Stenberg Hammar Katarina, Hedlin Gunilla, Konradsen Jon R, Nordlund Björn, Kull Inger, Giske Christian G, Pedroletti Christophe, Söderhäll Cilla, Melén Erik
Astrid Lindgren Children's Hospital, Karolinska University Hospital, Stockholm, Sweden; Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden.
Acta Paediatr. 2014 Aug;103(8):856-61. doi: 10.1111/apa.12666. Epub 2014 May 16.
This study evaluated risk factors for acute wheeze in preschool children and investigated whether subnormal levels of vitamin D were associated with increased risk for acute wheeze, atopy or viral/bacterial respiratory infections.
We recruited 130 children with acute wheeze, aged 6 months to 4 years, from paediatric emergency departments in Stockholm, Sweden, and 101 age-matched controls with no history of wheeze or sensitisation to airborne allergens. Parents answered standardised questionnaires, and blood samples were analysed for specific IgE to airborne and food allergens and levels of 25 hydroxyvitamin D (25(OH)D). Nasopharyngeal virus samples were collected during the emergency department visit in the group of children with wheeze, and a subset were also tested for bacteria.
Vitamin D insufficiency (25(OH)D < 75 nmol/L (30 ng/mL)) was associated with an odds ratio of 2.7 (95% confidence interval 1.1-6.2) for acute wheeze. However, no association was found between vitamin D insufficiency and atopy, presence of virus or bacteria or recurrent infections. Children older than 24 months were particularly at risk of subnormal vitamin D levels, irrespective of wheezing history.
Our findings support the hypothesis that subnormal levels of vitamin D are associated with acute wheeze in young children.
本研究评估了学龄前儿童急性喘息的风险因素,并调查了维生素D水平低于正常是否与急性喘息、特应性或病毒/细菌呼吸道感染风险增加有关。
我们从瑞典斯德哥尔摩的儿科急诊科招募了130名年龄在6个月至4岁之间的急性喘息儿童,以及101名年龄匹配、无喘息病史或对空气传播过敏原致敏史的对照儿童。家长回答标准化问卷,并对血样进行分析,检测针对空气传播和食物过敏原的特异性IgE以及25羟维生素D(25(OH)D)水平。在喘息儿童组的急诊科就诊期间采集鼻咽病毒样本,对其中一部分还进行了细菌检测。
维生素D不足(25(OH)D < 75 nmol/L(30 ng/mL))与急性喘息的比值比为2.7(95%置信区间1.1 - 6.2)。然而,未发现维生素D不足与特应性、病毒或细菌的存在或反复感染之间存在关联。无论有无喘息病史,24个月以上的儿童尤其有维生素D水平低于正常的风险。
我们的研究结果支持维生素D水平低于正常与幼儿急性喘息有关这一假设。