Immunological indicators in children with different types of obesity

Abstract

Background. To date, numerous prospective studies convincingly indicate a direct correlation of obesity with an increased risk of life-threatening diseases. It is important that over 60 % of patients has childhood-onset obesity. Purpose to determine the parameters of cellular and humoral immunity in obese children and adolescents. Materials and methods. The study was carried out in three stages. At the first stage, a cross-sectional epidemiological study of the children’s population aged 7–17 years was conducted during preventive examination in schools in Chernivtsi and Chernivtsi region (936 people). Primary screening included questioning, anthropometry (height, body weight, body mass index, waist circumference (WC), hip circumference (HC), WC/HC ratio calculation), and assessment of physical development. Physical development was evaluated using centile tables. Of the 936 individuals, 160 subjects were selected for detailed examination: overweight (n = 35), obese (abdominal type of obesity — 35, uniform type of obesity — 35 people), and 55 healthy individuals. Abdominal type of obesity was diagnosed if the WC/HC index for boys exceeded 0.9, and for girls — 0.8. In order to evaluate the immune status of children and adolescents, the parameters of cell and humoral immunity were determined using level 1 and 2 tests (CD3, CD4, CD8, CD16, CD19, CD22, CD16, CD19, CD22, CD72, HLA-DR, immunoregulatory index, leuko-T-cell index (leukocytes/СD8), leuko-B-cell index (leukocytes/CD19), T-lymphocyte activity index (HLA-DR/CD72), content of serum immunoglobulins (Ig) A, M, G. Evaluation of immunodeficiency degree was carried out. Statistical analysis of data was performed using Statistica 10.0 software package. Results. In children with abdominal obesity, the secondary hypothalamic form (77.1 %) and III–IV degree of obesity (III degree — 54.3 %, IV degree — 22.8 %) were more common. In group with uniform type of obesity, the primary exogenous-constitutional form of obesity (54.3 %) and I, II degree (I — 31.4 %, II — 60 %) were detected significantly more often. The relative number of lymphocytes, as well as CD4+, CD16+, HLA-DR+ and phagocytic index are significantly lower in all age groups of children with obesity. In children and adolescents with overweight, there was a tendency to change in the corresponding indicators. Consequently, in children with different types of obesity, T-cell immunosuppression may be observed, and it is more significant in abdominal type of obesity. Also, in all age groups of children with obesity, immunoregulatory and leuko-T-cell indices were increased. Among children and adolescents with different types of obesity, IgA and IgM concentrations are reduced, and there is a tendency to IgG decrease. Conclusions. Obese children have deviations in immune parameters. The results obtained can be used in the practice of pediatrician, endocrinologist, immunologist to evaluate the immune status of a child depending on the age and type of obesity. Children with a high degree of obesity need periodic examination of the immune status in order to control the state of the immune system of the body.