Purpose

In clinical practice, currently one reference range for serum immunoglobulin (Ig) A, G, and M is applied to all adults, although various factors may influence Ig serum levels. Population-based data on determinants of IgA, IgG, and IgM and recommendations for subgroup specific reference ranges are lacking. We aimed to provide an overview of determinants of IgA, IgG, and IgM in community-dwelling middle-aged and elderly individuals and explore determinants that influence Ig reference ranges.

Methods

Within the Rotterdam Study, we performed linear regression analyses for the association of demographic, lifestyle, and cardiovascular factors with serum IgA, IgG, and IgM. We furthermore calculated Ig reference ranges (based on percentiles), both overall and within relevant subgroups.

Results

We included 8768 participants (median age 62 years). IgA and IgG increased non-linearly with higher age (P < .0001 for both). Women had lower IgA (beta: − 0.24; 95% confidence interval [95% CI]: − 0.29; − 0.20) and IgG (beta: − 0.33; 95% CI: − 0.44; − 0.23), but higher IgM levels (beta: 0.08; 95% CI: 0.04;0.13) than men. Former and particularly current smoking were associated with lower IgA and IgG (betas between − 0.07 and − 1.03). Higher alcohol consumption was associated with lower IgG (beta for heavy drinking: − 0.70; 95% CI: − 0.91; − 0.48). Corticosteroid use was associated with lower IgG (beta: − 1.12; 95% CI: − 1.58; − 0.66). Associations with cardiovascular factors were heterogeneous and differed between sexes.

Conclusion

Age, sex, smoking, alcohol consumption, corticosteroid use, and cardiovascular factors are determinants that should be considered when interpreting serum Ig levels in middle-aged and elderly individuals and may require adjusted reference ranges.

中文翻译：

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中老年人血清免疫球蛋白的决定因素和参考范围：一项基于人群的研究

目的

在临床实践中，目前血清免疫球蛋白 (Ig) A、G 和 M 的一个参考范围适用于所有成人，尽管各种因素可能会影响 Ig 血清水平。缺乏关于 IgA、IgG 和 IgM 决定因素的基于人群的数据以及针对亚组特定参考范围的建议。我们旨在概述居住在社区的中老年个体中 IgA、IgG 和 IgM 的决定因素，并探索影响 Ig 参考范围的决定因素。

方法

在鹿特丹研究中，我们对人口统计学、生活方式和心血管因素与血清 IgA、IgG 和 IgM 的关联进行了线性回归分析。我们还计算了整体和相关亚组内的 Ig 参考范围（基于百分位数）。

结果

我们纳入了 8768 名参与者（中位年龄 62 岁）。随着年龄的增长，IgA 和 IgG 呈非线性增加（两者的P  < .0001）。女性的 IgA（β：- 0.24；95% 置信区间 [95% CI]：- 0.29；- 0.20）和 IgG（β：- 0.33；95% CI：- 0.44；- 0.23）较低，但 IgM 水平较高（ β：0.08；95% CI：0.04；0.13）高于男性。以前和特别是现在的吸烟与较低的 IgA 和 IgG 相关（β 在 - 0.07 和 - 1.03 之间）。较高的饮酒量与较低的 IgG 相关（大量饮酒的β：- 0.70；95% CI：- 0.91；- 0.48）。皮质类固醇的使用与较低的 IgG 相关（β：- 1.12；95% CI：- 1.58；- 0.66）。与心血管因素的关联是异质的，并且在性别之间存在差异。

结论

年龄、性别、吸烟、饮酒、皮质类固醇使用和心血管因素是解释中老年人血清 Ig 水平时应考虑的决定因素，可能需要调整参考范围。