Chawes Bo L, Bønnelykke Klaus, Jensen Pia F, Schoos Ann-Marie M, Heickendorff Lene, Bisgaard Hans
Copenhagen Prospective Studies on Asthma in Childhood, Health Sciences, University of Copenhagen, Danish Pediatric Asthma Center, Copenhagen University Hospital, Gentofte, Denmark.
Department of Clinical Biochemistry, Aarhus University Hospital, Aarhus, Denmark.
PLoS One. 2014 Jun 12;9(6):e99856. doi: 10.1371/journal.pone.0099856. eCollection 2014.
Epidemiological studies have suggested an association between maternal vitamin D dietary intake during pregnancy and risk of asthma and allergy in the offspring. However, prospective clinical studies on vitamin D measured in cord blood and development of clinical end-points are sparse.
To investigate the interdependence of cord blood 25-hydroxyvitamin D (25(OH)-Vitamin D) level and investigator-diagnosed asthma- and allergy-related conditions during preschool-age.
Cord blood 25(OH)-Vitamin D level was measured in 257 children from the Copenhagen Prospective Studies on Asthma in Childhood (COPSAC2000) at-risk mother-child cohort. Troublesome lung symptoms (TROLS), asthma, respiratory infections, allergic rhinitis, and eczema, at age 0-7 yrs were diagnosed exclusively by the COPSAC pediatricians strictly adhering to predefined algorithms. Objective assessments of lung function and sensitization were performed repeatedly from birth.
After adjusting for season of birth, deficient cord blood 25(OH)-Vitamin D level (<50 nmol/L) was associated with a 2.7-fold increased risk of recurrent TROLS (HR = 2.65; 95% CI = 1.02-6.86), but showed no association with respiratory infections or asthma. We saw no association between cord blood 25(OH)-Vitamin D level and lung function, sensitization, rhinitis or eczema. The effects were unaffected from adjusting for multiple lifestyle factors.
Cord blood 25(OH)-Vitamin D deficiency associated with increased risk of recurrent TROLS till age 7 years. Randomized controlled trials of vitamin D supplementation during pregnancy are needed to prove causality.
流行病学研究表明，孕期母亲维生素D的膳食摄入量与后代患哮喘和过敏的风险之间存在关联。然而，关于脐血中维生素D水平与临床终点发展的前瞻性临床研究却很稀少。
研究脐血25-羟基维生素D（25(OH)-维生素D）水平与学龄前儿童经研究者诊断的哮喘和过敏相关疾病之间的相互关系。
在哥本哈根儿童哮喘前瞻性研究（COPSAC2000）的高危母婴队列中，对257名儿童的脐血25(OH)-维生素D水平进行了测量。0至7岁儿童的令人烦恼的肺部症状（TROLS）、哮喘、呼吸道感染、过敏性鼻炎和湿疹，均由COPSAC的儿科医生严格按照预定义的算法进行诊断。从出生起就反复进行肺功能和致敏的客观评估。
在调整出生季节后，脐血25(OH)-维生素D水平不足（<50 nmol/L）与反复出现TROLS的风险增加2.7倍相关（HR = 2.65；95%CI = 1.02 - 6.86），但与呼吸道感染或哮喘无关。我们未发现脐血25(OH)-维生素D水平与肺功能、致敏、鼻炎或湿疹之间存在关联。调整多种生活方式因素后，这些影响不受影响。
脐血25(OH)-维生素D缺乏与7岁前反复出现TROLS风险增加相关。需要进行孕期补充维生素D的随机对照试验来证明因果关系。
