The Generation R Study Group, Erasmus MC, University Medical Center, Rotterdam, The Netherlands.
Department of Pediatrics, Division of Respiratory Medicine and Allergology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands.
Clin Exp Allergy. 2019 Jun;49(6):900-910. doi: 10.1111/cea.13384. Epub 2019 Apr 29.
Vitamin D deficiency in early life might affect the developing lung and immune system, and subsequently influence the risk of asthma and allergy in later life.
We examined the associations of 25-hydroxyvitamin D concentrations in mid-gestation and at birth with lung function, asthma, inhalant allergic sensitization and inhalant allergy at school-age.
This study among 4951 children and their mothers was embedded in a population-based prospective cohort in Rotterdam, the Netherlands. Maternal venous blood samples in mid-gestation and umbilical cord blood samples at birth were used to determine 25-hydroxyvitamin D concentrations. At age 10 years, lung function was measured by spirometry, current asthma and physician-diagnosed inhalant allergy by questionnaire, and inhalant allergic sensitization by skin prick tests. We used multivariable regression models to examine associations.
Higher 25-hydroxyvitamin D concentrations in mid-gestation were associated with a higher forced vital capacity (FVC), but a lower forced expiratory volume in 1 second/FVC (FEV /FVC) and a lower forced expiratory flow after exhaling 75% of FVC (FEF ) (Z-score differences [95% CI] 0.02 [0.00, 0.03], -0.02 [-0.03, -0.01] and -0.01 [-0.03, -0.00], respectively, per 10 nmol/L 25-hydroxyvitamin D), but not with asthma. Furthermore, higher 25-hydroxyvitamin D concentrations in mid-gestation were associated with an increased risk of inhalant allergy (Odds Ratio [95% CI] 1.07 [1.02, 1.12]), but not with inhalant allergic sensitization. After additional adjustment for child's 25-hydroxyvitamin D concentrations at the age of 6 years, only the associations of 25-hydroxyvitamin D concentrations in mid-gestation with FEV /FVC and FEF remained. We did not find consistent associations of 25-hydroxyvitamin D concentrations at birth with respiratory or allergy outcomes.
Our results suggest that maternal 25-hydroxyvitamin D concentrations in mid-gestation may influence lung development. The clinical implications of the observed associations remain unclear.
生命早期的维生素 D 缺乏可能会影响肺部和免疫系统的发育，并随后影响生命后期哮喘和过敏的风险。
我们研究了妊娠中期和出生时 25-羟维生素 D 浓度与学龄期肺功能、哮喘、吸入性变应原致敏和吸入性过敏的关系。
这项在荷兰鹿特丹进行的基于人群的前瞻性队列研究纳入了 4951 名儿童及其母亲。妊娠中期采集母亲静脉血样，出生时采集脐静脉血样，以测定 25-羟维生素 D 浓度。在 10 岁时，通过肺活量计测量肺功能，通过问卷调查当前哮喘和医生诊断的吸入性过敏，通过皮肤点刺试验测量吸入性变应原致敏。我们使用多变量回归模型来检验关联。
妊娠中期 25-羟维生素 D 浓度较高与用力肺活量（FVC）较高相关，但 1 秒用力呼气量/FVC（FEV/FVC）较低，用力呼出 75%FVC 后的呼气流速（FEF）较低（每增加 10nmol/L 25-羟维生素 D，Z 分数差异[95%CI]分别为 0.02[0.00，0.03]、-0.02[-0.03，-0.01]和-0.01[-0.03，-0.00]），但与哮喘无关。此外，妊娠中期 25-羟维生素 D 浓度较高与吸入性过敏的风险增加相关（优势比[95%CI]为 1.07[1.02，1.12]），但与吸入性变应原致敏无关。在进一步调整儿童 6 岁时的 25-羟维生素 D 浓度后，仅妊娠中期 25-羟维生素 D 浓度与 FEV/FVC 和 FEF 的关联仍然存在。我们没有发现出生时 25-羟维生素 D 浓度与呼吸或过敏结果的一致关联。
我们的结果表明，妊娠中期母亲 25-羟维生素 D 浓度可能会影响肺部发育。观察到的关联的临床意义尚不清楚。
