Department of Pathology and Molecular Medicine, McMaster University, Hamilton, Ontario, Canada.
National Institute of Hygiene and Epidemiology, Hanoi, Vietnam.
Influenza Other Respir Viruses. 2019 Mar;13(2):176-183. doi: 10.1111/irv.12615. Epub 2019 Jan 4.
It is uncertain whether vitamin D can reduce respiratory infection.
To determine whether vitamin D supplementation reduces influenza and other upper viral respiratory tract infections.
A total of 1300 healthy children and adolescents between the ages of 3 and 17 years were randomized to vitamin D (14 000 U weekly) or placebo for 8 months in Vietnam. The primary outcome was reverse transcriptase (RT)-PCR-confirmed influenza infection, and the coprimary outcome was multiplex PCR-confirmed non-influenza respiratory viruses. Participants, caregivers, and those assessing outcomes were blinded to group assignment.
A total of 650 children and adolescents were randomly assigned to vitamin D and 650 to placebo. The mean baseline serum 25-hydroxyvitamin D levels were 65.7 nmol/L and 65.2 nmol/L in the intervention and placebo groups, respectively, with an increase to 91.8 nmol/L in the vitamin D group and no increase, 64.5 nmol/L, in the placebo group. All 1300 participants randomized contributed to the analysis. We observed RT-PCR-confirmed influenza A or B occurred in 50 children (7.7%) in the vitamin D group and in 43 (6.6%) in the placebo group (hazard ratio [HR]: 1.18, 95% CI: 0.79-1.78). RT-PCR-confirmed non-influenza respiratory virus infection occurred in 146 (22.5%) in the vitamin D group and in 185 (28.5%) in the placebo group (hazard ratio [HR]: 0.76, 95% CI: 0.61-0.94). When considering all respiratory viruses, including influenza, the effect of vitamin D in reducing infection was significant, HR: 0.81, 95% CI: 0.66-0.99.
Vitamin D supplementation did not reduce the incidence of influenza but moderately reduced non-influenza respiratory viral infection.
维生素 D 是否能减少呼吸道感染还不确定。
确定维生素 D 补充剂是否能减少流感和其他上呼吸道病毒感染。
在越南，共纳入 1300 名年龄在 3 至 17 岁之间的健康儿童和青少年，将其随机分为维生素 D（每周 14000U）或安慰剂组，干预 8 个月。主要结局是逆转录酶（RT）-PCR 确诊的流感感染，共同主要结局是多重 PCR 确诊的非流感呼吸道病毒。参与者、照料者和评估结局的人员对分组情况设盲。
共有 650 名儿童和青少年被随机分配到维生素 D 组，650 名被分配到安慰剂组。干预组和安慰剂组的基线血清 25-羟维生素 D 水平分别为 65.7nmol/L 和 65.2nmol/L，维生素 D 组增加至 91.8nmol/L，安慰剂组无增加，为 64.5nmol/L。所有 1300 名随机参与者均纳入分析。我们观察到，在维生素 D 组中，有 50 名（7.7%）儿童出现 RT-PCR 确诊的流感 A 或 B，而在安慰剂组中，有 43 名（6.6%）儿童出现 RT-PCR 确诊的流感 A 或 B（风险比[HR]：1.18，95%置信区间：0.79-1.78）。在维生素 D 组中，有 146 名（22.5%）儿童出现 RT-PCR 确诊的非流感呼吸道病毒感染，而在安慰剂组中，有 185 名（28.5%）儿童出现 RT-PCR 确诊的非流感呼吸道病毒感染（风险比[HR]：0.76，95%置信区间：0.61-0.94）。当考虑所有呼吸道病毒，包括流感时，维生素 D 对减少感染的效果显著，HR：0.81，95%置信区间：0.66-0.99。
维生素 D 补充剂并未降低流感发病率，但适度降低了非流感呼吸道病毒感染。
