Low gestational vitamin D level and childhood asthma are related to impaired lung function in high-risk children.
Low gestational vitamin D level and childhood asthma are related to impaired lung function in high-risk children.
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妊娠期维生素 D 水平低和儿童哮喘与高危儿童的肺功能受损有关。
DOI：
10.1016/j.jaci.2020.12.647
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发表时间：
2021-07
期刊：
影响因子：
--
通讯作者：
Litonjua AA
中科院分区：
文献类型：
--
作者：
Knihtilä HM;Stubbs BJ;Carey VJ;Laranjo N;Chu SH;Kelly RS;Zeiger RS;Bacharier LB;O'Connor GT;Lasky-Su J;Weiss ST;Litonjua AA
早期的肺功能损害通常会持续到成年。因此，确定儿童肺功能低下的危险因素至关重要。在维生素D产前哮喘减少试验（VDAART）中，我们研究了25-羟基维生素D （25[OH]D）水平和儿童哮喘表型对儿童肺功能的影响。25(OH)D水平在怀孕期间的母亲和儿童在生命早期的设定时间点测量。根据父母报告，儿童被分为三种临床表型：无症状/不频繁喘息，早期短暂性喘息和6岁时的哮喘。在4岁、5岁和6岁时用脉冲振荡测定法评估肺功能，在5岁和6岁时用肺活量测定法评估肺功能。这项事后分析纳入了570对母子。平均妊娠25(OH)D水平四分位数与4 ~ 6岁儿童5 Hz呼吸阻力（R5）呈负相关（β - 0.021 kPa/L/s, 95% CI - 0.035 ~ - 0.007， P=0.003），与5 ~ 6岁儿童FEV1 （β 0.018 L, 95% CI 0.005 ~ 0.031， P=0.008）和FVC （β 0.022 L, 95% CI 0.009 ~ 0.036， P=0.002）呈正相关。6岁哮喘患儿4 ~ 6岁的肺功能低于无症状/不频繁喘息组（β 0.065 kPa/L/s; 95% CI 0.028 ~ 0.102； R5和β - 0.063 L P<0.001; 95% CI - 0.099 ~ - 0.028; FEV1 P<0.001）。低妊娠期25(OH)D水平和儿童哮喘是儿童早期肺功能下降的重要危险因素。本研究表明，妊娠期低维生素D水平和儿童哮喘表型是4 ~ 6岁儿童肺功能下降的重要独立危险因素。
Lung function impairment in early life often persists into adulthood. Therefore, identifying risk factors for low childhood lung function is crucial. We examined the effect of 25-hydroxyvitamin D (25[OH]D) level and childhood asthma phenotype on childhood lung function in the Vitamin D Antenatal Asthma Reduction Trial (VDAART). 25(OH)D level was measured at set time points in mothers during pregnancy and in children during early life. Based on parental reports, children were categorized into three clinical phenotypes: asymptomatic/infrequent wheeze, early transient wheeze, and asthma at age 6 years. Lung function was assessed with impulse oscillometry at ages 4, 5, and 6 years and with spirometry at ages 5 and 6 years. 570 mother-child pairs were included in this post-hoc analysis. Mean gestational 25(OH)D level quartiles were negatively associated with child respiratory resistance at 5 Hz (R5) from age 4 to 6 years (β −0.021 kPa/L/s; 95% CI −0.035 to −0.007; P=0.003) and positively associated with FEV1 (β 0.018 L; 95% CI 0.005 to 0.031; P=0.008) and FVC (β 0.022 L; 95% CI 0.009 to 0.036; P=0.002) from age 5 to 6 years. Children with asthma at age 6 years had lower lung function from age 4 to 6 years than the asymptomatic/infrequent wheeze group (β 0.065 kPa/L/s; 95% CI 0.028 to 0.102; P<0.001 for R5 and β −0.063 L; 95% CI −0.099 to −0.028; P<0.001 for FEV1). Low gestational 25(OH)D level and childhood asthma are important risk factors for decreased lung function in early childhood. This study provides evidence that low gestational vitamin D level and childhood asthma phenotype are important and independent risk factors for decreased childhood lung function from 4 to 6 years of age.
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影响因子：
5.8
作者：
Barry, Elizabeth L.;Rees, Judy R.;Baron, John A.
通讯作者：
Baron, John A.
影响因子：
2
作者：
Johnson, Donna D.;Wagner, Carol L.;Hollis, Bruce W.
通讯作者：
Hollis, Bruce W.
影响因子：
2.2
作者：
Litonjua AA;Lange NE;Carey VJ;Brown S;Laranjo N;Harshfield BJ;O'Connor GT;Sandel M;Strunk RC;Bacharier LB;Zeiger RS;Schatz M;Hollis BW;Weiss ST
通讯作者：
Weiss ST
DOI：
10.1165/rcmb.2019-0295oc
发表时间：
2020-07-01
影响因子：
6.4
作者：
Mandell, Erica W.;Ryan, Sharon;Abman, Steven H.
通讯作者：
Abman, Steven H.
影响因子：
2.8
作者：
Jaddoe, Vincent W. V.;Troe, Ernst-Jan W. M.;Witteman, Jacqueline C. M.
通讯作者：
Witteman, Jacqueline C. M.