Li Chaojie, Guo Ruixiang, Liu Yanyan, Zhang Yijing, Yang Yan, Ni Shoujie, Sun Xiaojing, Liu Huayang, Zhao Zehua, Li Yanzhong, Zou Juanjuan, Wang Yan, Lei Dapeng
Department of Otorhinolaryngology, NHC Key Laboratory of Otorhinolaryngology, Qilu Hospital of Shandong University, Shandong University, Jinan, 250012, China.
Department of Clinical Laboratory, Qilu Hospital of Shandong University, Jinan, 250012, China.
Eur Arch Otorhinolaryngol. 2025 Jan;282(1):457-466. doi: 10.1007/s00405-024-08941-1. Epub 2024 Sep 1.
Obesity is commonly linked to both adenotonsillar hypertrophy (ATH) and allergic disorders, in which the roles of adipokines are not fully illuminated. This study aims to investigate the levels of leptin and adiponectin and their associations with allergic sensitization in pediatric ATH.
Serum levels of specific immunoglobulin E (IgE), leptin and adiponectin were quantified in 35 controls and 111 ATH children, in which 54 were non-atopic and 57 were atopic. Spearman's correlation analysis and polynomial linear trend test were conducted. The odds ratios and 95% confidence intervals were calculated by binary logistic regression after multivariable adjustment.
The serum level of leptin and leptin/adiponectin (L/A) ratio was significantly increased in children with ATH. An increase in leptin level and L/A ratio and a decrease in adiponectin level were observed in atopic children compared with non-atopic children. Among ATH children, the level of adiponectin was negatively while L/A ratio was positively correlated with specific IgE. After multivariable adjustment, leptin was significantly associated with increased risk of atopy to D. pteronyssinus and D. farina, and adiponectin was significantly associated with decreased risk of atopy to willow and mugwort. Leptin was associated with higher odds while adiponectin was associated with lower odds of overall atopy. Besides, significant multiplicative interactions of obesity with leptin and adiponectin on atopy were observed respectively.
Leptin and adiponectin were both associated with allergic sensitization and function differently in pediatric ATH. Mechanistic studies are needed to elucidate the involvement of adipokines in allergic sensitization of pediatric ATH.
肥胖通常与腺样体扁桃体肥大（ATH）和过敏性疾病相关，其中脂肪因子的作用尚未完全阐明。本研究旨在调查小儿ATH患者中瘦素和脂联素水平及其与过敏致敏的关系。
对35名对照儿童和111名ATH儿童的血清特异性免疫球蛋白E（IgE）、瘦素和脂联素水平进行定量检测，其中54名儿童为非特应性，57名儿童为特应性。进行Spearman相关性分析和多项式线性趋势检验。多变量调整后，通过二元逻辑回归计算比值比和95%置信区间。
ATH儿童的血清瘦素水平和瘦素/脂联素（L/A）比值显著升高。与非特应性儿童相比，特应性儿童的瘦素水平和L/A比值升高，脂联素水平降低。在ATH儿童中，脂联素水平与特异性IgE呈负相关，而L/A比值与特异性IgE呈正相关。多变量调整后，瘦素与对尘螨和粉螨过敏的风险增加显著相关，脂联素与对柳树和艾蒿过敏的风险降低显著相关。瘦素与总体过敏的较高比值相关，而脂联素与总体过敏的较低比值相关。此外，分别观察到肥胖与瘦素和脂联素在过敏方面的显著相乘交互作用。
瘦素和脂联素均与小儿ATH的过敏致敏相关，且作用不同。需要进行机制研究以阐明脂肪因子在小儿ATH过敏致敏中的作用。
