Asia Pac Allergy.  2015 Apr;5(2):103-113. 10.5415/apallergy.2015.5.2.103.

Bronchial asthma and hypovitaminosis D in Saudi children

• Aldubi HM
• Alissa EM
• Kamfar HZ
• Gaber O
• Marzouki Z

• KMID: 2397057
• DOI: http://doi.org/10.5415/apallergy.2015.5.2.103

Abstract

BACKGROUND
Asthma, a common lung disease in children, is caused by excessive immune responses to environmental antigens.
OBJECTIVE
Given the immuno-modulatory properties of vitamin D, the aim of the current study was to investigate the relationship between vitamin D levels and markers of asthma severity.
METHODS
This was investigated in a 70 Saudi children with and without asthma and were recruited from the King Abdul Aziz University Hospital, Jeddah, Saudi Arabia, over the period of 11 months (May 2011-April 2012). Childhood asthma control test instrument was employed to assess the level of asthma control among asthmatic patients. Anthropometric measurements were taken and interviewer-administrated questionnaire was completed for all study participants. Pulmonary function test was performed by recording changes in the peak expiratory flow. Venous blood samples were withdrawn for measurements of vitamin D, bone profile, cytokines profile (interleukin-10, tumor necrosis factor-alpha, platelets derived growth factor), and atopy markers (IgE and eosinophil count).
RESULTS
Hypovitaminosis D is highly prevalent among asthmatic children with highly significant increase in several markers of allergy and asthma severity as compared with healthy control children. Significant correlations between several inflammatory and immunological markers and vitamin D levels were also found. Finally, lower 25-hydroxyvitamin D levels were associated with a higher asthma prevalence in multivariable analysis.
CONCLUSION
Our study showed that hypovitaminosis D is highly prevalent in the whole population in addition to a highly significant increase in several markers of allergy and asthma severity among asthmatic children as compared with healthy control children.

Keyword

Asthma; Hypersensitivity; Vitamin D; Child; Saudi Arabia

MeSH Terms

Asthma*
Child*
Cytokines
Eosinophils
Humans
Hypersensitivity
Lung Diseases
Prevalence
Respiratory Function Tests
Saudi Arabia
Tumor Necrosis Factor-alpha
Vitamin D
Cytokines
Tumor Necrosis Factor-alpha
Vitamin D

Figure

• 

  Fig. 1 (A) Error bar chart of the mean values of the childhood asthma control test scores among asthmatic patients in the study population (n = 45). A score ≥20 indicates controlled asthma, scores from 16 to 19 indicate partly controlled asthma, and scores <16 indicate uncontrolled asthma. (B) Error bar chart for lung function as indicated by the mean values of peak expiratory flow rate (L/min) of the asthmatic patients in the study population (n = 45). CI, confidence interval; C-ACT, childhood asthma control test; PEF, peak expiratory flow.

• 

  Fig. 2 Serum vitamin D levels among asthmatic patients in the study population (n = 45). Box and whiskers plots show the median indicated by a line inside each box, the 25th and 75th percentiles are indicated by the box limits, and the lower and upper error bars represent the 10th and 90th percentiles, respectively. The median values were compared and the p-values are indicated in the figure. *p<0.05 (vs. uncontrolled asthmatic patients). Kruskal-Wallis test assessed the difference between subgroups of asthmatic patients.

• 

  Fig. 3 Comparison of vitamin D status among asthmatic patients in the study population (n = 45). Serum vitamin D level was categorized as: deficient <50 nmol/L, insufficient 50-74.9 nmol/L, and sufficient 75-100 nmol/L).

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  Fig. 4 Scatter plots of serum levels of vitamin D and cytokines in the study population (n = 70). For serum platelet derived growth factor (PDGF) (A: r = 0.0.313, p < 0.05), for serum interleukin-10 (IL-10) (B: r = 0.868, p < 0.0001), and for serum tumor necrosis factor alpha (TNF-α) (C: r = -0.450, p < 0.0001).

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