脐血25(OH)D3对婴儿早期特应性皮炎的预测价值
[Predictive value of cord blood 25(OH)D3 for early infantile atopic dermatitis].
作者信息
Li Min-Min, Lu Chun-Yan, Wang Xiao-Ming
机构信息
Department of Pediatrics, Shanghai Fifth People′s Hospital Affiliated to Fudan University, Shanghai 200240, China.
出版信息
Zhongguo Dang Dai Er Ke Za Zhi. 2018 Apr;20(4):303-307. doi: 10.7499/j.issn.1008-8830.2018.04.010.
OBJECTIVE
To explore the predictive value of cord blood 25(OH)D [25(OH)D] for infantile atopic dermatitis (AD), and to provide a reference for primary prevention of early infantile AD.
METHODS
The neonates born from July to September, 2015 were enrolled. The cord blood samples were collected at birth to measure the level of 25(OH)D. Outpatient follow-up was conducted for all the infants at 6 weeks, 3 months, and 6 months after birth. A survey was performed to investigate the incidence of AD.
RESULTS
A total of 67 neonates completed a 6-month follow-up. The incidence of AD was 34% (23/67), and 91% (21/23) of these cases occurred in the first month after birth. The 23 AD children had a significantly lower cord 25(OH)D level than those without AD (P<0.05). The children with a cord 25(OH)D level <30 nmol/L showed a significantly higher incidence of AD than those with a cord 25(OH)D level ≥30 nmol/L (P<0.05). The receiver operating characteristic (ROC) analysis showed that the area under the ROC curve of cord 25(OH)D in predicting AD was 0.648 (standard error: 0.075; 95%CI: 0.502-0.795). Its sensitivity, specificity, positive predictive value, and negative predictive value were 52.2%, 79.5%, 57.1%, and 76.1%, respectively. Logistic regression analysis showed that low cord 25(OH)D level, preference for seafood during pregnancy, atopic family history, and mixed feeding were risk factors for infantile AD (P<0.05).
CONCLUSIONS
Cord 25(OH)D level is inversely associated with the risk of infantile AD, but it has a low diagnostic value for this disease.
目的
探讨脐血25（羟）维生素D[25（OH）D]对婴幼儿特应性皮炎（AD）的预测价值，为早期婴幼儿AD的一级预防提供参考。
方法
选取2015年7月至9月出生的新生儿。出生时采集脐血样本以测定25（OH）D水平。对所有婴儿在出生后6周、3个月和6个月进行门诊随访。进行调查以了解AD的发病率。
结果
共有67例新生儿完成了6个月的随访。AD的发病率为34%（23/67），其中91%（21/23）的病例发生在出生后的第一个月。23例AD患儿的脐血25（OH）D水平明显低于无AD的患儿（P<0.05）。脐血25（OH）D水平<30 nmol/L的儿童AD发病率明显高于脐血25（OH）D水平≥30 nmol/L的儿童（P<0.05）。受试者工作特征（ROC）分析显示，脐血25（OH）D预测AD的ROC曲线下面积为0.648（标准误：0.075；95%CI：0.502 - 0.795）。其敏感性、特异性、阳性预测值和阴性预测值分别为52.2%、79.5%、57.1%和76.1%。Logistic回归分析显示，脐血25（OH）D水平低、孕期偏爱海鲜、特应性家族史和混合喂养是婴幼儿AD的危险因素（P<0.05）。
结论
脐血25（OH）D水平与婴幼儿AD的风险呈负相关，但对该病的诊断价值较低。
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