In utero exposure to 25-hydroxyvitamin D and risk of childhood asthma, wheeze, and respiratory tract infections: A meta-analysis of birth cohort studies
In utero exposure to 25-hydroxyvitamin D and risk of childhood asthma, wheeze, and respiratory tract infections: A meta-analysis of birth cohort studies
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DOI：
10.1016/j.jaci.2016.06.065
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发表时间：
2017-05-01
影响因子：
14.2
通讯作者：
He, Ka
中科院分区：
文献类型：
--
作者：
Feng, Haixia;Xun, Pengcheng;He, Ka
背景：关于宫内25-羟基维生素D(25[OH]D)暴露与儿童哮喘、喘息和呼吸道感染风险之间的关系的研究不一致，也没有定论。目的：我们试图评估脐带血或母亲静脉血中25(OH)D水平与子女哮喘、喘息和呼吸道感染风险之间的关系。方法：数据来自PubMed，Embase，Google Scholar，相关文章的参考文献，以及截至2015年12月发表的研究的新结果。结果：25(OH)D水平最高组与最低组的合并优势比分别为哮喘0.84(95%CI，0.70~1.01；P=.064)、喘息0.77(95%CI，0.58~1.03；P=0.083)、呼吸道感染0.85(95%CI，0.66~1.09；P=.187)。在测量脐带血中25(OH)D水平(0.43；95%CI，0.29-0.62；P<；.001)的研究中，观察到的与喘息的反向关联更为明显。结论：这项荟萃分析产生的累积证据表明，宫内暴露于25(OH)D的增加与儿童时期哮喘和喘息的风险呈负相关。这些发现与最近发表的两项怀孕期间补充维生素D的随机临床试验的结果是一致的。
Background: Studies of the associations between in utero 25-hydroxyvitamin D (25[OH]D) exposure and risk of childhood asthma, wheeze, and respiratory tract infections are inconsistent and inconclusive.Objectives: We sought to assess associations between 25(OH)D levels in cord blood or maternal venous blood and risk of offspring's asthma, wheeze, and respiratory tract infections.Methods: Data were derived from PubMed, Embase, Google Scholar, references from relevant articles, and de novo results from published studies until December 2015. A random-effects meta-analysis was conducted among 16 birth cohort studies.Results: Comparing the highest with the lowest category of 25(OH) D levels, the pooled odds ratios were 0.84 (95% CI, 0.70-1.01; P = .064) for asthma, 0.77 (95% CI, 0.58-1.03; P = .083) for wheeze, and 0.85 (95% CI, 0.66-1.09; P = .187) for respiratory tract infections. The observed inverse association for wheeze was more pronounced and became statistically significant in the studies that measured 25(OH)D levels in cord blood (0.43; 95% CI, 0.29-0.62; P < .001).Conclusions: Accumulated evidence generated from this meta-analysis suggests that increased in utero exposure to 25(OH)D is inversely associated with the risk of asthma and wheeze during childhood. These findings are in keepingwith the results of 2 recently published randomized clinical trials of vitamin D supplementation during pregnancy.