From the *Pediatric Clinic 1, Department of Pathophysiology and Transplantation, Università degli Studi di Milano, †Epidemiology Unit, Department of Preventive Medicine, and ‡Laboratory Medicine Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
Pediatr Infect Dis J. 2013 Oct;32(10):1055-60. doi: 10.1097/INF.0b013e31829be0b0.
The aim of this study was to evaluate whether a deficit in vitamin D (VD) is associated with an increased risk of recurrent acute otitis media (AOM) and whether VD supplementation is effective in reducing the number of AOM episodes in otitis-prone children.
A total of 116 children with a history of recurrent AOM (≥3 episodes in preceding 6 months or ≥4 episodes in preceding 12 months) were prospectively and blindly randomized to receive oral VD 1000 IU/d or placebo for 4 months. Episodes of AOM were monitored for 6 months.
Fifty-eight children received placebo and 58 with similar characteristics were treated with VD. The number of children experiencing ≥1 AOM episode during the study period was significantly lower in the treatment group (26 versus 38; P = 0.03). There was a marked difference in the number of children who developed uncomplicated AOM (P < 0.001), but no difference in the number of children with ≥1 episode of spontaneous otorrhea. The likelihood of AOM was significantly reduced in the patients whose serum VD concentrations were ≥30 ng/mL.
VD hypovitaminosis is common in children with recurrent AOM and associated with an increase in the occurrence of AOM when serum 25(OH)D levels are <30 ng/mL. The administration of VD in a dosage of 1000 IU/d restores serum values of ≥30 ng/mL in most cases and is associated with a significant reduction in the risk of uncomplicated AOM.
本研究旨在评估维生素 D（VD）缺乏是否与复发性急性中耳炎（AOM）风险增加相关，以及 VD 补充是否能有效减少易患 AOM 儿童的 AOM 发作次数。
共纳入 116 例有复发性 AOM 病史（前 6 个月至少 3 次发作，或前 12 个月至少 4 次发作）的儿童，前瞻性、双盲随机分为口服 VD 1000IU/d 组或安慰剂组，疗程 4 个月。监测 AOM 发作情况 6 个月。
58 例患儿接受安慰剂治疗，58 例具有相似特征的患儿接受 VD 治疗。研究期间，≥1 次 AOM 发作的患儿数量在治疗组显著降低（26 例 vs. 38 例；P = 0.03）。单纯性 AOM 患儿数量存在显著差异（P < 0.001），但自发性耳漏≥1 次的患儿数量无差异。血清 VD 浓度≥30ng/mL 的患儿 AOM 发生风险显著降低。
复发性 AOM 患儿常存在 VD 缺乏，且血清 25(OH)D 水平<30ng/mL 时，AOM 发生率增加。每日 1000IU 的 VD 剂量补充可使大多数患儿血清值恢复至≥30ng/mL，与单纯性 AOM 风险显著降低相关。
