Trial of vitamin D supplementation to prevent asthma exacerbation in children
DOI:
https://doi.org/10.18203/2320-6012.ijrms20172479Keywords:
Asthma, Children, Exacerbation, Vitamin D, Vitamin D supplementationAbstract
Background: To assess the level of vitamin D in children with bronchial asthma and to study the effects of vitamin D supplementation in asthmatic children who had vitamin D deficiency in terms of asthma control test score and Number of exacerbations.
Methods: This interventional study was conducted in Department of Paediatrics, KAPV Government medical college, Trichy, Tamil Nadu, India from September 2016 to February 2017. 96 asthmatic children of age group 5-12 years who attended outpatient department and admitted in ward for asthma exacerbation were selected. After assessing their Vitamin D level, Vitamin D supplementation given along with standard treatment for asthma. Outcomes measured were ACTS (Asthma control test score), number of emergency room visits, number of hospital admissions and reliever medication use.
Results: Out of 96 children, 83 (86.4%) children had vitamin D deficiency. There was significant correlation between vitamin D level and absolute eosinophil count (p-value-0.037), asthma severity (p-value<0.001) and asthma control (p-value<0.001). Significant reduction in emergency room visits, (p-value<0.001) reliever medication use (p-value<0.001) and improvement in asthma control test score (p-value-0.008) occurs after vitamin D supplementation.
Conclusions: There is a significant correlation between vitamin D level, asthma severity and its control. Asthma exacerbation in terms of emergency room visits and reliever medication use were further reduced by vitamin D supplementation.
References
Pal R, Dahal S, Pal S. Prevalence of bronchial asthma in Indian children. Indian J Comm Med. 2009;34(4):310.
Sukumaran TU. Management of childhood bronchial asthma. Second edition. India: Jaypee brothers; 2014.
Lodha R, Puranik M, Kattal N, Kabra SK. Social and economic impact of childhood asthma. Indian Pediatr. 2003;40:874-9.
Balasubramanian S, Dhanalakshmi K, Amperayani S. Vitamin D deficiency in childhood- A review of current guidelines on diagnosis and management. Indian Pediatr. 2013;50(7):669-75.
Bener A, Ehlayel MS, Tulic MK, Hamid Q. Vitamin D deficiency as a strong predictor of asthma in children. Int Arch Allerg Immunol. 2012;157(2):168-75.
Brehm JM, Schuemann B, Fuhlbrigge AL, Hollis BW, Strunk RC, Zeiger RS, et al. Serum vitamin D levels and severe asthma exacerbations in the Childhood Asthma Management Program study. J Allerg Clin Immunol. 2010;126(1):52-8.
Gupta A, Sjoukes A, Richards D, Banya W, Hawrylowicz C, Bush A, et al. Relationship between serum vitamin D, disease severity, and airway remodelling in children with asthma. Am J Respir Crit Care Med. 2011;184(12):1342-9.
Brehm JM, Celedón JC, Soto-Quiros ME, Avila L, Hunninghake GM, Forno E, et al. Serum vitamin D levels and markers of severity of childhood asthma in Costa Rica. Am J Respir Crit Care Med. 2009 May 1;179(9):765-71.
Urashima M, Segawa T, Okazaki M, Kurihara M, Wada Y, Ida H. Randomized trial of vitamin D supplementation to prevent seasonal influenza A in schoolchildren. Am J Clin Nutr. 2010;91(5):1255-60.
Majak P, Olszowiec-Chlebna M, Smejda K, Stelmach I. Vitamin D supplementation in children may prevent asthma exacerbation triggered by acute respiratory infection. J Allerg Clin Immunol. 2011;127(5):1294-6.
Mishra D, Singh HP. Kuppuswamy’s socioeconomic status scale- a revision. Indian J Pediatr. 2003;70(3):273-4.
Chhabra SK, Gupta CK, Chhabra P, Pal SR. Prevalence of bronchial asthma in schoolchildren in Delhi. J Asthma. 1998;35(3):291-6.
Goh DY, Chew FT, Quek SC, Lee BW. Prevalence and severity of asthma, rhinitis, and eczema in Singapore schoolchildren. Arch Dis Childhood. 1996;74(2):131-5.
Chhabra SK, Gupta CK, Chhabra P, Rajpal S. Risk factors for development of Bronchial asthma in children in Delhi. Ann Allerg Asthma Immunol.1999;83(5):385-90.