Low vitamin D level at age 6 years is a predictor of atopy and asthma at 14 years of age

Vitamin D has been linked to atopy and asthma in children with already established disease. The aim of this study was to investigate if vitamin D status can be used as a predictor of allergy and asthma development in children aged 6 and 14 years in Perth, Australia.

Serum vitamin D was assayed in approximately 700 6-yr-old and 14-yr-old children from a birth cohort.

Higher vitamin D levels were negatively associated with allergy but the association was restricted mainly to males. Low vitamin D levels at age 6 years were significant predictors of subsequent atopy/asthma-associated phenotypes at age 14 years.

Children (particularly males) with inadequate vitamin D were at increased risk of developing atopy, and subsequently bronchial hyperresponsiveness (BHR) and asthma. Low vitamin D at age 6 years was a predictor of atopy and asthma at 14 years of age.

It would be interesting to evaluate if the addition of vitamin D level would improve the accuracy of the currently used modified Asthma Predictive Index (mAPI).

The index applies to 3-year-old children with 4 wheezing episodes in the past year. If a child has 1 major criterion or 2 minor criteria, he or she has a 76% risk of having persistent asthma during school years. A major criterion would be one of the following: eczema; a family history or either parent with asthma (including during childhood); or sensitization to aeroallergens, such as house dust mites, dog, cat, or pollen. Minor criteria are wheezing other than with colds, food allergy to egg, milk, or peanut, and blood eosinophilia.

Modified Asthma Predictive Index (mAPI) (click to enlarge the image):

A positive mAPI greatly increased future asthma probability (eg, 30% pretest probability to 90% posttest probability) http://buff.ly/ZJfMgQ


Vitamin D and atopy and asthma phenotypes in children: a longitudinal cohort study. E.M. Hollams et al. ERJ December 1, 2011 vol. 38 no. 6 1320-1327.

Image source: Wikipedia, public domain.

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