Serum Vitamin D Levels in a Population of Adult Asthmatics in Kinshasa, Democratic Republic of Congo

Authors

  • B Kabengele Department of Pneumology, University Clinics of Kinshasa, School of Medicine, University of Kinshasa, Kinshasa, Democratic Republic of Congo
  • P Akilimali Kinshasa School of Public Health, University of Kinshasa, Kinshasa, Democratic Republic of Congo
  • D Kaba Kinshasa School of Public Health, University of Kinshasa, Kinshasa, Democratic Republic of Congo
  • P Kayembe Kinshasa School of Public Health, University of Kinshasa, Kinshasa, Democratic Republic of Congo
  • Z Kashongwe Department of Pneumology, University Clinics of Kinshasa, School of Medicine, University of Kinshasa, Kinshasa, Democratic Republic of Congo
  • JM Kayembe Department of Pneumology, University Clinics of Kinshasa, School of Medicine, University of Kinshasa, Kinshasa, Democratic Republic of Congo

Keywords:

Asthma, BMI, Democratic Republic of Congo, FEV1, Sub-Saharan African, Vitamin D.

Abstract

Background: Vitamin D deficiency is common in general population and is thought to be involved in the natural history of several chronic lung diseases such as asthma. However, the magnitude of the association has not yet been reported in asthmatic adults in Sub-Saharan Africa.  The aim of this study was to determine serum vitamin D levels in adult patients with asthma living in Kinshasa. Methods: A sample of 216 subjects reporting asthma were recruited from the University Clinics of Kinshasa and some parishes in Kinshasa. Socio-demographic data were recorded, nutritional status assessed via body mass index (BMI) calculation, FEV1 values obtained, and serum vitamin D levels measured. Serum vitamin D levels were analyzed according to the time spent outdoors in the sun and their correlation with BMI and FEV1. Results: Participants were on average 45.23 years old (SD 17.56) and predominately female (74%). Serum vitamin D levels ranged from 5 to 42 ng/ml, with an average of 20.8 ng/ml (SD 6.1). Vitamin D levels were normal (?30 ng/ml) in ten subjects (4.8%; 95% CI: 1.9-7.7) and abnormal (<30 ng/ml) in 197 subjects (95.2%; 95% CI: 92.0-98.0); of this latter group, 89% (95% CI: 84.6-93.2) were vitamin D insufficient (10-29 ng/ml) and 6% (95% CI: 3.0-9.6) vitamin D deficient (<10 ng/ml).

Mean serum vitamin D levels did not differ based on the time spent outdoors in the sun (p = 0.714), and there was no correlation between serum vitamin D and FEV1 (r = 0.018) or BMI (r = 0.033). Conclusions: Vitamin D insufficiency is common in adult asthmatics in Kinshasa but does not appear to be correlated with FEV1 or BMI. Additional population-based surveys are needed to fully assess associations between asthma and vitamin D concentrations for targeted interventions.

References

. Global Initiative for Asthma. Global Strategy for Asthma Management and Prevention. [On-line]. Updated 2018. Available: http://www.ginasthma.org/ Global Strategy for Asthma Management and Prevention [Sept. 13, 2018].

. A.A. Awotedu, E. Igunbor, A.G. Falade AG. “Epidemiology of asthma in Africa - An overview,” in Asthma in Africa. 1st edit. Tetfund, 2012, pp. 5-22.

. Global Asthma Network. The Global Asthma Report 2014. [On-line]. Available: http://www.globalasthmareport.org/ The Global Asthma Report 2014 [May 23, 2018].

. Augusto A. Litonjua. “Vitamin D Deficiency as a risk factor for childhood allergic disease and asthma.” Current Opinion in Allergy and Clinical Immunology, vol. 12, pp. 179-85, Oct 2012.

. K.B. Obel, K.JM. Ntumba, K.P. Kalambayi, A.P. Zalagile, K.D. Kinkodi, K.Z. Munogolo.” Prevalence and determinants of asthma in adults in Kinshasa.” PLoS One, vol. 12, e0176875, May 2017.

. P. Lajoie, G. Dagenais, P. Ernst, F. Neukirch. ”Systèmes respiratoire et cardio-vasculaire, ” in Environnement et santé publique - Fondements et pratiques. pp. 713-45, 2003.

. W. Pearce, N. Aït-Khaled, R. Beasley, J. Nallol, U. Keil, E. Mitchell et al.” Worldwide trends in the prevalence of asthma symptoms: Phase III of the International Study of Asthma and Allergies in Childhood (ISAAC).” Thorax, vol. 62, pp. 757-66, May 2007.

. N. Le Moual, B. Jacquemin, R. Varraso, O. Dumas, F. Kauffmann, R. Nadif.” Environment and asthma in adults.” La Presse Médicale, vol. 42, pp. e317-e33, Sept. 2013.

. C. Laprise, E. Bouzigon. “To define the biological nature of asthma.” Current Opinion in Allergy and Clinical Immunology, vol. 11, pp. 391-92, Oct. 2011.

. JM. Kayembe Ntumba. “Asthma in Central Africa,” in Asthma in Africa. 1st edit. Tetfund,2012, pp. 45-52.

. A.A. Cruz, E.D. Baterman, J. Bousquet. “The social determinants of asthma.” European Respiratory Journal, vol. 35, pp. 239-42, Feb. 2010.

. F. Mugusi, R. Edwards, L. Kayes, N. Unwin, JC. Mbanya, D. Whiting et al. “Prevalence of wheeze and self-reported asthma and asthma care in an urban and rural area of Tanzania and Cameroun.” Tropical Doctor, vol. 34, pp. 209-14, Oct 2004.

. P. Autier, M. Boniol, C. Pizot, P. Mullie. “Vitamin D status and ill health: a systematic review.” The Lancet Diabetes & Endocrinology, vol. 2, pp. 76-89, Jan. 2014.

. A.M. Turner, L. McGowan, A. Millen, P. Rajesh, C. Webster, G. Langnan et al. “Circulating DBP level and prognosis in operated lung cancer: an exploration of pathophysiology. European Respiratory Journal, vol. 41, pp. 410-16, Feb. 2013.

. C. Herr, T. Greulich, R.A. Koczulla, S. Meyer, T. Zakharkina, M. Branscheidt et al. “The role of vitamin D in pulmonary disease: COPD, asthma, infection, and cancer. Respiratory Research, vol. 12, pp. 31, March 2011.

. J.L. Vacek, S.R. Vanga, M.L. Good, S.M. Lai, D. Lakkiredy, P.A. Howard. “Vitamin D deficiency and supplementation and relation to cardiovascular health.” The American Journal of Cardiology, vol. 109, pp. 359-63, Feb 2012.

. R.J. Freishtat, S.F. Iqbal, D.K. Pillai, C.J. Klein, L.M. Ryan, A.S. Benton et al.” High prevalence of vitamin D deficiency among inner-city African American youth with asthma in Washington, DC.” The Journal of Pediatrics, vol. 156, pp. 948-52, June 2010.

. D.A. Searing, Y. Zhang, J.R. Murphy, P.J. Hauk, E. Goleva, D.Y. Leung.” Decreased serum vitamin D levels in children with asthma are associated with increased corticosteroid use.” The Journal of Allergy and Clinical Immunology, vol. 125, pp. 995-1000, May 2010.

. M. Columbo, R.A. Panettieri Jr, A.S. Rohr. Asthma in the elderly: a study of the role of vitamin D. Allergy, Asthma & Clinical Immunology, vol. 10, pp. 48, Sept. 2014.

. E. Toubi, Y. Shoenfeld. “The role of vitamin D in regulating immune responses.” The Israel Medical Association journal, vol. 12, pp. 176-7, March 2010.

. D.A. Hughes, R. Norton. “Vitamin D and respiratory health.” Clinical and Experimental Immunology, vol. 158, pp. 20-5, Oct. 2009.

. H.A. Bischoff-Ferrari, E. Giovannucci, W.C. Willett, T. Dietrich, B. Dawson-Hughe. “Estimation of optimal serum concentration of 25-hydroxyvitamin D for multiple health outcomes. “The American Journal of Clinical Nutrition, vo. 84, pp. 18-24, Jul. 2006.

. C.R. Gilbert, S.M. Arum, C.M. Smith. “Vitamin D deficiency and chronic lung disease.” Canadian Respiratory Journal, vol. 16, pp. 75-80, May/June 2009.

. E. Giovannucci, Y. Liu, E.B. Rimm, B.W. Hollis, C.S. Frichs, M.J. Stampfer et al.” Prospective study of predictors of vitamin D status and cancer incidence and mortality in men.” Journal of Nationale Cancer Institute, vol. 98, pp. 451-9, April 2006.

. M.F. Holick.” Vitamin D deficiency.” The New England Journal of Medicine, vol. 357, pp. 266-81, July 2007.

. A.R. Foray. ”Etude de prévalence de la carence en vitamine D chez des sujets adultes sains de 18 à 50 ans en Haute Savoie. ” M.D. thesis, Université Joseph Fournier, Faculté de Médecine de Grenoble, France, 2012.

. M.F. Holick, T.C. Chen.” Vitamin D deficiency: a worldwide problem with health consequences.” The American Journal of Clinical Nutrition, vol. 87 Suppl, pp. 1080S-6S, 2008.

. B.A. Raby, R. Lazarus, E.K. Silverman, S. Lake, C. Lange, M. Wjst et al.” Association of Vitamin D receptor gene polymorphisms with childhood and adult asthma.” American Journal of Respiratory and Critical Care Medicine, vol. 170, pp. 1057-65, Nov. 2004.

. S. Hansdottir, M.M. Monick, S.L. Hinde, N. Lovan, D.C. Look, G.W. Hunninghake.” Respiratory epithelial cells convert inactive vitamin D to its active form: potential effects on host defense.” The Journal of Immunology, vol. 181, pp. 7090-9, Dec 2008.

. Z. Urry, E. Xystrakis, D.F. Richards, J. McDonald, Z. Sattar, D.J. Cousins et al.” Ligation of TLR9 induced on human IL-10-secreting Tregs by 1 alpha,25 dihydroxyvitamin D3 abrogates regulatory function.” The Journal of Clinical Investigation, vol. 119, pp. 387-98, Feb 2009.

. Y. Song, H. Qi, C. Wu.” Effect of 1,25-(OH)2D3 (a vitamin D analogue) on passively sensitized human airway smooth muscle cells.” Respirology, vol. 12, pp. 486-94, July 2007.

. C. Gonzales.” Vitamin D supplementation: an update.” US Pharmacist. Jobson Publishing. 2010.

. N. Binkley, R. Novotny, D. Krueger, T. Kawahara, Y.G. Daida, G. Lensmeyer et al.” Low Vitamin D Status despite Abundant Sun Exposure.” The Journal of Clinical Endocrinology & Metabolism, vol. 92, pp. 2130-5, June 2007.

. H. Friis, N. Range, J. Changalucha, G. PrayGod, K. Jeremiah, D. Faurholt-Jepsen et al. “ Vitamin D status among pulmonary TB patients and non-TB controls: a cross-sectional study from Mwanza, Tanzania.” PLoS One, vol. 8, pp. e81142, Dec. 2013.

. D. Nansera, F.M. Graziano, D.J. Friedman, M.K. Bobbs, A.N. Jones, K.E. Hansen.” Vitamin D and calcium levels in Uganda adults with human immunodeficiency virus and tuberculosis.” The International Journal of Tuberculosis and Lung Disease, vol. 15, pp. 1522-28, Nov 2011.

. National Health and Nutrition Examination Survey. Center for Health Statistics. Centers for Disease Control and Prevention. Internet: http://www.cdc.gov/nchs/nhanes/index.htm. [Jul. 28, 2018].

. J.D. Finklea, R.E. Grossmann, V. Tangpricha. “Vitamin D and chronic lung disease: a review of molecular mechanisms and clinical studies.” Advances in Nutrition, vol. 2, pp. 244-53, May 2011.

. E.W. Pefura-Yone, A.P. Kengne, A.D. Balkissou, JR. Boulleys-Nana, N.R. Efe-de-Melingui, P.I. Ndjeutcheu-Moualeu et al.” Prevalence of asthma and allergic rhinitis among adults in Yaounde, Cameroon.” PLoS One, vol. 10, pp. e0123099, Apr. 2015.

. A.M.B. Menezes, F.C. Wehrmeister, B. Horta, C.L. Szwarcwald, M.L. Vieira, D.C. Malta.” Prevalence of asthma medical diagnosis among Brazilian adults: National Health Survey, 2013.” Revista Brasileira de Epidemiologia, vol. 18 Suppl, pp. 204-13, Dec 2015.

. B. Wallaert, S. Kouzan, C. Leroyer, C. Delacourt, A.B. Roguedas. ” Quelle est la place de l’examen clinique chez l’asthmatique allergique. ” Revue des Maladies Respiratoires, vol. 24, pp. 34-40, Oct 2007.

. A. Ekici, M. Ekici, P. Kocyigit, A. Karlidag.” Prevalence of self-reported asthma in urban and rural areas of Turkey.” Journal of Asthma, vol. 49, pp. 522-6, Jun. 2012.

. T.D. Nyembwe, M. Jorissen, P.W. Hellings, C. Muyunga, JM. Kayembe. “Prevalence and determinants of allergic diseases in a Congolese population.” International Forum of Allergy and Rhinology, vol. 2, pp. 285-93, Jul./Aug. 2012.

. P. Ingala, J. Mbolokob, A. Tshiband, F. Lepira, P. Kayembe, B. Lebwaze et al.” Vitamin D Deficiency and Risk of Uterine Leiomyoma among Congolese Women. A Hospital-Based Case-Control Study.” American Scientific Research Journal for Engineering, Technology, and Sciences, vol. 22, pp. 126-37, 2016.

. JC. Souberbielle. ” Epidémiologie du déficit en vitamine D. ” Gériatrie Psychologie Neuropsychiatrie du Vieillissement, vol. 14, pp. 7-15, Mar. 2016.

. G. Rostand.” Ultraviolet light may contribute to geographic and racial blood pressure differences.” Hypertension, vol. 30, pp. 150-6, Aug. 1997.

. R. Goswami, N. Gupta, D. Goswami, R.K. Marwaha, N. Tandon, N. Kochupillai.” Prevalence and significance of low 25-hydroxyvitamin D concentration in healthy subjects in Delhi.” The American Journal of Clinical Nutrition, vol. 72, pp. 472-5, Aug. 2000.

. A.A Litonjua, S.T. Weiss. “Is vitamin D deficiency to blame for the asthma epidemic? “The Journal of Allergy and Clinical Immunology, vol. 120, pp. 1031-5, Nov. 2007.

. S. Korn, M. Hübner, M. Jung, M. Blettner, R. Buhl. “Severe and uncontrolled adult asthma is associated with vitamin D insufficiency and deficiency.” Respiratory Research, vol. 14, pp. 25, Feb. 2013.

. S.J. Parikh, M. Edelman, G.I. Uwaifo, R.J. Freedman, M. Semega-Janneh, J. Reynolds et al. “The relationship between obesity and serum 1,25-dihydroxy vitamin D concentration in healthy adults. “The Journal of Clinical Endocrinology and Metabolism, vol. 89 pp. 1196-9, Mar. 2004.

. I. Chinellato, M. Piazza, M. Sandri, D.G. Peroni, F. Cardinale, G.L. Piacentini et al. “Vitamin D serum levels and exercise –induced bronchoconstriction in children with asthma. “European Respiratory Journal, vol. 37, pp. 1366-70, Jun. 2011.

. F. Li, M. Peng, L. Jiang, Q. Sun, K. Zhang, F. Lian et al. “Vitamin D deficiency is associated with decreased lung function in Chinese adults with asthma. “Respiration, vol. 81, pp. 469-75, May 2011.

. E.R. Sutherland ER, E. Goleva E, L.P. Jackson, A.D. Stevens, D.Y.M. Leung. “Vitamin D levels, lung function, and steroid response in adult asthma. “ American Journal of Respiratory and Critical Care Medicine, vol. 181, pp. 699-704, Apr. 2010.

. G. Devereux, A. Wilson, A. Avenell, G. MacNeill, W.D. Fraser. “A case-control study of vitamin D status and asthma in adults. “Allergy, vol. 65, pp. 666-7, May 2010.

. J.M. Brehm, J.C. Celedón, M.E. Soto-Quiros, L. Avila, G.M. Hunninghake, E. Forno et al.” Serum vitamin D levels and markers of severity of childhood asthma in Costa Rica.” American Journal of Respiratory and Critical Care Medicine, vol. 179, pp. 765-71, May 2009.

Downloads

Published

2019-02-25

How to Cite

Kabengele, B., Akilimali, P., Kaba, D., Kayembe, P., Kashongwe, Z., & Kayembe, J. (2019). Serum Vitamin D Levels in a Population of Adult Asthmatics in Kinshasa, Democratic Republic of Congo. International Journal of Sciences: Basic and Applied Research (IJSBAR), 44(1), 102–114. Retrieved from https://gssrr.org/index.php/JournalOfBasicAndApplied/article/view/9757

Issue

Section

Articles