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Serum Vitamin D Levels and Markers of Severity of Childhood Asthma in Costa Rica

¹ Channing Laboratory, Department of Medicine and ² Division of Pulmonary/Critical Care Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts; ³ Harvard Medical School, Boston, Massachusetts; ⁴ Center for Genomic Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts; ⁵ Division of Pediatric Pulmonology, Department of Medicine, Hospital Nacional de Niños, San José, Costa Rica; ⁶ Division of Pediatric Pulmonology, Children's Hospital, Boston, Massachusetts; and ⁷ Darby Children's Research Institute, Medical University of South Carolina, Charleston, South Carolina

Correspondence and requests for reprints should be addressed to Juan C. Celedón, M.D., Channing Laboratory, 181 Longwood Avenue, Boston, MA 02115. E-mail: juan.celedon{at}channing.harvard.edu

Rationale: Maternal vitamin D intake during pregnancy has been inversely associated with asthma symptoms in early childhood. However, no study has examined the relationship between measured vitamin D levels and markers of asthma severity in childhood.

Objectives: To determine the relationship between measured vitamin D levels and both markers of asthma severity and allergy in childhood.

Methods: We examined the relation between 25-hydroxyvitamin D levels (the major circulating form of vitamin D) and markers of allergy and asthma severity in a cross-sectional study of 616 Costa Rican children between the ages of 6 and 14 years. Linear, logistic, and negative binomial regressions were used for the univariate and multivariate analyses.

Measurements and Main Results: Of the 616 children with asthma, 175 (28%) had insufficient levels of vitamin D (<30 ng/ml). In multivariate linear regression models, vitamin D levels were significantly and inversely associated with total IgE and eosinophil count. In multivariate logistic regression models, a log₁₀ unit increase in vitamin D levels was associated with reduced odds of any hospitalization in the previous year (odds ratio [OR], 0.05; 95% confidence interval [CI], 0.004–0.71; P = 0.03), any use of antiinflammatory medications in the previous year (OR, 0.18; 95% CI, 0.05–0.67; P = 0.01), and increased airway responsiveness (a 8.58-µmol provocative dose of methacholine producing a 20% fall in baseline FEV₁ [OR, 0.15; 95% CI, 0.024–0.97; P = 0.05]).

Conclusions: Our results suggest that vitamin D insufficiency is relatively frequent in an equatorial population of children with asthma. In these children, lower vitamin D levels are associated with increased markers of allergy and asthma severity.

AT A GLANCE COMMENTARY Scientific Knowledge on the Subject Maternal vitamin D intake during pregnancy has been inversely associated with asthma symptoms in early childhood. However, no study has examined the relationship between measured vitamin D levels and markers of asthma severity in childhood. What This Study Adds to the Field This study provides evidence of an inverse relationship between vitamin D levels and measures of allergy and asthma severity in Costa Rican children with asthma.

 

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