Azienda Ospedaliero Universitaria Città della Salute e della Scienza, S.C. Pneumologia U, 10126 Torino, Italy.
Department of Medical Sciences, University of Turin, 10126 Turin, Italy.
Nutrients. 2017 Nov 11;9(11):1234. doi: 10.3390/nu9111234.
Intervention studies with vitamin D in asthma are inconclusive for several reasons, such as inadequate dosing or duration of supplementation or uncontrolled baseline vitamin D status. Our aim was to evaluate the benefit of long term vitamin D add-on in asthmatic patients with actual vitamin D deficiency, that is a serum 25-hydroxy vitamin D (25-OHD ) below 20 ng/mL.
Serum 25-OHD, asthma exacerbations, spirometry and inhaled corticosteroids (CS) dose were evaluated in a cohort of 119 asthmatic patients. Patients with deficiency were evaluated again after one year vitamin supplementation.
25-OHD was low in 111 patients and was negatively related to exacerbations ( < 0.001), inhaled CS dose ( = 0.008) and asthma severity ( = 0.001). Deficiency was found in 90 patients, 55 of whom took the supplement regularly for one year, while 24 discontinued the study and 11 were not adherent. Patients with vitamin D deficiency after 12 months supplementation showed significant decrease of exacerbations (from 2.6 ± 1.2 to 1.6 ± 1.1, < 0.001), circulating eosinophils (from 395 ± 330 to 272 ± 212 10⁶/L, < 0.001), and need of oral CS courses (from 35 to 20, = 0.007) and improvement of airway obstruction.
Asthma exacerbations are favored by vitamin D deficiency and decrease after long-term vitamin D replacement. Patients who are vitamin D deficient benefit from vitamin D supplementation.
由于剂量不足或补充持续时间或未控制的基础维生素 D 状态等原因，维生素 D 干预哮喘的研究结果并不一致。我们的目的是评估长期维生素 D 补充对有实际维生素 D 缺乏症（即血清 25-羟维生素 D（25-OHD）<20ng/mL）的哮喘患者的益处。
评估了 119 例哮喘患者的血清 25-OHD、哮喘加重、肺功能和吸入皮质类固醇（CS）剂量。在维生素补充一年后，再次评估缺乏症患者。
111 例患者 25-OHD 较低，与加重（<0.001）、吸入 CS 剂量（=0.008）和哮喘严重程度（=0.001）呈负相关。发现 90 例患者存在缺乏症，其中 55 例患者定期补充维生素 D 一年，24 例患者停止研究，11 例患者不坚持。12 个月补充维生素 D 后维生素 D 缺乏的患者哮喘加重明显减少（从 2.6±1.2 降至 1.6±1.1，<0.001），循环嗜酸性粒细胞（从 395±330 降至 272±212 10⁶/L，<0.001）和口服 CS 疗程的需要（从 35 降至 20，=0.007），气道阻塞改善。
维生素 D 缺乏症会加重哮喘加重，并在长期维生素 D 替代后减少。维生素 D 缺乏症患者从维生素 D 补充中获益。
