青岛地区儿童食物不耐受情况的sIgG抗体临床分析

Clinical analysis of sIgG antibody in children with food intolerance in Qingdao

目的通过食物特异性免疫球蛋白G(sIgG)抗体分析青岛地区儿童食物不耐受情况。方法本研究为横断面研究,采用整体抽样方法,连续选取2017年5月至2020年12月因疑似食物不耐受就诊于青岛大学附属妇女儿童医院的4249例0~14岁儿童(均为青岛市常住人口)为研究对象,根据年龄分为0~<1岁组(440例)、1~<3岁组(1761例)、3~<6岁组(1193例)、≥6岁组(855例)4组,采用酶联免疫吸附法检测其血清中14种食物sIgG抗体的阳性情况,采用χ^(2)检验比较不同食物、性别及年龄组间的阳性率差异。结果4249例儿童食物sIgG抗体总阳性率为95.32%(4050/4249),14种食物中鸡蛋阳性率最高(81.50%),猪肉阳性率最低(1.15%)。男童牛奶(54.98%比49.69%,χ^(2)=11.627)、螃蟹(5.59%比3.71%,χ^(2)=8.049)、虾(4.62%比2.75%,χ^(2)=9.784)的sIgG抗体阳性率均显著高于女童,女童西红柿(49.19%比45.54%,χ^(2)=5.510)、鳕鱼(8.53%比5.96%,χ^(2)=10.512)、牛肉(2.58%比1.70%,χ^(2)=3.959)的sIgG抗体阳性率均显著高于男童(均P<0.05)。14种食物sIgG抗体总阳性率在0~<1岁组最低(89.09%),3~<6岁组最高(96.98%)(χ^(2)=63.950,P<0.001);0~<1岁组阳性率最高的食物是西红柿(56.36%),其余3组均为鸡蛋(85.29%、88.94%、85.50%);玉米、牛肉的阳性率均随年龄增加逐渐降低(χ^(2)=44.098、20.106,均P<0.001);鳕鱼、蘑菇的阳性率均随年龄增加逐渐升高(χ^(2)=32.315、40.338,均P<0.001);小麦(57.13%,χ^(2)=42.273)、西红柿(57.01%,χ^(2)=209.862)、大豆(24.99%,χ^(2)=92.580)、螃蟹(6.81%,χ^(2)=33.201)、虾(6.25%,χ^(2)=47.863)的阳性率在1~<3岁组均最高(均P<0.001);鸡肉的阳性率在3~<6岁组最高(7.88%,χ^(2)=29.875;P<0.001)。结论青岛地区儿童食物不耐受水平较高,其中鸡蛋阳性率最高;男童应重点关注的食物为牛奶、螃蟹和虾,女童为西红柿、鳕鱼和牛肉;不同年龄段儿童不耐受食物种类存在差异,应根据其特点合理调整饮食结构。

Objective To analyze food intolerance status in children in Qingdao by detecting the serum levels of food-specific IgG(sIgG).Methods In this cross-sectional study,a total of 4249 children aged 0 to 14 years(all were permanent residents of Qingdao City)admitted to Women and Children′s Hospital Affiliated to Qingdao University from May 2017 to December 2020 for suspected food intolerance were selected as the study objects with the whole sampling method.According to the age,the objects were divided into 4 groups:0-<1 year group(440 cases),1-<3 years group(1761 cases),3-<6 years group(1193 cases),and≥6 years group(855 cases).Positive condition of serum sIgG antibodies of 14 kinds of food in the children were detected by enzyme-linked immunosorbent assay.Chi-square test was used to compare the positive rate of the antibodies among different foods,gender and age groups.Results The total positive rate of food sIgG antibody in 4249 children was 95.32%(4050/4249),the highest positive rate was found in eggs(81.50%)and the lowest positive rate was found in pork(1.15%).The positive rates of sIgG antibody in milk(54.98%vs 49.69%,χ^(2)=11.627),crab(5.59%vs 3.71%,χ^(2)=8.049)and shrimp(4.62%vs 2.75%,χ^(2)=9.784)in boys were significantly higher than those in girls,and the positive rates of sIgG antibody in tomato(49.19%vs 45.54%,χ^(2)=5.510),cod(8.53%vs 5.96%,χ^(2)=10.512)and beef(2.58%vs 1.70%,χ^(2)=3.959)in girls were significantly higher than those in boys(all P<0.05).The total positive rate of sIgG antibody in 14 foods was the lowest in 0-<1 year group(89.09%),and it was the highest in 3-<6 years group(96.98%)(χ^(2)=63.950,P<0.001).The highest positive rate in 0-<1 year group was found in tomato(56.36%),and it was eggs(85.29%,88.94%,85.50%)in all the other 3 groups.The positive rates of corn and beef decreased with age(χ^(2)=44.098,20.106,P<0.001),while those of cod and mushroom increased with age(χ^(2)=32.315,40.338,P<0.001).The positive rate of wheat(57.13%,χ^(2)=42.273),tomato(57.01%,χ^(2)=209.862),soybean(24.99%,χ^(2)=92.580),crab(6.81%,χ^(2)=33.201),shrimp(6.25%,χ^(2)=47.863)were all the highest in 1-<3 years group among the 4 groups(all P<0.001),and the positive rate of chicken was the highest in 3-<6 years group(7.88%,χ^(2)=29.875;P<0.001).Conclusions Children in Qingdao have a high level of food intolerance,and the highest positive rate is for eggs.Milk,crab and shrimp should be focused on for boys,while tomatoes,cod and beef shoud be paid more attention to for girls.Children of different ages have different kinds of food intolerance,and their diets should be adjusted reasonably according to the characteristics.