脐血25羟基维生素D3对早期婴儿特应性皮炎的预测作用

李敏敏, 陆春燕, 王晓明

中国当代儿科杂志 ›› 2018, Vol. 20 ›› Issue (4) : 303-307.

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中国当代儿科杂志 ›› 2018, Vol. 20 ›› Issue (4) : 303-307. DOI: 10.7499/j.issn.1008-8830.2018.04.010
论著·临床研究

脐血25羟基维生素D3对早期婴儿特应性皮炎的预测作用

  • 李敏敏, 陆春燕, 王晓明
作者信息 +

Predictive value of cord blood 25(OH) D3 for early infantile atopic dermatitis

  • LI Min-Min, LU Chun-Yan, WANG Xiao-Ming
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摘要

目的 探讨脐血25羟基维生素D3[25(OH)D3]对婴儿特应性皮炎的预测价值,为婴儿早期特应性皮炎的一级预防提供参考指征。方法 选择2015年7~9月期间出生的新生儿,于生后立即采集脐血并检测脐血25(OH)D3水平。所有婴儿分别于生后6周、3个月、6个月时进行门诊随访,记录特应性皮炎的发生情况。结果 最终有67例婴儿全部完成了为期6个月的随访过程,纳入本研究。有23例(34%)出现特应性皮炎,其中91%(21/23)的婴儿特应性皮炎出现在生后的第1个月。根据特应性皮炎的发生情况将婴儿分为特应性皮炎组(n=23)和健康对照组(n=44),特应性皮炎组脐血25(OH)D3水平低于正常组(P < 0.05)。根据脐血25(OH)D3水平分为 < 30 nmol/L(n=21)和 ≥ 30 nmol/L组(n=46),<30 nmol/L组婴儿特应性皮炎发病率高于 ≥ 30 nmol/L组(P < 0.05)。ROC分析结果显示:曲线下面积(AUC)为0.648,标准误为0.075,95%CI为0.502~0.795,灵敏度为52.2%,特异度为79.5%,阳性预测值为57.1%,阴性预测值为76.1%,故脐血25(OH)D3对AD的诊断价值较低。Logistic回归分析结果显示:低脐血25(OH)D3水平、母孕期喜食海鲜、特应性家族史阳性、混合喂养4个因素是影响特应性皮炎发生的危险因素(P < 0.05)。结论 脐血25(OH)D3水平与特应性皮炎的发病风险呈现负性相关关系,但是对特应性皮炎的诊断价值较低。

Abstract

Objective To explore the predictive value of cord blood 25(OH)D3[25(OH)D3] for infantile atopic dermatitis (AD), and to provide a reference for primary prevention of early infantile AD. Methods The neonates born from July to September, 2015 were enrolled. The cord blood samples were collected at birth to measure the level of 25(OH)D3. Outpatient follow-up was conducted for all the infants at 6 weeks, 3 months, and 6 months after birth. A survey was performed to investigate the incidence of AD. Results A total of 67 neonates completed a 6-month follow-up. The incidence of AD was 34% (23/67), and 91% (21/23) of these cases occurred in the first month after birth. The 23 AD children had a significantly lower cord 25(OH)D3 level than those without AD (P < 0.05). The children with a cord 25(OH)D3 level < 30 nmol/L showed a significantly higher incidence of AD than those with a cord 25(OH)D3 level ≥ 30 nmol/L (P < 0.05). The receiver operating characteristic (ROC) analysis showed that the area under the ROC curve of cord 25(OH)D3 in predicting AD was 0.648 (standard error:0.075; 95%CI:0.502-0.795). Its sensitivity, specificity, positive predictive value, and negative predictive value were 52.2%, 79.5%, 57.1%, and 76.1%, respectively. Logistic regression analysis showed that low cord 25(OH)D3 level, preference for seafood during pregnancy, atopic family history, and mixed feeding were risk factors for infantile AD (P < 0.05). Conclusions Cord 25(OH)D3 level is inversely associated with the risk of infantile AD, but it has a low diagnostic value for this disease.

关键词

脐血 / 25羟基维生素D3 / 特应性皮炎 / 婴儿

Key words

Cord blood / 25(OH) D3 / Atopic dermatitis / Infant

引用本文

导出引用
李敏敏, 陆春燕, 王晓明. 脐血25羟基维生素D3对早期婴儿特应性皮炎的预测作用[J]. 中国当代儿科杂志. 2018, 20(4): 303-307 https://doi.org/10.7499/j.issn.1008-8830.2018.04.010
LI Min-Min, LU Chun-Yan, WANG Xiao-Ming. Predictive value of cord blood 25(OH) D3 for early infantile atopic dermatitis[J]. Chinese Journal of Contemporary Pediatrics. 2018, 20(4): 303-307 https://doi.org/10.7499/j.issn.1008-8830.2018.04.010

参考文献

[1] Wallach D, Taieb A. Atopic dermatitis/atopic eczema[J]. Chem Immunol Allergy, 2014, 100:81-96.
[2] Bieber T. Atopic dermatitis[J]. Ann Dermatol, 2010, 22(2):125-137.
[3] Halken S, Host A, Hansen LG, et al. Effect of an allergy prevention programme on incidence of atopic symptoms in infancy. A prospective study of 159"high-risk" infants[J]. Allergy, 1992, 47(5):545-553.
[4] White JH. Vitamin D signaling, infectious diseases, and regulation of innate immunity[J]. Infect Immun, 2008, 76(9):3837-3843.
[5] Sava F, Treszl A, Hajdú J, et al. Plasma vitamin D levels at birth and immune status of preterm infants[J]. Immunobiology, 2016, 221(11):1289-1292.
[6] Cizmeci MN, Kanburoglu MK, Akelma AZ, et al. Cord-blood 25-hydroxyvitamin D levels and risk of early-onset neonatal sepsis:a case-control study from a tertiary care center in Turkey[J]. Eur J Pediatr, 2015, 174(6):809-815.
[7] Çetinkaya M, Çekmez F, Erener-Ercan T, et al. Maternal/neonatal vitamin D deficiency:a risk factor for broncho-pulmonary dysplasia in preterms?[J]. J Perinatol, 2015, 35(10):813-817.
[8] Dinlen N, Zenciroglu A, Beken S, et al. Association of vitamin D deficiency with acute lower respiratory tract infections in newborns[J]. J Matern Fetal Neonatal Med, 2016, 29(6):928-932.
[9] Williams HC, Burney PG, Hay RJ, et al. The U.K. Working Party's Diagnostic Criteria for Atopic Dermatitis. I. Derivation of a minimum set of discriminators for atopic dermatitis[J]. Br J Dermatol, 1994, 131(3):383-396.
[10] Asher MI, Montefort S, Björkstén B, et al. Worldwide time trends in the prevalence of symptoms of asthma, allergic rhinoconjunctivitis, and eczema in childhood:ISAAC Phases One and Three repeat multicountry cross-sectional surveys[J]. Lancet, 2006, 368(9537):733-743.
[11] Gustafsson D, Sjöberg O, Foucard T. Development of allergies and asthma in infants and young children with atopic dermatitis-a prospective follow-up to 7 years of age[J]. Allergy, 2000, 55(3):240-245.
[12] Sugarman JL. The epidermal barrier in atopic dermatitis[J]. Semin Cutan Med Surg, 2008, 27(2):108-114.
[13] Bikle DD. Vitamin D metabolism and function in the skin[J]. Mol Cell Endocrinol, 2011, 347(1-2):80-89.
[14] Wang SS, Hon KL, Kong AP, et al. Vitamin D deficiency is associated with diagnosis and severity of childhood atopic dermatitis[J]. Pediatr Allergy Immunol, 2014, 25(1):30-35.
[15] Baiz N, Dargent-Molina P, Wark JD, et al. Cord serum 25-hydroxyvitamin D and risk of early childhood transient wheezing and atopic dermatitis[J]. J Allergy Clin Immunol, 2014, 133(1):147-153.
[16] Jones AP, Palmer D, Zhang G, et al. Cord blood 25-hydroxyvitamin D3 and allergic disease during infancy[J]. Pediatrics, 2012, 130(5):e1128-e1135.


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