• John M Brehm, Brooke Schuemann, Anne L Fuhlbrigge, Bruce W Hollis, Robert C Strunk, Robert S Zeiger, Scott T Weiss, Augusto A Litonjua, and Childhood Asthma Management Program Research Group.
• Channing Laboratory, Department of Medicine, Brigham and Women's Hospital, Boston, Mass, USA.
• J. Allergy Clin. Immunol. 2010 Jul 1;126(1):52-8.e5.

BackgroundAsthma exacerbations, most often caused by respiratory tract infections, are the leading causes of asthma morbidity and comprise a significant proportion of asthma-related costs. Vitamin D status might play a role in preventing asthma exacerbations.ObjectivesWe sought to assess the relationship between serum vitamin D levels and subsequent severe asthma exacerbations.MethodsWe measured 25-hydroxyvitamin D levels in sera collected from 1024 children with mild-to-moderate persistent asthma at the time of enrollment in a multicenter clinical trial of children randomized to receive budesonide, nedocromil, or placebo (as-needed beta-agonists): the Childhood Asthma Management Program. Using multivariable modeling, we examined the relationship between baseline vitamin D levels and the odds of any hospitalization or emergency department visit over the 4 years of the trial.ResultsThirty-five percent of all subjects were vitamin D insufficient, as defined by a level of 30 ng/mL or less 25-hydroxyvitamin D. Mean vitamin D levels were lowest in African American subjects and highest in white subjects. After adjusting for age, sex, body mass index, income, and treatment group, insufficient vitamin D status was associated with a higher odds of any hospitalization or emergency department visit (odds ratio, 1.5; 95% CI, 1.1-1.9; P = .01).ConclusionVitamin D insufficiency is common in this population of North American children with mild-to-moderate persistent asthma and is associated with higher odds of severe exacerbation over a 4-year period.Copyright 2010 American Academy of Allergy, Asthma & Immunology. Published by Mosby, Inc. All rights reserved.

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