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产前、围产期和儿童期维生素D暴露及其与儿童过敏性鼻炎和过敏致敏的关联。

Prenatal, perinatal, and childhood vitamin D exposure and their association with childhood allergic rhinitis and allergic sensitization.

作者信息

Bunyavanich Supinda, Rifas-Shiman Sheryl L, Platts-Mills Thomas A, Workman Lisa, Sordillo Joanne E, Camargo Carlos A, Gillman Matthew W, Gold Diane R, Litonjua Augusto A

机构信息

Division of Allergy and Immunology, Department of Pediatrics, Icahn School of Medicine at Mount Sinai, New York, NY; Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY.

Department of Population Medicine, Harvard Pilgrim Health Care Institute, Boston, Mass; Harvard Medical School, Boston, Mass.

出版信息

J Allergy Clin Immunol. 2016 Apr;137(4):1063-1070.e2. doi: 10.1016/j.jaci.2015.11.031. Epub 2016 Feb 10.

Abstract

BACKGROUND

The role of early-life vitamin D in childhood allergy is controversial.

OBJECTIVE

We sought to assess vitamin D exposure in early life by multiple modalities and ascertain its association with childhood allergic rhinitis and allergic sensitization.

METHODS

One thousand two hundred forty-eight mother-child pairs from a US prebirth cohort unselected for any disease were studied. Vitamin D exposure was assessed by measures of maternal intake during the first and second trimesters of pregnancy and serum 25-hydroxyvitamin D (25[OH]D) levels in mothers during pregnancy, cord blood, and children at school age (median age, 7.7 years; interquartile range, 1.0 years). Tests for associations between vitamin D exposure with ever allergic rhinitis, serum total IgE level, and allergen sensitization at school age were conducted.

RESULTS

The correlations between maternal intake of vitamin D during pregnancy and serum 25(OH)D levels in pregnant mothers, cord blood, and children at school age were weak to moderate (r = -0.03 to 0.53). Each 100 IU/d of food-based vitamin D intake during the first and second trimesters (equivalent to the amount of vitamin D in an 8-ounce serving of milk) was associated with 21% and 20% reduced odds of ever allergic rhinitis at school age (odds ratios of 0.79 [95% CI, 0.67-0.92] and 0.80 [95% CI, 0.68-0.93]), respectively. There were no associations between maternal supplemental vitamin D intake or serum 25(OH)D levels at any time point with ever allergic rhinitis. There were no associations between any vitamin D exposure and serum total IgE level or allergen sensitization at school age.

CONCLUSIONS

Inclusion of foods containing vitamin D in maternal diets during pregnancy may have beneficial effects on childhood allergic rhinitis.

摘要

背景

儿童早期维生素D在儿童过敏中的作用存在争议。

目的

我们试图通过多种方式评估儿童早期的维生素D暴露情况,并确定其与儿童过敏性鼻炎和过敏致敏的关联。

方法

对来自美国一个未因任何疾病而入选的产前队列的1248对母婴进行了研究。通过孕期头三个月和第二个三个月的母体摄入量以及孕期母亲、脐带血和学龄儿童(中位年龄7.7岁;四分位间距1.0岁)的血清25-羟基维生素D(25[OH]D)水平来评估维生素D暴露情况。对维生素D暴露与学龄期过敏性鼻炎、血清总IgE水平和过敏原致敏之间的关联进行了检测。

结果

孕期母亲维生素D摄入量与孕期母亲、脐带血和学龄儿童血清25(OH)D水平之间的相关性为弱至中度(r = -0.03至0.53)。孕期头三个月和第二个三个月每100 IU/d基于食物的维生素D摄入量(相当于8盎司牛奶中的维生素D量)分别与学龄期过敏性鼻炎的患病几率降低21%和20%相关(优势比分别为0.79 [95% CI,0.67 - 0.92]和0.80 [95% CI,0.68 - 0.93])。孕期任何时间点母体补充维生素D摄入量或血清25(OH)D水平与过敏性鼻炎均无关联。任何维生素D暴露与学龄期血清总IgE水平或过敏原致敏均无关联。

结论

孕期母亲饮食中纳入含维生素D的食物可能对儿童过敏性鼻炎有有益影响。

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