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妊娠 16 至 20 周时维生素 D 缺乏与 6 岁时肺功能受损和哮喘有关。

Vitamin D deficiency at 16 to 20 weeks' gestation is associated with impaired lung function and asthma at 6 years of age.

机构信息

1 School of Medicine, University of Tasmania, Tasmania, Australia.

出版信息

Ann Am Thorac Soc. 2014 May;11(4):571-7. doi: 10.1513/AnnalsATS.201312-423OC.

DOI:10.1513/AnnalsATS.201312-423OC
PMID:24601713
Abstract

RATIONALE

Vitamin D deficiency is associated with chronic lung disease. We have previously shown in an in vivo mouse model that maternal vitamin D deficiency is associated with alterations in early life lung structure and function. However, there are limited data to support a relationship between maternal vitamin D deficiency during the early stages of lung development and postnatal lung function in human populations.

OBJECTIVES

To assess the association between maternal vitamin D deficiency, postnatal lung function, and asthmatic status in a longitudinal birth cohort.

METHODS

Serum was collected at 16 to 20 weeks' gestation at the time of recruitment in a community-based prospective birth cohort for measurement of vitamin D (25[OH]D). Lung function was assessed by spirometry according to American Thoracic Society guidelines in children at 6 and 14 years of age. Demographic and clinical history data were collected by questionnaire at recruitment and at the follow-up visits.

MEASUREMENTS AND MAIN RESULTS

FVC Z-scores in both sexes (β, 0.007 [95% confidence interval (CI), 0.001-0.013]; P = 0.02) and FEV1 Z-scores in girls (β, 0.007 [95% CI, 0.001-0.013]; P = 0.02) were positively associated with maternal serum 25(OH)D at 6 years of age. These associations were mostly absent at 14 years of age. Maternal vitamin D deficiency was positively associated with asthma at 6 years of age but only in boys (odds ratio, 3.03 [95% CI, 1.02-9.02]; P = 0.04).

CONCLUSIONS

This study supports the notion that vitamin D deficiency during lung development may impact on postnatal lung growth and increase the risk of developing lung disease.

摘要

背景

维生素 D 缺乏与慢性肺部疾病有关。我们之前在体内小鼠模型中已经证明,母体维生素 D 缺乏与生命早期肺部结构和功能的改变有关。然而,在人类群体中,仅有有限的数据支持在肺部发育早期母体维生素 D 缺乏与产后肺功能之间存在关联。

目的

在一个纵向出生队列中评估母体维生素 D 缺乏与产后肺功能和哮喘状态之间的关系。

方法

在一个基于社区的前瞻性出生队列中,在招募时收集妊娠 16 至 20 周的血清,以测量维生素 D(25[OH]D)。根据美国胸科学会的指南,在儿童 6 岁和 14 岁时通过肺活量测定法评估肺功能。在招募时和随访时通过问卷调查收集人口统计学和临床病史数据。

测量和主要结果

在两性中,FVC Z 分数(β,0.007[95%置信区间(CI),0.001-0.013];P=0.02)和女孩的 FEV1 Z 分数(β,0.007[95% CI,0.001-0.013];P=0.02)与 6 岁时母体血清 25(OH)D 呈正相关。这些关联在 14 岁时大多不存在。母体维生素 D 缺乏与 6 岁时的哮喘呈正相关,但仅在男孩中(比值比,3.03[95% CI,1.02-9.02];P=0.04)。

结论

本研究支持这样一种观点,即肺部发育过程中的维生素 D 缺乏可能会影响产后肺生长并增加患肺部疾病的风险。

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