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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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