Cork Centre for Vitamin D and Nutrition Research, School of Food and Nutritional Sciences, University College Cork, Cork, Ireland.
The Irish Centre for Fetal and Neonatal Translational Research (INFANT), University College Cork, Cork, Ireland.
Allergy. 2018 Nov;73(11):2182-2191. doi: 10.1111/all.13590. Epub 2018 Aug 29.
Prospective studies of antenatal and infant vitamin D exposure and atopic disease from extensively characterised, disease-specific, maternal-infant cohorts with gold standard analysis of vitamin D status and clinically validated atopic outcomes are lacking. This study aimed to investigate associations between intrauterine vitamin D status and atopic outcomes in an extensively characterised, disease-specific, maternal-infant cohort.
Circulating 25-hydroxyvitamin D (25(OH)D) was measured in maternal sera at 15 weeks of gestation (n = 1537) and umbilical cord blood (n = 1050) using a CDC-accredited LC-MS/MS platform, and the association with clinically validated atopic disease outcomes (eczema, food allergy, asthma, allergic rhinitis) at 2 and 5 years was explored using multivariable logistic regression.
Persistent eczema in the first 2 years of life was present in 5% of infants. Food allergy at 2 years was confirmed in 4%. The prevalence of aeroallergen sensitisation at 2 years was 8%. Asthma at 5 years was reported in 15% and allergic rhinitis in 5% of 5-year-olds. There were no significant differences in the distributions of maternal 25(OH)D at 15 weeks of gestation (mean [SD] 58.4 [26.2] and 58.5 [26.1] nmol/L) and cord 25(OH)D concentrations (mean [SD] 35.2 [17.8] and 35.4 [18.3] nmol/L) between children with and without atopic disease. Neither maternal (aOR [95% CI]: 1.02 [0.97, 1.08], P = 0.450) nor cord 25(OH)D (aOR [95% CI]: 1.00 [0.91, 1.09], P = 0.991) were significant predictors of atopic disease outcomes in fully adjusted models.
These data in a disease-specific cohort with prospectively collected, validated atopic outcomes do not support an association between antenatal exposure to vitamin D and atopic disease outcomes in childhood.
缺乏来自广泛特征描述、特定疾病、母婴队列的产前和婴儿维生素 D 暴露与特应性疾病的前瞻性研究,这些队列具有金标准的维生素 D 状态分析和临床验证的特应性结局。本研究旨在调查广泛特征描述、特定疾病、母婴队列中子宫内维生素 D 状态与特应性结局之间的关联。
使用 CDC 认可的 LC-MS/MS 平台在 15 周妊娠(n=1537)和脐带血(n=1050)中测量母体血清中循环 25-羟维生素 D(25(OH)D),并使用多变量逻辑回归探索其与 2 岁和 5 岁时临床验证的特应性疾病结局(湿疹、食物过敏、哮喘、过敏性鼻炎)的相关性。
在生命的头 2 年中,持续性湿疹的发生率为 5%。2 岁时确诊食物过敏的比例为 4%。2 岁时,气传过敏原致敏率为 8%。5 岁时,有 15%的儿童报告哮喘,5%的儿童报告过敏性鼻炎。患有特应性疾病的儿童与未患有特应性疾病的儿童的 15 周妊娠时的母体 25(OH)D 分布(平均值[标准差]分别为 58.4[26.2]和 58.5[26.1]nmol/L)和脐带 25(OH)D 浓度(平均值[标准差]分别为 35.2[17.8]和 35.4[18.3]nmol/L)没有显著差异。母体(优势比[95%CI]:1.02[0.97,1.08],P=0.450)和脐带 25(OH)D(优势比[95%CI]:1.00[0.91,1.09],P=0.991)均不是完全调整模型中特应性疾病结局的显著预测因子。
在具有前瞻性收集、验证的特应性结局的特定疾病队列中,这些数据不支持产前维生素 D 暴露与儿童期特应性疾病结局之间的关联。