Krishnan Shasidharan, Sikri Gaurav, Bharshankar Rajay N, Wakode Santosh L, Jiwane Rekha, Pundage Rangnath
Physiology, All India Institute of Medical Sciences, Bhopal, Bhopal, IND.
Physiology, Armed Forces Medical College, Pune, IND.
Cureus. 2024 Oct 30;16(10):e72713. doi: 10.7759/cureus.72713. eCollection 2024 Oct.
Background Bronchial asthma is a major health problem both globally and in developing countries like India. This heterogenous disease is characterised by chronic airway inflammation and hyperresponsiveness to various extrinsic and intrinsic stimuli. The innate and adaptive immune mechanisms play an important role in the pathogenesis of asthma. Vitamin D through its immunomodulatory function on innate and acquired immunity can affect asthma control and its exacerbation. In this study, serum levels of vitamin D in bronchial asthma patients were determined, and their correlation with asthma symptom control and exacerbation was studied. Materials and methods Serum vitamin D levels of patients diagnosed with bronchial asthma (based on their history and reversible obstruction in spirometry) who reported for follow-up at the Respiratory outpatient department of a tertiary care hospital in Western Maharashtra, India, were tested after obtaining informed consent. A questionnaire was given to assess their asthma control and exacerbations. Based on their symptom control over the past four weeks, they were categorized into well-controlled (WC), partially controlled (PC), and uncontrolled (UC) asthma groups. Results Serum vitamin D levels were determined for 70 patients diagnosed with asthma, of which 10 patients fell into the UC group, 28 into the PC group, and 32 into the WC group. Among the 10 patients in the WC group, vitamin D levels were deficient in six (60%) patients, insufficient in two (20%) patients, and normal in two (20%) patients. Among the 28 patients in the PC group, vitamin D levels were deficient in 19 (67%) patients, insufficient in seven (25%) patients, and normal in two (7.1%) patients. Among the 32 patients in the UC group, vitamin D levels were deficient in 17 (53.1%) patients, insufficient in 10 (31.2%) patients, and normal in five (15.6%) patients. Conclusions Although vitamin D deficiency was highly prevalent among Indian adult asthma patients, there was no statistically significant relationship between serum vitamin D levels and asthma control.
支气管哮喘在全球以及像印度这样的发展中国家都是一个主要的健康问题。这种异质性疾病的特征是慢性气道炎症以及对各种外在和内在刺激的高反应性。先天性和适应性免疫机制在哮喘的发病机制中起重要作用。维生素D通过其对先天性和获得性免疫的免疫调节功能，可以影响哮喘的控制及其加重。在本研究中，测定了支气管哮喘患者的血清维生素D水平，并研究了其与哮喘症状控制和加重的相关性。
在获得知情同意后，对印度马哈拉施特拉邦西部一家三级护理医院呼吸门诊前来随访的、被诊断为支气管哮喘（根据病史和肺功能检查中的可逆性阻塞）的患者的血清维生素D水平进行检测。发放问卷以评估他们的哮喘控制情况和病情加重情况。根据他们过去四周的症状控制情况，将他们分为哮喘控制良好（WC）、部分控制（PC）和未控制（UC）组。
对70名诊断为哮喘的患者测定了血清维生素D水平，其中10名患者属于UC组，28名属于PC组，32名属于WC组。在WC组的10名患者中，6名（60%）患者维生素D水平缺乏，2名（20%）患者不足，2名（20%）患者正常。在PC组的28名患者中，19名（67%）患者维生素D水平缺乏，7名（25%）患者不足，2名（7.1%）患者正常。在UC组的32名患者中，17名（53.1%）患者维生素D水平缺乏，10名（31.2%）患者不足，5名（15.6%）患者正常。
尽管维生素D缺乏在印度成年哮喘患者中非常普遍，但血清维生素D水平与哮喘控制之间没有统计学上的显著关系。
