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Clinical and Molecular Allergy

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01-12-2020 | Bronchial Asthma | Research

Association of 25-hydroxy vitamin D with asthma and its severity in children: a case–control study

Authors: Alireza Sharif, Hamed Haddad Kashani, Mohammad Reza Sharif

Published in: Clinical and Molecular Allergy | Issue 1/2020

Abstract

Background

Universally, asthma has high prevalence rates and this has led numerous studies done into its causes. Despite extensive study on asthma the association between 25-Hydroxy Vitamin D (25(OH) vit. D) and asthma remains uncertain. In this study, the associations of 25(OH) vit. D levels with asthma and with the severity of asthma were evaluated.

Methods

This was a case–control study performed in 2015 in the city of Isfahan. In this study 520 children were studied. Children with asthma were classified as cases and children who were referred for reasons other than respiratory problems and asthma were considered as controls. Serum 25 (OH) vit. D levels were then examined and compared between the two groups. Differences among groups were stated to be statistically significant when P-values < 0.05.

Results

There were 260 asthmatic children and 260 controls in the present study. The mean 25 (OH) vit. D levels in the case group was 25.5 ± 16.62 and 16.76 ± 31.40 the control group and this difference was statistically significant (P < 0.05). 25(OH) vit. D levels were found to be 28.05 ± 16.98 in non-severe asthma and 21.41 ± 15.20 in severe asthma. Consequently 25(OH) vit. D level had inverse relationship with asthma severity (P = 0.002).

Conclusions

As the results of this study showed, the lower level of 25(OH) vit. D correlated with the higher severity of asthma manifestations. Therefore, it is recommended that 25(OH) vit. D levels get routinely checked especially in severe asthma cases and if the deficiency presents, appropriate therapeutic measures be used to reduce the asthma severity.

Banasiak NC. Spirometry in primary care for children with asthma. Pediatr Nurs. 2014;40(4):195–8.PubMed

Egan KB, Ettinger AS, Bracken MB. Childhood body mass index and subsequent physician-diagnosed asthma: a systematic review and meta-analysis of prospective cohort studies. BMC Pediatr. 2013;13(1):121. https://doi.org/10.1186/1471-2431-13-121.CrossRefPubMedPubMedCentral

Litonjua AA. Vitamin D deficiency as a risk factor for childhood allergic disease and asthma. Curr Opin Allergy Clin Immunol. 2012;12(2):179–85.CrossRef

Centers for Disease Control and Prevention (CDC). Vital signs: asthma prevalence, disease characteristics, and self-management education: United States, 2001–2009. MMWR Morb Mortal Wkly Rep. 2011;60(17):547–52.

Prasad S, Rana RK, Sheth R, Mauskar AV. A hospital based study to establish the correlation between recurrent wheeze and vitamin D deficiency among children of age group less than 3 years in Indian scenario. J Clin Diagn Res. 2016;10(2):SC18–21.PubMedPubMedCentral

Turkeli A, Ayaz O, Uncu A, Ozhan B, Bas V, Tufan A, et al. Effects of vitamin D levels on asthma control and severity in pre-school children. Eur Rev Med Pharmacol Sci. 2016;20(1):26–36.PubMed

Kho AT, Sharma S, Qiu W, Gaedigk R, Klanderman B, Niu S, et al. Vitamin D related genes in lung development and asthma pathogenesis. BMC Med Genomics. 2013;6(1):47. https://doi.org/10.1186/1755-8794-6-47.CrossRefPubMedPubMedCentral

Hollis BW. Circulating 25-hydroxyvitamin D levels indicative of vitamin D sufficiency: implications for establishing a new effective dietary intake recommendation for vitamin D. J Nutr. 2005;135(2):317–22.CrossRef

Sharif MR, Kashani HH, Ardakani AT, Kheirkhah D, Tabatabaei F, Sharif A. The effect of a yeast probiotic on acute diarrhea in children. Probiotics Antimicrob Proteins. 2016;8(4):211–4.CrossRef

10.

Alavi NM, Madani M, Sadat Z, Kashani HH, Sharif MR. Fatigue and vitamin D status in Iranian female nurses. Glob J Health Sci. 2016;8(6):196–202. https://doi.org/10.5539/gjhs.v8n6p196.CrossRef

11.

Vu LH, Whiteman DC, van der Pols JC, Kimlin MG, Neale RE. Serum vitamin D levels in office workers in a subtropical climate. Photochem Photobiol. 2011;87(3):714–20. https://doi.org/10.1111/j.1751-1097.2011.00899.x.CrossRefPubMed

12.

Kimlin M, Harrison S, Nowak M, Moore M, Brodie A, Lang C. Does a high UV environment ensure adequate vitamin D status? J Photochem Photobiol B. 2007;89(2-3):139–47 (Epub 2007 Sep 25).CrossRef

13.

Tamadon MR, Soleimani A, Keneshlou F, Mojarrad MZ, Bahmani F, Naseri A, et al. Clinical trial on the effects of vitamin D supplementation on metabolic profiles in diabetic hemodialysis. Horm Metab Res. 2018;50(1):50–5. https://doi.org/10.1055/s-0043-119221.CrossRefPubMed

14.

Lotfi A, Shiasi K, Amini R, Jahangiri M, Sharif MR, Akbari H, et al. Comparing the effects of two feeding methods on metabolic bone disease in newborns with very low birth weights. Glob J Health Sci. 2016;8(1):249–54.CrossRef

15.

Andersen R, Mølgaard C, Skovgaard LT, Brot C, Cashman K, Chabros E, et al. Teenage girls and elderly women living in northern Europe have low winter vitamin D status. Eur J Clin Nutr. 2005;59(4):533–41.CrossRef

16.

Zardast M, Namakin K, Sharifzadeh G, Rezvani MR, Rahmani Y, Behrozifar Sh. Vitamin D deficiency in 7–11 year old children in Eastern Iran. Int J School Health. 2015;2(4):e27749. https://doi.org/10.17795/intjsh27749.CrossRef

17.

Holick MF. Vitamin D deficiency. N Engl J Med. 2007;357(3):266–81. https://doi.org/10.1056/nejmra070553.CrossRefPubMed

18.

Peroni DG, Bonomo B, Casarotto S, Boner AL, Piacentini GL. How changes in nutrition have influenced the development of allergic diseases in childhood. Ital J Pediatr. 2012;31(38):22. https://doi.org/10.1186/1824-7288-38-22.CrossRef

19.

Bikle DD. Vitamin D and immune function: understanding common pathways. Curr Osteoporos Rep. 2009;7(2):58–63.CrossRef

20.

Petrarca C, Clemente E, Amato V, Gatta A, Cortese S, Lamolinara A, et al. Vitamin D3 improves the effects of low dose Der p 2 allergoid treatment in Der p 2 sensitized BALB/c mice. Clin Mol Allergy. 2016;5(14):7. https://doi.org/10.1186/s12948-016-0044-1.CrossRef

21.

Maslova E, Hansen S, Jensen CB, Thorne-Lyman AL, Strøm M, Olsen SF. Vitamin D intake in mid-pregnancy and child allergic disease–a prospective study in 44,825 Danish mother-child pairs. BMC Pregnancy Childbirth. 2013;13(1):199. https://doi.org/10.1186/1471-2393-13-199.CrossRefPubMedPubMedCentral

22.

Litonjua AA. Childhood asthma may be a consequence of vitamin D deficiency. Curr Opin Allergy Clin Immunol. 2009;9(3):202–7.CrossRef

23.

Shin YH, Yu J, Kim KW, Ahn K, Hong S-A, Lee E, Yang S-I, Jung Y-H, Kim HY, Seo J-H. Association between cord blood 25-hydroxyvitamin D concentrations and respiratory tract infections in the first 6 months of age in a Korean population: a birth cohort study (COCOA). Korean J Pediatr. 2013;56(10):439–45. https://doi.org/10.3345/kjp.2013.56.10.439.CrossRefPubMedPubMedCentral

24.

Zosky GR, Hart PH, Whitehouse AJ, Kusel MM, Ang W, Foong RE, et al. Vitamin D deficiency at 16 to 20 weeks’ gestation is associated with impaired lung function and asthma at 6 years of age. Ann Am Thorac Soc. 2014;11(4):571–7. https://doi.org/10.1513/annalsats.201312-423oc.CrossRefPubMed

25.

Magnus MC, Stene LC, Håberg SE, Nafstad P, Stigum H, London SJ, et al. Prospective study of maternal mid-pregnancy 25-hydroxyvitamin d level and early childhood respiratory disorders. Paediatr Perinat Epidemiol. 2013;27(6):532–41. https://doi.org/10.1111/ppe.12080.CrossRefPubMed

26.

Chi A, Wildfire J, McLoughlin R, Wood RA, Bloomberg GR, Kattan M, et al. Umbilical cord plasma 25-hydroxyvitamin D concentration and immune function at birth: the Urban Environment and Childhood Asthma study. Clin Exp Allergy. 2011;41(6):842–50. https://doi.org/10.1111/j.1365-2222.2011.03712.x.CrossRefPubMedPubMedCentral

27.

Wu AC, Tantisira K, Li L, Fuhlbrigge AL, Weiss ST, Litonjua A. Effect of vitamin D and inhaled corticosteroid treatment on lung function in children. Am J Respir Crit Care Med. 2012;186(6):508–13. https://doi.org/10.1164/rccm.201202-0351oc.CrossRefPubMedPubMedCentral

28.

Foong RE, Zosky GR. Vitamin D deficiency and the lung: disease initiator or disease modifier? Nutrients. 2013;5(8):2880–900.CrossRef

29.

Comberiati P, Tsabouri S, Piacentini G, Moser S, Minniti F, Peroni D. Is vitamin D deficiency correlated with childhood wheezing and asthma? Front Biosci (Elite Ed). 2013;6:31–9.

30.

Thuesen B, Skaaby T, Husemoen L, Fenger M, Jørgensen T, Linneberg A. The association of serum 25-OH vitamin D with atopy, asthma, and lung function in a prospective study of Danish adults. Clin Exp Allergy. 2015;45(1):265–72. https://doi.org/10.1111/cea.12299.CrossRefPubMed

31.

Bäck O, Blomquist HK, Hernell O, Stenberg B. Does vitamin D intake during infancy promote the development of atopic allergy? Acta Derm Venereol. 2009;89(1):28–32. https://doi.org/10.2340/00015555-0541.CrossRefPubMed

32.

Bush A, Fleming L. Phenotypes of refractory/severe asthma. Paediatr Respir Rev. 2011;12(3):177–81. https://doi.org/10.1016/j.prrv.2011.01.003.CrossRefPubMed

33.

Piroozmand A, Kashani HH, Zamani B. Correlation between Epstein-Barr virus infection and disease activity of systemic lupus erythematosus: a cross-sectional study. Asian Pac J Cancer Prev. 2017;18(2):523–7. https://doi.org/10.22034/apjcp.2017.18.2.523.CrossRefPubMedPubMedCentral

34.

Ferdosian M, Khatami MR, Malekshahi ZV, Mohammadi A, Kashani HH, Shooshtari MB. Identification of immunotopes against Mycobacterium leprae as immune targets using PhDTm-12mer phage display peptide library. Trop J Pharm Res. 2015;14:1153–9.CrossRef

35.

Jalali HK, Salamatzadeh A, Jalali AK, et al. Antagonistic activity of Nocardia brasiliensis PTCC 1422 against isolated enterobacteriaceae from Urinary tract infections. Probiotics Antimicrob Proteins. 2016;8(1):41–5. https://doi.org/10.1007/s12602-016-9207-0.CrossRefPubMed

36.

Saggese G, Vierucci F, Prodam F, Cardinale F, Cetin I, Chiappini E, de’Angelis GL, Massari M, Del Giudice EM, Del Giudice MM. Vitamin D in pediatric age: consensus of the Italian pediatric society and the italian society of preventive and social pediatrics, jointly with the Italian Federation of pediatricians. Ital J Pediatr. 2018;44(1):51. https://doi.org/10.1186/s13052-018-0488-7.CrossRefPubMedPubMedCentral

37.

Kashani HH, Nikzad H, Mobaseri S, Hoseini ES. Synergism effect of nisin peptide in reducing chemical preservatives in food industry. Life Sci J. 2012;9(1):496.

38.

Sharif A, Kashani HH, Nasri E, Soleimani Z, Sharif MR. The role of probiotics in the treatment of dysentery: a randomized double-blind clinical trial. Probiotics Antimicrob Proteins. 2017;9(4):380–5. https://doi.org/10.1007/s12602-017-9271-0.CrossRefPubMed

39.

Chinellato I, Piazza M, Sandri M, Peroni D, Piacentini G, Boner AL. Vitamin D serum levels and markers of asthma control in Italian children. J Pediatr. 2011;158(3):437–41. https://doi.org/10.1016/j.jpeds.2010.08.043.CrossRefPubMed

40.

Chinellato I, Piazza M, Sandri M, Peroni DG, Cardinale F, Piacentini GL, et al. Serum vitamin D levels and exercise-induced bronchoconstriction in children with asthma. Eur Respir J. 2011;37(6):1366–70. https://doi.org/10.1183/09031936.00044710.CrossRefPubMed

41.

Mithal A, Wahl D, Bonjour J-P, Burckhardt P, Dawson-Hughes B, Eisman J, et al. Global vitamin D status and determinants of hypovitaminosis D. Osteoporos Int. 2009;20(11):1807–20. https://doi.org/10.1007/s00198-009-0954-6.CrossRefPubMed

42.

Bener A, Ehlayel MS, Tulic MK, Hamid Q. Vitamin D deficiency as a strong predictor of asthma in children. Int Arch Allergy Immunol. 2012;157(2):168–75. https://doi.org/10.1159/000323941.CrossRefPubMed

43.

Montero-Arias F, Sedó-Mejía G, Ramos-Esquivel A. Vitamin D insufficiency and asthma severity in adults from Costa Rica. Allergy Asthma Immunol Res. 2013;5(5):283–8. https://doi.org/10.4168/aair.2013.5.5.283.CrossRefPubMedPubMedCentral

44.

Korn S, Hübner M, Jung M, Blettner M, Buhl R. Severe and uncontrolled adult asthma is associated with vitamin D insufficiency and deficiency. Respir Res. 2013;14(1):25. https://doi.org/10.1186/1465-9921-14-25.CrossRefPubMedPubMedCentral

45.

Gupta A, Bush A, Hawrylowicz C, Saglani S. Vitamin D and asthma in children. Paediatr Respir Rev. 2012;13(4):236–43. https://doi.org/10.1016/j.prrv.2011.07.003.CrossRefPubMed

46.

Brehm JM, Acosta-Pérez E, Klei L, Roeder K, Barmada M, Boutaoui N, et al. Vitamin D insufficiency and severe asthma exacerbations in Puerto Rican children. Am J Respir Crit Care Med. 2012;186(2):140–6. https://doi.org/10.1164/rccm.201203-0431oc.CrossRefPubMedPubMedCentral

47.

Huang H, Porpodis K, Zarogoulidis P, Domvri K, Giouleka P, Papaiwannou A, et al. Vitamin D in asthma and future perspectives. Drug Des Devel Ther. 2013;7:1003–13. https://doi.org/10.2147/dddt.s50599.CrossRefPubMedPubMedCentral

48.

Krobtrakulchai W, Praikanahok J, Visitsunthorn N, Vichyanond P, Manonukul K, Pratumvinit B, et al. The effect of vitamin d status on pediatric asthma at a university hospital,Thailand. Allergy Asthma Immunol Res. 2013;5(5):289–94. https://doi.org/10.4168/aair.2013.5.5.289.CrossRefPubMedPubMedCentral

49.

Menon J, Maranda L, Nwosu BU. Serum 25-hydroxyvitamin D levels do not correlate with asthma severity in a case-controlled study of children and adolescents. J Pediatr Endocrinol Metab. 2012;25(7–8):673–9.PubMed

50.

Gupta A, Sjoukes A, Richards D, Banya W, Hawrylowicz C, Bush A, et al. Relationship between serum vitamin D, disease severity, and airway remodeling in children with asthma. Am J Respir Crit Care Med. 2011;184(12):1342–9. https://doi.org/10.1164/rccm.201107-1239oc.CrossRefPubMedPubMedCentral

51.

Hollams EM. Vitamin D and atopy and asthma phenotypes in children. Curr Opin Allergy Clin Immunol. 2012;12(3):228–34. https://doi.org/10.1097/aci.0b013e3283534a32.CrossRefPubMed

52.

Poon AH, Mahboub B, Hamid Q. Vitamin D deficiency and severe asthma. Pharmacol Ther. 2013;140(2):148–55. https://doi.org/10.1016/j.pharmthera.2013.06.006.CrossRefPubMed

53.

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(1):78. https://doi.org/10.1186/1824-7288-39-78.CrossRefPubMedPubMedCentral

54.

Litonjua AA. Vitamin D and corticosteroids in asthma: synergy, interaction and potential therapeutic effects. Expert Rev Respir Med. 2013;7(2):101–4. https://doi.org/10.1586/ers.12.85.CrossRefPubMed

55.

Zhang Y, Leung DY, Goleva E. Anti-inflammatory and corticosteroid-enhancing actions of vitamin D in monocytes of patients with steroid-resistant and those with steroid-sensitive asthma. J Allergy Clin Immunol. 2014;133(6):1744-52.e1. https://doi.org/10.1016/j.jaci.2013.12.004.CrossRefPubMed

56.

Yadav M, Mittal K. Effect of vitamin D supplementation on moderate to severe bronchial asthma. Indian J Pediatr. 2014;81(7):650–4. https://doi.org/10.1007/s12098-013-1268-4.CrossRefPubMed

57.

Baris S, Kiykim A, Ozen A, Tulunay A, Karakoc-Aydiner E, Barlan I. Vitamin D as an adjunct to subcutaneous allergen immunotherapy in asthmatic children sensitized to house dust mite. Allergy. 2014;69(2):246–53. https://doi.org/10.1111/all.12278.CrossRefPubMed

58.

Keating P, Munim A, Hartmann JX. Effect of vitamin D on T-helper type 9 polarized human memory cells in chronic persistent asthma. Ann Allergy Asthma Immunol. 2014;112(2):154–62. https://doi.org/10.1016/j.anai.2013.11.015.CrossRefPubMed

59.

Zhong H, Zhou X-J, Hong J-G. The effects of vitamin D on allergen-induced expression of interleukin-13 and interleukin-17 in cord blood CD4 sup^ + T^ cells. Iran J Allergy Asthma Immunol. 2014;13(2):93–7.PubMed

60.

Rance K. The emerging role of vitamin D in asthma management. J Am Assoc Nurse Pract. 2014;26(5):263–7. https://doi.org/10.1002/2327-6924.12062.CrossRefPubMed

Title: Association of 25-hydroxy vitamin D with asthma and its severity in children: a case–control study
Authors: Alireza Sharif
Hamed Haddad Kashani
Mohammad Reza Sharif
Publication date: 01-12-2020
Publisher: BioMed Central
Keywords: Bronchial Asthma
Vitamin D Deficiency
Published in: Clinical and Molecular Allergy / Issue 1/2020
Electronic ISSN: 1476-7961
DOI: https://doi.org/10.1186/s12948-020-00122-9

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Association of 25-hydroxy vitamin D with asthma and its severity in children: a case–control study

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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