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25-羟维生素 D 浓度、儿童哮喘和特应性皮炎:世代研究。

25-Hydroxyvitamin D concentrations, asthma and eczema in childhood: The generation R study.

机构信息

From the Generation R Study Group, The Netherlands; Departments of Pediatrics, Erasmus University, Rotterdam, The Netherlands.

Departments of Epidemiology, Erasmus University, Rotterdam, The Netherlands.

出版信息

Clin Nutr. 2018 Feb;37(1):169-176. doi: 10.1016/j.clnu.2016.11.019. Epub 2016 Dec 8.

DOI:10.1016/j.clnu.2016.11.019
PMID:28017448
Abstract

BACKGROUND & AIMS: A role of vitamin D in the development of respiratory and allergic disease in children remains unclear. It may be likely that vitamin D has an effect on airway inflammation, but only few studies examined the effect in children. We aimed to examine whether serum 25-hydroxyvitamin D (25(OH) vitamin D) concentrations are associated with the fraction of exhaled nitric oxide (FeNO), airway interrupter resistance (Rint), physician diagnosed asthma ever, wheezing and eczema in a population-based cohort study in 6 year old children.

METHODS

Serum 25(OH) vitamin D concentration was assessed in 3815 children. 25(OH) vitamin D concentrations ≥75 nmol/L were considered as sufficient, between 50 and 75 nmol/L as insufficient, and <50 nmol/L as deficient. FeNO and Rint were measured at the research center. Data on physician diagnosed asthma, wheezing, and eczema were obtained by parent-reported questionnaires.

RESULTS

In comparison with sufficient 25(OH) vitamin D concentration, deficient concentrations were associated with elevated FeNO of ≥25 ppb (OR: 2.54; 95% CI: 1.34-4.80). In addition, deficient and insufficient 25(OH) vitamin D concentrations were associated with a lower Rint (Z-score: -1.26; 95% CI: -1.66 to -0.85) (ß: -0.75; 95% CI: -1.08 to -0.42), and increased risks of eczema (OR: 1.65; 95% CI: 1.13-2.41) (OR: 1.44; 95% CI: 1.06-1.95). Insufficient 25(OH) vitamin D concentration were associated with a decreased risk of physician diagnosed asthma ever (OR: 0.59; 95% CI: 0.38-0.94).

CONCLUSIONS

Our results indicate that lower 25(OH) vitamin D levels are associated with elevated FeNO levels, but lower Rint values. Lower 25(OH) vitamin D levels are also associated with a decreased risk for asthma diagnoses but an increased risk for eczema.

摘要

背景与目的

维生素 D 在儿童呼吸道和过敏疾病发展中的作用尚不清楚。维生素 D 可能对气道炎症有影响,但仅有少数研究对此进行了检测。我们旨在通过一项基于人群的 6 岁儿童队列研究,检测血清 25-羟维生素 D [25(OH) 维生素 D] 浓度与呼出气一氧化氮分数(FeNO)、气道阻断阻力(Rint)、医生诊断的哮喘史、喘息和湿疹之间的相关性。

方法

对 3815 名儿童的血清 25(OH) 维生素 D 浓度进行评估。将 25(OH) 维生素 D 浓度≥75 nmol/L 定义为充足,50~75 nmol/L 为不足,<50 nmol/L 为缺乏。在研究中心测量 FeNO 和 Rint。通过父母报告的问卷获取医生诊断的哮喘、喘息和湿疹的数据。

结果

与充足的 25(OH) 维生素 D 浓度相比,缺乏浓度与 FeNO 升高(≥25 ppb)相关(OR:2.54;95%CI:1.344.80)。此外,缺乏和不足的 25(OH) 维生素 D 浓度与较低的 Rint(Z 评分:-1.26;95%CI:-1.66-0.85)(β:-0.75;95%CI:-1.08-0.42)和湿疹风险增加(OR:1.65;95%CI:1.132.41)(OR:1.44;95%CI:1.061.95)相关。不足的 25(OH) 维生素 D 浓度与医生诊断的哮喘史减少相关(OR:0.59;95%CI:0.380.94)。

结论

我们的结果表明,较低的 25(OH) 维生素 D 水平与 FeNO 水平升高相关,但与 Rint 值降低相关。较低的 25(OH) 维生素 D 水平也与哮喘诊断风险降低相关,但与湿疹风险增加相关。

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