ORAL PRESENTATION -- ALLERGY & IMMUNOLOGY

OBESITY AND HISTORY OF ATOPY IN

SCHOOL AGED CHILDREN
Shekina Rondonuwu, Raynald O. Takumansang, Diana Takumansang - Sondakh

KONIKA XVI PALEMBANG

Palembang, August 25th 2014

Dept. Of Child Health, Faculty of Medicine, Sam Ratulangi University

ORAL PRESENTATION -- ALLERGY & IMMUNOLOGY

Backgrounds
Obesity
over accumulation of body fat tissues
Worldwide problem
Multifactorial cause

Dept. Of Child Health, Faculty of Medicine, Sam Ratulangi University

ORAL PRESENTATION -- ALLERGY & IMMUNOLOGY

Backgrounds
Obesity in children: 3.4%
Survei Kesehatan Nasional, 2005.

boys 9.5%, girls 6.4%

Riset Kesehatan Dasar, 2007.

WHO estimation prevalence: 10% on children

aged 5 17 y.o.

Dept. Of Child Health, Faculty of Medicine, Sam Ratulangi University

ORAL PRESENTATION -- ALLERGY & IMMUNOLOGY

Backgrounds
Obesity
Low degree chronic inflammation
Inflammation markers (e.g. IL-6, IL-8, leptin, CRP,
PAI-1 and haptoglobin ) increased
TNF produced in adipose tissue increase of
Th2 cytokines stimulates IgE production as
atopy marker
Dept. Of Child Health, Faculty of Medicine, Sam Ratulangi University

ORAL PRESENTATION -- ALLERGY & IMMUNOLOGY

Backgrounds
Atopy
Someones tendency to produce IgE due to
response of allergens sensitizations
Atopy and obesity increase in prevalence
Correlation between atopy and obesity
controversy
Dept. Of Child Health, Faculty of Medicine, Sam Ratulangi University

ORAL PRESENTATION -- ALLERGY & IMMUNOLOGY

Backgrounds
This study
To determine is there any correlation between
obesity and history of atopy in school aged
children

Dept. Of Child Health, Faculty of Medicine, Sam Ratulangi University

ORAL PRESENTATION -- ALLERGY & IMMUNOLOGY

Methods and Materials

January March 2014 in randomly selected
elementary school in Tuminting subdistrict
Cross sectional method
school aged children that fulfill the criteria of obesity
and healthy school aged children
parents had signed informed consent
Exclusion: children with chronic disease or having a
congenital disease
Dept. Of Child Health, Faculty of Medicine, Sam Ratulangi University

ORAL PRESENTATION -- ALLERGY & IMMUNOLOGY

Methods and Materials

ISAAC questionnaire to examine the history of
atopy in the family

Obesity determined by BMI/age charts

Divided into 4:
normal weight with and without history of atopy
obese with and without history of atopy

Dept. Of Child Health, Faculty of Medicine, Sam Ratulangi University

ORAL PRESENTATION -- ALLERGY & IMMUNOLOGY

Methods and Materials

Atopy
Determined by IgE total level
Statistically analyzed by SPSS 17.0:
Chi square test p<0.05 considered to be
significant
Dept. Of Child Health, Faculty of Medicine, Sam Ratulangi University

ORAL PRESENTATION -- ALLERGY & IMMUNOLOGY

Result
72 subjects, consists of 36 obese children and 36
normal weight children aged 6 12 years old
Table 1. Subjects Characteristics
Subjects Characteristics

Obese children

Normal weight
children

Boys
Girls

18
18

17
19

6 8 y.o.
9 12 y.o.

13
23

20
16

22

Sex

Age

History of atopy
(ISAAC Questionnaire)

Dept. Of Child Health, Faculty of Medicine, Sam Ratulangi University

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ORAL PRESENTATION -- ALLERGY & IMMUNOLOGY

Result
Table 2. Total IgE level in 4 groups of children
Total IgE
(u/ mL)

Total IgE > 100

Obese children

Normal weight
children

History
(+)

History
(-)

History
(+)

History
(-)

16

10

Normal IgE level

10

14

Total

18

18

18

18

Dept. Of Child Health, Faculty of Medicine, Sam Ratulangi University

p<0.001

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ORAL PRESENTATION -- ALLERGY & IMMUNOLOGY

Discussions
Obesity
Hypertrophy fatty cells adiposity
Adipose tissue secreted adipokines
Leptin

Adiponectin

Cytokines

Chemokines

TNF, IL-6, IL-10, IL-1

Radon K, Schulze A. J Allergy Clin Immunol. 2006
Dept. Of Child Health, Faculty of Medicine, Sam Ratulangi University

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ORAL PRESENTATION -- ALLERGY & IMMUNOLOGY

Discussions
Obese people
IL-6 and leptin
Leptin ressistance hyperleptinemia
Elevated secretion of Th2
Switching on B lymphocytes produced IgE
Hersoug, et al., Allergy. 2007
Dept. Of Child Health, Faculty of Medicine, Sam Ratulangi University

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ORAL PRESENTATION -- ALLERGY & IMMUNOLOGY

Discussions
From 18 obese children with history of atopy 16
elevated total IgE level
Obesity has a correlation with family history of atopy in
children
Visness et al. J Allergy Clin Immunol. 2009.
Ramadhinara A. Acta Med Indones. 2008.
Apandi et al. Pediatr Indones. 2011

12 normal weight children with total IgE > 100 u/mL

Dept. Of Child Health, Faculty of Medicine, Sam Ratulangi University

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ORAL PRESENTATION -- ALLERGY & IMMUNOLOGY

Discussions
Family history of atopy is an important predisposing factor
for atopy
Eldin et al. Egypt J Pediatr Allergy Immunol. 2008

Chi square test: p<0.05 significant

Dept. Of Child Health, Faculty of Medicine, Sam Ratulangi University

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ORAL PRESENTATION -- ALLERGY & IMMUNOLOGY

Discussions
Limitation in this study

Only total IgE count done in the research, without

detecting further predictors such as Leptin
Samples were taken without other examinations to
rule out other cause of elevation of IgE
Family blood samples were not taken to determine
the history of atopy in family
Dept. Of Child Health, Faculty of Medicine, Sam Ratulangi University

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ORAL PRESENTATION -- ALLERGY & IMMUNOLOGY

Conclusion
Obesity has a significant correlation with
history of atopy in school aged children

Dept. Of Child Health, Faculty of Medicine, Sam Ratulangi University

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ORAL PRESENTATION -- ALLERGY & IMMUNOLOGY

Thank You
Dept. Of Child Health, Faculty of Medicine, Sam Ratulangi University

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