Effect of vitamin D supplementation on asthma control in patients with vitamin D deficiency: the ACVID randomised clinical trial

Thorax ◽  
2020 ◽  
pp. thoraxjnl-2019-213936
Author(s):  
Rubén Andújar-Espinosa ◽  
Lourdes Salinero-González ◽  
Fátima Illán-Gómez ◽  
Manuel Castilla-Martínez ◽  
Chunshao Hu-Yang ◽  
...  

BackgroundThe relationship between asthma and vitamin D deficiency has been known for some time. However, interventional studies conducted in this regard have shown conflicting results.ObjectiveTo evaluate the efficacy of vitamin D supplementation in asthmatic patients in improving the degree of control of asthma.MethodsRandomised, triple-blind, placebo-controlled, parallel-group study in adult asthmatic patients with serum 25-hydroxyvitamin-D3 <30 ng/mL. The intervention group received oral supplementation with 16 000 IU of calcifediol per week, and the control group had placebo added to their usual asthma treatment. The study period was 6 months. The primary endpoint was the degree of asthma control as determined by the asthma control test (ACT). Secondary endpoints included quality of life measured using the mini Asthma Quality of Life Questionnaire, the number of asthma attacks, oral corticosteroid cycles, the dose of inhaled corticosteroids, number of emergency visits, unscheduled consultations with the primary care physician and hospitalisations for asthma.ResultsOne hundred and twelve patients were randomised (mean age 55 years, with 87 (78%) being women). Of the 112 patients, 106 (95%) completed the trial. Half the patients (56) were assigned to the intervention group and the other half to the control group. A statistically significant clinical improvement was observed in the intervention group (+3.09) compared with the control group (−0.57) (difference 3.66 (95% CI 0.89 to 5.43); p<0.001) as measured using ACT scores. Among the secondary endpoints, a significant improvement in the quality of life was found in the intervention group (5.34), compared with the control group (4.64) (difference 0.7 (95% CI 0.15 to 1.25); p=0.01).ConclusionAmong adults with asthma and vitamin D deficiency, supplementation with weekly oral calcifediol compared with placebo improved asthma control over 6 months. Further research is needed to assess long-term efficacy and safety.Trial registration numberNCT02805907.

2021 ◽  
Author(s):  
Soraia Nogueira Felix ◽  
Rosana Camara Agondi ◽  
Marcelo Vivolo Aun ◽  
Clarice Rosa Olivo ◽  
Francine Maria de Almeida ◽  
...  

Abstract This study aimed to evaluate the clinical evolution, functional parameters and inflammatory activity of asthma in patients who submitted to an educational intervention. 58 adult patients over 18 years of age with partly controlled and uncontrolled asthma were randomized into an intervention group (IG) (N = 32) and a control group (CG) (N = 26) and evaluated for 12 weeks. The Asthma Control Test (ACT), Asthma Control Questionnaire (ACQ), Asthma Quality Life Questionnaire (AQLQ) and Beck Depression Inventory (BDI) questionnaires were applied. Spirometry, exhaled nitric oxide (NO), exhaled breath condensate (EBC) and induced sputum (IS), measurement of the peak flow and symptoms were performed. The IG patients received an educational activity for 30 minutes applied by a nurse. Statistical analysis: analysis of variance with repeated intragroup measures. IG presented a decreased number of eosinophils in IS and IL-17A in EBC, an increase in the percentage of FEV1 after bronchodilatation and an improvement in quality of life compared to the CG. There was an improvement in depression levels and a decrease in IL-4 and IL-5 in the IS and in the EBC in the IG compared to the CG. Our results suggest that an educational intervention can bring benefits concerning the control of inflammation, lung function alterations, quality of life and levels of depression in asthmatic patients. Registration: ClinicalTrials.gov; NCT03655392.


2018 ◽  
Vol 17 (1) ◽  
pp. 17-22
Author(s):  
Mottaghi Peyman ◽  
Miraghajani Maryam ◽  
Hajianfar Hossein ◽  
Abadi Rayehe Shekl

Non-specific musculoskeletal pains (CNMP) are common problem with unknown etiology which has become a major concern because of their negative impact on health. The aim of the present study was to investigate the effect of vitamin D supplementation on pain scores, quality of life, self-rated health and sexual satisfaction among CNMP patients with vitamin D deficiency. In this clinical trial study, sixty-six patients (18–50 years in both sex) with CNMP and vitamin D deficiency were randomly assigned to consume 50000 IU vitamin D, once every week for 8 weeks in the intervention group or placebo in the control condition. Clinical examination, pain scores, quality of life (QoL), self-rated health and sexual satisfaction were measured at the beginning and at the end of study. Patients in the vitamin D group had a significant pain relief after 8 weeks compared to the placebo group (p = 0.04 vs. p = 0.42). Also, they had increased QoL scores and sexual satisfaction compared with placebo (p < 0.0001 and p = 0.01, respectively). We observed a significant effect on improvement of quality of life, sexual satisfaction and pain in patients with CNMP after administration of therapeutic doses of vitamin D. Such findings could be considered to implement informative interventional programs to control CNMP complications and develop practical policies to improve the diet quality among CNMP patients. Further studies are needed to determine whether vitamin D supplementation lead to significant modifications in CNMP complications with consideration of confounding factors in different population.


2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Soraia Nogueira Felix ◽  
Rosana Câmara Agondi ◽  
Marcelo Vivolo Aun ◽  
Clarice Rosa Olivo ◽  
Francine Maria de Almeida ◽  
...  

AbstractThis study aimed to evaluate the clinical evolution, functional parameters and inflammatory activity of asthma in patients who submitted to an educational intervention. 58 adult patients over 18 years of age with partly controlled and uncontrolled asthma were randomized into an intervention group (IG) (N = 32) and a control group (CG) (N = 26) and evaluated for 12 weeks. The Asthma Control Test (ACT), Asthma Control Questionnaire (ACQ), Asthma Quality Life Questionnaire (AQLQ) and Beck Depression Inventory (BDI) questionnaires were applied. Spirometry, exhaled nitric oxide (NO), exhaled breath condensate (EBC) and induced sputum (IS), measurement of the peak flow and symptoms were performed. The IG patients received an educational activity for 30 min applied by a nurse. Statistical analysis: analysis of variance with repeated intragroup measures. IG presented a decreased number of eosinophils in IS and IL-17A in EBC, an increase in the percentage of FEV1 before and after bronchodilator and an improvement in quality of life compared to the CG. There was an improvement in depression levels and a decrease in IL-4 and IL-5 in the IS and in the EBC in both groups. Our results suggest that an educational intervention can bring benefits concerning the control of inflammation, lung function alterations, quality of life and levels of depression in asthmatic patients. Registration: ClinicalTrials.gov; NCT03655392.


2002 ◽  
Vol 9 (4) ◽  
pp. 253-259 ◽  
Author(s):  
Robert L Cowie ◽  
Margot F Underwood ◽  
Cinde B Little ◽  
Ian Mitchell ◽  
Sheldon Spier ◽  
...  

BACKGROUND: Asthma is common and is often poorly controlled in adolescent subjects.OBJECTIVE: To determine the impact of an age-specific asthma program on asthma control, particularly on exacerbations of asthma requiring emergency department treatment, and on the quality of life of adolescents with asthma.METHODS: The present randomized, controlled trial included patients who were 15 to 20 years of age and had visited emergency departments for management of their asthma. The interventional group attended an age-specific asthma program that included assessment, education and management by a team of asthma educators, respiratory therapists and respiratory physicians. In the control group, spirometry was performed, and the patients continued to receive usual care from their regular physicians. The outcomes were assessed by a questionnaire six months after entry into the study.RESULTS: Ninety-three subjects entered the study and were randomly assigned to the intervention or control group. Of these, only 62 patients were available for review after six months. Subjects in both the control and the intervention groups showed a marked improvement in their level of asthma control, reflected primarily by a 73% reduction in the rate of emergency department attendance for asthma. Other indexes of disease control, including disease-specific quality of life, as assessed by questionnaires, were improved. There was, however, no discernible difference between the subjects in the two groups, with the exception of an improvement in favour of the intervention group in the symptom (actual difference 0.7, P=0.048) and emotional (actual difference 0.8, P=0.028) domains of the asthma quality of life questionnaire. The overall quality of life score favoured the intervention group by a clinically relevant difference of 0.6, but this difference did not reach statistical significance (P=0.06).CONCLUSIONS: Although all subjects demonstrated a significant improvement in asthma control and quality of life, the improvement attributable to this intervention was limited to two domains in disease-specific quality of life.


2018 ◽  
Vol 50 (10) ◽  
pp. 747-753
Author(s):  
Yanhui Lu ◽  
Xiaomin Fu ◽  
Lili Zhang ◽  
Minyan Liu ◽  
Xiaoling Cheng ◽  
...  

AbstractThe incidence of vitamin D deficiency is high globally, and vitamin D supplementation draws particular attention. The objective of this study was to investigate the effects of stratified vitamin D supplementation in middle-aged and elderly individuals with vitamin D insufficiency in Beijing. A total of 448 subjects aged over 40 years old were selected from a community in Beijing. Among them, 100 middle-aged and elderly people with vitamin D insufficiency were randomly selected on a voluntary basis. They were further divided into control group and intervention group. The control group received health education and lifestyle guidance, and the intervention group received lifestyle guidance and vitamin D supplementation for nine months. The doses were stratified as follows: for vitamin D insufficiency, oral vitamin D3 supplement was given at 5000 IU/w; for mild vitamin D deficiency, oral vitamin D3 supplement was given at 10 000 IU/w; for severe vitamin D deficiency, oral vitamin D3 supplement was given at 15 000 IU/w. Safety evaluation was conducted after three-month treatment. The intervention group consisted of 8%, 62%, and 30% of cases who had vitamin D insufficiency, mild vitamin D deficiency, and severe vitamin D deficiency, respectively, which were similar with the control group. It showed that the blood 25(OH)D level increased significantly in the intervention group, from 14.30±4.30 ng/ml to 33.62±6.99 ng/ml (p<0.001), in contrast to insignificant change in the control group. Stratified vitamin D supplementation effectively increased the blood 25(OH)D level, as well as the number of cases with corrected vitamin D insufficiency or deficiency.


2019 ◽  
Vol 6 (1) ◽  
pp. 59
Author(s):  
Dewi Kania Intan Permatasari ◽  
Irna Sufiawati

Background: Vitamin D has several roles, namely physiological function of calcium and bone metabolism, cell growth and differentiation, immune and cardiovascular function. Vitamin D deficiency can cause the risk of cancer. Head and neck cancer is one of the cancers that occur due to vitamin D deficiency in the body. This literature review was to asses and evaluate the impact and benefits of vitamin D supplementation for head and neck cancer.Discussion: A study found an association between vitamin D supplementation and a low risk of recurrence in conditions of high total vitamin D levels. Another study found a significant increase in quality of life (QOL). The primary mechanism of vitamin D action is mediated through binding of either 1,25(OH)2D3 (active form) or 25(OH)D (less active form) to the VDR, which is a member of the nuclear receptor superfamily of steroid and thyroid hormones with gene-regulatory and consequent anti-proliferative properties.Conclusions: Vitamin D supplementation provides a role in improving the condition of patients with head and neck cancer. Both in terms of suppressing recurrence and in terms of increasing quality of life


2015 ◽  
Vol 27 (1) ◽  
pp. 185 ◽  
Author(s):  
M. Taheri ◽  
M. Modarres ◽  
A. Abdollahi

Vitamin D deficiency has been correlated with the infertility and lower clinical pregnancy following IVF. Anti-Mullerian hormone (AMH) plays a key role during follicle development; it has been recognised as a predictor of regular ovulation and probably IVF success. Considering the critical need for experimental human study to investigate the impact of vitamin D supplementation on ovulatory function, the aim of this study was to demonstrate the effectiveness of the vitamin D supplementation on AMH serum levels among reproductive-age women with vitamin D deficiency. 195 reproductive women (18–35 year-old) with confirmed vitamin D deficiency [serum 25(OH)D <75 nmol L–1] and without diagnosed polycystic ovary syndrome (PCOS) were enrolled to this controlled clinical trial. Participants were randomly assigned to a control group (n = 96) or an intervention group (n = 99). Women in the intervention group used 2000 IU day–1 vitamin D drops for 15 weeks. 19 participants were missed during the follow-up; finally the numbers of women in the intervention and control groups were 91 and 85, respectively. At the beginning of the study and after the intervention, 25-hydroxyvitamin D and AMH serum levels were quantified using enzyme immunoassay (EIA; Immunodiagnostic Systems, Boldon, UK) and ELISA (Beckman-Coulter Inc., Fullerton, CA, USA) methods respectively. The post-intervention AMH measurement was performed after 2–5 weeks in the same day-of-cycle on which basal AMH measurement was done. Paired t-test, independent t-test, and Pearson correlation were used as appropriate and a P-value of less than 0.05 was considered significant. Significantly low AMH levels were seen in the vitamin D deficient women of this study (14.46 ± 11.92 pmol L–1 in control group and 14.09 ± 11.52 pmol L–1 in intervention group). After the intake of vitamin D supplementation in intervention group, AMH levels were increased to 24.89 ± 12.47 pmol L–1, which were significantly different from the 15.43 ± 13.03 pmol L–1 in control group (P < 0.001). Correlation coefficients for AMH with pre-intervention and post-intervention vitamin D were r = 0.489 and r = 0.599 respectively (P < 0.001). Treatment of vitamin D deficiency increases AMH to the optimum levels. Vitamin D deficient women had low levels of AMH. These findings support other studies which found a correlation of poor IVF outcomes with low vitamin D levels. Vitamin D supplementation could be useful in the improvement of controlled ovarian hyper-stimulation/IVF outcomes in case of vitamin D deficiency.


2021 ◽  
Author(s):  
Elahe Bahmani ◽  
Rastegar Hoseini ◽  
Ehsan Amiri

Abstract Background: Multiple sclerosis (MS)is the most common neurological disease that causes disability in the nervous system which reduces the quality of life(QoL). Studies have shown positive effects of therapeutic exercise with supplementation on motor- and cognitive functionandfatigue as well as on QoLin persons with MS. The purpose of this study was to the effect of home-based aerobic training (AT) and vitamin D(Vit D) supplementation on fatigue and QoL in patients with MS during the covid-19 outbreak. Methods: We recruited 40 females (20 - 40 years) with MS(EDSS: 3-5). Then, using simple randomization, the subjects were assigned to four groups including aerobic training (AT; n=9; 50%-75%, 20-40 min/day, 3 days/wk aerobic training), vitamin D supplementation (Vit D; n=9; 50,000 IU one day/week), aerobic training plus vitamin D supplementation (AT + Vit D; n=10), and sedentary control (C; n=10 placebo). The data were analyzed using paired t-test and one-way analysis of variance and Tukey’s post hoc test with SPSS21 at a significance level of P < 0.05.Results: After eight weeks of intervention, fatigue grade markedly reduced in the AT + Vit D, AT, and Vit D groups); However, fatigue increased in the control group. QoLincreased significantly in AT+Vit D, AT, and Vit D compared to C. Also, the results show that the AT+Vit D had significantly higherQoL compared to AT and Vit D. Conclusion:These findings suggest that therapeutic AT and VitD supplementation is very effective in reducing fatigue and consequently improves the QoLin female MS patients.


Author(s):  
A. T. Sharman ◽  
Sh. K. Adambekov ◽  
A. A. Imandosova ◽  
G. F. Elemesova

Objective: to study the prevalence of vitamin D deficiency and analyze the results of therapy in office workers, including an assessment of the quality of life.Material and methods. An observational non-interventional cross-sectional, cohort, prospective phase IV clinical study included office workers (151 people, age 18–44 years), who were prescribed an aqueous solution of vitamin D. The concentration of 25(OH)D in the blood of patients was measured before and after undergoing treatment. The duration of therapy, depending on the degree of deficiency, was 4 or 8 weeks. The SF-36 scale was used to assess the physiological and psychological status.Results. In 75.5% of the study participants, a insufficiency or deficiency of vitamin D was detected. Differences in the average content of 25(OH)D in blood serum before and after treatment with vitamin D were statistically significant. The level of vitamin D in blood serum, measured by the content of its metabolite 25(OH)D <30 ng/ml, is regarded as suboptimal, i.e. its insufficiency occurs, and <20 ng/ml – as vitamin D deficiency (p<0.0001). The SF-36 score showed significant statistically significant improvements in overall health, physical functioning, and pain in individuals with vitamin D deficiency after vitamin D supplementation. The use of multiple linear regression demonstrated an association of serum 25(OH)D levels with vitamin D-rich foods taken less than once a week.Conclusions. Vitamin D deficiency is very common among office workers: 75.5% had D 25(OH)D levels below 30 ng/ml. Vitamin D deficiency is corrected by taking this vitamin. Vitamin D supplementation helps to improve physical and mental health indicators. Serum 25(ОН)D levels are associated with intake of vitamin D-rich foods and duration of vitamin D treatment.


2019 ◽  
Vol 2019 ◽  
pp. 1-9 ◽  
Author(s):  
Anita Yadav ◽  
Parbati Thapa

Purpose. Asthma is a chronic disease which cannot be cured but can be controlled. Although drug therapy is used to relieve and prevent symptoms of asthma and treat exacerbations, still a good asthma control and a better quality of life in many patients is suboptimal due to improper use of inhalation technique. Thus, this interventional study was conducted to evaluate the effect of a pharmacist intervention on asthma control, quality of life and inhaler technique in adult asthmatic patients. Patients and Methods. A total of 72 patients who met the inclusion criteria and agreed to give written consent were enrolled in the study. These patients were randomly divided into two groups i.e., test group (36) and control group (36) by simple block randomization technique. Test group were the interventional groups. Mini Asthma Quality of Life Questionnaire (AQLQ), Asthma Control Questionnaire (ACQ) and structured questionnaires were used to sort the information like quality of life, asthma control and demographic details. They were counselled by the pharmacist about the asthma management and proper use of inhalers. Out of 72 patients, only forty six patients came for follow up after one month. Data were entered and analyzed using Statistical Package for Social Sciences (SPSS) software version 20. Results. A significant change was observed in the mean score of quality of life (p=0.001) in test group as well as control group, however change in the mean score of asthma control in the test group (p=0.001) was more significant as compared to the control group (p=0.099). Inhalation technique was found to be improved significantly after intervention among patients using the metered dose inhaler and dry powder inhaler. Majority of the patients were prescribed with Methylxanthines (24.5%) followed by combined Beta 2 agonists and Inhaled Corticosteroids (21.7%). Conclusion. Pharmacist provided intervention improves the quality of life, asthma control and inhalation technique among asthmatic patients.


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