Total Serum IgE in a Population-Based Study of Asian Children in Taiwan: Reference Value and Significance in the Diagnosis of Allergy

Tu, Yu-Ling; Chang, Su-Wei; Tsai, Hui‐Ju; Chen, Li‐Chen; Lee, Wen-I; Hua, Mau‐Sun; Cheng, Ju-Hui; Ou, Liang-Shiou; Yeh, Kuo‐Wei; Huang, Jing‐Long; Yao, Tsung‐Chieh

doi:10.1371/journal.pone.0080996

Cited by 56 publications

(50 citation statements)

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“…An European study showed that the geometric mean values of total IgE were 51.9 kU/L in 5–7 year-olds and 62.2 kU/L in 11–14 year-olds (20). However, a study among Taiwanese children aged 5–18 years reported geometric mean total IgE levels of 91.1 kU/L, which were similar to those of our study (17). A previous Korean study reported a geometric mean total IgE level of 80.5 kU/L in preschool children aged 3–6 years (15).…”

Section: Discussionsupporting

confidence: 90%

“…As found in the present study, many studies have also shown that total IgE concentrations tend to be higher in patients with allergic diseases compared with non-allergic individuals (111516171819). A study in the US reported that the geometric mean for total IgE level was significantly higher among asthmatic subjects than non-asthmatics subjects (81.1 vs. 40.8 kU/L) (11).…”

Section: Discussionsupporting

confidence: 87%

“…Serum total IgE levels have been widely used to aid in the diagnosis of allergic disease, although the reference values are affected by various factors, such as age, sex, race, and geographic area (1315161718). Its usefulness depends on the establishment of reliable reference values for the particular population and age groups, therefore cut-off value should be derived from the most recent and geographically defined normalized reference values.…”

Section: Discussionmentioning

confidence: 99%

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Reference Values and Utility of Serum Total Immunoglobulin E for Predicting Atopy and Allergic Diseases in Korean Schoolchildren

et al. 2017

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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.

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Section: Discussionsupporting

confidence: 90%

Section: Discussionsupporting

confidence: 87%

Section: Discussionmentioning

confidence: 99%

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Reference Values and Utility of Serum Total Immunoglobulin E for Predicting Atopy and Allergic Diseases in Korean Schoolchildren

et al. 2017

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“…Detailed descriptions of subject recruitment and data collection have been reported previously [8], [16], [17], [18], [19]. The subject flow diagram of the current study is presented in Figure 1 .…”

Section: Methodsmentioning

confidence: 99%

Suboptimal Vitamin D Status in a Population-Based Study of Asian Children: Prevalence and Relation to Allergic Diseases and Atopy

Yao

Chang

et al. 2014

PLoS ONE

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BackgroundNew evidence shows high prevalence of vitamin D deficiency in many countries and some studies suggest a possible link between vitamin D status and allergic diseases. The objectives of this study were to determine the prevalence of suboptimal vitamin D status in a population sample of Asian children and to investigate the relationship of vitamin D status with allergic diseases and atopy.MethodsChildren aged 5–18 years (N = 1315) in the Prediction of Allergies in Taiwanese CHildren (PATCH) study were evaluated using questionnaires, anthropometric measurements, and serum levels of 25-hydroxyvitamin D [25(OH)D] and total and specific immunoglobulin E (IgE).ResultsThe mean concentration of serum 25(OH)D was 20.4 ng/mL (SD: 7.1 ng/mL). Vitamin D deficiency (defined as serum 25(OH)D<20 ng/mL) was present in 670 subjects (51.0%), while vitamin D insufficiency (defined as serum 25(OH)D<30 ng/mL) was observed in 1187 subjects (90.3%). Older age (P<0.001), female gender (P<0.001), higher body mass index (P = 0.001), winter and spring seasons (compared to summer; P both<0.001), and passive smoking (P = 0.011) were independently associated with low serum 25(OH)D levels. After adjusting for potential confounders, serum 25(OH)D status had no association with asthma, rhinitis, eczema, atopy, or total serum IgE (all P>0.05).ConclusionsLow serum 25(OH)D levels are remarkably common in this population sample of Asian children, suggesting that millions of children living in Taiwan may have suboptimal levels of vitamin D, which should be a matter of public health concern. Our results provides epidemiological evidence against the association of vitamin D status with various allergic diseases and atopy in Asian children.

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“…The PATCH study launched in 2007, aiming to investigate the epidemiology and predictive factors related to asthma and allergies in children. Detailed descriptions of the study population, data collection and previous findings in publications derived from the PATCH study have been reported elsewhere 4,9,12,[35][36][37][38][39] . The flow chart for subject recruitment is depicted in Fig.…”

Section: Methodsmentioning

confidence: 99%

Exposure to Tobacco Smoke and Childhood Rhinitis: A Population-Based Study

Tsai

Yao

Chang

et al. 2017

Journal of Allergy and Clinical Immunology

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Exposure to tobacco smoke has been associated with harmful effects on child health. The association between tobacco smoke exposure and childhood rhinitis has not been established in developed or developing countries. We investigated the association between serum cotinine levels and rhinitis in a population sample of 1,315 Asian children. Serum cotinine levels were positively associated with rhinitis ever (adjusted odds ratio [AOR] = 2.95; 95% confidence interval [CI]: 1.15-7.60) and current rhinitis (AOR = 2.71; 95% CI: 1.07-6.89), while the association for physician-diagnosed rhinitis approaching borderline significance (AOR = 2.26; 95% CI: 0.88-5.83). Stratified analyses demonstrated significant association of serum cotinine levels with current rhinitis among children without allergic sensitization (AOR = 6.76; 95% CI: 1.21-37.74), but not among those with allergic sensitization. Serum cotinine levels were positively associated with rhinitis ever (AOR = 3.34; 95% CI: 1.05-10.61) and current rhinitis (AOR = 4.23; 95% CI: 1.28-13.97) among adolescents but not in children aged less than 10 years. This population-based study demonstrates supportive evidence for positive association of tobacco smoke exposure with rhinitis, while the effect is mainly confined to non-allergic rhinitis and more pronounced in adolescents than in young children, highlighting the need for raising public health awareness about the detrimental effects of tobacco smoke exposure on children's respiratory health.Allergic diseases commonly develop during childhood as a result of interaction between genetic and environmental factors 1 . For several decades, there has been a remarkable increase in prevalence of childhood allergic diseases such as asthma, allergic rhinitis, and atopic dermatitis (eczema), which has reached epidemic numbers in several countries including Taiwan [2][3][4] . Specifically, the prevalence of allergic rhinoconjunctivitis in 6-7-year-old children in Taiwan is among the highest around the world 3 , attracting substantial research and public attention. Changes in lifestyle are thought to be at least partly responsible for the allergy epidemics extending beyond the past few decades 2 . Tobacco use is one of the leading modifiable risk factors for non-communicable diseases 5 . Smoking population has been estimated around 1.3 billion worldwide 6 . It is estimated that approximately one billion people may die due to tobacco-related causes during the twenty-first century 6 . Exposure to environmental tobacco smoke is one of the most common preventable health hazards for children 7 , whose respiratory and immune systems are still growing and defense mechanisms are relatively vulnerable. Using data collected from 192 countries, Oberg et al.report that approximately 40% of children, 33% of men, and 35% of women worldwide are regularly exposed to

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Total Serum IgE in a Population-Based Study of Asian Children in Taiwan: Reference Value and Significance in the Diagnosis of Allergy

Cited by 56 publications

References 25 publications

Reference Values and Utility of Serum Total Immunoglobulin E for Predicting Atopy and Allergic Diseases in Korean Schoolchildren

Reference Values and Utility of Serum Total Immunoglobulin E for Predicting Atopy and Allergic Diseases in Korean Schoolchildren

Suboptimal Vitamin D Status in a Population-Based Study of Asian Children: Prevalence and Relation to Allergic Diseases and Atopy

Exposure to Tobacco Smoke and Childhood Rhinitis: A Population-Based Study

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