Asthma has been treated by 40 ng of vitamin D, but not this time – meta-analysis
The Effect of Vitamin D Supplementation in Children With Asthma: A Meta-Analysis
Front. Pediatr. 10:840617. doi: 10.3389/fped.2022.840617
Meiqi Hao1,2, Ruoxin Xu1,2, Nachuan Luo1,2, Miaowen Liu1,2, Junping Xie3* and Wenxiong Zhang1*
1 Department of Thoracic Surgery, The Second Affiliated Hospital of Nanchang University Nanchang, China,2 Jiangxi Medical College, Nanchang University, Nanchang, China,3 Department of Respiratory and Critical Care Medicine, The Second Affiliated Hospital of Nanchang University, Nanchang, China
Background: An increasing number of studies have suggested that vitamin D can be used to treat childhood asthma, but its clinical effects are still unclear. We conducted this meta-analysis to examine the latest estimates of the effectiveness and safety of using vitamin D to treat childhood asthma.
Methods: The PubMed, The Cochrane Library, ScienceDirect, Embase, Scopus, Ovid MEDLINE, Web of Science, and Google Scholar databases were searched for randomized controlled trials (RCTs) describing vitamin D supplementation interventions for asthmatic children. Asthma exacerbation, vitamin D levels, the predicted percentage of forced expiratory volume in the first second (FEV1 %) and adverse effects (AEs) were analyzed as the main outcome measures.
Results: After screening, eight RCTs with 738 children were included. Compared with placebos, vitamin D supplementation had a stronger effect on serum vitamin D levels [mean difference (MD) = 13.51 (4.24, 22.79), p = 0.004]. The pooled results indicated that no significant changes were found between the groups in asthma control, as measured by adopting the following indicators: asthma exacerbation [risk ratio (RR) = 0.92 (0.68, 1.25), p = 0.60]; Childhood Asthma Control Test (CACT) scores [MD = 0.15 (-0.43, 0.74), p = 0.61]; hospitalizations for asthma exacerbation [RR = 1.20 (0.48, 2.96), p = 0.70]; acute care visits [RR = 1.13 (0.77, 1.65), p = 0.63]; steroid use [RR = 1.03 (0.41, 2.57), p = 0.95]; and fractional exhaled nitric oxide (FeNO) [MD =-3.95 (-22.87, 14.97), p = 0.68]. However, vitamin D supplementation might reduce the FEV1% [MD = -4.77 (-9.35, -0.19), p = 0.04] and the percentage of predicted forced vital capacity (FVC%) [MD =-5.01 (-9.99, -0.02), p = 0.05] in patients. Subgroup analysis revealed no difference in AEs between the two groups.
Conclusions: Vitamin D supplementation significantly increased patients' serum vitamin D levels, but it had no benefit for asthma control. However, vitamin D supplementation might reduce patients' lung function. It is essential to systemically search for more large-scale, rigorous, and well-designed RCTs to fully confirm these conclusions.
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7 possible reasons
Genetics 5 genes can restrict the amount of vitamin D that actually gets to the cells
Comorbidities other health problems compete for the same vitamin D
Lack of Magnesium needed to get Vitamin D in the blood into the cells
Lack of Zinc to get vitamin D into the cells via the Vitamin D Receptor
Lack of loading dose the successful trial started with a 100,000 IU loading dose
Asthma duration before treatment days, months, years
Patient age
VitaminDWiki - Overview Asthma and Vitamin D contains
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VitaminDWiki Meta-analyses with ASTHMA in title (13 as of July 2022)
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