Study on the correlation between vitamin D level and eczema in early life of infants

doi:10.11852/zgetbjzz2018-1263

Abstract

Abstract: Objective To make clear the correlation between serum 25-(OH)D₃level and the development of eczema in early life of infants,so as to provide evidence for vitamin D supplementation in early infancy. Methods Totally 605 infants who took physical examination inSuzhou Municipal Hospital were recruited in this study from November 2016 to October 2017.The baseline data were collected by questionnaires survey,and SCORAD table was used to assess the severity of eczema.The level of 25-(OH)D₃was tested by immune colloidal gold chromatography through blood samples collected from tip of small fingers. Results The average level of 25-(OH)D₃in 605 infants was (28.48±6.10)ng/ml.Totally 457 children developed eczema(75.5%),of whom 421(65.9%) children were mild,35(5.8%) children were moderate,and one(0.2%) child developed severe eczema.The levels of 25-(OH)D₃(F=21.75,P<0.001)and the incidence rate of eczema(χ²=16.01,P=0.014) in different seasons were significantly different.The level of 25-(OH)D₃ was lowest in winter,but risk of eczema was highest in winter.Moreover,the SCORAD was significantly higher in spring (Z=-3.94, P＜0.001) and winter (Z=-2.72,P=0.039) than that in summer.There was no significant difference on the incidence of eczema among different 25-(OH)D₃ level groups,but the level of 25-(OH)D₃was related to the severity of eczema.The risk of moderate to sever eczema increased with the level of 25-(OH)D₃ (OR=1.063,95% CI:1.001-1.129,P=0.045),while infants with severe eczema had lower rate of vitamin D intake behavior than infants with mild eczema(OR=0.365,95%CI:0.179-0.741,P=0.005).Allergic history of parent increased the risk for severe eczema(OR=2.857,95%CI:1.399-5.837, P=0.004). Conclusion The level of 25-(OH)D₃ is higher in infants with severe eczema,but those who take vitamin D supplementation are less.Further researches are warranted to explore the underlying reasons for this discrepancy.

Key words: 25-(OH)D₃, eczema, infant, allergy diseases

摘要： 目的探讨婴儿早期血清25-(OH)D₃水平与湿疹发病的相互关系,并为婴儿早期维生素D的补充提供参考。方法随机抽取2016年11月-2017年10月医院体检的38~48 d龄婴儿605例,通过问卷采集基线资料,利用SCORAD评分法对湿疹进行评分,采集婴儿指尖血,采用胶体金免疫层析技术检测血清25-(OH)D₃水平。结果 605例样本血清25-(OH)D₃平均水平为(28.48±6.10)ng/ml,湿疹患病人数为457例(75.5%),其中421例(69.5%)为轻度,35例(5.8%)为中度,1例(0.2%)为重度。不同季节的血清25-(OH)D₃水平(F=21.75,P<0.001)和湿疹发病率(χ²=16.01,P=0.014)差异均有统计学意义,其中冬季血清25-(OH)D₃水平最低,但冬季湿疹的发病风险最高;而且发生在冬(Z=-2.72,调整后P=0.039)、春(Z=-3.94,调整后P<0.001)两季湿疹的SCORAD评分值均明显高于夏季。不同血清25-(OH)D₃水平患儿的湿疹发病率差异无统计学意义(P>0.05),但在湿疹的严重程度上差异有统计学意义(P>0.05)。随着血清25-(OH)D₃水平增加,中重度湿疹的发生风险明显增高(OR=1.063,95%CI:1.001~1.129, P=0.045);与轻度湿疹患儿相比,中重度湿疹患儿有外源性维生素D补充行为者较少(OR=0.365,95%CI:0.179~0.741,P＝0.005),父母有过敏史则可增加中重度湿疹的发病风险(OR=2.857,95%CI:1.399~5.837,P=0.004)。结论婴儿早期患有较严重湿疹者血清25-(OH)D₃水平偏高,而外源性维生素D补充行为却少,该人群体内高水平25-(OH)D₃的产生原因有待进一步研究。

关键词: 25-(OH)D₃, 湿疹, 婴儿, 过敏性疾病

CLC Number:

R758.23

DENG Sha-sha, YE Kan, SHEN Yan, SONG Yuan. Study on the correlation between vitamin D level and eczema in early life of infants[J]. journal1, 2020, 28(2): 215-218.

邓莎莎, 叶侃, 沈燕, 宋媛. 婴儿早期维生素D水平状况及湿疹的相关性研究[J]. 中国儿童保健杂志, 2020, 28(2): 215-218.

References

[1] 冯梅,肖异珠,罗晓艳,等.不同遗传背景婴儿湿疹发病的环境影响因素分析[J].中国儿童保健杂志,2015,23(10):1070-1073.
[2] 申春平,闫琦,王召阳,等.低龄婴儿湿疹的流行病学调查与治疗随访[J].临床皮肤科杂志,2015,44(8):469-472.
[3] 闫瑰娟,方明珠.产后42天回访母婴健康状况分析[J].中国妇幼保健,2011,26(21):3235-3236.
[4] Abo-Zaid G,Sharpe RA,Fleming LE,et al.Association of infant eczema with childhood and adult asthma:analysis of data from the 1958 birth cohort study[J].Int J Environ Res Public Health,2018,15(7):1415.
[5] Agrawal R,Wisniewski JA,Woodfolk JA.The role of regulatory T cells in atopic dermatitis[J].Curr Probl Dermatol,2011,41:112-124.
[6] Moosbrugger-Martinz V,Tripp CH,Clausen BE,et al.Atopic dermatitis induces the expansion of thymus-derived regulatory T cells exhibiting a Th2-like phenotype in mice[J].J Cell Mol Med,2016,20(5):930-938.
[7] Chang J,Mitra N,Hoffstad O,et al.Association of filaggrin loss of function and thymic stromal lymphopoietin variation with treatment use in pediatric atopic dermatitis[J].JAMA Dermatol,2017,153(3):275-281.
[8] Hossein-Nezhad A,Holick MF.Vitamin D for health:a global perspective[J].Mayo Clin Proc,2013,88(7):720-755.
[9] Hanifin J.Diagnostic features of atopic eczema[J].Acta Dermatol Venereol,1980,92:44-47.
[10] Kunz B,Oranje AP,Labreze L,et al.Clinical validation and guidelines for the SCORAD index:consensus report of the European Task Force on Atopic Dermatitis[J].Dermatology,1997,195(1):10-19.
[11] Zhao X,Xiao J,Liao X,et al.Vitamin D status among young children aged 1~3 Years:a cross-sectional study in Wuxi,China[J].PLoS One,2015,10(10):e141595.
[12] Guo Y,Ke HJ,Liu Y,et al.Prevalence of vitamin D insufficiency among children in southern China:A cross-sectional survey[J].Medicine (Baltimore),2018,97(25):e11030.
[13] Wu F,Laslett LL,Zhang Q.Threshold effects of vitamin d status on bone health in Chinese adolescents with low calcium intake[J].J Clin Endocrinol Metab,2015,100(12):4481-4489.
[14] Back O,Blomquist HK,Hernell O,et al.Does vitamin D intake during infancy promote the development of atopic allergy?[J].Acta Derm Venereol,2009,89(1):28-32.
[15] Gale CR,Robinson SM,Harvey NC,et al.Maternal vitamin D status during pregnancy and child outcomes[J].Eur J Clin Nutr,2008,62(1):68-77.
[16] Heimbeck I,Wjst M,Apfelbacher CJ.Low vitamin D serum level is inversely associated with eczema in children and adolescents in Germany[J].Allergy,2013,68(7):906-910.
[17] Berents TL,Lodrup CK,Mowinckel P,et al.Vitamin D levels and atopic eczema in infancy and early childhood in Norway:a cohort study[J].Br J Dermatol,2016,175(1):95-101.
[18] Noh S,Park CO,Bae JM,et al.Lower vitamin D status is closely correlated with eczema of the head and neck[J].J Allergy Clin Immunol,2014,133(6):1767-1770.
[19] Albenali LH,Danby S,Moustafa M,et al.Vitamin D and antimicrobial peptide levels in patients with atopic dermatitis and atopic dermatitis complicated by eczema herpeticum:A pilot study[J].J Allergy Clin Immunol,2016,138(6):1715-1719.
[20] Wang WL,Li HY,Zhang MS,et al.Thymic stromal lymphopoietin:a promising therapeutic target for allergic diseases[J].Int Arch Allergy Immunol,2013,160(1):18-26.
[21] Ginde AA,Blatchford P,Breese K,et al.High-Dose monthly vitamin d for prevention of acute respiratory infection in older long-term care residents:a randomized clinical trial[J].J Am Geriatr Soc,2017,65(3):496-503.
[22] Thyssen JP,Thuesen B,Huth C,et al.Skin barrier abnormality caused by filaggrin (FLG) mutations is associated with increased serum 25-hydroxyvitamin D concentrations[J].J Allergy Clin Immunol,2012,130(5):1204-1207.
[23] Hartmann B,Riedel R,Jorss K,et al.Vitamin D receptor activation improves allergen-triggered eczema in mice[J].J Invest Dermatol,2012,132(2):330-336.