Association of asthma with low serum vitamin D and its related musculoskeletal and psychological symptoms in adults: a case-control study

Mohammad J Alkhatatbeh,Khalid K Abdul-Razzak,Shaher Samrah,Haneen S Almomani

doi:10.1038/s41533-021-00239-7

Mohammad J Alkhatatbeh, Khalid K Abdul-Razzak + Show 2 more

Open Access

https://doi.org/10.1038/s41533-021-00239-7

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Abstract

There are complex potential inter-relationships between the chronic inflammation of asthma and poor control, vitamin D deficiency, musculoskeletal pain and anxiety and depression. The aim was to investigate associations between vitamin D and these possible co-morbidities. This case-controlled study involved 75 adults with asthma and 75 controls. Serum 25-hydroxyvitamin D (25(OH)D) was measured, levels of anxiety, depression, musculoskeletal pain, and asthma control were assessed. Participants with asthma had lower 25(OH)D and higher anxiety scores and higher measures of musculoskeletal pain compared to controls. Binary logistic regression showed that asthma was associated with decreased 25(OH)D (Odds ratio (OR) = 0.86), general weakness (OR = 13.29), complaint of musculoskeletal pain (OR = 13.73), and increased intensity of musculoskeletal pain (OR = 0.61) and number of painful sites (OR = 2.58). Asthma was not associated with anxiety or depression. Further studies are required to investigate if vitamin D supplementation can improve asthma symptoms and musculoskeletal pain.

Highlights

Asthma is a chronic inflammatory airway disease that is characterized by bronchial hyper-responsiveness and tissue remodeling[1]
Differences in study variables between participants with asthma and healthy controls As shown in Table 1, participants with asthma had significantly lower overall levels of 25(OH)D (p value = 0.04), and were more likely to have deficient vitamin D levels compared to healthy controls (90.5% vs. 65.3%, p value
Because vitamin D deficiency was reported to be associated with higher blood eosinophil counts[47], a randomized controlled trial of vitamin D supplementation was conducted and both participants with asthma and healthy controls was very high (77.3% and 20.0%, respectively) in the recruited cohort

Summary

Introduction

Asthma is a chronic inflammatory airway disease that is characterized by bronchial hyper-responsiveness and tissue remodeling[1]. Asthma is usually triggered by a combination of genetic and environmental factors that end with inappropriate immune-mediated chronic inflammatory responses, which may influence the severity of the disease and response to treatment[1,2]. There is a possible association between asthma and certain psychological conditions including stress, anxiety, and depression[4]. This connection could be explained by an interaction between behavioral, neural, endocrine, and immune processes, which may trigger bronchial inflammatory responses, hyperresponsiveness and the development of asthma[4]. Regardless of the nature of association between asthma and the psychological symptoms, these mental health issues can interfere with the optimal management of asthma and inversely affect asthma control[7]

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