血清免疫球蛋白水平的决定因素：系统评价和荟萃分析。
Determinants of Serum Immunoglobulin Levels: A Systematic Review and Meta-Analysis.
机构信息
Department of Epidemiology, Erasmus University Medical Center, Rotterdam, Netherlands.
Department of Internal Medicine, Division of Clinical Immunology, Erasmus University Medical Center, Rotterdam, Netherlands.
出版信息
Front Immunol. 2021 Apr 7;12:664526. doi: 10.3389/fimmu.2021.664526. eCollection 2021.
BACKGROUND
An up-to-date overview of determinants of serum immunoglobulins in adults is pivotal for clinical practice and research, but currently lacking. We therefore performed a systematic review and meta-analysis to identify determinants of serum immunoglobulin levels.
METHODS
Embase, Web of Science, Medline, Cochrane, and Google Scholar were searched from inception to July 11, 2019 for articles reporting on determinants of serum immunoglobulin A, G or M (IgA, IgG or IgM) in adult humans. Random and fixed effect models were applied to obtain pooled mean differences (MDs) and 95% confidence intervals (CIs) for the association of age and sex with serum immunoglobulins.
RESULTS
We retrieved 117 articles reporting on determinants of serum immunoglobulins, of which 28 could be meta-analyzed. Older compared to younger individuals had higher IgA (MD: 0.38; CI: 0.18 - 0.58), but lower IgM levels (MD: -0.40; 95%: -0.66 - -0.14). Men had higher IgA (MD: 0.22; CI: 0.03 - 0.42), but lower IgM levels (MD: -0.21; CI: -0.32 - -0.10) than women. Age and sex did not influence IgG. Caucasian ethnicity was associated with lower IgA, IgG, and IgM. Smoking and corticosteroid use were associated with lower IgG. Positive associations were reported of probiotics with IgG, alcohol with IgA, hypertension with IgA and IgG, and acute psychological stress with IgA, IgG, and IgM.
CONCLUSIONS
Older age and male sex are associated with higher IgA, but lower IgM, and urge investigation of age- and sex-specific reference ranges of immunoglobulins. Other identified determinants were ethnicity, diet, lifestyle and cardio-metabolic factors.
背景
成人血清免疫球蛋白决定因素的最新概述对临床实践和研究至关重要，但目前仍缺乏相关信息。因此，我们进行了系统综述和荟萃分析，以确定血清免疫球蛋白水平的决定因素。
方法
从建库至 2019 年 7 月 11 日，我们在 Embase、Web of Science、Medline、Cochrane 和 Google Scholar 中搜索了关于成人血清免疫球蛋白 A、G 或 M（IgA、IgG 或 IgM）决定因素的文章。应用随机和固定效应模型来获得年龄和性别与血清免疫球蛋白之间关联的汇总平均差异（MD）和 95%置信区间（CI）。
结果
我们检索到 117 篇关于血清免疫球蛋白决定因素的文章，其中 28 篇可以进行荟萃分析。与年轻个体相比，老年人的 IgA 水平更高（MD：0.38；CI：0.18-0.58），但 IgM 水平更低（MD：-0.40；95%：-0.66-0.14）。男性的 IgA 水平更高（MD：0.22；CI：0.03-0.42），但 IgM 水平更低（MD：-0.21；CI：-0.32-0.10）。年龄和性别不影响 IgG。白种人种族与较低的 IgA、IgG 和 IgM 相关。吸烟和皮质类固醇的使用与 IgG 降低相关。益生菌与 IgG、酒精与 IgA、高血压与 IgA 和 IgG、急性心理应激与 IgA、IgG 和 IgM 之间存在正相关关系。
结论
年龄较大和男性与较高的 IgA 但较低的 IgM 相关，提示需要对免疫球蛋白的年龄和性别特异性参考范围进行进一步研究。其他确定的决定因素包括种族、饮食、生活方式和心血管代谢因素。
Zotero 插件