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Khan SR, Chaker L, Ikram MA, et al. Determinants and Reference Ranges of Serum Immunoglobulins in Middle-Aged and Elderly Individuals: a Population-Based Study. J Clin Immunol. 2021;41(8):1902-1914doi: 10.1007/s10875-021-01120-5.
Khan, S. R., Chaker, L., Ikram, M. A., Peeters, R. P., van Hagen, P. M., & Dalm, V. A. S. H. (2021). Determinants and Reference Ranges of Serum Immunoglobulins in Middle-Aged and Elderly Individuals: a Population-Based Study. Journal of clinical immunology, 41(8), 1902-1914. https://doi.org/10.1007/s10875-021-01120-5
Khan, Samer Raza, et al. "Determinants and Reference Ranges of Serum Immunoglobulins in Middle-Aged and Elderly Individuals: a Population-Based Study." Journal of clinical immunology vol. 41,8 (2021): 1902-1914. doi: https://doi.org/10.1007/s10875-021-01120-5
Khan SR, Chaker L, Ikram MA, Peeters RP, van Hagen PM, Dalm VASH. Determinants and Reference Ranges of Serum Immunoglobulins in Middle-Aged and Elderly Individuals: a Population-Based Study. J Clin Immunol. 2021 Nov;41(8):1902-1914. doi: 10.1007/s10875-021-01120-5. Epub 2021 Sep 10. PMID: 34505230; PMCID: PMC8604889.
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J Clin Immunol. 2021 Nov;41(8):1902-1914. doi: 10.1007/s10875-021-01120-5. Epub 2021 Sep 10.

Determinants and Reference Ranges of Serum Immunoglobulins in Middle-Aged and Elderly Individuals: a Population-Based Study.

Journal of clinical immunology

Samer Raza Khan, Layal Chaker, Mohammad Arfan Ikram, Robin Patrick Peeters, Petrus Martinus van Hagen, Virgil Alain Silvester Hovestadt Dalm

Affiliations

  1. Department of Internal Medicine, Division of Allergy & Clinical Immunology, Erasmus University Medical Center, Rotterdam, the Netherlands.
  2. Department of Epidemiology, Erasmus University Medical Center, Rotterdam, the Netherlands.
  3. Department of Internal Medicine, Division of Endocrinology, Erasmus University Medical Center, Rotterdam, the Netherlands.
  4. Department of Immunology, Erasmus University Medical Center, Rotterdam, the Netherlands.
  5. Department of Internal Medicine, Division of Allergy & Clinical Immunology, Erasmus University Medical Center, Rotterdam, the Netherlands. [email protected].
  6. Department of Immunology, Erasmus University Medical Center, Rotterdam, the Netherlands. [email protected].
  7. Department of Internal Medicine, Erasmus University Medical Center, Dr. Molewaterplein 40, 3015 GD, Rotterdam, the Netherlands. [email protected].

PMID: 34505230 PMCID: PMC8604889 DOI: 10.1007/s10875-021-01120-5

Abstract

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.

© 2021. The Author(s).

Keywords: Aging; Epidemiologic factors; Immunoglobulin A; Immunoglobulin G; Immunoglobulin M; Reference values

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