Hidajat Dedianto, Haq Abiyyu Didar, Warnaini Cut, Kadriyan Hamsu
Department of Dermatology and Venereology, Faculty of Medicine, University of Mataram, Indonesia.
Medical Doctor Profession Program, Faculty of Medicine, University of Mataram, Indonesia.
Malays J Med Sci. 2024 Aug;31(4):50-62. doi: 10.21315/mjms2024.31.4.4. Epub 2024 Aug 27.
Although Indonesia is located in an equatorial region with adequate year-round sun exposure, the prevalence of 25-hydroxyvitamin D (25[OH]D) deficiency is as high as 90%. Mothers are especially vulnerable to deficiencies due to changes in their gastrointestinal system. Previous studies have reported a correlation between the 25[OH]D status of mothers with atopic dermatitis (AD) and their offspring. However, studies investigating maternal cord blood 25[OH]D levels and the incidence of AD have yielded controversial results due to its variability. As such, this systematic review and meta-analysis aimed to evaluate the correlation between maternal cord blood 25[OH]D levels and the risk for AD. In accordance with Preferred Reporting System for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, the PubMed, Cochrane Library and ScienceDirect databases were searched for relevant observational studies and a meta-analysis was performed to obtain odds ratios (OR) and corresponding 95% confidence intervals (CI). Nine studies were included in the qualitative synthesis, five of which were included in the quantitative synthesis. Meta-analysis revealed that cord blood 25[OH]D levels < 50 nmol/L were associated with a 60% higher risk for the development of AD (OR = 1.60; 95% CI: 1.15, 2.22; I = 0%; < 0.05). However, qualitative synthesis revealed a variety of cord blood 25[OH]D measurements and different methods of diagnosing AD in each study. Based on the current analysis, maternal cord blood 25[OH]D levels were significantly correlated with the risk for AD. Therefore, studies investigating 25[OH]D supplementation in pregnant women and its efficacy in decreasing the risk for AD are needed, especially in tropical and equatorial countries. This study also serves as a proof of concept that cord blood 25[OH]D levels can be used as a more affordable predictive parameter for AD.
尽管印度尼西亚位于赤道地区，全年阳光充足，但25-羟基维生素D（25[OH]D）缺乏症的患病率高达90%。母亲们由于胃肠道系统的变化，尤其容易出现维生素缺乏。此前的研究报告了患有特应性皮炎（AD）的母亲及其后代的25[OH]D状态之间的相关性。然而，由于其变异性，调查母亲脐带血25[OH]D水平与AD发病率的研究得出了有争议的结果。因此，本系统评价和荟萃分析旨在评估母亲脐带血25[OH]D水平与AD风险之间的相关性。根据系统评价和荟萃分析的首选报告系统（PRISMA）指南，在PubMed、Cochrane图书馆和ScienceDirect数据库中搜索相关观察性研究，并进行荟萃分析以获得比值比（OR）和相应的95%置信区间（CI）。九项研究纳入定性综合分析，其中五项纳入定量综合分析。荟萃分析显示，脐带血25[OH]D水平<50 nmol/L与AD发生风险高60%相关（OR = 1.60；95% CI：1.15，2.22；I² = 0%；P < 0.05）。然而，定性综合分析显示，每项研究中脐带血25[OH]D的测量方法各不相同，AD的诊断方法也不同。基于目前的分析，母亲脐带血25[OH]D水平与AD风险显著相关。因此，需要开展研究，调查孕妇补充25[OH]D及其在降低AD风险方面的疗效，特别是在热带和赤道国家。本研究还证明了脐带血25[OH]D水平可作为AD更经济实惠的预测参数。
