Critical Care Dept of Medicine, Division of Pulmonary and Critical Care, School of Medicine, Johns Hopkins University, Baltimore, MD 21212, USA.
Eur Respir J. 2011 Dec;38(6):1310-9. doi: 10.1183/09031936.00006911. Epub 2011 Jun 23.
Animal models suggest that vitamin A deficiency affects lung development adversely and promotes airway hyperresponsiveness, and may predispose to an increased risk of asthma. We examined the long-term effects of vitamin A supplementation early in life on later asthma risk. In 2006-2008, we revisited participants from two cohorts in rural Nepal who were enrolled in randomised trials of vitamin A supplementation. The first cohort received vitamin A or placebo for <16 months during their pre-school years (1989-1991). The second cohort was born to mothers who received vitamin A, β-carotene or placebo before, during and after pregnancy (1994-1997). At follow-up, we asked about asthma symptoms and performed spirometry. Out of 6,421 subjects eligible to participate, 5,430 (85%) responded to our respiratory survey. Wheezing prevalence during the previous year was 4.8% in participants aged 9-13 yrs and 6.6% in participants aged 14-23 yrs. We found no differences between the vitamin A supplemented and placebo groups from either trial in the prevalence of lifetime or current asthma and wheeze or in spirometric indices of obstruction (p ≥ 0.12 for all comparisons). Vitamin A supplementation early in life was not associated with a decreased risk of asthma in an area with chronic vitamin A deficiency.
动物模型表明，维生素 A 缺乏会对肺部发育产生不利影响，促进气道高反应性，并可能增加哮喘的风险。我们研究了生命早期补充维生素 A 对以后哮喘风险的长期影响。2006-2008 年，我们重新联系了尼泊尔农村两个队列的参与者，他们参加了维生素 A 补充的随机试验。第一队列在学前期间（1989-1991 年）接受了不到 16 个月的维生素 A 或安慰剂治疗。第二队列的母亲在怀孕前、怀孕中和怀孕后接受了维生素 A、β-胡萝卜素或安慰剂治疗。随访时，我们询问了哮喘症状并进行了肺功能检查。在 6421 名符合条件的参与者中，有 5430 名（85%）对我们的呼吸调查做出了回应。在年龄为 9-13 岁的参与者中，过去一年喘息的患病率为 4.8%，在年龄为 14-23 岁的参与者中为 6.6%。我们发现，来自两个试验的补充维生素 A 组与安慰剂组在终身或当前哮喘和喘息的患病率以及气道阻塞的肺功能指标方面没有差异（所有比较的 p 值均≥0.12）。在慢性维生素 A 缺乏的地区，生命早期补充维生素 A 与哮喘风险降低无关。
