Department of Paediatrics: Child and Youth Health, The University of Auckland, Auckland, New Zealand.
Division of Otolaryngology-Head and Neck Surgery, Counties-Manukau District Health Board, Auckland, New Zealand.
Acta Paediatr. 2017 Sep;106(9):1487-1492. doi: 10.1111/apa.13908. Epub 2017 Jun 9.
Vitamin D supplementation and higher 25(OH)-vitamin D concentration are associated with reduced risk of acute respiratory infection. This study examined whether there is a similar association between higher serum 25(OH)D concentration and lower risk of chronic otitis media with effusion (COME).
In a case-control study, serum 25(OH)D concentration in children referred for tympanostomy tube placement for COME (n = 178) was compared to that of healthy children randomly sampled from primary care practices (n = 179). Subjects aged three and four years were recruited in Auckland, New Zealand between May 2011 and November 2013. Blood samples were collected from the children, and their guardians were interviewed. Odds ratios were calculated using logistic regression.
In a multivariable analysis, higher serum 25(OH)D concentration was associated with a lower risk of COME (OR: 0.86 per 10 nmol/L; 95% CI 0.77-0.97) after adjusting for age, sex, deprivation index, ethnicity, tobacco smoke exposure, duration of breastfeeding and season of blood sampling. Further adjustment for eight additional risk factors did not change the result.
This finding supports further investigation into whether the risk of COME could be reduced by increasing serum 25(OH)D concentration through increased sun exposure, higher dietary intake or vitamin D supplementation.
维生素 D 补充和更高的 25(OH)-维生素 D 浓度与急性呼吸道感染风险降低相关。本研究旨在检验血清 25(OH)D 浓度升高与分泌性中耳炎（OME）风险降低之间是否存在类似关联。
在病例对照研究中，比较了因 OME 而接受鼓膜切开置管术的儿童（n=178）和从初级保健机构中随机抽取的健康儿童（n=179）的血清 25(OH)D 浓度。2011 年 5 月至 2013 年 11 月，在新西兰奥克兰招募了年龄在 3 至 4 岁的儿童。从儿童身上采集血样，并对其监护人进行访谈。采用逻辑回归计算比值比。
在多变量分析中，在校正年龄、性别、贫困指数、种族、吸烟暴露、母乳喂养持续时间和采血季节等因素后，较高的血清 25(OH)D 浓度与 OME 风险降低相关（OR：每 10 nmol/L 降低 0.86；95%CI 0.77-0.97）。进一步调整 8 个额外的危险因素后，结果未发生改变。
这一发现支持进一步研究通过增加阳光暴露、增加饮食摄入或维生素 D 补充来提高血清 25(OH)D 浓度是否可以降低 OME 的风险。
