Abstract
Objective
To investigate vitamin D levels in patients with recurrent wheeze at early ages of childhood.
Methods
In the present cross-sectional study, serum 25-hydroxy vitamin D [25 (OH)D], levels which is known as an indicator of vitamin D adequacy, was examined in infants with three or more wheezing attacks.
Results
A total of 186 infants with recurrent wheezing were included in the study along with 118 healthy control peers. The recurrent wheezing study participants were classified into two groups according to Asthma Predictive Index (API) positivity and compared to control subjects regarding their serum vitamin D status. The API negative group had the lowest mean serum 25 (OH)D level (n = 121; 22.71 ± 10.76 ng/ml) followed by API positive group (n = 65; 24.08 ± 9.02 ng/ml) compared to healthy group (26.24 ± 11.88 ng/ml) (p < 0.05). In addition, higher vitamin D deficiency was observed in infants in API negative group (52.1 %; p < 0.01) and API positive group (38.5 %; p < 0.05) than control group (31.4 %).
Conclusions
Low levels of 25 (OH)D were detected in infants with two different phenotypes of recurrent wheeze. Vitamin D deficiency may play a role in the pathogenesis of infants with recurrent wheezing.
Similar content being viewed by others
References
Mansbach JM, Camarrgo CA. Respiratory viruses in bronchiolitis and their link to recurrent wheezing and asthma. Clin Lab Med. 2009;29:741–55.
Liu AH, Covar RA. Asthma: clinical features, outcomes, and prognosis. In: Taussig LM, Landau LI, Le Souëf PN, Martinez FD, Morgan WJ, Sly PD, editors. Pediatric respiratory medicine. Philadelphia: Mosby EIsevier; 2008. p. 805–27.
Martinez FD, Wright AL, Taussig LM, Holberg CJ, Halonen M, Morgan WJ. Asthma and wheezing in the first six years of life. N Engl J Med. 1995;332:133–8.
Castro-Rodriguez JA, Holberg CJ, Wright AL, Martinez F. A clinical index to define risk of asthma in young children with recurrent wheeze. Am J Respir Crit Care Med. 2000;162:1403–6.
GuiIbert TW, Morgan WJ, Zeiger RS, et al. Atopic characteristics of children with recurrent wheezing at risk for the development of childhood asthma. J Allergy Clin Immunol. 2004;114:1282–7.
Comberiati P, Tsabouri S, Piacentini GL, Serena M, Minniti F, Peroni PG. Is vitamin D deficiency correlated with childhood wheezing and asthma? Front Biosci (Elite Ed). 2014;6:31–9.
Kamen DL, Tangpricha V. Vitamin D and molecular actions on the immune system: modulation of innate and otoimmunity. J Mol Med. 2010;88:441–50.
Lange NE, Litonjua A, Hawrylowicz CM, Weiss S. Vitamin D, the immune system and asthma. Expert Rev Clin Immunol. 2009;5:693–702.
White JH. Vitamin D as an inducer of cathelicidin antimicrobial peptide expression: past, present and future. J Steroid Biochem Mol Biol. 2010;121:234–8.
Bosse Y, Maghni K, Hudson TJ. 1 alpha,25-dihydroxy-vitamin D3 stimulation of bronchial smooth muscle cells induces autocrine, contractility, and remodeling process. Physiol Genomics. 2007;29:161–8.
Damera G, Fogle HW, Lim P, et al. Vitamin D inhibits growth of human airway smooth muscle cells through growth factor-induced phosphorylation of retinoblastoma protein and checkpoint kinase 1. Br J Pharmacol. 2009;158:1429–41.
Keet CA, McCormack MC, Peng RD, Matsui EC. Age-and atopy-dependent effects of vitamin D on wheeze and asthma. J Allergy Clin Immunol. 2011;128:414–6.
Bener A, Ehlavel MS, Bener HZ, Hamid Q. The impact of vitamin D deficiency on asthma, allergic rhinitis and wheezing in children: an emerging public health problem. J Family Community Med. 2014;21:154–61.
Hammar KS, Hedlin G, Konradsen JR, et al. Subnormal levels of vitamin D are associated with acute wheezing in young children. Acta Paediatr. 2014;103:856–61.
Beigelman A, Bacharier LB. The role of early life viral bronchiolitis in the inception of asthma. Curr Opin Allergy Clin Immunol. 2013;13:211–6.
Jartti T, Ruuskanen O, Mansbach JM, Vuorinen T, Camargo CA. Low serum 25-hydroxyvitamin D levels are associated with increased risk of viral coinfections in wheezing children. J Allergy Clin Immunol. 2010;126:1074–6.
Brehm JM, Schuemann B. Fuhlbrigge AL, et al; Childhood asthma management program research group. Serum vitamin D levels and severe asthma exacerbations in the Childhood Asthma Management Program study. J Allergy Clin Immunol. 2010;126:52–8.
Brehm JM, CeIedon JC, Soto-Quiros ME, et al. Serum vitamin D levels and markers of severity of childhood asthma in Costa Rica. Am J Respir Crit Care Med. 2009;179:765–71.
Hollams EM, Hart PH, Holt BJ, et al. Vitamin D and atopy and asthma phenotypes in children: a longitudinal cohort study. Eur Respir J. 2011;38:1320–7.
Özaydin E, Bütün MF, Cakir BC, Köse G. The association between vitamin D status and recurrent wheezing. Indian J Pediatr. 2013;80:907–10.
Uysalol M, Uysalol EP, Yilmaz Y, et al. Serum level of vitamin D and trace elements in children with recurrent wheezing: a cross-sectional study. BMC Pediatr. 2014;14:270.
Beigelman A, Zeiger RS, Mauger D, et al. The association between vitamin D status and the rate of exacerbations requiring oral corticosteroids in preschool children with recurrent wheezing. J Allergy Clin Immunol. 2014;133:1489–92.
Prasad S, Rana RK, Sheth R, Mauskar AV. A hospital based study to establish the correlation between recurrent wheeze and vitamin D deficiency among children less than 3 years of age. J Clin Diagn Res. 2016;10:SC18–21.
Akman AO, Tumer L, Hasanoglu A, Ilhan M, Cayci B. Frequency of vitamin D insufficiency in healthy children between 1 and 16 years of age in Turkey. Pediatr Int. 2011;53:968–73.
Acknowledgments
The authors would like to thank Prof Mark Brown for reviewing the manuscript.
Contributions
AO is the primary investigator and made substantial contribution to conception, data interpretation and design of the study. DD made substantial contribution in accessing the statistical analysis and preparation of the manuscript. OY made substantial contribution in patient enrollment to the study and preparation of the manuscript. All authors read and approved the final version of the manuscript. AO will act as guarantor for the paper.
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Conflict of Interest
None.
Source of Funding
None.
Rights and permissions
About this article
Cite this article
Ozdemir, A., Dogruel, D. & Yilmaz, O. Vitamin D Status in Infants with Two Different Wheezing Phenotypes. Indian J Pediatr 83, 1386–1391 (2016). https://doi.org/10.1007/s12098-016-2184-1
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s12098-016-2184-1