Tyler Harkness1, Xiaoqing Fu2, Yuqing Zhang3, Hyon K Choi4, John H Stone4, Kimberly G Blumenthal5, Zachary S Wallace6. 1. Clinical Epidemiology Program, Mongan Institute, Massachusetts General Hospital, Boston, Massachusetts; Rheumatology Unit, Division of Rheumatology, Allergy, and Immunology, Massachusetts General Hospital, Boston, Massachusetts; Allergy and Clinical Immunology Unit, Division of Rheumatology, Allergy, and Immunology, Massachusetts General Hospital, Boston, Massachusetts; Medical Practice Evaluation Center, Massachusetts General Hospital, Boston, Massachusetts. 2. Clinical Epidemiology Program, Mongan Institute, Massachusetts General Hospital, Boston, Massachusetts; Rheumatology Unit, Division of Rheumatology, Allergy, and Immunology, Massachusetts General Hospital, Boston, Massachusetts; Allergy and Clinical Immunology Unit, Division of Rheumatology, Allergy, and Immunology, Massachusetts General Hospital, Boston, Massachusetts. 3. Clinical Epidemiology Program, Mongan Institute, Massachusetts General Hospital, Boston, Massachusetts; Rheumatology Unit, Division of Rheumatology, Allergy, and Immunology, Massachusetts General Hospital, Boston, Massachusetts. 4. Clinical Epidemiology Program, Mongan Institute, Massachusetts General Hospital, Boston, Massachusetts; Rheumatology Unit, Division of Rheumatology, Allergy, and Immunology, Massachusetts General Hospital, Boston, Massachusetts; Harvard Medical School, Boston, Massachusetts. 5. Clinical Epidemiology Program, Mongan Institute, Massachusetts General Hospital, Boston, Massachusetts; Allergy and Clinical Immunology Unit, Division of Rheumatology, Allergy, and Immunology, Massachusetts General Hospital, Boston, Massachusetts; Medical Practice Evaluation Center, Massachusetts General Hospital, Boston, Massachusetts; Harvard Medical School, Boston, Massachusetts. 6. Clinical Epidemiology Program, Mongan Institute, Massachusetts General Hospital, Boston, Massachusetts; Rheumatology Unit, Division of Rheumatology, Allergy, and Immunology, Massachusetts General Hospital, Boston, Massachusetts; Harvard Medical School, Boston, Massachusetts. Electronic address: zswallace@mgh.harvard.edu.
Abstract
BACKGROUND: Serum immunoglobulin G (IgG) concentrations are integral to the workup of immune deficiencies and IgG4-related disease (IgG4-RD). Demographic differences in IgG concentrations are poorly described but can influence test interpretation, contribute to racial disparities in primary immunodeficiency diagnosis, and explain demographic differences in IgG concentrations in IgG4-RD. OBJECTIVE: To assess differences in IgG and IgG subclass concentrations according to sex and race. METHODS: We identified patients with IgG and IgG subclass concentrations measured in a large health care system. Multivariate-adjusted differences in IgG and IgG subclass concentrations and the proportion of subjects with results outside of reference ranges according to sex and race were estimated. RESULTS: Of the 12,851 patients, the mean age was 54.7 years and 7917 (62%) were female. Of these, 11,673 (91%) were white, 611 (5%) were black, and 302 (2%) were Asian. Compared with the mean concentrations of white patients, Asian and black patients had higher mean concentrations of IgG (1340.0 and 1504.4 vs 988.1 mg/dL, P < .001), IgG1 (782.0 and 938.4 vs 592.4 mg/dL, P < .001), IgG2 (493.5 and 384.2 vs 305 mg/dL, P < .001), IgG3 (76.6 and 91.9 vs 55.9 mg/dL, P < .001), and IgG4 (140.4 and 53.6 vs 41.6 mg/dL, P < .001). Immunoglobin G subclass 4 concentrations were higher in males than those in females (56.3 vs 37.4 mg/dL, P < .001). Similar observations were made when comparing the proportions of patients with results outside of reference ranges and after stratifying by diagnosis. CONCLUSION: Immunoglobin G and IgG subclass concentrations differ according to sex and race. These findings may have implications for the interpretation of these test results but require confirmation in diverse, healthy populations.
BACKGROUND: Serum immunoglobulin G (IgG) concentrations are integral to the workup of immune deficiencies and IgG4-related disease (IgG4-RD). Demographic differences in IgG concentrations are poorly described but can influence test interpretation, contribute to racial disparities in primary immunodeficiency diagnosis, and explain demographic differences in IgG concentrations in IgG4-RD. OBJECTIVE: To assess differences in IgG and IgG subclass concentrations according to sex and race. METHODS: We identified patients with IgG and IgG subclass concentrations measured in a large health care system. Multivariate-adjusted differences in IgG and IgG subclass concentrations and the proportion of subjects with results outside of reference ranges according to sex and race were estimated. RESULTS: Of the 12,851 patients, the mean age was 54.7 years and 7917 (62%) were female. Of these, 11,673 (91%) were white, 611 (5%) were black, and 302 (2%) were Asian. Compared with the mean concentrations of white patients, Asian and black patients had higher mean concentrations of IgG (1340.0 and 1504.4 vs 988.1 mg/dL, P < .001), IgG1 (782.0 and 938.4 vs 592.4 mg/dL, P < .001), IgG2 (493.5 and 384.2 vs 305 mg/dL, P < .001), IgG3 (76.6 and 91.9 vs 55.9 mg/dL, P < .001), and IgG4 (140.4 and 53.6 vs 41.6 mg/dL, P < .001). Immunoglobin G subclass 4 concentrations were higher in males than those in females (56.3 vs 37.4 mg/dL, P < .001). Similar observations were made when comparing the proportions of patients with results outside of reference ranges and after stratifying by diagnosis. CONCLUSION: Immunoglobin G and IgG subclass concentrations differ according to sex and race. These findings may have implications for the interpretation of these test results but require confirmation in diverse, healthy populations.
Authors: L A Hanson; R Söderström; A Avanzini; U Bengtsson; J Björkander; T Söderström Journal: Pediatr Infect Dis J Date: 1988-05 Impact factor: 2.129
Authors: Francisco A Bonilla; David A Khan; Zuhair K Ballas; Javier Chinen; Michael M Frank; Joyce T Hsu; Michael Keller; Lisa J Kobrynski; Hirsh D Komarow; Bruce Mazer; Robert P Nelson; Jordan S Orange; John M Routes; William T Shearer; Ricardo U Sorensen; James W Verbsky; David I Bernstein; Joann Blessing-Moore; David Lang; Richard A Nicklas; John Oppenheimer; Jay M Portnoy; Christopher R Randolph; Diane Schuller; Sheldon L Spector; Stephen Tilles; Dana Wallace Journal: J Allergy Clin Immunol Date: 2015-09-12 Impact factor: 10.793
Authors: Juan C Zambrano; Holliday T Carper; Gary P Rakes; James Patrie; Deborah D Murphy; Thomas A E Platts-Mills; Frederick G Hayden; Jack M Gwaltney; Tina K Hatley; Angela M Owens; Peter W Heymann Journal: J Allergy Clin Immunol Date: 2003-05 Impact factor: 10.793
Authors: Morgan E Grams; Kunihiro Matsushita; Yingying Sang; Michelle M Estrella; Meredith C Foster; Adrienne Tin; W H Linda Kao; Josef Coresh Journal: J Am Soc Nephrol Date: 2014-04-10 Impact factor: 10.121
Authors: Iana H Haralambieva; Hannah M Salk; Nathaniel D Lambert; Inna G Ovsyannikova; Richard B Kennedy; Nathaniel D Warner; V Shane Pankratz; Gregory A Poland Journal: Vaccine Date: 2014-02-13 Impact factor: 3.641
Authors: Verena Endmayr; Cansu Tunc; Lara Ergin; Anna De Rosa; Rosa Weng; Lukas Wagner; Thin-Yau Yu; Andreas Fichtenbaum; Thomas Perkmann; Helmuth Haslacher; Nicolas Kozakowski; Carmen Schwaiger; Gerda Ricken; Simon Hametner; Sigrid Klotz; Lívia Almeida Dutra; Christian Lechner; Désirée de Simoni; Kai-Nicolas Poppert; Georg Johannes Müller; Susanne Pirker; Walter Pirker; Aleksandra Angelovski; Matus Valach; Michelangelo Maestri; Melania Guida; Roberta Ricciardi; Florian Frommlet; Daniela Sieghart; Miklos Pinter; Karl Kircher; Gottfried Artacker; Romana Höftberger; Inga Koneczny Journal: Front Immunol Date: 2022-01-14 Impact factor: 7.561