Murdoch Childrens Research Institute, Department of Paediatrics, The University of Melbourne, Department of Allergy and Immunology, The Royal Children's Hospital, Parkville, Victoria, Australia.
J Allergy Clin Immunol. 2013 Apr;131(4):1109-16, 1116.e1-6. doi: 10.1016/j.jaci.2013.01.017. Epub 2013 Feb 27.
Epidemiological evidence has shown that pediatric food allergy is more prevalent in regions further from the equator, suggesting that vitamin D insufficiency may play a role in this disease.
To investigate the role of vitamin D status in infantile food allergy.
A population sample of 5276 one-year-old infants underwent skin prick testing to peanut, egg, sesame, and cow's milk or shrimp. All those with a detectable wheal and a random sample of participants with negative skin prick test results attended a hospital-based food challenge clinic. Blood samples were available for 577 infants (344 with challenge-proven food allergy, 74 sensitized but tolerant to food challenge, 159 negative on skin prick test and food challenge). Serum 25-hydroxyvitamin D levels were measured by using liquid chromatography tandem mass spectrometry. Associations between serum 25-hydroxyvitamin D and food allergy were examined by using multiple logistic regression, adjusting for potential risk and confounding factors.
Infants of Australian-born parents, but not of parents born overseas, with vitamin D insufficiency (≤50 nmol/L) were more likely to be peanut (adjusted odds ratio [aOR], 11.51; 95% CI, 2.01-65.79; P=.006) and/or egg (aOR, 3.79; 95% CI, 1.19-12.08; P=.025) allergic than were those with adequate vitamin D levels independent of eczema status. Among those with Australian-born parents, infants with vitamin D insufficiency were more likely to have multiple food allergies (≥2) rather than a single food allergy (aOR, 10.48; 95% CI, 1.60-68.61 vs aOR, 1.82; 95% CI, 0.38-8.77, respectively).
These results provide the first direct evidence that vitamin D sufficiency may be an important protective factor for food allergy in the first year of life.
流行病学证据表明，离赤道越远的地区，儿科食物过敏越普遍，这表明维生素 D 不足可能在这种疾病中起作用。
研究维生素 D 状态在婴儿食物过敏中的作用。
对 5276 名一岁婴儿进行了花生、鸡蛋、芝麻、牛奶或虾的皮肤点刺试验。所有皮试阳性且有记录的婴儿和随机抽取的皮试阴性但食物挑战阳性的婴儿参加了以医院为基础的食物挑战门诊。577 名婴儿的血样可供分析（344 名食物挑战阳性的食物过敏婴儿、74 名食物挑战阳性但耐受的致敏婴儿、159 名皮试和食物挑战均阴性的婴儿）。采用液相色谱串联质谱法检测血清 25-羟维生素 D 水平。采用多因素 logistic 回归分析维生素 D 与食物过敏的相关性，调整潜在的风险和混杂因素。
维生素 D 不足（≤50 nmol/L）的澳裔父母所生婴儿比维生素 D 充足的澳裔父母所生婴儿更有可能发生花生（调整优势比[aOR]，11.51；95%置信区间[CI]，2.01-65.79；P=.006）和/或鸡蛋过敏（aOR，3.79；95% CI，1.19-12.08；P=.025），且不论湿疹状态如何。在澳裔父母所生的婴儿中，维生素 D 不足的婴儿更有可能发生多种食物过敏（≥2 种）而不是单一食物过敏（aOR，10.48；95% CI，1.60-68.61 比 aOR，1.82；95% CI，0.38-8.77）。
这些结果首次直接证明，维生素 D 充足可能是婴儿期食物过敏的一个重要保护因素。
