Associations of Age, Gender, and BMI with Prevalence of Allergic Diseases in Children: PATCH Study

Abstract

Background. Little is known about the prevalence of allergic diseases in children of different ages. This study aimed to investigate the prevalence of allergic diseases and allergic sensitization in children over a wide age range, with emphasis on the influence of age, gender, and body mass index (BMI). Methods. In a cross-sectional study, we assessed 5351 Taiwanese children aged 4–18 years using an International Study of Asthma and Allergies in Childhood questionnaire, BMI, and total and specific serum immunoglobulin E. Results. Forty-eight percent were currently symptomatic for at least one of three allergic diseases. Prevalence of wheeze ever, current wheeze, and diagnosed asthma were 17.0%, 7.5%, and 9.8%, respectively; analogous features for rhinitis were 47.8%, 44.2%, and 39.8%. Allergic sensitization was very common (57.3%). Half of the children (50.6%) with current wheeze had not been diagnosed with asthma by physicians, whereas undiagnosed rates were 32.3% for rhinitis and 25.3% for eczema. The male-to-female prevalence ratios of current wheeze increased with age from <1 at 4–5 years, peaked at 10–11 years (2.24), then reversed to 0.57 at 16–18 years. Childhood wheezing tended to remit with age, but rhinitis and eczema were more persistent. Total immunoglobulin E levels increased with age until 14–15 years, and declined thereafter. Elevated BMI was associated with greater prevalence of wheezing and eczema, with no evidence of significant effect modification by either gender or age. Multivariate analyses revealed that younger age, boys, and obesity were significantly and independently associated with current wheezing in children (all p < .01). Conclusions. The burden and co-morbidity of childhood allergies are substantial. There are striking age-dependent gender differences in asthma prevalence, exhibiting an inverted U-shaped curve for male-to-female prevalence ratios by age. Obesity is associated with a greater prevalence of asthma in children with no evidence of a significant modulation by either gender or age.

• age
• allergic disease
• body mass index
• children
• gender
• obesity
• prevalence

Acknowledgments

We thank the study subjects, their parents, their teachers, and the school nurses, as well as the involved schools, for their active participation in this study. We also thank the Department of Education of the Keelung City Government for administrative support for the study. We thank professor Chee-Jen Chang (Director, Chang Gung Clinical Informatics and Medical Statistics Research Center) for providing statistical support and Kevin Bullaughey (University of Chicago) for providing English editing assistance. This work was supported by Chang Gung Memorial Hospital (grant CMRPG260291, CMRPG260292, CMRPG260293, and CMRPG260261).

Declaration of Interest

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.