The impact of Vitamin D deficiency on asthma, allergic rhinitis and wheezing in children: An emerging public health problem

Background: Vitamin D deficiency has been declared a public health problem for both adults and children worldwide. Asthma and related allergic diseases are the leading causes of morbidity in children. The objective of this study was to investigate the potential role of Vitamin D deficiency in childhood asthma and other allergic diseases such as allergic rhinitis and wheezing. Materials and Methods: This cross-sectional study was conducted in Primary Health Care Centers (PHCs), from March 2012 to October 2013. A total of 2350 Qatari children below the age of 16 were selected from PHCs, and 1833 agreed to participate in this study giving a response rate of (78%). Face-to-face interviews with parents of all the children were based on a questionnaire that included variables such as socio-demographic information, assessment of nondietary covariates, Vitamin D intake, type of feeding, and laboratory investigations. Their health status was assessed by serum Vitamin D (25-hydoxyvitamin D), family history and body mass index. Results: Most of the children who had asthma (38.5%), allergic rhinitis (34.8%) and wheezing (35.7%) were below 5 years. Consanguinity was significantly higher in parents of children with allergic rhinitis (48.6%), followed by those with asthma (46.4%) and wheezing (40.8%) than in healthy children (35.9%) (P < 0.001). The proportion of severe Vitamin D deficiency was significantly higher in children with wheezing (23.4%), allergic rhinitis (18.5%), and asthma (17%) than in healthy children (10.5%). Exposure to the sun was significantly less in Vitamin D deficient children with asthma (60.3%), allergic rhinitis (62.5%) and wheezing (64.4%) than in controls (47.1%) (P = 0.008). It was found that Vitamin D deficiency was a significant correlate for asthma (odds ratio [OR] =2.31; P < 0.001), allergic rhinitis (OR = 1.59; P < 0.001) and wheezing (relative risk = 1.29; P = 0.05). Conclusion: The study findings revealed a high prevalence of Vitamin D deficiency in children with asthma and allergic diseases. Vitamin D deficiency was a strong correlate for asthma, allergic rhinitis and wheezing.

[1]  D. Fabian,et al.  The global burden of asthma: executive summary of the GINA Dissemination Committee Report , 2004, Allergy.

[2]  R. Peng,et al.  Outdoor exposure and vitamin D levels in urban children with asthma , 2010, Nutrition Journal.

[3]  S. Weiss,et al.  Maternal diet vs lack of exposure to sunlight as the cause of the epidemic of asthma, allergies and other autoimmune diseases , 2007, Thorax.

[4]  K. Smejda,et al.  Vitamin D supplementation in children may prevent asthma exacerbation triggered by acute respiratory infection. , 2011, The Journal of allergy and clinical immunology.

[5]  Abdulbari Bener,et al.  Genetics and environmental risk factors associated with asthma in schoolchildren. , 2005, European annals of allergy and clinical immunology.

[6]  S. Alsowaidi,et al.  Role of breast feeding in primary prevention of asthma and allergic diseases in a traditional society. , 2007, European annals of allergy and clinical immunology.

[7]  Q. Hamid,et al.  Vitamin D Deficiency as a Strong Predictor of Asthma in Children , 2011, International Archives of Allergy and Immunology.

[8]  C. Hawrylowicz,et al.  Vitamin D and asthma: time for intervention? , 2009, American journal of respiratory and critical care medicine.

[9]  K. Dear,et al.  The role of latitude, ultraviolet radiation exposure and vitamin D in childhood asthma and hayfever: an Australian multicenter study , 2011, Pediatric allergy and immunology : official publication of the European Society of Pediatric Allergy and Immunology.

[10]  Ann R Webb,et al.  Who, what, where and when-influences on cutaneous vitamin D synthesis. , 2006, Progress in biophysics and molecular biology.

[11]  A. Bener,et al.  Is high prevalence of vitamin D deficiency evidence for asthma and allergy risks? , 2011, European annals of allergy and clinical immunology.

[12]  D. Lawlor,et al.  Prospective Association of 25-Hydroxyvitamin D3 and D2 with Childhood Lung Function, Asthma, Wheezing, and Flexural Dermatitis , 2013, Epidemiology.

[13]  S. Sasaki,et al.  Dairy food, calcium and vitamin D intake in pregnancy, and wheeze and eczema in infants , 2009, European Respiratory Journal.

[14]  K. Roeder,et al.  Vitamin D insufficiency and severe asthma exacerbations in Puerto Rican children. , 2012, American journal of respiratory and critical care medicine.

[15]  S. Willsie.  Maternal vitamin D intake during pregnancy and early childhood wheezing , 2008 .

[16]  Q. Hamid,et al.  Vitamin D deficiency and severe asthma. , 2013, Pharmacology & therapeutics.

[17]  J. Brehm,et al.  Serum vitamin D levels and severe asthma exacerbations in the Childhood Asthma Management Program study. , 2010, The Journal of allergy and clinical immunology.

[18]  T. Casale,et al.  The role of vitamin D in asthma. , 2010, Annals of allergy, asthma & immunology : official publication of the American College of Allergy, Asthma, & Immunology.

[19]  A. Litonjua.  Childhood asthma may be a consequence of vitamin D deficiency , 2009, Current opinion in allergy and clinical immunology.

[20]  A. Litonjua,et al.  Maternal intake of vitamin D during pregnancy and risk of recurrent wheeze in children at 3 y of age. , 2007, The American journal of clinical nutrition.

[21]  A. Bener,et al.  International Journal of Women's Health Dovepress Association between Vitamin D Insufficiency and Adverse Pregnancy Outcome: Global Comparisons , 2022 .

[22]  S. Teach,et al.  High prevalence of vitamin D deficiency among inner-city African American youth with asthma in Washington, DC. , 2010, The Journal of pediatrics.

[23]  A. Litonjua,et al.  Is vitamin D deficiency to blame for the asthma epidemic? , 2007, The Journal of allergy and clinical immunology.

[24]  A. Bener,et al.  Vitamin D deficiency in healthy children in a sunny country: associated factors , 2009, International journal of food sciences and nutrition.

[25]  R. Heaney,et al.  Low vitamin D status despite abundant sun exposure , 2007 .

[26]  C. Camargo,et al.  Regional differences in EpiPen prescriptions in the United States: the potential role of vitamin D. , 2006, The Journal of allergy and clinical immunology.

[27]  C. Camargo,et al.  Regional differences in EpiPen prescriptions in the United States: the potential role of vitamin D. , 2006, The Journal of allergy and clinical immunology.

[28]  A. Litonjua,et al.  Childhood asthma is a fat‐soluble vitamin deficiency disease , 2008, Clinical and experimental allergy : journal of the British Society for Allergy and Clinical Immunology.

[29]  A. Alipour,et al.  The Relationship Between Serum 25 Hydroxy Vitamin D Levels and Asthma in Children , 2011, Allergy, asthma & immunology research.