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Published on: August 7, 2017
Vitamin D and atopy and asthma phenotypes in children: a longitudinal cohort study
E M Hollams1, P H Hart, B J Holt
1Telethon Institute for Child Health, 100 Roberts Road, Subiaco WA 6008, Australia.
Insights
Low vitamin D levels in children, especially males, are linked to increased risk of developing allergies and asthma. Inadequate vitamin D at age 6 predicts later development of atopy and bronchial hyperresponsiveness.
Area of Science:
- Pediatric Allergy and Immunology
- Nutritional Epidemiology
- Respiratory Medicine
Background:
- The role of vitamin D in the development of atopy and asthma at the community level remains unclear.
- Previous studies have suggested links between vitamin D and established allergic diseases in children.
- Understanding vitamin D's influence on disease inception is crucial for preventative strategies.
Purpose of the Study:
- To investigate the association between vitamin D status and allergy/asthma development in children.
- To examine vitamin D as a potential risk modifier for respiratory and allergic outcomes.
- To determine the predictive value of early-life vitamin D levels for later disease phenotypes.
Main Methods:
- Serum vitamin D levels were measured in a large community birth cohort of children aged 6 and 14 years in Perth, Australia.
- Phenotypic data for allergic and respiratory outcomes were previously ascertained.
- Statistical analyses assessed the association between vitamin D levels and concurrent/subsequent phenotypes, including sex-specific effects.
Main Results:
- Serum vitamin D levels showed a negative association with concurrent allergic phenotypes in children of both ages, primarily in males.
- Vitamin D levels at age 6 years significantly predicted the development of atopy and asthma-associated phenotypes at age 14 years.
- Inadequate vitamin D levels were associated with increased risk of atopy and bronchial hyperresponsiveness (BHR) in males at both 6 and 14 years.
Conclusions:
- Inadequate vitamin D status in childhood, particularly in males, increases the risk of developing atopy.
- Low vitamin D levels are a significant predictor of subsequent bronchial hyperresponsiveness and asthma development.
- Community-level vitamin D status may play a critical role in the inception of allergic respiratory diseases in children.
Abstract:
Vitamin D has been linked in some studies with atopy- and asthma-associated phenotypes in children with established disease, but its role in disease inception at the community level is less clear. The aim of the present study was to investigate associations between vitamin D status and biological signatures indicative of allergy and asthma development in children aged 6 and 14 years in Perth, WA, Australia (latitude 32° S). Serum vitamin D was assayed in 989 6-yr-olds and 1,380 14-yr-olds from an unselected community birth cohort; 689 subjects were assessed at both ages. Vitamin D levels were assessed as a risk modifier for respiratory and allergic outcomes at both ages, using previously ascertained phenotypic data. The predictive value of vitamin D levels at age 6 yrs for development of clinical phenotypes at age 14 yrs was also examined. Serum vitamin D levels in children of both ages were negatively associated with concurrent allergic phenotypes; sex stratification revealed that this association was restricted mainly to males. Furthermore, vitamin D levels at age 6 yrs were significant predictors of subsequent atopy/asthma-associated phenotypes at age 14 yrs. In an unselected community setting, children (particularly males) with inadequate vitamin D are at increased risk of developing atopy, and subsequently bronchial hyperresponsiveness (BHR) and asthma. In a large unselected cohort, males with inadequate vitamin D at 6 and 14 yrs of age had increased atopy and BHR. Low vitamin D at age 6 yrs was a predictor of atopy and asthma at 14 yrs of age.
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