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孕期和儿童期维生素 D 水平与儿童期过敏和哮喘的关系。

Prenatal and child vitamin D levels and allergy and asthma in childhood.

机构信息

ISGlobal, Barcelona, Spain.

Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Madrid, Spain.

出版信息

Pediatr Res. 2023 May;93(6):1745-1751. doi: 10.1038/s41390-022-02256-9. Epub 2022 Sep 3.

Abstract

BACKGROUND

Early-life vitamin D deficiency may impair immune system development contributing to allergy and asthma onset. Findings from prospective studies are inconsistent.

OBJECTIVE

To examine whether maternal and child vitamin D levels are associated with allergic and asthma-related symptoms throughout childhood in a Spanish birth cohort.

METHODS

25-Hydroxyvitamin D (25(OH)D) levels were measured in the serum of pregnant women (N = 2525) and children (N = 803). Information on allergic and asthma-related symptoms was obtained from repeated questionnaires from 1 to 9 years.

RESULTS

A total of 19% of mothers and 24% of children had deficient 25(OH)D levels (<20 ng/ml). Higher child 25(OH)D levels at 4 years were associated with lower odds of atopic eczema from 4 to 9 years (adjusted odds ratio = 0.90; 95% CI = 0.84-0.97 per 5 ng/ml). Higher maternal and child 25(OH)D levels were associated with a lower prevalence of late-onset wheezing at the limit of statistical significance (adjusted relative risk ratio (RRR) = 0.86; 95% CI = 0.74-1.00 and RRR = 0.76; 95% CI = 0.58-1.02 per 5 ng/ml, respectively). All the remaining associations were null.

CONCLUSION

Child 25(OH)D levels at pre-school age are associated with a reduced odds of atopic eczema in later childhood and both maternal and child levels may reduce the prevalence of late-onset wheezing.

IMPACT

In this Spanish birth cohort, with a total of 19% of mothers and 24% of children with deficient levels of vitamin D, higher child vitamin D at 4 years of age was associated with reduced odds of atopic eczema up to 9 years. There was also some evidence that higher maternal and child vitamin D levels reduced the prevalence of late-onset wheezing. Although these findings need replication, they may imply optimal vitamin D levels at pre-school age to prevent atopic eczema.

摘要

背景

生命早期维生素 D 缺乏可能会损害免疫系统的发育,从而导致过敏和哮喘的发生。前瞻性研究的结果并不一致。

目的

在一个西班牙出生队列中,研究孕妇和儿童的维生素 D 水平是否与整个儿童期的过敏和哮喘相关症状有关。

方法

测量了 25-羟维生素 D(25(OH)D)在孕妇(N=2525)和儿童(N=803)血清中的水平。从 1 岁到 9 岁,通过反复问卷调查获取过敏和哮喘相关症状的信息。

结果

共有 19%的母亲和 24%的儿童维生素 D 水平不足(<20ng/ml)。4 岁时儿童 25(OH)D 水平较高与 4 至 9 岁时特应性皮炎的患病风险降低相关(调整后的优势比=每增加 5ng/ml,0.90;95%置信区间=0.84-0.97)。较高的母体和儿童 25(OH)D 水平与晚发性喘息的发生率呈负相关(调整后的相对风险比(RRR)=0.86;95%置信区间=0.74-1.00 和 RRR=0.76;95%置信区间=0.58-1.02,每增加 5ng/ml)。所有其他关联均为无效。

结论

学前儿童 25(OH)D 水平与儿童后期特应性皮炎的患病风险降低有关,而母体和儿童的水平可能会降低晚发性喘息的发病率。

影响

在这个西班牙出生队列中,共有 19%的母亲和 24%的儿童维生素 D 水平不足,4 岁时儿童维生素 D 水平较高与 9 岁时特应性皮炎的患病风险降低有关。还有一些证据表明,较高的母体和儿童维生素 D 水平降低了晚发性喘息的发病率。虽然这些发现需要进一步验证,但它们可能意味着在学前阶段获得最佳的维生素 D 水平可以预防特应性皮炎。

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