Srivastava Shetanshu, Tiwari Vandana, Singh Shivani, Karoli Ritu, Bhattacharya Piyali, Gupta Nikhil
Pediatrics, Dr. Ram Manohar Lohia Institute of Medical Sciences, Lucknow, IND.
Biochemistry, Dr. Ram Manohar Lohia Institute of Medical Sciences, Lucknow, IND.
Cureus. 2023 Jun 28;15(6):e41082. doi: 10.7759/cureus.41082. eCollection 2023 Jun.
Background Asthma is a chronic inflammatory disease with its control being affected by underlying oxidative stress. Trace elements, along with vitamin D3, play an important role in immune alterations leading to an imbalance of Th1/Th2 helper cells. However, their role in asthma pathogenesis and control is inconsistent and inconclusive. The objective of our study was to assess levels of serum trace elements like zinc, copper, selenium, iron, magnesium, vitamin D3 levels, IgE, and HsCRP in asthmatic children, compare with healthy controls, and assess their association with the level of asthma control. Methods A cross-sectional study was conducted from 2019 to 2021 enrolling 100 asthmatic children and 75 healthy controls. The level of asthma control was assessed as uncontrolled, partly controlled, and controlled asthma as per GINA Guidelines. Mean and standard deviation were calculated for each element and mean differences between groups were analyzed by student t-test. A p-value of <0.05 was considered significant. Results The mean age was 8.75±2.89 yrs in cases and 9.04±2.79 in controls. A total of 57.6% of cases had atopic comorbidities. The mean serum zinc levels were 51±12.8 mg/dl, which was very low in asthmatic children as compared to 60±18.2mg/dl (p-value 0.0002) in healthy controls. Serum selenium was 13±3 µg/dl in asthmatics vs. 15±4 µg/dl (p-value 0.0002) in healthy controls. Serum copper was 115.2±21.92µg/dl vs. 125.3±31.99µg/dl (p-value 0.015), Serum vitamin D3 levels were 13.07±7.82ng/ml vs. 17.82±14.62 ng/ml(p-value 0.006) in both groups, respectively. SIgE and HsCRP were high in asthmatic children suggestive of eosinophilic inflammation. Serum zinc was 49±5.45 mg/dl in the uncontrolled group, 53±6.1 in the partly controlled, and 58±8.0 in the well-controlled group (p<0.0001). Serum selenium was 10± 3.0 µg/dl in the uncontrolled group vs. 13± 2.0 and 14± 2.0 µg/dl in the partly controlled and well-controlled groups, respectively (p-value <0.0001). Vitamin D3 was significantly low (9.32±5.95ng/dl) in the uncontrolled group vs. 12.99±4.97 and 13.40±5.92 ng/dl(p<0.005) in the partly controlled and well-controlled groups respectively. Vitamin D3 showed a strong positive correlation with zinc (r=0.4,p< 0.0001) and a negative correlation with inflammatory markers like SIgE and HsCRP. Conclusion Children with asthma had low zinc, selenium, and vitamin D3 levels, and were associated with airway inflammation and poor asthma control.
哮喘是一种慢性炎症性疾病，其控制受潜在氧化应激的影响。微量元素与维生素D3在导致辅助性Th1/Th2细胞失衡的免疫改变中起重要作用。然而，它们在哮喘发病机制和控制中的作用并不一致且尚无定论。我们研究的目的是评估哮喘儿童血清中锌、铜、硒、铁、镁等微量元素水平、维生素D3水平、免疫球蛋白E（IgE）和超敏C反应蛋白（HsCRP），与健康对照进行比较，并评估它们与哮喘控制水平的关联。
2019年至2021年进行了一项横断面研究，纳入100例哮喘儿童和75例健康对照。根据全球哮喘防治创议（GINA）指南，将哮喘控制水平评估为未控制、部分控制和控制良好的哮喘。计算每个元素的均值和标准差，并通过学生t检验分析组间均值差异。p值<0.05被认为具有统计学意义。
病例组的平均年龄为8.75±2.89岁，对照组为9.04±2.79岁。共有57.6%的病例有特应性合并症。哮喘儿童的血清锌平均水平为51±12.8mg/dl，与健康对照的60±18.2mg/dl相比非常低（p值0.0002）。哮喘患者的血清硒为13±3μg/dl，而健康对照为15±4μg/dl（p值0.0002）。血清铜为115.2±21.92μg/dl，对照为125.3±31.99μg/dl（p值0.015），两组的血清维生素D3水平分别为13.07±7.82ng/ml和17.82±I4.62ng/ml（p值0.006）。哮喘儿童的特异性IgE和HsCRP升高，提示嗜酸性粒细胞炎症。未控制组的血清锌为49±5.45mg/dl，部分控制组为53±6.1mg/dl，控制良好组为58±8.0mg/dl（p<0.0001）。未控制组的血清硒为10±3.0μg/dl，部分控制组和控制良好组分别为13±2.0μg/dl和14±2.0μg/dl（p值<0.0001）。未控制组的维生素D3显著降低（9.32±5.95ng/dl），部分控制组和控制良好组分别为12.99±4.97ng/dl和13.40±5.92ng/dl（p<0.005）。维生素D3与锌呈强正相关（r=0.4，p<0.0001），与特异性IgE和HsCRP等炎症标志物呈负相关。
哮喘儿童锌、硒和维生素D3水平较低，与气道炎症和哮喘控制不佳有关。
