纬度、紫外线暴露和维生素D在儿童哮喘和枯草热中的作用：一项澳大利亚的多中心研究
2010/12/17
摘要
随着与赤道距离的缩短，过敏症的发生率呈现逐渐增加的趋势，这可能与环境中的紫外线暴露增加相关。因此，越来越多的研究集中于评价维生素D在过敏症中的作用。本试验旨在描述澳大利亚儿童过敏症随着纬度变化的情况，评价紫外线暴露（UVR）和维生素D相关指标与枯草热和/或哮喘的相关性。参与者为来自于参加一项基于人群的多中心病例对照研究的对照人群（18～61岁）以及4个研究区域（南纬27°～43°）中某个区域的居民（18～61岁）。数据来自于自填式问卷调查、访谈和生物学样本检测。根据受试者居住的位置，为纬度和经度进行地理编码，气候数据与当前居住地的邮编进行关联。取血清，检测25-羟基维生素D的浓度和皮肤硅橡胶管形，后者是评价皮肤累计光损伤的一个客观指标。纬度与哮喘呈现负相关关系（每增加一个纬度，哮喘下降9%），但经过平均日气温校正后，该相关性则不存在。UVR和维生素D相关指标与儿童哮喘无相关性，但6～15岁儿童冬季日光暴露时间的增加，与枯草热发生的优势比增加相关（校正后OR：1.29; 95% CI 1.01-1.63）。儿童口服鱼肝油能增加哮喘和枯草热并发病史的优势比（2.87; 1.00-8.32）。有必要进一步研究早期维生素D干预在过敏症发病过程中的作用。
我们的结果同时提示，儿童期日光暴露是过敏症发生的一个重要因素，对其可能的原因，包括生物学机制，有必要进行深入研究。
（苏楠 审校）
Pediatr Allergy Immunol. 2010 Sep 30. doi: 10.1111/j.1399-3038.2010.01099.x.
The role of latitude, ultraviolet radiation exposure and vitamin D in childhood asthma and hayfever: an Australian multicenter study.
Hughes AM, Lucas RM, Ponsonby AL, Chapman C, Coulthard A, Dear K, Dwyer T, Kilpatrick TJ, McMichael AJ, Pender MP, Taylor BV, Valery P, Van Der Mei IA, Williams D.
National Centre for Epidemiology and Population Health, The Australian National University, Canberra, Australia Murdoch Childrens Research Institute, Melbourne, Australia Barwon Health, Geelong, Australia The University of Queensland and the Royal Brisbane and Women’s Hospital, Brisbane, Australia Centre for Neuroscience, The University of Melbourne, Melbourne, Australia Otago University, Christchurch, New Zealand Queensland Institute of Medical Research, Brisbane, Australia Menzies Research Institute, Hobart, Australia John Hunter Hospital, Newcastle, Australia.
Abstract
Observations of increasing allergy prevalence with decreasing distance from the Equator and positive associations with ambient ultraviolet radiation have contributed to a growing interest in the possible role of vitamin D in the etiology of allergy. The aims of this study were to describe any latitudinal variation in the prevalence of childhood allergy in Australia and to evaluate, in parallel, the individual associations between ultraviolet radiation (UVR)- and vitamin D-related measures and hayfever asthma and both conditions. Participants were population-based controls who took part in a multicenter case-control study,18～61 yr and resident in one of four study regions ranging in latitude from aged 18-61 27°S to 43°S. Data were derived from a self-administered questionnaire, interview and examination by a research officer and biologic sampling. Latitude and longitude coordinates were geocoded from participants’ residential locations and climatic data were linked to postcodes of current residence. Stored serum was analyzed for 25-hydroxyvitamin D concentrations and silicone rubber casts of the skin were used as an objective measure of cumulative actinic damage. There was an inverse latitude gradient for asthma (a 9% decrease per increasing degree of latitude); however, this pattern did not persist after adjusting for average daily temperature. There was no association between any of the UVR- or vitamin D-related measures and childhood asthma, but greater time in the sun in winter between the ages 6-15 yr was associated with an increase in the odds of having hayfever [adjusted odds ratios (OR) 1.29; 95% CI 1.01-1.63].. Oral supplementation with cod liver oil in childhood increased the odds of a history of having both asthma and hayfever (2.87; 1.00-8.32). Further investigation of the possible role of early vitamin D supplementation in the development of allergy is warranted. Our results also suggest that solar exposure during childhood may be important in allergic sensitization. Plausible explanations, including biologic mechanisms, exist for both observations.
Pediatr Allergy Immunol. 2010 Sep 30. doi: 10.1111/j.1399-3038.2010.01099.x.
随着与赤道距离的缩短，过敏症的发生率呈现逐渐增加的趋势，这可能与环境中的紫外线暴露增加相关。因此，越来越多的研究集中于评价维生素D在过敏症中的作用。本试验旨在描述澳大利亚儿童过敏症随着纬度变化的情况，评价紫外线暴露（UVR）和维生素D相关指标与枯草热和/或哮喘的相关性。参与者为来自于参加一项基于人群的多中心病例对照研究的对照人群（18～61岁）以及4个研究区域（南纬27°～43°）中某个区域的居民（18～61岁）。数据来自于自填式问卷调查、访谈和生物学样本检测。根据受试者居住的位置，为纬度和经度进行地理编码，气候数据与当前居住地的邮编进行关联。取血清，检测25-羟基维生素D的浓度和皮肤硅橡胶管形，后者是评价皮肤累计光损伤的一个客观指标。纬度与哮喘呈现负相关关系（每增加一个纬度，哮喘下降9%），但经过平均日气温校正后，该相关性则不存在。UVR和维生素D相关指标与儿童哮喘无相关性，但6～15岁儿童冬季日光暴露时间的增加，与枯草热发生的优势比增加相关（校正后OR：1.29; 95% CI 1.01-1.63）。儿童口服鱼肝油能增加哮喘和枯草热并发病史的优势比（2.87; 1.00-8.32）。有必要进一步研究早期维生素D干预在过敏症发病过程中的作用。
我们的结果同时提示，儿童期日光暴露是过敏症发生的一个重要因素，对其可能的原因，包括生物学机制，有必要进行深入研究。
（苏楠 审校）
Pediatr Allergy Immunol. 2010 Sep 30. doi: 10.1111/j.1399-3038.2010.01099.x.
The role of latitude, ultraviolet radiation exposure and vitamin D in childhood asthma and hayfever: an Australian multicenter study.
Hughes AM, Lucas RM, Ponsonby AL, Chapman C, Coulthard A, Dear K, Dwyer T, Kilpatrick TJ, McMichael AJ, Pender MP, Taylor BV, Valery P, Van Der Mei IA, Williams D.
National Centre for Epidemiology and Population Health, The Australian National University, Canberra, Australia Murdoch Childrens Research Institute, Melbourne, Australia Barwon Health, Geelong, Australia The University of Queensland and the Royal Brisbane and Women’s Hospital, Brisbane, Australia Centre for Neuroscience, The University of Melbourne, Melbourne, Australia Otago University, Christchurch, New Zealand Queensland Institute of Medical Research, Brisbane, Australia Menzies Research Institute, Hobart, Australia John Hunter Hospital, Newcastle, Australia.
Abstract
Observations of increasing allergy prevalence with decreasing distance from the Equator and positive associations with ambient ultraviolet radiation have contributed to a growing interest in the possible role of vitamin D in the etiology of allergy. The aims of this study were to describe any latitudinal variation in the prevalence of childhood allergy in Australia and to evaluate, in parallel, the individual associations between ultraviolet radiation (UVR)- and vitamin D-related measures and hayfever asthma and both conditions. Participants were population-based controls who took part in a multicenter case-control study,18～61 yr and resident in one of four study regions ranging in latitude from aged 18-61 27°S to 43°S. Data were derived from a self-administered questionnaire, interview and examination by a research officer and biologic sampling. Latitude and longitude coordinates were geocoded from participants’ residential locations and climatic data were linked to postcodes of current residence. Stored serum was analyzed for 25-hydroxyvitamin D concentrations and silicone rubber casts of the skin were used as an objective measure of cumulative actinic damage. There was an inverse latitude gradient for asthma (a 9% decrease per increasing degree of latitude); however, this pattern did not persist after adjusting for average daily temperature. There was no association between any of the UVR- or vitamin D-related measures and childhood asthma, but greater time in the sun in winter between the ages 6-15 yr was associated with an increase in the odds of having hayfever [adjusted odds ratios (OR) 1.29; 95% CI 1.01-1.63].. Oral supplementation with cod liver oil in childhood increased the odds of a history of having both asthma and hayfever (2.87; 1.00-8.32). Further investigation of the possible role of early vitamin D supplementation in the development of allergy is warranted. Our results also suggest that solar exposure during childhood may be important in allergic sensitization. Plausible explanations, including biologic mechanisms, exist for both observations.
Pediatr Allergy Immunol. 2010 Sep 30. doi: 10.1111/j.1399-3038.2010.01099.x.
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