Journal
JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY
Volume 126, Issue 1, Pages 52-58Publisher
MOSBY-ELSEVIER
DOI: 10.1016/j.jaci.2010.03.043
Keywords
Asthma; vitamin D; inhaled corticosteroids; asthma exacerbations
Categories
Funding
- National Heart, Lung, and Blood Institute
- National Heart, Lung, and Blood Institute(NHLBI)/National Institutes of Health [U01 HL075419, U01 HL65899, P01 HL083069, R01 HL086601, T32 HL07427]
- NHLBI [U01 HL51510, U01 HL51834, U01 HL51831, U01 HL51845, U01 HL 51843, M01 RR00079, M01 RR03186]
- National Institutes of Health [R21HL089842]
- GlaxoSmithKline
- National Institutes of Health
- AstraZeneca
- Aerocrine
- Genentech
- Novartis
- Merck, Schering-Plough
- Med Immune
- GlaxoSmith Kline
- Merck
- TEVA Pharmaceuticals
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Background: Asthma exacerbations, most often caused by respiratory tract infections, are the leading causes of asthma morbidity and comprise a significant proportion of asthma-related costs. Vitamin D status might play a role in preventing asthma exacerbations. Objectives: We sought to assess the relationship between serum vitamin D levels and subsequent severe asthma exacerbations. Methods: We measured 25-hydroxyvitamin D levels in sera collected from 1024 children with mild-to-moderate persistent asthma at the time of enrollment in a multicenter clinical trial of children randomized to receive budesonide, nedocromil, or placebo (as-needed beta-agonists): the Childhood Asthma Management Program. Using multivariable modeling, we examined the relationship between baseline vitamin D levels and the odds of any hospitalization or emergency department visit over the 4 years of the trial. Results: Thirty-five percent of all subjects were vitamin D insufficient, as defined by a level of 30 ng/mL or less 25-hydroxyvitamin D. Mean vitamin D levels were lowest in African American subjects and highest in white subjects. After adjusting for age, sex, body mass index, income, and treatment group, insufficient vitamin D status was associated with a higher odds of any hospitalization or emergency department visit (odds ratio, 1.5; 95% CI, 1.1-1.9; P = .01). Conclusion: Vitamin D insufficiency is common in this population of North American children with mild-to-moderate persistent asthma and is associated with higher odds of severe exacerbation over a 4-year period. (J Allergy Clin Immunol 2010;126:52-8.)
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