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      Serum 25(OH)D concentrations and atopic diseases at age 10: results from the GINIplus and LISAplus birth cohort studies

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          Abstract

          Background

          Vitamin D is well recognized for its role in skeletal health and its involvement in the modulation of the immune system. In the literature, controversial results are reported for atopic diseases. Thus, we investigated the association between vitamin D status and the prevalence of atopic diseases.

          Methods

          Serum 25-hydroxy-vitamin D (25(OH)D) concentrations were measured in a sample of 2815 10-years old children from two German birth cohort studies. Self-reported physician-diagnosed eczema, hay fever or allergic rhinitis, and asthma were used as outcome variables as well as specific IgE positivity against common allergens. We applied logistic regression models, deriving adjusted odds ratio estimates (aOR) and 95% confidence intervals (CI).

          Results

          For asthma and hay fever or allergic rhinitis, no associations existed with serum 25(OH)D concentrations. We observed a significant positive relationship between serum 25(OH)D levels and eczema at age 10 (aOR = 1.09, CI = 1.01-1.17, per 10 nmol/l increase in serum 25(OH)D levels) and for the lifetime prevalence of eczema (aOR = 1.05, CI = 1.01-1.09). Specific IgE positivity for food allergens (aOR = 1.07, CI = 1.02-1.11) and aeroallergens (aOR = 1.05, CI = 1.01-1.08) at age 10, as well as lifetime prevalence, was significantly related to the vitamin D status.

          Conclusion

          In this study we found no indication that higher blood 25(OH)D levels are associated with decreased risk for any of the atopic outcomes in children. However, we observed a positive association of serum 25(OH)D concentrations with eczema and detectable specific IgE. Due to the given limitations of our study, the clinical relevance of these findings needs further clarification.

          Electronic supplementary material

          The online version of this article (doi:10.1186/s12887-014-0286-3) contains supplementary material, which is available to authorized users.

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          Most cited references30

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          Maternal vitamin D status during pregnancy and child outcomes.

          To investigate whether exposure to high maternal concentrations of 25(OH)-vitamin D in pregnancy poses any risk to the child. Prospective study. Princess Anne Maternity Hospital, Southampton, UK. A group of 596 pregnant women were recruited. A total of 466 (78%) children were examined at birth, 440 (74%) at age 9 months and 178 (30%) at age 9 years. Maternal 25 (OH)-vitamin D concentrations were measured in late pregnancy. Anthropometry of the child was recorded at birth, 9 months and 9 years. At 9 months, atopic eczema was assessed. At 9 years, children had an echocardiogram and a dual energy x-ray absorptiometry scan, blood pressure, arterial compliance and carotid intima-media thickness were measured and intelligence and psychological function assessed. There were no associations between maternal 25(OH)-vitamin D concentrations and the child's body size or measures of the child's intelligence, psychological health or cardiovascular system. Children whose mothers had a 25(OH)-vitamin D concentration in pregnancy >75 nmol/l had an increased risk of eczema on examination at 9 months (OR 3.26, 95% CI 1.15-9.29, P=0.025) and asthma at age 9 years (OR 5.40, 95% CI, 1.09-26.65, P=0.038) compared to children whose mothers had a concentration of <30 nmol/l. Exposure to maternal concentrations of 25(OH)-vitamin D in pregnancy in excess of 75 nmol/l does not appear to influence the child's intelligence, psychological health or cardiovascular system; there could be an increased risk of atopic disorders, but this needs confirmation in other studies.
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            Blood biomarkers of vitamin D status.

            J Zerwekh (2008)
            In the past quarter century, more than 50 metabolites of vitamin D have been described. To date, only a few of these have been quantified in blood, but this has widened our understanding of the pathologic role that altered vitamin D metabolism plays in the development of diseases of calcium homeostasis. Currently, awareness is growing of the prevalence of vitamin D insufficiency in the general population in association with an increased risk of several diseases. However, for many researchers, it is not clear which vitamin D metabolites should be quantified and what the information gained from such an analysis tells us. Only 2 metabolites, namely, 25-hydroxyvitamin D [25(OH)D] and 1,25-dihydroxyvitamin D [1,25(OH)2D], have received the greatest attention. Of these, the need for measuring serum 1,25(OH)2D is limited, and this metabolite should therefore not be considered as part of the standard vitamin D testing regimen. On the other hand, serum 25(OH)D provides the single best assessment of vitamin D status and thus should be the only vitamin D assay typically performed. Currently, numerous formats exist for measuring serum 25(OH)D concentrations, each with its own advantages and disadvantages. This article reviews the currently available methods for serum 25(OH)D quantitation and considers important issues such as whether both the D2 and the D3 forms of the vitamin should be assayed, whether total or free concentrations are most important, and what measures should be taken to ensure the fidelity of the measurements.
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              Serum 25-hydroxyvitamin D and IgE - a significant but nonlinear relationship.

              Hormonal vitamin D system affects the determination of T-cell responses. It is unknown if there is an association between vitamin D status and allergic conditions. Our aim was to investigate differences in serum IgE concentrations by vitamin D status [measured by 25(OH)D] and by a genetic variation in a key vitamin D activation enzyme (CYP27B1) previously shown to be associated with type 1 diabetes. 9377 participants in the 1958 British birth cohort completed a biomedical assessment at 45 years of age ; 7288 eligible participants had data on 25(OH)D and IgE, with 6429 having further information on CYP27B1 genotype ()1260C>A). There was a nonlinear association between 25(OH)D and IgE (P-value for curvature = 0.0001). Compared with the reference group with the lowest IgE concentrations [25(OH)D 100-125 nmol/l], IgE concentrations were 29% higher (95% CI 9-48%) for participants with the 25(OH)D 135 nmol/l (adjusted for sex, month, smoking, alcohol consumption, time spent outside, geographical location, social class, PC/TV time, physical activity, body mass index and waist circumference). CYP27B1 genotype was associated with both 25(OH)D (difference for A vs. C allele: 1.88%, 95% CI 0.37-3.4%, P = 0.01) and IgE concentrations ()6.59%, )11.6% to )1.42%, P = 0.01). These data suggest that there may be a threshold effect with both low and high 25(OH)D levels associated with elevated IgE concentrations. The same CYP27B1 allele that is protective of diabetes was associated with increased IgE concentrations.
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                Author and article information

                Contributors
                nina.wawro@helmholtz-muenchen.de
                heinrich@helmholtz-muenchen.de
                elisabeth.thiering@helmholtz-muenchen.de
                Juergen.Kratzsch@medizin.uni-leipzig.de
                dr.med.schaaf@t-online.de
                Barbara.Hoffmann@IUF-Duesseldorf.de
                irina.lehmann@ufz.de
                cpbauer@t-online.de
                Sibylle.Koletzko@med.uni-muenchen.de
                avb.rodehorst@gmx.de
                berdel.vonberg@t-online.de
                j.linseisen@helmholtz-muenchen.de
                Journal
                BMC Pediatr
                BMC Pediatr
                BMC Pediatrics
                BioMed Central (London )
                1471-2431
                25 November 2014
                25 November 2014
                2014
                : 14
                : 1
                : 286
                Affiliations
                [ ]Helmholtz Centre Munich, Institute of Epidemiology 2, Ingolstaedter Landstr 1, 85764 Neuherberg, Germany
                [ ]Helmholtz Centre Munich, Institute of Epidemiology 1, Neuherberg, Germany
                [ ]Ludwig-Maximilians-University Munich, Dr. von Hauner Children’s Hospital, Munich, Germany
                [ ]Institute of Laboratory Medicine, Clinical Chemistry, and Molecular Diagnostics, University Hospital Leipzig, Leipzig, Germany
                [ ]Medical Praxis for Children, Bad Honnef, Germany
                [ ]IUF Leibniz Research Institute for Environmental Medicine, Düsseldorf, Germany
                [ ]UFZ Helmholtz Centre for Environmental Research, Leipzig, Germany
                [ ]Department of Pediatrics, Technical University of Munich, Munich, Germany
                [ ]Department of Pediatrics, Ludwig-Maximilians-University, Munich, Germany
                [ ]Department of Pediatrics, Marien-Hospital, Wesel, Germany
                Article
                286
                10.1186/s12887-014-0286-3
                4251945
                25421846
                3ed22b24-cef2-444f-b292-a21358b1a15a
                © Wawro et al.; licensee BioMed Central Ltd. 2014

                This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

                History
                : 24 April 2014
                : 27 October 2014
                Categories
                Research Article
                Custom metadata
                © The Author(s) 2014

                Pediatrics
                asthma,atopic diseases,eczema,allergic rhinitis,birth cohort,hay fever,sensitization,vitamin d
                Pediatrics
                asthma, atopic diseases, eczema, allergic rhinitis, birth cohort, hay fever, sensitization, vitamin d

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