Department of Medical Statistics and Epidemiology, Hamad Medical Corporation, Doha, Qatar.
Int Arch Allergy Immunol. 2012;157(2):168-75. doi: 10.1159/000323941. Epub 2011 Oct 6.
Epidemiological studies suggest a link between vitamin D deficiency in early life and development of asthma in later life.
The aim of this study was to measure serum vitamin D levels in asthmatic children and to compare these to healthy non-asthmatic controls.
Asthmatic (n = 483) and healthy control (n = 483) children were recruited from the Pediatric Allergy-Immunology Clinics of Hamad General Hospital and the Primary Health Care Clinics in Qatar from October 2009 to July 2010. All children were below 16 years of age and asthma was diagnosed by a physician. Parents of all children completed extensive questionnaires documenting demographics, child's feeding practice and vitamin D intake. Serum vitamin D (25-hydroxyvitamin D), calcium, phosphorus, alkaline phosphatase, magnesium, creatinine and parathyroid hormone assays were performed. Subjects with serum containing less than 20 ng/ml vitamin D were deemed deficient.
Asthmatic children had significantly reduced serum vitamin D levels compared to non-asthmatic children (p < 0.001); 68.1% of all asthmatics were vitamin D deficient. Asthmatic children had significantly higher degrees of moderate (41.8 vs. 25.1%) and severe (26.3 vs. 11.0%) vitamin D deficiency compared to healthy controls (p < 0.001). Positive familial history of vitamin D deficiency (35.6%, p = 0.005) and asthma (36.4%, p = 0.009) were significantly higher in asthmatic children. Along with vitamin D deficiency, asthmatics also had reduced phosphorus (p < 0.001) and magnesium (p = 0.001) levels but elevated serum alkaline phosphatase (p < 0.001) and IgE (p < 0.001). The majority of asthmatic children had less exposure to sunlight (66.7%, p = 0.006) and less physical activity (71.3%, p < 0.001). Vitamin D deficiency was the strongest predictor of asthma in this population (OR 4.82; 95% CI 2.41-8.63, p < 0.001).
The present study revealed that the majority of asthmatic children had vitamin D deficiency compared to control children. Vitamin D deficiency was the major predictor of asthma in Qatari children.
流行病学研究表明，生命早期维生素 D 缺乏与生命后期哮喘的发生有关。
本研究旨在测量哮喘儿童的血清维生素 D 水平，并将其与健康非哮喘对照组进行比较。
2009 年 10 月至 2010 年 7 月，从哈马德综合医院儿科过敏免疫科和卡塔尔初级保健诊所招募哮喘（n=483）和健康对照组（n=483）儿童。所有儿童年龄均在 16 岁以下，哮喘由医生诊断。所有儿童的家长均完成了详细的问卷，记录了人口统计学、儿童喂养习惯和维生素 D 摄入量。进行血清维生素 D（25-羟维生素 D）、钙、磷、碱性磷酸酶、镁、肌酐和甲状旁腺激素检测。血清中维生素 D 含量低于 20ng/ml 的患者被认为是缺乏维生素 D。
与非哮喘儿童相比，哮喘儿童的血清维生素 D 水平显著降低（p<0.001）；所有哮喘儿童中，68.1%的儿童存在维生素 D 缺乏。与健康对照组相比，哮喘儿童的中度（41.8%比 25.1%）和重度（26.3%比 11.0%）维生素 D 缺乏更为严重（p<0.001）。哮喘儿童的维生素 D 缺乏家族史（35.6%，p=0.005）和哮喘家族史（36.4%，p=0.009）显著高于健康对照组。除了维生素 D 缺乏外，哮喘儿童的磷（p<0.001）和镁（p=0.001）水平也较低，而血清碱性磷酸酶（p<0.001）和 IgE（p<0.001）水平较高。大多数哮喘儿童暴露在阳光下的时间较少（66.7%，p=0.006），身体活动较少（71.3%，p<0.001）。在该人群中，维生素 D 缺乏是哮喘的最强预测因素（OR 4.82；95%CI 2.41-8.63，p<0.001）。
本研究显示，与对照组儿童相比，大多数哮喘儿童存在维生素 D 缺乏。维生素 D 缺乏是卡塔尔儿童哮喘的主要预测因素。
