소아 천식 환자에서 혈청 leptin의 측정
Association between Leptin and Asthma in Children
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목 적 : 최근 천식과 비만의 유병률이 증가하고 있어 천식과 비만 사이의 연관성에 관심이 모아지고 있다. 비만과 관련된 천식 병인에 관한 연구의 일환으로 우리나라 소아 천식에서 leptin의 역할을 규명하고자 하였으며, leptin과 아토피 인자, 폐기능 변수 및 기관지과민성과의 연관성에 대해 알아보고자 하였다. 방 법 : 126명의 천식 환자와 38명의 정상 대조군을 대상으로 하였다. 전체 대상아에서 폐기능 검사 및 메타콜린 기관지 유발 검사 당일 측정된 신장과 체중을 이용하여 BMI(kg/m2)를 산출하였고, 혈액 내 호산구수, 혈청 총 IgE, ECP 및 leptin 농도를 측정하였다. 결 과 : 전체 대상아에서 혈중 leptin 농도는 천식군은 2.40(0.63-4.66) ng/mL, 대조군은 1.82 (0.67-3.78) ng/mL로 두 군간의 차이를 보이지 않았으며, 성별에 따라 구분 하였을 때에도 천식군과 대조군 사이에 유의한 차이를 보이지 않았다. 혈청 leptin 농도는 FEV1와 유의한 음의 상관관계를 나타내었으나,(γ=-0.223, P<0.01) FVC, FEF 25-75% 및 PC20와는 연관성을 보이지 않았다. 또한 혈청 leptin 농도와 아토피 인자인 혈액 내 호산구수, 혈청 총 IgE 및 ECP 농도 사이에는 의미있는 상관관계를 보이지 않았다. 결 론 : 혈청 leptin 농도는 천식과 직접적인 연관은 보이지 않았으며 성별에 따라 분류하였을 때에도 관련을 나타내지 않았으나, FEV1과 연관성을 나타내어 천식 환아에서 질병을 조절하는 요소가 될 수 있을 것으로 생각된다.
Abstract
Purpose : The prevalences of asthma and obesity have increased substantially during the last several decades in many countries, leading to speculation that obese persons might be at increased risk of asthma development. As a part of the investigation of asthma pathogenesis associated with obesity, we evaluated the role of leptin in childhood asthma and its effect on the levels of atopy markers, pulmonary function and bronchial hyperresponsiveness. Methods : We studied 126 asthmatic children and 38 healthy children. Body mass index was calculated using height and weight, which were measured on the same day that pulmonary function tests and methacholine challenge tests were performed. Total eosinophil count, total serum IgE, serum eosinophil cationic protein and leptin were measured in all subjects. Results : BMI percentile did not differ between the asthma group and controls. Leptin did not show any difference between asthmatic patients and control subjects in all, male and female participants. Leptin was found to be associated with FEV1 (P<0.01), but not with FVC, FEF25-75% and PC20 in all subjects. Also, there were no correlations between leptin and markers of atopy, which are total eosinophil count, total serum IgE, serum eosinophil cationic protein. Conclusion : Our findings suggest that leptin showed close associations with pulmonary function and may have disease-modifying effects in children with asthma.
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