Vitamin D deficiency in children with asthma


  • Kasim Resivi Ullerithody Department of Pediatrics, Medical College Kozhikode, Kerala, India
  • Rajalakshmi Harihara Iyer Department of Pediatrics, Medical College Kozhikode, Kerala, India
  • Kinattinkara Ramachandran Subharaman Department of Pediatrics, Medical College Kozhikode, Kerala, India



Asthma, Children, Exacerbation, Vitamin D


Background: Asthma is one of the most common chronic respiratory diseases worldwide. Its exact cause remains unknown. Vitamin D has been implicated as a critical regulator of immunity and found to be associated with several immune mediated diseases. Recently there has been increasing interest in the possible link between vitamin D and asthma. Hence, we planned this study to assess the existence of any correlation between asthma and vitamin D levels in India.

Methods: Fifty consecutive cases of clinically diagnosed asthma attending asthma clinic and those admitted in IMCH Calicut, Kerala, India were included in the study and administered detailed questionnaire. Routine physical examination and investigation as per the protocol in asthma clinic were done. Blood was drawn for 25 hydroxy cholecalciferol and serum analyzed by Roche Elecsys chemiluminescence assay. Controls were selected only after all fifty cases were selected. Vitamin D levels were assayed in the same manner as in patients with asthma. Vitamin D levels were then analyzed with other parameters and variables. Statistical analysis was performed using SPSS software, version 16.

Results: Prevalence of vitamin D deficiency is high in study population. The difference in vitamin D levels between cases and controls is significant.

Conclusions: More studies need to be done to ascertain the relationship between asthma and vitamin D in developing countries like India.


Holick MF. Vitamin D deficiency. N Engl J Med. 2007;357(3):266-81.

Bender DA, Mayes PA. Vitamins and Minerals. In: Murray RK, Granner DK, Rodwell VW, Mayes PA, editors. Harper’s Illustrated Biochemistry. 26th ed. Unites States of America: Lange Medical Books/ McGraw-Hill; 2003:494.

Harvey RA, Ferrier DR. Biochemistry. 6th ed. North America: Lippincott Williams and Wilkins; 2011.

Lange NE, Litonjua A, Hawrylowicz CM, Weiss S. Vitamin D, the immune system and asthma. Expert Rev Clin Immunol. 2009;5(6):693-702.

Matheu V, Bäck O, Mondoc E, Issazadeh-Navikas S. Dual effects of vitamin D-induced alteration of TH1/TH2 cytokine expression: enhancing IgE production and decreasing airway eosinophilia in murine allergic airway disease. J Allergy Clin Immunol. 2003;112(3):585-92.

Latitude and Longitude of Kerala, Lat Long of Kerala. Available at: http://www.mapsofindia. com/lat_long/kerala/. Accessed on 11 February 2020.

Szefler SJ. Advances in pediatric asthma in 2010: addressing the major issues. J Allergy Clin Immunol. 2011;127(1):102-15.

Litonjua AA, Weiss ST. Is vitamin D deficiency to blame for the asthma epidemic? J Allergy Clin Immunol. 2007;120(5):1031-5.

Brehm JM, Celedón JC, Soto-Quiros ME, Avila L, Hunninghake GM, Forno E, et al. Serum vitamin D levels and markers of severity of childhood asthma in Costa Rica. Am J Respir Crit Care Med. 2009;179(9): 765-71.

Alyasin S, Momen T, Kashef S, Alipour A, Amin R. The relationship between serum 25 hydroxy vitamin d levels and asthma in children. Allergy Asthma Immunol Res. 2011;3(4):251-5.

Gern JE, Lemanske RF Jr, Busse WW. Early life origins of asthma. J Clin Invest. 1999;104(7):837-43.

Horwood LJ, Fergusson DM, Shannon FT. Social and familial factors in the development of early childhood asthma. Pediatrics. 1985;75(5):859-68.

Borkar VV, Devidayal, Verma S, Bhalla AK. Low levels of vitamin D in North Indian children with newly diagnosed type 1 diabetes. Pediatr Diabetes. 2010;11(5):345-50.

Searing DA, Zhang Y, Murphy JR, Hauk PJ, Goleva E, Leung DYM. Decreased serum vitamin D levels in children with asthma are associated with increased corticosteroid use. J Allergy Clin Immunol. 2010;125(5):995-1000.

Gern JE, Busse WW. Relationship of viral infections to wheezing illnesses and asthma. Nat Rev Immunol. 2002;2(2):132-8.

Hollis BW. Circulating 25-hydroxyvitamin D levels indicative of vitamin D sufficiency: implications for establishing a new effective dietary intake recommendation for vitamin D. J Nutr. 2005;135(2):317-22.

Linus Pauling Institute at Oregon State University. Available at: vitamins/vitaminD/. Accessed on 8 November 2012.

Lu Z, Chen TC, Zhang A, Persons KS, Kohn N, Berkowitz R, et al. An evaluation of the vitamin D3 content in fish: Is the vitamin D content adequate to satisfy the dietary requirement for vitamin D?. J Steroid Biochem Mol Biol. 2007;103(3-5):642-4.

Kliegman RM, Behrman RE. Nelson textbook of pediatrics. 18th ed. Amsterdam: Saunders Elsevier Limited; 2011.

Goswami R, Mishra SK, Kochupillai N. Prevalence and potential significance of vitamin D deficiency in Asian Indians. Indian J Med Res. 2008;127(3):229-38.

Marwaha RK, Sripathy G. Vitamin D and bone mineral density of healthy school children in northern India. Indian J Med Res. 2008;127(3):239-44.

Harinarayan CV, Ramalakshmi T, Prasad UV, Sudhakar D. Vitamin D status in Andhra Pradesh : a population based study. Indian J Med Res. 2008;127(3):211-8.






Original Research Articles