Vitamin D insufficiency and severe asthma exacerbations in Puerto Rican children

John M. Brehm, Edna Acosta-Pérez, Lambertus Klei, Kathryn Roeder, Michael Barmada, Nadia Boutaoui, Erick Forno, Roxanne Kelly, Kathryn Paul, Jody Sylvia, Augusto A. Litonjua, Michael Cabana, María Alvarez, Angel Colón-Semidey, Glorisa Canino, Juan C. Celedón

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Abstract

Rationale: Vitamin D insufficiency (a serum 25(OH)D <30 ng/ml) has been associated with severe asthma exacerbations, but this could be explained by underlying racial ancestry or disease severity. Little is known about vitamin D and asthma in Puerto Ricans. Objectives: To examine whether vitamin D insufficiency is associated with severe asthma exacerbations in Puerto Rican children, independently of racial ancestry, atopy, and time outdoors. Methods: A cross-sectional study was conducted of 560 children ages 6-14 years with (n = 287) and without (n = 273) asthma in San Juan, Puerto Rico. We measured plasma vitamin D and estimated the percentage of African racial ancestryamongparticipants usinggenomewide genotypic data. We tested whether vitamin D insufficiency is associated with severe asthma exacerbations, lung function, or atopy (greater than or equal to one positive IgE to allergens) using logistic or linear regression. Multivariate models were adjusted for African ancestry, time outdoors, atopy, and other covariates. Measurements and Main Results: Vitamin D insufficiency was common in children with (44%) and without (47%) asthma. In multivariate analyses, vitamin D insufficiency was associated with higher odds of greater than or equal to one severe asthma exacerbation in the prior year (odds ratio [OR], 2.6; 95% confidence interval [CI], 1.5-4.9; P =0.001) and atopy, and a lower FEV 1/FVC in cases. After stratification by atopy, the magnitude of the association between vitamin D insufficiency and severe exacerbations was greater in nonatopic (OR, 6.2; 95% CI, 2-21.6; P = 0.002) than in atopic (OR, 2; 95% CI, 1-4.1; P =0.04) cases. Conclusions: Vitamin D insufficiency is associated with severe asthma exacerbations in Puerto Rican children, independently of racial ancestry, atopy, or markers of disease severity or control.

Original languageEnglish (US)
Pages (from-to)140-146
Number of pages7
JournalAmerican journal of respiratory and critical care medicine
Volume186
Issue number2
DOIs
StatePublished - Jul 15 2012

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ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine
  • Critical Care and Intensive Care Medicine

Cite this

Brehm, J. M., Acosta-Pérez, E., Klei, L., Roeder, K., Barmada, M., Boutaoui, N., Forno, E., Kelly, R., Paul, K., Sylvia, J., Litonjua, A. A., Cabana, M., Alvarez, M., Colón-Semidey, A., Canino, G., & Celedón, J. C. (2012). Vitamin D insufficiency and severe asthma exacerbations in Puerto Rican children. American journal of respiratory and critical care medicine, 186(2), 140-146. https://doi.org/10.1164/rccm.201203-0431OC