Damianaki Anthie, Marmarinos Antonios, Avgeris Margaritis, Gourgiotis Dimitrios, Vlachopapadopoulou Elpis-Athina, Charakida Marietta, Tsolia Maria, Kossiva Lydia
Second Department of Pediatrics, School of Medicine, National and Kapodistrian University of Athens, Children's Hospital P. and A. Kyriakou, 115 27 Athens, Greece.
Laboratory of Clinical Biochemistry-Molecular Diagnostics, Second Department of Pediatrics, School of Medicine, National and Kapodistrian University of Athens, Children's Hospital P. and A. Kyriakou, 115 27 Athens, Greece.
Diseases. 2025 Mar 10;13(3):78. doi: 10.3390/diseases13030078.
The aim of this study was to evaluate whether increased body mass index (BMI) and biochemical and lifestyle parameters linked to obesity and smoke exposure disrupt immune responses of children and adolescents following vaccination with the mRNA BNT162b2 vaccine.
A prospective, single-center, cohort study was conducted. Participants were assigned to receive two doses of the mRNA vaccine. Anti-SARS-CoV-2 IgG and neutralizing antibodies (AB) were measured before vaccination (T0) and 14 days after the second dose (T1). BMI and biochemical parameters were evaluated at T0. A questionnaire on lifestyle characteristics was filled in.
IgG optical density (OD) ratio at T1 was lower in the overweight-obese group regardless of COVID-19 disease positive history [ = 0.028 for the seronegative group, = 0.032 for the seropositive group]. Neutralizing AB were lower in overweight-obese participants in the seronegative group at T1 [ = 0.008]. HDL, fasting glucose/insulin ratio (FGIR), C-reactive protein (CRP), HBA1c, uric acid, and smoke exposure were significantly correlated with BMI [ = 0.006, < 0.001, < 0.001, = 0.006, = 0.009, < 0.001, respectively]. The main biochemical parameters that were inversely correlated with IgG and neutralizing AB titers at T1 were uric acid [ = 0.018, = 0.002], FGIR [ = 0.001, = 0.008] and HBA1C [ = 0.027, = 0.038], while smoke exposure negatively affected the humoral immune responses at T0 in the convalescent group [ = 0.004, = 0.005].
Current data suggests that uric acid, insulin resistance (IR), and smoke exposure could adversely affect the immune responses in overweight-obese vaccinated children, highlighting the need for actions to enhance the protection of this particular subgroup.
本研究的目的是评估体重指数（BMI）增加以及与肥胖和接触烟雾相关的生化和生活方式参数是否会破坏儿童和青少年接种mRNA BNT162b2疫苗后的免疫反应。
进行了一项前瞻性、单中心队列研究。参与者被分配接受两剂mRNA疫苗。在接种疫苗前（T0）和第二剂接种后14天（T1）测量抗SARS-CoV-2 IgG和中和抗体（AB）。在T0评估BMI和生化参数。填写一份关于生活方式特征的问卷。
无论COVID-19疾病阳性史如何，超重肥胖组在T1时的IgG光密度（OD）比值较低[血清阴性组P = 0.028，血清阳性组P = 0.032]。血清阴性组中，超重肥胖参与者在T1时的中和AB较低[P = 0.008]。高密度脂蛋白（HDL）、空腹血糖/胰岛素比值（FGIR）、C反应蛋白（CRP）、糖化血红蛋白（HBA1c）、尿酸和接触烟雾与BMI显著相关[分别为P = 0.006、P < 0.001、P < 0.001、P = 0.006、P = 0.009、P < 0.001]。在T1时与IgG和中和AB滴度呈负相关的主要生化参数是尿酸[P = 0.018、P = 0.002]、FGIR[P = 0.001、P = 0.008]和HBA1C[P = 0.027、P = 0.038]，而在恢复期组中，接触烟雾在T0时对体液免疫反应有负面影响[P = 0.004、P = 0.005]。
目前的数据表明，尿酸、胰岛素抵抗（IR）和接触烟雾可能会对超重肥胖的接种疫苗儿童的免疫反应产生不利影响，突出了采取行动加强对这一特定亚组保护的必要性。
