肥胖、高脂血症、饮食摄入和体力活动对 I 型与 IV 型过敏的差异影响。

BACKGROUND: Alongside metabolic diseases (esp. obesity), allergic disorders are becoming increasingly prevalent. Since both obesity and allergies are highly impacted by environmental determinants, with this study we assessed the potential link between metabolic implications and two distinct types of allergies. METHODS: Using cross-sectional data from the German FoCus cohort, = 385 allergy cases, either hay fever (=type I allergy, = 183) or contact allergy (=type IV allergy, = 202) were compared to age- and sex-matched healthy control subjects (1:1 ratio, in total = 770) regarding their metabolic phenotype, diet, physical activity, sleep, gut microbial composition, and serum metabolite profile using suitable BMI-adjusted models. RESULTS: Obesity and metabolic alterations were found significantly more prevalent in subjects with allergies. In fact, this relation was more pronounced in contact allergy than hay fever. Subsequent BMI-adjusted analysis reveals particular importance of co-occurring hyperlipidaemia for both allergy types. For contact allergy, we revealed a strong association to the dietary intake of poly-unsaturated fatty acids, particularly α-linolenic acid, as well as the enrichment of the corresponding metabolic pathway. For hay fever, there were no major associations to the diet but to a lower physical activity level, shorter duration of sleep, and an altered gut microbial composition. Finally, genetic predisposition for hyperlipidaemia was associated to both contact allergy and hay fever. CONCLUSIONS: Reflected by higher allergy prevalence, our findings indicate an impaired immune response in obesity and hyperlipidaemia, which is differentially regulated in type I and type IV allergies by an unfavourable lifestyle constellation and subsequent microbial and metabolic dysfunctions.

背景：随着代谢性疾病（尤其是肥胖症）的增加，过敏症也越来越普遍。由于肥胖症和过敏症都受到环境决定因素的严重影响，因此本研究评估了代谢影响与两种不同类型过敏症之间的潜在联系。

方法：利用德国 FoCus 队列的横断面数据，将 385 例过敏病例（花粉热[即 I 型过敏，n=183]或接触过敏[n=202]）与年龄和性别匹配的健康对照者（1:1 比例，共 770 例）进行比较，评估其代谢表型、饮食、身体活动、睡眠、肠道微生物组成和血清代谢物谱，使用合适的 BMI 调整模型。

结果：在过敏症患者中，肥胖症和代谢改变的发生率明显更高。实际上，这种关联在接触过敏症中比花粉热更为明显。随后的 BMI 调整分析表明，高脂血症的共同发生对两种过敏类型都具有特别重要的意义。对于接触过敏症，我们发现与多不饱和脂肪酸（尤其是α-亚麻酸）的饮食摄入以及相应代谢途径的富集有很强的关联。对于花粉热，饮食没有主要关联，但与较低的身体活动水平、较短的睡眠时间和肠道微生物组成的改变有关。最后，高脂血症的遗传易感性与接触过敏症和花粉热均有关。

结论：我们的研究结果表明，肥胖症和高脂血症中存在免疫反应受损，反映在更高的过敏症患病率中，而 I 型和 IV 型过敏症的免疫反应则通过不良的生活方式和随后的微生物及代谢功能障碍而呈现出不同的调节方式。