School of Population Health, The University of Auckland, Auckland, New Zealand.
Department of Emergency Medicine, and Division of Rheumatology, Allergy, and Immunology, Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States.
J Steroid Biochem Mol Biol. 2019 Apr;188:1-7. doi: 10.1016/j.jsbmb.2018.11.016. Epub 2018 Nov 30.
Previous studies, mostly with children, have reported inconsistent findings on the associations of vitamin D status with asthma prevalence, exacerbations, and control. Because of limited research with adults, we examined these associations in a large community-based sample of New Zealand adults.
5110 participants, aged 50-84 years, were recruited from the community into a clinical trial of vitamin D supplementation. The current analysis is based on baseline blood sample collection to measure serum 25-hydroxyvitamin D (25(OH)D), which was deseasonalized for data analyses; and baseline asthma assessment, which included questions on asthma prevalence, urgent medical care for asthma in the previous 12 months, and control of asthma symptoms in the previous 4 weeks.
702 (13.2%) of 5088 participants reported having doctor-diagnosed asthma. There was no difference in mean (SE) 25(OH)D concentration between participants with and without asthma: 66 (0.9) and 66 (0.4) nmol/L, respectively, adjusting for sex (p = 0.71). However, in multivariable analyses restricted to participants who reported having asthma, mean (SE) 25(OH)D concentration was 6.3 (2.6) nmol/L lower in those who reported having urgent medical care for asthma in the previous 12 months compared to others (p = 0.02), and 10.4 (3.9) nmol/L lower in those with very poor asthma control compared to those who were well-controlled (p = 0.03).
These cross-sectional results suggest that asthmatic adults with lower vitamin D status are more likely to receive urgent asthma medical care and to experience poor asthma control. Clinical trials are needed to determine the role of vitamin D supplementation in asthma management.
先前的研究主要针对儿童，其结果显示维生素 D 状况与哮喘患病率、加重和控制之间的关联并不一致。由于成人相关研究有限，我们在新西兰一项大型社区成人样本中对这些关联进行了研究。
从社区招募了 5110 名年龄在 50-84 岁的参与者，参加维生素 D 补充剂的临床试验。目前的分析基于基线血液样本采集，以测量血清 25-羟维生素 D（25（OH）D），为了数据分析对其进行了去季节性处理；并基于基线哮喘评估，包括过去 12 个月内哮喘的患病率、因哮喘接受紧急医疗护理以及过去 4 周内哮喘症状控制情况的问题。
在 5088 名参与者中，有 702 名（13.2%）报告有医生诊断的哮喘。有和没有哮喘的参与者的平均（SE）25（OH）D 浓度没有差异：分别为 66（0.9）和 66（0.4）nmol/L，性别调整后（p=0.71）。然而，在仅限于报告有哮喘的参与者的多变量分析中，与没有接受过紧急医疗护理的参与者相比，在过去 12 个月内因哮喘接受过紧急医疗护理的参与者的平均（SE）25（OH）D 浓度低 6.3（2.6）nmol/L（p=0.02），与控制良好的参与者相比，控制不佳的参与者的平均（SE）25（OH）D 浓度低 10.4（3.9）nmol/L（p=0.03）。
这些横断面结果表明，维生素 D 状态较低的哮喘成年患者更有可能接受紧急哮喘医疗护理，并经历哮喘控制不佳。需要开展临床试验来确定维生素 D 补充剂在哮喘管理中的作用。
