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一项维生素 D 补充剂预防儿童季节性流感和肠病毒感染的随机试验。

A randomized trial of vitamin D supplementation to prevent seasonal influenza and enterovirus infection in children.

机构信息

Department of Pediatric Infectious Diseases, MacKay Children's Hospital, Taipei, Taiwan; Department of Pediatrics, Hsinchu MacKay Memorial Hospital, Hsinchu, Taiwan.

Department of Pediatric Infectious Diseases, MacKay Children's Hospital, Taipei, Taiwan; Department of Medicine, MacKay Medicine College, New Taipei, Taiwan.

出版信息

J Microbiol Immunol Infect. 2022 Oct;55(5):803-811. doi: 10.1016/j.jmii.2022.01.003. Epub 2022 Feb 25.

Abstract

PURPOSE

This study aimed to evaluate whether vitamin D supplementation can reduce the incidence of influenza and enterovirus infection in Taiwanese children.

METHODS

This randomized, double-blind, controlled trial included children aged two to five years between April 2018 and October 2019 from daycare centers. All the participants were randomly assigned to a vitamin D supplementation group (2000 IU/day) or placebo group for one month. The primary outcome was the incidence of influenza and enterovirus infection in the following six months, and the secondary outcome was the incidence of influenza and enterovirus infection in the children's household members.

RESULTS

Two hundred and forty-eight children participated. The vitamin D group showed a relative risk reduction of 84% against influenza compared to the placebo group but did not reach statistical significance. Kaplan-Meier curves revealed that the placebo group had a higher probability of influenza infection than the vitamin D group (log-rank test, p = 0.055), but the incidence of enterovirus infection was similar between the two groups (p = 0.946) among children. Among children's household members, the incidence of influenza (p = 0.586) and enterovirus infection (p = 0.528) were both similar between the two groups. All children who were tested for serum 25(OH)D levels after vitamin D intervention had 25(OH)D levels above 30 ng/ml CONCLUSION: Vitamin D supplementation may have a small preventative effect against influenza infection but does not affect enterovirus infection among preschool children. A high-dose short-term vitamin D intervention might be a way to elevate children's serum vitamin D levels in the first month of starting kindergarten.

摘要

目的

本研究旨在评估维生素 D 补充剂是否能降低台湾儿童流感和肠病毒感染的发生率。

方法

这是一项随机、双盲、对照试验,纳入了 2018 年 4 月至 2019 年 10 月来自托儿所的 2 至 5 岁儿童。所有参与者被随机分为维生素 D 补充组(2000IU/天)或安慰剂组,持续 1 个月。主要结局是接下来 6 个月内流感和肠病毒感染的发生率,次要结局是儿童家庭成员中流感和肠病毒感染的发生率。

结果

共有 248 名儿童参与。与安慰剂组相比,维生素 D 组的流感相对风险降低了 84%,但未达到统计学意义。Kaplan-Meier 曲线显示,安慰剂组发生流感感染的概率高于维生素 D 组(对数秩检验,p=0.055),但两组儿童的肠病毒感染发生率相似(p=0.946)。在儿童家庭成员中,两组流感(p=0.586)和肠病毒感染(p=0.528)的发生率均相似。所有接受维生素 D 干预后检测血清 25(OH)D 水平的儿童,其血清 25(OH)D 水平均高于 30ng/ml。

结论

维生素 D 补充可能对流感感染有一定的预防作用,但不会影响学龄前儿童的肠病毒感染。短期高剂量维生素 D 干预可能是提高儿童在进入幼儿园第一个月血清维生素 D 水平的一种方法。

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