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纯母乳喂养与过敏性疾病——长期保护还是反弹效应?

Full Breastfeeding and Allergic Diseases-Long-Term Protection or Rebound Effects?

机构信息

Institute of Nutrition, Consumption and Health, Faculty of Natural Sciences, Paderborn University, Warburger Straße 100, 33098 Paderborn, Germany.

Children's Hospital, Evangelisches Krankenhaus Düsseldorf, 40217 Düsseldorf, Germany.

出版信息

Nutrients. 2023 Jun 16;15(12):2780. doi: 10.3390/nu15122780.

Abstract

A previous follow-up of the GINIplus study showed that breastfeeding could protect against early eczema. However, effects diminished in adolescence, possibly indicating a "rebound effect" in breastfed children after initial protection. We evaluated the role of early eczema until three years of age on allergies until young adulthood and assessed whether early eczema modifies the association between breastfeeding and allergies. Data from GINIplus until 20-years of age ( = 4058) were considered. Information on atopic eczema, asthma, and rhinitis was based on reported physician's diagnoses. Adjusted Odds Ratios (aOR) were modelled by using generalized estimating equations. Early eczema was associated with eczema (aORs = 3.2-14.4), asthma (aORs = 2.2-2.7), and rhinitis (aORs = 1.2-2.7) until young adulthood. For eczema, this association decreased with age (-for-interaction = 0.002-0.006). Longitudinal models did not show associations between breastfeeding and the respective allergies from 5 to 20 years of age. Moreover, early eczema generally did not modify the association between milk feeding and allergies except for rhinitis in participants without family history of atopy. Early eczema strongly predicts allergies until young adulthood. While preventive effects of full breastfeeding on eczema in infants with family history of atopy does not persist until young adulthood, the hypothesis of a rebound effect after initial protection cannot be confirmed.

摘要

先前对 GINIplus 研究的随访表明,母乳喂养可以预防早期特应性皮炎。然而,这种保护作用在青春期减弱,这可能表明母乳喂养的儿童在最初的保护后出现了“反弹效应”。我们评估了三岁前的早期特应性皮炎对成年早期过敏的作用,并评估了早期特应性皮炎是否改变了母乳喂养与过敏之间的关联。我们考虑了 GINIplus 直到 20 岁(=4058)的数据。特应性皮炎、哮喘和鼻炎的信息基于报告的医生诊断。使用广义估计方程对调整后的优势比(aOR)进行建模。早期特应性皮炎与成年早期的特应性皮炎(aORs=3.2-14.4)、哮喘(aORs=2.2-2.7)和鼻炎(aORs=1.2-2.7)有关。对于特应性皮炎,这种关联随着年龄的增长而降低(-交互作用=0.002-0.006)。从 5 岁到 20 岁,纵向模型没有显示母乳喂养与各自过敏之间的关联。此外,早期特应性皮炎通常不会改变牛奶喂养与过敏之间的关联,除非参与者没有特应性家族史。早期特应性皮炎强烈预测成年早期的过敏。虽然有特应性家族史的婴儿完全母乳喂养对特应性皮炎的预防作用不会持续到成年早期,但最初保护后的反弹效应假说无法得到证实。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2e8c/10301269/54bda5b20a36/nutrients-15-02780-g001.jpg

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