J Molloy1,2,3,4, J J Koplin3,4,5, K J Allen3,4,6,7, M L K Tang3,4,6,7, F Collier1,2,3, J B Carlin3,5,6, R Saffery3, D Burgner3,6,8, S Ranganathan3,6,9, T Dwyer10, A C Ward1, M Moreno-Betancur3,11, M Clarke12, A L Ponsonby3,4, P Vuillermin1,2,3,4. 1. School of Medicine, Deakin University, Waurn Ponds, VIC, Australia. 2. Child Health Research Unit, Barwon Health, Geelong, VIC, Australia. 3. Murdoch Childrens Research Institute, Parkville, VIC, Australia. 4. Centre for Food and Allergy Research, Parkville, VIC, Australia. 5. Centre for Epidemiology and Biostatistics, The University of Melbourne, Carlton, VIC, Australia. 6. Department of Paediatrics, University of Melbourne, Parkville, VIC, Australia. 7. Department of Allergy and Immunology, Royal Children's Hospital, Parkville, VIC, Australia. 8. Department of Paediatrics, Monash University, Clayton, VIC, Australia. 9. Department of Respiratory Medicine, Royal Children's Hospital, Parkville, VIC, Australia. 10. The George Institute for Global Health, University of Oxford, Oxford, UK. 11. Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, VIC, Australia. 12. Biological and Molecular Mass Spectrometry Facility, Centre for Microscopy, Characterisation and Analysis, University of Western Australia, Perth, Western Australia, 6009.
Abstract
BACKGROUND: Ecological evidence suggests vitamin D insufficiency (VDI) due to lower ambient ultraviolet radiation (UVR) exposure may be a risk factor for IgE-mediated food allergy. However, there are no studies relating directly measured VDI during early infancy to subsequent challenge-proven food allergy. OBJECTIVE: To prospectively investigate the association between VDI during infancy and challenge-proven food allergy at 1 year. METHODS: In a birth cohort (n = 1074), we used a case-cohort design to compare 25-hydroxyvitamin D3 (25(OH)D3 ) levels among infants with food allergy vs a random subcohort (n = 274). The primary exposures were VDI (25(OH)D3 <50 nM) at birth and 6 months of age. Ambient UVR and time in the sun were combined to estimate UVR exposure dose. IgE-mediated food allergy status at 1 year was determined by formal challenge. Binomial regression was used to examine associations between VDI, UVR exposure dose and food allergy and investigate potential confounding. RESULTS: Within the random subcohort, VDI was present in 45% (105/233) of newborns and 24% (55/227) of infants at 6 months. Food allergy prevalence at 1 year was 7.7% (61/786), and 6.5% (53/808) were egg-allergic. There was no evidence of an association between VDI at either birth (aRR 1.25, 95% CI 0.70-2.22) or 6 months (aRR 0.93, 95% CI 0.41-2.14) and food allergy at 1 year. CONCLUSIONS: There was no evidence that VDI during the first 6 months of infancy is a risk factor for food allergy at 1 year of age. These findings primarily relate to egg allergy, and larger studies are required.
BACKGROUND: Ecological evidence suggests vitamin Dinsufficiency (VDI) due to lower ambient ultraviolet radiation (UVR) exposure may be a risk factor for IgE-mediated food allergy. However, there are no studies relating directly measured VDI during early infancy to subsequent challenge-proven food allergy. OBJECTIVE: To prospectively investigate the association between VDI during infancy and challenge-proven food allergy at 1 year. METHODS: In a birth cohort (n = 1074), we used a case-cohort design to compare 25-hydroxyvitamin D3 (25(OH)D3 ) levels among infants with food allergy vs a random subcohort (n = 274). The primary exposures were VDI (25(OH)D3 <50 nM) at birth and 6 months of age. Ambient UVR and time in the sun were combined to estimate UVR exposure dose. IgE-mediated food allergy status at 1 year was determined by formal challenge. Binomial regression was used to examine associations between VDI, UVR exposure dose and food allergy and investigate potential confounding. RESULTS: Within the random subcohort, VDI was present in 45% (105/233) of newborns and 24% (55/227) of infants at 6 months. Food allergy prevalence at 1 year was 7.7% (61/786), and 6.5% (53/808) were egg-allergic. There was no evidence of an association between VDI at either birth (aRR 1.25, 95% CI 0.70-2.22) or 6 months (aRR 0.93, 95% CI 0.41-2.14) and food allergy at 1 year. CONCLUSIONS: There was no evidence that VDI during the first 6 months of infancy is a risk factor for food allergy at 1 year of age. These findings primarily relate to egg allergy, and larger studies are required.
Authors: Giuseppe Saggese; Francesco Vierucci; Flavia Prodam; Fabio Cardinale; Irene Cetin; Elena Chiappini; Gian Luigi De' Angelis; Maddalena Massari; Emanuele Miraglia Del Giudice; Michele Miraglia Del Giudice; Diego Peroni; Luigi Terracciano; Rino Agostiniani; Domenico Careddu; Daniele Giovanni Ghiglioni; Gianni Bona; Giuseppe Di Mauro; Giovanni Corsello Journal: Ital J Pediatr Date: 2018-05-08 Impact factor: 2.638