Park Peong Gang, Heo Ju Sun, Ahn Yo Han, Kang Hee Gyung
Department of Pediatrics, Ajou University School of Medicine, Suwon, South Korea; Department of Translational Medicine, Seoul National University College of Medicine, Seoul, South Korea.
Department of Pediatrics, Seoul National University Children's Hospital, Seoul National University College of Medicine, Seoul, South Korea.
J Pediatr. 2025 Jan;276:114266. doi: 10.1016/j.jpeds.2024.114266. Epub 2024 Aug 30.
To assess the relationship between breastfeeding and the risk of developing nephrotic syndrome using a population-based nationwide birth cohort in Korea.
This nationwide cohort study utilized data from the National Health Information Database and the National Health Screening Program for Infants and Children. The study included all children born between January 1, 2010, and December 31, 2018, who underwent their first health screening, which included a specific questionnaire on breastfeeding between 4 and 6 months of age. Associations between nephrotic syndrome and exclusive breastfeeding were estimated using adjusted hazard ratios (aHR) derived from Cox proportional hazards models, adjusted for sociodemographic variables, with follow-up until the occurrence of nephrotic syndrome, 8 years postindex date, death, or December 31, 2022, whichever was first.
The study population comprised 1 787 774 children (median follow-up: 7.96 years; IQR: 6.31-8.00 years), including 612 556 exclusively breastfed and 1 175 218 formula-fed children. Exclusive breastfeeding was associated with a decreased risk of developing nephrotic syndrome (aHR: 0.80; 95% CI: 0.69-0.93). Subgroup analysis stratified by sex mirrored the overall findings, although statistical significance was not observed in girls (boys: aHR, 0.75; 95% CI, 0.62-0.92; girls: aHR, 0.87; 95% CI, 0.70-1.09). Sensitivity analysis confirmed these results.
Exclusive breastfeeding was associated with a 20% reduced risk of developing nephrotic syndrome up to 8 years of age.
利用韩国一项基于全国人口的出生队列研究评估母乳喂养与患肾病综合征风险之间的关系。
这项全国队列研究使用了来自国家健康信息数据库以及婴幼儿国家健康筛查项目的数据。该研究纳入了2010年1月1日至2018年12月31日期间出生且接受首次健康筛查的所有儿童,筛查包括一份关于4至6个月龄时母乳喂养情况的特定问卷。使用Cox比例风险模型得出的调整后风险比(aHR)来估计肾病综合征与纯母乳喂养之间的关联,并对社会人口统计学变量进行了调整,随访至肾病综合征发生、索引日期后8年、死亡或2022年12月31日,以先发生者为准。
研究人群包括1787774名儿童(中位随访时间:7.96年;四分位间距:6.31 - 8.00年),其中612556名纯母乳喂养儿童和1175218名配方奶喂养儿童。纯母乳喂养与患肾病综合征风险降低相关(aHR:0.80;95%可信区间:0.69 - 0.93)。按性别分层的亚组分析反映了总体结果,尽管在女孩中未观察到统计学显著性(男孩:aHR,0.75;95%可信区间,0.62 - 0.92;女孩:aHR,0.87;95%可信区间,0.70 - 1.09)。敏感性分析证实了这些结果。
纯母乳喂养与8岁前患肾病综合征的风险降低20%相关。