Allergy, Asthma and Immunology: Vitamin D insufficiency and asthma severity in adults from Costa Rica.

Original Article

Open Access

Allergy Asthma Immunol Res. 2013 Sep;5(5):283-288. English. Published online 2013 July 24. http://dx.doi.org/10.4168/aair.2013.5.5.283
Copyright © 2013 The Korean Academy of Asthma, Allergy and Clinical Immunology • The Korean Academy of Pediatric Allergy and Respiratory Disease


Felicia Montero-Arias,¹^, Giovanni Sedó-Mejía,²^, and Allan Ramos-Esquivel³^,
¹Department of Pneumology, Hospital San Juan de Dios, San José, Costa Rica.
²Department of Internal Medicine and Allergology, Hospital San Juan de Dios, San José, Costa Rica.
³Department of Pharmacology, University of Costa Rica, San José, Costa Rica.
Correspondence to: Allan Ramos-Esquivel, MD, Sede Rodrigo Facio, Department of Pharmacology, Faculty of Medicine, University of Costa Rica, PO BOX 2060, San José, Costa Rica. Tel: +506-88448187; Fax: +506-22373930; Email: allan.ramos@ucr.ac.cr This work has been equally distributed.

Received August 07, 2012; Revised November 12, 2012; Accepted November 20, 2012.
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract
Purpose Non-classical actions of vitamin D as a cytokine are related to the immunopathology of asthma. Few studies have examined vitamin D levels and asthma severity in adults. The aim of this research was to assess the relationship between vitamin D levels, atopy markers, pulmonary function, and asthma severity. Methods We analyzed 25-hydroxyvitamin D levels in serum collected from 121 asthmatic adults from Costa Rica to investigate the association between vitamin D levels (categorized as sufficient, ≥30 ng/mL, or insufficient, <30 1="" allergic="" analyses="" and="" as="" assess="" asthma="" atopy="" baseline="" blood="" capacity="" eosinophils="" expiratory="" forced="" ige="" in="" markers="" ml="" multivariate="" ng="" of="" p="" performed="" peripheral="" relationships.="" rhinitis="" second="" severity="" these="" to="" total="" univariate="" vital="" volume="" were=""> Results When the population was stratified by vitamin D status, 91% of asthmatic patients with vitamin D levels below 20 ng/mL (n=36) and 74% of patients with vitamin D levels between 20 and 30 ng/mL (n=73) had severe asthma versus 50% of those with vitamin D sufficiency (n=12; P=0.02). Vitamin D insufficiency was associated with a higher risk of severe asthma (odds ratio [OR], 5.04; 95% Confidence interval [CI], 1.23-20.72; P=0.02). High vitamin D levels were associated with a lower risk of hospitalization or emergency department visit during the last year (OR, 0.90; 95% CI, 0.84-0.98; P=0.04). Although there appeared to be a direct relationship between vitamin D levels and FEV1 (regression coefficient=0.48; r²=0.03), it did not reach statistical significance (P=0.07). Conclusions Our findings suggest that vitamin D insufficiency is common among our cohort of asthmatic adults. Lower vitamin D levels are associated with asthma severity.