25-羟维生素D和儿童早期哮喘的卫生服务利用
2018/07/09
摘要
背景：哮喘是儿童时期最常见的慢性病，也是入院的常见原因。研究表明低维生素D水平可能与儿童哮喘的卫生服务利用（HSU）有关。本文主要目标是确定儿童早期维生素D血清水平是否与哮喘HSU相关，包括：a）住院; b）急诊就诊; 和c）门诊病人就诊。次要目标是确定怀孕或童年时补充维生素D是否与哮喘HSU有关。
方法：参加目标儿童的儿童的前瞻性队列研究！在加拿大多伦多2008年至2013年期间基于实践的研究网络。通过将每个孩子的省级健康保险号码与健康管理数据库相关联来确定HSU。 使用多变量拟泊松和逻辑回归来评估25-羟基维生素D浓度，妊娠期和儿童期维生素D补充量与哮喘HSU之间的关联。
结果：共有2926名0-6岁健康儿童获得25-羟基维生素D数据，并纳入主要分析。平均（IQR）25-羟基维生素D水平为84nmol/L（65-98nmol/L），218和1267名儿童25-羟基维生素D浓度分别为<50nmol/L和<75nmol/L。在调整后的模型中，25-羟基维生素D浓度（在50和75nmol/L下连续或二分化），怀孕或童年维生素D补充量以及哮喘HSU之间没有关联。
结论：在这个健康城市儿童人群中，维生素D血液值似乎与哮喘HSU无关。
25-hydroxyvitamin D and health service utilization for asthma in early childhood.
Omand JA, To T, L O'Connor D, Parkin PC, Birken CS, Thorpe KE, Maguire JL.
Abstract
BACKGROUND:Asthma is the most common chronic illness of childhood and a common reason for hospital admission. Studies suggest that low vitamin D levels may be associated with health service utilization (HSU) for childhood asthma. The primary objective was to determine if vitamin D serum levels in early childhood were associated with HSU for asthma including: a) hospital admissions; b) emergency department visits; and c) outpatient sick visits. Secondary objectives were to determine whether vitamin D supplementation in pregnancy or childhood were associated with HSU for asthma.
METHODS:Prospective cohort study of children participating in the TARGet Kids! practice-based research network between 2008 and 2013 in Toronto, Canada. HSU was determined by linking each child's provincial health insurance number to health administrative databases. Multivariable quasi-Poisson and logistic regression were used to evaluate the association between 25-hydroxyvitamin D concentrations, vitamin D supplementation in pregnancy, and childhood and HSU for asthma.
RESULTS:A total of 2926 healthy children aged 0-6 years had 25-hydroxyvitamin D data available and were included in the primary analysis. Mean (IQR) 25-hydroxyvitmain D level was 84 nmol/L (65-98 nmol/L), 218 and 1267 children had 25-hydroxyvitamin D concentrations <50 nmol/L and <75 nmol/L, respectively. In the adjusted models, there were no associations between 25-hydroxyvitamin D concentrations (continuously or dichotomized at 50 and 75 nmol/L), vitamin D supplementation in pregnancy or childhood and HSU for asthma.
CONCLUSIONS:Vitamin D blood values do not appear to be associated with HSU for asthma in this population of healthy urban children.
背景：哮喘是儿童时期最常见的慢性病，也是入院的常见原因。研究表明低维生素D水平可能与儿童哮喘的卫生服务利用（HSU）有关。本文主要目标是确定儿童早期维生素D血清水平是否与哮喘HSU相关，包括：a）住院; b）急诊就诊; 和c）门诊病人就诊。次要目标是确定怀孕或童年时补充维生素D是否与哮喘HSU有关。
方法：参加目标儿童的儿童的前瞻性队列研究！在加拿大多伦多2008年至2013年期间基于实践的研究网络。通过将每个孩子的省级健康保险号码与健康管理数据库相关联来确定HSU。 使用多变量拟泊松和逻辑回归来评估25-羟基维生素D浓度，妊娠期和儿童期维生素D补充量与哮喘HSU之间的关联。
结果：共有2926名0-6岁健康儿童获得25-羟基维生素D数据，并纳入主要分析。平均（IQR）25-羟基维生素D水平为84nmol/L（65-98nmol/L），218和1267名儿童25-羟基维生素D浓度分别为<50nmol/L和<75nmol/L。在调整后的模型中，25-羟基维生素D浓度（在50和75nmol/L下连续或二分化），怀孕或童年维生素D补充量以及哮喘HSU之间没有关联。
结论：在这个健康城市儿童人群中，维生素D血液值似乎与哮喘HSU无关。
(中日友好医院呼吸与危重症医学科 王瑞茵 摘译 林江涛 审校)
(Pediatr Pulmonol. 2018 Jun 15. doi: 10.1002/ppul.24067. [Epub ahead of print])
(Pediatr Pulmonol. 2018 Jun 15. doi: 10.1002/ppul.24067. [Epub ahead of print])
25-hydroxyvitamin D and health service utilization for asthma in early childhood.
Omand JA, To T, L O'Connor D, Parkin PC, Birken CS, Thorpe KE, Maguire JL.
Abstract
BACKGROUND:Asthma is the most common chronic illness of childhood and a common reason for hospital admission. Studies suggest that low vitamin D levels may be associated with health service utilization (HSU) for childhood asthma. The primary objective was to determine if vitamin D serum levels in early childhood were associated with HSU for asthma including: a) hospital admissions; b) emergency department visits; and c) outpatient sick visits. Secondary objectives were to determine whether vitamin D supplementation in pregnancy or childhood were associated with HSU for asthma.
METHODS:Prospective cohort study of children participating in the TARGet Kids! practice-based research network between 2008 and 2013 in Toronto, Canada. HSU was determined by linking each child's provincial health insurance number to health administrative databases. Multivariable quasi-Poisson and logistic regression were used to evaluate the association between 25-hydroxyvitamin D concentrations, vitamin D supplementation in pregnancy, and childhood and HSU for asthma.
RESULTS:A total of 2926 healthy children aged 0-6 years had 25-hydroxyvitamin D data available and were included in the primary analysis. Mean (IQR) 25-hydroxyvitmain D level was 84 nmol/L (65-98 nmol/L), 218 and 1267 children had 25-hydroxyvitamin D concentrations <50 nmol/L and <75 nmol/L, respectively. In the adjusted models, there were no associations between 25-hydroxyvitamin D concentrations (continuously or dichotomized at 50 and 75 nmol/L), vitamin D supplementation in pregnancy or childhood and HSU for asthma.
CONCLUSIONS:Vitamin D blood values do not appear to be associated with HSU for asthma in this population of healthy urban children.
