Vitamin D3 for uncontrolled childhood asthma: A pilot study
Vitamin D3 for uncontrolled childhood asthma: A pilot study
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DOI：
10.1111/pai.12547
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发表时间：
2016-06-01
影响因子：
4.4
通讯作者：
Elnazir, Basil
中科院分区：
文献类型：
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作者：
Kerley, Conor P.;Hutchinson, Katrina;Elnazir, Basil
背景：观察和机制数据表明维生素 D 在儿童哮喘中发挥作用。然而，随后的干预试验却不一致。我们的目的是评估与安慰剂 (PL) 相比，补充 15 周维生素 D-3 对爱尔兰哮喘儿童的效果。方法：我们对 44 名高纬度城市白人儿童进行了一项双盲、随机、PL 对照试验，补充维生素 D（2000 IU/天）。评估在基线时和补充 15 周后完成。结果指标包括肺功能、主观哮喘控制和总维生素 D 生化参数、过敏、免疫力、气道炎症和全身炎症。最后，家长/监护人在试验期间完成每周日记。 结果：基线 25(OH) D 水平没有显着差异，但维生素 D-3 组 (57.5-105 nmol/l) 与 PL 组 (52.5-57.5 nmol/l) 相比，中位 25(OH) D 显着增加 (p < 0.0001)。在主观哮喘控制方面，各组之间没有显着差异。与 PL 相比，维生素 D-3 组因哮喘（1 天 vs. 5 天，p = 0.04）和碱性磷酸酶（-3.4 vs. + 16；p = 0.037）而缺课的天数显着减少，但其他几个次要终点没有产生有益影响。然而，与维生素 D-3 组相比，PL 组在主观哮喘控制和肺功能方面存在不显着的有利变化，特别是 1 秒内预测用力呼气量的百分比（+ 2.5 与 -4；p = 0.06）。 结论：补充维生素 D-3 导致血清 25(OH) D 显着增加，缺课天数减少 (p = 0.04)，但与对照组相比，哮喘参数没有其他有利变化。 PL。维生素 D 缺乏对生长的潜在不利影响以及高血清 25(OH) D 对肺功能的潜在负面影响值得进一步研究。
Background: Observational and mechanistic data suggest a role for vitamin D in childhood asthma. However, subsequent interventional trials have been inconsistent. We aimed to assess the effect of 15 weeks of vitamin D-3 supplementation compared with placebo (PL) in Irish children with asthma.Methods: We conducted a double-blind, randomized, PL-controlled trial of vitamin D supplementation (2000 IU/day) in 44 urban, Caucasian children at high latitude. Assessments were completed at baseline and after 15 weeks of supplementation. Outcome measures were lung function, subjective asthma control and biochemical parameters of total vitamin D, allergy, immunity, airway inflammation, and systemic inflammation. Finally, parents/guardians completed a weekly diary during the trial.Results: There was no significant difference in baseline 25(OH) D levels, but there was a significant increase in median 25(OH) D in the vitamin D-3 group (57.5-105 nmol/l) compared with the PL group (52.5-57.5 nmol/l) (p < 0.0001). There was no significant difference between groups regarding subjective asthma control. Compared with PL, there was a significant decrease in school days missed due to asthma (1 vs. 5 days, p = 0.04) and alkaline phosphatase (-3.4 vs. + 16; p = 0.037) in the vitamin D-3 group, but there were no beneficial effects regarding several other secondary end-points. However, there were non-significant, advantageous changes in the PL group compared with the vitamin D-3 group in subjective asthma control and lung function, particularly percentage of predicted forced expiratory volume in 1 s (+ 2.5 vs. -4; p = 0.06).Conclusion: Vitamin D-3 supplementation led to a significant increase in serum 25(OH) D and decreased school days missed (p = 0.04), but no other advantageous changes in asthma parameters compared with PL. The potential adverse effect of vitamin D deficiency on growth and the potential negative effect of high serum 25(OH) D on pulmonary function warrant further investigation.