Association between serum 25-hydroxyvitamin D level and upper respiratory tract infection in the Third National Health and Nutrition Examination Survey.
Association between serum 25-hydroxyvitamin D level and upper respiratory tract infection in the Third National Health and Nutrition Examination Survey.
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DOI：
10.1001/archinternmed.2008.560
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发表时间：
2009-02-23
影响因子：
--
通讯作者：
Camargo, Carlos A., Jr.
中科院分区：
文献类型：
--
作者：
Ginde, Adit A.;Mansbach, Jonathan M.;Camargo, Carlos A., Jr.
最近的研究表明维生素D在先天免疫中的作用，包括预防呼吸道感染（RTI）。我们假设血清25-羟基维生素D（25[OH]D）水平与自我报告的近期上呼吸道感染（URTI）呈负相关。我们对1988年至1994年进行的第三次全国健康和营养检查调查进行了二次分析。我们在18883名12岁及以上的参与者中研究了25（OH）D水平与近期URTI之间的关系。该分析调整了人口统计学和临床因素（季节，体重指数，吸烟史，哮喘和慢性阻塞性肺疾病）。中位血清25（OH）D水平为29 ng/mL（转换为纳摩尔/升，乘以2.496）（四分位数范围，21-37 ng/mL），19%（95%置信区间[CI]，18%-20%）的参与者报告了最近的URTI。24%的参与者报告最近的URTI，25（OH）D水平低于10 ng/mL，20%的水平为10至低于30 ng/mL，17%的水平为30 ng/mL或更高（P<.001）。即使在调整人口统计学和临床特征后，较低的25（OH）D水平与近期URTI独立相关（与25[OH]D水平≥30 ng/mL相比：比值比[OR]为1.36; 95%CI，1.01-1.84 <10 ng/mL和1.24; 1.07-1.43 <30 ng/mL）。在哮喘和慢性阻塞性肺疾病患者中，25（OH）D水平与URTI之间的相关性似乎更强（OR分别为5.67和2.26）。血清25（OH）D水平与近期URTI呈负相关。这种关联在呼吸道疾病患者中可能更强。有必要进行随机对照试验来探索维生素D补充剂对RTI的影响。
Recent studies suggest a role for vitamin D in innate immunity, including the prevention of respiratory tract infections (RTIs). We hypothesize that serum 25-hydroxyvitamin D (25[OH]D) levels are inversely associated with self-reported recent upper RTI (URTI). We performed a secondary analysis of the Third National Health and Nutrition Examination Survey, a probability survey of the US population conducted between 1988 and 1994. We examined the association between 25(OH)D level and recent URTI in 18 883 participants 12 years and older. The analysis adjusted for demographics and clinical factors (season, body mass index, smoking history, asthma, and chronic obstructive pulmonary disease). The median serum 25(OH)D level was 29 ng/mL (to convert to nanomoles per liter, multiply by 2.496) (interquartile range, 21–37 ng/mL), and 19% (95% confidence interval [CI], 18%–20%) of participants reported a recent URTI. Recent URTI was reported by 24% of participants with 25(OH)D levels less than 10 ng/mL, by 20% with levels of 10 to less than 30 ng/mL, and by 17% with levels of 30 ng/mL or more (P<.001). Even after adjusting for demographic and clinical characteristics, lower 25(OH)D levels were independently associated with recent URTI (compared with 25[OH]D levels of ≥30 ng/mL: odds ratio [OR], 1.36; 95% CI, 1.01–1.84 for <10 ng/mL and 1.24; 1.07–1.43 for 10 to <30 ng/mL). The association between 25(OH)D level and URTI seemed to be stronger in individuals with asthma and chronic obstructive pulmonary disease (OR, 5.67 and 2.26, respectively). Serum 25(OH)D levels are inversely associated with recent URTI. This association may be stronger in those with respiratory tract diseases. Randomized controlled trials are warranted to explore the effects of vitamin D supplementation on RTI.
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