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Association of food allergy in children with vitamin D insufficiency: a systematic review and meta-analysis

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Abstract

Current literature regarding the association of vitamin D insufficiency and food allergy is contradicting. The purpose of our study was to investigate this association. This is a systematic review and meta-analysis according to the PRISMA statement. PubMeD and Scopus databases were systematically searched for case–control studies investigating the association between pediatric food allergy and vitamin D insufficiency. Our search yielded 806 studies. Ten final studies were considered eligible for qualitative and quantitative analysis. Children with vitamin D insufficiency were found to have 68% more probability to present a food allergy episode (adjusted pooled OR: 1.68, 95% CI [1.25–2.27], p-value: 0.001). In their second year of life they were 4 times more likely to present a food allergy episode (adjusted pooled OR: 4.06, 95% CI [1.93–8.56], p-value: < 0.001), and 56% more probable to develop food sensitization (OR: 1.56, 95% CI [1.15–2.11], p-value: < 0.004). Children in Australia with vitamin D insufficiency were almost 4 times more likely to develop egg sensitization (adjusted OR: 3.79, 95% CI [1.19–12.08], p-value: 0.024). Children with vitamin D insufficiency were almost twice as likely to have peanut sensitization (OR: 1.96, 95% CI [1.08–3.57], p-value: 0.028).

  Conclusion: Decreased maternal vitamin D levels and infant vitamin D insufficiency appear to increase the incidence of food allergies, particularly in the second year of life. To confirm this association, multicenter longitudinal studies are required.

What is Known:

• In newborns and young children, vitamin D deficiency and insufficiency are prevalent.

• The exact role of vitamin D in atopic diseases remains controversial.

What is New:

• Decreased maternal vitamin D levels and infant vitamin D insufficiency appear to increase the incidence of food allergies. This association is more evident in the second year of life.

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Availability of data and material

All data are presented in the manuscript and supplementary file. For any inquiry, the corresponding author may be contacted.

Code availability

Available upon request.

Change history

  • 22 February 2023

    Supplementary material was replaced with the clean version of material.

Abbreviations

25(OH)D:

25 Hydroxyvitamin D

CAMP:

Cathelicidin antimicrobial peptide

CI:

Confidence interval

CMA:

Cow milk allergy

EIA:

Enzyme immunoassay

IFN:

Interferon

IL:

Interleukin

MeSH:

Medical Subject Headings

Odds Ratio:

OR

PRISMA:

Reporting Items for Systematic Reviews and Meta-Analyses

PROSPERO:

Prospective register of systematic reviews

sIgE:

Specific IgE

SRMA:

Systematic review and meta-analysis

Th1:

T-helper 1

Th2:

T-helper 2

TNF:

Tumor necrosis factor

Tregs:

T regulatory cells

UVB:

Type B ultraviolet

VDR:

Vitamin D receptor

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Author notes

  1. Evdokia Psaroulaki and Georgios N. Katsaras contributed equally to this work.

Authors and Affiliations

  1. Paediatric Department, General Hospital of Pella – Hospital Unit of Edessa, Edessa, Greece

    Evdokia Psaroulaki, Georgios N. Katsaras, Petrina Samartzi, Evangelos Oikonomou & Pelagia Tsitsani

  2. Orthopaedic Department, “Ippokrateio” General Hospital of Thessaloniki, Thessaloniki, Greece

    Vasiliki Chatziravdeli

  3. Aristotle University of Thessaloniki School of Veterinary Medicine, Thessaloniki, Greece

    Danai Psaroulaki

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Contributions

GNK and EP: conceived the study, participated in its design, and in the data collection and extraction, as well as the interpretation of the data, the statistical analyses, and helped to draft the manuscript. PS, VC, and DP: participated in the data collection and extraction, as well as the interpretation of the data, the statistical analyses, and helped to draft the manuscript. EO and PT: participated in the interpretation of the data and drafting of the manuscript. All authors critically revised the paper for important intellectual content and approved the final version to be published.

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Correspondence to Georgios N. Katsaras.

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Psaroulaki, E., Katsaras, G.N., Samartzi, P. et al. Association of food allergy in children with vitamin D insufficiency: a systematic review and meta-analysis. Eur J Pediatr 182, 1533–1554 (2023). https://doi.org/10.1007/s00431-023-04843-2

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