Elsevier

The Journal of Pediatrics

Volume 165, Issue 4, October 2014, Pages 849-854.e1
The Journal of Pediatrics

Original Article
The Link between Serum Vitamin D Level, Sensitization to Food Allergens, and the Severity of Atopic Dermatitis in Infancy

https://doi.org/10.1016/j.jpeds.2014.06.058Get rights and content

Objective

To investigate the association between serum vitamin D levels, sensitization to food allergens, and the severity of atopic dermatitis in infants.

Study design

We investigated serum 25-hydroxyvitamin D (25[OH]D) and specific immunoglobulin E levels to common or suspected food allergens in 226 infants with atopic dermatitis or food allergy. The severity of atopic dermatitis by the Scoring Atopic Dermatitis index and amount of vitamin D intake was measured in subcohort children. Sensitization to food allergen was categorized by the number (non-, mono-, and poly-) of sensitized allergens and the degree (undetected-, low-, and high-level) of sensitization.

Results

Significant differences in 25(OH)D levels were found between groups on number (P = .006) and degree (P = .005) of food sensitization. The polysensitization group had significantly lower levels of 25(OH)D than the nonsensitization (P = .001) and monosensitization (P = .023) group. High-level sensitization group had significantly lower 25(OH)D levels compared with undetected (P = .005) and low-level (P = .009) sensitization group. Vitamin D deficiency increased the risk of sensitization to food allergens (OR 5.0; 95% CI 1.8-14.1), especially to milk (OR 10.4; 95% CI 3.3-32.7) and wheat (OR 4.2; 95% CI 1.1-15.8). In addition, the Scoring Atopic Dermatitis index was independently related to 25(OH)D levels after adjusting for the level of sensitization (adjusted R2 = 0.112, P = .031).

Conclusions

Our results suggest that vitamin D deficiency increases the risk of sensitization to food allergens and that atopic dermatitis may be more severe in infants with vitamin D deficiency.

Section snippets

Methods

This is a cross-sectional study in which subjects were recruited consecutively between January 2011 and December 2012 at the CHA Bundang Hospital, Korea (located at latitude 37°26'N). The inclusion criteria were children aged 3-24 months with atopic dermatitis or suspected food allergy, who had not been on vitamin supplementation for at least 1 month prior to the study. Exclusion criteria were children with suspected chronic diseases or congenital anomaly, those with previous history of

Results

The characteristics of the study population are shown in the Table. The prevalence of exclusively breast-fed infants until 3 and 6 months of age was 61.5% and 48.9%, respectively. The median serum 25(OH)D level was 18.1 ng/mL (IQR 4.7-28.9 ng/mL).

Discussion

This study suggests that low 25(OH)D levels increase the risk of food allergen sensitization and are associated with the severity of atopic dermatitis. The severity of atopic dermatitis was independently influenced by the serum 25(OH)D levels and by food allergen sensitization. This report indicates the relationship between the vitamin D status in infancy (not cord blood levels), the degree of sensitization, and the severity of atopic dermatitis.

In line with previous studies, the dietary

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    The authors declare no conflicts of interest.

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