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

被引:409
作者
Brehm, John M. [1 ,2 ,4 ]
Schuemann, Brooke [1 ]
Fuhlbrigge, Anne L. [1 ,2 ]
Hollis, Bruce W. [5 ]
Strunk, Robert C. [6 ,7 ]
Zeiger, Robert S. [8 ]
Weiss, Scott T. [1 ,2 ,3 ,4 ]
Litonjua, Augusto A. [1 ,2 ,4 ]
机构
[1] Brigham & Womens Hosp, Channing Lab, Boston, MA 02115 USA
[2] Brigham & Womens Hosp, Div Pulm Crit Care Med, Boston, MA 02115 USA
[3] Brigham & Womens Hosp, Dept Med, Ctr Genom Med, Boston, MA 02115 USA
[4] Harvard Univ, Sch Med, Dept Med, Boston, MA USA
[5] Med Univ S Carolina, Darby Childrens Res Inst, Charleston, SC 29425 USA
[6] Washington Univ, Sch Med, Dept Pediat, Div Allergy & Pulm Med, St Louis, MO 63130 USA
[7] St Louis Childrens Hosp, St Louis, MO 63178 USA
[8] Kaiser Permanente Med Ctr, Dept Allergy, San Diego, CA USA
基金
美国国家卫生研究院;
关键词
Asthma; vitamin D; inhaled corticosteroids; asthma exacerbations; 25-HYDROXYVITAMIN-D; RADIOIMMUNOASSAY; POPULATION; INDUCTION; HEALTH; CELLS;
D O I
10.1016/j.jaci.2010.03.043
中图分类号
R392 [医学免疫学];
学科分类号
100102 ;
摘要
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. (J Allergy Clin Immunol 2010;126:52-8.)
引用
收藏
页码:52 / 58
页数:7
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