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牛奶蛋白过敏的小婴儿血液嗜酸性粒细胞增多与维生素D不足的关联

Association of blood eosinophilia and vitamin D insufficiency in young infants with cow milk allergy.

作者信息

Li Jingwen, Mei Xiaoli, Cai Xinyi, Zhuo Yujie, Zhang Lanfang, Guo Hongmei, Yang Hui, Yang Guang

机构信息

Children's Hospital of Nanjing Medical University, Nanjing, China.

出版信息

Asia Pac J Clin Nutr. 2019;28(3):550-557. doi: 10.6133/apjcn.201909_28(3).0014.

Abstract

BACKGROUND AND OBJECTIVES

Cow milk allergy is the most common food allergic disease in young infants and vitamin D has a critical role in regulating intestinal inflammation.

METHODS AND STUDY DESIGN

To determine roles of vitamin D in cow milk allergy, fifty-six young infants with cow milk allergy were enrolled. The serum 25-hydroxyvitamin D (25OHD), total and specific IgE, circulating regulatory T lymphocytes, and blood eosino-phil counts were determined.

RESULTS

The serum 25OHD in cow milk allergy and age-matched infants were sim-ilar (68.3±38.9 nmol/L versus 72.9±33.1 nmol/L, p>0.05), 71% Cow milk allergy infants (40/56) had serum 25OHD lower than 75 nmol/L compared to 66% (37/56) in the controls. The cow milk allergy infants with 25OHD lower than 75 nmol/L had persistent blood eosinophilia and delayed resolution of symptoms after cow milk elimination compared to those with 25OHD above 75 nmol/L (odd ratio 3.7, 95% CI 1.1-12.6, p<0.05). The serum 25OHD inversely correlated with blood eosinophil counts after cow milk elimination (r=-0.37, p<0.01). Cow milk allergy infants with 25OHD lower than 50 nmol/L (vitamin D deficiency, n = 22) were in general at younger age (1.6±0.6 months) compared to infants with insufficient (50-75 nmol/L) or normal (>=75 nmol/L) group (4.3±1.2 and 4.6±0.9 months, respectively, p<0.001).

CONCLUSIONS

Low serum vitamin D associates with persistent blood eosinophilia and symptoms in young cow milk allergy infants.

摘要

背景与目的

牛奶过敏是幼儿最常见的食物过敏性疾病,维生素D在调节肠道炎症中起关键作用。

方法与研究设计

为确定维生素D在牛奶过敏中的作用,招募了56名牛奶过敏的幼儿。测定血清25-羟基维生素D(25OHD)、总IgE和特异性IgE、循环调节性T淋巴细胞以及血液嗜酸性粒细胞计数。

结果

牛奶过敏幼儿与年龄匹配的婴儿血清25OHD相似(68.3±38.9 nmol/L对72.9±33.1 nmol/L,p>0.05),71%的牛奶过敏幼儿(40/56)血清25OHD低于75 nmol/L,而对照组为66%(37/56)。与25OHD高于75 nmol/L的牛奶过敏幼儿相比,25OHD低于75 nmol/L的牛奶过敏幼儿在牛奶消除后持续存在血液嗜酸性粒细胞增多且症状缓解延迟(比值比3.7,95%可信区间1.1 - 12.6,p<0.05)。牛奶消除后血清25OHD与血液嗜酸性粒细胞计数呈负相关(r = -0.37,p<0.01)。25OHD低于50 nmol/L(维生素D缺乏,n = 22)的牛奶过敏幼儿总体年龄比不足(50 - 75 nmol/L)或正常(≥75 nmol/L)组的幼儿小(分别为1.6±0.6个月对4.3±1.2个月和4.6±0.9个月,p<0.001)。

结论

低血清维生素D与牛奶过敏幼儿持续的血液嗜酸性粒细胞增多及症状相关。

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