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维生素 D 与儿童哮喘发病的关系:系统评价和荟萃分析。

Vitamin D and asthma occurrence in children: A systematic review and meta-analysis.

机构信息

Department of Pediatrics, Second Hospital of Jiaxing City, Zhejiang Province, PR China.

Department of Pediatrics, Second Hospital of Jiaxing City, Zhejiang Province, PR China.

出版信息

J Pediatr Nurs. 2022 Jan-Feb;62:e60-e68. doi: 10.1016/j.pedn.2021.07.005. Epub 2021 Aug 6.

DOI:10.1016/j.pedn.2021.07.005
PMID:34366195
Abstract

PROBLEM

The association between serum 25-Hydroxyvitamin D (25-OHD) level and asthma occurrence in children was controversial.

ELIGIBILITY CRITERIA

The Pubmed, Ovid Medline, Embase, Cochrane Library were systematically searched up to April 13th 2020. All the study measured the serum 25-OHD level in children, or classified the children based on the 25-OHD level into severe vitamin D deficiency, insufficient deficiency and comparing the prevalence of asthma in childhood were included in our study.

SAMPLE

A total of 35 studies were included in our meta-analysis. Among them, 24 studies were included for analyzing the association between 25-OHD level and asthma, and 12 studies evaluated the treatment effect of vitamin D.

RESULTS

The children with asthma (5711 participants) had significant lower 25-OHD level than children without asthma (21,561 participants) (21.7 ng/ml versus 26.5 ng/ml, SMD = -1.36, 95% = -2.40--0.32, P = 0.010). Besides, the children with asthma treated with vitamin D supplement had a significantly lower recurrence rate than the placebo group (18.4% versus 35.9%, RR = 0.35, 95%CI = 0.35-0.79, P = 0.002).

CONCLUSIONS

Children with asthma had a lower 25-OHD level than healthy children. Vitamin D supplement could decrease the asthma recurrence rate in the follow-up years.

IMPLICATIONS

This study implies that lower 25-OHD may cause asthma in childhood.

摘要

问题

血清 25-羟维生素 D(25-OHD)水平与儿童哮喘发病的关系存在争议。

纳入标准

系统检索了 PubMed、Ovid Medline、Embase 和 Cochrane Library,检索时间截至 2020 年 4 月 13 日。所有研究均测量了儿童的血清 25-OHD 水平,或根据 25-OHD 水平将儿童分为严重维生素 D 缺乏、维生素 D 不足,并比较儿童哮喘的患病率。

样本

共有 35 项研究纳入本 meta 分析。其中,24 项研究用于分析 25-OHD 水平与哮喘的关系,12 项研究评估了维生素 D 的治疗效果。

结果

哮喘患儿(5711 例)的 25-OHD 水平明显低于无哮喘患儿(21561 例)(21.7ng/ml 比 26.5ng/ml,SMD=-1.36,95%CI=-2.40-0.32,P=0.010)。此外,维生素 D 补充治疗的哮喘患儿复发率明显低于安慰剂组(18.4%比 35.9%,RR=0.35,95%CI=0.350.79,P=0.002)。

结论

哮喘患儿的 25-OHD 水平低于健康儿童。维生素 D 补充剂可降低哮喘患儿随访期间的复发率。

意义

本研究提示,低 25-OHD 可能导致儿童哮喘。

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