Department of Thoracic Medicine, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway; K.G. Jebsen Centre for Genetic Epidemiology, Department of Public Health and Nursing, NTNU, Norwegian University of Science and Technology, Norway; MRC Integrative Epidemiology Unit, University of Bristol, UK.
Department of Public Health and General Practice, Faculty of Medicine, NTNU, Norwegian University of Science and Technology, Trondheim, Norway.
Respir Med. 2018 Mar;136:65-70. doi: 10.1016/j.rmed.2018.01.017. Epub 2018 Jan 31.
Few studies have investigated the association between serum 25-hydroxyvitamin D (25[OH]D), vitamin D supplement and asthma control among adults. We aimed to examine whether low levels of serum 25(OH)D or not taking vitamin D supplement were associated with an increased risk of poorly controlled asthma among Norwegian adults with asthma. We used a definition of asthma control adapted from the Global Initiative for Asthma. We first examined cross-sectional associations between serum 25(OH)D (n = 806) or vitamin D supplement (n = 1179) and poorly controlled asthma. Next, among those with well controlled asthma at baseline, we examined prospective associations between serum 25(OH)D (n = 147) or vitamin D supplement (n = 208) and poorly controlled asthma at follow-up, approximately 11 years later. We estimated risk ratios (RR) and 95% confidence intervals (CI) with Poisson regression. The adjusted RR for poorly controlled asthma was 1.00 (95% CI, 0.89-1.13) for adults with serum 25(OH)D < 50 nmol/L in cross-sectional and 1.50 (95% CI, 0.46-4.95) in prospective analyses. The adjusted RR for poorly controlled asthma was 1.17 (95% CI 1.00-1.37) for non-users of vitamin D supplement in cross-sectional and 1.66 (95% CI 0.49-5.67) in prospective analyses. Our study did not show strong evidence that among adults with asthma, having a low serum 25(OH)D or being a non-user of vitamin D supplement was associated with an increased risk of poorly controlled asthma. Some point estimates indicated an increased risk, however our estimates were generally imprecise and further evidence is needed.
很少有研究调查血清 25-羟维生素 D（25[OH]D）、维生素 D 补充剂与成年人哮喘控制之间的关系。我们旨在研究挪威成年人哮喘患者中，血清 25(OH)D 水平低或不服用维生素 D 补充剂是否与哮喘控制不佳的风险增加相关。我们使用了一种改编自全球哮喘倡议的哮喘控制定义。我们首先检查了血清 25(OH)D（n=806）或维生素 D 补充剂（n=1179）与哮喘控制不佳之间的横断面关联。接下来，在基线时哮喘控制良好的人群中，我们检查了血清 25(OH)D（n=147）或维生素 D 补充剂（n=208）与大约 11 年后随访时哮喘控制不佳之间的前瞻性关联。我们使用泊松回归估计风险比（RR）和 95%置信区间（CI）。在横断面和前瞻性分析中，血清 25(OH)D<50 nmol/L 的成年人患有哮喘控制不佳的调整 RR 分别为 1.00（95%CI，0.89-1.13）和 1.50（95%CI，0.46-4.95）。在横断面和前瞻性分析中，非维生素 D 补充剂使用者患有哮喘控制不佳的调整 RR 分别为 1.17（95%CI，1.00-1.37）和 1.66（95%CI，0.49-5.67）。我们的研究没有强有力的证据表明，在患有哮喘的成年人中，血清 25(OH)D 水平低或不服用维生素 D 补充剂与哮喘控制不佳的风险增加相关。一些点估计表明风险增加，但我们的估计通常不精确，需要进一步的证据。
