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孕期中期预测的维生素D状态与儿童过敏性疾病

Predicted vitamin D status in mid-pregnancy and child allergic disease.

作者信息

Maslova Ekaterina, Hansen Susanne, Thorne-Lyman Andrew L, Jensen Camilla B, Strøm Marin, Cohen Arieh, Nielsen Nina O, Olsen Sjurdur F

机构信息

Centre for Fetal Programming, Department of Epidemiology Research, Statens Serum Institut, Copenhagen, Denmark.

出版信息

Pediatr Allergy Immunol. 2014 Nov;25(7):706-13. doi: 10.1111/pai.12295. Epub 2014 Dec 5.

Abstract

BACKGROUND

Vitamin D deficiency in pregnancy may be a risk factor for child allergic disease. However, less is known about disease risk across different levels of vitamin D.

OBJECTIVE

We aimed to examine the relation between a maternal vitamin D prediction score and child allergic disease.

METHODS

A total of 32,456 pregnant women were enrolled in the Danish National Birth Cohort (1996-2003) and had data on a validated vitamin D prediction score based on 1497 mid-pregnancy plasma 25(OH)D samples. Child allergic disease was assessed at 18 months and at 7 years using questionnaire data and national registry extracts. We used multivariable log-binomial models to quantify risk ratios (RR) and 95% CI. Plasma 25(OH)D was examined in a stability analysis.

RESULTS

Median (IQR) vitamin D prediction score was 58.7 (49.2-69.0) nmol/l. In main analysis, there was no association between vitamin D prediction score examined in quintiles or by restricted categories (≥75 nmol/l and <25 nmol/l vs. 25-74.9 nmol/l) and child allergic disease. However, maternal vitamin D prediction score ≥100 nmol/l(vs. 50-79.9 nmol/l) was associated with increased risks of child asthma at 18 months (RR: 1.36, 95% CI: 1.02, 1.80) and asthma by hospital admission (RR: 1.65, 95% CI: 1.04, 2.62). For vitamin D prediction score <25-30 nmol/l, there were increased risks of child asthma at 18 months and by hospital admission and medication prescription at age 7, although these findings were not robust to covariate adjustment. Similar results were found for plasma 25(OH)D.

CONCLUSIONS

Our study provided little evidence for an association between maternal vitamin D prediction score and child allergic disease for scores ≥75 nmol/l. However, increased risks were observed for vitamin D prediction score ≥100 nmol/l. These associations are hypothesis generating and would need to be replicated in other cohorts.

摘要

背景

孕期维生素D缺乏可能是儿童过敏性疾病的一个风险因素。然而,对于不同维生素D水平下的疾病风险了解较少。

目的

我们旨在研究母亲维生素D预测评分与儿童过敏性疾病之间的关系。

方法

丹麦国家出生队列(1996 - 2003年)共纳入32456名孕妇,她们有基于1497份孕中期血浆25(OH)D样本的经过验证的维生素D预测评分数据。使用问卷数据和国家登记处摘录在18个月和7岁时评估儿童过敏性疾病。我们使用多变量对数二项式模型来量化风险比(RR)和95%置信区间(CI)。在稳定性分析中检测了血浆25(OH)D。

结果

维生素D预测评分的中位数(四分位间距)为58.7(49.2 - 69.0)nmol/l。在主要分析中,按五分位数或按受限类别(≥75 nmol/l和<25 nmol/l与25 - 74.9 nmol/l相比)检测的维生素D预测评分与儿童过敏性疾病之间无关联。然而,母亲维生素D预测评分≥100 nmol/l(与50 - 79.9 nmol/l相比)与18个月时儿童哮喘风险增加(RR:1.36,95% CI:1.02,1.80)以及因哮喘住院风险增加(RR:1.65,95% CI:1.04,2.62)相关。对于维生素D预测评分<25 - 30 nmol/l,18个月时儿童哮喘风险以及7岁时因哮喘住院和药物处方风险增加,尽管这些结果在进行协变量调整后并不稳健。血浆25(OH)D也得到了类似结果。

结论

我们的研究几乎没有提供证据表明母亲维生素D预测评分≥75 nmol/l与儿童过敏性疾病之间存在关联。然而,观察到维生素D预测评分≥100 nmol/l时风险增加。这些关联只是提出了假设,需要在其他队列中进行重复验证。

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