Department of Pediatrics, Chang Gung Memorial Hospital at Keelung and Chang Gung University College of Medicine, Taoyuan, Taiwan.
Division of Pediatric Pulmonology, College of Medicine, Chang Gung Memorial Hospital, Chang Gung University, Taoyuan, Taiwan.
Pediatr Allergy Immunol. 2018 May;29(3):254-259. doi: 10.1111/pai.12846. Epub 2018 Jan 5.
There are few studies addressing the longitudinal analysis of vitamin D deficiency and its impact on the development of atopic diseases in early childhood.
We investigated 155 children who regularly followed up at our clinic for 5 years as subjects enrolled in a birth cohort study. The pattern of vitamin D levels from birth to 5 years of age was clustered using K-means method in R software. Absolute eosinophil count (AEC), and total serum and specific immunoglobulin E antibodies against food (egg white, milk, and wheat) and inhalant allergens (Dermatophagoides pteronyssinus, Dermatophagoides farina, and Cladosporium herbarum) were measured at 1.5, 3, 4 and 5 years of age.
A total of 137 children with serum samples obtained over at least 3 time points during the follow-up period were recruited. Using K-means clustering, the dynamic changes in vitamin D levels were significantly stratified into 3 clusters (cluster A, ≥30 ng/mL, n = 61; cluster B, 20-29.9 ng/mL, n = 53; cluster C, <20 ng/mL, n = 23). Despite no statistical association with atopic diseases, a persistent vitamin D deficiency appeared to be associated with eosinophilia at age 3, and total serum and mite-specific immunoglobulin E (IgE) levels at age 4. Furthermore, an associated higher prevalence of mite sensitization at age 4 was significantly associated with the risk of allergic rhinitis and asthma.
Vitamin D deficiency is inversely associated with AEC and mite-specific IgE levels, which may potentially increase susceptibility to develop allergies including rhinitis and asthma in early childhood.
鲜有研究针对维生素 D 缺乏及其对婴幼儿期特应性疾病发展的影响进行纵向分析。
我们以参加一项出生队列研究的 155 名定期在我们诊所随访 5 年的儿童为研究对象。使用 R 软件中的 K-均值方法对从出生到 5 岁的维生素 D 水平模式进行聚类。在 1.5、3、4 和 5 岁时测量绝对嗜酸性粒细胞计数（AEC）以及针对食物（蛋清、牛奶和小麦）和吸入性过敏原（屋尘螨、粉尘螨和粗枝木层孔菌）的总血清和特异性免疫球蛋白 E 抗体。
共纳入 137 名在随访期间至少获得 3 个时间点血清样本的儿童。使用 K-均值聚类，维生素 D 水平的动态变化显著分为 3 组（A 组，≥30ng/mL，n=61；B 组，20-29.9ng/mL，n=53；C 组，<20ng/mL，n=23）。尽管与特应性疾病无统计学关联，但持续的维生素 D 缺乏似乎与 3 岁时的嗜酸性粒细胞增多以及 4 岁时的总血清和螨特异性免疫球蛋白 E（IgE）水平相关。此外，4 岁时螨致敏的更高患病率与过敏性鼻炎和哮喘的发病风险显著相关。
维生素 D 缺乏与 AEC 和螨特异性 IgE 水平呈负相关，这可能使儿童早期对过敏包括鼻炎和哮喘的易感性增加。
