Sex‐associated differences between BMI and SARS‐CoV‐2 antibody titers following the BNT162b2 vaccine

  1. Shohei Yamamoto
  2. Tetsuya Mizoue
  3. Akihito Tanaka
  4. Yusuke Oshiro
  5. Natsumi Inamura
  6. Maki Konishi
  7. Mitsuru Ozeki
  8. Kengo Miyo
  9. Wataru Sugiura
  10. Haruhito Sugiyama
  11. Norio Ohmagari

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Abstract

Objective

This study investigated the sex‐associated difference in the impact of obesity on antibody response to a COVID‐19 vaccine.

Methods

This study included 2,435 health care workers who received two doses of the BioNTech, Pfizer (BNT162b2) vaccine and participated in a serological survey, during which they were tested for anti‐SARS‐CoV‐2 spike immunoglobin G (IgG) antibodies and asked for information on height, weight, and vaccination history via a questionnaire. Multivariable linear regression analysis was used to estimate the geometric mean titers (GMT) of antibodies for each sex and BMI category.

Results

The relationship between BMI and anti‐SARS‐CoV‐2 spike IgG titers markedly differed by sex ( p value for interaction = 0.04). Spike IgG antibody titers tended to decrease with increasing BMI in men ( p value for trend = 0.03); GMT (95% CI) were 6,093 (4,874‐7,618) and 4,655 (3,795‐5,708) for BMI < 18.5 and ≥30 kg/m 2 , respectively. In contrast, spike IgG antibody titers did not significantly differ across BMI categories in women ( p value for for trend = 0.62); GMT (95% CI) were 6,171 (5,714‐6,665) and 5,506 (4,404‐6,883) for BMI <18.5 and ≥30, respectively.

Conclusions

Higher BMI was associated with lower titers of SARS‐CoV‐2 spike antibodies in men, but not in women, suggesting the need for careful monitoring of vaccine efficacy in men with obesity, who are at high risk of severe COVID‐19 outcomes.

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  1. Version published to 10.1002/oby.23417
  2. ScreenIT

    SciScore for 10.1101/2021.08.30.21262862: (What is this?)

    Please note, not all rigor criteria are appropriate for all manuscripts.

    Table 1: Rigor

    EthicsConsent: Written informed consent was obtained from each participant, and the study procedure was approved by the NCGM ethics committee.
    IRB: Written informed consent was obtained from each participant, and the study procedure was approved by the NCGM ethics committee.
    Sex as a biological variablenot detected.
    Randomizationnot detected.
    Blindingnot detected.
    Power Analysisnot detected.

    Table 2: Resources

    Software and Algorithms
    SentencesResources
    IgG against the SARS-CoV-2 spike protein was quantitatively measured (AdviseDx SARS-CoV-2 IgG II assay, Abbott ARCHITECT®; positive threshold: ≥50.0 AU/mL).
    Abbott
    suggested: (Abbott, RRID:SCR_010477)

    Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).

    Results from LimitationRecognizer: An explicit section about the limitations of the techniques employed in this study was not found. We encourage authors to address study limitations.

    Results from TrialIdentifier: No clinical trial numbers were referenced.

    Results from Barzooka: We did not find any issues relating to the usage of bar graphs.

    Results from JetFighter: We did not find any issues relating to colormaps.

    Results from rtransparent:
    • Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
    • Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
    • No protocol registration statement was detected.

    Results from scite Reference Check: We found no unreliable references.

    About SciScore

    SciScore is an automated tool that is designed to assist expert reviewers by finding and presenting formulaic information scattered throughout a paper in a standard, easy to digest format. SciScore checks for the presence and correctness of RRIDs (research resource identifiers), and for rigor criteria such as sex and investigator blinding. For details on the theoretical underpinning of rigor criteria and the tools shown here, including references cited, please follow this link.

  3. Version published to 10.1101/2021.08.30.21262862v1 on medRxiv