36.0%, p=0.03). African American children also tended to have higher total IgE (geometric means 23.4 IU/mL (95%CI 20.8, 27.6) versus 16.7 IU/mL (95%CI 13.6, 20.6 IU/mL), Wilcoxon Rank Sum p=0.004). With the exception of wheezing, the associations did not vary after adjusting for common social economic status variables (e.g.; household income), environmental variables (endotoxin; dog, cat and cockroach allergen in house dust) or variables that differed between the racial groups (e.g.; breastfeeding). After adjustment, the wheeze difference was ameliorated. With disparities emerging as early as age 2 years, investigations into sources of the disparities should include the prenatal period and early life.
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