Vitamin D, asthma prevalence and asthma exacerbations: a large adult population-based study
Vitamin D, asthma prevalence and asthma exacerbations: a large adult population-based study
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DOI：
10.1111/all.12508
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发表时间：
2014-12-01
期刊：
影响因子：
12.4
通讯作者：
Feldman, B. S.
中科院分区：
文献类型：
--
作者：
Confino-Cohen, R.;Brufman, I.;Feldman, B. S.
背景低维生素D水平对哮喘、哮喘发病率和控制的影响尚不清楚。方法2008年7月1日至2012年7月1日，从Clalit Health Services(HMO)获取了一组年龄在22-50岁、有维生素D记录的以色列成年人。在这些人群中，那些被医生诊断为哮喘和哮喘恶化的人被发现。哮喘恶化被定义为以下任何一种：口服皮质类固醇处方，5张短效β-激动剂处方，以及四次以上哮喘内科就诊。Logistic回归模型评估了维生素D与哮喘和哮喘加重的关系。结果大约308000名成员至少有一次维生素D测量进入队列。其中，6.9%(21237)的患者被医生诊断为哮喘，而普通人群中的这一比例为5.7%。两组患者的血清25-OHD水平相似。然而，在维生素D缺乏的人中，病情恶化的几率比那些维生素D水平在正常范围内的人高出25%。在控制了已知的混杂因素后，这种相关性仍然显著。结论虽然维生素D状态与医生诊断的哮喘没有显著关联，但与哮喘加重有很强的相关性。目前提出的证据支持在未控制和反复加重的哮喘患者亚组中进行维生素D筛查。
BackgroundThe impact of low vitamin D status on asthma, asthma morbidity and control is unclear. We aimed to investigate in adults the associations between serum 25-hydroxyvitamin D level and prevalent asthma as well as asthma exacerbations.MethodsA cohort of Israeli adults aged 22-50years with documented vitamin D status were extracted from Clalit Health Services (HMO) between July 1, 2008 and July 1, 2012. Among this population, those with physician-diagnosed asthma and asthma exacerbations were identified. Asthma exacerbations were defined as any of the following: prescription for oral corticosteroids, >5 prescriptions for short acting beta agonists and more than four visits to a physician for asthma. Logistic regression models assessed the associations between vitamin D and both asthma and asthma exacerbations.ResultsApproximately 308000 members with at least one vitamin D measurement were included in the cohort. Among them, 6.9% (21237) had physician-diagnosed asthma vs 5.7% in the general population. Serum 25-OHD levels across both groups were similar. However, among those with vitamin D deficiency, the odds of having an exacerbation were 25% greater compared to those with levels in the normal range. This association remained significant after controlling for known confounders.ConclusionWhile there was no significant association between vitamin D status and physician-diagnosed asthma, there was a strong association with asthma exacerbations. The presented evidence supports vitamin D screening in the subgroup of asthmatics that are uncontrolled and experience recurrent exacerbations.