Association of vitamin D supplementation with respiratory tract infection in infants
Association of vitamin D supplementation with respiratory tract infection in infants
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补充维生素 D 与婴儿呼吸道感染的关系
DOI：
10.1111/mcn.12987
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发表时间：
2020-07-01
影响因子：
3.4
通讯作者：
Hao, Liping
中科院分区：
文献类型：
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作者：
Hong, Miao;Xiong, Ting;Hao, Liping
据报道，维生素D缺乏与呼吸道感染（RTI）有关。然而，关于维生素D补充剂对婴儿RTI易感性影响的证据有限。在这项前瞻性出生队列研究中，我们研究了维生素D补充剂是否降低了2,244名从出生到6个月大的婴儿的RTI风险。结局终点为儿科医生诊断的RTI首次发作或6个月大时未发生RTI事件。从出生到结局终点接受每日剂量为400-600 IU维生素D补充剂的婴儿被定义为维生素D补充剂，并根据平均补充频率分为四组：0，1-2，3-4和5-7天/周。我们用Kaplan-Meier曲线评估了维生素D补充与RTI首次发作时间之间的关系。采用改良Poisson回归分析评估维生素D补充与婴儿RTI、低RTI（LRTI）和RTI相关住院的关系。对于未补充营养的婴儿，首次RTI发作的中位时间为出生后60天（95%CI [60，90]），而对于补充营养的婴儿，首次RTI发作的中位时间超过6个月（p<0.001）。我们观察到补充频率与RTI、LRTI和RTI相关住院风险呈相反趋势（趋势p < .001），每周补充5-7天组的风险比为0.46（95% CI [0.41，0.50]）、0.17（95% CI [0.13，0.24]）和0.18（95% CI [0.12，0.27]）。这些关联在按婴儿喂养分层的亚组分析中是显著和一致的。
Vitamin D deficiency has been reported to be associated with respiratory tract infection (RTI). However, evidence regarding the effects of vitamin D supplementation on susceptibility of infants to RTI is limited. In this prospective birth cohort study, we examined whether vitamin D supplementation reduced RTI risk in 2,244 infants completing the follow-up from birth to 6 months of age. The outcome endpoint was the first episode of paediatrician-diagnosed RTI or 6 months of age when no RTI event occurred. Infants receiving vitamin D supplements at a daily dose of 400-600 IU from birth to the outcome endpoint were defined as vitamin D supplementation and divided into four groups according to the average frequency of supplementation: 0, 1-2, 3-4, and 5-7 days/week. We evaluated the relationship between vitamin D supplementation and time to the first episode of RTI with Kaplan-Meier plots. The associations of vitamin D supplementation with infant RTI, lower RTI (LRTI), and RTI-related hospitalization were assessed using modified Poisson regression. The median time to first RTI episode was 60 days after birth (95% CI [60, 90]) for infants without supplementation and longer than 6 months of age for infants with supplementation (p< .001). We observed inverse trends between supplementation frequency and risk of RTI, LRTI, and RTI-related hospitalization (pfor trend < .001), with the risk ratios in the 5-7 days/week supplementation group of 0.46 (95% CI [0.41, 0.50]), 0.17 (95% CI [0.13, 0.24]), and 0.18 (95% CI [0.12, 0.27]), respectively. These associations were significant and consistent in a subgroup analysis stratified by infant feeding.