Factors Influencing Total Serum IgE in Adults: The Role of Obesity and Related Metabolic Disorders

Abstract

<b><i>Background and Aim:</i></b> Few reports have investigated the association between metabolic abnormalities (obesity and related metabolic syndrome) and total serum IgE concentrations. <b><i>Methods:</i></b> This cross-sectional study included a random sample of 1,516 adult individuals (44.7% men, aged 18–91 years, median 52 years) from a single municipality in Spain. Serum IgE was measured in the ADVIA Centaur system. Atopy was defined by the presence of positive skin prick tests to a panel of common aeroallergens in the area. Body mass index and data related to the definition of metabolic syndrome were obtained from all participants. Alcohol consumption, smoking, and regular physical exercise were assessed by a questionnaire. <b><i>Results:</i></b> Atopy (present in 21.9% of 1,514 evaluable individuals) was the strongest factor determining serum IgE concentrations. Male sex and heavy alcohol drinking were independently associated with higher IgE concentrations, particularly in the non-atopic individuals. Body mass index was positively associated with IgE concentrations, independent of potential confounders, although the effect was only evident among non-atopic individuals. In that group, median IgE concentrations in normal-weight and obese individuals were 15 and 24 kU/L, respectively (<i>p</i> < 0.001); likewise, obesity was associated with high (>100 kU/L) IgE concentrations after adjusting for potential confounders (odds ratio: 1.79, 95% confidence interval: 1.26–2.56, <i>p</i> = 0.001). The presence of metabolic syndrome and its components, particularly abdominal obesity and hyperglycaemia, was also positively and independently associated with higher IgE concentrations in non-atopic individuals. <b><i>Conclusions:</i></b> Obesity and metabolic syndrome components are associated with high total serum IgE concentrations, particularly in non-atopic individuals.

Characterization of T2-Low and T2-High Asthma Phenotypes in Real-Life

“…Despite the IgE ≥ 75 IU/mL threshold was recently used in the clustering of severe asthma [ 29 ] and IgE ≥ 100 IU/mL has been covered in the definition of T2-high allergic inflammation [ 19 ], we deliberately ruled out the serum total IgE content from our patients’ stratification. Total IgE levels have been independently associated, in non-atopic individuals, with cigarette smoking and alcohol consumption, while variable concentrations have also been detected in aging, autoimmunity, immunodeficiency (e.g., Job’s Syndrome), cancer, obesity, parasitic infection, and metabolic syndrome [ 30 ]; otherwise, allergic patients may have low total IgE levels. The IgE clinical utility has been judged modest in clinical practice [ 31 ]; hence, total IgE cannot be considered a reliable biomarker for T2-high allergic phenotyping [ 5 , 32 ].…”

Associations between vitamin D, immunoglobulin E concentrations, and obesity

“…Data from the National Health and Nutrition Examination Survey 2005-2006 suggested that vitamin D deficiency is associated with higher levels of IgE sensitization in children and adolescents (47). However, for a long time obesity has not been considered a modulator of IgE serum concentrations (48) 1).…”

Periostin as an important biomarker of inflammatory phenotype T2 in Brazilian asthma patients

“…(25) Um achado previamente descrito, embora pouco estudado, foram níveis mais elevados de IgE total em pacientes obesos. (26) A FeNO também é um biomarcador importante não apenas para identificar o fenótipo inflamatório, mas também como preditor da resposta ao tratamento com anti-IL-4/IL-13. (27) Uma das formas de determinar a FeNO é por meio de um dispositivo portátil de fácil manuseio (28) na prática clínica.…”

“… 25 A previously described albeit poorly studied finding was higher total IgE levels in obese patients. 26 …”