Higher Cord Blood 25-Hydroxyvitamin D_fix_lg

7/25/2019 Higher Cord Blood 25-Hydroxyvitamin D_fix_lg

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W A N D A N I S Y A H R I R , T E N R I E S A , U L E N G B A H R U N

D E P A R T E M E N I L M U P A T O L O G I K L I N I K F K U H - R S W S


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Background: Aim of this study was to determinewhether cord

blood vitamin D concentrations were associated

with risk of early childhood allergic disease.

ABSTRACT


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Methods: Measurements of cord blood 25-hydroyvitamin D

!25"#$%D& concentrations were available in 2'(

mother-child )airs who were )artici)ating in theallergy follow-u) "n * '(+% of the D#M,n#randomised controlled trial.

ABSTRACT


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ABSTRACT

All of the children had a hereditary risk of allergicdisease.

he diagnosis of allergic disease was made duringmedical assessments at and / years of age.

Methods:


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0esults: mean "standard deviation% standardised cord blood

25"#$%D concentration was 5'.( "21.% nmol3.

cumulative incidence of ec4ema to / years of agen* (25( "1( 6% was associated with standardisedcord blood 25"#$%D concentration

( nmol3 rise in 25"#$%D concentration reducing

the risk of ec4ema by 7 6 "relative risk (.82 85 6confidence interval (.7+9(.8' ; * (.((5%.

ABSTRACT


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0esults: association was stronger at year of age when a (

nmol3 rise in standardised cord blood 25"#$%Dconcentration reduced the risk of ec4ema by 2 6"relative risk (.77 85 6 confidence interval (.79(.8+ ;* (.((2%

ABSTRACT


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ABSTRACT

associations between cord blood 25"#$%Dconcentrations and develo)ment of allergicsensitisation allergic rhinitis or asthma in earlychildhood were found.

0esults:


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Backgroun

@ome e)idemiological studies have shown:

vitamin D dietary intakes during )regnancy

risk of allergic disease ato)ic dermatitisec4emafood allergen sensitisation asthma and allergicrhinitis in the offs)ring.


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Backgroun

measurement of serum 25-hydroyvitamin D"25"#$%D%most abundant and stable vitamin Dmetabolite

During )regnancy the fetus is e)osed to vitamin Dthrough the cord blood su))ly and the ability of25"#$%D to cross the )lacenta.


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M!"#o$

@ubects and study design :

thics


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M!"#o$


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M!"#o$

% &!ar '!(ca) r!*(!+-A))!rg(c $!n$("($a"(on &!ar '!(ca) r!*(!+-A))!rg(c $!n$("($a"(on


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M!"#o$

>arly childhood allergic disease outcome assessments and definitions :

Allergic sensitisation


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M!"#o$

Asthma

>arly childhood allergic disease outcome assessments and definitions :"continue%


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M!"#o$

25"#$%D concentrations were standardised toaccount for variability in cord blood 25"#$%D bymonth of birth.


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S"a"($"(ca) M!"#o$A)) a$$oc(aC#!ck$ +!r! 3!r1or'! "o !n$ur! a!4ua"! 'o!) 1(" "#ro


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R!$u)"$


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R!$u)"$


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R!$u)"$


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R!$u)"$


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D($cu$$(on

( nmol3 rise in standardisedcord blood 25"#$%Dconcentrationrisk of ec4ema

cumulative incidence ofec4ema with sensitisation by /years of age was alsoassociated with cord blood

25"#$%D concentration.

-he )athogenesisof ec4ema involvesimmunedysregulation

altered e)idermalbarrier functionand inadeEuatebacterial defenceand vitamin D isknown to have aregulatory influenceon all of these.

consistent with the findings ofother observational studies


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D($cu$$(on

no association of cord blood 25"#$%D concentrationswith asthma or allergic rhinitis outcomes

)attern of allergic disease is known to differ with age:

food allergy and ato)ic dermatitisec4ema being in the

first few years of life asthma and allergic rhinitis continue to rise until

adulthood.


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D($cu$$(on

longer term follow-u) of these children is neededbefore this result can be conclusive and we arecurrently following u) the children in our cohort at +

years of age for allergic disease outcomes.


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D($cu$$(on

he strengths of this study

standardised medical assessments of allergic diseaseoutcomes with high follow u) rates ofF85 6 at year

and F8( 6 at / years of age.standardised cord blood 25"#$%D concentrations

which is im)ortant to adust for seasonal variabilityin 25"#$%D concentrations due to month of birth.


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D($cu$$(on

limitation of this studynot taken blood sam)lesfrom the children to eamine vitamin D status atmulti)le time)oints during early life.


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D($cu$$(on

,t may be that the timing of differential vitamin Dstatus could have variable effects on the develo)mentof allergic diseases.

A family history of allergic disease in all the)artici)ants in this study may reduce the ability togenerali4e our findings to the whole )o)ulation


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D($cu$$(on

Bia4 et al. who did not select )artici)ants based on afamily history of allergic disease also re)orted thathigher cord blood 25"#$%D concentrations wereassociated with decreased risk of early childhoodec4ema.


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D($cu$$(on

Another )ossible limitation to the generalisability ofthe results was that a )redominance of


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Conc)u$(on

,n children with a family history of allergic diseasehigher cord blood 25"#$%D concentrations a))ear to

be associated with a reduction in the risk of ec4emadevelo)ment through to / years of age.


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dan fungsi efektor dari sel monositdan makrofaga.!2&ungsi rutin ,3-( tam)aknya terutama menghambat atau

meniadakan res)on )eradangan selain mengendalikan)erkembangan dan diferensiasi sel B sel G= sel $

sel


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Documents

Higher Cord Blood 25-Hydroxyvitamin D_fix_lg