Abstract

Recently the effects of vitamin D as a hormone have gained attention. Vitamin D appears to have regulatory effects on every part of the immune system, vitamin D deficiency being linked to an array of immunologically based diseases focusing on asthma. Vitamin D deficiency has become more prevalent and is mainly attributed to diet, lifestyle, and behavioural changes. Recent reports have shown how decreased vitamin D levels may adversely influence asthma out comes. Vitamin D plays a key role in regulating the innate immune system, and is a major player in the production of antimicrobial peptides that kill microorganisms. Vitamin D deficiency has been linked to a predisposition to respiratory infections, which are major triggers for asthma attacks. Previous studies have shown that children with mild to moderate asthma who also had low serum vitamin D levels had poor asthma control, more exacerbations, more hospitalizations in the previous year, decreased lung function, reduced responses to inhaled corticosteroids. Furthermore, it has been reported that serum vitamin D levels are positively related with FEV1% predicted and the ratio of FEV1 to FVC. Aims: To Study the effect of vitamin d levels on lung function in adult bronchial asthma patients. Material and Methods: Demographic details of every patients will be collected. Detailed history and physical examination will be done in all patients. Information will be collected regarding symptoms and duration of symptoms of bronchial asthma. Asthma control will be assessed using the asthma control test (ACT). Blood samples for vitamin D measurements will be collected in EDTA tubes, then centrifuged, aliquoted, and stored at —80 °C. Plasma 25- hydroxyvitamin D will be measured using the Tandem test. Difference between two groups was determined using t test as well as chi square test. Results: Out of 270 subjects, low vitamin d level was found among 61.48% of the subjects. Mean BMI (kg/m2) among the subjects with low and normal vitamin d was 26.01±4.78 and 26.94±7.83 years respectively. Smoking was found to be present and absent in 89.16% and 10.84% of the subjects with low vitamin d level respectively with statistically significant difference. Mean FEVI/FVC ratio among the subjects with low and normal vitamin d was 56.24±6.13 and 48.59±7.02 respectively. Significant positive correlation (r=0.87, p<0.01) was found between ACT and vitamin d level. Conclusion: Vitamin D deficiency is highly prevalent in patients with exacerbations of bronchial asthma. Supplementation of Vitamin D has a significant positive effect in decreasing the severity and number of exacerbations of bronchial asthma. The association between ACT and vitamin D in the absence of any association with respiratory function could reflect the importance of low vitamin D as a marker for severity

Description

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