Original Article
High Prevalence of Vitamin D Deficiency among Inner-City African American Youth with Asthma in Washington, DC

https://doi.org/10.1016/j.jpeds.2009.12.033Get rights and content

Objective

The goal of this study was to examine the prevalence of vitamin D insufficiency and deficiency among urban African-American (AA) youth with asthma compared with control subjects without asthma.

Study design

A cross-sectional case-control study was conducted at an urban pediatric medical center. Total 25-hydroxyvitamin D insufficiency (<30 ng/mL) and deficiency (<20 ng/mL) were assessed in urban self-reported AA patients, aged 6 to 20 years, with (n = 92) and without (n = 21) physician-diagnosed asthma.

Results

Blood samples were available for 85 (92%) cases. The prevalence of vitamin D insufficiency and deficiency were significantly greater among cases than control subjects (73/85 [86%] vs 4/21 [19%], adjusted odds ratio = 42 [95% confidence interval: 4.4 to 399] for insufficiency and 46/85 [54%] vs 1/21 [5%], adjusted odds ratio = 20 [95% confidence interval: 1.4 to 272] for deficiency).

Conclusions

Most of this sample of urban AA youth with persistent asthma were vitamin D deficient or insufficient. Given the emerging associations between low vitamin D levels and asthma, strong consideration should be given to routine vitamin D testing in urban AA youth, particularly those with asthma.

Section snippets

Methods

We conducted a cross-sectional case-control study between April 2008 and June 2009 at Children's National Medical Center (CNMC), an urban pediatric medical center in Washington, DC. All cases and control subjects were studied in the CNMC General Clinical Research Center. This study was approved by the CNMC Institutional Review Board. All participants or their guardians provided informed consent and assent.

The Asthma Severity Modifying Polymorphisms (AsthMaP) Project based at CNMC provided the

Cases

At the time of these analyses, there were 92 AA youth studied in AsthMaP. Of those, 58 (63%) were male, and the mean (SE) age was 11.1 (0.4) years. The mean BMI percentile for age was 69.3 A total of 83 of 92 (90%) had persistent asthma by National Institutes of Health, National Asthma Education and Prevention Program criteria.19 A detailed description of measured asthma phenotypes in these cases can be found in the Table. Notable phenotypic data included a mean fractional excretion of nitric

Discussion

Most of this sample of urban AA youth with persistent asthma in Washington, DC, were vitamin D deficient or insufficient. However, vitamin D deficiency has been documented in many populations around the world regardless of sun exposure.20, 21

Vitamin D deficiency is more common in AA individuals than in other races.11, 20, 22 One study of preadolescent AA children in the Pittsburgh area found that 71% had vitamin D levels below 30 ng/mL during the winter and early spring, including almost 50%

References (39)

  • C. Mathieu et al.

    Vitamin D and type 1 diabetes mellitus: state of the art

    Trends Endocrinol Metab

    (2005)
  • R. Vieth et al.

    The urgent need to recommend an intake of vitamin D that is effective

    Am J Clin Nutr

    (2007)
  • D.L. Ersfeld et al.

    Analytical and clinical validation of the 25 OH vitamin D assay for the LIAISON automated analyzer

    Clin Biochem

    (2004)
  • M.L. Burr et al.

    Changes in asthma prevalence: two surveys 15 years apart

    Arch Dis Child

    (1989)
  • M. Erkkola et al.

    Maternal vitamin D intake during pregnancy is inversely associated with asthma and allergic rhinitis in 5-year-old children

    Clin Exp Allergy

    (2009)
  • M. Wjst

    The vitamin D slant on allergy

    Pediatr Allergy Immunol

    (2006)
  • A.A. Ginde et al.

    Association between serum 25-hydroxyvitamin D level and upper respiratory tract infection in the Third National Health and Nutrition Examination Survey

    Arch Intern Med

    (2009)
  • J.M. Brehm et al.

    Serum vitamin D levels and markers of severity of childhood asthma in Costa Rica

    Am J Respir Crit Care Med

    (2009)
  • J. Kumar et al.

    Prevalence and associations of 25-hydroxyvitamin D deficiency in US children: NHANES 2001-2004

    Pediatrics

    (2009)

    • Cited by (143)

    • Does anti-IgE therapy prevent chronic allergic asthma-related bone deterioration in asthmatic mice?

      2022, Journal of Biomechanics
      Citation Excerpt :

      Accumulated evidence has demonstrated an association between airway hyperresponsiveness (AHR) or asthma and several factors regarding bone metabolism. Findings have revealed a significant negative correlation between reduced bone mineral density, serum vitamin-D, serum total or ionized calcium levels and the severity and exacerbation frequencies of AHR or asthma (Freishtat et al., 2010; Nagdeote et al., 2011; Chinellato et al., 2011; Jung et al., 2014; Hussein et al., 2019). Given that lifelong persistence of asthma developed in adulthood and evidence regarding bone metabolism, asthma morbidity can be a potential risk factor for bone health.

    • Pediatric Inner-City Asthma

      2021, Immunology and Allergy Clinics of North America

    • Pediatric Inner-City Asthma

      2019, Pediatric Clinics of North America

    • Trends of vitamin D in asthma in the pediatric population for two decades: a systematic review

      2023, Clinical and Experimental Pediatrics

    • The Role of Vitamins in the Pathogenesis of Asthma

      2023, International Journal of Molecular Sciences

    • Vitamin D status, sleep patterns, genetic susceptibility, and the risk of incident adult-onset asthma: a large prospective cohort study

      2023, Frontiers in Nutrition
    View all citing articles on Scopus

    Funded by grants from the National Center on Minority Health and Health Disparities (P20MD000198) and the National Center for Research Resources, National Institutes of Health (M01RR020359). Additional funding was provided by the Children's Research Institute of Children's National Medical Center, Washington, DC. The authors declare no conflicts of interest.

    View full text
    Copyright © 2010 Mosby, Inc. All rights reserved.