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Vitamin D levels in asthmatic patients with and without allergic bronchopulmonary aspergillosis
Ritesh Agarwal1, Inderpaul S Sehgal1, Sahajal Dhooria1
1Department of Pulmonary Medicine, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India.
Abstract:
Vitamin D deficiency is believed to be a pathogenetic factor in patients with allergic bronchopulmonary aspergillosis (ABPA) and cystic fibrosis. Whether vitamin D deficiency is also prevalent in ABPA complicating asthma, remains unknown. Herein, we evaluated vitamin D levels in asthmatic patients with and without ABPA. In a prospective study, plasma vitamin D (25[OH]D) levels were measured in consecutive subjects with asthma (n = 75), ABPA (n = 158) and healthy volunteers (n = 50). Vitamin D levels <20 ng/mL were considered as vitamin D deficiency. There was no difference in mean (95% CI) vitamin D levels between healthy controls (15.3 [12.7-17.9]), asthmatics (19.2 [16.3-22.1]) and subjects with ABPA (18.9 [16.9-20.8]) (P = .22). Vitamin D deficiency was encountered in 70%, 64% and 65% of the healthy controls, asthmatics and ABPA subjects, respectively, and was not different between the groups (P = .79). There was no difference in the asthma control, pulmonary function, immunological findings and the severity of bronchiectasis, in patients with ABPA, with and without vitamin D deficiency. Vitamin D deficiency is equally prevalent in asthmatic patients with or without ABPA in the Indian subcontinent, and does not appear to play a major role in the pathogenesis of ABPA complicating asthma.
Insights
Vitamin D deficiency is common in asthma and allergic bronchopulmonary aspergillosis (ABPA) patients. This study found no difference in vitamin D levels or deficiency prevalence between these groups, suggesting it
Area of Science:
- Immunology
- Pulmonology
- Endocrinology
Background:
- Vitamin D deficiency is implicated in allergic bronchopulmonary aspergillosis (ABPA) and cystic fibrosis.
- Its role in ABPA complicating asthma is not well understood.
Purpose of the Study:
- To evaluate vitamin D levels in asthmatic patients with and without ABPA.
- To determine if vitamin D deficiency influences ABPA in asthma.
Main Methods:
- Prospective study measuring plasma 25(OH)D levels.
- Included subjects with asthma (n=75), ABPA (n=158), and healthy controls (n=50).
- Defined vitamin D deficiency as levels <20 ng/mL.
Main Results:
- No significant difference in mean vitamin D levels between healthy controls, asthmatics, and ABPA patients (P=.22).
- Vitamin D deficiency prevalence was similar across all groups (P=.79).
- No association found between vitamin D status and asthma control, lung function, or bronchiectasis severity in ABPA patients.
Conclusions:
- Vitamin D deficiency is equally prevalent in asthmatic patients with or without ABPA.
- Vitamin D deficiency does not appear to be a major factor in the pathogenesis of ABPA complicating asthma.
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