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Long-term effects of vitamin D on exacerbation rate, health care utilization and lung function in children with
Qinyuan Li1, Qi Zhou2, Guangli Zhang1
1Department of Respiratory Medicine, Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, Chongqing, China.
Insights
Maintaining sufficient vitamin D levels in children with asthma is linked to fewer exacerbations and hospital visits over three years. However, these protective benefits diminish over time, highlighting the need for ongoing monitoring.
Area of Science:
- Pediatric Pulmonology
- Nutritional Immunology
- Clinical Pediatrics
Background:
- Asthma exacerbations significantly impact children's health, leading to unplanned healthcare use and reduced lung function.
- Vitamin D sufficiency offers short-term protection against asthma exacerbations in children, but long-term effects remain under investigation.
Purpose of the Study:
- To evaluate the long-term impact of vitamin D levels on asthma exacerbations, healthcare utilization, and lung function in children.
- To investigate the temporal trends of vitamin D's protective effects in pediatric asthma.
Main Methods:
- Retrospective cohort study of children with asthma admitted between 2017-2021.
- Multivariable regression analysis (Negative binomial, Poisson, logistic) adjusting for confounders.
- Assessment of asthma exacerbations, emergency visits/hospitalizations, and lung function over three years.
Main Results:
- Higher vitamin D levels correlated with reduced asthma exacerbations and fewer emergency visits/hospitalizations over three years.
- Vitamin D levels were negatively associated with large and small airway dysfunction in the first year.
- The protective association of vitamin D showed a decreasing trend over the follow-up period.
Conclusions:
- Sufficient vitamin D levels are associated with a reduced risk of asthma exacerbations and healthcare utilization in children over three years.
- Vitamin D sufficiency also demonstrated improved lung function within the first year of follow-up.
- The protective effects of vitamin D on asthmatic children gradually decreased over time.
Background:
Asthma exacerbations lead to unplanned health care utilization and reduced lung function in children. Sufficient vitamin D level has been found to have a short-term protective effect against asthma exacerbation in children. However, it is unclear whether this effect remains in the long term. We evaluated the long-term effects of vitamin D levels on the occurrence of asthma exacerbations, emergency department visits or hospitalizations, and lung function among children with asthma, and further investigated the temporal trends of the effects.
Methods:
In this retrospective cohort study, children with asthma who were admitted to the Children's Hospital of Chongqing Medical University from 2017 to 2021 were enrolled. Negative binomial, Poisson, or logistic regression model was used for the multivariable analysis, adjusting for age, sex, body mass index z-score, and severity of asthma exacerbation.
Results:
Of the 370 children with asthma, 87.8% had vitamin D level less than or equal to 30 ng/mL. After adjustment for confounding factors, higher baseline vitamin D levels in asthma children were significantly associated with reduced occurrence of asthma exacerbations during the first [odds ratio 0.842, 95% confidence interval (CI): 0.805-0.881; P<0.001], second (odds ratio 0.848, 95% CI: 0.793-0.907; P<0.001) and third years (odds ratio 0.865, 95% CI: 0.811-0.922; P<0.001) of follow-up. Higher vitamin D levels in asthmatic children were also strongly associated with a reduced number of emergency department visits or hospitalizations during the first (odds ratio 0.880, 95% CI: 0.842-0.920; P<0.001), second (odds ratio 0.885, 95% CI: 0.832-0.941; P<0.001), and third years (odds ratio 0.922, 95% CI: 0.851-0.998; P=0.044) of follow-up. In addition, the vitamin D levels in asthmatic children were found to be negatively associated with the odds of large airway dysfunction (odds ratio 0.865, 95% CI: 0.771-0.970; P=0.013) and small airway dysfunction (odds ratio 0.922, 95% CI: 0.855-0.996; P=0.038) during the first year of follow-up.
Conclusions:
Sufficient vitamin D level is associated with lower risk of asthma exacerbations and health care utilization over a 3-year period, and improved lung function over 1 year. The protective effects of vitamin D on asthmatic children decreased over time.
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