Journal of Allergy Clinical and Immunology
|Volume 123, Issue 5, Pages 1163-1169.e4 (May 2009)|
Association of obesity with IgE levels and allergy symptoms in children and adolescents: Results from the National Health and Nutrition Examination Survey 2005-2006
Cynthia M. Visness, PhDab, Stephanie J. London, MD, DrPHc, Julie L. Daniels, PhDa, Jay S. Kaufman, PhDa, Karin B. Yeatts, PhDa, Anna-Maria Siega-Riz, PhDa, Andrew H. Liu, MDd, Agustin Calatroni, MA, MSb, Darryl C. Zeldin, MDc
Received 3 December 2008; accepted 19 December 2008. published online 23 February 2009.
The prevalence of both obesity and allergic disease has increased among children over the last several decades. Previous literature on the relationship between obesity and allergic disease has been inconsistent. It is not known whether systemic inflammation could be a factor in this relationship.
We sought to examine the association of obesity with total and allergen-specific IgE levels and allergy symptoms in US children and adolescents and to assess the role of C-reactive protein.
National Health and Nutrition Examination Survey data from 2005-2006 included measurement of total and allergen-specific IgE levels and allergy questions. Overweight was defined as the 85th or greater to less than the 95th percentile of body mass index for age, and obesity was defined as the 95th percentile or greater. Linear and logistic regression models were used to examine the association of weight categories with total IgE levels, atopy, allergen-specific IgE levels, and allergy symptoms among youth aged 2 to 19 years.
Geometric mean total IgE levels were higher among obese (geometric mean ratio, 1.31; 95% CI, 1.10-1.57) and overweight (ratio, 1.25; 95% CI, 1.02-1.54) children than among normal-weight children. The odds ratio (OR) for atopy (any positive specific IgE measurement) was increased in the obese children compared with that seen in those of normal weight; this association was driven largely by allergic sensitization to foods (OR for atopy, 1.26 [95% CI, 1.03-1.55]; OR for food sensitization, 1.59 [95% CI, 1.28-1.98]). C-reactive protein levels were associated with total IgE levels, atopy, and food sensitization.
Obesity might be a contributor to the increased prevalence of allergic disease in children, particularly food allergy. Systemic inflammation might play a role in the development of allergic disease.
Key words: Atopy, allergen-specific IgE, total IgE, body mass index, obesity, overweight, allergic disease, inflammationAbbreviations used: BMI, Body mass index, CRP, C-reactive protein, DXA, Dual x-ray absorptiometry, NHANES, National Health and Nutrition Examination Survey, OR, Odds ratio
a Department of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, NC
b Rho Federal Systems Division, Inc, Chapel Hill, NC
c Division of Intramural Research, National Institute of Environmental Health Sciences, Research Triangle Park, NC
d National Jewish Health and University of Colorado Health Science Center, Denver, Colo
Reprint requests: Cynthia M. Visness, PhD, Rho Federal Systems Division, Inc, 6330 Quadrangle Dr, Suite 500, Chapel Hill, NC 27517.
Supported in part by the Intramural Research Program of the National Institutes of Health, National Institute of Environmental Health Sciences (Z01 ES025041-10), and by the National Institute of Allergy and Infectious Diseases, National Institutes of Health (NO1-AI-25482).
Disclosure of potential conflict of interest: J. S. Kaufman receives grant support from the Robert Wood Johnson Foundation and the National Institutes of Health. A.-M. Siega-Riz receives grant support from the National Institute of Diabetes and Digestive and Kidney Diseases, the Centers for Disease Control and Prevention, the National Institutes of Health, and the National Heart, Lung, and Blood Institute; is on the advisory board for the American Diabetes Association; and is a scientific advisor for Nestle-Gerber products and Shoulder to Shoulder. A. H. Liu is on the review board for the National Institutes of Health/National Institute of Environmental Health Sciences. The rest of the authors have declared that they have no conflict of interest.
© 2009 American Academy of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved
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