Allergy and Lung Health Unit, Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia.
Murdoch Childrens Research Institute, Melbourne, VIC, Australia.
Allergy. 2018 Feb;73(2):295-312. doi: 10.1111/all.13300. Epub 2017 Oct 24.
Dietary polyunsaturated fatty acids (PUFAs) have immunoregulatory properties. Breast milk is rich in PUFA, and it has been hypothesized that these PUFAs may be important in the aetiology of allergic diseases. Despite a growing body of evidence, the associations between breast milk PUFA and allergic disease have not previously been systematically reviewed.
The search was performed in PubMed and EMBASE databases using breastfeeding, fatty acid and allergic disease terms. Two authors were involved in selecting papers for review according to the inclusion criteria and extracting information on study characteristics and measures of association. Only studies that reported numeric associations between concentration of breast milk fatty acids and allergic disease outcomes were included.
A total of 18 papers met the inclusion criteria, reporting results from 15 study populations. The majority were cohort studies (n=11), with data from only two case-control and two cross-sectional studies. Sample size varied between 30 and 352 participants, and follow-up time of the cohorts varied between 3 months and 14 years. Nine studies reported on eczema, seven reported on sensitization, and only five reported on asthma/wheeze. There was heterogeneity among studies in terms of presenting the association between PUFA and allergy; therefore, estimates could not be pooled. Only a few studies observed associations between n-3 and n-6 PUFAs and allergic disease, and the magnitude of this effect varied greatly.
There is insufficient evidence to suggest that colostrum or breast milk polyunsaturated fatty acids influence the risk of childhood allergic diseases.
膳食多不饱和脂肪酸（PUFA）具有免疫调节作用。母乳富含 PUFA，有人假设这些 PUFAs 可能在过敏性疾病的发病机制中起重要作用。尽管有越来越多的证据，但母乳 PUFAs 与过敏性疾病之间的关联尚未得到系统审查。
使用母乳喂养、脂肪酸和过敏性疾病术语在 PubMed 和 EMBASE 数据库中进行了搜索。两名作者根据纳入标准参与选择论文进行审查，并提取有关研究特征和关联度量的信息。仅包括报告母乳脂肪酸浓度与过敏性疾病结果之间存在数值关联的研究。
共有 18 篇论文符合纳入标准，报告了来自 15 个研究人群的结果。大多数是队列研究（n=11），只有两项病例对照研究和两项横断面研究的数据。样本量在 30 到 352 名参与者之间变化，队列的随访时间在 3 个月到 14 年之间变化。9 项研究报告了湿疹，7 项研究报告了致敏，只有 5 项研究报告了哮喘/喘息。在呈现 PUFA 与过敏之间的关联方面，研究之间存在异质性；因此，无法合并估计值。只有少数研究观察到 n-3 和 n-6 PUFAs 与过敏性疾病之间存在关联，并且这种关联的程度差异很大。
没有足够的证据表明初乳或母乳多不饱和脂肪酸会影响儿童过敏性疾病的风险。
