Eosinophil Cationic Protein (ECP)/Eosinophil-derived Neurotoxin (EDN) 농도와 천식 아동의 성장 상태 사이의 연관성
Relationship with Eosinophil Cationic Protein (ECP)/Eosinophil-derived Neurotoxin (EDN) Levels and Growth Status among Asthmatic Children
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목 적 : 천식은 흔히 볼 수 있는 만성 질환의 하나로 천식환아의 성장에 있어 성장지연이나 비만을 야기시킨다고 알려져 있으나 그 기전은 확실하지 않다. 이에 저자들은 천식을 가진 환아들을 대상으로 신체 계측을 통해 성장 상태를 평가하여 성장 지연 유무를 확인하고 비만도를 측정하였으며 EDN, ECP 수치와 혈중 호산구수를 측정하여 성장상태와의 상관성을 알아보고자 하였다. 방 법 : 천식으로 입원한 아동 90명(남아 57명, 여아 33명, 4-16세)을 를 대상으로 입원 당시 신장과 체중을 측정하여 각각의 표준편차 점수치를 구하였고 혈중 EDN, ECP 농도와의 연관성을 알아보았다. 결 과 : 1) 대상아동의 평균 신장표준편차 점수(height SDS)는 0.33±0.85, 체중 SDS는 0.23±1.20였다. 2) 체중 SDS가 -2에서 -1인 저체중군 환아는 7.8%, -1에서 1인 정상 체중군은 71.1%, 1에서 2인 과체중군은 21.1%였고, 신장 SDS가 -2에서 -1인 저신장군 환아는 2.2%, -1에서 1인 정상 신장군 75.5%, 1에서 2인 고신장군은 22.2% 였다. 3) 신장 SDS는 혈청ECP 농도(r=-0.27, P=0.01) 및 EDN 농도(r=-0.27, P=0.009)와 유의한 음의 상관성이 있었다. 체중 SDS는 ECP와 유의한 음의 상관관계에 있었다(r= -0.20, P=0.05). 4) ECP 수치가 높은 군은 ECP 수치가 정상인 군에 비해 신장 SDS가 유의하게 낮았으며(0.21±0.82 vs 0.63 ±0.85, P<0.01), 체중 SDS 또한 ECP수치가 높은 군이 정상인 군에 비해 유의하게 낮았다(0.03±1.07 vs 0.76±1.37, P<0.06). EDN 수치가 높은 군은 EDN 수치가 정상인 군에 비해 신장 SDS가 유의하게 낮았다(0.27±0.85 vs 0.45±0.80, P<0.009). 결 론 : 천식 아동에서 ECP와 EDN 수치가 높을수록 키와 체중의 저하를 보였다.
Abstract
Purpose : Short statue or obesity has been reported in asthmatic children, but the results are inconsistent. Recently eosinophil cationic protein (ECP), eosinophil-derived neurotoxin (EDN) levels has been known as important markers of airway inflammation and reflect asthma severity as well. The aim of this study is to evaluate the growth status and to analyze the possible relation with serum EDN and ECP levels. Methods : A total of 90 children (57 boys and 33 girls, 4 to 16 years old) who had been admitted for bronchial asthma were included. To standardize the data for age and sex, standard deviation scores (SDS) were calculated for height and weight. Values less than -2 SDS below the mean were considered to be extremely low, -1 SDS to 1 SDS as normal, values higher than 2 SDS considered very high. Serum EDN and ECP levels were measured. Results : The mean height SDS was 0.33±0.85 and weight SDS was 0.23±1.20. The prevalence of short stature was 2.2%, normal stature 75.5%, and tall stature 22.2%. The prevalence of underweight was 7.8%, normal weight 71.1%, and overweight 21.1%. Height SDS was negatively correlated with serum ECP (r=-0.27, P=0.01) and EDN (r=-0.27, P=0.009) and weight SDS was negatively correlated with serum ECP (r=-0.20, P=0.05). Height SDS were significantly lower in high ECP and EDN groups compared to normal ECP and EDN groups (P<0.01 and P<0.009, respectively). Weight SDS was lower in high ECP group compared to normal ECP group (P<0.05). Conclusion : Growth (height and weight) was inversely correlated with serum EDN and ECP levels. These results suggest that high ECP and EDN levels might be related with growth retardation of asthmatic children.
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