Serum vitamin D levels and severe asthma exacerbations in the Childhood Asthma Management Program study.

Abstract

BACKGROUND:

Asthma exacerbations, most often caused by respiratory tract infections, are the leading causes of asthma morbidity and comprise a significant proportion of asthma-related costs. Vitamin D status might play a role in preventing asthma exacerbations.

OBJECTIVES:

We sought to assess the relationship between serum vitamin D levels and subsequent severe asthma exacerbations.

METHODS:

We measured 25-hydroxyvitamin D levels in sera collected from 1024 children with mild-to-moderate persistent asthma at the time of enrollment in a multicenter clinical trial of children randomized to receive budesonide, nedocromil, or placebo (as-needed beta-agonists): the Childhood Asthma Management Program. Using multivariable modeling, we examined the relationship between baseline vitamin D levels and the odds of any hospitalization or emergency department visit over the 4 years of the trial.

RESULTS:

Thirty-five percent of all subjects were vitamin D insufficient, as defined by a level of 30 ng/mL or less 25-hydroxyvitamin D. Mean vitamin D levels were lowest in African American subjects and highest in white subjects. After adjusting for age, sex, body mass index, income, and treatment group, insufficient vitamin D status was associated with a higher odds of any hospitalization or emergency department visit (odds ratio, 1.5; 95% CI, 1.1-1.9; P = .01).

CONCLUSION:

Vitamin D insufficiency is common in this population of North American children with mild-to-moderate persistent asthma and is associated with higher odds of severe exacerbation over a 4-year period.

• Authors: John M Brehm, Brooke Schuemann, Anne L Fuhlbrigge, Bruce W Hollis, Robert C Strunk, Robert S Zeiger, Scott T Weiss, Augusto A Litonjua, Childhood Asthma Management Program Research Group
• Journal: The Journal of allergy and clinical immunology (J Allergy Clin Immunol) Vol. 126 Issue 1 Pg. 52-8.e5 (Jul 2010) ISSN: 1097-6825 [Electronic] United States
• PMID: 20538327 (Publication Type: Journal Article, Multicenter Study, Randomized Controlled Trial, Research Support, N.I.H., Extramural)
• Copyright: Copyright 2010 American Academy of Allergy, Asthma & Immunology. Published by Mosby, Inc. All rights reserved.

Chemical References

• Adrenal Cortex Hormones
• Vitamin D
• 25-hydroxyvitamin D

Topics

• Adrenal Cortex Hormones (administration & dosage)
• Asthma (blood, complications, drug therapy, physiopathology)
• Bronchial Hyperreactivity (physiopathology)
• Child
• Double-Blind Method
• Female
• Forced Expiratory Volume
• Humans
• Male
• Vitamin D (analogs & derivatives, blood)