Department of Pediatrics, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India.
Department of Pediatrics, Post Graduate Institute of Medical Education and Research, Chandigarh, India.
Pediatr Pulmonol. 2021 Jun;56(6):1427-1433. doi: 10.1002/ppul.25287. Epub 2021 Feb 1.
To determine the role of vitamin D supplementation as an adjunct to standard treatment in childhood asthma.
In this placebo-controlled, blinded, randomized controlled trial, we enrolled 60 children aged 6 to 11 years with moderate persistent asthma and randomly assigned them into intervention (2000 IU per day of vitamin D) and placebo groups (n = 30 each). The primary outcome was asthma control as assessed by the childhood asthma control test (C-ACT) scores at 12 weeks post-randomization. The secondary outcomes were improvement in the forced expiration in 1 s (FEV ), fractional exhaled nitric oxide (FeNO), asthma exacerbations, use of systemic steroids, number of emergency visits, post-intervention vitamin D levels, and adverse outcomes. We analyzed by intention to treat.
There was no significant difference between the C-ACT score in the two groups (median [first-third quartile] scores were 25 [24-26] in both groups, p = 0.7). Also, there was no significant difference between the two groups in terms of the FEV , FeNO, number of exacerbations, emergency visits, hospital admissions, and adverse outcomes. However, the post-intervention vitamin D levels (ng/ml) were significantly higher in the intervention group (35.5 vs. 18.8; p < 0.001). As compared to the baseline, both the groups showed better asthma control at 12 weeks post-intervention, irrespective of the type of intervention.
Vitamin-D supplementation as an adjunct to standard treatment does not improve asthma control in children.
确定维生素 D 补充剂作为标准治疗的辅助手段在儿童哮喘中的作用。
在这项安慰剂对照、双盲、随机对照试验中,我们招募了 60 名年龄在 6 至 11 岁的中度持续性哮喘儿童,并将他们随机分为干预组(每天 2000IU 维生素 D)和安慰剂组(每组 30 名)。主要结局是通过儿童哮喘控制测试(C-ACT)评分在随机分组后 12 周评估的哮喘控制情况。次要结局是 1 秒用力呼气量(FEV )、呼气中一氧化氮分数(FeNO)的改善、哮喘加重、全身类固醇的使用、急诊就诊次数、干预后维生素 D 水平以及不良结局。我们采用意向治疗进行分析。
两组的 C-ACT 评分无显著差异(中位数[第一至第三四分位数]评分分别为 25[24-26],p=0.7)。此外,两组在 FEV 、FeNO、发作次数、急诊就诊次数、住院次数和不良结局方面也无显著差异。然而,干预组的干预后维生素 D 水平(ng/ml)显著升高(35.5 与 18.8;p<0.001)。与基线相比,两组在干预后 12 周都显示出更好的哮喘控制,无论干预类型如何。
维生素 D 补充剂作为标准治疗的辅助手段并不能改善儿童的哮喘控制。