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随机对照试验维生素 D 补充剂预防学龄儿童季节性流感 A

Randomized trial of vitamin D supplementation to prevent seasonal influenza A in schoolchildren.

机构信息

Division of Molecular Epidemiology, Jikei University School of Medicine, Nishi-shimbashi 3-25-8, Minato-ku, Tokyo 105-8461, Japan.

出版信息

Am J Clin Nutr. 2010 May;91(5):1255-60. doi: 10.3945/ajcn.2009.29094. Epub 2010 Mar 10.

Abstract

BACKGROUND

To our knowledge, no rigorously designed clinical trials have evaluated the relation between vitamin D and physician-diagnosed seasonal influenza.

OBJECTIVE

We investigated the effect of vitamin D supplements on the incidence of seasonal influenza A in schoolchildren.

DESIGN

From December 2008 through March 2009, we conducted a randomized, double-blind, placebo-controlled trial comparing vitamin D(3) supplements (1200 IU/d) with placebo in schoolchildren. The primary outcome was the incidence of influenza A, diagnosed with influenza antigen testing with a nasopharyngeal swab specimen.

RESULTS

Influenza A occurred in 18 of 167 (10.8%) children in the vitamin D(3) group compared with 31 of 167 (18.6%) children in the placebo group [relative risk (RR), 0.58; 95% CI: 0.34, 0.99; P = 0.04]. The reduction in influenza A was more prominent in children who had not been taking other vitamin D supplements (RR: 0.36; 95% CI: 0.17, 0.79; P = 0.006) and who started nursery school after age 3 y (RR: 0.36; 95% CI: 0.17, 0.78; P = 0.005). In children with a previous diagnosis of asthma, asthma attacks as a secondary outcome occurred in 2 children receiving vitamin D(3) compared with 12 children receiving placebo (RR: 0.17; 95% CI: 0.04, 0.73; P = 0.006).

CONCLUSION

This study suggests that vitamin D(3) supplementation during the winter may reduce the incidence of influenza A, especially in specific subgroups of schoolchildren. This trial was registered at https://center.umin.ac.jp as UMIN000001373.

摘要

背景

据我们所知,目前尚无严格设计的临床试验评估过维生素 D 与医生诊断的季节性流感之间的关系。

目的

我们研究了维生素 D 补充剂对学龄儿童季节性甲型流感发病率的影响。

设计

2008 年 12 月至 2009 年 3 月,我们开展了一项随机、双盲、安慰剂对照试验,比较了维生素 D3(1200IU/d)补充剂与安慰剂在学龄儿童中的作用。主要结局是通过鼻咽拭子样本进行流感抗原检测诊断的甲型流感发病率。

结果

在维生素 D3 组的 167 名儿童中,有 18 名(10.8%)发生了甲型流感,而安慰剂组的 167 名儿童中有 31 名(18.6%)发生了流感[相对风险(RR)为 0.58;95%置信区间:0.34,0.99;P=0.04]。未服用其他维生素 D 补充剂的儿童(RR:0.36;95%置信区间:0.17,0.79;P=0.006)和 3 岁以后开始上幼儿园的儿童(RR:0.36;95%置信区间:0.17,0.78;P=0.005)中,流感 A 的减少更为明显。在既往诊断为哮喘的儿童中,作为次要结局的哮喘发作,接受维生素 D3 的 2 名儿童与接受安慰剂的 12 名儿童相比(RR:0.17;95%置信区间:0.04,0.73;P=0.006)。

结论

本研究表明,冬季补充维生素 D3 可能会降低甲型流感的发病率,特别是在特定的学龄儿童亚组中。本试验在 https://center.umin.ac.jp 注册,注册号为 UMIN000001373。

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