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Vitamin D deficiency and asthma morbidity in school-age children: a single-center cohort study
1Department of Pediatrics, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China.
Insights
Vitamin D deficiency is common in children with asthma, linked to worse asthma control and more exacerbations. Routine screening and supplementation are recommended for better pediatric asthma management.
Area of Science:
- Pediatric Pulmonology
- Nutritional Immunology
- Public Health
Background:
- Asthma is a significant cause of childhood illness globally.
- Vitamin D deficiency is increasingly recognized as a factor in immune regulation and respiratory health.
- Limited data exist on vitamin D's association with asthma control and exacerbations in children from low- and middle-income populations.
Purpose of the Study:
- To investigate the prevalence of vitamin D deficiency in school-age children with asthma.
- To determine the association between vitamin D status and asthma control, exacerbation frequency, and hospitalization rates.
- To identify vitamin D deficiency as an independent predictor of poor asthma control in pediatric patients.
Main Methods:
- Retrospective study of 210 children (6-14 years) diagnosed with asthma.
- Data collected included demographics, asthma control, exacerbations, hospitalizations, and serum vitamin D levels.
- Statistical analyses included chi-squared tests, ANOVA, and multivariable logistic regression.
Main Results:
- Vitamin D deficiency was prevalent in 45.2% of children; insufficiency in 31.0%.
- Poor asthma control (63.2%), higher exacerbations (2.6/year), and hospitalizations (31.6%) were significantly more common in deficient children.
- Vitamin D deficiency independently predicted poor asthma control (aOR: 2.8, p < 0.001).
Conclusions:
- Vitamin D deficiency is highly prevalent in children with asthma and linked to poorer disease control and outcomes.
- Routine vitamin D screening and supplementation should be considered in pediatric asthma care.
- Public health initiatives focusing on nutritional interventions may reduce asthma burden in children.
Background:
Asthma remains a major cause of morbidity among school-age children worldwide, with deficiency of vitamin D increasingly recognized as a modifiable factor influencing immune regulation and respiratory health. However, evidence on its association with asthma control and exacerbation patterns in pediatric populations is limited, in low- and middle-income population.
Methods:
A retrospective single-center study of 320 children, 6-14 years, diagnosed with asthma between January 2019 and December 2023. Following application of inclusion and exclusion criteria, 210 children were analyzed. Data were obtained from medical records and structured questionnaires, including socio-demographic characteristics, asthma control status, exacerbation frequency, hospitalization history, and biochemical assays (serum vitamin D, calcium, phosphate, parathyroid hormone). Patients were categorized as vitamin D deficient, insufficient, or sufficient. Statistical analyses, including χ2 tests, ANOVA, and multivariable logistic regression, were performed using R (v4.3.2).
Results:
Vitamin D deficiency was prevalent in 45.2% of children, while 31.0% were insufficient and 23.8% sufficient. Poor asthma control was more common among deficient children (63.2%) compared to insufficient (43.1%) and sufficient groups (24.0%). The mean annual exacerbation rate was highest in the deficient group (2.6 ± 1.3) vs. insufficient (1.9 ± 1.1) and sufficient groups (1.1 ± 0.9). Hospitalization rates also differed significantly (31.6, 18.5, and 12.0%, respectively; p = 0.014). Multivariable logistic regression confirmed that vitamin D deficiency independently predicted poor asthma control (adjusted OR: 2.8, 95% CI: 1.6-4.9, p < 0.001) after adjustment for age, sex, BMI, and treatment profile.
Conclusion:
Vitamin D deficiency is highly prevalent among school-age children with asthma and is independently associated with poor control, higher exacerbation frequency, and increased hospitalizations. As part of integrated pediatric asthma care, these findings emphasize the significance of routine screening and the need to take vitamin D supplements into account. At the public health level, targeted nutritional interventions may reduce disease burden and improve long-term outcomes in children.
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