Hanna M Knihtilä1, Benjamin J Stubbs1, Vincent J Carey1, Nancy Laranjo1, Su H Chu1, Rachel S Kelly1, Robert S Zeiger2, Leonard B Bacharier3, George T O'Connor4, Jessica Lasky-Su1, Scott T Weiss5, Augusto A Litonjua6. 1. Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Mass. 2. Departments of Allergy and Research and Evaluation, Kaiser Permanente Southern California Region, San Diego and Pasadena, Calif. 3. Division of Allergy, Immunology, and Pulmonary Medicine, Department of Pediatrics, St Louis Children's Hospital, Washington University School of Medicine, St Louis, Mo. 4. Pulmonary Center, Department of Medicine, Boston University School of Medicine, Boston, Mass. 5. Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Mass. Electronic address: scott.weiss@channing.harvard.edu. 6. Division of Pediatric Pulmonary Medicine, Golisano Children's Hospital, University of Rochester Medical Center, Rochester, NY.
Abstract
BACKGROUND: Lung function impairment in early life often persists into adulthood. Therefore, identifying risk factors for low childhood lung function is crucial. OBJECTIVE: We examined the effect of 25-hydroxyvitamin D (25[OH]D) level and childhood asthma phenotype on childhood lung function in the Vitamin D Antenatal Asthma Reduction Trial (VDAART). METHODS: The 25(OH)D level was measured at set time points in mothers during pregnancy and in children during early life. On the basis of parental reports, children were categorized into 3 clinical phenotypes: asymptomatic/infrequent wheeze, early transient wheeze, and asthma at age 6 years. Lung function was assessed with impulse oscillometry at ages 4, 5, and 6 years and with spirometry at ages 5 and 6 years. RESULTS: A total of 570 mother-child pairs were included in this post hoc analysis. Mean gestational 25(OH)D-level quartiles were negatively associated with child respiratory resistance at 5 Hz (R5) from age 4 to 6 years (β, -0.021 kPa/L/s; 95% CI, -0.035 to -0.007; P = .003) and positively associated with FEV1 (β, 0.018 L; 95% CI, 0.005-0.031; P = .008) and forced vital capacity (β, 0.022 L; 95% CI, 0.009-0.036; P = .002) from age 5 to 6 years. Children with asthma at age 6 years had lower lung function from age 4 to 6 years than the asymptomatic/infrequent wheeze group (β, 0.065 kPa/L/s; 95% CI, 0.028 to 0.102; P < .001 for R5 and β, -0.063 L; 95% CI, -0.099 to -0.028; P < .001 for FEV1). CONCLUSIONS: Low gestational 25(OH)D level and childhood asthma are important risk factors for decreased lung function in early childhood.
BACKGROUND: Lung function impairment in early life often persists into adulthood. Therefore, identifying risk factors for low childhood lung function is crucial. OBJECTIVE: We examined the effect of 25-hydroxyvitamin D (25[OH]D) level and childhood asthma phenotype on childhood lung function in the Vitamin D Antenatal Asthma Reduction Trial (VDAART). METHODS: The 25(OH)D level was measured at set time points in mothers during pregnancy and in children during early life. On the basis of parental reports, children were categorized into 3 clinical phenotypes: asymptomatic/infrequent wheeze, early transient wheeze, and asthma at age 6 years. Lung function was assessed with impulse oscillometry at ages 4, 5, and 6 years and with spirometry at ages 5 and 6 years. RESULTS: A total of 570 mother-child pairs were included in this post hoc analysis. Mean gestational 25(OH)D-level quartiles were negatively associated with child respiratory resistance at 5 Hz (R5) from age 4 to 6 years (β, -0.021 kPa/L/s; 95% CI, -0.035 to -0.007; P = .003) and positively associated with FEV1 (β, 0.018 L; 95% CI, 0.005-0.031; P = .008) and forced vital capacity (β, 0.022 L; 95% CI, 0.009-0.036; P = .002) from age 5 to 6 years. Children with asthma at age 6 years had lower lung function from age 4 to 6 years than the asymptomatic/infrequent wheeze group (β, 0.065 kPa/L/s; 95% CI, 0.028 to 0.102; P < .001 for R5 and β, -0.063 L; 95% CI, -0.099 to -0.028; P < .001 for FEV1). CONCLUSIONS: Low gestational 25(OH)D level and childhood asthma are important risk factors for decreased lung function in early childhood.
Authors: Stephen W Turner; Lyle J Palmer; Peter J Rye; Neil A Gibson; Parveenjeet K Judge; Moreen Cox; Sally Young; Jack Goldblatt; Louis I Landau; Peter N Le Souëf Journal: Am J Respir Crit Care Med Date: 2004-02-05 Impact factor: 21.405
Authors: M Nguyen; C L Trubert; M Rizk-Rabin; V K Rehan; F Besançon; Y E Cayre; M Garabédian Journal: J Steroid Biochem Mol Biol Date: 2004-05 Impact factor: 4.292
Authors: Steve Turner; Shona Fielding; Dave Mullane; Des W Cox; Jack Goldblatt; Lou Landau; Peter le Souef Journal: Thorax Date: 2014-06-02 Impact factor: 9.139
Authors: Per Thunqvist; Per M Gustafsson; Erica S Schultz; Tom Bellander; Eva Berggren-Broström; Mikael Norman; Magnus Wickman; Erik Melén; Jenny Hallberg Journal: Pediatrics Date: 2016-03-23 Impact factor: 7.124
Authors: Elizabeth L Barry; Judy R Rees; Janet L Peacock; Leila A Mott; Christopher I Amos; Roberd M Bostick; Jane C Figueiredo; Dennis J Ahnen; Robert S Bresalier; Carol A Burke; John A Baron Journal: J Clin Endocrinol Metab Date: 2014-07-29 Impact factor: 5.958