Article Contents
Clin Exp Pediatr > Volume 66(8); 2023 |
|
Study | Design | Subjects | Description | |
---|---|---|---|---|
Hollams et al. [12] 2011 | Large unselected cohort study | 989 (6-yr-olds)/1,380 (14-yr-olds) children: 689 subjects were assessed at both ages | Vitamin D levels at age 6 years were significant predictors of subsequent atopy/ asthma-associated phenotypes at age 14 years. | |
Clinical and immunological phenotyping at ages 6 and 14 years | ||||
Gazibara et al. [13] 2015 | Population-based prospective cohort study during 6 years | 3,130 Mothers/ their children | Low 25(OH)D levels at birth were associated with a higher airway resistance in childhood. | |
Serum 25(OH)D levels in midgestation and at birth | ||||
Chiu et al. [14] 2015 | Birth cohort of children aged from 0 to 4 years | A total of 164 mother-child pairs | Low maternal 25(OH)D levels appear not only to be associated with an increase in the prevalence of allergic sensitization but also the risk of asthma in early childhood. | |
Serum 25(OH)D levels in maternal blood before delivery, cord blood, and at ages 1.5, 3, and 4 | ||||
Mensink-Bout et al. [15] 2019 | A population-based prospective cohort | 4,951 Mothers/their children | The associations of 25(OH)D concentrations in midgestation with FEV1/FVC and FEF75% at age 10 years | |
Maternal (midgestation)/umbilical cord (birth) blood | ||||
At age 10 years, lung function, question- naire, and inhalant allergic sensitization by skin prick tests | ||||
Hypponen et al. [17] 2004 | The Northern Finland Birth Cohort | Those who attended clinical examination (n=6,007) were compared with those who were not invited or were invited but did not attend (n=5,630). | Association between vitamin D supplemen- tation in infancy and an increased risk of atopy and allergic rhinitis later in life, but not asthma | |
Vitamin D supplementation during the first year of life | ||||
Women during pregnancy and their offspring are followed up at ages 1, 14, and 31 years. | ||||
Bäck et al. [16] 2009 | A prospective birth cohort study up to the age of 6 years. | 123 (6-yr-olds) children | Prevention through modified vitamin D3 supplementation in infancy could reduce allergic diseases. | |
The relationship between lower or higher vitamin D3 intake and atopic illness later in childhood was assessed. | ||||
Goldring et al. [18] 2013 | A randomized controlled trial | 180 Pregnant women at 27 weeks gestation | Prenatal vitamin D supplementation in late pregnancy was not associated with de- creased wheezing in offspring at age 3 years. | |
Assessed offspring at 3 years | - No vitamin D (n=60) | |||
- Daily 800 IU ergocalciferol (n=60) | ||||
- Single 200,000 IU bolus of cholecalciferol (n=60) | ||||
Grant et al. [20] 2016 | A randomized, double-blind, placebo-con- trolled parallel-group trial | A total of 260 mother-child pairs | Vitamin D supplementation during pregnancy and infancy reduces the proportion of children sensitized to mites at age 18 months. | |
Pregnant women (from 27-week gestation to birth) and their infants (from birth to 6 months) | - Placebo (n=87) | |||
- Lower dose oral vitamin D (n=87) | There were study group differences in the proportion of children with primary care visits described by the doctor as being for asthma. | |||
Woman/infant pairs: placebo/placebo, 1,000/400 IU, or 2,000/800 IU | - Higher dose oral vitamin D (n=86) | |||
Litonjua et al. [19] 2016 | A randomized, double-blind, placebo-con- trolled trial: (1) parental report of physician-diagnosed asthma or recurrent wheezing through 3 years of age; (2) third trimester maternal 25(OH)D level | 881 Pregnant women (from 10 to 18 weeks' gestation) at high risk of having children with asthma | The incidence of asthma and recurrent wheezing in their children at age 3 years was lower by 6.1%, but this did not meet statistical significance. | |
- Daily 4,000 IU vitamin D+prenatal vita- min containing 400 IU vitamin D (n=440) | ||||
- Placebo+prenatal vitamin containing 400 IU vitamin D (n=436) |
Study | Design | Subjects | Description | |
---|---|---|---|---|
Brehm et al. [7] 2009 | Cross-sectional study | 616 Children with asthma (aged: 6–14 years) | Lower vitamin D levels are associated with increased markers of allergy and asthma severity. | |
Hospitalization/use of anti-inflammatory medications in the previous year | ||||
Alyasin et al. [21] 2011 | Case-control study and cross-sectional study | 50 Childhood asthmatics & 50 healthy controls (aged: 6–18 years) | 25(OH)D was significantly lower in asthmatic patients than controls and positively correlated with FEV1 and FEV1/FVC. | |
Serum vitamin D level, pulmonary function test, and eosinophil counts were examined | No correlation with eosinophil counts, asthma duration, number of hospitalizations, or unscheduled | |||
Chinellato et al. [23] 2011 | Case-control study and cross-sectional study | 45 Asthmatic & 59 healthy children (aged: 9–11 years) | No significant difference in the 25(OH)D level between the 2 groups. 25(OH)D positively correlated with FVC and FEV1 but negatively with exercise induced bronchoconstriction. | |
Serum vitamin D level, pulmonary function test, and exercise challenge test were examined. | ||||
Maalmi et al. [22] 2012 | Case-control and cross-sectional study | 39 Children with controlled asthma/30 controls (aged: 6–16 years): age- and sex- matched | Vitamin D deficiency was higher in asthma compared to control; vitamin D sufficiency was lower in asthma than control. | |
Vitamin D, Th1, Th2, Th17, Treg, and pulmonary function test | Th1/Th2 ratio and CD25(þ) Foxp3(þ) Treg cells were positively related to 25(OH) D level while IL-17 was negatively correlated. | |||
Ehlayel et al. [24] 2011 | Case-control study and cross-sectional study | 483 Asthma & 483 controls (aged: <15 years): age, gen- der & ethnicity matched | 25(OH)D levels were significantly lower, and IgE significantly higher in cases than in controls, with a negative correlation evident. | |
Serum vitamin D level and IgE | Vitamin D deficiency was the strongest predictor of asthma. | |||
Dabbah et al. [26] 2015 | Cross-sectional study | 71 Nonobese children with asthma (aged: 6–18 years) | No correlation was found between vitamin D level and response to the methacholine challenge test, FeNO, IgE levels, eosinophil counts. | |
Methacholine challenge test/FeNO) | ||||
Serum vitamin D, total IgE, blood eosinophil counts | ||||
Han et al. [25] 2017 | Using data from the National Health and Nutrition Examination Survey from 2001 to 2010 | Current asthma or wheeze in 10,860 children (6–17 years)/24,115 adults (18–79 years) | Positive correlation between vitamin D insufficiency (<30 ng/ mL) and current asthma or current wheeze in children and adults | |
Lung function in a subset of participants | Children with asthma (n=1,192) were likelier to have a higher BMI z score and a lower serum vitamin D level. | |||
Gupta et al. [28] 2011 | Case-control and cross-sectional study | 36 Children with steroid-resis- tant asthma, 26 with mode- rate asthma, and 24 healthy controls (aged: 6–16 years) | 25(OH)D levels were significantly lower in steroid-resistant asthma than either mild asthmatics or controls and inversely correlated with airway smooth muscle mass, bronchodilator response and IgE but positively correlated with asthma control, FEV1 and FVC. | |
25(OH)D, asthma control test, spirometry, corticosteroid use, and exacerbations were assessed. | ||||
Fiberoptic bronchoscopy, bronchoalveolar lavage, and endobronchial biopsy (severe, therapy-resistant asthma) | Low 25(OH)D was correlated with asthma exacerbation and medication usage | |||
Brehm et al. [29] 2012 | Case-control and cross-sectional study | 287 Asthmatic/ 273 healthy children (aged: 6–14 years). | No significant difference in 25(OH)D between cases and controls | |
Serum vitamin D level, pulmonary function test, and specific IgE | Lower 25(OH)D correlated with severe asthma exacerbation, atopy, and a lower FEV1/FVC in cases | |||
Turkeli et al. [30] 2016 | Case-control and cross-sectional study | 102 Preschool children with asthma/102 healthy controls in winter (aged: 1–4 years) | The frequency of vitamin D deficiency and insufficiency was higher in children with asthma, compared to the controls. | |
In the vitamin D-sufficient group, total number of exacerbations during the previous year was much lower compared to the vitamin D-insufficient group. | ||||
Yoseph et al. [34] 2015 | Double-blind, randomized, placebo- controlled trial | Children with mild asthma, PC20-FEV1 | No difference could be demonstrated between the effect of vitamin D and placebo | |
Methacholine challenge test, skin prick tests, FeNO, and exhaled breath con- densate collection | <16 mg/mL, and vitamin D <30 ng/mL for 6 weeks of treatment | |||
- Oral vitamin D 14,000 in 2-mL units once weekly | ||||
- Placebo (2 mL of olive oil) | ||||
Jensen et al. [31] 2016 | Double-blind, randomized, placebo- controlled trial | 22 preschool-aged children with asthma | Following 100,000 IU vitamin D3, all children reached serum 25OHD ≥75 nmol/L (>30 ng/mL), compared with half who received placebo. | |
Serum 25(OH)D: baseline, 10 days, 3/6 months | - 100,000 IU vitamin D3 (intervention)/placebo (control) | |||
- Followed by 400 IU vitamin D3 daily for 6 months | ||||
Tachimoto et al. [32] 2016 | Double-blind, randomized, placebo- controlled trial | Japanese schoolchildren with asthma | Low-dose, short-term vitamin D supplemen- tation in addition to standard treatment may improve levels of asthma control in schoolchildren. | |
Childhood asthma control test scores at 2, 6 months. | - Vitamin D3 supplements (800 IU/day) with placebo for 2 months | |||
Kerley et al. [33] 2016 | Double-blind, randomized, placebo- controlled trial | Caucasian 51 children from 44 urban (aged: 6–16 years) | Vitamin D3 supplementation led to a signifi- cant decreased school days missed. | |
Assessments were completed at base- line and after 15 weeks of supplemen- tation. | - Vitamin D supplementation (2,000 IU/day) | There were nonsignificant, advantageous changes in the placebo group compared with the vitamin D3 group in subjective asthma control and lung function, particularly percentage of predicted FEV1. | ||
Alansari et al. [35] 2017 | Randomized, controlled trial | Children with moderate-to-severe asthma and vitamin D levels<25 ng/mL for 12 months (aged: 2–14 years) | Rapid compared to maintenance vitamin D supplementation for children with the lowest levels resulted in short- but not long-term reduction in asthma exacer- bations. | |
- IM+ Oral group (n=116): 400 IU/d + 300,000 IU (IM, <5 years) or 600,000 IU (IM+ oral, >5 years) | ||||
- Oral-only group (n=115) : 400 IU/day | ||||
Kalmarzi et al. [39] 2020 | Interventional study | 68 Asthmatic children | Therapeutic prescription of vitamin D is very effective in improving the clinical status of asthmatic children. | |
Serum levels of 25(OH)D, asthma se- verity and pulmonary function tests before and after therapeutic prescrip- tion of vitamin D | - Vitamin D levels <10 ng/mL: 800-IU capsules (#4) a day for 12 weeks or 50,000-IU tablets (#1) a day for up to 6 days at secondary care level: cholecalciferol 300,000-unit ampoules once a month for 3 months | |||
- Vitamin D levels: 10–30 ng/mL: Vitamin D was administered based on the patient's calcium level | ||||
Forno et al. [37] 2020 | Double-blind, randomized, placebo-con- trolled trial | 400 with low-dose inhaled corticosteroids and serum 25(OH) D levels <0 ng/mL (aged: 6–16 years) | Among children with persistent asthma and low vitamin D levels, vitamin D3 supple- mentation, compared with placebo, did not significantly improve the time to a severe asthma exacerbation. | |
Pulmonary function test | - Vitamin D3, 4,000 IU/d (n=96) | |||
Asthma Control Test (≥12 years)/Child- hood ACT (<12 years) | - Placebo (n=96) for 48 weeks | The findings do not support the use of vitamin D3 supplementation to prevent severe asthma exacerbations in this group of patients. | ||
Maintained with fluticasone propionate | ||||
Thakur et al. [38] 2021 | Double-blind, randomized, placebo- controlled trial | 60 Children with moderate persistent asthma and placebo (n=30) (aged: 6–11 years) | Vitamin‐D supplementation as an adjunct to standard treatment does not improve asthma control in children. | |
Childhood asthma control test scores at 12 weeks | ||||
FEV1, FeNO, asthma exacerbations, use of systemic steroids, number of emer- gency visits, postintervention vitamin D levels, and adverse outcomes | - 2,000 IU per day of vitamin D |
25(OH)D, 25-hydroxyvitamin D; FEF75%, forced expiratory flow at 75%; FeNO, fraction of exhaled nitric oxide; FEV1, forced expiratory volume in 1 second; FVC, forced vital capacity; IgE, immunoglobulin E; IU, international unit; Treg, regulatory T cells; PC20, provocation concentration of methacholine required to induce a 20% decrease in FEV1.
Study | Design | Subjects | Description | |
---|---|---|---|---|
Turer et al. [45] 2013 | Cross-sectional study (the 2003–2006 National Health and Nutrition Examination Survey) | 12,292 Children (aged: 6–18 years) | Compared with healthy-weight children, overweight, obese, and severely obese children had significantly greater adjusted odds of vitamin D deficiency. | |
Age- and gender-specific BMI- percentile cut point | - 79% of children with overweight (BMI 85th–95th percentile for age and gender) | |||
- 86% of children with obesity (BMI≥ 95th percentile) | Vitamin D deficiency is highly prevalent in overweight and obese children. | |||
Lautenbacher et al. [47] 2016 | Cross-sectional study | 72 Obese and 71 normal-weight Hispanic and African-American children with asthma recruited at an urban children's hospital (aged: 7–11 years) | Vitamin D deficiency was associated with pulmonary function deficits among obese children, but not among normal- weight children with asthma, an association that was independent of Th1 and Th2 serum inflammatory measures. | |
Pulmonary function test, serum vitamin D and cytokines | ||||
Reinehr et al. [46] 2018 | NIKI cohort | 235 Children (60% boys, age 9.3±1.7 years) with obesity, ADHD, BA, and AD | Vitamin D concentrations were not lower in children with obesity, ADHD, BA, and AD compared to healthy children. | |
Multicenter study between 2013 and 2016 | 3,352 children from a healthy population | Vitamin D levels were not linked to the severity of asthma measured as FEV1. | ||
Bose et al. [48] 2019 | Longitudinal cohort study | 120 Children with physician-diagnosed asthma (aged: 5–12 years) | Among obese urban children with asthma, low vitamin 25(OH) D enhanced adverse respiratory effects associated with indoor PM2.5. | |
Indoor PM2.5, serum 25(OH)D levels and asthma symptoms | 25-OH D was protective against asthma symptoms in high PM2.5 environments. |