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Chanie ES, Zhang G, Le Souef P. The serum level of vitamin D and prevalence of vitamin D deficiency among children with asthma in Asia and Africa: a systematic review and meta-analysis. Arch Public Health 2024; 82:103. [PMID: 38970116 PMCID: PMC11225331 DOI: 10.1186/s13690-024-01321-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Accepted: 06/09/2024] [Indexed: 07/07/2024] Open
Abstract
BACKGROUND Several studies on the serum level of vitamin D and the percentage of vitamin D deficiency in children with asthma have been conducted in Asia and Africa, but the results have been inconsistent and inconclusive, requiring a systematic review and meta-analysis to assess the strength of the evidence. OBJECTIVE The objective of this review is to synthesize evidence on serum levels of vitamin D and the percentage of vitamin D deficiency among children with asthma in Asia and Africa. METHODS To identify relevant articles, a comprehensive search was conducted across various databases and repositories such as PubMed, Google Scholar, Hinary, Web of Science, ResearchGate, as well as gray literature sources. The Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines were followed during the retrieval process. Data extraction was performed following a standardized format based on the JBI (Joanna Briggs Institute) data extraction guidelines. Microsoft Excel was utilized for data extraction, and subsequently, the data was exported to STATA 17 for further analysis. To assess the heterogeneity among the included studies, Cochrane Q-statistics and the I2 tests were employed. Publication bias was assessed using the Egger test and funnel plot. RESULT This meta-analysis investigated 33 articles encompassing a total of 3432 children diagnosed with asthma. The findings demonstrated that in low- or middle-income countries across Africa and Asia, children with asthma had an average serum vitamin D level of 21.9 ng/ml (95% confidence interval [CI]: 18.0-25.9 ng/ml), with 53.7% (95% CI: 40.5-66.9) experiencing vitamin D deficiency. Additionally, when considering the continent, children with asthma in Asia had an average serum vitamin D level of 18.5 ng/ml (95% CI: 13.8-23.3), while those in Africa had a level of 28.7 ng/ml (95% CI: 22.7-34.8). The analysis further explored different sub-group analyses. Depending on the study design, case-control studies yielded an average serum vitamin D level of 20.3 ng/ml (95% CI: 18.2-22.4), whereas cross-sectional studies resulted in 23.8 ng/ml (95% CI: 17.5-30.1). Based on publication year, studies published on or before 2015 had an average serum level of 21.0 ng/ml (95% CI: 18.0-24.0), while those published after 2015 had a level of 22.4 ng/ml (95% CI: 17.2-27.7). Moreover, when considering sample size, studies with 100 participants or less had an average serum level of 21.7 ng/ml (95% CI: 17.3-26.1), while studies with more than 100 participants had a level of 22.1 ng/ml (95% CI: 18.6-25.6). CONCLUSION Children with asthma in Asia and Africa were found to have low serum levels of vitamin D and a high percentage of vitamin D deficiency. This highlights the importance of early detection and monitoring of vitamin D levels in these children to prevent potential complications associated with vitamin D deficiency. Taking proactive measures to address and manage vitamin D deficiency is crucial for the well-being of children with asthma in these regions.
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Affiliation(s)
- Ermias Sisay Chanie
- Department of Paediatric and Child Health, Debre Tabor University, Debre Tabor, Ethiopia.
| | - Guicheng Zhang
- School of Population Health, Curtin University, Perth, WA, 6102, Australia
- School of Medicine, The University of Western Australia, Perth, WA, 6008, Australia
| | - Peter Le Souef
- School of Medicine, The University of Western Australia, Perth, WA, 6008, Australia
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do Amaral CSF, Jordão ÉADOC, de Oliveira CL, Felix MMR, Kuschnir MCC, Kuschnir FC. Asthma and vitamin D in Brazilian adolescents: Study of Cardiovascular Risks in Adolescents (ERICA). J Bras Pneumol 2021; 47:e20210281. [PMID: 34932722 PMCID: PMC8836642 DOI: 10.36416/1806-3756/e20210281] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Accepted: 09/08/2021] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVE To evaluate the association between asthma prevalence and serum levels of vitamin D in Brazilian adolescents. METHODS This was a cross-sectional, school-based study involving adolescents between 12-17 years of age from four large Brazilian cities located at different latitudes (Fortaleza, Rio de Janeiro, Brasília, and Porto Alegre). Information on asthma diagnosis, lifestyle, and sociodemographic characteristics was collected by means of self-administered questionnaires. Serum concentrations of calcifediol were dichotomized as sufficient (≥ 20 ng/mL) or insufficient/deficient (< 20 ng/mL) levels. Bivariate analyses were carried out between vitamin D levels and prevalence of active asthma (AA), as well as other variables in study, using the chi-square test. Generalized linear models were configured to analyze potential confounding factors (p < 0.20). RESULTS Between 2013 and 2014, 1,053 adolescents were evaluated. The prevalences of AA and insufficient/deficient levels of calcifediol were 15.4% and 21%, respectively. There were no statistically significant associations between AA and hypovitaminosis D. The prevalences of AA and vitamin D insufficiency were, respectively, 2.34 (95% CI, 1,28-4.30) and 3.22 (95% CI, 1.75-5.95) times higher in Porto Alegre than in Rio de Janeiro, regardless of possible confounding factors. However, no significant associations were found between the prevalence of AA and vitamin-D-related variables in any of the cities. CONCLUSIONS No association was found between AA and low levels of vitamin D in adolescents living at different latitudes in Brazil.
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Affiliation(s)
- Cláudia Soïdo Falcão do Amaral
- . Programa de Pós-Graduação em Ciências Médicas, Universidade do Estado do Rio de Janeiro - UERJ - Rio de Janeiro (RJ) Brasil
| | | | - Cecília Lacroix de Oliveira
- . Departamento de Nutrição Aplicada, Universidade do Estado do Rio de Janeiro - UERJ - Rio de Janeiro (RJ) Brasil
| | - Mara Morelo Rocha Felix
- . Escola de Medicina e Cirurgia, Universidade Federal do Estado do Rio de Janeiro - UNIRIO - Rio de Janeiro (RJ) Brasil
| | - Maria Cristina Caetano Kuschnir
- . Programa de Pós-Graduação em Ciências Médicas, Universidade do Estado do Rio de Janeiro - UERJ - Rio de Janeiro (RJ) Brasil
- . Núcleo de Estudos da Saúde do Adolescente, Universidade do Estado do Rio de Janeiro - NESA/UERJ - Rio de Janeiro (RJ) Brasil
| | - Fábio Chigres Kuschnir
- . Programa de Pós-Graduação em Ciências Médicas, Universidade do Estado do Rio de Janeiro - UERJ - Rio de Janeiro (RJ) Brasil
- . Departamento de Pediatria, Universidade do Estado do Rio de Janeiro - UERJ - Rio de Janeiro (RJ) Brasil
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Al-Zayadneh E, Alnawaiseh NA, Ajarmeh S, Altarawneh AH, Albataineh EM, AlZayadneh E, Shatanawi A, Alzayadneh EM. Vitamin D deficiency in children with bronchial asthma in southern Jordan: a cross-sectional study. J Int Med Res 2021; 48:300060520974242. [PMID: 33284716 PMCID: PMC7724425 DOI: 10.1177/0300060520974242] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Objectives To assess serum 25-hydroxycholecalciferol (25-OH vitamin D) levels in
Jordanian children with bronchial asthma, and to examine correlations
between 25-OH vitamin D levels and asthma severity and control. Methods A cross-sectional study was conducted at the Paediatric Chest Clinic,
Al-Karak Governmental Hospital, Southern Jordan, between May 2015 and
February 2016. Serum 25-hydroxyvitamin D level was determined in children
aged 1–14 years diagnosed with bronchial asthma (6–14 years) or recurrent
wheezing episodes (<6 years). Asthma severity was determined based on the
Global Initiative for Asthma assessment, the Asthma Control Test, and the
Childhood Asthma Control Test. Demographic and clinical characteristics were
compared between patients with low and normal 25-OH vitamin D levels, and
correlations between asthma severity and 25-OH vitamin D level were
assessed. Results Out of 98 included children, 25-OH vitamin D levels were deficient and
insufficient in 41 (41.8%) and 34 (34.7%) children, respectively. Only 23
(23.5%) had sufficient 25-OH vitamin D levels. A significant correlation was
found between severity of asthma symptoms and 25-OH vitamin D
deficiency. Conclusion 25-OH vitamin D deficiency is highly prevalent in Jordanian children with
bronchial asthma and correlates significantly with asthma severity.
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Affiliation(s)
- Enas Al-Zayadneh
- Department of Paediatrics, School of Medicine, The University of Jordan, Amman, Jordan
| | - Nedal Awad Alnawaiseh
- Department of Public Health, School of Medicine, University of Mutah, Al-Karak, Jordan
| | - Salma Ajarmeh
- Department of Paediatrics, School of Medicine, University of Mutah, Al-Karak, Jordan
| | - Areej Hamed Altarawneh
- Department of Obstetrics, Gynaecology and Woman's Health, Ministry of Health, Al-Karak, Jordan
| | - Eman M Albataineh
- Department of Microbiology and Immunology, School of Medicine, University of Mutah, Al-Karak, Jordan
| | - Eyas AlZayadneh
- Department of Paediatrics, Faculty of Medicine, The Hashemite University, Zarqa, Jordan
| | - Alia Shatanawi
- Department of Pharmacology, School of Medicine, The University of Jordan, Amman, Jordan
| | - Ebaa M Alzayadneh
- Department of Physiology and Biochemistry, School of Medicine, The University of Jordan, Amman, Jordan
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Leão LMCS, Rodrigues BC, Dias PTP, Gehrke B, de Souza TDSP, Hirose CK, Freire MDC. Vitamin D status and prevalence of hypovitaminosis D in different genders throughout life stages: A Brazilian cross-sectional study. Clinics (Sao Paulo) 2021; 76:e2571. [PMID: 33852654 PMCID: PMC8009065 DOI: 10.6061/clinics/2021/e2571] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2020] [Accepted: 02/17/2021] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVES To evaluate the mean concentration of 25-hydroxivitamin D [25(OH) D] and prevalence of hypovitaminosis D in individuals residing in Rio de Janeiro, Brazil. METHODS The data of 80,000 consecutive individuals who had 25(OH) D measurements performed by electrochemiluminescence between 1/2/2018 and 2/5/2018 were selected. Patients who reported the use of therapies/supplements were excluded. Levels of 25(OH) D ≥20 ng/mL (ages <60 years) and ≥30 ng/mL (ages ≥60 years) were considered adequate. RESULTS We analyzed the data of 24,074 individuals (1-95 years old, 64.7% female). Descriptive curves showed that, in both sexes, the mean values of 25(OH) D decreased from the first years of life until adolescence, then slightly increased, and then tended to stabilize during adulthood. Levels of 25(OH) D <20 ng/mL were observed in 6% of girls versus 3.6% of boys and in 13.6% of adolescent girls versus 12.6% of adolescent boys and 11% of adults. The percentage of seniors with serum levels of 25(OH) D <20 ng/mL was 13.6% in women and 12.7% in men; 53.2% of women and 50.6% of men had levels <30 ng/mL. CONCLUSIONS Mean 25(OH) D values were higher in children and lower in adolescents and women. Approximately 90% of non-seniors and presumably healthy residents of the urban metropolitan region of Rio de Janeiro presented satisfactory levels of 25(OH) D during the summer months; however, in over half of the elderly, the serum concentrations of 25(OH) D were inadequate. Therefore, strategies for the prevention of hypovitaminosis D should be considered in the senior population.
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Affiliation(s)
- Lenora M. Camarate S.M. Leão
- Servico de Endocrinologia, Hospital Universitario Pedro Ernesto, Faculdade de Ciencias Medicas, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, RJ, BR
| | | | - Paulo Telles Pires Dias
- Nucleo de Estudos e Pesquisas em Atencao ao Uso de Drogas, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, RJ, BR
- Departamento de Epidemiologia e Bioestatistica (MEB-ISC), Universidade Federal Fluminense, Niteroi, RJ, BR
| | - Bárbara Gehrke
- Programa de Pos-Graduacao em Fisiopatologia Clinica e Experimental (FISCLINEX), Faculdade de Ciencias Medicas, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, RJ, BR
- *Corresponding author. E-mail:
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Teixeira TL, Linden MA, Lomazi EA, Saron MGL, Riccetto AL, Bellomo-BrandÃo MÂ. CASE-CONTROL STUDY ON VITAMIN D STATUS IN CHILDREN AND ADOLESCENTS WITH EOSINOPHILIC ESOPHAGITIS. ARQUIVOS DE GASTROENTEROLOGIA 2020; 57:409-415. [PMID: 33331474 DOI: 10.1590/s0004-2803.202000000-75] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/03/2020] [Accepted: 07/14/2020] [Indexed: 11/22/2022]
Abstract
BACKGROUND Vitamin D is an essential fat-soluble steroid hormone and vitamin D deficiency is a global public health problem especially among children and adolescents. Factors such as the low intake of vitamin D-rich food sources, poor absorption and less exposure to the sun influence this outcome. Vitamin D has an anti-inflammatory effect in the body by promoting regulatory T cell differentiation as well as recovering T helper 17 cell response and secretion of anti-inflammatory cytokines. Eosinophilic esophagitis (EoE) is a chronic disease, histologically characterized by predominantly eosinophilic inflammation. The most common therapeutic approaches are allergen-eliminating diets, such as excluding cow's milk, egg, soy, wheat, peanuts and seafood, or more specific dietary restrictions. OBJECTIVE To verify the serum levels of vitamin D in children and adolescents with eosinophilic esophagitis on a restricted food diet and to analyze their association with nutritional status, consumption of different food sources, exposure to the sun and skin color. METHODS Case-control study conducted in the city of Campinas-SP, Brazil, in which included patients were aged 2 to 18 years old, and those diagnosed with eosinophilic esophagitis was referred to as the case group (n=15), meanwhile a control group (n=17) was also formed. Epidemiological data, nutritional status, data on vitamin D intake (24-hour recall - performed only by EoE patients - and self-reported intake of vitamin D food sources: milk and dairy products, canned tuna and sardines, Bull's liver, chicken eggs - applied in both groups), and daily time of sun exposure (≥30 min or ≤30 min) were recorded. The samples were collected for serum levels of 25-hydroxy-vitamin D, where sufficiency levels >30 ng/mL were considered, insufficiency 21 to 30 ng/mL, deficiency <20 ng/mL. RESULTS There was a higher frequency of vitamin D insufficiency/ deficiency in the Eosinophilic Esophagitis group (P=0.035), even with longer sun exposure (P= 0.035). Skin color was not associated with lower levels of vitamin D in both groups studied. No difference was found in nutritional status between the groups. CONCLUSION The present study demonstrated a higher frequency of inadequate/ deficient levels of vitamin D in children and adolescents with EoE on a restricted diet. When necessary, serum levels should be investigated and correct exposure to the sun should be encouraged, with special attention to the recommended guidelines, time spent in the sun and the appropriate clothing for correct absorption. Since exposure for more than 30 minutes in the sun does not appear to have provided a protective effect in the EoE group, even in a region with high levels of solar radiation. There was a significant difference only in the consumption of cow's milk between the case and control groups, demonstrating the low adherence to the restriction diet by the case group. No association was found between serum 25 hydroxyvitamin D levels and nutritional status. Moreover, no association regarding the adequate or inadequate status of 25 hydroxyvitamin D and the consumption vitamin D-rich foods was identified. Multicentered studies with a larger number of cases should be performed to assess serum 25 hydroxyvitamin D levels and associated factors in pediatric patients with EoE.
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Affiliation(s)
- Thaís Longo Teixeira
- Universidade Estadual de Campinas, Faculdade de Ciências Médicas, Departamento de Saúde da Criança e do Adolescente, Campinas, SP, Brasil
| | - Marcela Almeida Linden
- Universidade Estadual de Campinas, Faculdade de Ciências Médicas, Departamento de Saúde da Criança e do Adolescente, Campinas, SP, Brasil
| | - Elizete Aparecida Lomazi
- Universidade Estadual de Campinas, Faculdade de Ciências Médicas, Departamento de Saúde da Criança e do Adolescente, Campinas, SP, Brasil
| | - Margareth Galvão Lopes Saron
- Universidade Estadual de Campinas, Faculdade de Ciências Médicas, Departamento de Saúde da Criança e do Adolescente, Campinas, SP, Brasil
| | - Adriana Lopes Riccetto
- Universidade Estadual de Campinas, Faculdade de Ciências Médicas, Departamento de Saúde da Criança e do Adolescente, Campinas, SP, Brasil
| | - Maria Ângela Bellomo-BrandÃo
- Universidade Estadual de Campinas, Faculdade de Ciências Médicas, Departamento de Saúde da Criança e do Adolescente, Campinas, SP, Brasil
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Amorim CLCGD, Oliveira JMD, Rodrigues A, Furlanetto KC, Pitta F. Vitamin D: association with eosinophil counts and IgE levels in children with asthma. ACTA ACUST UNITED AC 2020; 47:e20200279. [PMID: 33174974 PMCID: PMC7889310 DOI: 10.36416/1806-3756/e20200279] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2020] [Accepted: 07/06/2020] [Indexed: 11/19/2022]
Abstract
In this cross-sectional study, we investigated the relationship that levels of vitamin D had with eosinophil counts and IgE levels in 26 children with asthma (6-12 years of age) in the city of Londrina, Brazil. Vitamin D levels were found to correlate significantly, albeit moderately, with age (r = −0.51) and eosinophilia (r = −0.49), although not with IgE levels (r = −0.12). When we stratified the sample into two groups by the median vitamin D level (< or ≥ 24 ng/mL), we found that those in the < 24 ng/mL group were older, had higher eosinophil counts, and had higher IgE levels. To our knowledge, this is the first study to show an association between low levels of vitamin D and more pronounced eosinophilia in children with asthma in Brazil.
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Affiliation(s)
- Claudio Luiz Castro Gomes de Amorim
- . Programa de Pós-Graduação em Ciências da Saúde, Universidade Estadual de Londrina, Londrina (PR) Brasil.,. Laboratório de Pesquisa em Fisioterapia Pulmonar, Departamento de Fisioterapia, Universidade Estadual de Londrina, Londrina (PR) Brasil
| | - Joice Mara de Oliveira
- . Laboratório de Pesquisa em Fisioterapia Pulmonar, Departamento de Fisioterapia, Universidade Estadual de Londrina, Londrina (PR) Brasil.,. Centro de Pesquisa e Pós-Graduação, Universidade Pitágoras-Universidade Norte do Paraná - UNOPAR - Londrina (PR) Brasil
| | - Antenor Rodrigues
- . Laboratório de Pesquisa em Fisioterapia Pulmonar, Departamento de Fisioterapia, Universidade Estadual de Londrina, Londrina (PR) Brasil.,. Rehabilitation Aimed at Muscle Performance-RAMP-University of Toronto, Toronto, ON, Canada
| | - Karina Couto Furlanetto
- . Laboratório de Pesquisa em Fisioterapia Pulmonar, Departamento de Fisioterapia, Universidade Estadual de Londrina, Londrina (PR) Brasil.,. Centro de Pesquisa e Pós-Graduação, Universidade Pitágoras-Universidade Norte do Paraná - UNOPAR - Londrina (PR) Brasil
| | - Fabio Pitta
- . Programa de Pós-Graduação em Ciências da Saúde, Universidade Estadual de Londrina, Londrina (PR) Brasil.,. Laboratório de Pesquisa em Fisioterapia Pulmonar, Departamento de Fisioterapia, Universidade Estadual de Londrina, Londrina (PR) Brasil
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Suboptimal Serum 25-Hydroxy-Vitamin D Is Associated with a History of Recent Disease Exacerbation in Pediatric Patients with Bronchial Asthma or Asthma-Suggestive Recurrent Wheezing. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17186545. [PMID: 32916790 PMCID: PMC7558096 DOI: 10.3390/ijerph17186545] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Revised: 09/02/2020] [Accepted: 09/07/2020] [Indexed: 12/27/2022]
Abstract
Even though vitamin D is widely acknowledged as having a potential immunomodulatory role in asthma, its exact beneficial mechanisms are yet to be clarified. An optimal serum 25-hydroxy-vitamin D (25-OH-VitD) level in pediatric asthma patients might not rely solely on the effect of dose-dependent vitamin D3 intake, but might also be influenced by factors related to insufficient asthma control. We aimed to survey the prevalence of serum 25-OH-VitD deficiency and analyze whether suboptimal levels were associated with asthma severity factors. The current cross-sectional study enrolled 131 pediatric asthma or asthma-suggestive recurrent wheezing patients, for whom serum 25-OH-VitD, IgE, and eosinophil count were assessed. The prevalence of suboptimal serum 25-OH-VitD was 58.8%. A suboptimal vitamin D status was associated with asthma exacerbation in the previous month (p = 0.02). Even under seasonal oral vitamin D3 supplementation, patients with a positive history of asthma attack in the previous four weeks presented significantly lower serum 25-OH-VitD concentrations, compared to their peers with no disease exacerbation. In conclusion, sequential measurements of serum 25-OH-VitD might prove useful for future studies evaluating the dynamic changes in vitamin D3 status in regard to asthma, especially in symptomatic patients.
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Galvão AA, de Araújo Sena F, Andrade Belitardo EMMD, de Santana MBR, Costa GNDO, Cruz ÁA, Barreto ML, Costa RDS, Alcantara-Neves NM, Figueiredo CA. Genetic polymorphisms in vitamin D pathway influence 25(OH)D levels and are associated with atopy and asthma. Allergy Asthma Clin Immunol 2020; 16:62. [PMID: 32834827 PMCID: PMC7386242 DOI: 10.1186/s13223-020-00460-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2020] [Accepted: 06/26/2020] [Indexed: 12/28/2022] Open
Abstract
Background Vitamin D deficiency or insufficiency, has been associated with atopy and lack of asthma control. Our objective was to investigate associations between variants in genes of vitamin D pathway with serum levels of 25-hydroxyvitamin D (25(OH)D), atopy, asthma and asthma severity in teenagers from Northeast Brazil. Methods This is a cross sectional study nested in a cohort population of asthma. 25(OH)D was quantified from 968 of 11–17 years old individuals by ELISA. Asthma diagnosis was obtained by using the ISAAC Phase III questionnaire. Specific IgE was determined by ImmunoCAP; genotyping was performed using the 2.5 HumanOmni Biochip from Illumina. Statistical analyses were performed in PLINK 1.07 and SPSS 22.1. Results After quality control, 104 Single Nucleotides Variants (SNVs) in vitamin D pathway genes, typed in 792 individuals, were included in the analysis. The allele A of rs10875694 on VDR was positively associated with atopy (OR = 1.35; 95% CI 1.01–1.81). The allele C of rs9279 on VDR, was negatively associated with asthma risk (OR = 0.66; 95% CI 0.45–0.97), vitamin D insufficiency (OR = 0.78; 95% CI 0.70–0.96) and higher VDR expression. Two variants in VDR were associated with asthma severity, the allele A of rs2189480 (OR = 0.34; 95% CI 0.13–0.89) and the allele G of rs4328262 (OR = 3.18; 95% CI 1.09–9.28). The combination of variants in CYP2R1 and CYP24A1 (GAC, to rs10500804, rs12794714 and rs3886163, respectively) was negatively associated with vitamin D production (β = − 1.24; 95% CI − 2.42 to − 0.06). Conclusions Genetic variants in the vitamin D pathway affect vitamin D serum levels and, thus, atopy and asthma.
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Affiliation(s)
- Alana Alcântara Galvão
- Instituto de Ciências da Saúde, Universidade Federal da Bahia (UFBA), Salvador, Bahia, Brazil.,Programa de Pós Graduação em Imunologia (PPGIm), Bahia, Brazil
| | - Flávia de Araújo Sena
- Instituto de Ciências da Saúde, Universidade Federal da Bahia (UFBA), Salvador, Bahia, Brazil.,Programa de Pós Graduação em Imunologia (PPGIm), Bahia, Brazil
| | | | - Maria Borges Rabelo de Santana
- Instituto de Ciências da Saúde, Universidade Federal da Bahia (UFBA), Salvador, Bahia, Brazil.,Programa de Pós Graduação em Imunologia (PPGIm), Bahia, Brazil
| | - Gustavo Nunes de Oliveira Costa
- Instituto de Saúde Coletiva, Universidade Federal da Bahia (UFBA), Salvador, Bahia, Brazil.,Universidade Salvador (UNIFACS), Salvador, Bahia, Brazil
| | - Álvaro Augusto Cruz
- ProAR, Faculdade de Medicina, Universidade Federal da Bahia (UFBA), Salvador, Bahia, Brazil
| | - Maurício Lima Barreto
- Instituto de Saúde Coletiva, Universidade Federal da Bahia (UFBA), Salvador, Bahia, Brazil.,Centro de Integração de dados e Conhecimentos para Saúde(CIDACS), Fiocruz, Bahia Brazil
| | - Ryan Dos Santos Costa
- Instituto de Ciências da Saúde, Universidade Federal da Bahia (UFBA), Salvador, Bahia, Brazil.,Programa de Pós Graduação em Imunologia (PPGIm), Bahia, Brazil
| | - Neuza Maria Alcantara-Neves
- Instituto de Ciências da Saúde, Universidade Federal da Bahia (UFBA), Salvador, Bahia, Brazil.,Programa de Pós Graduação em Imunologia (PPGIm), Bahia, Brazil
| | - Camila Alexandrina Figueiredo
- Instituto de Ciências da Saúde, Universidade Federal da Bahia (UFBA), Salvador, Bahia, Brazil.,Programa de Pós Graduação em Imunologia (PPGIm), Bahia, Brazil.,Departamento de Ciências da Biorregulação, Instituto de Ciências da Saúde, Universidade Federal da Bahia, Canela, CEP 41110-100 Salvador, BA Brazil
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Linden MA, Freitas RGBDON, Hessel G, Marmo DB, Bellomo-Brandão MÂ. DEFINITION OF VITAMIN D DEFICIENCY IN SCHOOLCHILDREN: SYSTEMATIC REVIEW WITH META-ANALYSIS. ARQUIVOS DE GASTROENTEROLOGIA 2020; 56:425-430. [PMID: 31721968 DOI: 10.1590/s0004-2803.201900000-64] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/12/2019] [Accepted: 09/12/2019] [Indexed: 12/11/2022]
Abstract
BACKGROUND Vitamin D deficiency is being recognized as a pandemic due to the volume of people affected by the deficiency and the number of illnesses generated or stimulated by the deficiency. There is a lack of consensus in the literature on what is considered vitamin D deficiency [25(OH)D]. OBJECTIVE This review brings together the most common levels of 25(OH)D found in healthy schoolchildren and what is considered deficient. METHODS This systematic review was based on the literature accessed from the electronic databases: MEDLINE, EMBASE, LILACS, SCOPUS and WEB OF SCIENCE. The following descriptors were used in English, Portuguese and Spanish: "Vitamin D"; "Vitamin D deficiency"; "Nutritional Supplements" as well as all their synonyms. The meta-analysis was performed considering the random model. Inclusion criteria: healthy children aged 6 to 12 years, studies that had vitamin D levels, defined vitamin D deficiency. RESULTS Of the 191 potentially eligible articles, only six articles were included, with 2618 students in total. The mean value of 25(OH)D was estimated at 18.11 ng/mL with 95% confidence interval. Among the articles found, three were considered deficiency levels below 20 ng/mL, one considered below 18 ng/mL, another below 15 ng/mL, and the latter below 11 ng/ mL. The prevalence of vitamin D deficiency among the articles was 48.6%, 7%, 98%, 64.63%, 19.5%, 28.4%, according to each classification used by the same. CONCLUSION The most common definition in the literature of 25(OH)D deficiency in schoolchildren was at levels below 20 ng/mL. No side effects have been reported in studies that used fortification and/or vitamin D supplementation. Daily supplementation is more effective than seasonal supplementation. However, more studies are needed to define what can be considered as optimal levels of 25(OH)D in children.
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Affiliation(s)
| | | | - Gabriel Hessel
- Universidade Estadual de Campinas (UNICAMP), Campinas, SP, Brasil
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Feketea G, Bocsan CI, Stanciu LA, Buzoianu AD, Zdrenghea MT. The Role of Vitamin D Deficiency in Children With Recurrent Wheezing-Clinical Significance. Front Pediatr 2020; 8:344. [PMID: 32695735 PMCID: PMC7338661 DOI: 10.3389/fped.2020.00344] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2019] [Accepted: 05/26/2020] [Indexed: 01/25/2023] Open
Abstract
Recurrent wheezing (RW) in infancy is one of the most frequent reasons for parents to consult health care providers and creates a significant global burden. Clinical course of RW is difficult to predict, also which infants will progress to asthma, since no valid biomarkers have been established. Identification of those infants with RW who are at risk of further recurrences and/or severe acute respiratory tract infection (ARTI) could help pediatricians to improve their therapeutic decisions. Increasing research interest is focused on the extra-skeletal actions of vitamin D (VD) and the clinical impact of VD insufficiency/deficiency. As VD deficiency could be a risk factor for causing RW in children, measurement of their serum level of 25-hydroxycholecalciferol [25(OH)D] is recommended. In the case of deficiency, VD administration is recommended in age-appropriate doses for at least 6 weeks, until achievement of normal blood 25(OH)D level, followed by supplementation as long as exposure to sun is inadequate. Higher doses of VD given in an attempt to prevent asthma development appear to be of no additional benefit. In children with severe ARTI, VD level is recommended to be assess.
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Affiliation(s)
- Gavriela Feketea
- Department of Hematology, "Iuliu Hatieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania.,Department of Pediatrics, Pediatric Allergy Outpatient Clinic, "Karamandaneio" Children Hospital, Patras, Greece
| | - Corina I Bocsan
- Department of Pharmacology, Toxicology and Clinical Pharmacology, "Iuliu Hatieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Luminita Aurelia Stanciu
- Airways Disease Infection Section, National Heart and Lung Institute, Imperial College London, London, United Kingdom
| | - Anca Dana Buzoianu
- Department of Pharmacology, Toxicology and Clinical Pharmacology, "Iuliu Hatieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Mihnea Tudor Zdrenghea
- Department of Hematology, "Iuliu Hatieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania.,Department of Hematology, Ion Chiricuta Oncology Institute, Cluj-Napoca, Romania
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Pulvirenti G, Parisi GF, Manti S, Licari A, del Giudice MM, Salpietro C, Marseglia GL, Leonardi S. The Immunomodulatory Role of Vitamin D in Respiratory Diseases. CURRENT RESPIRATORY MEDICINE REVIEWS 2020. [DOI: 10.2174/1573398x15666191114144230] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
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The growing interest in the new role of vitamin D, particularly as an immunomodulatory
factor, has spurred basic research and the development of clinical trials to better understand the
influence of supplementation on various diseases. Vitamin D is an important nutrient factor in human
health due to its role in calcium metabolism regulation, cellular growth, differentiation and its
fundamental discovered activity in immune functions. It has influenced different diseases,
particularly inflammatory and autoimmune diseases, through immune response regulation,
modulating innate and adaptive immunity.
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The aim of this review was to explore the role of vitamin D in the main respiratory diseases in
children such as asthma, chronic rhinosinusitis, cystic fibrosis and recurrent respiratory infections.
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Affiliation(s)
- Giulio Pulvirenti
- Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
| | - Giuseppe Fabio Parisi
- Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
| | - Sara Manti
- Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
| | - Amelia Licari
- Department of Pediatrics, Fondazione IRCCS Policlinico San Matteo, University of Pavia, Pavia, Italy
| | - Michele Miraglia del Giudice
- Department of Woman, Child and General and Specialist Surgery, University of Campania "Luigi Vanvitelli", Naples, Italy
| | | | - Gian Luigi Marseglia
- Department of Pediatrics, Fondazione IRCCS Policlinico San Matteo, University of Pavia, Pavia, Italy
| | - Salvatore Leonardi
- Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
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