Serum vitamin D levels and markers of severity of childhood asthma in Costa Rica

Am J Respir Crit Care Med. 2009 May 1;179(9):765-71. doi: 10.1164/rccm.200808-1361OC. Epub 2009 Jan 29.

Abstract

Rationale: Maternal vitamin D intake during pregnancy has been inversely associated with asthma symptoms in early childhood. However, no study has examined the relationship between measured vitamin D levels and markers of asthma severity in childhood.

Objectives: To determine the relationship between measured vitamin D levels and both markers of asthma severity and allergy in childhood.

Methods: We examined the relation between 25-hydroxyvitamin D levels (the major circulating form of vitamin D) and markers of allergy and asthma severity in a cross-sectional study of 616 Costa Rican children between the ages of 6 and 14 years. Linear, logistic, and negative binomial regressions were used for the univariate and multivariate analyses.

Measurements and main results: Of the 616 children with asthma, 175 (28%) had insufficient levels of vitamin D (<30 ng/ml). In multivariate linear regression models, vitamin D levels were significantly and inversely associated with total IgE and eosinophil count. In multivariate logistic regression models, a log(10) unit increase in vitamin D levels was associated with reduced odds of any hospitalization in the previous year (odds ratio [OR], 0.05; 95% confidence interval [CI], 0.004-0.71; P = 0.03), any use of antiinflammatory medications in the previous year (OR, 0.18; 95% CI, 0.05-0.67; P = 0.01), and increased airway responsiveness (a < or =8.58-mumol provocative dose of methacholine producing a 20% fall in baseline FEV(1) [OR, 0.15; 95% CI, 0.024-0.97; P = 0.05]).

Conclusions: Our results suggest that vitamin D insufficiency is relatively frequent in an equatorial population of children with asthma. In these children, lower vitamin D levels are associated with increased markers of allergy and asthma severity.

MeSH terms

  • Adolescent
  • Anti-Inflammatory Agents / therapeutic use
  • Asthma / blood*
  • Biomarkers / blood
  • Bronchial Provocation Tests
  • Bronchoconstrictor Agents
  • Child
  • Costa Rica
  • Eosinophils / metabolism
  • Female
  • Forced Expiratory Volume
  • Hospitalization / statistics & numerical data
  • Humans
  • Hypersensitivity / blood
  • Immunoglobulin E / blood
  • Leukocyte Count
  • Male
  • Methacholine Chloride
  • Multivariate Analysis
  • Severity of Illness Index*
  • Spirometry
  • Vitamin D / analogs & derivatives*
  • Vitamin D / blood

Substances

  • Anti-Inflammatory Agents
  • Biomarkers
  • Bronchoconstrictor Agents
  • Methacholine Chloride
  • Vitamin D
  • Immunoglobulin E
  • 25-hydroxyvitamin D