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The Role of Vitamin D in the Severity and Control of Asthma in Children and Adolescents: A Systematic Review and Meta-analysis
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  • Joelia M. Ladeira,
  • Olívia Zacas,
  • Amanda Miranda Ferreira,
  • Patrícia Chaib Gomes Stegun,
  • TIAGO DE SOUZA,
  • Milena Grotta,
  • Adyléia Aparecida Dalbo Contrera Toro
Joelia M. Ladeira
Universidade Estadual de Campinas

Corresponding Author:[email protected]

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Olívia Zacas
Universidade Estadual de Campinas
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Amanda Miranda Ferreira
Universidade Estadual de Campinas
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Patrícia Chaib Gomes Stegun
Universidade Estadual de Campinas
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TIAGO DE SOUZA
Universidade Estadual de Campinas
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Milena Grotta
Universidade Estadual de Campinas
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Adyléia Aparecida Dalbo Contrera Toro
Universidade Estadual de Campinas
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Abstract

Background: Vitamin D may contribute to the balance in between regulatory and suppressive functions of T cells to modulate the inflammatory process in asthma. Objective: To assess serum vitamin D levels and their relationship with asthma control, asthma severity and its anti-inflammatory effect in children. Methods: This systematic review was based on articles published between 2009 and August 2022. Children under 18 years old with asthma were included. Results: The initial database search identified 2,015 manuscripts. Through screening identified only 25 eligible articles, but only eight studies met criteria for inclusion in the meta-analysis. The analysis revealed that in six studies involving 588 participants, mean 25-hydroxyvitamin D levels were lower in children with uncontrolled asthma compared to those with controlled asthma, with a mean difference of -5.07 (-8.57, -1.57) and a high rate of heterogeneity I 2 = 89%. In five studies comprising 362 patients, the relationship between vitamin D and asthma severity was assessed. Lower levels of vitamin D were associated with a higher risk of severe asthma in children, with a mean difference of -6.00 (-8.09, -3.90) and substantial heterogeneity (90%, p<0.00001). In most patients, no significant correlation was found between vitamin D and lung function. Furthermore, serum vitamin D showed an association with interleukins and with regulatory T lymphocytes. Conclusion: Vitamin D plays a critical role in reducing asthma attacks. However, more randomized studies are necessary for a thorough evaluation and definitive recommendation for vitamin D supplementation.
30 Oct 2023Submitted to Pediatric Pulmonology
31 Oct 2023Assigned to Editor
31 Oct 2023Submission Checks Completed
31 Oct 2023Review(s) Completed, Editorial Evaluation Pending
16 Nov 2023Reviewer(s) Assigned