Womack Julie, Tien Phyllis C, Feldman Joseph, Shin Ja Hyun, Fennie Kristopher, Anastos Kathryn, Cohen Mardge H, Bacon Melanie C, Minkoff Howard
Yale University School of Nursing, New Haven, CT 06536-0740, USA.
Metabolism. 2007 Jul;56(7):998-1004. doi: 10.1016/j.metabol.2007.03.008.
Obesity is common in women and is associated with a number of adverse health outcomes including cardiovascular disease, infectious diseases, and cancer. We explore the relationship between obesity and immune cell counts in women in a longitudinal study of 322 women from 1999 through 2003 enrolled as HIV-negative comparators in the Women's Interagency HIV Study. Body mass index (BMI, kg/m(2)) was categorized as normal weight (BMI 18.5-24.9), overweight (BMI 25-29.9), obese (BMI 30-34.9), and morbidly obese (BMI >/=35). CD4 and CD8 counts and percents and total lymphocyte and white blood cell (WBC) counts were measured annually using standardized techniques. A mixed model repeated measures analysis was performed using an autoregressive correlation matrix. At the index visit, 61% of women were African American; mean age was 35 years, and median BMI was 29 kg/m(2). Immunologic parameters were in the reference range (median CD4 count, 995 cells/mm(3); CD8 count, 488 cells/mm(3); total lymphocyte count, 206 cells/mm(3); median WBC, 6 x 10(3) cells/mm(3)). In multivariate analyses, being overweight, obese, or morbidly obese were independently associated with higher CD4, total lymphocyte, and WBC counts than being normal weight; morbid obesity was associated with a higher CD8 count. The strongest associations between body weight and immune cell counts were demonstrated in the morbidly obese. Increasing body weight is associated with higher CD4, CD8, total lymphocyte, and WBC counts in women. Investigation into the impact of obesity on immune function and long-term adverse outcomes is needed.
肥胖在女性中很常见，并且与许多不良健康后果相关，包括心血管疾病、传染病和癌症。在一项对322名女性进行的纵向研究中，我们探讨了肥胖与免疫细胞计数之间的关系。这些女性在1999年至2003年期间作为女性机构间HIV研究中的HIV阴性对照者被纳入研究。体重指数（BMI，kg/m²）被分为正常体重（BMI 18.5 - 24.9）、超重（BMI 25 - 29.9）、肥胖（BMI 30 - 34.9）和病态肥胖（BMI≥35）。每年使用标准化技术测量CD4和CD8计数及百分比以及总淋巴细胞和白细胞（WBC）计数。使用自回归相关矩阵进行混合模型重复测量分析。在首次就诊时，61%的女性为非裔美国人；平均年龄为35岁，BMI中位数为29 kg/m²。免疫参数在参考范围内（CD4计数中位数为995个细胞/mm³；CD8计数为488个细胞/mm³；总淋巴细胞计数为206个细胞/mm³；WBC中位数为6×10³个细胞/mm³）。在多变量分析中，与正常体重相比，超重、肥胖或病态肥胖与更高的CD4、总淋巴细胞和WBC计数独立相关；病态肥胖与更高的CD8计数相关。体重与免疫细胞计数之间最强的关联在病态肥胖者中得到证实。体重增加与女性更高的CD4、CD8、总淋巴细胞和WBC计数相关。需要调查肥胖对免疫功能和长期不良后果的影响。
