Hon K L, Tsang Y C, Poon T C W, Pong N H H, Luk N M, Leung T N H, Chow C M, Leung T F
Department of Paediatrics, Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong SAR, China.
Pilot Laboratory, Faculty of Health Sciences, University of Macau, Avenida da Universidade, Taipa, Macau, China.
Clin Exp Dermatol. 2016 Mar;41(2):129-37. doi: 10.1111/ced.12714. Epub 2015 Jul 30.
Many parents of children with atopic eczema (AE) practise empirical dietary avoidance and supplementation, and seek healthcare advice on whether consumption of dairy and nondairy beverages may be beneficial or detrimental for this condition.
We investigated if frequency of consumption of beverages was associated with disease severity and quality of life (QoL).
Parent-reported frequency of drinks and beverages were recorded in consecutive children with AE, and disease severity (Nottingham Eczema Severity Score; NESS), QoL (Children's Dermatology Life Quality Index; CDLQI), skin hydration (SH), transepidermal water loss (TEWL), blood pressure (BP), resting heart rate (RHR) and body mass index (BMI) were evaluated.
AE was associated with worse QoL than miscellaneous non-AE skin diseases (P < 0.001). Compared with children without AE, there was a trend for children with AE to drink less milk (P = 0.06) and more miscellaneous beverages (such as Chinese herbal tea and soymilk; P = 0.03). In children with AE, NESS correlated with CDLQI (ρ = 0.66, P < 0.001) and reduced SH (ρ = -0.32, P < 0.001), whereas CDLQI correlated with a higher RHR (ρ = 0.25, P < 0.01). Multiple logistic regression showed that male sex (OR = 0.44, 95% CI 0.20-0.97; P = 0.04) and drinking fresh milk (OR = 0.42, 95% CI 0.20-0.93; P = 0.03) were independent factors associated with less severe disease. Moderate to severe impairment of CDLQI was associated with NESS (OR = 1.48, 95% CI 1.28-1.71; P < 0.001) and RHR (OR = 1.05, 95% CI 1.02-1.08; P < 0.01) but not with reported habits of beverage consumption. Concerning cardiovascular health in AE, frequency of formula milk consumption was associated with RHR (ρ = 0.17, P = 0.04), and soft drink consumption was associated with higher systolic blood pressure (SBP) (ρ = 0.18, P = 0.04).
This study provides evidence for parental/patient guidance. Children with AE who reported more fresh milk consumption had less severe disease. There was no correlation between consumption of nondairy beverages with disease severity or QoL, but frequency of soft drink consumption correlated with SBP. With these results being supported by a literature review, it is reasonable to advise parents that fresh milk can be consumed by unsensitized children with AE. Soft drinks and other beverages should not be consumed in excess for optimal cardiovascular health and for other health reasons.
许多特应性皮炎（AE）患儿的家长采取经验性饮食回避和补充措施，并就饮用乳制品和非乳制品饮料对该病是有益还是有害寻求医疗建议。
我们调查了饮料的饮用频率是否与疾病严重程度和生活质量（QoL）相关。
记录连续纳入的AE患儿家长报告的饮料饮用频率，并评估疾病严重程度（诺丁汉湿疹严重程度评分；NESS）、生活质量（儿童皮肤病生活质量指数；CDLQI）、皮肤水合作用（SH）、经表皮水分流失（TEWL）、血压（BP）、静息心率（RHR）和体重指数（BMI）。
与其他非AE皮肤病相比，AE患儿的生活质量更差（P < 0.001）。与无AE的儿童相比，AE患儿有少喝牛奶的趋势（P = 0.06），多喝其他饮料（如中药茶和豆浆；P = 0.03）。在AE患儿中，NESS与CDLQI相关（ρ = 0.66，P < 0.001）且与SH降低相关（ρ = -0.32，P < 0.001），而CDLQI与较高的RHR相关（ρ = 0.25，P < 0.01）。多因素logistic回归显示，男性（OR = 0.44，95%CI 0.20 - 0.97；P = 0.04）和饮用鲜牛奶（OR = 0.42，95%CI 0.20 - 0.93；P = 0.03）是疾病较轻的独立相关因素。CDLQI的中度至重度损害与NESS（OR = 1.48，95%CI 1.28 - 1.71；P < 0.001）和RHR（OR = 1.05，95%CI 1.02 - 1.08；P < 0.01）相关，但与报告的饮料饮用习惯无关。关于AE患儿的心血管健康，配方奶饮用频率与RHR相关（ρ = 0.17，P = 0.04），软饮料饮用与较高的收缩压（SBP）相关（ρ = 0.18，P = 0.04）。
本研究为家长/患者指导提供了证据。报告饮用较多鲜牛奶的AE患儿疾病较轻。非乳制品饮料的饮用与疾病严重程度或生活质量之间无相关性，但软饮料饮用频率与SBP相关。这些结果得到文献综述的支持，建议家长让未致敏的AE患儿饮用鲜牛奶是合理的。为了最佳心血管健康和其他健康原因，不应过量饮用软饮料和其他饮料。
