Background: Epidemiological studies suggest a link between vitamin D deficiency in early life and development of asthma in later life. Aim: The aim of this study was to measure serum vitamin D levels in asthmatic children and to compare these to healthy non-asthmatic controls. Methods: Asthmatic (n = 483) and healthy control (n = 483) children were recruited from the Pediatric Allergy-Immunology Clinics of Hamad General Hospital and the Primary Health Care Clinics in Qatar from October 2009 to July 2010. All children were below 16 years of age and asthma was diagnosed by a physician. Parents of all children completed extensive questionnaires documenting demographics, child’s feeding practice and vitamin D intake. Serum vitamin D (25-hydroxyvitamin D), calcium, phosphorus, alkaline phosphatase, magnesium, creatinine and parathyroid hormone assays were performed. Subjects with serum containing less than 20 ng/ml vitamin D were deemed deficient. Results: Asthmatic children had significantly reduced serum vitamin D levels compared to non-asthmatic children (p < 0.001); 68.1% of all asthmatics were vitamin D deficient. Asthmatic children had significantly higher degrees of moderate (41.8 vs. 25.1%) and severe (26.3 vs. 11.0%) vitamin D deficiency compared to healthy controls (p < 0.001). Positive familial history of vitamin D deficiency (35.6%, p = 0.005) and asthma (36.4%, p = 0.009) were significantly higher in asthmatic children. Along with vitamin D deficiency, asthmatics also had reduced phosphorus (p < 0.001) and magnesium (p = 0.001) levels but elevated serum alkaline phosphatase (p < 0.001) and IgE (p < 0.001). The majority of asthmatic children had less exposure to sunlight (66.7%, p = 0.006) and less physical activity (71.3%, p < 0.001). Vitamin D deficiency was the strongest predictor of asthma in this population (OR 4.82; 95% CI 2.41–8.63, p < 0.001). Conclusion: The present study revealed that the majority of asthmatic children had vitamin D deficiency compared to control children. Vitamin D deficiency was the major predictor of asthma in Qatari children.

1.
Janahi IA, Bener A, Bush A: Prevalence of asthma among Qatari schoolchildren: International Study of Asthma and Allergies in Childhood, Qatar. Paediatr Pulmonol 2006;41:80–86.
[PubMed]
2.
Masoli M, Fabian D, Holt S, Beasley R: Global Initiative for Asthma (GINA) Program. The global burden of asthma: executive summary of the GINA Dissemination Committee report. Allergy 2004;59:469–478.
[PubMed]
3.
Robertson CF, Roberts MF, Kappers JH: Asthma prevalence in Melbourne schoolchildren: have we reached the peak? Med J Aust 2004;180:273–276.
[PubMed]
4.
Mannino DM, Homa DM, Akinbami LJ, Mooman JE, Gwynn C, Redd SC: Surveillance for asthma – United States, 1980–1999. MMWR Surveill Summ 2002;51:1–3.
[PubMed]
5.
Stevens E, Cullinan P, Colvile R: Urban air pollution and children’s asthma: what do parents and health professionals think? Pediatry Pulmonol 2004;37:530–536.
[PubMed]
6.
Bener A, Ehlayel MS, Alsowaidi S, Sabbah A: Role of breastfeeding in primary prevention of asthma and allergic diseases in a traditional society. Eur Ann Allergy Clin Immunol 2007;39:337–343.
[PubMed]
7.
Lee YL, Lin YC, Hsiue TR, Hwang BF, Guo YL: Indoor and outdoor environmental exposures, parental atopy, and physician-diagnosed asthma in Taiwanese schoolchildren. Pediatrics 2003;112;e389.
[PubMed]
8.
Bener A, Abdulrazzaq YM, Al Mutawwa J, Debuse P: Genetics and environmental factors associated with asthma. Hum Biol 1996;68:405–414.
[PubMed]
9.
Al Frayh AR, Shakoor Z, Gad El Rab MO, Hasnain SM: Increased prevalence of asthma in Saudi Arabia. Ann Allergy Asthma Immunol 2001;86:292–296.
[PubMed]
10.
Sobki SH, Zakzouk SM: Point prevalence of allergic rhinitis among Saudi children. Rhinology 2004;42:137–140.
[PubMed]
11.
Behbehani BA, Abal A, Syabbalo NC, Abd Azeem A, Shareef E, Al-Momen J: Prevalence of asthma, allergic rhinititis and eczema in 13- to 14-year-old children in Kuwait: an ISAAC study. International Study of Asthma and Allergies in Children. Ann Allergy Asthma Immunol 2000;85:58–63.
[PubMed]
12.
Bener A, Abdulrazzaq YM, Debuse P, Al Mutawwa J: Prevalence of asthma among Emirates school children. Eur J Epidemiol 1994;10:271–278.
[PubMed]
13.
Bener A, Janahi I, Sabbah A: Genetics and environmental risk factors associated with asthma in school children. Eur Ann Allergy Clin Immunol 2005;37:163–168.
[PubMed]
14.
ISAAC Steering Committee. Worldwide variation in prevalence of symptoms of asthma, allergic rhinoconjunctivitis, and atopic eczema: ISAAC. The International Study of Asthma and Allergies in Childhood. Lancet 1998;351:1225–1232.
[PubMed]
15.
Bener A, Ehlayel M, Sabbah A: The pattern of genetics of paediatric extrinsic asthma risk factors in polluted environment. Allerg Immunol 2007;39:58–63.
16.
Litonjua AA, Weiss ST: Is vitamin D deficiency to blame for the asthma epidemic? J Allergy Clin Immunol 2007;120:1031–1035.
[PubMed]
17.
Weiss ST, Litonjua AA: Maternal diet versus lack of exposure to sunlight as the cause of the epidemic of asthma, allergies and other autoimmune diseases. Thorax 2007;62:746–748.
[PubMed]
18.
Brehm JM, Celedón JC, Soto-Quiros ME, Avila L, Hunninghake GM, Forno E, Laskey D, Sylvia JS, Hollis BW, Weiss ST, Litonjua AA: Serum vitamin D levels and markers of severity of childhood asthma in Costa Rica. Am J Respir Crit Care Med 2009;179:765–771.
[PubMed]
19.
Al-Riyami BM, Al-Rawas OA, Al-Riyami AA, Jasim LG, Mohammed AJ: A relatively high prevalence and severity of asthma, allergic rhinitis and atopic eczema in school children in the Sultanate of Oman. Respirology 2003;8:69–76.
[PubMed]
20.
Bapai A, Bardia A, Mantan M, Hari P, Bagga A: Non-azotemic refractory rickets in Indian children. Indian Pediatr 2005;42:23–30.
[PubMed]
21.
Bener A, Kamal A: Growth patterns of Qatari school children and adolescents aged 6–18 years. J Health Pop Nutr 2005;23:250–258.
[PubMed]
22.
Bener A, Al-Ali M, Hoffmann GF: High prevalence of vitamin D deficiency in young children in a highly sunny humid country: a global health problem. Minerva Pediatr 2009;61:15–22.
[PubMed]
23.
Barday L: Vitamin D insufficiency linked to asthma severity. Am J Respir Crit Care Med 2009;179:739–742.
[PubMed]
24.
Bener A, Alsaied A, Al-Ali M, Al-Kubaisi A, Basha B, Abraham A, Guiter G, Mian M: High prevalence of vitamin D deficiency in type 1 diabetes mellitus and healthy children. Acta Diabetol 2009;46:183–189.
[PubMed]
25.
Bener A, Alsaied A, Al-Ali M, Hassan AS, Basha B, Al-Kubaisi A, Abraham A, Mian M, Guiter G, Tewfik I: Impact of lifestyle and dietary habits on hypovitaminosis D in T1DM and healthy children from Qatar: a sun rich country. Ann Nutrition Metab 2008;53:215–222.
[PubMed]
26.
Freishtat RJ, Iqbal SF, Pillai DK, Klein CJ, Ryan LM, Benton AS, Teach SJ: High prevalence of vitamin D deficiency among inner city-African-American youth with asthma in Washington, D.C. J Pediatr 2010;156:948–952.
[PubMed]
27.
Ginde AA, Mansback JM, Camargo CA Jr: Association between serum-25-hydroxyvitamin D level and upper RTI in the 3rd National Health and Nutrition Examination Survey. Arch Intern Med 2009;39:875–882.
28.
Nesby-O’Dell S, Scanlon KS, Cogswell ME, Gillespie C, Hollis BW, Look AC, et al: Hypovitaminosis D prevalence and determinants among African-American and white women of reproductive age: third National Health and Nutrition Examination Survey, 1988–1994. Am J Clin Nutr 2002;76:187–192.
[PubMed]
29.
El-Hajj Fuleihan G, Nabulsi M, Chou Cair M, Salamoun M, Shahine CM, Kizirian A, Tannous R: Hypovitaminosis D in healthy school children. Pediatr 2009;107:E53.
30.
Gordon CM, Feldman HA, Sinclair L, Williams AL, Kleinmann PK, Perez-Rosello J, et al: Prevalence of vitamin D deficiency among healthy infants and toddlers. Arch Pediatr Adolesc Med 2008;162:505–512.
[PubMed]
31.
Gordon CM, De Peter KC, Feldman HA, Grace E, Emans SJ: Prevalence of vitamin D deficiency among healthy adolescents. Arch Pediatr Adolesc Med 2004;158:531–537.
[PubMed]
32.
Devereux G, Litonjua AA, Turner SW, Craig LC, McNeill G, Martindale S, et al: Maternal vitamin D intake during pregnancy and early childhood wheezing. Am J Clin Nutr 2007;85:853–859.
[PubMed]
33.
Hollick MF: Vitamin D deficiency. N Engl J Med 2007;357:266–281.
[PubMed]
You do not currently have access to this content.