Allergen Sensitization Patterns of Allergic Diseases in Children Living at High Altitude

Background:Childhood allergic diseases are rising worldwide, but data from high-altitude regions with distinct environmental and ethnic profiles remain limited. Objective:To characterize allergen sensitization among high-altitude children and explore associations with allergic diseases, diet, environment, and ethnicity. Methods:A cross-sectional study was conducted among 125 children (1-14 years) in Derong County, Sichuan, China. Serum specific IgE to 18 common allergens was measured, and structured questionnaires assessed clinical conditions, diet, and exposures. Results:The prevalence of allergic diseases was 45.6%, with allergic rhinitis being the most common (30.4%). Boys showed a higher prevalence than girls (56.9% vs. 33.3%, χ 2 =6.9, P =0.008).Inhaled allergens (40.0%) had a significantly higher positivity rate than ingested allergens (24.8%). The top three inhaled allergens were tree pollen mix 2 (willow, poplar, elm; 24.0%), Artemisia (23.2%), and ragweed (17.6%), while the leading ingested allergens were soybean (13.6%), peanut (11.2%), and egg white (5.6%). Multiple sensitization (≥2 allergens) was observed in 27.2% of children, with 16.8% exhibiting mixed ingestion–inhalation sensitization. Co-sensitization analysis revealed pollen-dominant patterns, particularly Artemisia with tree pollen mix 2. Dietary analysis showed a negative association between legume intake and overall sensitization (OR=0.42, 95%CI: 0.24-0.74, P =0.002), and between tsampa (roasted barley flour) consumption and rhinitis prevalence (OR=0.41, 95%CI: 0.21-0.78, P =0.007). Environmental risk factors included home renovation within the past year (OR=3.17, 95%CI: 1.27–7.92, P =0.01) and residence within 200 m of major roads (OR=3.43, 95%CI: 1.51-7.78, P =0.003). Ethnic differences were evident: Han children showed higher prevalence than Tibetan children (80.0% vs. 42.6%, P =0.03). Conclusion:High-altitude children exhibit distinct sensitization profiles, dominated by tree pollen and Artemisia with low dust mite prevalence. Diet, environment, and ethnicity significantly influence risk. This study establishes the allergen profile of children in high-altitude regions, providing evidence for prevention and individualized interventions in allergic diseases.