Food, drug, insect sting allergy, and anaphylaxis
Allergy-related outcomes in relation to serum IgE: Results from the National Health and Nutrition Examination Survey 2005-2006

https://doi.org/10.1016/j.jaci.2010.12.1106Get rights and content

Background

The National Health and Nutrition Examination Survey (NHANES) 2005-2006 was the first population-based study to investigate levels of serum total and allergen-specific IgE in the general US population.

Objective

We estimated the prevalence of allergy-related outcomes and examined relationships between serum IgE levels and these outcomes in a representative sample of the US population.

Methods

Data for this cross-sectional analysis were obtained from NHANES 2005-2006. Study subjects aged 6 years and older (n = 8086) had blood taken for measurement of total IgE and 19 specific IgE levels against common aeroallergens, including Alternaria alternata, Aspergillus fumigatus, Bermuda grass, birch, oak, ragweed, Russian thistle, rye grass, cat dander, cockroach, dog dander, dust mite (Dermatophagoides farinae and Dermatophagoides pteronyssinus), mouse and rat urine proteins, and selected foods (egg white, cow’s milk, peanut, and shrimp). Serum samples were analyzed for total and allergen-specific IgE by using the Pharmacia CAP System. Information on allergy-related outcomes and demographics was collected by questionnaire.

Results

In NHANES 2005-2006, 6.6% reported current hay fever, and 23.5% had current allergies. Allergy-related outcomes increased with increasing total IgE levels (adjusted odds ratios for a 10-fold increase in total IgE level of 1.86 [95% CI, 1.44-2.41] for hay fever and 1.64 [95% CI, 1.41-1.91] for allergies). Increased levels of plant-, pet-, and mold-specific IgE contributed independently to allergy-related symptoms. The greatest increase in odds was observed for hay fever and plant-specific IgE (adjusted odds ratio, 4.75; 95% CI, 3.83-5.88).

Conclusion

In the US population self-reported allergy symptoms are most consistently associated with increased levels of plant-, pet-, and mold-specific IgE.

Section snippets

Study population

Data for this cross-sectional analysis were obtained from NHANES 2005-2006, a national survey designed to assess the health and nutritional status of adults and children in the United States. NHANES used a complex multistage design to sample the civilian, noninstitutionalized US population. To ensure adequate sample sizes of certain subgroups of the population, NHANES 2005-2006 oversampled persons of low income, adolescents (12-19 years), elderly subjects (≥60 years of age), African Americans,

Results

In NHANES 2005-2006 the prevalence of diagnosed hay fever was 11.3%, and 6.6% reported current hay fever. One third of the participants (33.9%) had diagnosed allergies, and 23.5% had current allergies. The weighted characteristics of the study population are presented in Table I. The prevalence of the primary outcomes (current hay fever and current allergies) varied significantly based on sociodemographic variables (Table I). The prevalence increased with age until it peaked in the fourth

Discussion

NHANES 2005-2006 provided a unique opportunity to evaluate how levels of total IgE and allergen-specific IgE relate to allergic conditions and symptoms in the US population. None of the previous NHANES studies have examined both qualitative and quantitative patterns of atopy in relation to allergy-related outcomes. Moreover, this many allergens have been examined in only a few large-scale European studies.16, 17, 18 Although several studies have investigated allergic outcomes in relation to

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    Supported by the Intramural Research Program of the National Institutes of Health, National Institute of Environmental Health Sciences.

    Disclosure of potential conflict of interest: S. J. Arbes is employed by Rho, Inc, and has a contract with the National Institute of Dental and Craniofacial Research/National Institutes of Health. The rest of the authors have declared that they have no conflict of interest.

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