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睡眠呼吸障碍儿童中维生素D缺乏与腺扁桃体肥大之间是否存在关联?

Is there an association between vitamin D deficiency and adenotonsillar hypertrophy in children with sleep-disordered breathing?

作者信息

Shin Ji-Hyeon, Kim Byung-Guk, Kim Boo Young, Kim Soo Whan, Kim Sung Won, Kim Hojong

机构信息

Department of Otolaryngology-Head and Neck Surgery, College of Medicine, The Catholic University of Korea, 222 Banpo-daero, Seocho-gu, Seoul, 06591, Republic of Korea.

出版信息

BMC Pediatr. 2018 Jun 19;18(1):196. doi: 10.1186/s12887-018-1178-8.

Abstract

BACKGROUND

Low vitamin D levels have been linked to the risk of sleep-disordered breathing (SDB) in children. Although adenotonsillar hypertrophy (ATH) is the major contributor to childhood SDB, the relationship between ATH and serum vitamin D is uncertain. We therefore investigated the relationship between vitamin D levels and associated factors in children with ATH.

METHODS

We reviewed data from all children with SDB symptoms who were treated from December 2013 to February 2014. Of these, 88 children whose serum vitamin D levels were measured were enrolled in the study. We divided the children into four groups based on adenoidal and/or tonsillar hypertrophy. We conducted a retrospective chart review to analyze demographic data, the sizes of tonsils and adenoids, serum 25-hydroxy-vitamin D [25(OH)D] level, body mass index (BMI), and allergen sensitization patterns.

RESULTS

Children in the ATH group had a lower mean 25(OH)D level than did those in the control group (p < 0.05). Children with vitamin D deficiencies exhibited markedly higher frequencies of adenoidal and/or tonsillar hypertrophy than did those with sufficient vitamin D (p < 0.05). Spearman's correlation analysis identified an inverse correlation between serum 25(OH)D levels and age, tonsil and adenoid size, and height (all p < 0.05). In a multiple regression analysis, tonsil and adenoid size as well as BMI-z score, were associated with 25(OH)D levels after controlling for age, sex, height, and mite sensitization (p < 0.05).

CONCLUSIONS

Our results suggest that low vitamin D levels are linked to ATH. Both the sizes of the adenoids and tonsils and the BMI-z score were associated with the 25(OH)D level. Therefore, measurement of the serum 25(OH)D level should be considered in children with ATH and SDB symptoms.

摘要

背景

低维生素D水平与儿童睡眠呼吸障碍(SDB)风险相关。尽管腺样体扁桃体肥大(ATH)是儿童SDB的主要原因,但ATH与血清维生素D之间的关系尚不确定。因此,我们研究了ATH患儿维生素D水平与相关因素之间的关系。

方法

我们回顾了2013年12月至2014年2月期间所有有SDB症状并接受治疗的儿童的数据。其中,88名检测了血清维生素D水平的儿童被纳入研究。我们根据腺样体和/或扁桃体肥大情况将儿童分为四组。我们进行了回顾性病历审查,以分析人口统计学数据、扁桃体和腺样体大小、血清25-羟维生素D [25(OH)D]水平、体重指数(BMI)和过敏原致敏模式。

结果

ATH组儿童的平均25(OH)D水平低于对照组(p < 0.05)。维生素D缺乏的儿童腺样体和/或扁桃体肥大的频率明显高于维生素D充足的儿童(p < 0.05)。Spearman相关性分析确定血清25(OH)D水平与年龄、扁桃体和腺样体大小以及身高之间呈负相关(均p < 0.05)。在多元回归分析中,在控制年龄、性别、身高和螨虫致敏因素后,扁桃体和腺样体大小以及BMI-z评分与25(OH)D水平相关(p < 0.05)。

结论

我们的结果表明低维生素D水平与ATH有关。腺样体和扁桃体大小以及BMI-z评分均与25(OH)D水平相关。因此,对于有ATH和SDB症状的儿童,应考虑检测血清25(OH)D水平。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b306/6011183/6bb0ffb12bdb/12887_2018_1178_Fig1_HTML.jpg

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