Willits Erin K, Wang Zhen, Jin Jay, Patel Bhavisha, Motosue Megan, Bhagia Amrita, Almasri Jehad, Erwin Patricia J, Kumar Seema, Joshi Avni Y
Allergy Asthma Proc. 2017 May 1;38(3):21-28. doi: 10.2500/aap.2017.38.4043.
Vitamin D insufficiency has been associated with immune dysfunction and linked to the epidemic of atopic diseases in the Western hemisphere, yet there are studies with conflicting results, and the risk has not been quantified uniformly across studies.
To perform a systematic review and meta-analysis to evaluate and quantify if vitamin D deficiency is associated with the presence and persistence of food allergy.
A systematic review was undertaken to assess for the association between food allergy and vitamin D status in children.
A total of 368 citations relevant to this systematic review were identified. In the whole review, 5105 children were included. We did not find a significant association between 25 hydroxy vitamin D (25(OH)D) status and risk of food allergy in children (odds ratio [OR] 1.35 [95% confidence interval {CI}, 0.79-2.29]; p = 0.27, I2 = 58.3%). We conducted subgroup analyses based on different cutoffs of the 25(OH)D status (20 versus 30 ng/mL). Only one study used 30 ng/mL and found that children with <30 ng/mL were more likely to report food allergy than children with a 25(OH)D status of ≥30 ng/mL (OR 2.04 [95% CI, 1.02-4.04]; p = 0.04). Four studies compared children with a 25(OH)D status of <20 ng/mL to children with a 25(OH)D status of ≥20 ng/mL and found no significant differences (OR 1.18 [95% CI, 0.62-2.27]; p = 0.62, I2 = 62.7%).
Based on the studies analyzed, this systematic review did not identify a significant association between vitamin D status and food allergy. Interpretation of the included studies was limited by a lack of a standard definition for vitamin D deficiency and insufficient knowledge regarding the optimal vitamin D status needed to impact immune function. Longitudinal studies are warranted to assess if vitamin D might contribute to the development of food allergy.
维生素D不足与免疫功能障碍有关，并与西半球特应性疾病的流行相关，但仍有研究结果相互矛盾，且各研究中该风险的量化并不统一。
进行一项系统评价和荟萃分析，以评估和量化维生素D缺乏是否与食物过敏的存在和持续相关。
开展一项系统评价，以评估儿童食物过敏与维生素D状态之间的关联。
共识别出368条与该系统评价相关的文献。在整个评价中，纳入了5105名儿童。我们未发现25羟维生素D（25(OH)D）状态与儿童食物过敏风险之间存在显著关联（优势比[OR]1.35[95%置信区间{CI}，0.79 - 2.29]；p = 0.27，I² = 58.3%）。我们根据25(OH)D状态的不同临界值（20对30 ng/mL）进行了亚组分析。仅一项研究使用30 ng/mL作为临界值，发现25(OH)D状态<30 ng/mL的儿童比25(OH)D状态≥30 ng/mL的儿童更有可能报告食物过敏（OR 2.04[95% CI，1.02 - 4.04]；p = 0.04）。四项研究比较了25(OH)D状态<20 ng/mL的儿童与25(OH)D状态≥20 ng/mL的儿童，未发现显著差异（OR 1.18[95% CI，0.62 - 2.27]；p = 0.62，I² = 62.7%）。
基于所分析的研究，该系统评价未发现维生素D状态与食物过敏之间存在显著关联。纳入研究的解读受到维生素D缺乏缺乏标准定义以及影响免疫功能所需最佳维生素D状态相关知识不足的限制。有必要开展纵向研究以评估维生素D是否可能导致食物过敏的发生。
