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Respir Med. 2019 Apr;150:85-94. doi: 10.1016/j.rmed.2019.02.016. Epub 2019 Feb 21.

Association between vitamin D status and asthma control: A meta-analysis of randomized trials.

Author information

1
School of Life Sciences and Biopharmaceutis, Shenyang Pharmaceutical University, Shenyang, 110016, Liaoning, China.
2
Department of Respiratory, General Hospital of Shenyang Military Area, Shenhe District, Shenyang, 110016, Liaoning, China.
3
School of Pharmacy, Shenyang Pharmaceutical University, Shenyang, 110016, Liaoning, China.
4
School of Pharmacy, Shenyang Pharmaceutical University, Shenyang, 110016, Liaoning, China. Electronic address: chenggang63@hotmail.com.

Abstract

BACKGROUND:

There is a controversy in terms of the efficacy of vitamin D supplementation in improving asthma symptom control. Moreover, whether there is a difference in the treatment effect with respect to baseline vitamin D status remains unknown. This meta-analysis was to assess the correlations of vitamin D status with asthma-related respiratory outcomes.

METHODS:

PubMed, EMBASE, and Cochrane Library were searched for randomized controlled trials of vitamin D supplementation in patients with asthma. Primary outcomes were the rate of asthma exacerbation and predicted percentage of forced expiratory volume in first second (FEV1%). Secondary outcomes were asthma control test (ACT) scores, fractional exhaled nitric oxide (FeNO), interleukin-10 (IL-10) and adverse events.

RESULTS:

A total of 14 randomized controlled trials (1421 participants) fulfilled the inclusion. Vitamin D supplementation was associated with a significant reduction in the rate of asthma exacerbation by 27% (RR: 0.73 95%Cl (0.58-0.92)). In subgroup analysis, the protective effect of exacerbation was restricted in patients with vitamin D insufficiency (vitamin D < 30 ng/ml) (RR: 0.76 95%Cl (0.61-0.95)). An improvement of FEV1% was demonstrated in patients with vitamin D insufficiency and air limitation (FEV1% < 80%) (MD: 8.3 95%Cl (5.95-10.64). No significant difference was observed in ACT scores, FeNO, IL-10 and adverse events.

CONCLUSIONS:

Vitamin D supplementation reduced the rate of asthma exacerbation, especially in patients with vitamin D insufficiency. Additionally, the benefit of vitamin D had a positive effect on pulmonary function in patients with air limitation and vitamin D insufficiency.

KEYWORDS:

Asthma; Meta-analysis; RCTs; Treatment; Vitamin D

PMID:
30961957
DOI:
10.1016/j.rmed.2019.02.016

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