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Elevated atopy in healthy obese women^1,2,3,4,5

¹ From the Department of Animal and Nutritional Sciences, University of New Hampshire, Durham, NH (VJV, AMR, MRW, and ART)

Background: Allergic disorders, including asthma, have increased dramatically in the United States in the past 20 y. Epidemiologic studies have found body mass index (body weight in kg/height squared in m) to be a positive independent correlate of atopy in women but not in men.

Objective: We investigated the prevalence of atopy among healthy obese and nonobese women and its relation to fat mass (FM), insulin resistance, and plasma concentrations of 17ß-estradiol, interleukin 4 (IL-4), and leptin.

Design: A cross-sectional study of 21 obese (30% body fat) and 22 nonobese (<30% body fat) women (18–41 y of age) was performed. The following measurements were taken: FM by plethysmography, total and specific immunoglobulin E (IgE) by automated immunosorbent analysis, and blood glucose, insulin, C-peptide, 17ß-estradiol, sex hormone–binding globulin, and IL-4. Insulin sensitivity was determined on the basis of the fasting insulin resistance index and with an oral-glucose-tolerance test.

Results: The frequency of specific IgE in the obese group was almost 3 times that in the nonobese group (P = 0.008). The total IgE concentration was not significantly different between groups. Plasma concentrations of 17ß-estradiol, the ratio of 17ß-estradiol to sex hormone–binding globulin, the fasting insulin resistance index, and C-peptide and leptin concentrations were higher in the obese than in the nonobese group (P < 0.05) after adjustment for oral contraceptive use. All factors correlated positively with FM. Logistic regression showed FM to be the only positive predictor of specific IgE (P = 0.01).

Conclusion: The findings confirm a direct relation between obesity and a T helper 2 cell immune response in women.

Key Words: Allergy • obesity • leptin • atopy • insulin resistance • 17ß-estradiol