Details
Category: Volume 07 Issue 03 March 2019
Hits: 1220

Title: Association of Vitamin D levels with the severity of bronchial asthma in adult patients

Authors: Dr Hanadi Habib Meherali, Dr Santwana Chandrakar, Dr Varun Shetty

 DOI: https://dx.doi.org/10.18535/jmscr/v7i3.54

Abstract

Introduction: Role of diet in causation and exacerbation of asthma has been proposed by numerous authors, of which the role of vitamin D status is of particular interest. The present study is aimed to assess the association of vitamin D levels with the severity of bronchial asthma.

Methodology: This cross-sectional study was conducted in the Department of General Medicine, DY Patil School of Medicine, Navi Mumbai in which 90 asthmatic patients were included. Using a pre-designed semi-structured questionnaire, demographic and clinical information of the patients was obtained. Biochemical variables like serum calcium, phosphate, alkaline phosphatase and vitamin D levels were noted. Mean vitamin D levels of patients with mild, moderate and severe asthma were compared.

Results: The baseline demographic data of the patients like age and gender distribution was similar in the three asthmatic groups. Serum 25-OH-cholicalciferol levels were significantly lower (p value <0.01) among patients with severe asthma. Vitamin D deficiency (<20 ng/ml) was observed in a total of 30 patients, insufficiency (20 to 29 ng/ml) in 44 patients and sufficiency (30 to 100 ng/ml) in 16 patients. Vitamin D levels were found to be significantly associated with the severity of asthma (p value < 0.001).

Conclusions: The appropriate dose, route, and safety of vitamin D supplementation in asthmatics needs to be established. Molecular studies of vitamin D receptors to explain the role of vitamin D supplementation in asthma are needed in future.

Keywords: Asthma severity; Bronchial asthma; Vitamin D deficiency; Vitamin D insufficiency.

References

  1. Moore WC, Meyers DA, Wenzel SE, et al.: Identification of asthma phenotypes using cluster analysis in the Severe Asthma Research Program. Am J Respir Crit Care Med. 2010, 181:315– 323.
  2. Shifren A, Witt C, Christie C, et al.: Mechanisms of remodeling in asthmatic airways . J Allergy. 2012, 2012:12
  3. Nurmatov U, Devereux G, Sheikh A: Nutrients and foods for the primary prevention of asthma and allergy: systematic review and meta-analysis. J Allergy Clin Immunol. 2011, 127:724–733.
  4. Parodi V, de Florentiis D, Martini M, et al.: Inactivated influenza vaccines. Drugs Aging. 2011, 28:93–106
  5. Global Initiative for Asthma. Global Strategy for Asthma Management and Prevention, 2016. Global Initiative for Asthma (GINA). Available at http://www.ginasthma.org. 2016; Accessed: October31, 2018.
  6. Michael F. Holick, Neil C. Binkley, Heike A. Bischoff-Ferrari, Catherine M. Gordon, David A. Hanley, Robert P. Heaney et al. Evaluation, Treatment, and Prevention of Vitamin D Deficiency: an Endocrine Society Clinical Practice Guideline. J Clin Endocrinol Metab. 2011;96(7):1911-30.
  7. Chinellato I, Piazza M, Sandri M, et al.: Vitamin D serum levels and markers of asthma control in Italian children. J Pediatr. 2011, 158:437–441.
  8. Devereux G, Wilson A, Avenell A, et al.: A case-control study of vitamin D status and asthma in adults. Allergy. 2014, 65:666–667.
  9. Thuesen BH, Skaaby T, Husemoen LLN, et al.: The association of serum 25OH vitamin D with atopy, asthma, and lung function in a prospective study of Danish adults. Clin Exp Allergy. 2015, 45:265–272
  10. Gupta A, Sjoukes A, Richards D, et al. Relationship between Serum Vitamin D, Disease Severity, and Airway Remodeling in Children with Asthma. American journal of respiratory and critical care medicine. 2011;184(12):1342-1349.
  11. Banerjee A, Panettieri R, Jr. Vitamin D modulates airway smooth muscle function in COPD. Current opinion in pharmacology. 2012;12(3):266-274.
  12. Baeke F, Takiishi T, Korf H, et al.: Vitamin D: modulator of the immune system. Curr Opin Pharmacol. 2010, 10:482–496.
  13. Yadav M, Mittal K: Effect of vitamin D supplementation on moderate to severe bronchial asthma. Indian J Pediatr. 2014, 81:650–654.
  14. Gale CR, Robinson SM, Harvey NC, et al.: Maternal vitamin D status during pregnancy and child outcomes. Eur J Clin Nutr. 2008,62:68–77
  15. Erkkola M, Kaila M, Nwaru BI, et al.: Maternal vitamin D intake during pregnancy is inversely associated with asthma and allergic rhinitis in 5-year-old children. Clin Exp Allergy. 2009, 39:875–882.
  16. Morales E, Romieu I, Guerra S, et al.: Maternal vitamin D status in pregnancy and risk of lower respiratory tract infections, wheezing, and asthma in offspring. Epidemiology. 2012, 23:64– 71.
  17. Brehm JM, Celedn JC, Soto-Quiros ME, et al.: Serum vitamin D levels and markers of severity of childhood asthma in Costa Rica. Am J Respir Crit Care Med. 2009, 179:765–771.
  18. Brehm JM, Schuemann B, Fuhlbrigge AL, et al.: Serum vitamin D levels and severe asthma exacerbations in the Childhood Asthma Management Program study. J Allergy Clin Immunol. 2010, 126:52–58.

Corresponding Author

Dr Hanadi Habib Mehrali

Department of General Medicine, DY Patil University, School of Medicine,  Nerul, Navi Mumbai-400706, India

Email: This email address is being protected from spambots. You need JavaScript enabled to view it.