Uticaj hipovitaminoze D na oboljevanje od alergijskih bolesti kod dece

Abstract

Uvod: Povezanost hipovitaminoze D i porasta prevalence alegijskih bolesti zasnovana je na rezultatima studija koje ukazuju na nekompetentan imunološki odgovor u toku hipovitaminoze D što doprinosi porastu obolevanja od alergijske bolesti. Ciljistraživanja: je da se dokaže da hipovitaminoza D doprinosi učestalosti oboljevanja dece od alergijskih bolesti. Metod: Serumska koncentracija vitamina D određuje se merenjem koncentracije curkulišućeg metabolita 25, hidroksivitamina D (kalcidiol) u serumu. U prvom delui straživanja analizirali smo podatke prikupljene iz istorija bolesti 558 pacijenta hospitalizovanih na Klinici za Pedijatriju Kliničkog centra "Kragujevac" u periodu od januara 2011 do juna 2016 godine. Drugi deo istraživanja obuhvatio je 94 ispitanika sa hipovitaminozom D koji su bili na supstituciji vitaminom D3. Treći deo istraživanja je case-control studija (slučaj-kontrola). Iz kohorte smo odabrali uzorak ispitanikaobolelih od alergijske bolesti bez prateće hipovitaminoze D i koji nisu bili na supstituciji vitaminom D3 u prethodnih 6 nedelja a koje smo poredili sa obolelim od alergijske bolesti sa pratećom hipovitaminozom D, kao i sa obolelim od akutne respiratorne bolesti. Rezultati: Hipovitaminoza D je utvrđena u 74.6% dece obolele od alergijske i/ili respiratorne bolesti. Dokazali smo povezanost i zavisnost incidence obolevanja od alergijske od hipovitaminoze D. Supstituciona doza od 4000 IU/dnevno vitamina D3 i 8 nedelja primene ove doze u toku jesenjih, zimskih i prolećnih meseci nedovoljni su da se postigne koncentracija vitamina D u serumu >30 ng/ml u 49% ispitanika. Zaključak: Referentna vrednost serumske koncentracije vitamina D vezana za alergijsku bolest u dece treba da bude 40 ng/mL, umesto usvojene vrednosti vezane za metabolizam kostiju od 30 ng/mL. Sigurna klinička potvrda atopijskog statusa u dece dobija se istovremenom analizom srednje vrednost serumske koncentracije vitamina D, serumske koncentracije ukupnog IgE i rezultata alergo Prick kožnog testa.

Introduction: The correlation between hypovitaminosis D and the increased prevalence of allergic disease is based on the results of studies that indicate an incompetent immune response during the D vitamin deficiency, which contributes to increasing incidence of allergic diseases. Researchgoal: is to prove that hypovitaminosis D contributes to the frequencyof allergic diseases in children. Method: The serum concentration of vitamin D is determined by measuring the concentration of circulating metabolite 25 hydroxyvitamin D (calcidiol) in the serum. In the first part of the study we analyzed data collected from the medical history of 558 patients who were hospitalized at the Clinic of Pediatrics, Clinical Center "Kragujevac", from January 2011 to June 2016. The second part of the study included 94 subjects with hypovitaminosis D who were on the substitution with vitamin D3. The third part of the research was a case-control study. From the cohort, we selected a sample of patients who had allergic diseases without any accompanying hypovitaminosis D and who were not on the substitution with vitamin D3 in the past 6 weeks, and this sample compared with a patient who had an allergic disease with the accompanying hypovitaminosis D, as well as a patient with acute respiratory disease. Results: Hypovitaminosis D was confirmed in 74.6% of children with allergic and/or respiratory disease. We proved the connectivity and dependence the incidence of allergic disease from hypovitaminosis D. A substitution dose of 4000 IU/day of vitamin D 3 and 8 weeks of these doses during autumn, winter and spring months is still insufficient to achieve a serum concentration >30 ng/ml of the vitamin Din 49% of children. Conclusion: A reference value for the serum concentrations of vitamin D related to allergic disease in children should be 40 ng/mL, instead of the used values related to the bone metabolism of 30 ng/mL. Certain clinical corroboration of the atopic state in children, we can received with the simultaneous analysis of a medium value of the serum concentrations of vitamin D, serum concentrations of total IgE and allergy results prick skin test.