肥胖与老年人对流感疫苗接种的脆弱性和血清学反应之间的关系。
Association between obesity and vulnerability and serologic response to influenza vaccination in older adults.
机构信息
Vanderbilt University, Nashville, TN.
Marshfield Clinic Research Foundation, Marshfield, WI.
出版信息
Vaccine. 2012 Jun 6;30(26):3937-3943. doi: 10.1016/j.vaccine.2012.03.071. Epub 2012 Apr 3.
BACKGROUND
Serologic response to influenza vaccination declines with age. Few other host factors are known to be associated with serologic response. Our objective was to determine whether obesity and vulnerability independently predicted serologic response to influenza vaccination.
METHODS
Adults ≥ 50 years were recruited during the 2008-2009 influenza season. Subjects provided pre- and post-vaccination sera for measuring antibody titers to 2008-2009 vaccine components. Body mass index (BMI) was calculated as weight (kg)/height (m(2)). Data were collected on vulnerability using the vulnerable elders survey (VES13). Logistic regression evaluated the associations between obesity and vulnerability and the serologic response to vaccination (both seroprotection and seroconversion), adjusting for gender, age, comorbidities, pre-vaccination titer, and site.
RESULTS
Mean (± standard deviation) age of 415 study subjects was 65 ± 10 years; 40% were obese. Mean BMI was 29 ± 5.6 kg/m(2); mean VES13 was 1.6 ± 1.8. The proportions of subjects who seroconverted and had seroprotective titers were 40% and 49%, respectively, for A/Brisbane/59 (H1N1); 73% and 80% for A/Brisbane/10 (H3N2); and 34% and 94% for B/Florida. Modified VES-13 (score 0-10, with 10 being most vulnerable) was not associated with seroprotection against H1N1 or H3N2, and VES-13 was directly associated with seroconversion to H1N1 but not H3N2 or B. Obesity (BMI ≥ 30 kg/m(2) vs. BMI 18.5-30 kg/m(2)) was not associated with seroprotection for H1N1 or H3N2; obesity was directly associated with seroconversion to H3N2 but not H1N1 or B. Age was inversely associated with seroprotection and seroconversion against H1N1 and with seroconversion to influenza B.
CONCLUSION
Based on this sample of older healthy subjects, there were no consistent relationships between VES 13 or obesity and either seroprotection or seroconversion to three influenza vaccine antigens.
背景
流感疫苗接种后的血清学反应随年龄增长而下降。目前已知的其他宿主因素与血清学反应有关。我们的目的是确定肥胖和脆弱性是否独立预测流感疫苗接种的血清学反应。
方法
在 2008-2009 年流感季节期间招募了年龄在 50 岁及以上的成年人。受试者在接种疫苗前后提供血清，以测量针对 2008-2009 年疫苗成分的抗体滴度。体重指数（BMI）按体重（kg）/身高（m(2)）计算。使用脆弱性老人调查（VES13）收集脆弱性数据。使用 logistic 回归评估肥胖和脆弱性与接种疫苗后的血清学反应（血清保护和血清转化）之间的关系，调整性别、年龄、合并症、接种前滴度和地点。
结果
415 名研究对象的平均（±标准差）年龄为 65 ± 10 岁，40%为肥胖。平均 BMI 为 29 ± 5.6 kg/m(2)；平均 VES13 为 1.6 ± 1.8。血清转化率和血清保护率分别为 A/Brisbane/59（H1N1）的 40%和 49%，A/Brisbane/10（H3N2）的 73%和 80%，B/Florida 的 34%和 94%。改良的 VES-13（得分 0-10，10 为最脆弱）与 H1N1 或 H3N2 的血清保护无关，而 VES-13 与 H1N1 但与 H3N2 或 B 的血清转化直接相关。肥胖（BMI ≥ 30 kg/m(2) 与 BMI 18.5-30 kg/m(2)）与 H1N1 或 H3N2 的血清保护无关；肥胖与 H3N2 的血清转化直接相关，但与 H1N1 或 B 无关。年龄与 H1N1 和 B 型流感的血清保护和血清转化呈负相关。
结论
根据这项针对老年健康受试者的样本研究，VES13 或肥胖与三种流感疫苗抗原的血清保护或血清转化之间没有一致的关系。
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