Njå Frode, Nystad Wenche, Lødrup Carlsen Karin C, Hetlevik Oystein, Carlsen Kai-Håkon
Geilomo Children's Hospital for Asthma and Allergy, Geilo and Sandvika, Norway.
Acta Paediatr. 2005 Feb;94(2):147-54. doi: 10.1111/j.1651-2227.2005.tb01882.x.
To assess the associations between nutrition supplements in infancy and later asthma and allergy in school-age children, and to explore the impact of environmental factors in early life.
Five hundred and two children underwent clinical examination, skin prick test and a second parentally completed questionnaire within 2 y of a cross-sectional questionnairebased study, including 4585 primary school children (6-16 y old) in 1994 from urban Oslo (37%), the mountainous area of Hallingdal (42%), and the industrial, coastal area of Odda (21%). The children were selected from the 1994 survey on the basis of reported diagnosed asthma (n=166), wheeze in the last 12 mo (n=155) and no asthma/no wheeze (n=181). Questions were related to nutrition and environmental exposure in early life. Possible associations between allergic sensitization or asthma at school age and exposures were estimated by logistic regression analysis, adjusting for potential confounders.
Daily intake of fresh fruit or vegetables, but not extra vitamins or cod liver oil supplements, in infancy decreased the risk of asthma (adjusted odds ratio (aOR) 0.57 (95% confidence interval (CI): 0.37-0.88). Early supplements of cod liver oil and extra vitamins were associated with increased allergic sensitization (aOR 1.78 (95% CI: 1.03-3.07) and 1.71 (95% CI: 1.01-2.88), respectively). A significantly higher prevalence of allergic sensitization was found in children living in Hallingdal compared to Odda, while the latter children, on the other hand, had the highest prevalence of house dust mite allergy (p = 0.001 vs Hallingdal and p = 0.04 vs Oslo).
The present study suggests that the early introduction of daily fresh fruit or vegetables may decrease the risk of asthma after 1 y of life, whereas allergic sensitization at school age seemed to increase with extra vitamin and cod liver oil supplements during infancy. Living area influenced allergic sensitization, with differences between coastal and inland areas.
评估婴儿期营养补充剂与学龄儿童后期哮喘及过敏之间的关联,并探讨早期生活环境因素的影响。
在一项基于横断面问卷调查的研究的2年内,502名儿童接受了临床检查、皮肤点刺试验,并由父母再次填写问卷,该研究包括1994年来自奥斯陆市区(37%)、哈灵达尔山区(42%)和工业沿海地区奥达(21%)的4585名小学生(6 - 16岁)。这些儿童是从1994年的调查中根据报告诊断的哮喘(n = 166)、过去12个月内的喘息(n = 155)以及无哮喘/无喘息(n = 181)情况选取的。问题涉及早期生活中的营养和环境暴露。通过逻辑回归分析估计学龄期过敏性致敏或哮喘与暴露之间的可能关联,并对潜在混杂因素进行调整。
婴儿期每日摄入新鲜水果或蔬菜,而非额外补充维生素或鱼肝油,可降低哮喘风险(调整后的优势比(aOR)为0.57(95%置信区间(CI):0.37 - 0.88))。早期补充鱼肝油和额外维生素与过敏性致敏增加相关(分别为aOR 1.78(95% CI:1.03 - 3.07)和1.71(95% CI:1.01 - 2.88))。与奥达相比,哈灵达尔地区儿童的过敏性致敏患病率显著更高,而另一方面,后者儿童的屋尘螨过敏患病率最高(与哈灵达尔相比p = 0.001,与奥斯陆相比p = 0.04)。
本研究表明,婴儿期每日尽早引入新鲜水果或蔬菜可能降低1岁后哮喘的风险,而学龄期过敏性致敏似乎随着婴儿期额外补充维生素和鱼肝油而增加。居住地区影响过敏性致敏,沿海和内陆地区存在差异。