Institute of Population Health Sciences, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
MRC Integrative Epidemiology Unit, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK.
Eur Respir J. 2021 Oct 28;58(4). doi: 10.1183/13993003.04407-2020. Print 2021 Oct.
Longitudinal epidemiological data are scarce on the relationship between dietary intake of vitamin A and respiratory outcomes in childhood. We investigated whether a higher intake of preformed vitamin A or pro-vitamin β-carotene in mid-childhood is associated with higher lung function and with asthma risk in adolescence.
In the Avon Longitudinal Study of Parents and Children, dietary intakes of preformed vitamin A and β-carotene equivalents were estimated by food frequency questionnaire at 7 years of age. Post-bronchodilator forced expiratory volume in 1 s (FEV), forced vital capacity (FVC) and forced expiratory flow at 25-75% of FVC (FEF) were measured at 15.5 years and transformed to z-scores. Incident asthma was defined by new cases of doctor-diagnosed asthma at age 11 or 14 years.
In multivariable adjusted models, a higher intake of preformed vitamin A was associated with higher lung function and a lower risk of incident asthma: comparing top bottom quartiles of intake, regression coefficients for FEV and FEF were 0.21 (95% CI 0.05-0.38; p=0.008) and 0.18 (95% CI 0.03-0.32; p=0.02), respectively; odds ratios for FEV/FVC below the lower limit of normal and incident asthma were 0.49 (95% CI 0.27-0.90; p=0.04) and 0.68 (95% CI 0.47-0.99; p=0.07), respectively. In contrast, there was no evidence for association with β-carotene. We also found some evidence for modification of the associations between preformed vitamin A intake and lung function by , and gene polymorphisms.
A higher intake of preformed vitamin A, but not β-carotene, in mid-childhood is associated with higher subsequent lung function and lower risk of fixed airflow limitation and incident asthma.
关于儿童时期维生素 A 饮食摄入与呼吸道结果之间的关系,纵向流行病学数据较为缺乏。我们研究了儿童中期摄入较高的预成型维生素 A 或前维生素 β-胡萝卜素是否与更高的肺功能以及青少年时期的哮喘风险相关。
在阿冯纵向研究父母和孩子中,通过食物频率问卷在 7 岁时估计预成型维生素 A 和 β-胡萝卜素当量的摄入量。在 15.5 岁时测量支气管扩张后 1 秒用力呼气量(FEV)、用力肺活量(FVC)和 FEV 为 25-75%时的呼气流量(FEF),并将其转换为 z 分数。新诊断为哮喘的病例定义为 11 或 14 岁时医生诊断为哮喘的新病例。
在多变量调整模型中,较高的预成型维生素 A 摄入量与更高的肺功能和较低的哮喘新发病风险相关:比较摄入量最高和最低四分位数,FEV 和 FEF 的回归系数分别为 0.21(95%CI 0.05-0.38;p=0.008)和 0.18(95%CI 0.03-0.32;p=0.02);低于正常下限的 FEV/FVC 和新发生哮喘的比值比分别为 0.49(95%CI 0.27-0.90;p=0.04)和 0.68(95%CI 0.47-0.99;p=0.07)。相比之下,β-胡萝卜素与两者均无关联。我们还发现,预成型维生素 A 摄入量与肺功能之间的关联存在一些基因多态性的修饰作用,这些基因多态性包括、和。
儿童中期摄入较高的预成型维生素 A(而非 β-胡萝卜素)与较高的肺功能和较低的固定气流受限以及新发生哮喘的风险相关。