Exponent Health Sciences Practice, Wood Dale, IL 60191, USA.
J Pediatr Gastroenterol Nutr. 2010 Apr;50(4):422-30. doi: 10.1097/MPG.0b013e3181cea52b.
A reduced risk of atopic dermatitis (AD) among healthy infants who received 100% whey protein partially hydrolyzed formula (PHF-W) compared with intact protein cow's milk formula (CMF), has been reported in several studies. To validate these observations and estimate the magnitude of this potential association with greater statistical precision, we conducted a meta-analysis of clinical trial and intervention studies.
A total of 18 articles representing 12 independent study populations met our inclusion criteria.
A statistically significant 44% (summary relative risk estimate [SRRE] = 0.56, 95% confidence interval 0.40-0.77) reduced risk of atopic manifestations, which included AD, was found among infants receiving PHF-W compared with infants receiving CMF. In a subanalysis of 4 studies that reported results specifically for AD and that were considered of superior methodological quality, the incidence of AD was reduced by 55% (SRRE = 0.45, 95% confidence interval 0.30-0.70).
Regardless of study design, infant population, follow-up time, or study location, individual study findings were consistent because a reduced incidence of AD was reported in all of the reviewed studies. Exclusive breast-feeding should be encouraged as the standard for infant nutrition in the first months of life. For infants who are not exclusively breast-fed, feeding with PHF-W instead of CMF reduces the risk of AD in infants, particularly in infants with a family history of allergy.
与完整蛋白牛乳配方(CMF)相比,健康婴儿食用 100%乳清蛋白部分水解配方(PHF-W)可降低特应性皮炎(AD)的风险,这在几项研究中已有报道。为了验证这些观察结果,并估计这种潜在关联的幅度,以获得更高的统计精度,我们对临床试验和干预研究进行了荟萃分析。
共有 18 篇文章代表 12 个独立的研究人群符合我们的纳入标准。
与接受 CMF 的婴儿相比,接受 PHF-W 的婴儿发生特应性表现(包括 AD)的风险显著降低 44%(综合相对风险估计值 [SRRE] = 0.56,95%置信区间 0.40-0.77)。在专门报告 AD 结果且被认为具有较高方法学质量的 4 项研究的亚分析中,AD 的发病率降低了 55%(SRRE = 0.45,95%置信区间 0.30-0.70)。
无论研究设计、婴儿人群、随访时间或研究地点如何,个体研究结果都是一致的,因为所有审查的研究均报告 AD 的发病率降低。应鼓励纯母乳喂养作为婴儿生命最初几个月的标准婴儿营养。对于非纯母乳喂养的婴儿,用 PHF-W 喂养而不是 CMF 喂养可降低婴儿患 AD 的风险,尤其是有过敏家族史的婴儿。