Psaroulaki Evdokia, Katsaras Georgios N, Samartzi Petrina, Chatziravdeli Vasiliki, Psaroulaki Danai, Oikonomou Evangelos, Tsitsani Pelagia
Paediatric Department, General Hospital of Pella - Hospital Unit of Edessa, Edessa, Greece.
Orthopaedic Department, "Ippokrateio" General Hospital of Thessaloniki, Thessaloniki, Greece.
Eur J Pediatr. 2023 Apr;182(4):1533-1554. doi: 10.1007/s00431-023-04843-2. Epub 2023 Feb 15.
Current literature regarding the association of vitamin D insufficiency and food allergy is contradicting. The purpose of our study was to investigate this association. This is a systematic review and meta-analysis according to the PRISMA statement. PubMeD and Scopus databases were systematically searched for case-control studies investigating the association between pediatric food allergy and vitamin D insufficiency. Our search yielded 806 studies. Ten final studies were considered eligible for qualitative and quantitative analysis. Children with vitamin D insufficiency were found to have 68% more probability to present a food allergy episode (adjusted pooled OR: 1.68, 95% CI [1.25-2.27], p-value: 0.001). In their second year of life they were 4 times more likely to present a food allergy episode (adjusted pooled OR: 4.06, 95% CI [1.93-8.56], p-value: < 0.001), and 56% more probable to develop food sensitization (OR: 1.56, 95% CI [1.15-2.11], p-value: < 0.004). Children in Australia with vitamin D insufficiency were almost 4 times more likely to develop egg sensitization (adjusted OR: 3.79, 95% CI [1.19-12.08], p-value: 0.024). Children with vitamin D insufficiency were almost twice as likely to have peanut sensitization (OR: 1.96, 95% CI [1.08-3.57], p-value: 0.028). Conclusion: Decreased maternal vitamin D levels and infant vitamin D insufficiency appear to increase the incidence of food allergies, particularly in the second year of life. To confirm this association, multicenter longitudinal studies are required. What is Known: • In newborns and young children, vitamin D deficiency and insufficiency are prevalent. • The exact role of vitamin D in atopic diseases remains controversial. What is New: • Decreased maternal vitamin D levels and infant vitamin D insufficiency appear to increase the incidence of food allergies. This association is more evident in the second year of life.
当前关于维生素D缺乏与食物过敏之间关联的文献存在矛盾之处。我们研究的目的是调查这种关联。这是一项根据PRISMA声明进行的系统评价和荟萃分析。我们系统检索了PubMeD和Scopus数据库，以查找调查儿童食物过敏与维生素D缺乏之间关联的病例对照研究。我们的检索共得到806项研究。最终有10项研究符合定性和定量分析的条件。结果发现，维生素D缺乏的儿童出现食物过敏发作的可能性要高68%（校正合并比值比：1.68，95%置信区间[1.25 - 2.27]，p值：0.001）。在他们生命的第二年，出现食物过敏发作的可能性要高4倍（校正合并比值比：4.06，95%置信区间[1.93 - 8.56]，p值：<0.001），出现食物致敏的可能性要高56%（比值比：1.56，95%置信区间[1.15 - 2.11]，p值：<0.004）。澳大利亚维生素D缺乏的儿童发生鸡蛋致敏的可能性几乎高4倍（校正比值比：3.79，95%置信区间[1.19 - 12.08]，p值：0.024）。维生素D缺乏的儿童发生花生致敏的可能性几乎高两倍（比值比：1.96，95%置信区间[1.08 - 3.57]，p值：0.028）。结论：母亲维生素D水平降低和婴儿维生素D缺乏似乎会增加食物过敏的发生率，尤其是在生命的第二年。为证实这种关联，需要进行多中心纵向研究。已知信息：• 在新生儿和幼儿中，维生素D缺乏和不足很普遍。• 维生素D在特应性疾病中的确切作用仍存在争议。新发现：• 母亲维生素D水平降低和婴儿维生素D缺乏似乎会增加食物过敏的发生率。这种关联在生命的第二年更为明显。
