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During the past two decades, the prevalence of obesity in children has risen greatly worldwide. It has reached epidemic levels internationally. Approximately 22 million children under 5 years of age are overweight across the world. Comorbidities associated with obesity and overweight are similar in children as in the adult population. Elevated blood pressure, dyslipidemia, and a higher prevalence of factors associated with insulin resistance and type 2 diabetes appear as frequent comorbidities in the overweight and obese pediatric population.
Obesity seems to reduce lymphocyte immune functions. It has found that obese children and adolescents showed a variable impairment of cell-mediated immune responses such as delayed cutaneous hypersensitivity, abnormal lymphoproliferative responses to mitogens and a reduction in intracellular bacterial killing capacity by poly-morph-nuclear leucocytes.
The present study was designed to evaluate the effect of childhood obesity on cell mediated immunity through CD4/CD8 ratio & CD56 by comparing these values in obese and non-obese children.
This study included 30 children in school age, group 1 (control group) was 10 children who were not considered obese according to WHO criteria [4 females (40%) and 6 males (60%)] with mean age (10±3.27 years), mean weight (32±12 kg), mean BMI (18.4±1.9) and mean waist hip ratio (0.6±0.1).
group 2 (patient group) was 20 children who were considered obese according to WHO criteria [11 females (55%) and 9 males (45%)] with mean age (9.9±2.65 years), mean weight (63±26 kg), mean BMI (39.2±12.5) and mean waist hip ratio (1±0.1).
All children in the study were subjected to adequate history taking, full clinical examination, CBC, fasting blood sugar, Percentage and count of CD4+ cells,CD8+ cells,CD56+ natural killer cells and CD4/CD8 ratio by Flow-cytometry.
In our study we found that CD4/CD8 ratio was significantly lower in obese group than control group, as in group 1 (control group) the mean ratio was (1.5±0.5) while in group 2 (obese group) the mean ratio was (1±0.5).
There was a significant negative correlation between CD4/CD8 ratio and weight, BMI and waist hip ratio
In our study also we found that CD56 count and percent wasn’t significantly different between the two groups, as in group 1 (control group) the mean CD56 count was (355±142) and the mean percent was (15.00%±9.50%) while in group 2 (obese group) the mean CD56 count was (298±316) and the mean percent was (15.50%±6.30%).
There was no significant correlation between CD56 and weight, BMI or waist hip ratio.
Our study revealed that the best cut-off point regarding CD4/CD8 ratio was >0.8 with sensitivity of 95% and specificity of 50% and that the best cut-off point between the two studied groups regarding absolute CD56 count was ≤ 180 with sensitivity of 50% and specificity of 100% while the best cut-off point between the two studied groups regarding CD56 percent was >14 with sensitivity of 55% and specificity of 70%.
Our study found that CD4/CD8 ratio is of value to detect effect of obesity on cell mediated immunity.
We attributed the difference between our results and those studies to the small number of our study group and short time of the study.
We conclude that obesity affect cell mediated immunity through CD4/CD8 ratio