Association Between Serum 25-Hydroxyvitamin D Level and Upper Respiratory Tract Infection in the Third National Health and Nutrition Examination Survey

By A. Ginde, J. Mansbach, C. Camargo. Archives of Internal Medicine, 2009

985 citations recorded by the source corpus.

Background Recent studies suggest a role for vitamin D in innate immunity, including the prevention of respiratory tract infections (RTIs). We hypothesize that serum 25-hydroxyvitamin D (25[OH]D) levels are inversely associated with self-reported recent upper RTI (URTI). Methods We performed a secondary analysis of the Third National Health and Nutrition Examination Survey, a probability survey of the US population conducted between 1988 and 1994. We examined the association between 25(OH)D level and recent URTI in 18 883 participants 12 years and older. The analysis adjusted for demographics and clinical factors (season, body mass index, smoking history, asthma, and chronic obstructive pulmonary disease). Results The median serum 25(OH)D level was 29 ng/mL (to convert to nanomoles per liter, multiply by 2.496) (interquartile range, 21–37 ng/mL), and 19% (95% confidence interval [CI], 18%–20%) of participants reported a recent URTI. Recent URTI was reported by 24% of participants with 25(OH)D levels less than 10 ng/mL, by 20% with levels of 10 to less than 30 ng/mL, and by 17% with levels of 30 ng/mL or more (P<.001). Even after adjusting for demographic and clinical characteristics, lower 25(OH)D levels were independently associated with recent URTI (compared with 25[OH]D levels of ≥30 ng/mL: odds ratio [OR], 1.36; 95% CI, 1.01–1.84 for <10 ng/mL and 1.24; 1.07–1.43 for 10 to <30 ng/mL). The association between 25(OH)D level and URTI seemed to be stronger in individuals with asthma and chronic obstructive pulmonary disease (OR, 5.67 and 2.26, respectively). Conclusions Serum 25(OH)D levels are inversely associated with recent URTI. This association may be stronger in those with respiratory tract diseases. Randomized controlled trials are warranted to explore the effects of vitamin D supplementation on RTI.

Subfields: Nutrition and Dietetics, Pathology and Forensic Medicine, Physiology

View Paper: https://www.semanticscholar.org/paper/757db3da41ad09f2c0f4f280fc2a60fa4a2cf088

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The researchers whose trusted networks rank it highest, strongest advocate first. Every researcher gets a different order.

In Nutrition and Dietetics

1. D. Black
2. J. Adams
3. C. Kovacs
4. JoAnn E. Manson
5. M. H. Murad
6. C. Rosen
7. K. Amrein
8. M. Demay

In Pathology and Forensic Medicine

1. M. F. Holick
2. J. Adams
3. D. Black
4. J. Adams
5. C. Kovacs
6. JoAnn E. Manson
7. M. H. Murad
8. C. Rosen

In Physiology

1. JoAnn E. Manson
2. D. Bikle

Citations in the corpus

• The nonskeletal effects of vitamin D: an Endocrine Society scientific statement. (2012, background): “Infectious mycobacterial (TLR2/1 and TLR4) (233, 235), bacterial (TLR4 and TLR6) (242, 243), and viral diseases (TLR 7) (244), as well as autoimmune diseases (TLR7) (245) have all been significantly associated with low serum 25(OH)D levels in cross-sectional studies.”
• Vitamin D—Effects on Skeletal and Extraskeletal Health and the Need for Supplementation (2013, neutral): “26 in chronic obstructive airway disease) [221].”
• Vitamin D supplementation to prevent acute respiratory tract infections: systematic review and meta-analysis of individual participant data (2017, methodology): “31 32 To minimise the chance of type 1 error arising from multiple analyses, we inferred statistical significance for subgroup analyses only where P values for treatment-covariate interaction terms were < 0.05.”
• Update in vitamin D. (2010, background): “(25) recently demonstrated that the prevalence of upper respiratory tract infections in the NHANES III population 1) increased significantly, regardless of season of the year, as the serum 25OHD dropped; and 2) was greatest during winter months when 25OHD levels were at their lowest.”
• Randomized trial of vitamin D supplementation to prevent seasonal influenza A in schoolchildren. (2010, background): “On the other hand, a significant inverse association between serum vitamin D intake and recent upper respiratory tract infections was seen in the third National Health and Nutrition Examination Survey (5).”
• Vitamin D and Immune Function (2013, background): “Low calcitriol concentrations have also been linked to elevated mortality caused by severe infections in end-stage renal disease patients [48], and low serum 25(OH)D levels have been associated with upper respiratory tract infections (URTI) [49–51], including influenza [52], chronic obstructive pulm”