Vitamin D with asthma and COPD: not a false hope? A systematic review and meta-analysis

Vitamin D deficiency and insufficiency are increasingly being recognized in the general population over the last few decades. However, a number of other disorders have now been linked to vitamin D deficiency and insufficiency, including asthma and COPD. The aim of this study was to evaluate the evidence on the effect of vitamin D on asthma and COPD. We searched electronic databases including SCI, EMBASE, Ovid, and PubMed. Reviewers working independently and in duplicate extracted study characteristics, quality, and the outcomes. The weighted mean differences across trials and random-effect meta-analysis were used to pool the relative risks (RR). This is the first meta-analysis about the risk of vitamin D deficiency for asthma and COPD. Ten studies were available for this meta-analysis and systematic review. The prevalence of vitamin D deficiency was significantly greater among cases than control subjects [RR=1.59, 95%CI=1.07-2.36, 488/812 (60%) vs 278/875 (32%)] for asthma. However, vitamin D insufficiency was not significantly associated with asthma [RR=1.09, 95%CI=0.91-1.30, 702/996 (70%) vs 665/1016 (65%)]. Moreover, studies failed to demonstrate that COPD patients had an increased risk for vitamin D deficiency or insufficiency compared to controls (RR=0.89, 95%CI=0.63-1.25). Vitamin D deficiency was associated with a significant decrease in lung function in asthmatic children. Vitamin D deficiency was highly prevalent in asthma patients, and vitamin D status was associated with lung function. COPD cannot be considered as completely free of vitamin D deficiency.