面包酵母葡聚糖可减少中国儿童寒冷季节常见疾病发生

　　感染，特别是上呼吸道感染（URTI），在儿童早期很常见，这对医疗保健系统和个体家庭造成了巨大的经济负担。有许多食物和膳食补充剂成分可改善儿童的健康状况和免疫功能，以降低对常见儿童疾病的易感性。北京市昌平区妇幼保健院在中国进行的12周随机、双盲、安慰剂对照研究中，评价了面包酵母β-葡聚糖（BYBG）减少1～4岁儿童中常见疾病发生次数的能力。

　　20世纪40年代，康奈尔大学首次发现并报道酵母细胞壁有一种物质具有提高免疫力的作用。之后，经过杜兰大学的进一步研究发现，酵母细胞壁中提高免疫力的物质是β-葡聚糖，并从面包酵母中分离出这种物质。

　　该研究将在前3个月中经历至少2次URTI发生的总共174位12～48月龄受试者被随机分入2个治疗组（BYBG每天35或75mg）或安慰剂（对照组）。主要研究结局为研究期间未经历任何确诊常见感染性疾病发生的受试者比例，次要结局包括总感染和URTI的发生次数和持续时间。

　　结果共有156位受试者（73位男孩和83位女孩）完成研究，并被纳入完整分析集统计分析。 3组的所有相关特征有可比性。研究期间，BYBG组儿童比安慰剂组儿童明显更健康。在12周研究过程中，安慰剂组中85%的儿童经历了1次或多次感染性疾病。相比之下，BYBG治疗组仅47%和32%的儿童经历感染性疾病，显著低于安慰剂组（P＜0.001）。与BYBG组相比，安慰剂组有显著较高的URTI发病率（P＜0.0001）和更多有URTI症状的天数（P＜0.0001）。2个BYBG治疗组的主要或次要结局之间无统计学显著差异。所有报告的不良事件（AE）为轻至中度，并且在研究期间无严重AE报告。BYBG的35mg/d组仅1例AE（轻度呕吐）被认为与研究产品存在可疑相关性。

　　因此，BYBG可显著减少日间照料机构12～48月龄儿童的常见感染性疾病总发生和URTI发生，BYBG的两种剂量均可被较好耐受。

　　该研究摘要被2016年美国肠外肠内营养学会（ASPEN）临床营养周（CNW）评选为最佳国际摘要（Best International Abstract）。

JPEN J Parenter Enteral Nutr. 2016;40(4):133-134.

Baker's Yeast Beta-Glucan Decreases Episodes of Common Childhood Illness in 1- to 4-Year-Old Children During Cold Season in China.

Xia Zhou, Tiemin She, Yongmei Zhang, Naxin Yang, Chunyan Sun.

Chang Ping Women and Children Health Care Hospital, Beijing, China.

Purpose: Infections, especially upper respiratory tract infections (URTIs), are common in early childhood, which creates a large economic burden on both the healthcare system and individual families. There are many foods and dietary supplement ingredients intended to improve children's health status and immune function to decrease their susceptibility to common childhood illness. The ability of baker's yeast beta-glucan (BYBG) to reduce the number of episodes of common childhood illness in 1- to 4-year old children was evaluated in a 12-week randomized, double-blinded, placebo-controlled study conducted in China.

Methods: A total of 174 subjects (12 to 48 months old) who had experienced at least 2 episodes of URTI in the previous 3 months were enrolled and randomized to 2 treatment groups (35 or 75 mg of BYBG per day) or placebo. The primary study outcome was the proportion of subjects that did not experience any confirmed common childhood infectious illness episodes during the study. Secondary outcomes included number of episodes and duration of both total infections and URTI.

Results: A total of 156 subjects (73 boys and 83 girls) completed the study and were included in full analysis set statistical analysis. All relevant characteristics in the 3 groups were comparable. Children in the BYBG groups were significantly healthier during the study period than those in the placebo group. During the 12-week course of the study, 85% of children in the placebo group experienced 1 or more episodes of infectious illness. By contrast, only 47% and 32% children in BYBG treatment groups experienced infectious illness, significantly less than placebo group (P < .001). The placebo group had significantly higher URTI incidence per child (P < .0001) and more days with URTI symptoms (P < .0001) compared with either BYBG group. There were no statistically significant differences between the 2 BYBG treatment groups for either primary or secondary outcomes. All reported adverse events (AEs) were mild to moderate, and no serious AEs were reported during the study. Only 1 AE (mild vomiting) in the BYBG 35-mg/d group was considered to have a doubtful relationship with the study product.

Conclusions: BYBG significantly decreased total episodes of common childhood infectious illness and episodes of URTI for children aged 12 to 48 months in a day care setting. Both dosages of BYBG were well tolerated.