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Vitamin D Status Modifies the Response to Indoor Particulate Matter in Obese Urban Children with Asthma
Sonali Bose1, Gregory B Diette2, Han Woo1
1Department of Pulmonary and Critical Care Medicine, Johns Hopkins School of Medicine, Baltimore, Md.
Background:
Indoor fine particulate air pollution (PM2.5) is linked to asthma morbidity; however, whether vitamin D status influences individual susceptibility to airborne exposures is unclear.
Objective:
We aimed to determine if vitamin D modifies the effects of indoor PM2.5 on asthma symptoms in urban children.
Methods:
A total of 120 children aged 5 to 12 years with physician-diagnosed asthma were evaluated at baseline and every 3 months for 9 months. Indoor PM2.5, serum 25-hydroxy vitamin D (25-OH D) levels, and asthma symptoms were simultaneously assessed at each time point. Adjusting for confounders, generalized estimating equations assessed the 3-way interaction effects of 25-OH D, obesity, and PM on asthma symptoms.
Results:
Children were of mean (standard deviation [SD]) age 9.7 (2.2) years, 36% were obese, and 95% self-reported black race. Mean (SD) PM2.5 indoor exposure was 38.2 (42.9) μg/m3 and 25-OH D was 19.1 (7.5) ng/mL. Three-way interaction models demonstrated significantly greater PM2.5-associated effects on daytime asthma symptoms only among obese children with low 25-OH D levels (odds ratio [OR]PM2.5 = 1.26, P = .049 at vitamin D = 15.5 ng/mL, increasingly stronger PM effects at levels <15.5 ng/mL). In homes with increased PM2.5, higher 25-OH D was associated with decreased symptom odds (eg, ORVitamin D = 0.87; P = .049 at PM2.5 = 52.5 μg/m3, increasingly protective effects >52.5 μg/m3) among obese children.
Conclusions:
Among obese urban children with asthma, low individual 25-OH D enhanced adverse respiratory effects associated with indoor PM2.5. In high PM2.5 environments, 25-OH D was protective against asthma symptoms. Optimizing vitamin D status in children may help reduce asthma morbidity driven by indoor air pollution.
Insights
Low vitamin D levels worsen asthma symptoms in obese children exposed to indoor fine particulate matter (PM2.5). Optimizing vitamin D may reduce asthma morbidity from air pollution.
Area of Science:
- Environmental Health
- Pediatric Pulmonology
- Nutritional Immunology
Background:
- Indoor fine particulate air pollution (PM2.5) is a known asthma trigger.
- The role of vitamin D status in susceptibility to PM2.5-induced asthma morbidity is not well understood.
Purpose of the Study:
- To investigate whether vitamin D status modifies the impact of indoor PM2.5 on asthma symptoms in urban children.
- To explore the interaction between vitamin D, obesity, and PM2.5 exposure on asthma exacerbations.
Main Methods:
- Longitudinal study of 120 children (5-12 years) with asthma over 9 months.
- Simultaneous assessment of indoor PM2.5, serum 25-hydroxy vitamin D (25-OH D), and asthma symptoms.
- Statistical analysis using generalized estimating equations to evaluate three-way interaction effects.
Main Results:
- Obese children with low 25-OH D showed significantly increased asthma symptoms with higher PM2.5 exposure.
- In high PM2.5 environments, higher 25-OH D levels were associated with reduced asthma symptom severity among obese children.
- Low vitamin D status (below 15.5 ng/mL) amplified the adverse respiratory effects of PM2.5 in obese children.
Conclusions:
- Low vitamin D status exacerbates the negative respiratory effects of indoor PM2.5 in obese children with asthma.
- Adequate vitamin D levels can be protective against asthma symptoms in polluted environments.
- Improving vitamin D status may be a strategy to mitigate asthma morbidity linked to indoor air pollution.
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