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Vitamin D supplementation in children with asthma: a systematic review and meta-analysis.

Abstract

BACKGROUND

Epidemiologic studies suggest an association between vitamin D deficiency and atopic diseases, including asthma. The objective of this study was to systematically review the benefits and harms of vitamin D supplementation in children with asthma.

METHODS

We used standard Cochrane systematic review methodology. The search strategy included an electronic search in February 2013 of MEDLINE and EMBASE. Two reviewers completed in duplicate and independently study selection, data abstraction, and assessment of risk of bias. We pooled the results of trials using a random-effects model. We assessed the quality of evidence by outcome using the GRADE methodology.

RESULTS

Four trials with a total of 149 children met eligibility criteria. The trials had major methodological limitations. Given the four studies reporting on asthma symptoms used different instruments to measure that outcome, we opted not to conduct a meta-analysis. Three of those studies reported improvement in asthma symptoms in the vitamin D supplemented group study, while the fourth reported no effect (very low quality evidence). For the lung function outcome, a meta-analysis of two trials assessing post treatment FEV-1 found a mean difference of 0.54 liters per second (95% CI -5.28; 4.19; low quality evidence). For the vitamin D level outcome, a meta-analysis of three trials found a mean difference of 6.56 ng/ml (95% CI -0.64; 13.77; very low quality evidence).

CONCLUSIONS

The available very low to low quality evidence does not confirm or rule out beneficial effects of vitamin D supplementation in children with asthma. Large-scale, well-designed and executed randomized controlled trials are needed to better understand the effectiveness and safety of vitamin D in children with asthma.

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  • Authors+Show Affiliations

    ,

    Department of Pediatrics and Adolescent Medicine, American University of Beirut, Beirut, Lebanon. fares.munes@gmail.com.

    ,

    Department of Pediatrics and Adolescent Medicine, American University of Beirut, Beirut, Lebanon. lina.alkhaled@hotmail.com.

    ,

    Department of Pediatrics and Adolescent Medicine, American University of Beirut, Beirut, Lebanon. smroueh@aub.edu.lb.

    Department of Internal Medicine, American University of Beirut, Beirut, Lebanon. ea32@aub.edu.lb. Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, ON, Canada. ea32@aub.edu.lb. Department of Medicine, State University of New York at Buffalo, Buffalo, NY, USA. ea32@aub.edu.lb.

    Source

    BMC research notes 8: 2015 Feb 03 pg 23

    MeSH

    Adolescent
    Asthma
    Child
    Clinical Trials as Topic
    Dietary Supplements
    Female
    Humans
    Male
    Respiratory Function Tests
    Vitamin D
    Vitamin D Deficiency

    Pub Type(s)

    Journal Article
    Review
    Systematic Review

    Language

    eng

    PubMed ID

    25643669

    Citation

    Fares, Munes M., et al. "Vitamin D Supplementation in Children With Asthma: a Systematic Review and Meta-analysis." BMC Research Notes, vol. 8, 2015, p. 23.
    Fares MM, Alkhaled LH, Mroueh SM, et al. Vitamin D supplementation in children with asthma: a systematic review and meta-analysis. BMC Res Notes. 2015;8:23.
    Fares, M. M., Alkhaled, L. H., Mroueh, S. M., & Akl, E. A. (2015). Vitamin D supplementation in children with asthma: a systematic review and meta-analysis. BMC Research Notes, 8, p. 23. doi:10.1186/s13104-014-0961-3.
    Fares MM, et al. Vitamin D Supplementation in Children With Asthma: a Systematic Review and Meta-analysis. BMC Res Notes. 2015 Feb 3;8:23. PubMed PMID: 25643669.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Vitamin D supplementation in children with asthma: a systematic review and meta-analysis. AU - Fares,Munes M, AU - Alkhaled,Lina H, AU - Mroueh,Salman M, AU - Akl,Elie A, Y1 - 2015/02/03/ PY - 2014/04/20/received PY - 2014/12/24/accepted PY - 2015/2/4/entrez PY - 2015/2/4/pubmed PY - 2015/12/15/medline SP - 23 EP - 23 JF - BMC research notes JO - BMC Res Notes VL - 8 N2 - BACKGROUND: Epidemiologic studies suggest an association between vitamin D deficiency and atopic diseases, including asthma. The objective of this study was to systematically review the benefits and harms of vitamin D supplementation in children with asthma. METHODS: We used standard Cochrane systematic review methodology. The search strategy included an electronic search in February 2013 of MEDLINE and EMBASE. Two reviewers completed in duplicate and independently study selection, data abstraction, and assessment of risk of bias. We pooled the results of trials using a random-effects model. We assessed the quality of evidence by outcome using the GRADE methodology. RESULTS: Four trials with a total of 149 children met eligibility criteria. The trials had major methodological limitations. Given the four studies reporting on asthma symptoms used different instruments to measure that outcome, we opted not to conduct a meta-analysis. Three of those studies reported improvement in asthma symptoms in the vitamin D supplemented group study, while the fourth reported no effect (very low quality evidence). For the lung function outcome, a meta-analysis of two trials assessing post treatment FEV-1 found a mean difference of 0.54 liters per second (95% CI -5.28; 4.19; low quality evidence). For the vitamin D level outcome, a meta-analysis of three trials found a mean difference of 6.56 ng/ml (95% CI -0.64; 13.77; very low quality evidence). CONCLUSIONS: The available very low to low quality evidence does not confirm or rule out beneficial effects of vitamin D supplementation in children with asthma. Large-scale, well-designed and executed randomized controlled trials are needed to better understand the effectiveness and safety of vitamin D in children with asthma. SN - 1756-0500 UR - https://www.unboundmedicine.com/medline/citation/25643669/full_citation L2 - https://bmcresnotes.biomedcentral.com/articles/10.1186/s13104-014-0961-3 DB - PRIME DP - Unbound Medicine ER -