Division of Endocrinology, Metabolism and Diabetes, Istanbul University-Cerrahpaşa, Cerrahpaşa Medical Faculty, Istanbul, Turkey.
European Association for the Study of Obesity-Collaborating Center for Obesity Management, Istanbul, Turkey.
Obes Facts. 2023;16(4):374-380. doi: 10.1159/000530315. Epub 2023 May 25.
Obesity and aging negatively affect the immune system and host defense mechanisms, increasing vulnerability to and worsening prognosis of infectious diseases, leading to vaccine failure. Our aim was to investigate the antibody response against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) spike antigens and the risk factors affecting antibody levels in elderly patients living with obesity (PwO) after inactive SARS-CoV-2 vaccine (CoronaVac) administration.
One hundred twenty-three consecutive elderly patients with obesity (age ≥65 years, body mass index [BMI] ≥30 kg/m2) and 47 adults with obesity (age 18-64 years, BMI ≥30 kg/m2) admitted between August and November 2021 were enrolled. Seventy-five nonobese elderly people (age ≥65 years, BMI 18.5-29.9 kg/m2) and 105 nonobese adults (age 18-64 years, BMI 18.5-29.9 kg/m2) were recruited from subjects who visited the Vaccination Unit. SARS-CoV-2 spike protein antibody titers were measured in patients with obesity and nonobese controls who received two doses of CoronaVac.
SARS-CoV-2 levels of patients with obesity were found to be significantly lower than those of nonobese elderly individuals who had non-prior infection. There was no difference in SARS-CoV-2 levels between patients with obesity and nonobese individuals with prior infection. Age and SARS-CoV-2 level were found to be highly correlated in the correlation analysis in the group of elderly individuals (r: -0.184). In multivariate regression analysis, when SARS-CoV-2 immunoglobulin class G (IgG) was regressed on age, sex, BMI, type 2 diabetes mellitus, and hypertension (HT), HT was found to be an independent factor of the SARS-CoV-2 level (β: -2,730).
In the non-prior infection group, elderly patients with obesity generated significantly reduced antibody titers against SARS-CoV-2 spike antigen after CoronaVac vaccine compared to nonobese people. It is anticipated that the results obtained will provide invaluable information about SARS-CoV-2 vaccination strategies in this vulnerable population. Antibody titers may be measured, and booster doses should be delivered accordingly in elderly PwO for optimal protection.
肥胖和衰老会对免疫系统和宿主防御机制产生负面影响，增加感染性疾病的易感性和预后恶化风险，导致疫苗失效。我们的目的是研究肥胖患者（BMI≥30kg/m2）接种灭活的 SARS-CoV-2 疫苗（科兴疫苗）后针对严重急性呼吸综合征冠状病毒 2 （SARS-CoV-2）刺突抗原的抗体反应，以及影响抗体水平的危险因素。
2021 年 8 月至 11 月期间，我们纳入了 123 例连续的肥胖老年患者（年龄≥65 岁，BMI≥30kg/m2）和 47 例肥胖成年人（年龄 18-64 岁，BMI≥30kg/m2）。我们还招募了 75 例非肥胖老年患者（年龄≥65 岁，BMI 18.5-29.9kg/m2）和 105 例非肥胖成年患者（年龄 18-64 岁，BMI 18.5-29.9kg/m2）作为对照组。肥胖患者和非肥胖对照组在接种两剂科兴疫苗后，测量 SARS-CoV-2 刺突蛋白抗体滴度。
与无既往感染的非肥胖老年个体相比，肥胖患者的 SARS-CoV-2 水平明显较低。肥胖患者和有既往感染的非肥胖个体之间的 SARS-CoV-2 水平没有差异。在老年人群的相关性分析中，年龄和 SARS-CoV-2 水平高度相关（r：-0.184）。在多元回归分析中，当 SARS-CoV-2 免疫球蛋白 G（IgG）回归年龄、性别、BMI、2 型糖尿病和高血压（HT）时，HT 是 SARS-CoV-2 水平的独立因素（β：-2730）。
在无既往感染组中，与非肥胖人群相比，肥胖患者接种科兴疫苗后针对 SARS-CoV-2 刺突抗原的抗体滴度显著降低。预计这些结果将为这一脆弱人群的 SARS-CoV-2 疫苗接种策略提供宝贵信息。应该测量抗体滴度，并在肥胖的老年 PwO 中相应地给予加强剂量，以获得最佳保护。
