Dabbah Husein, Bar Yoseph Ronen, Livnat Galit, Hakim Fahed, Bentur Lea
Department of Pediatrics, Galilee Medical Center, Nahariya, Israel, and the Faculty of Medicine in the Galilee, Bar-Ilan University, Safed, Israel.
Pediatric Pulmonology Unit, Meyer Children's Hospital, Rambam Health Care Campus, Haifa, Israel.
Respir Care. 2015 Aug;60(8):1157-63. doi: 10.4187/respcare.03763. Epub 2015 Apr 21.
A low serum vitamin D level may represent a marker of other perplexing factors that may lead to increased asthma prevalence and severity. Our aim was to assess the correlation between vitamin D levels and asthma and allergy markers in a subgroup of children with fewer confounding factors.
Non-obese children (6-18 y old) with asthma who were not receiving anti-inflammatory treatment were recruited. Subjects underwent spirometry with a methacholine challenge test, and fractional exhaled nitric oxide (FENO), serum vitamin D levels, total immunoglobulin E (IgE) levels, blood eosinophil counts, and high-sensitivity C-reactive protein levels were determined. The primary end point was the correlation between vitamin D level and airway hyper-responsiveness as assessed by a methacholine challenge test. The secondary end point was the correlation between vitamin D level and FENO, systemic inflammatory markers, and allergy.
Seventy-one children with asthma (25 females, 35%; 12.5 ± 3.6 y of age) were included. The median vitamin D level was 23 ng/mL (range of 6-48.5, mean of 23.02 ± 7.74), the median IgE level was 305 IU/mL (range of 4.3-4,240), the median provocational concentration of methacholine that produced a 20% decrease in FEV1 was 1.1 mg/mL (range of 0-13.9), and the median FENO was 26.5 ppb (range of 3.6-285). No correlation was found between vitamin D level and response to the methacholine challenge test, FENO, high-sensitivity C-reactive protein levels, IgE levels, eosinophil counts, and frequency of allergic rhinitis or atopic dermatitis.
In our group of children with asthma, no correlation was found between the level of vitamin D and the degree of airway reactivity, airway inflammation, and allergy. The cause-and-effect relationship between vitamin D, asthma, and allergy should be further clarified. (ClinicalTrials.gov registration NCT01287455).
血清维生素D水平低可能是其他复杂因素的一个标志，这些因素可能导致哮喘患病率和严重程度增加。我们的目的是在混杂因素较少的儿童亚组中评估维生素D水平与哮喘及过敏标志物之间的相关性。
招募未接受抗炎治疗的非肥胖哮喘儿童（6 - 18岁）。受试者接受肺活量测定及乙酰甲胆碱激发试验，并测定呼出一氧化氮分数（FENO）、血清维生素D水平、总免疫球蛋白E（IgE）水平、血液嗜酸性粒细胞计数和高敏C反应蛋白水平。主要终点是通过乙酰甲胆碱激发试验评估的维生素D水平与气道高反应性之间的相关性。次要终点是维生素D水平与FENO、全身炎症标志物及过敏之间的相关性。
纳入71例哮喘儿童（25例女性，占35%；年龄12.5 ± 3.6岁）。维生素D水平中位数为23 ng/mL（范围6 - 48.5，均值23.02 ± 7.74），IgE水平中位数为305 IU/mL（范围4.3 - 4240），使第一秒用力呼气容积（FEV1）降低20%的乙酰甲胆碱激发浓度中位数为1.1 mg/mL（范围0 - 13.9），FENO中位数为26.5 ppb（范围3.6 - 285）。未发现维生素D水平与乙酰甲胆碱激发试验反应、FENO、高敏C反应蛋白水平、IgE水平、嗜酸性粒细胞计数以及过敏性鼻炎或特应性皮炎的发生率之间存在相关性。
在我们的哮喘儿童组中，未发现维生素D水平与气道反应性程度、气道炎症及过敏之间存在相关性。维生素D、哮喘和过敏之间的因果关系应进一步阐明（ClinicalTrials.gov注册号NCT01287455）。
