Youssef Doaa Mohammed, Elbehidy Rabab Mohamed, Shokry Dina Mahamoud, Elbehidy Eman Mohamed
Zagazig University, Cairo, Egypt.
J Bras Pneumol. 2013 Sep-Oct;39(5):562-8. doi: 10.1590/S1806-37132013000500006.
In individuals with asthma, obesity induces the production of leptin and is associated with disease severity. Our objective was to evaluate the levels of serum leptin and their effect on Th1/Th2 balance in obese and non-obese children with asthma, as well as to investigate the association between serum leptin levels and clinical outcomes.
We evaluated 50 atopic children with physician-diagnosed moderate-to-severe persistent asthma and 20 controls. The children with asthma were divided into two groups, by body mass index percentile: obese (n = 25) and non-obese (n = 25). From all subjects, we collected peripheral blood samples in order to determine the levels of leptin, IFN-γ, and IL-4. Asthma severity was assessed by an asthma symptom score, and the results were correlated with the parameters studied.
Serum leptin levels were significantly higher in the obese asthma group than in the non-obese asthma group, as well as being significantly higher in the children with asthma than in the controls, whereas IFN-γ levels were significantly higher and IL-4 levels were significantly lower in the obese asthma group than in the non-obese asthma group. In addition, the obese asthma group showed higher asthma symptom scores and significantly lower FEV1 (% of predicted) than did the non-obese asthma group. There was a significant positive correlation between leptin and IFN-γ levels only in the obese asthma group.
Although leptin is involved in the pathogenesis of asthma in obese and non-obese children, its effect is more pronounced in the former. In the presence of high leptin levels, only obese children with asthma exhibited Th1 polarization, with higher IFN-γ levels and greater asthma severity.
在哮喘患者中，肥胖会诱导瘦素的产生，并与疾病严重程度相关。我们的目的是评估肥胖和非肥胖哮喘儿童的血清瘦素水平及其对Th1/Th2平衡的影响，并研究血清瘦素水平与临床结局之间的关联。
我们评估了50名经医生诊断为中度至重度持续性哮喘的特应性儿童和20名对照。哮喘儿童根据体重指数百分位数分为两组：肥胖组（n = 25）和非肥胖组（n = 25）。我们从所有受试者中采集外周血样本，以测定瘦素、IFN-γ和IL-4的水平。通过哮喘症状评分评估哮喘严重程度，并将结果与所研究的参数进行关联。
肥胖哮喘组的血清瘦素水平显著高于非肥胖哮喘组，哮喘儿童的血清瘦素水平也显著高于对照组；而肥胖哮喘组的IFN-γ水平显著高于非肥胖哮喘组，IL-4水平显著低于非肥胖哮喘组。此外，肥胖哮喘组的哮喘症状评分更高，FEV1（预测值的百分比）显著低于非肥胖哮喘组。仅在肥胖哮喘组中，瘦素与IFN-γ水平之间存在显著正相关。
尽管瘦素参与肥胖和非肥胖儿童哮喘的发病机制，但其在前者中的作用更为明显。在瘦素水平较高的情况下，只有肥胖哮喘儿童表现出Th1极化，IFN-γ水平更高，哮喘严重程度更大。
