Guler Nermin, Kirerleri Emel, Ones Ulker, Tamay Zeynep, Salmayenli Nihal, Darendeliler Feyza
Department of Pediatrics, Division of Allergy and Chest Diseases, Istanbul Medical Faculty, Turkey.
J Allergy Clin Immunol. 2004 Aug;114(2):254-9. doi: 10.1016/j.jaci.2004.03.053.
Although there is evidence of a positive association between asthma and obesity in adults and children, very little is known about the role of leptin in asthmatic children.
The aims of this study were to evaluate the relation between leptin and parameters of atopy and asthma in children.
Body mass index (BMI) and serum leptin levels were measured in 102 (37 female, 65 male; mean age, 5.9 +/- 3.4 years) asthmatic and 33 (14 female, 19 male; mean age, 6.1 +/- 3.4 years) healthy children. Skin prick tests, total serum IgE, and pulmonary function tests were performed and were completed.
A significant difference was observed in serum leptin levels between asthmatic and healthy children. Median (interquartile range) levels were 3.53 (2.06-7.24) ng/mL and 2.26 (1.26-4.71) ng/mL, respectively (P=.008). Subgroup analysis revealed that this difference in leptin levels was confined entirely to boys: 3.09 (1.99-7.51) ng/mL in boys with asthma versus 1.52 (1.06-3.17) ng/mL in boys without asthma (P=.003). By logistic regression analysis, we found that leptin was a predictive factor for having asthma (odds ratio, 1.98; CI, 1.10-3.55; P=.021), whereas sex, age, or BMI were not. In a stepwise multiple regression analysis including sex (P=.001), age (P=.016), BMI (P <.001), and asthma (P=.022), all of these variables were found to affect log leptin levels (R2=0.404). There was no significant sex difference in serum leptin levels among asthmatic children, whereas healthy boys had significantly lower leptin levels than healthy girls (P=.019). Atopic asthmatic subjects had significantly higher leptin levels than nonatopic asthmatic subjects (P=.038) with similar BMI. A significant, but weak, correlation was observed between leptin levels and IgE in the overall group of asthmatic children (r=0.231; P=.019). Again, this correlation was confined entirely to boys (r=0.319; P=.010). There was no relation between leptin levels and skin prick tests, pulmonary function tests, passive smoking, birth weight, and duration of breast-feeding.
Our findings suggest that leptin may play a role in atopic asthma. High serum leptin levels in asthmatic boys may partly explain the higher prevalence of childhood asthma in male sex.
尽管有证据表明成人和儿童哮喘与肥胖之间存在正相关，但关于瘦素在哮喘儿童中的作用知之甚少。
本研究旨在评估瘦素与儿童特应性和哮喘参数之间的关系。
测量了102名（37名女性，65名男性；平均年龄5.9±3.4岁）哮喘儿童和33名（14名女性，19名男性；平均年龄6.1±3.4岁）健康儿童的体重指数（BMI）和血清瘦素水平。进行了皮肤点刺试验、总血清IgE和肺功能测试并完成。
哮喘儿童和健康儿童的血清瘦素水平存在显著差异。中位数（四分位间距）水平分别为3.53（2.06 - 7.24）ng/mL和2.26（1.26 - 4.71）ng/mL（P = 0.008）。亚组分析显示，瘦素水平的这种差异完全局限于男孩：哮喘男孩为3.09（1.99 - 7.51）ng/mL，无哮喘男孩为1.52（1.06 - 3.17）ng/mL（P = 0.003）。通过逻辑回归分析，我们发现瘦素是患哮喘的预测因素（比值比，1.98；CI，1.10 - 3.55；P = 0.021），而性别、年龄或BMI不是。在包括性别（P = 0.001）、年龄（P = 0.016）、BMI（P < 0.001）和哮喘（P = 0.022）的逐步多元回归分析中，发现所有这些变量均影响瘦素水平对数（R2 = 0.404）。哮喘儿童血清瘦素水平无显著性别差异，而健康男孩的瘦素水平显著低于健康女孩（P = 0.019）。特应性哮喘患者的瘦素水平显著高于非特应性哮喘患者（P = 0.038），BMI相似。在整个哮喘儿童组中，瘦素水平与IgE之间存在显著但较弱的相关性（r = 0.231；P = 0.019）。同样，这种相关性完全局限于男孩（r = 0.319；P = 0.010）。瘦素水平与皮肤点刺试验、肺功能测试、被动吸烟、出生体重和母乳喂养持续时间之间无关联。
我们的研究结果表明瘦素可能在特应性哮喘中起作用。哮喘男孩血清瘦素水平高可能部分解释了儿童哮喘在男性中患病率较高的原因。
