The effect of vitamin D Status on Pediatric Asthma in a university hospital, Thailand

Abstract

higher prevalence of hypovitaminosis D in asthmatics than in the normal population; in addition, low vitamin D levels are associated with a higher severity of asthma and impaired pulmonary function. 5,6 Patients with vitamin D deficiency have shown to have increased airway hyper-responsiveness and increased corticosteroid requirements. Vitamin D might increase the response to glucocorticoid in asthmatic patients. 7,8 In pregnancy, maternal vitamin D intake has an inverse correlation with risk of recurrent wheezing in childhood. The problems of vitamin D deficiency/insufficiency are in- Original ArticleAllergy Asthma Immunol Res. 2013 September;5(5):289-294. http://dx.doi.org/10. 4168/aair.2013.5.5.289 pISSN 2092-7355 • eISSN 2092 Purpose: In the USA and Europe, hypovitaminosis D is associated with increased asthma severity, emergency department (ED) visit, and impaired pulmonary function in asthmatic patients. However, in tropical countries, data on the effect of vitamin D status on asthma is limited. This study evaluates the relationship between vitamin D status and the level of asthma control as well as other asthmatic parameters. Methods: Asthmatic children were evaluated for serum 25-hydroxyvitamin D, pulmonary function tests, a skin prick test, and the level of asthma control. Results: A total of 125 asthmatic children were recruited (boys, 66.4%). Their mean age±SD was 10.8±3.0 years. Vitamin D statuses were: deficiency (<20 ng/mL) in 19.2% of the patients, insufficiency (20-30 ng/mL) in 44.8%, and sufficiency (>30 ng/mL) in 36%. The vitamin D levels were 25.9±9.4 ng/mL in uncontrolled patients, 29.2±8.6 ng/mL in partly controlled patients, and 27.9±8.0 ng/mL in controlled patients (P>0.05). There were no significant differences in pulmonary function, asthma exacerbation, inhaled-corticosteroid (ICS) dose, anti-inflammatory drugs, or ED visit or hospitalization between different vitamin D statuses. Vitamin D deficiency patients were older and had a delayed onset of asthma than insufficiency or sufficiency patients. There was no significant correlation between serum vitamin D and pulmonary function/doses of ICS. Conclusions: High prevalences of vitamin D deficiency and insufficiency were found in asthmatic children in Thailand; however, there was no significant relationship between vitamin D status and the level of asthma control or other asthma parameters.

Vitamin D Levels In Children with Bronchial Asthma

“…68.18% of the asthmatic children had deficient serum vitamin-D levels (≤15ng/mL) and 31.28% of them had insufficient vitamin-D levels (>15ng/mL to <20ng/mL). These findings are consistent with a similar study done in Thailand, where 61.4% of the asthmatic children had vitamin-D deficiency (31.2% of uncontrolled asthmatics, 17.4% of partly controlled and 12.8% of controlled asthmatic children) [17].…”

“…Vitamin-D deficiency has been linked to many disorders having an immunological basis like multiple sclerosis, rheumatoid arthritis, inflammatory bowel disease, Crohn's disease, type 2 diabetes mellitus and cardiovascular disease [15,17,22]. Vitamin-D has been proposed to have modulatory actions on the immune system.…”

“…There are a few studies that could not find a correlation between serum vitamin D levels and pulmonary function and explained this to be due to a number of confounding factors that affect vitamin-D levels and asthma severity [17,28].…”

Bronchial Reactivity, Inflammatory and Allergic Parameters, and Vitamin D Levels in Children With Asthma

“…Our results are supported by studies in adults with asthma 32 and studies that failed to show an association between vitamin D levels and pulmonary function, degree of asthma control, or doses of inhaled corticoids in children with asthma. 33 …”

Vitamin D with asthma and COPD: not a false hope? A systematic review and meta-analysis

“…Some reviews and studies have not confirmed a positive association between blood vitamin D and asthma and COPD. Some have supported the notion that vitamin D is not associated with asthma or COPD (Schauber and Gallo, 2008;Camargo et al, 2011;Shaheen et al, 2011;Krobtrakulchai et al, 2012), but some have an opposite opinion (Li et al, 2011;Chinellato et al, 2011;Goleva et al, 2012).…”