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oo IgG Antibodies Against Food Antigens are Correlated with Inflammation and Intima Media Thickness in Results: Obese juveniles showed highly sig- Obese Juveniles at widens H Mane Lee rer Me i on ‘celine eda od hoi ay Dons Me ney, Aa “SSommreretneynginar sons os Abstract o toes 7 (© consort incgences © oat rected 78062007 frst decision 11102007 accepted 26102007 sbography ot 0.1055):2007-095165, Published December 0.2007 [Bp Cn éxdocino| Oabetes 2008; 116.241-265, ©} Barth veragin Georg There Vrag KG Seutgar- New York IssNo7. 7349 Cncal inte of Medel ‘nd Chemical aboratory Diagostis| Medical Univers Graz Aeenbruggeplatz 15 5036G2 ‘estria Tels ¥49/316)385 334 Fa: ¢43/316385 3430 mate trschigahliiku- omeat Objective: systemic low grade inflammation ‘may contribute to the development of obesity, Insulin resistance, diabetes mellitus and athero- sclerotic vascular disease. Food intolerance reflected by iramunoglobulin G (IgG) antibodies ‘may predispose to low grade inflammation and atherogenesis. We examined the relationship between IgG antibodies specific for food compo- ‘nents, ow grade inflammation and early thero- sclerotic lesions in obese and normal weight Juveniles. Research Methods and Procedures: We deter- ‘mined IgG antibodies directed against food anti- sgens, C-reactive protein (CRP) and the thickness of the intima media layer (IMT) of the carotid arteries in 30 obese children and in 30 normal eight children, Introduction Low grade inflammation may play a causal roe in the development of obesity, insulin resistance, iabetes metus and atherosclerosis [1-3]. In obese subjects adults as well as children, nflam- ‘matory markers, ike C-reactive protein (CRP) cor- relate with the degree of obesity and insulin resistance and normalise after weight reduction [4-9]. We previously observed a close correlation between the intima media thickness (IMT) of the ‘common carotid arteries and CRP, indicative for a pre-atherosclerotic status in obese children [10] Our findings are confirmed, as these childhood obesity related effects have been shown to con- tribute to the development of atherosclerosis [11-14]. Despite the overwhelming evidence that low grade inflammation is associated with diabe- tes mellitus and atherosclerosis, factors and ‘mechanisms which initiate and uphold low grade systemic inflammation are still under discussion, Wier cig Metal Ant-Food Anode bese Chien, nificant increase in IMT (p=0,0001),elevated CRP ‘values (p~0.0001) and anti-ood IgG antibody concentrations (p=0.0001) compared to normal weight juveniles. Anti-food IgG. showed tight correlations with CRP (p=0.001/r=0.546) and IMT (p=0.0001/r~0513) and sustained highly significant in a multiple regression model Discussion: We show here, that obese chil dren have significantly higher IgG antibody ‘values directed against food antigens than nor: smal weight children. Anti- food IgG antibodies are tightly associated with low grade systemic inflammation and with the IMT of the common ‘carotid arteries. These findings raise the pos- sibility, that anti-food IgG is pathogenetically involved in the development of obesity and atherosclerosis Recently, immunoglobulin G (IgG) antibodies ‘against food antigens have been suggested to ‘cause low grade inflammation in the iritable bowel syndrome by subtle mucosal inflamma- tion [15] Food elimination therapy based on la {esting was abe to improve the symptoms of the inrtable bowel syndrome [16), IgG-mediated food intolerance may be explained by low level absorption af foad macromolecules from the gut [17], Thus, IgG antibodies to some food compo- nents are detectable in healthy individuals although at lower levels, the role ofthis cass of antibodies remains highly controversial [18-20] ‘Aimof the present study was to examine, whether IgG mediated food intolerance is associated with inflammation and pre-atheroscerosis in obese juveniles. We determined specific IgG antibodies against food antigens as well as plasma CRP lev- ‘els and IMT of the carotid arteries in obese and normal weight children. ‘4p Cha Endocrnt Diabetes 2008; 16:281-245 a... “able Gincal and biochemical caractensis, ant fod Gand nner weight and obese chigen| ‘Normal weight (0-20) age jean) 14426 ‘bodymasindex i?) 205817 sos aris systolic blood pressure (mg) 1258 asi lod pressure (mtg) nT Intima meda thes) 0482008 ghee gi) 034.038 cholesterol) 22027 DL colesteral mai) 00023 HL Cholesterol nai) 046.1009, plasma gcse (a) 0824024 ini) raret07 RP (mai) 12e17 aifod iG) 005327 ‘otic Ser ste oingpeder sams “Mann Wnty Utes ns natant Research Methods and Procedures Patients ‘We investigated 30 obese juveniles and 30 normal weight cil- drenat the Clinical institute of Medical and Chemical Laboratory Diagnostics and the Department of Pediatrics, Medical Univer- sity of Graz. Obesity was defined as a body mass index (BMI) value greater than the 974 percentile. BMI and BMI-standard ‘deviation score (BMI-SDS) were calculated by the Growth Ana- Iyser Program. BMI-SDS represents an age and sex specifi standard deviation. Obese subjects attended the clinics to get dietary advice. The normal weight control persons came for minor surgical interventions and were otherwise healthy. All patients included in the study had to be fre of any infectious 4iseases at least for three weeks prior to blood sampling. The study was approved by the ethics committee ofthe University of Gaz (serial numberof approval: 13-200 ex 02/03). Blood collec- tion was performed after written informed consent was given by the patients. Blood collection Blood was obtained by venous puncture, immediately centri- fuged at 3500xmin"' at ambient temperature and the serum was stored at ~25°C until analysis, Laboratory procedures Glucose (hexokinase method). cholesterol, and triglycerides were measured enzymatically (Roche Diagnostics, Mannheit Germany). LDL cholesterol and HDL cholesterol were measured by a combined ultracentrfugation and precipitation method [21], CRP was measured with a particle-enhanced immunotur- bidimetric assay (Tinaquant®, C-reactive protein ultra sensitive assay, Roche Diagnostics, Mannheim, Germany). Insulin was {etermined by radioimmunoassay (INSI-CTK IRMA; Sorin Diag nostics Disseldor?. Serum IgG. antibodies against 277 food antigens were detected using 2 commercial available enzyme immunoassay (Imupro 300, Evomed/R-Blopharm, Darmstadt, Germaty) Wider Meta. Antfond Anodes in Obese Childe, bese (30) ee 128128 oom? so1sas ‘<0001" 5950155