Ann Allergy Asthma Immunol. 2026 Apr 3:S1081-1206(26)00147-X. doi: 10.1016/j.anai.2026.03.025. Online ahead of print.
ABSTRACT
BACKGROUND: Population-based studies have identified an association between milk-specific IgE and cardiovascular (CV) mortality. However, whether this sensitization reflects broader cardiovascular risk or adverse clinical outcomes remains unknown.
OBJECTIVE: To examine associations between milk-specific IgE sensitization and CVD events and risk enhancers, including coronary artery calcium (CAC).
METHODS: We performed a retrospective chart review of adults ≥50 years within a multi-hospital health system. Patients with serum food-specific IgE testing were classified as milk-IgE negative (<0.10 kU/L), borderline (0.10-0.35 kU/L), or sensitized (>0.35 kU/L). Individuals with clinically confirmed milk allergy were excluded. Outcomes included myocardial infarction, cerebrovascular accident, coronary artery disease, and CAC, ascertained from electronic medical records using CPT/ICD codes and imaging reports (2012-2024). Analyses used χ²/Wilcoxon tests and multivariable models adjusting for demographics and comorbidities.
RESULTS: Among 1,220 patients (mean age 64.4 years; 63.6% female), 113 (9.3%) were milk-IgE sensitized. Cardiovascular events did not differ by milk sensitization status. LDL-P was higher in elevated milk IgE (p<.001); associations with LDL particle metrics were inconsistent, likely reflecting limited NMR testing (n=122). High-sensitivity CRP was not associated with milk sensitization. In a CAC-subsample (n=104), median CAC was higher with milk sensitization versus negative milk IgE (885.8 vs 145.2 Agatston units; p<.0001) CONCLUSION: Milk-specific IgE sensitization was not associated with increased clinical CVD events or systemic inflammatory markers. There was a dose-dependent relationship between milk-specific IgE and CAC in a small subset that may be explained by calcified, potentially more stable plaque biology. Prospective studies should evaluate temporality and mechanisms and clarify clinical implications.
PMID:41936963 | DOI:10.1016/j.anai.2026.03.025