Mai Xiao-Mei, Böttcher Malin F, Leijon Ingemar
Department of Molecular and Clinical Medicine, Division of Pediatrics, Linköping University, Linköping, Sweden.
Pediatr Allergy Immunol. 2004 Dec;15(6):523-30. doi: 10.1111/j.1399-3038.2004.00195.x.
Obesity is suggested as a risk factor for asthma, but the mechanisms are unclear. The relationship between obesity and asthma has not been considered in children born with very low-birth weight (VLBW). We hypothesized that overweight was a contributing factor for asthma in VLBW children, and that leptin and leptin-associated cytokines might play roles in overweight-related asthma. Seventy-four VLBW and 64 normal birth weight (NBW) children participated in a 12-yr follow up study assessing asthma and allergy. Twenty-seven (12 VLBW) of the 138 children were overweight according to the proposed international definition. The diagnosis of current asthma was made by a pediatrician. Serum levels of leptin and interferon (IFN)-gamma were analyzed by enzyme-linked immunosorbent assay (ELISA). Leptin levels were considerably higher in the overweight than in the non-overweight children (median value: 18.1 vs. 2.8 ng/ml, p < 0.001). In the overweight children, current asthmatics had twice as high levels of leptin as children without current asthma (median value: 30.8 vs. 14.3 ng/ml, p = 0.14), but this was not the case in the non-overweight children. IFN-gamma was more often detected in the overweight than in the non-overweight children (61% vs. 12%, p < 0.001), and there was a positive correlation between the levels of leptin and the levels of IFN-gamma (Rho = 0.40, p < 0.001). In the VLBW group, the overweight children had a significantly increased risk for current asthma compared with the non-overweight children after adjustment for the neonatal risk factors [adjusted odds ratio (OR) 5.8, 95% confidence interval (CI): 1.2-27]. Thus, overweight was associated with asthma in the VLBW children. Our hypothesis remained that leptin might be involved in the pathogenesis of asthma in the overweight children, and IFN-gamma might be a pathway in the process of leptin-induced inflammation.
肥胖被认为是哮喘的一个危险因素，但其机制尚不清楚。极低出生体重（VLBW）儿中肥胖与哮喘的关系尚未得到研究。我们假设超重是VLBW儿童患哮喘的一个促成因素，并且瘦素和瘦素相关细胞因子可能在超重相关哮喘中发挥作用。74名VLBW儿童和64名正常出生体重（NBW）儿童参与了一项为期12年的随访研究，评估哮喘和过敏情况。根据提议的国际定义，138名儿童中有27名（12名VLBW儿童）超重。由儿科医生做出当前哮喘的诊断。通过酶联免疫吸附测定（ELISA）分析血清瘦素和干扰素（IFN）-γ水平。超重儿童的瘦素水平显著高于非超重儿童（中位数：18.1对2.8 ng/ml，p<0.001）。在超重儿童中，当前哮喘患者的瘦素水平是无当前哮喘儿童的两倍（中位数：30.8对14.3 ng/ml，p = 0.14），但在非超重儿童中并非如此。超重儿童中IFN-γ的检测频率高于非超重儿童（61%对12%，p<0.001），并且瘦素水平与IFN-γ水平之间存在正相关（Rho = 0.40，p<0.001）。在VLBW组中，在对新生儿危险因素进行调整后，超重儿童患当前哮喘的风险显著高于非超重儿童[调整后的优势比（OR）5.8，95%置信区间（CI）：1.2 - 27]。因此，超重与VLBW儿童的哮喘有关。我们的假设仍然是，瘦素可能参与超重儿童哮喘的发病机制，而IFN-γ可能是瘦素诱导炎症过程中的一条途径。
