Hemant Sharma - Authorea

Background: The effect of race, age, sex, atopy, environmental exposures, and social determinants of health on total serum immunoglobulin E (IgE) has not been examined in children with food allergy. Method: We conducted a cross-sectional analysis with univariable and multivariable linear mixed effect models of data from 398 African American and European American children 0-12 years with allergist-diagnosed food allergy from the multi-center, observational cohort FORWARD; total serum IgE in kU/L was the primary outcome measure. Results: Total serum IgE positively associated with African American race ( p < .0001), older age ( p < .0001), male sex ( p =. 0142), lower household income ( p = .0051), lower parent/caregiver education ( p = .0051), allergic rhinitis ( p < .0001), asthma ( p < .0001), eczema ( p = .0240), and a higher number of food allergies ( p < .0001), but not tobacco smoke exposure. After covariate adjustment in multivariable analysis, total serum IgE remained higher in African American than European American ( p < .0001), older than younger ( p < .0001), and male than female children and in children with allergic rhinitis ( p = .0083), asthma ( p < .0001), eczema ( p = .0140), and a higher number of food allergies ( p < .0001). Conclusions: We provide foundational data that total serum IgE varies by race in children with food allergy; values were higher in African American than European American children, independent of atopic status. These findings call attention to the need to establish race-dependent values of total serum IgE for diagnostic and therapeutic purposes.