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Published in: BMC Pulmonary Medicine 1/2024

Open Access 01-12-2024 | Bronchial Asthma | Research

Association of serum vitamin C levels with Asthma in adults: results of NHANES 2003–2006 and mendelian randomization study

Authors: Kang Wang, Lintao Zhao, Hu Luo, Caixia Deng, Liang Gong, Zhujun Chen

Published in: BMC Pulmonary Medicine | Issue 1/2024

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Abstract

Background

The protective effect of vitamin C as an antioxidant against asthma in adults remains controversial. This study used an observational study and Mendelian randomization (MR) analysis to investigate the association between adult asthma and serum vitamin C levels.

Methods

Using information from the National Health and Nutrition Examination Survey (NHANES) 2003–2006, we carried out an observational study. A multivariate logistic regression model was employed to examine the connection between adult asthma and serum vitamin C levels. We used the inverse-variance weighted (IVW) method of MR analysis as the primary method to analyze the causal effect of serum vitamin C levels on asthma in adults.

Results

A total of 8,504 participants were included in the observational study, including 639 in the asthma group and 7,865 in the non-asthma group. Before sample weighting, serum vitamin C was associated with a reduced risk of asthma in adults (OR = 0.798, 95% CI: 0.673–0.945, P = 0.009). After sample weighting, serum vitamin C was not associated with adult asthma risk (OR = 0.829, 95% CI: 0.660 ~ 1.042, P = 0.104). MR analysis showed no causal relationship between serum vitamin C and adult asthma in either the UK Biobank (OR = 0.957, 95% CI: 0.871 ~ 1.053, P = 0.370) or FinnGen (OR = 0.973, 95% CI: 0.824 ~ 1.149, P = 0.750) cohorts.

Conclusion

Our study did not support a causal association between serum vitamin C levels and adult asthma risk. The relationship between serum vitamin C and adult asthma requires further research.
Appendix
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Literature
1.
go back to reference Miller RL, Grayson MH, Strothman K. Advances in Asthma: New understandings of Asthma’s natural history, risk factors, underlying mechanisms, and clinical management. J Allergy Clin Immunol. 2021;148(6):1430–41.CrossRefPubMed Miller RL, Grayson MH, Strothman K. Advances in Asthma: New understandings of Asthma’s natural history, risk factors, underlying mechanisms, and clinical management. J Allergy Clin Immunol. 2021;148(6):1430–41.CrossRefPubMed
2.
go back to reference GBD 2019 Chronic Respiratory Diseases Collaborators. Global burden of chronic Respiratory Diseases and risk factors, 1990–2019: an update from the global burden of Disease Study 2019. EClinicalMedicine. 2023;59:101936. GBD 2019 Chronic Respiratory Diseases Collaborators. Global burden of chronic Respiratory Diseases and risk factors, 1990–2019: an update from the global burden of Disease Study 2019. EClinicalMedicine. 2023;59:101936.
3.
go back to reference Huang K, Yang T, Xu J, Yang L, Zhao J, Zhang X, et al. Prevalence, risk factors, and management of Asthma in China: a national cross-sectional study. Lancet. 2019;394(10196):407–18.CrossRefPubMed Huang K, Yang T, Xu J, Yang L, Zhao J, Zhang X, et al. Prevalence, risk factors, and management of Asthma in China: a national cross-sectional study. Lancet. 2019;394(10196):407–18.CrossRefPubMed
5.
go back to reference James BN, Oyeniran C, Sturgill JL, Newton J, Martin RK, Bieberich E, et al. Ceramide in apoptosis and oxidative stress in allergic inflammation and Asthma. J Allergy Clin Immunol. 2021;147(5):1936–48e9.CrossRefPubMed James BN, Oyeniran C, Sturgill JL, Newton J, Martin RK, Bieberich E, et al. Ceramide in apoptosis and oxidative stress in allergic inflammation and Asthma. J Allergy Clin Immunol. 2021;147(5):1936–48e9.CrossRefPubMed
6.
go back to reference Tecklenburg SL, Mickleborough TD, Fly AD, Bai Y, Stager JM. Ascorbic acid supplementation attenuates exercise-induced bronchoconstriction in patients with Asthma. Respir Med. 2007;101(8):1770–8.CrossRefPubMed Tecklenburg SL, Mickleborough TD, Fly AD, Bai Y, Stager JM. Ascorbic acid supplementation attenuates exercise-induced bronchoconstriction in patients with Asthma. Respir Med. 2007;101(8):1770–8.CrossRefPubMed
7.
go back to reference Doseděl M, Jirkovský E, Macáková K, Krčmová LK, Javorská L, Pourová J, et al. Vitamin C-Sources, physiological role, Kinetics, Deficiency, Use, Toxicity, and determination. Nutrients. 2021;13(2):615.CrossRefPubMedPubMedCentral Doseděl M, Jirkovský E, Macáková K, Krčmová LK, Javorská L, Pourová J, et al. Vitamin C-Sources, physiological role, Kinetics, Deficiency, Use, Toxicity, and determination. Nutrients. 2021;13(2):615.CrossRefPubMedPubMedCentral
8.
go back to reference Kaur B, Rowe BH, Arnold E. Vitamin C supplementation for Asthma. Cochrane Database Syst Rev. 2009;2009(1). CD000993. Kaur B, Rowe BH, Arnold E. Vitamin C supplementation for Asthma. Cochrane Database Syst Rev. 2009;2009(1). CD000993.
9.
go back to reference Ahluwalia N, Dwyer J, Terry A, Moshfegh A, Johnson C. Update on NHANES Dietary Data: Focus on Collection, Release, Analytical considerations, and uses to inform Public Policy. Adv Nutr. 2016;7(1):121–34.CrossRefPubMedPubMedCentral Ahluwalia N, Dwyer J, Terry A, Moshfegh A, Johnson C. Update on NHANES Dietary Data: Focus on Collection, Release, Analytical considerations, and uses to inform Public Policy. Adv Nutr. 2016;7(1):121–34.CrossRefPubMedPubMedCentral
10.
11.
go back to reference Burgess S, Thompson SG. Avoiding bias from weak instruments in mendelian randomization studies. Int J Epidemiol. 2011;40(3):755–64.CrossRefPubMed Burgess S, Thompson SG. Avoiding bias from weak instruments in mendelian randomization studies. Int J Epidemiol. 2011;40(3):755–64.CrossRefPubMed
12.
go back to reference Papadimitriou N, Dimou N, Tsilidis KK, Banbury B, Martin RM, Lewis SJ, et al. Physical activity and risks of breast and Colorectal cancer: a mendelian randomisation analysis. Nat Commun. 2020;11(1):597.CrossRefPubMedPubMedCentral Papadimitriou N, Dimou N, Tsilidis KK, Banbury B, Martin RM, Lewis SJ, et al. Physical activity and risks of breast and Colorectal cancer: a mendelian randomisation analysis. Nat Commun. 2020;11(1):597.CrossRefPubMedPubMedCentral
13.
go back to reference Zheng JS, Luan J, Sofianopoulou E, Imamura F, Stewart ID, Day FR, et al. Plasma Vitamin C and type 2 Diabetes: Genome-Wide Association Study and Mendelian Randomization Analysis in European populations. Diabetes Care. 2021;44(1):98–106.CrossRefPubMed Zheng JS, Luan J, Sofianopoulou E, Imamura F, Stewart ID, Day FR, et al. Plasma Vitamin C and type 2 Diabetes: Genome-Wide Association Study and Mendelian Randomization Analysis in European populations. Diabetes Care. 2021;44(1):98–106.CrossRefPubMed
14.
go back to reference Valette K, Li Z, Bon-Baret V, Chignon A, Bérubé JC, Eslami A, et al. Prioritization of candidate causal genes for Asthma in susceptibility loci derived from UK Biobank. Commun Biol. 2021;4(1):700.CrossRefPubMedPubMedCentral Valette K, Li Z, Bon-Baret V, Chignon A, Bérubé JC, Eslami A, et al. Prioritization of candidate causal genes for Asthma in susceptibility loci derived from UK Biobank. Commun Biol. 2021;4(1):700.CrossRefPubMedPubMedCentral
15.
go back to reference Hartwig FP, Davey Smith G, Bowden J. Robust inference in summary data mendelian randomization via the zero modal pleiotropy assumption. Int J Epidemiol. 2017;46(6):1985–98.CrossRefPubMedPubMedCentral Hartwig FP, Davey Smith G, Bowden J. Robust inference in summary data mendelian randomization via the zero modal pleiotropy assumption. Int J Epidemiol. 2017;46(6):1985–98.CrossRefPubMedPubMedCentral
16.
go back to reference Bowden J, Del Greco MF, Minelli C, Davey Smith G, Sheehan N, Thompson J. A framework for the investigation of pleiotropy in two-sample summary data mendelian randomization. Stat Med. 2017;36(11):1783–802.CrossRefPubMedPubMedCentral Bowden J, Del Greco MF, Minelli C, Davey Smith G, Sheehan N, Thompson J. A framework for the investigation of pleiotropy in two-sample summary data mendelian randomization. Stat Med. 2017;36(11):1783–802.CrossRefPubMedPubMedCentral
17.
go back to reference Bowden J, Davey Smith G, Burgess S. Mendelian randomization with invalid instruments: effect estimation and bias detection through Egger regression. Int J Epidemiol. 2015;44(2):512–25.CrossRefPubMedPubMedCentral Bowden J, Davey Smith G, Burgess S. Mendelian randomization with invalid instruments: effect estimation and bias detection through Egger regression. Int J Epidemiol. 2015;44(2):512–25.CrossRefPubMedPubMedCentral
18.
go back to reference Verbanck M, Chen CY, Neale B, Do R. Detection of widespread horizontal pleiotropy in causal relationships inferred from mendelian randomization between complex traits and Diseases. Nat Genet. 2018;50(5):693–8.CrossRefPubMedPubMedCentral Verbanck M, Chen CY, Neale B, Do R. Detection of widespread horizontal pleiotropy in causal relationships inferred from mendelian randomization between complex traits and Diseases. Nat Genet. 2018;50(5):693–8.CrossRefPubMedPubMedCentral
21.
go back to reference Ben Anes A, Ben Nasr H, Fetoui H, Bchir S, Chahdoura H, Yacoub S, et al. Alteration in systemic markers of oxidative and antioxidative status in Tunisian patients with Asthma: relationships with clinical severity and airflow limitation. J Asthma. 2016;53(3):227–37.CrossRefPubMed Ben Anes A, Ben Nasr H, Fetoui H, Bchir S, Chahdoura H, Yacoub S, et al. Alteration in systemic markers of oxidative and antioxidative status in Tunisian patients with Asthma: relationships with clinical severity and airflow limitation. J Asthma. 2016;53(3):227–37.CrossRefPubMed
22.
go back to reference Shidfar F, Baghai N, Keshavarz A, Ameri A, Shidfar S. Comparison of plasma and leukocyte vitamin C status between asthmatic and healthy subjects. East Mediterr Health J. 2005;11(1–2):87–95.PubMed Shidfar F, Baghai N, Keshavarz A, Ameri A, Shidfar S. Comparison of plasma and leukocyte vitamin C status between asthmatic and healthy subjects. East Mediterr Health J. 2005;11(1–2):87–95.PubMed
23.
go back to reference Picado C, Deulofeu R, Lleonart R, Agustí M, Mullol J, Quintó L, et al. Dietary micronutrients/antioxidants and their relationship with bronchial Asthma severity. Allergy. 2001;56(1):43–9.CrossRefPubMed Picado C, Deulofeu R, Lleonart R, Agustí M, Mullol J, Quintó L, et al. Dietary micronutrients/antioxidants and their relationship with bronchial Asthma severity. Allergy. 2001;56(1):43–9.CrossRefPubMed
24.
go back to reference Uysalol M, Mutlu LC, Saracoglu GV, Karasu E, Guzel S, Kayaoglu S, et al. Childhood Asthma and vitamin D deficiency in Turkey: is there cause and effect relationship between them? Ital J Pediatr. 2013;39:78.CrossRefPubMedPubMedCentral Uysalol M, Mutlu LC, Saracoglu GV, Karasu E, Guzel S, Kayaoglu S, et al. Childhood Asthma and vitamin D deficiency in Turkey: is there cause and effect relationship between them? Ital J Pediatr. 2013;39:78.CrossRefPubMedPubMedCentral
25.
go back to reference Beckhaus AA, Garcia-Marcos L, Forno E, Pacheco-Gonzalez RM, Celedón JC, Castro-Rodriguez JA. Maternal nutrition during pregnancy and risk of Asthma, wheeze, and atopic Diseases during childhood: a systematic review and meta-analysis. Allergy. 2015;70(12):1588–604.CrossRefPubMed Beckhaus AA, Garcia-Marcos L, Forno E, Pacheco-Gonzalez RM, Celedón JC, Castro-Rodriguez JA. Maternal nutrition during pregnancy and risk of Asthma, wheeze, and atopic Diseases during childhood: a systematic review and meta-analysis. Allergy. 2015;70(12):1588–604.CrossRefPubMed
26.
go back to reference Hysinger EB, Roizen JD, Mentch FD, Vazquez L, Connolly JJ, Bradfield JP, et al. Mendelian randomization analysis demonstrates that low vitamin D is unlikely causative for pediatric Asthma. J Allergy Clin Immunol. 2016;138(6):1747–9e4.CrossRefPubMedPubMedCentral Hysinger EB, Roizen JD, Mentch FD, Vazquez L, Connolly JJ, Bradfield JP, et al. Mendelian randomization analysis demonstrates that low vitamin D is unlikely causative for pediatric Asthma. J Allergy Clin Immunol. 2016;138(6):1747–9e4.CrossRefPubMedPubMedCentral
27.
go back to reference Gans MD, Gavrilova T. Understanding the immunology of Asthma: pathophysiology, biomarkers, and treatments for Asthma endotypes. Paediatr Respir Rev. 2020;36:118–27.PubMed Gans MD, Gavrilova T. Understanding the immunology of Asthma: pathophysiology, biomarkers, and treatments for Asthma endotypes. Paediatr Respir Rev. 2020;36:118–27.PubMed
28.
go back to reference McEvoy CT, Schilling D, Clay N, Jackson K, Go MD, Spitale P, et al. Vitamin C supplementation for pregnant Smoking women and pulmonary function in their newborn infants: a randomized clinical trial. JAMA. 2014;311(20):2074–82.CrossRefPubMedPubMedCentral McEvoy CT, Schilling D, Clay N, Jackson K, Go MD, Spitale P, et al. Vitamin C supplementation for pregnant Smoking women and pulmonary function in their newborn infants: a randomized clinical trial. JAMA. 2014;311(20):2074–82.CrossRefPubMedPubMedCentral
29.
go back to reference Nakamura K, Wada K, Sahashi Y, Tamai Y, Tsuji M, Watanabe K, et al. Associations of intake of antioxidant vitamins and fatty acids with Asthma in pre-school children. Public Health Nutr. 2013;16(11):2040–5.CrossRefPubMed Nakamura K, Wada K, Sahashi Y, Tamai Y, Tsuji M, Watanabe K, et al. Associations of intake of antioxidant vitamins and fatty acids with Asthma in pre-school children. Public Health Nutr. 2013;16(11):2040–5.CrossRefPubMed
Metadata
Title
Association of serum vitamin C levels with Asthma in adults: results of NHANES 2003–2006 and mendelian randomization study
Authors
Kang Wang
Lintao Zhao
Hu Luo
Caixia Deng
Liang Gong
Zhujun Chen
Publication date
01-12-2024
Publisher
BioMed Central
Published in
BMC Pulmonary Medicine / Issue 1/2024
Electronic ISSN: 1471-2466
DOI
https://doi.org/10.1186/s12890-023-02821-w

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