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Vitamin D Levels Linked to Asthma Severity in Children NEW YORK -- April 23, 2009 -- A study published in the first May issue of the American Journal of Respiratory and Critical Care Medicine provides evidence for a link between vitamin D insufficiency and asthma severity. Serum levels of vitamin D in more than 600 Costa Rican children were inversely linked to several indicators of allergy and asthma severity, including hospitalisations for asthma, use of inhaled steroids, and total IgE levels. While previous in vitro studies have suggested that vitamin D may affect how airway cells respond to treatment with inhaled steroids, this is the first in vivo study of vitamin D and disease severity in children with asthma. Juan Celedón, MD, and Augusto Litonjua, MD, Harvard Medical School, Boston, Massachusetts, and colleagues recruited 616 children with asthma living in the Central Valley of Costa Rica. Each child was assessed for allergic markers, including both allergen-specific and general sensitivity tests, and assessed for lung function and circulating vitamin D levels. Children whose forced expiratory volume in one second (FEV1) exceeded 65% of the predicted value were also tested for airway reactivity. They found that children with lower vitamin D levels were significantly more likely to have been hospitalised for asthma in the previous year, tended to have airways with increased hyperreactivity, and were likely to have used more inhaled corticosteroids. These children were also significantly more likely to have several markers of allergy, including dust-mite sensitivity. "To our knowledge this is the first study to demonstrate an inverse association between circulating levels of vitamin D and markers of asthma severity and allergy," the authors wrote. "While it is difficult to establish causation in a cross-sectional study such as this, the results were robust even after controlling for markers of baseline asthma severity." "This study suggests that there may be added health benefits to vitamin D supplementation" said Dr. Celedón. "This study also provides epidemiological support for a growing body of in vitro evidence that vitamin D insufficiency may worsen asthma severity, and we suspect that giving vitamin D supplements to asthma patients who are deficient may help with their asthma control," the authors wrote. "Whether vitamin D supplementation can prevent the development of asthma in very young children is a separate question, which will be answered by clinical trials that are getting under way." "Ultimately, it is only by investigating the effects of vitamin D in doses at, and above, those currently recommended that decisions can be made on the optimal intake of vitamin D and the possible prevention and treatment of asthma," said Graham Devereux, MD, Department of Environmental and Occupational Medicine, University of Aberdeen, Aberdeen, United Kingdom, in an accompanying editorial. SOURCE: American Thoracic Society E-mail this page to a friend or colleague! To print, use this version