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Higher economic status increased risk for childhood peanut allergy
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Higher rates of peanut allergy were linked to higher socioeconomic status, according to study results presented at the American College of Allergy, Asthma and Immunology Annual Scientific Meeting.
Researchers said this lends support to the “hygiene hypothesis” linking a child’s lack of exposure to germs to increased chances for allergic diseases.
Researchers analyzed data from the 2005-2006 National Health and Nutrition Examination Survey, comparing socioeconomic status with peanut antibody (immunoglobulin E) levels (>0.35 kU/L). The study examined 8,306 patients, of whom 776 had elevated antibody level to peanuts.
Socioeconomic status was calculated based on overall household income and poverty income ratios determined by the US Census Bureau.
Peanut IgE prevalence peaked in the 10- to 19-year-old age group in both males (14.3%; 95% CI, 10.7-18.9) and females (8.4%; 95% CI, 6.7-10.5). Peanut IgE prevalence ratios were higher in the 1- to 9-year-old age group with higher socioeconomic status, after adjusting for gender and race.
“Overall household income is only associated with peanut sensitization in children aged 1 to 9 years,” study researcher Sandy K. Yip, MD, of the US Air Force, said. “This may indicate that development of peanut sensitization at a young age is related to affluence, but those developed later in life are not.”
For more information:
Yip SK. P278. Presented at: ACAAI Annual Scientific Meeting; Nov. 8-13, 2012; Anaheim, Calif.
Perspective
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Matthew J. Greenhawt, MD
Yip and colleages present interesting data obtained from analysis of the 2005-2006 NHANES study. The 2005-2006 survey was the first to also obtain food specific IgE levels in a segment of the sample, looking at sensitization (presence of specific IgE) to milk, egg, peanut and shrimp. Yip’s analysis suggests that higher sensitization rates correlate with higher family income levels, seen in children aged younger than 9 years.
While interesting, the clinical significance of this finding is hard to judge. Foremost, the NHANES study only obtained sensitization, but did not provide any clinical correlation to determine if the sensitization to the food in question was actually related to symptom development if this food was eaten. Not all sensitization is reflective of clinical allergy. In fact, a recent study led by Corrine Keet, MD, at Johns Hopkins demonstrates the limitations of the NHANES food sensitization data (J Allergy Clinical Immunology.2012; http://download.journals.elsevierhealth.com/pdfs/journals/0091-6749/PIIS0091674912011967.pdf).
Thus, while there may be a correlation within a certain age range between peanut specific IgE and family income, the significance of this is hard to judge given the difficulty in assessing if the sensitization is actually reflective of true peanut allergy. However, given there is limited previous work pertaining to economic disparity within food allergy, this concept is important to expand upon, to help us understand what segments of the population are most vulnerable to potential food allergy.
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