title: Reference Values and Utility of Serum Total Immunoglobulin E for Predicting Atopy and Allergic Diseases in Korean Schoolchildren.
abstract: The present study aimed to investigate the distribution of total serum immunoglobulin E (IgE) levels in Korean schoolchildren and to evaluate its utility in the prediction of atopy and allergic diseases. A nationwide, cross-sectional survey was conducted in first grade students from randomly selected elementary and middle schools. Total IgE levels were measured by ImmunoCAP. Skin prick tests were performed for 18 common inhalant allergens to determine the presence of atopy. Children aged 12-13 years and parents of children aged 6-7 years were asked to complete questionnaire assessing allergic diseases. The cut-off levels of total IgE were determined by analyzing receiver operating characteristic curves. The median total IgE level was 86.7 kU/L (range: 1.5-4,523.1) in 3,753 children aged 6-7 years and 94.7 kU/L (range: 1.5-3,000.0) in 3,930 children aged 12-13 years. Total IgE concentrations were higher in children with atopy or allergic diseases than in those without (all P < 0.001). At the cut-off value of 127.7 kU/L, sensitivity, specificity, and positive and negative predictive values (PPV and NPV) were 67.1%, 75.4%, 65.4%, and 76.7%, respectively, in elementary schoolchildren. At the cut-off value of 63.0 kU/L, sensitivity, specificity, PPV, and NPV were 81.9%, 66.6%, 75.0%, and 75.1%, respectively, in middle schoolchildren. PPV and NPV were ≥ 70% when cut-offs of 258.8 kU/L and 38.4 kU/L were used for the diagnosis of atopy in 6-7 year-olds and 12-13 year-olds, respectively. This nationwide population-based study provided the first normal reference ranges of total IgE in Korean schoolchildren.
authors.affiliation: Department of Pediatrics, Medical Research Institute of Pusan National University Hospital, Pusan National University School of Medicine, Busan, Korea.
authors.forename: Hye Young
authors.identifier: http://orcid.org/0000-0001-7125-8840
authors.initials: HY
authors.lastname: Kim
authors.affiliation: Department of Pediatrics, Samyook Medical Center, Seoul, Korea.
authors.forename: Jaehee
authors.identifier: http://orcid.org/0000-0002-6651-4480
authors.initials: J
authors.lastname: Choi
authors.affiliation: Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.|Environmental Health Center for Atopic Diseases, Samsung Medical Center, Seoul, Korea.
authors.forename: Kangmo
authors.identifier: http://orcid.org/0000-0001-7751-9829
authors.initials: K
authors.lastname: Ahn
authors.affiliation: Department of Health Administration and Management, Soonchunhyang University College of Medical Science, Asan, Korea.
authors.forename: Myung Il
authors.identifier: http://orcid.org/0000-0002-4790-3739
authors.initials: MI
authors.lastname: Hahm
authors.affiliation: Department of Pediatrics, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, Korea.
authors.forename: So Yeon
authors.identifier: http://orcid.org/0000-0002-2499-0702
authors.initials: SY
authors.lastname: Lee
authors.affiliation: Department of Pediatrics, Inje University College of Medicine, Seoul, Korea.
authors.forename: Woo Kyung
authors.identifier: http://orcid.org/0000-0001-8730-010X
authors.initials: WK
authors.lastname: Kim
authors.affiliation: Department of Occupational and Environmental Medicine, College of Medicine, Dankook University, Cheonan, Korea.
authors.forename: Yoomi
authors.identifier: http://orcid.org/0000-0003-1071-6099
authors.initials: Y
authors.lastname: Chae
authors.affiliation: Department of Pediatrics, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, Korea.
authors.forename: Yong Mean
authors.identifier: http://orcid.org/0000-0002-2586-584X
authors.initials: YM
authors.lastname: Park
authors.affiliation: Department of Pediatrics, CHA University School of Medicine, Seongnam, Korea.
authors.forename: Man Yong
authors.identifier: http://orcid.org/0000-0002-9077-5779
authors.initials: MY
authors.lastname: Han
authors.affiliation: Department of Information and Statistics, Korea National Open University, Seoul, Korea.
authors.forename: Kee Jae
authors.identifier: http://orcid.org/0000-0002-9499-5971
authors.initials: KJ
authors.lastname: Lee
authors.affiliation: Department of Preventive Medicine, Dankook University College of Medicine, Cheonan, Korea.
authors.forename: Ho Jang
authors.identifier: http://orcid.org/0000-0003-3029-5674
authors.initials: HJ
authors.lastname: Kwon
authors.affiliation: Biostatistics and Clinical Epidemiology Center, Research Institute for Future Medicine, Samsung Medical Center, Seoul, Korea.
authors.forename: Seonwoo
authors.identifier: http://orcid.org/0000-0002-9236-560X
authors.initials: S
authors.lastname: Kim
authors.affiliation: Biostatistics and Clinical Epidemiology Center, Research Institute for Future Medicine, Samsung Medical Center, Seoul, Korea.
authors.forename: Heejin
authors.identifier: http://orcid.org/0000-0003-4341-6906
authors.initials: H
authors.lastname: Yoo
authors.affiliation: Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.|Environmental Health Center for Atopic Diseases, Samsung Medical Center, Seoul, Korea. jhlovechild@gmail.com.
authors.forename: Jihyun
authors.identifier: http://orcid.org/0000-0001-8493-2881
authors.initials: J
authors.lastname: Kim
mesh_terms: D000293:Adolescent; D000485:Allergens / Q000032:analysis / Q000276:immunology; D019540:Area Under Curve; D044466:Asian People; D002648:Child; D003430:Cross-Sectional Studies; D003876:Dermatitis, Atopic / Q000175:diagnosis* / Q000453:epidemiology; D005260:Female; D006801:Humans; D007073:Immunoglobulin E / Q000097:blood*; D001239:Inhalation; D008297:Male; D015995:Prevalence; D012372:ROC Curve; D056910:Republic of Korea / Q000453:epidemiology; D065631:Rhinitis, Allergic / Q000175:diagnosis* / Q000453:epidemiology; D012680:Sensitivity and Specificity; D012882:Skin Tests
chemical_list: D000485:Allergens; D007073:Immunoglobulin E
keywords: Allergy; Atopy; Immunoglobulin E; Korea; Schoolchildren