Læknablaðið - 15.12.2000, Blaðsíða 35

FRÆÐIGREINAR / OFNÆMI OG ÓÞOL
Fæðuofnæmi og fæðuóþol
Islendinga á aldrinum 20-44 ára
Davíð Gíslason,
Eyþór Björnsson,
Þórarinn Gíslason
Landspítali Vífilsstöðum.
Fyrirspumir, bréfaskipti:
Davíð Gíslason Landspítala
Vífilsstöðum, 210 Garðabæ.
Sími: 560 2800; bréfasími: 560
2835; netfang: davidg@rsp.is
Lykilorð: fœðuofnœmi,
fæðuóþol, íslendingar,
ECRHS.
Ágrip
Inngangur: Ymis einkenni tengd neyslu ákveðinna
fæðutegunda eru algeng umkvörtunarefni. í fæstum
tilvikum er þó hægt að staðfesta fæðuofnæmi/-óþol
við prófanir. í íslenska hluta European Community
Respiratory Health Survey var kannað algengi
fæðutengdra einkenna meðal fullorðinna Islendinga.
Efniviður og aðferðir: Rannsökuð voru 3600
karlar og konur 20-44 ára og úr þeim hópi voru 800
valin af handahófi og rannsökuð sérstaklega. Einnig
voru skoðuð öll þau sem notuðu astmalyf, eða höfðu
astmaeinkenni. Spurt var meðal annars um einkenni
frá öndunarfærum, matarvenjur og einkenni tengd
mat. Auk þess var hérlendis spurt um lyfjaóþol,
ofsakláða, ofsabjúg, barnaeksem, mígreni og sóra.
Öll gengust undir húðpróf fyrir 12 algengum
ofnæmisvökum, blásturspróf og mælingu á berkju-
auðreitni með metakólíni. Mæld voru sértæk IgE
mótefni fyrir fimm loftbornum ofnæmisvökum og
sex algengum fæðutegundum.
Niðurstöður: Af einstaklingum með fæðutengd
einkenni höfðu 68% einkenni frá meltingarvegi, 22%
útbrot eða kláða, 15% slæman höfuðverk, 11%
mæði, 8% nefrennsli/nefstíflur og 4% þreytu. Sam-
tals voru 42 fæðuefni talin völd að þeim einkennum
sem nefnd voru.
I slembiúrtakinu töldu 22% sér hafa orðið illt af
ákveðinni fæðu, 15% töldu sig alltaf veikjast með
sama hætti af þessari sérstöku fæðu. Konur lýstu
oftar fæðuóþoli en karlar (17% á móti 13%
(p=0,21)). Af slembiúrtakinu höfðu einungis 1,8%
mótefni fyrir ákveðinni fæðutegund. Marktækt
samband fæðutengdra einkenna var við einkenni um
mígreni, ofsakláða og ofsabjúg en þó sérstaklega við
ætlað lyfjaofnæmi. Konur voru í miklum meirihluta
þeirra sem töldu sig hafa mígreni (p<0,0001),
ofsakláða (p<0,01), ofsabjúg (p<0,05) og lyfjaofnæmi
(p<0,002). Engin tengsl voru milli fæðutengdra
einkenna og metakólínprófa.
Alyktanir: Könnun þessi hefur sýnt fram á hóp
einstaklinga sem hefur einkenni af neyslu ákveðinna
ENGLISH SUMMARY
Gíslason D, Björnsson E, Gíslason Þ
Allergy and intolerance to food in an lcelandic
urban population 20-44 years of age
Læknablaðið 2000; 86: 851-7
Objective: Symptoms related to the intake of certain food
items are common. In most of these cases food
allergy/intolerance can not be confirmed. In the lcelandic
part of the European Community Respiratory Health
Survey the prevalence of food-related symptoms was
assessed among adult lcelanders.
Material and methods: Three thousand and six hundred
men and women, 20-44 years, were studied, among them
800 were randomly chosen for a more detailed
investigation. Additionally, all those using asthma
medication or having asthma symptoms were investigated.
A questionnaire inquired about chest symptoms,
symptoms related to food-intake and eating habits. In
lceland additional questions were asked concerning drug
intolerance, urticaria, Quincke oedema, childhood eczema,
migraine and psoriasis. All subjects underwent skin prick
tests against 12 common allergens, spirometry and
methacholine challenge. Specific IgE antibodies against
five airborne allergens and six common food allergens
were measured.
Results: Among subjects with food-related symptoms,
68% reported complaints from the Gl-tract, 22% had skin
rash or pruritus, 15% severe headache, 11 %
breathlessness, 8% a running/stuffy nose and 4% fatique.
Altogether 42 food items were considered likely causes of
the reported symptoms.
Twenty-two percent of the random sample had symptoms
related to the intake of a particular food and 15% reported
always having the same symptom after intake of this food.
Women reported food-related symptoms somewhat more
often that men (17% and 13% respectively (p=0.21)). In the
random sample only 1.8% had antibodies to one or more
of the foods measured. There was a significant relationship
between food-related symptoms and reported migraine,
urticaria and Quincke oedema and a particularily strong
relationship with drug intolerance. Migraine, urticaria,
Quincke oedema and drug intolerance were significantly
more common among women (p<0.0001, p<0.01, p<0.05
and <0.002 respectively). No relationship was seen
between food-related symptoms and positive
methacholine tests.
Conclusions: In conclusion this study reveales a large
group of subjects reporting food-releated symptoms. This
group also reported a big prevalence of unrelated
symptoms such as drug intolerance and migraine. Type-1
allergy is unlikely to be the cause to more than a small part
of these symptoms.
Key words: allergy, intolerance, food, ECRHS, lceland.
Correspondence: Davíð Gíslason. E-mail: davidg@rsp.is
Læknablaðið 2000/86 851