TY - JOUR
T1 - Association of free vitamin D3 concentrations and asthma treatment failures in the VIDA Trial
AU - Lima, John J.
AU - Castro, Mario
AU - King, Tonya S.
AU - Lang, Jason E.
AU - Ortega, Victor E.
AU - Peters, Stephen P.
AU - Denlinger, Loren C.
AU - Israel, Elliot
AU - Sorkness, Christine A.
AU - Wechsler, Michael E.
AU - Wenzel, Sally E.
AU - Smith, Lewis J.
N1 - Publisher Copyright:
© 2018 American College of Allergy, Asthma 8 Immunology
PY - 2018/10
Y1 - 2018/10
N2 - Background: Use of vitamin D3 serum concentrations as a biomarker of vitamin D status is questionable because of variation in vitamin D binding protein. Objective: To determine associations between free vitamin D3 concentrations and rates of treatment failure and exacerbations in patients with asthma participating in the Vitamin D Add-on Therapy Enhances Corticosteroid Responsiveness in Asthma (VIDA) trial. Methods: Free concentrations were directly measured by enzyme-linked immunosorbent assay and stratified into low, medium, and high groups: less than 5 pg/ mL (n = 65), 5 to 9 pg/ mL (n = 84), and greater than 9 pg/ mL (n = 48) after 12 weeks of supplementation with oral vitamin D3 and associated with outcomes. Results: Outcomes did not associate with free concentrations: overall treatment failure rates were 0.60 (95% confidence interval [CI] 0.46-0.78), 0.53 (95%CI 0.40- 0.70), and 0.69 (95%CI 0.54-0.90)/person-year (P =.51), respectively; overall exacerbation rates were 0.28 (95%CI 0.17-0.48), 0.15 (95%CI 0.08-0.30) and 0.42 (95%CI 0.27-0.66)/person-year (P =.22). Mean (standard deviation) baseline free concentrations were lower in non-Hispanic blacks and Hispanics compared with non-Hispanic whites: 4.10 (1.33) and 4.38 (1.11) pg/mL vs 5.16 (1.65) pg/ml, (P <.001 and P = 0.038), respectively. Mean (standard deviation) baseline free concentrations differed between females and males: 4.57 (1.58) and 5.08 (1.41) (P =.026); and between non-overweight (body mass index [BMI] < 25) and overweight (BMI > 25): 5.45 (1.86) vs 4.54 (1.39) (P <.001). The free fraction differed by race and sex but not by BMI. Conclusion: The use of free concentrations was inferior to total concentrations as a biomarker of efficacy of vitamin D3 supplementation in VIDA trial participants. Future studies of vitamin D status in patients with asthma should measure both free and total concentrations to better understand which marker of vitamin D function is most informative.
AB - Background: Use of vitamin D3 serum concentrations as a biomarker of vitamin D status is questionable because of variation in vitamin D binding protein. Objective: To determine associations between free vitamin D3 concentrations and rates of treatment failure and exacerbations in patients with asthma participating in the Vitamin D Add-on Therapy Enhances Corticosteroid Responsiveness in Asthma (VIDA) trial. Methods: Free concentrations were directly measured by enzyme-linked immunosorbent assay and stratified into low, medium, and high groups: less than 5 pg/ mL (n = 65), 5 to 9 pg/ mL (n = 84), and greater than 9 pg/ mL (n = 48) after 12 weeks of supplementation with oral vitamin D3 and associated with outcomes. Results: Outcomes did not associate with free concentrations: overall treatment failure rates were 0.60 (95% confidence interval [CI] 0.46-0.78), 0.53 (95%CI 0.40- 0.70), and 0.69 (95%CI 0.54-0.90)/person-year (P =.51), respectively; overall exacerbation rates were 0.28 (95%CI 0.17-0.48), 0.15 (95%CI 0.08-0.30) and 0.42 (95%CI 0.27-0.66)/person-year (P =.22). Mean (standard deviation) baseline free concentrations were lower in non-Hispanic blacks and Hispanics compared with non-Hispanic whites: 4.10 (1.33) and 4.38 (1.11) pg/mL vs 5.16 (1.65) pg/ml, (P <.001 and P = 0.038), respectively. Mean (standard deviation) baseline free concentrations differed between females and males: 4.57 (1.58) and 5.08 (1.41) (P =.026); and between non-overweight (body mass index [BMI] < 25) and overweight (BMI > 25): 5.45 (1.86) vs 4.54 (1.39) (P <.001). The free fraction differed by race and sex but not by BMI. Conclusion: The use of free concentrations was inferior to total concentrations as a biomarker of efficacy of vitamin D3 supplementation in VIDA trial participants. Future studies of vitamin D status in patients with asthma should measure both free and total concentrations to better understand which marker of vitamin D function is most informative.
UR - http://www.scopus.com/inward/record.url?scp=85052064943&partnerID=8YFLogxK
U2 - 10.1016/j.anai.2018.06.001
DO - 10.1016/j.anai.2018.06.001
M3 - Article
C2 - 29908319
AN - SCOPUS:85052064943
SN - 1081-1206
VL - 121
SP - 444-450.e1
JO - Annals of Allergy, Asthma and Immunology
JF - Annals of Allergy, Asthma and Immunology
IS - 4
ER -