Maria A Slack1, Princess U Ogbogu2, Gary Phillips3, Thomas A E Platts-Mills4, Elizabeth A Erwin5. 1. Division of Pulmonary, Allergy, Critical Care, and Sleep Medicine, The Ohio State University Wexner Medical Center, Columbus, Ohio. Electronic address: mariaslackai@gmail.com. 2. Division of Pulmonary, Allergy, Critical Care, and Sleep Medicine, The Ohio State University Wexner Medical Center, Columbus, Ohio. 3. Department of Biomedical Informatics, Center for Biostatistics, The Ohio State University Wexner Medical Center, Columbus, Ohio. 4. Division of Allergy and Immunology, University of Virginia, Charlottesville, Virginia. 5. Center for Innovation in Pediatric Practice, Nationwide Children's Hospital, Columbus, Ohio.
Abstract
BACKGROUND: Vitamin D deficiency has been associated with increased risk for severe asthma, challenge-proven food allergy, and severe atopic dermatitis. Vitamin D levels have not been reported in patients with eosinophilic esophagitis (EoE). OBJECTIVE: To determine levels of 25-hydroxyvitamin D in a cohort of patients with EoE. METHODS: Total serum 25-hydroxyvitamin D was measured using liquid chromatography with tandem mass spectroscopy in adults (n = 35) and children (n = 34) with EoE. Results were compared with patient demographics, EoE-specific disease parameters, markers of sensitization, and features of severity using multivariable logistic regression. RESULTS: The median vitamin D level was 28.9 ng/mL. Patients with insufficient vitamin D (<30 ng/mL) were older (median 25.5 vs 16.2 years) and had a higher body mass index (median 25.2 vs 19.8 kg/m(2)). Peak median esophageal eosinophil counts were not significantly different for vitamin D insufficient and sufficient patient groups; however, higher vitamin D levels correlated with higher histologic eosinophil counts (R = 0.61, P = .03). Although there were no statistical differences in total IgE or levels of specific IgE between patients with vitamin D insufficiency and those with sufficiency, a positive skin prick test reaction to peanut was more common in patients who had vitamin D insufficiency (adjusted odds ratio 7.57, P = .009). Vitamin D insufficiency was not associated with surrogate markers of severity (dilation in adults or hospitalization or emergency visits in children). CONCLUSION: In these patients with EoE, vitamin D levels were low overall (median <30 ng/mL). The only marker of sensitization associated with insufficient vitamin D in these patients with EoE was a positive skin prick test reaction to peanut.
BACKGROUND:Vitamin D deficiency has been associated with increased risk for severe asthma, challenge-proven food allergy, and severe atopic dermatitis. Vitamin D levels have not been reported in patients with eosinophilic esophagitis (EoE). OBJECTIVE: To determine levels of 25-hydroxyvitamin D in a cohort of patients with EoE. METHODS: Total serum 25-hydroxyvitamin D was measured using liquid chromatography with tandem mass spectroscopy in adults (n = 35) and children (n = 34) with EoE. Results were compared with patient demographics, EoE-specific disease parameters, markers of sensitization, and features of severity using multivariable logistic regression. RESULTS: The median vitamin D level was 28.9 ng/mL. Patients with insufficientvitamin D (<30 ng/mL) were older (median 25.5 vs 16.2 years) and had a higher body mass index (median 25.2 vs 19.8 kg/m(2)). Peak median esophageal eosinophil counts were not significantly different for vitamin Dinsufficient and sufficient patient groups; however, higher vitamin D levels correlated with higher histologic eosinophil counts (R = 0.61, P = .03). Although there were no statistical differences in total IgE or levels of specific IgE between patients with vitamin Dinsufficiency and those with sufficiency, a positive skin prick test reaction to peanut was more common in patients who had vitamin Dinsufficiency (adjusted odds ratio 7.57, P = .009). Vitamin Dinsufficiency was not associated with surrogate markers of severity (dilation in adults or hospitalization or emergency visits in children). CONCLUSION: In these patients with EoE, vitamin D levels were low overall (median <30 ng/mL). The only marker of sensitization associated with insufficientvitamin D in these patients with EoE was a positive skin prick test reaction to peanut.
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