Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Ontario, Canada.
Faculty of Medicine, Department of Nutritional Sciences, University of Toronto, Toronto, Ontario, Canada.
Pediatr Pulmonol. 2018 Aug;53(8):1018-1026. doi: 10.1002/ppul.24067. Epub 2018 Jun 15.
Asthma is the most common chronic illness of childhood and a common reason for hospital admission. Studies suggest that low vitamin D levels may be associated with health service utilization (HSU) for childhood asthma. The primary objective was to determine if vitamin D serum levels in early childhood were associated with HSU for asthma including: a) hospital admissions; b) emergency department visits; and c) outpatient sick visits. Secondary objectives were to determine whether vitamin D supplementation in pregnancy or childhood were associated with HSU for asthma.
Prospective cohort study of children participating in the TARGet Kids! practice-based research network between 2008 and 2013 in Toronto, Canada. HSU was determined by linking each child's provincial health insurance number to health administrative databases. Multivariable quasi-Poisson and logistic regression were used to evaluate the association between 25-hydroxyvitamin D concentrations, vitamin D supplementation in pregnancy, and childhood and HSU for asthma.
A total of 2926 healthy children aged 0-6 years had 25-hydroxyvitamin D data available and were included in the primary analysis. Mean (IQR) 25-hydroxyvitmain D level was 84 nmol/L (65-98 nmol/L), 218 and 1267 children had 25-hydroxyvitamin D concentrations <50 nmol/L and <75 nmol/L, respectively. In the adjusted models, there were no associations between 25-hydroxyvitamin D concentrations (continuously or dichotomized at 50 and 75 nmol/L), vitamin D supplementation in pregnancy or childhood and HSU for asthma.
Vitamin D blood values do not appear to be associated with HSU for asthma in this population of healthy urban children.
哮喘是儿童最常见的慢性疾病，也是住院的常见原因。研究表明，维生素 D 水平低可能与儿童哮喘的医疗服务利用（HSU）有关。主要目的是确定儿童早期维生素 D 血清水平是否与哮喘的 HSU 相关，包括：a）住院；b）急诊就诊；c）门诊就诊。次要目标是确定孕妇或儿童期维生素 D 补充是否与哮喘的 HSU 相关。
对 2008 年至 2013 年期间在加拿大多伦多参加 TARGet Kids!基于实践的研究网络的儿童进行前瞻性队列研究。通过将每个儿童的省级健康保险号码与健康管理数据库相关联，确定 HSU。使用多变量拟泊松和逻辑回归来评估 25-羟维生素 D 浓度、孕妇和儿童期维生素 D 补充与哮喘 HSU 之间的关系。
共有 2926 名 0-6 岁健康儿童有 25-羟维生素 D 数据，纳入主要分析。平均（IQR）25-羟维生素 D 水平为 84nmol/L（65-98nmol/L），218 名和 1267 名儿童的 25-羟维生素 D 浓度分别<50nmol/L 和<75nmol/L。在调整后的模型中，25-羟维生素 D 浓度（连续或二分类为 50 和 75nmol/L）、孕妇或儿童期维生素 D 补充与哮喘的 HSU 之间均无关联。
在该健康城市儿童人群中，维生素 D 血液值似乎与哮喘的 HSU 无关。
