title: Association of Polysensitization, Allergic Multimorbidity, and Allergy Severity: A Cross-Sectional Study of School Children.
abstract: BACKGROUND
  Aeroallergen sensitization is related to the coexistence of allergic diseases, but the nature of this relationship is poorly understood. The aim of this study was to clarify the relationship of polysensitization with allergic multimorbidities and the severity of allergic diseases.
  
  
  METHODS
  This study is a cross-sectional analysis of 3,368 Korean children aged 6-7 years-old. We defined IgE-mediated allergic diseases based on structured questionnaires, and classified the sensitivity to 18 aeroallergens by logistic regression and the Ward hierarchical clustering method. The relationship of polysensitization (positive IgE responses against 2 or more aeroallergens classes) with allergic multimorbidities (coexistence of 2 or more of the following allergic diseases: asthma, rhinitis, eczema, and conjunctivitis) and severity of allergic diseases was determined by ordinal logistic regression analysis.
  
  
  RESULTS
  The rate of polysensitization was 13.6% (n = 458, 95% CI 12.4-14.8) and that of allergic multimorbidity was 23.5% (n = 790, 95% CI 22.0-24.9). Children sensitized to more aeroallergens tended to have more allergic diseases (rho = 0.248, p < 0.001), although the agreement between polysensitization and multimorbidity was poor (kappa = 0.11, p < 0.001). The number allergen classes to which a child was sensitized increased the risk of wheezing attacks (1 allergen: adjusted odds ratio [aOR] 2.22, 4 or more allergens: aOR 9.39), absence from school (1 allergen: aOR 1.96, 3 allergens: aOR 2.08), and severity of nasal symptoms (1 allergen: aOR 1.61, 4 or more allergens: aOR 4.38).
  
  
  CONCLUSIONS
  Polysensitization was weakly related to multimorbidity. However, the number of allergens to which a child is sensitized is related to the severity of IgE-mediated symptoms.
authors.affiliation: Department of Pediatrics, CHA University School of Medicine, Seongnam, Korea.
authors.forename: Eun Kyo
authors.initials: EK
authors.lastname: Ha
authors.forename: Ji Hyeon
authors.initials: JH
authors.lastname: Baek
authors.forename: So-Yeon
authors.initials: SY
authors.lastname: Lee
authors.forename: Yong Mean
authors.initials: YM
authors.lastname: Park
authors.forename: Woo Kyung
authors.initials: WK
authors.lastname: Kim
authors.forename: Youn Ho
authors.initials: YH
authors.lastname: Sheen
authors.forename: Seung Jin
authors.initials: SJ
authors.lastname: Lee
authors.forename: Youngoh
authors.initials: Y
authors.lastname: Bae
authors.forename: Jihyeon
authors.initials: J
authors.lastname: Kim
authors.forename: Kee-Jae
authors.initials: KJ
authors.lastname: Lee
authors.forename: Kangmo
authors.initials: K
authors.lastname: Ahn
authors.forename: Ho-Jang
authors.initials: HJ
authors.lastname: Kwon
authors.forename: Man Yong
authors.initials: MY
authors.lastname: Han
mesh_terms: D000485:Allergens / Q000276:immunology*; D002648:Child; D015897:Comorbidity; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D006967:Hypersensitivity / Q000175:diagnosis* / Q000453:epidemiology*; D007114:Immunization; D008297:Male; D015995:Prevalence; D062486:Public Health Surveillance; D012574:Schools; D012720:Severity of Illness Index; D012882:Skin Tests; D013334:Students
chemical_list: D000485:Allergens