Feng Qi, Bønnelykke Klaus, Ek Weronica E, Chawes Bo L, Yuan Shuai, Cheung Ching Lung, Li Gloria Hy, Leung Raymond Yh, Cheung Bernard My
Division of Clinical Pharmacology and Therapeutics, Department of Medicine, LKS Faculty of Medicine, Queen Mary Hospital, the University of Hong Kong, Pokfulam, Hong Kong, China.
COPSAC, Copenhagen Prospective Studies on Asthma in Childhood, Herlev and Gentofte Hospital, University of Copenhagen, Copenhagen, Denmark.
Clin Exp Allergy. 2021 Jan;51(1):78-86. doi: 10.1111/cea.13739. Epub 2020 Sep 28.
Previous observational studies have not found a conclusive association between serum 25-hydroxyvitamin D (25(OH)D) levels and allergic rhinitis (AR) or allergic sensitization (AS).
To investigate a causal association between 25(OH)D levels with risk of AR and AS, using a two-sample Mendelian randomization (MR) approach.
Seven single nucleotide polymorphisms (SNPs), previously shown to be associated with serum 25(OH)D levels, were identified as instrumental variables. The primary outcome was AR, and the secondary outcomes were AS and non-allergic rhinitis (NAR). The genome-wide association (GWA) summary statistics of the outcomes were obtained from two cohort studies (EAGLE Consortium and UK Biobank). An MR analysis with random-effects inverse-variance weighted method was performed as the primary analysis to estimate overall effect size (odds ratio [OR] and 95% confidence interval [CI]). Sensitivity analysis using weighted median method and MR-Egger regression method was conducted. A subgroup analysis based on 25(OH)D synthesis-related SNPs was further applied.
Serum 25(OH)D levels were not causally associated with risk of AR (OR: 0.960; 95% CI: 0.779-1.184), AS (OR: 1.059; 95% CI: 0.686 to 1.634) or NAR (OR: 0.937; 95% CI: 0.588-1.491). Subgroup analysis also showed null association between 25(OH)D synthesis-related SNPs and the outcomes. Sensitivity analyses yielded similar results.
This MR study found no evidence supporting a causal association between serum 25(OH)D levels and risk of AR, AS and NAR in European-ancestry population. This argues against the previous postulation that vitamin D supplementation is effective in prevention of allergic diseases.
既往观察性研究未发现血清25-羟维生素D(25(OH)D)水平与变应性鼻炎(AR)或变应性致敏(AS)之间存在确凿关联。
采用两样本孟德尔随机化(MR)方法研究25(OH)D水平与AR及AS风险之间的因果关联。
七个先前已证明与血清25(OH)D水平相关的单核苷酸多态性(SNP)被确定为工具变量。主要结局为AR,次要结局为AS和非变应性鼻炎(NAR)。结局的全基因组关联(GWA)汇总统计数据来自两项队列研究(EAGLE联盟和英国生物银行)。采用随机效应逆方差加权法进行MR分析作为主要分析,以估计总体效应大小(比值比[OR]和95%置信区间[CI])。进行了加权中位数法和MR-Egger回归法的敏感性分析。进一步应用基于25(OH)D合成相关SNP的亚组分析。
血清25(OH)D水平与AR风险(OR:0.960;95%CI:0.779 - 1.184)、AS风险(OR:1.059;95%CI:0.686至1.634)或NAR风险(OR:0.937;95%CI:0.588 - 1.491)无因果关联。亚组分析也显示25(OH)D合成相关SNP与结局之间无关联。敏感性分析得出类似结果。
这项MR研究未发现证据支持在欧洲血统人群中血清25(OH)D水平与AR、AS和NAR风险之间存在因果关联。这与先前关于补充维生素D可有效预防变应性疾病的假设相悖。