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探讨孕期饮食炎症指数与出生时促炎细胞因子和趋化因子水平之间的关系,以及它们与 4 岁以下儿童哮喘和/或喘息的关系。

Examining Associations Between Dietary Inflammatory Index in Pregnancy, Pro-inflammatory Cytokine and Chemokine Levels at Birth, and Offspring Asthma and/or Wheeze by Age 4 Years.

机构信息

Children's Hospital Colorado, Aurora.

University of Colorado Anschutz Medical Campus, Aurora.

出版信息

J Acad Nutr Diet. 2021 Oct;121(10):2003-2012.e3. doi: 10.1016/j.jand.2021.02.015. Epub 2021 Mar 17.

Abstract

BACKGROUND

Few studies have demonstrated associations between maternal dietary inflammatory index (DII) during pregnancy and offspring asthma and/or wheeze.

OBJECTIVE

The study aimed to assess associations between maternal DII during pregnancy and 1) offspring cord sera pro-inflammatory cytokines (interleukin [IL]-1β, IL-4, IL-6, IL-10, tumor necrosis factor-α) and chemokines (IL-8, monocyte chemoattractant protein-1) at birth and 2) offspring asthma and/or wheeze at age 4 years.

DESIGN

The Healthy Start study is a prospective prebirth longitudinal study that recruited pregnant women in Denver, Colorado and tracked their offspring.

PARTICIPANTS AND SETTING

This study used data from 1228 mother-child dyads enrolled in the Healthy Start study. Pregnant women were recruited in Denver, Colorado, between 2009 and 2014, and offspring tracked until age 4 years.

MAIN OUTCOME MEASURES

Cord sera cytokines and chemokines were analyzed with multiplex panel immunoassays. Offspring diagnosis of asthma and/or wheeze by age 4 years was extracted from electronic medical records.

STATISTICAL ANALYSES PERFORMED

Unadjusted and adjusted linear and logistic regression models were used to assess associations. Covariates included factors such as nulliparity, race/ethnicity, gestational smoking, and maternal history of asthma.

RESULTS

Unadjusted analysis showed that increasing maternal DII scores were associated with increased odds of child asthma and/or wheeze by 4 years (odds ratio = 1.17; 95% CI: 1.07-1.27), but the association was attenuated and no longer statistically significant in the adjusted model (odds ratio = 1.15; 95% CI: 0.99-1.33). There were no significant associations between DII scores and cord sera cytokine or chemokine levels.

CONCLUSIONS

The study showed that the inflammatory profile of the maternal diet was not associated with cytokines and chemokine levels at birth. The results suggested that a more inflammatory maternal diet was associated with increased odds of offspring asthma and/or wheeze by age 4 years, which could be considered of clinical relevance but the finding was not statistically significant at the .05 level.

摘要

背景

很少有研究表明孕妇饮食炎症指数(DII)与后代哮喘和/或喘息之间存在关联。

目的

本研究旨在评估孕妇孕期 DII 与以下两者之间的关联:1)出生时脐带血清促炎细胞因子(白细胞介素[IL]-1β、IL-4、IL-6、IL-10、肿瘤坏死因子-α)和趋化因子(IL-8、单核细胞趋化蛋白-1);2)4 岁时后代哮喘和/或喘息的发生情况。

设计

健康启动研究是一项前瞻性的产前纵向研究,招募了科罗拉多州丹佛市的孕妇,并对其后代进行了跟踪调查。

参与者和设置

本研究使用了 1228 对母婴对子的健康启动研究数据。孕妇于 2009 年至 2014 年在科罗拉多州丹佛市招募,对后代的跟踪调查一直持续到 4 岁。

主要观察指标

采用多指标免疫分析方法检测脐带血清细胞因子和趋化因子。4 岁时通过电子病历提取后代哮喘和/或喘息的诊断结果。

统计学分析

采用未调整和调整后的线性及逻辑回归模型评估关联。协变量包括初产、种族/民族、妊娠期吸烟以及母亲哮喘病史等因素。

结果

未调整分析显示,孕妇 DII 评分增加与 4 岁时儿童哮喘和/或喘息的发生几率增加相关(比值比=1.17;95%置信区间:1.07-1.27),但在调整模型中,这种关联减弱且不再具有统计学意义(比值比=1.15;95%置信区间:0.99-1.33)。DII 评分与脐带血清细胞因子或趋化因子水平之间无显著关联。

结论

本研究表明,母体饮食的炎症特征与出生时的细胞因子和趋化因子水平无关。结果提示,炎症程度更高的孕妇饮食与 4 岁时后代哮喘和/或喘息的发生几率增加相关,这可能具有临床意义,但在.05 水平上无统计学意义。

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