TY - JOUR
T1 - Folate deficiency, atopy, and severe asthma exacerbations in puerto rican children
AU - Blatter, Joshua
AU - Brehm, John M.
AU - Sordillo, Joanne
AU - Forno, Erick
AU - Boutaoui, Nadia
AU - Acosta-Pérez, Edna
AU - Alvarez, Mara
AU - Colón-Semidey, Angel
AU - Weiss, Scott T.
AU - Litonjua, Augusto A.
AU - Canino, Glorisa
AU - Celedón, Juan C.
N1 - Publisher Copyright:
Copyright © 2016 by the American Thoracic Society.
PY - 2016/2
Y1 - 2016/2
N2 - Background: Little is known about folate and atopy or severe asthma exacerbations. We examined whether folate deficiency is associated with number of positive skin tests to allergens or severe asthma exacerbations in a high-risk population and further assessed whether such association is explained or modified by Vitamin D status. Methods: Cross-sectional study of 582 children aged 6 to 14 years with (n = 304) and without (n = 278) asthma in San Juan, Puerto Rico. Folate deficiency was defined as plasma folate less than or equal to 20 ng/ml.Our outcomes were the number of positive skin tests to allergens (range, 0-15) in all children and (in children with asthma) one or more severe exacerbations in the previous year. Logistic and negative binomial regression models were used for the multivariate analysis. All multivariate models were adjusted for age, sex, household income, residential proximity to a major road, and (for atopy) case/control status; those for severe exacerbations were also adjusted for use of inhaled corticosteroids and Vitamin D insufficiency (a plasma 25[OH] D ,30 ng/ml). Measurements and Main Results: In a multivariate analysis, folate deficiency was significantly associated with an increased degree of atopy and 2.2 times increased odds of at least one severe asthma exacerbation (95% confidence interval for odds ratio, 1.1-4.6). Compared with children who had normal levels of both folate and Vitamin D, those with both folate deficiency and Vitamin D insufficiency had nearly eightfold increased odds of one or more severe asthma exacerbation (95% confidence interval for adjusted odds ratio, 2.7-21.6). Conclusions: Folate deficiency is associated with increased degree of atopy and severe asthma exacerbations in school-aged Puerto Ricans. Vitamin D insufficiency may further increase detrimental effects of folate deficiency on severe asthma exacerbations.
AB - Background: Little is known about folate and atopy or severe asthma exacerbations. We examined whether folate deficiency is associated with number of positive skin tests to allergens or severe asthma exacerbations in a high-risk population and further assessed whether such association is explained or modified by Vitamin D status. Methods: Cross-sectional study of 582 children aged 6 to 14 years with (n = 304) and without (n = 278) asthma in San Juan, Puerto Rico. Folate deficiency was defined as plasma folate less than or equal to 20 ng/ml.Our outcomes were the number of positive skin tests to allergens (range, 0-15) in all children and (in children with asthma) one or more severe exacerbations in the previous year. Logistic and negative binomial regression models were used for the multivariate analysis. All multivariate models were adjusted for age, sex, household income, residential proximity to a major road, and (for atopy) case/control status; those for severe exacerbations were also adjusted for use of inhaled corticosteroids and Vitamin D insufficiency (a plasma 25[OH] D ,30 ng/ml). Measurements and Main Results: In a multivariate analysis, folate deficiency was significantly associated with an increased degree of atopy and 2.2 times increased odds of at least one severe asthma exacerbation (95% confidence interval for odds ratio, 1.1-4.6). Compared with children who had normal levels of both folate and Vitamin D, those with both folate deficiency and Vitamin D insufficiency had nearly eightfold increased odds of one or more severe asthma exacerbation (95% confidence interval for adjusted odds ratio, 2.7-21.6). Conclusions: Folate deficiency is associated with increased degree of atopy and severe asthma exacerbations in school-aged Puerto Ricans. Vitamin D insufficiency may further increase detrimental effects of folate deficiency on severe asthma exacerbations.
KW - Asthma
KW - Children
KW - Folate
KW - Puerto Ricans
UR - http://www.scopus.com/inward/record.url?scp=84988942596&partnerID=8YFLogxK
U2 - 10.1513/AnnalsATS.201508-549OC
DO - 10.1513/AnnalsATS.201508-549OC
M3 - Article
C2 - 26561879
AN - SCOPUS:84988942596
SN - 2325-6621
VL - 13
SP - 223
EP - 230
JO - Annals of the American Thoracic Society
JF - Annals of the American Thoracic Society
IS - 2
ER -