Clinical and Experimental Pediatrics

대한소아청소년과학회 (The Korean Pediatric Society)
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Association between cord blood 25-hydroxyvitamin D concentrations and respiratory tract infections in the first 6 months of age in a Korean population: a birth cohort study (COCOA)

  • Shin, Youn Ho (Department of Pediatrics, Gangnam CHA Medical Center, CHA University School of Medicine) ;
  • Yu, Jinho (Department of Pediatrics, Childhood Asthma Atopy Center, Research Center for Standardization of Allergic Diseases, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Kim, Kyung Won (Department of Pediatrics, Yonsei University College of Medicine) ;
  • Ahn, Kangmo (Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Hong, Seo-Ah (Department of Pediatrics, Childhood Asthma Atopy Center, Research Center for Standardization of Allergic Diseases, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Lee, Eun (Department of Pediatrics, Childhood Asthma Atopy Center, Research Center for Standardization of Allergic Diseases, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Yang, Song-I (Department of Pediatrics, Childhood Asthma Atopy Center, Research Center for Standardization of Allergic Diseases, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Jung, Young-Ho (Department of Pediatrics, Childhood Asthma Atopy Center, Research Center for Standardization of Allergic Diseases, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Kim, Hyung Young (Department of Pediatrics, Gosin University College of Medicine) ;
  • Seo, Ju-Hee (Department of Pediatrics, Korean Cancer Hospital) ;
  • Kwon, Ji-Won (Department of Pediatrics, Seoul National University Bundang Hospital) ;
  • Kim, Byoung-Ju (Department of Pediatrics, Inje University Haeundae Paik Hospital) ;
  • Kim, Hyo-Bin (Department of Pediatrics, Inje University Sanggye Paik Hospital) ;
  • Shim, Jung Yeon (Department of Pediatrics, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine) ;
  • Kim, Woo Kyung (Department of Pediatrics, Inje University Seoul Paik Hospital) ;
  • Song, Dae Jin (Department of Pediatrics, Korea University College of Medicine) ;
  • Lee, So-Yeon (Department of Pediatrics, Hallym University Sacred Heart Hospital, Hallym University College of Medicine) ;
  • Lee, Soo Young (Department of Pediatrics, Ajou University School of Medicine) ;
  • Jang, Gwang Cheon (Department of Pediatrics, National Health Insurance Corporation Ilsan Hospital) ;
  • Suh, Dong In (Department of Pediatrics, Seoul National University College of Medicine) ;
  • Yang, Hyeon-Jong (Department of Pediatrics, Soonchunhyang University School of Medicine) ;
  • Kim, Bong Sung (Department of Pediatrics, Childhood Asthma Atopy Center, Research Center for Standardization of Allergic Diseases, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Hong, Soo-Jong (Department of Pediatrics, Childhood Asthma Atopy Center, Research Center for Standardization of Allergic Diseases, Asan Medical Center, University of Ulsan College of Medicine)
  • 투고 : 2013.04.29
  • 심사 : 2013.08.30
  • 발행 : 2013.10.15
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초록

Purpose: Previous studies suggest that the concentration of 25-hydroxyvitamin D [25(OH)D] in cord blood may show an inverse association with respiratory tract infections (RTI) during childhood. The aim of the present study was to examine the influence of 25(OH)D concentrations in cord blood on infant RTI in a Korean birth cohort. Methods: The levels of 25(OH)D in cord blood obtained from 525 Korean newborns in the prospective COhort for Childhood Origin of Asthma and allergic diseases were examined. The primary outcome variable of interest was the prevalence of RTI at 6-month follow-up, as diagnosed by pediatricians and pediatric allergy and pulmonology specialists. RTI included acute nasopharyngitis, rhinosinusitis, otitis media, croup, tracheobronchitis, bronchiolitis, and pneumonia. Results: The median concentration of 25(OH)D in cord blood was 32.0 nmol/L (interquartile range, 21.4 to 53.2). One hundred and eighty neonates (34.3%) showed 25(OH)D concentrations less than 25.0 nmol/L, 292 (55.6%) showed 25(OH)D concentrations of 25.0-74.9 nmol/L, and 53 (10.1%) showed concentrations of ${\geq}75.0$ nmol/L. Adjusting for the season of birth, multivitamin intake during pregnancy, and exposure to passive smoking during pregnancy, 25(OH)D concentrations showed an inverse association with the risk of acquiring acute nasopharyngitis by 6 months of age (P for trend=0.0004). Conclusion: The results show that 89.9% of healthy newborns in Korea are born with vitamin D insufficiency or deficiency (55.6% and 34.3%, respectively). Cord blood vitamin D insufficiency or deficiency in healthy neonates is associated with an increased risk of acute nasopharyngitis by 6 months of age. More time spent outdoors and more intensified vitamin D supplementation for pregnant women may be needed to prevent the onset of acute nasopharyngitis in infants.

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참고문헌

  1. Holick MF. Vitamin D deficiency. N Engl J Med 2007;357:266-81. https://doi.org/10.1056/NEJMra070553
  2. Belenchia AM, Tosh AK, Hillman LS, Peterson CA. Correcting vitamin D insufficiency improves insulin sensitivity in obese adolescents: a randomized controlled trial. Am J Clin Nutr 2013; 97:774-81. https://doi.org/10.3945/ajcn.112.050013
  3. Holick MF. Sunlight and vitamin D for bone health and prevention of autoimmune diseases, cancers, and cardiovascular disease. Am J Clin Nutr 2004;80(6 Suppl):1678S-1688S.
  4. Chinellato I, Piazza M, Sandri M, Peroni D, Piacentini G, Boner AL. Vitamin D serum levels and markers of asthma control in Italian children. J Pediatr 2011;158:437-41. https://doi.org/10.1016/j.jpeds.2010.08.043
  5. Camargo CA Jr, Ingham T, Wickens K, Thadhani R, Silvers KM, Epton MJ, et al. Cord-blood 25-hydroxyvitamin D levels and risk of respiratory infection, wheezing, and asthma. Pediatrics 2011; 127:e180-7. https://doi.org/10.1542/peds.2010-0442
  6. Belderbos ME, Houben ML, Wilbrink B, Lentjes E, Bloemen EM, Kimpen JL, et al. Cord blood vitamin D deficiency is associated with respiratory syncytial virus bronchiolitis. Pediatrics 2011;127: e1513-20. https://doi.org/10.1542/peds.2010-3054
  7. Holick MF. High prevalence of vitamin D inadequacy and implications for health. Mayo Clin Proc 2006;81:353-73. https://doi.org/10.4065/81.3.353
  8. Merewood A, Mehta SD, Grossman X, Chen TC, Mathieu JS, Holick MF, et al. Widespread vitamin D deficiency in urban Massachusetts newborns and their mothers. Pediatrics 2010;125:640-7. https://doi.org/10.1542/peds.2009-2158
  9. Camargo CA Jr, Ingham T, Wickens K, Thadhani RI, Silvers KM, Epton MJ, et al. Vitamin D status of newborns in New Zealand. Br J Nutr 2010;104:1051-7. https://doi.org/10.1017/S0007114510001674
  10. Choi HS, Oh HJ, Choi H, Choi WH, Kim JG, Kim KM, et al. Vitamin D insufficiency in Korea--a greater threat to younger generation: the Korea National Health and Nutrition Examination Survey (KNHANES) 2008. J Clin Endocrinol Metab 2011;96:643-51. https://doi.org/10.1210/jc.2010-2133
  11. Bartley J. Vitamin D, innate immunity and upper respiratory tract infection. J Laryngol Otol 2010;124:465-9. https://doi.org/10.1017/S0022215109992684
  12. Yildiz I, Unuvar E, Zeybek U, Toptas B, Cacina C, Toprak S, et al. The role of vitamin D in children with recurrent tonsillopharyngitis. Ital J Pediatr 2012;38:25. https://doi.org/10.1186/1824-7288-38-25
  13. Ginde AA, Mansbach JM, Camargo CA Jr. Association between serum 25-hydroxyvitamin D level and upper respiratory tract infection in the Third National Health and Nutrition Examination Survey. Arch Intern Med 2009;169:384-90. https://doi.org/10.1001/archinternmed.2008.560
  14. Shin YH, Kim KE, Lee C, Shin HJ, Kang MS, Lee HR, et al. High prevalence of vitamin D insufficiency or deficiency in young adolescents in Korea. Eur J Pediatr 2012;171:1475-80. https://doi.org/10.1007/s00431-012-1746-0
  15. Vitamin D supplementation: Recommendations for Canadian mothers and infants. Paediatr Child Health 2007;12:583-98.
  16. Ginde AA, Liu MC, Camargo CA Jr. Demographic differences and trends of vitamin D insufficiency in the US population, 1988-2004. Arch Intern Med 2009;169:626-32. https://doi.org/10.1001/archinternmed.2008.604
  17. Ginde AA, Sullivan AF, Mansbach JM, Camargo CA Jr. Vitamin D insufficiency in pregnant and nonpregnant women of childbearing age in the United States. Am J Obstet Gynecol 2010;202:436.e1-8. https://doi.org/10.1016/j.ajog.2009.11.036
  18. van der Meer IM, Karamali NS, Boeke AJ, Lips P, Middelkoop BJ, Verhoeven I, et al. High prevalence of vitamin D deficiency in pregnant non-Western women in The Hague, Netherlands. Am J Clin Nutr 2006;84:350-3.
  19. Dong Y, Pollock N, Stallmann-Jorgensen IS, Gutin B, Lan L, Chen TC, et al. Low 25-hydroxyvitamin D levels in adolescents: race, season, adiposity, physical activity, and fitness. Pediatrics 2010;125:1104-11. https://doi.org/10.1542/peds.2009-2055
  20. Erkkola M, Nwaru BI, Viljakainen HT. Maternal vitamin D during pregnancy and its relation to immune-mediated diseases in the offspring. Vitam Horm 2011;86:239-60. https://doi.org/10.1016/B978-0-12-386960-9.00010-1
  21. Litonjua AA. Childhood asthma may be a consequence of vitamin D deficiency. Curr Opin Allergy Clin Immunol 2009;9:202-7. https://doi.org/10.1097/ACI.0b013e32832b36cd
  22. Brun P, Dupret JM, Perret C, Thomasset M, Mathieu H. Vitamin D- dependent calcium-binding proteins (CaBPs) in human fetuses: comparative distribution of 9K CaBP mRNA and 28K CaBP during development. Pediatr Res 1987;21:362-7. https://doi.org/10.1203/00006450-198704000-00008
  23. Phokela SS, Peleg S, Moya FR, Alcorn JL. Regulation of human pulmonary surfactant protein gene expression by 1alpha,25-dihydroxyvitamin D3. Am J Physiol Lung Cell Mol Physiol 2005; 289:L617-26. https://doi.org/10.1152/ajplung.00129.2004
  24. Nguyen M, Trubert CL, Rizk-Rabin M, Rehan VK, Besancon F, Cayre YE, et al. 1,25-Dihydroxyvitamin D3 and fetal lung maturation: immunogold detection of VDR expression in pneumocytes type II cells and effect on fructose 1,6 bisphosphatase. J Steroid Biochem Mol Biol 2004;89-90:93-7. https://doi.org/10.1016/j.jsbmb.2004.03.054
  25. Marin L, Dufour ME, Nguyen TM, Tordet C, Garabedian M. Maturational changes induced by 1 alpha,25-dihydroxyvitamin D3 in type II cells from fetal rat lung explants. Am J Physiol 1993;265(1 Pt 1):L45-52.
  26. Sakurai R, Shin E, Fonseca S, Sakurai T, Litonjua AA, Weiss ST, et al. 1alpha,25(OH)2D3 and its 3-epimer promote rat lung alveolar epithelial-mesenchymal interactions and inhibit lipofibroblast apoptosis. Am J Physiol Lung Cell Mol Physiol 2009;297:L496-505. https://doi.org/10.1152/ajplung.90539.2008
  27. Wang TT, Nestel FP, Bourdeau V, Nagai Y, Wang Q, Liao J, et al. Cutting edge: 1,25-dihydroxyvitamin D3 is a direct inducer of antimicrobial peptide gene expression. J Immunol 2004;173:2909-12.
  28. Wayse V, Yousafzai A, Mogale K, Filteau S. Association of subclinical vitamin D deficiency with severe acute lower respiratory infection in Indian children under 5 y. Eur J Clin Nutr 2004;58: 563-7. https://doi.org/10.1038/sj.ejcn.1601845
  29. Karatekin G, Kaya A, Salihoglu O, Balci H, Nuhoglu A. Association of subclinical vitamin D deficiency in newborns with acute lower respiratory infection and their mothers. Eur J Clin Nutr 2009;63: 473-7. https://doi.org/10.1038/sj.ejcn.1602960
  30. Roth DE, Shah R, Black RE, Baqui AH. Vitamin D status and acute lower respiratory infection in early childhood in Sylhet, Bangladesh. Acta Paediatr 2010;99:389-93. https://doi.org/10.1111/j.1651-2227.2009.01594.x
  31. Inamo Y, Hasegawa M, Saito K, Hayashi R, Ishikawa T, Yoshino Y, et al. Serum vitamin D concentrations and associated severity of acute lower respiratory tract infections in Japanese hospitalized children. Pediatr Int 2011;53:199-201. https://doi.org/10.1111/j.1442-200X.2010.03224.x
  32. Jeffery LE, Burke F, Mura M, Zheng Y, Qureshi OS, Hewison M, et al. 1,25-Dihydroxyvitamin D3 and IL-2 combine to inhibit T cell production of inflammatory cytokines and promote development of regulatory T cells expressing CTLA-4 and FoxP3. J Immunol 2009;183:5458-67. https://doi.org/10.4049/jimmunol.0803217
  33. Hansdottir S, Monick MM, Lovan N, Powers L, Gerke A, Hunninghake GW. Vitamin D decreases respiratory syncytial virus induction of NF-kappaB-linked chemokines and cytokines in airway epithelium while maintaining the antiviral state. J Immunol 2010;184:965-74. https://doi.org/10.4049/jimmunol.0902840
  34. Liu PT, Stenger S, Li H, Wenzel L, Tan BH, Krutzik SR, et al. Toll- like receptor triggering of a vitamin D-mediated human antimicrobial response. Science 2006;311:1770-3. https://doi.org/10.1126/science.1123933
  35. Adams JS, Ren S, Liu PT, Chun RF, Lagishetty V, Gombart AF, et al. Vitamin d-directed rheostatic regulation of monocyte antibacterial responses. J Immunol 2009;182:4289-95. https://doi.org/10.4049/jimmunol.0803736

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