Allergy Asthma Respir Dis.  2014 Sep;2(4):293-297. 10.4168/aard.2014.2.4.293.

Factors associated with serum vitamin D levels in children with recurrent wheezing less than 3 years old

• Choi EJ
• Bag NR
• Jung JA
• Kim DC
• Ahn HS
• Yun HJ

• KMID: 2262398
• DOI: http://doi.org/10.4168/aard.2014.2.4.293

Abstract

PURPOSE
We evaluated the relationship between laboratory/clinical factors and vitamin D levels in recurrent wheezers less than 3 years old.
METHODS
We retrospectively analyzed clinical data and laboratory factors (25-hydroxyvitamin D, complete blood count, C-reactive protein, glutamic oxaloacetic transaminase, glutamyl purovic transaminase, alkaline phosphatase [ALP], eosinophil counts, and serum IgE IgG, IgA, IgM) of 84 children less than 3 years who had experienced wheezing episodes at least 3 times.
RESULTS
Children in the normal group (1.4+/-0.9 years) were younger than those in the deficient (2.2+/-1.2 years) and insuffient (2.3+/-1.0 years) groups (P=0.010). Glutamyl purovic transaminase were higher in the normal group (24.5+/-19.4 IU/L) than in the deficient (16.0+/-4.7 IU/L) and insufficient (15.3+/-4.5 IU/L) groups (P=0.009). ALP were higher in the deficient (791.4+/-180.8 IU/L) and insufficient (770.4+/-251.2 IU/L) groups than in the normal group (631.9+/-127.0 IU/L, P=0.034). Total IgE levels were higher in the deficient group (171.9+/-212.1 kU/L) than in the normal group (43.7+/-58.3 kU/L, P<0.05), and the rate of sensitization to aeroallergens was higher in the insufficient group (36.1%) than in the normal group (10%, P<0.05).
CONCLUSION
Among children with recurrent wheezing less than 3 years old, low vitamin D levels may be associated with older age, total IgE, ALP level, glutamic pyruvate transaminase level, and rate of sensitization to aeroallergens.

Keyword

Vitamin D; Asthma; Wheezing; Young childhood

MeSH Terms

Alkaline Phosphatase
Aspartate Aminotransferases
Asthma
Blood Cell Count
C-Reactive Protein
Child*
Eosinophils
Humans
Immunoglobulin A
Immunoglobulin E
Immunoglobulin G
Pyruvic Acid
Respiratory Sounds*
Retrospective Studies
Vitamin D*
Alkaline Phosphatase
Aspartate Aminotransferases
C-Reactive Protein
Immunoglobulin A
Immunoglobulin E
Immunoglobulin G
Pyruvic Acid
Vitamin D

Reference

1. Tsiaras WG, Weinstock MA. Factors influencing vitamin D status. Acta Derm Venereol. 2011; 91:115–124.

2. Dror DK, King JC, Durand DJ, Allen LH. Association of modifiable and nonmodifiable factors with vitamin D status in pregnant women and neonates in Oakland, CA. J Am Diet Assoc. 2011; 111:111–116.

3. Wang TJ, Zhang F, Richards JB, Kestenbaum B, van Meurs JB, Berry D, et al. Common genetic determinants of vitamin D insufficiency: a genome-wide association study. Lancet. 2010; 376:180–188.

4. Benson AA, Toh JA, Vernon N, Jariwala SP. The role of vitamin D in the immunopathogenesis of allergic skin diseases. Allergy. 2012; 67:296–301.

5. Hewison M. An update on vitamin D and human immunity. Clin Endocrinol (Oxf). 2012; 76:315–325.

6. Camargo CA Jr, Ingham T, Wickens K, Thadhani R, Silvers KM, Epton MJ, et al. Cord-blood 25-hydroxyvitamin D levels and risk of respiratory infection, wheezing, and asthma. Pediatrics. 2011; 127:e180–e187.

7. García de Tena J, El Hachem Debek A, Hernandez Gutierrez C, Izquierdo Alonso JL. The role of vitamin D in chronic obstructive pulmonary disease, asthma and other respiratory diseases. Arch Bronconeumol. 2014; 50:179–184.

8. Blanken MO, Rovers MM, Bont L. Dutch RSV Neonatal Network. Respiratory syncytial virus and recurrent wheeze. N Engl J Med. 2013; 369:782–783.

9. van der Gugten AC, van der Zalm MM, Uiterwaal CS, Wilbrink B, Rossen JW, van der Ent CK. Human rhinovirus and wheezing: short and long-term associations in children. Pediatr Infect Dis J. 2013; 32:827–833.

10. El-Gamal YM, El-Sayed SS. Wheezing in infancy. World Allergy Organ J. 2011; 4:85–90.

11. Jartti T, Ruuskanen O, Mansbach JM, Vuorinen T, Camargo CA Jr. Low serum 25-hydroxyvitamin D levels are associated with increased risk of viral coinfections in wheezing children. J Allergy Clin Immunol. 2010; 126:1074–1076. 1074.e1–1076.e4.

12. Miyake Y, Sasaki S, Tanaka K, Hirota Y. Dairy food, calcium and vitamin D intake in pregnancy, and wheeze and eczema in infants. Eur Respir J. 2010; 35:1228–1234.

13. Holick MF. Vitamin D: evolutionary, physiological and health perspectives. Curr Drug Targets. 2011; 12:4–18.

14. Brehm JM, Celedon JC, Soto-Quiros ME, Avila L, Hunninghake GM, Forno E, 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.

15. Hollams EM, Hart PH, Holt BJ, Serralha M, Parsons F, de Klerk NH, et al. Vitamin D and atopy and asthma phenotypes in children: a longitudinal cohort study. Eur Respir J. 2011; 38:1320–1327.

16. Devereux G, Litonjua AA, Turner SW, Craig LC, McNeill G, Martindale S, et al. Maternal vitamin D intake during pregnancy and early childhood wheezing. Am J Clin Nutr. 2007; 85:853–859.

17. Erkkola M, Kaila M, Nwaru BI, Kronberg-Kippila C, Ahonen S, Nevalainen J, 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.

18. van Drunen Littel-van den Hurk S, Watkiss ER. Pathogenesis of respiratory syncytial virus. Curr Opin Virol. 2012; 2:300–305.

19. Belderbos ME, Houben ML, Wilbrink B, Lentjes E, Bloemen EM, Kimpen JL, et al. Cord blood vitamin D deficiency is associated with respiratory syncytial virus bronchiolitis. Pediatrics. 2011; 127:e1513–e1520.

20. Godang K, Froslie KF, Henriksen T, Qvigstad E, Bollerslev J. Seasonal variation in maternal and umbilical cord 25(OH) vitamin D and their associations with neonatal adiposity. Eur J Endocrinol. 2014; 170:609–617.

21. Bozzetto S, Carraro S, Giordano G, Boner A, Baraldi E. Asthma, allergy and respiratory infections: the vitamin D hypothesis. Allergy. 2012; 67:10–17.

22. Wortsman J, Matsuoka LY, Chen TC, Lu Z, Holick MF. Decreased bioavailability of vitamin D in obesity. Am J Clin Nutr. 2000; 72:690–693.

23. MacLaughlin J, Holick MF. Aging decreases the capacity of human skin to produce vitamin D3. J Clin Invest. 1985; 76:1536–1538.

24. Holick MF, Matsuoka LY, Wortsman J. Age, vitamin D, and solar ultraviolet. Lancet. 1989; 2:1104–1105.

25. Pappa HM, Bern E, Kamin D, Grand RJ. Vitamin D status in gastrointestinal and liver disease. Curr Opin Gastroenterol. 2008; 24:176–183.

26. Skaaby T, Husemoen LL, Borglykke A, Jorgensen T, Thuesen BH, Pisinger C, et al. Vitamin D status, liver enzymes, and incident liver disease and mortality: a general population study. Endocrine. 2014; 47:213–220.

27. Brehm JM, Schuemann B, Fuhlbrigge AL, Hollis BW, Strunk RC, Zeiger RS, 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.e5.

28. Goleva E, Searing DA, Jackson LP, Richers BN, Leung DY. Steroid requirements and immune associations with vitamin D are stronger in children than adults with asthma. J Allergy Clin Immunol. 2012; 129:1243–1251.

29. Wjst M, Hypponen E. Vitamin D serum levels and allergic rhinitis. Allergy. 2007; 62:1085–1086.

30. Sharief S, Jariwala S, Kumar J, Muntner P, Melamed ML. Vitamin D levels and food and environmental allergies in the United States: results from the National Health and Nutrition Examination Survey 2005-2006. J Allergy Clin Immunol. 2011; 127:1195–1202.