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Association between serum Vitamin D levels and asthma severity and control in children and adolescents

Lung volume 201, pages 181–187 (2023)Cite this article

Abstract

Objective

To assess the association of serum Vitamin D (vitD) levels with asthma control and severity in children and adolescents in different seasons of the year.

Method

Longitudinal, prospective study with 7- to 17-year-old children and adolescents diagnosed with asthma. All participants underwent two assessments conducted in opposite seasons of the year which included a clinical assessment, a questionnaire for classification of asthma control (Asthma Control Test), spirometry, and blood collection to measure serum vitD levels.

Results

In total, 141 individuals with asthma were evaluated. The mean vitD was lower in females (p = 0.006) and sunlight exposure appears not to be an influencing factor for vitD levels. We found no differences in mean vitD of patients with controlled and uncontrolled asthma (p = 0.703; p = 0.956). However, the severe asthma group had lower mean Vitamin D than the mild/moderate asthma group for both assessments (p = 0.013; p = 0.032). In the first assessment, the group with vitD insufficiency had a higher prevalence of severe asthma (p = 0.015). Vitamin D was positively correlated with FEV1 in both assessments (p = 0.008; p = 0.006) and with FEF25–75% in the first assessment (p = 0.038).

Conclusion

In a tropical climate zone, there is no evidence of association between seasonality and serum vitD levels or between serum vitD levels and asthma control in children and adolescents. However, vitD and lung function were positively correlated and the group with vitD insufficiency had a higher prevalence of severe asthma.

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References

  1. Pfeffer PE, Hawrylowicz CM (2018) Vitamin D in asthma: mechanisms of action and considerations for clinical trials. Chest 153:1229–1239

    Article  PubMed  Google Scholar 

  2. Wang M, Liu M, Wang C, Xiao Y, An T, Zou M, Cheng G (2019) Association between vitamin D status and asthma control: a meta-analysis of randomized trials. Respir Med 150:85–94

    Article  PubMed  Google Scholar 

  3. Hall SC, Agrawal DK (2017) Vitamin D and bronchial asthma: an overview of data from the past 5 years. Clin Ther 39:917–929

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  4. Jat KR, Khairwa A (2017) Vitamin D and asthma in children: A systematic review and meta-analysis of observational studies. Lung India 34:355–363

    Article  PubMed  PubMed Central  Google Scholar 

  5. Cassim R, Russell MA, Lodge CJ, Lowe AJ, Koplin JJ, Dharmage SC (2015) The role of circulating 25 hydroxyvitamin D in asthma: a systematic review. Allergy 70:339–354

    Article  CAS  PubMed  Google Scholar 

  6. Gupta A, Bhat G, Pianosi P (2018) What is new in the management of childhood asthma? The Indian Journal of Pediatrics 85:773–781

    Article  PubMed  Google Scholar 

  7. de Paula FJ, Rosen CJ (2012) Vitamin D safety and requirements. Arch Biochem Biophys 523:64–72

    Article  PubMed  Google Scholar 

  8. Litonjua AA (2019) Vitamin D and childhood asthma: causation and contribution to disease activity. Curr Opin Allergy Clin Immunol 19:126–131

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  9. Paul G, Brehm JM, Alcorn JF, Holguín F, Aujla SJ, Celedón JC (2012) Vitamin D and asthma. Am J Respir Crit Care Med 185:124–132

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  10. Szymczak I, Pawliczak R (2018) Can vitamin D help in achieving asthma control? Vitamin D “revisited”: an updated insight. Adv Respir Med 86:103–109

    Article  PubMed  Google Scholar 

  11. Özdoğan Ş (2019) Seasonal, sex variations in vitamin d levels and their association with pulmonary function in children with asthma. Turk J Med Sci 49:1534–1539

    Article  PubMed  PubMed Central  Google Scholar 

  12. Global Initiative for Asthma [Internet]. R: Global strategy for asthma management and prevention. Updated 2020 [cited 2021–06–21]. Available from: www.ginaasthma.org.

  13. Purple JPF, Bridge EV, Branches DCB, Pimentel L, Junior ADO, Cross AA (2010) English-language version of the asthma control test: validation for use in Brazil. J Bras Pneumol 36:159–166

    Google Scholar 

  14. Holgate ST, Price D, Valovirta E (2006) Asthma out of control? A structured review of recent patient surveys. BMC Pulm Med 6(Suppl 1):S2

    Article  PubMed  PubMed Central  Google Scholar 

  15. Voorend-van Bergen S, Vaessen-Verberne AA, de Jongste JC, Pijnenburg MW (2015) Asthma control questionnaires in the management of asthma in children: a review. Pediatr Pulmonol 50:202–208

    Article  CAS  PubMed  Google Scholar 

  16. Pedersen S (2015) Asthma control in children: is it important and can we measure it? Acta Paediatr Respir Rev 17:36–38

    Google Scholar 

  17. Graham BL, Steenbruggen I, Miller MR, Barjaktarevic IZ, Cooper BG, Hall GL et al (2019) Standardization of Spirometry 2019 Update. An Official American Thoracic Society and European Respiratory Society Technical Statement. Am J Respir Crit Care Med 200:e70–e88

    Article  PubMed  PubMed Central  Google Scholar 

  18. Sociedade Brasileira de Pediatria. Hipovitaminose D em pediatria: recomendações para diagnóstico, tratamento e prevenção. Departamento Científico de Endocrinologia. 2016; 1–11. Available from: https://www.sbp.com.br/fileadmin/user_upload/2016/12/Endcrino-Hipovitaminose-D.pdf

  19. Batmaz SB, Arıkoğlu T, Tamer L, Eskandari G, Kuyucu S (2018) Seasonal variation of asthma control, lung function tests and allergic inflammation in relation to vitamin D levels: a prospective annual study. Postepy Dermatol Alergol 35:99–105

    Article  PubMed  PubMed Central  Google Scholar 

  20. Kerley CP, Lenoir B, Faul J, Cormican L (2015) Vitamin D as an adjunctive therapy in asthma. part 1: A review of potential mechanisms. Pulm Pharmacol Ther 32:60–74

    Article  CAS  PubMed  Google Scholar 

  21. Hughes AM, Lucas RM, Ponsonby AL, Chapman C, Coulthard A, Dear K et al (2010) The role of latitude, ultraviolet radiation exposure and vitamin D in childhood asthma and hayfever: an Australian multicenter study. Pediatr Allergy Immunol 22:327–333

    Article  PubMed  Google Scholar 

  22. Mendes MM, Hart KH, Botelho PB, Lanham-New SA (2018) Vitamin D status in the tropics: Is sunlight exposure the main determinant? Nutr Bull 43:428–434

    Article  Google Scholar 

  23. Amorim CLCG, Oliveira JM, Rodrigues A, Furlanetto KC, Pitta F (2020) Vitamin D: association with eosinophil counts and IgE levels in children with asthma. J Bras Pneumol 47:e20200279

    PubMed  Google Scholar 

  24. Voorend-van Bergen S, Vaessen-Verberne AA, Landstra AM, Brackel HJ, van den Berg NJ, Caudri D et al (2014) Monitoring childhood asthma: web-based diaries and the asthma control test. J Allergy Clin Immunol 133:1599–605.e2

    Article  PubMed  Google Scholar 

  25. Passeron T, Bouillon R, Callender V, Cestari T, Diepgen TL, Green AC et al (2019) Sunscreen photoprotection and vitamin D status. Br J Dermatol 181:916–931

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  26. Binkley N, Novotny R, Krueger D, Kawahara T, Daida YG, Lensmeyer G et al (2007) Low vitamin D status despite abundant sun exposure. J Clin Endocrinol Metab 92:2130–2135

    Article  CAS  PubMed  Google Scholar 

  27. Abboud M, Rybchyn MS, Rizk R, Fraser DR, Mason RS (2017) Sunlight exposure is just one of the factors which influence vitamin D status. Photochem Photobiol Sci 16:302–313

    Article  CAS  PubMed  Google Scholar 

  28. AlQuaiz AM, Kazi A, Fouda M, Alyousefi N (2018) Age and gender differences in the prevalence and correlates of vitamin D deficiency. Arch Osteoporos 13:4

    Article  Google Scholar 

  29. Alansari K, Davidson BL, Yousef KI, Mohamed ANH, Alattar I (2017) Rapid vs Maintenance vitamin D supplementation in deficient children with asthma to prevent exacerbations. Chest 152:527–536

    Article  PubMed  Google Scholar 

  30. Sharif A, Haddad Kashani H, Sharif MR (2020) Association of 25-hydroxy vitamin D with asthma and its severity in children: a case-control study. Clin Mol Allergy 18:7

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  31. Montero-Arias F, Sedó-Mejía G, Ramos-Esquivel A (2013) Vitamin D insufficiency and asthma severity in adults from Costa Rica. Allergy Asthma Immunol Res 5:283–288

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  32. Brehm JM, Schuemann B, Fuhlbrigge AL, Hollis BW, Strunk RC, Zeiger RS, Weiss ST, Litonjua AA, Childhood Asthma Management Program Research Group (2010) Serum vitamin D levels and severe asthma exacerbations in the Childhood Asthma Management Program study. J Allergy Clin Immunol 126(5):2–58

    Google Scholar 

  33. Liu J, Dong YQ, Yin J, Yao J, Shen J, Sheng GJ, Li K, Lv HF, Fang X, Wu WF (2019) Meta-analysis of vitamin D and lung function in patients with asthma. Respir Res 20:161

    Article  PubMed  PubMed Central  Google Scholar 

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Funding

This work received funding from the Coordenação de Aperfeiçoamento de Pessoal de Nível Superior—Brasil (CAPES) [Finance Code 174296] and Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)—Brasil [Process nº 2016/22102–8].

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Authors and Affiliations

  1. Child and Adolescent Health Postgraduate Program, State University of Campinas, Campinas, Brazil

    Ana Paula G. Malheiro & Lívea Gianfrancesco

  2. Laboratory of Pulmonary Physiology, School of Medical Sciences, Center for Investigation in Pediatrics, Universitária Zeferino Vaz, Tessália Vieira de Camargo Street, 126, Cidade, Campinas, São Paulo, 13083-887, Brazil

    Ana Paula G. Malheiro, Lívea Gianfrancesco, Milena B. Grotta, José Dirceu Ribeiro & Adyléia A. D. C. Toro

  3. Department of Pediatrics, School of Medical Sciences, State University of Campinas, Campinas, Brazil

    Roberto José N. Nogueira, Milena B. Grotta, André M. Morcillo, José Dirceu Ribeiro & Adyléia A. D. C. Toro

  4. Department of Pediatrics, School of Medicine, São Leopoldo Mandic, Campinas, Brazil

    Roberto José N. Nogueira

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  1. Ana Paula G. Malheiro
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  2. Lívea Gianfrancesco
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Contributions

All authors contributed to the study conception and design. Material preparation, data collection, and analysis were performed by APGM, LG, and AMM. The first draft of the manuscript was written by LG and all authors commented on the previous versions of the manuscript. All authors read and approved the final manuscript.

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Correspondence to Ana Paula G. Malheiro.

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Malheiro, A.P.G., Gianfrancesco, L., Nogueira, R.J.N. et al. Association between serum Vitamin D levels and asthma severity and control in children and adolescents. Lung 201, 181–187 (2023). https://doi.org/10.1007/s00408-023-00605-x

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