Byung-Keun Kim, MD
,
Division of Allergy and Clinical Immunology, Department of Internal Medicine, Seoul National University Hospital, Seoul, South Korea
Kyonghee Sohn
,
Division of Allergy and Clinical Immunology, Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, South Korea
Woo-Jung Song, MD
,
Division of Allergy and Clinical Immunology, Department of Internal Medicine, Seoul National University Hospital, Seoul, South Korea
Sae-Hoon Kim, MD, PhD
,
Division of Allergy and Clinical Immunology, Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, South Korea
Sun-Sin Kim, MD
,
Division of Allergy and Clinical Immunology, Department of Internal Medicine, Seoul National University Hospital, Seoul, South Korea
Chang-Han Park
,
Department of Internal Medicine, Sung-Ae General Hospital, Seoul, South Korea
Suk-Il Chang
,
Department of Internal Medicine, Sung-Ae General Hospital, Seoul, South Korea
Heung Woo Park, MD, PhD
,
Division of Allergy and Clinical Immunology, Department of Internal Medicine, Seoul National University Hospital, Seoul, South Korea
Sang-Heon Cho, MD, PhD
,
Division of Allergy and Clinical Immunology, Department of Internal Medicine, Seoul National University Hospital, Seoul, South Korea
Kyung-up Min, MD, PhD
,
Division of Allergy and Clinical Immunology, Department of Internal Medicine, Seoul National University Hospital, Seoul, South Korea
Yoon-Seok Chang, MD, PhD
,
Division of Allergy and Clinical Immunology, Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, South Korea
Background: Recent evidence suggests the mechanistic links between allergies and metabolic disorders. However, metabolic associations have not been comprehensively examined for atopy, particularly in older adults. Here we aimed to explore metabolic associations of atopy in the elderly (≥65 years), using a comprehensive database of a community-population cohort study.
Method: We analyzed the baseline database of the Korean Longitudinal Study on Health and Aging (KLoSHA) cohort study, which was conducted during 2005-2006. Atopic status was assessed by skin prick tests for 12 common inhalant allergens. Asthma and rhinitis was defined by structured questionnaires. Body mass index (BMI) and waist circumference (WC) were measured. Metabolic markers included serum adiponectin, retinol-binding proten-4 (RBP-4), cholesterols, C-reactive protein (CRP), vitamin D, fasting glucose levels, HbA1c and insulin resistance (HOMA-IR).
Results: A total of 854 elderly subjects were analyzed, and 17.2% had atopy. Atopy in the elderly had specifically significant associations with lower serum adiponectin (p=0.04), high RBP-4 levels (p=0.003) or RBP-4/adiponectin ratio (p=0.01); however, atopy was not related to other metabolic markers such as BMI, WC, or lipid levels. RBP-4 levels showed significant correlations with triglyceride (p<0.001) and CRP (p=0.001), but not with adiponectin (p=0.191). Both RBP and RBP-4/adiponection had significant associations with atopy, independent of co-variates including age, gender, smoking, log-triglyceride and log-CRP levels. RBP-4 levels also had significant associations with current rhinitis but not with wheeze or cough. However, neither of adiponectin levels or RBP-4/adiponectin ratio had no associations with rhinitis or asthma symptoms.
Conclusion: The present analyses indicate a potential role of metabolic dysregulation in the pathophysiology of atopy in the elderly. In particular, mechanistic roles of RBP-4 warrant further investigations.
