急性下呼吸道感染儿童的维生素D摄入

Vitamin D intake in young children with acute lower respiratory infection

摘要:

目的：明确维生素D（Vit D）摄入是否与儿童急性下呼吸道感染（ALRI）相关。方法：比较因毛细支气管炎或肺炎入院的5岁以下儿童和非配对、无呼吸道感染的同龄对照组儿童之间Vit D摄入的差别。197例儿童的看护人完成了问卷调查，内容包括人口统计变量、ALRI 危险因素和饮食。评估ALRI与Vit D摄入及其他危险因素的相关性。结果：ALRI组儿童的平均Vit D摄入为每日48 IU/kg，对照组为每日60 IU/kg。当控制年龄、民族、社会经济地位、北部地区居住、母乳喂养、免疫接种和接触吸烟等因素时，Vit D每日摄入<80 IU/kg 的儿童患ALRI 的可能性比每日摄入≥80 IU/kg 的儿童高4倍（OR=4.9; 95%CI: 1.5~16.4）。结论：为了避免罹患ALRI等疾病，5岁以下儿童可能需要摄入比现在推荐量更高的Vit D剂量。 因毛细支气管炎和肺炎是年幼儿童住院的最常见原因，增加Vit D的补充可能有重要的公共卫生保健意义。

Abstract:

OBJECTIVE: To determine if vitamin D intake is associated with acute lower respiratory infections (ALRI) in children. METHODS: The vitamin D intakes of children younger than 5 years of age admitted to hospital with either bronchiolitis or pneumonia were compared to an unmatched control group of the same age without respiratory infection. Caregivers of 197 children completed a questionnaire collecting information on demographic variables, ALRI risk factors and diet. Associations of ALRI with vitamin D intake and other ALRI risk factors were determined. RESULTS: The mean vitamin D intake of children with ALRI was 48 IU/kg/d compared to 60 IU/kg/d in the control group. When controlling for age, ethnicity, socio-economic status, northern residence, breastfeeding, immunizations and smoking contact, children with a vitamin D intake of less than 80 IU/kg/d were greater than 4 times more likely to have ALRI compared to children with a vitamin D intake exceeding 80 IU/kg/d (OR=4.9; 95%CI: 1.5~16.4). CONCLUSIONS: A higher vitamin D intake than currently recommended might be needed to offer protection against diseases such as ALRI. Increased vitamin D supplementation could have important public health consequences, as bronchiolitis and pneumonia are the most common reasons for hospitalization in young children. (Full English version will be available online at www.amepc.org/tp.)