Relationship of serum cholesterol levels to atopy in the US population

Laboratory of Respiratory Biology, National Institute of Environmental Health Sciences, National Institutes of Health, Department of Health and Human Services, Research Triangle Park, NC 27709, USA.
Allergy (Impact Factor: 6.03). 12/2009; 65(7):859-64. DOI: 10.1111/j.1398-9995.2009.02287.x
Source: PubMed


Cholesterol promotes Th2 immunity and allergic inflammation in rodents; whether this occurs in humans is unclear. Reports of both direct and inverse associations between serum cholesterol and atopy in different populations suggest that race and/or other demographic variables may modify these relationships. Aims OF THE STUDY: To determine the relationships between levels of three serum cholesterol measures [total cholesterol (TC), high density lipoprotein-cholesterol (HDL-C), and non-HDL-C] and atopy in a sample representative of the US population.
Cross-sectional study of 6854 participants aged > or =6 years from the 2005-2006 National Health and Nutrition Examination Survey.
In the overall population, adjusted odds ratios (AORs) per two-standard deviation increase in TC and non-HDL-C for biochemical atopy (defined as > or =1 allergen-specific IgE to 19 allergens) were 1.17 [95% confidence interval (CI), 1.00-1.38] and 1.19 (95% CI, 1.03-1.39), respectively. Interactions by race were noted for the two relationships (interaction P = 0.004 and P = 0.009, respectively) with non-Hispanic Whites (NHWs) having direct relationships [TC: AOR 1.27 (95% CI, 1.03-1.57); non-HDL-C: AOR 1.27 (95% CI, 1.03-1.56)] and non-Hispanic Blacks (NHBs) inverse relationships [TC: AOR 0.77 (95% CI, 0.62-0.95); non-HDL-C: AOR 0.86 (95% CI, 0.69-1.08)]. The adjusted HDL-C-atopy relationship was nonsignificant for NHWs and inverse for NHBs [AOR 0.77 (95% CI, 0.61-0.96)]. Relationships were independent of body mass index and serum C-reactive protein and unmodified by corticosteroid or statin usage. Results were similar using current hay fever/allergy as the atopy outcome.
There are marked inter-racial differences in the relationship between serum cholesterol and atopy in the US population.

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    • "However, Fessler et al found that the odds ratio of atopy defined as serum specific IgE positivity against allergens was OR = 1.17 (95% CI: 1.00, 1.38) per two standard deviation increase in total cholesterol which is comparable to ORs of serum cholesterol for myocardial infarction[14]. The possible underlying mechanism may be an effect of serum lipids on proatopic Th2 immunity and allergic inflammation[13,14]. The strengths of our study include the large population-based samples and the inclusion of multiple studies. "
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