Niruban S J, Alagiakrishnan K, Beach J, Senthilselvan A
School of Public Health, University of Alberta, Edmonton, Alberta, Canada.
Department of Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada.
Eur J Clin Nutr. 2014 Dec;68(12):1334-40. doi: 10.1038/ejcn.2014.121. Epub 2014 Jul 2.
BACKGROUND/OBJECTIVES: Vitamin D modifies airway inflammation and appears to be important in building immunity against respiratory infections, and so is potentially beneficial in asthma. However, to date results from studies investigating the relationship of vitamin D with respiratory outcomes are inconsistent. The objective of this study was to determine the association of vitamin D with current wheeze, ever asthma and lung function.
SUBJECTS/METHODS: Data on 1213 children aged 6-12 years, from the Canadian Health Measures Survey, were considered for the study. Serum 25-hydroxy vitamin D (25(OH)D) levels were categorized into three categories: ⩽49 nmol/l (low); 50-74 nmol/l (moderate); and ⩾75 nmol/l (high).
Children in the low and high 25(OH)D categories were more likely to report current wheeze in comparison to those in the moderate category (odds ratio (OR): 3.26, 95% confidence interval (CI): 1.16-9.17 and OR: 2.14, 95% CI: 1.07-4.28, respectively). The results for the association between 25(OH)D levels and ever asthma were similar to those observed for current wheeze, except that a significant association was observed only in the lower category. The rate of increase in forced expiratory volume in one second and forced vital capacity with age was greater in the moderate category.
Children in both low and high 25(OH)D categories had increased risk of current wheeze and reduced rate of change in lung function with age in comparison to the moderate category, raising the possibility of a U-shaped association between vitamin D levels and respiratory health. Clearer guidelines for optimal vitamin D levels are required to improve respiratory health in children.
背景/目的:维生素D可调节气道炎症,在增强抵抗呼吸道感染的免疫力方面似乎很重要,因此对哮喘可能有益。然而,迄今为止,研究维生素D与呼吸道疾病结局之间关系的研究结果并不一致。本研究的目的是确定维生素D与当前喘息、曾患哮喘和肺功能之间的关联。
受试者/方法:本研究纳入了加拿大健康措施调查中1213名6至12岁儿童的数据。血清25-羟基维生素D(25(OH)D)水平分为三类:≤49 nmol/l(低);50 - 74 nmol/l(中);≥75 nmol/l(高)。
与中等水平组相比,低水平和高水平25(OH)D组的儿童更有可能报告当前喘息(优势比(OR)分别为:3.26,95%置信区间(CI):1.16 - 9.17和OR:2.14,95% CI:1.07 - 4.28)。25(OH)D水平与曾患哮喘之间的关联结果与当前喘息的观察结果相似,只是仅在较低水平组观察到显著关联。中等水平组一秒用力呼气量和用力肺活量随年龄的增加速率更大。
与中等水平组相比,低水平和高水平25(OH)D组的儿童当前喘息风险增加,且肺功能随年龄的变化率降低,这增加了维生素D水平与呼吸道健康呈U形关联的可能性。需要更明确的最佳维生素D水平指南来改善儿童的呼吸道健康。