维生素A、D、E与儿童反复呼吸道感染相关性的病例对照研究

目的 探讨血清维生素A、D、E水平与儿童反复呼吸道感染(RRTI)的相关性，为RRTI的防治提供更多理论依据。方法 选择于2016年9月-2018年8月在哈尔滨市儿童医院呼吸内科/儿童保健门诊就诊的1200名0.5~14岁儿童为研究对象，其中RRTI组600名儿童(就诊时存在呼吸道感染症状)，对照组600名儿童按病例对照原则与RRTI组进行1DK]∶1匹配。将儿童的一般资料和血液检查结果纳入logistic回归模型检验，探讨维生素A、D、E与RRTI的相关性，以ROC曲线确定最佳截断值。结果 RRTI组儿童的血清维生素A、E和25(OH)D水平低于对照组，差异均具有统计学意义(t分别为6.85, 7.15和9.50, P均＜0.001)；在校正了性别、年龄、年龄别身高、年龄别体重、年龄别身体质量指数和血红蛋白后，VA不足(OR=1.669, 95% CI: 1.032~2.700))、VA缺乏(OR=1.502, 95% CI: 1.173~1.924)、VD缺乏(OR=2.356, 95% CI: 1.798~3.088)、VD严重缺乏(OR=1.595, 95% CI: 1.147~2.219)和VE不足(OR=1.673, 95% CI: 1.295~2.160)均为RRTI的危险因素；高于截断值水平的维生素A(OR=0.669, 95% CI: 0.554~0.882)、E(OR=0.590, 95% CI: 0.464~0.750)和25(OH)D(OR= 0.476, 95% CI: 0.372~0.609)均为RRTI的保护性因素。结论 维生素A、D、E水平均与儿童RRTI存在相关性。

Association of serum levels of vitamins A,D, and E with recurrent respiratory tract infections in children: a case control study

Objective To investigate the association of serum concentrations of vitamins A, D, and E with recurrent respiratory tract infections (RRTI), and to provide a theoretical basis for the prevention of RRTI in children. Methods A total of 1200 children aged 0.5~14 years who visited in department of respiratory or child healthcare of Harbin Children’s Hospital from September 2016 to August 2018 were selected. Among the participants, 600 children suffered from RRTI and had respiratory tract infection symptoms upon enrollment, whereas 600 children were used as controls whom selected based on a 1:1 case control design. Logistic regression model was constructed to test general data and blood test results. The association of RRTI with the serum levels of vitamins A, E, as well as 25(OH) D was discussed and the ROC curve was used to determine the optimum cutoff values. Results Serum levels of vitamins A and E, as well as 25(OH) D, were lower in the RRTI group than the control group (t=6.85, 7.15, and 9.50, respectively, all P<0.001). After adjustment for age, sex, height-for-age, weight-for-age, body mass index-for-age and hemoglobin, the OR value was 1.669 (95% CI: 1.032~2.700) for vitamin A insufficiency, 1.502 (95% CI: 1.173~1.924) for vitamin A deficiency, 2.356 (95% CI: 1.798~3.088) for vitamin D deficiency, 1.595 (95% CI: 1.147~2.219) for significant vitamin D reduction and 1.673 (95% CI: 1.295~2.160) for vitamin E insufficiency. Contrarily, serum levels of vitamins A (OR=0.669, 95% CI: 0.554~0.882), E (OR=0.590, 95% CI: 0.464~0.750), and 25(OH) D (OR=0.476, 95% CI: 0.372~0.609) that were higher than cutoff values were negatively associated with RRTI, respectively. Conclusion Serum concentrations of vitamins A, D, and E are associated with RRTI in children.