Correlation between Serum Vitamin D Levels and Allergic Rhinitis Severity at Vajira Hospital: A Cross-Sectional Study Correlation between Serum Vitamin D Levels and Allergic Rhinitis Severity
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Abstract
OBJECTIVE: Vitamin D affects the immune system and inflammatory process, and its deficiency is significantly associated with an increased prevalence of allergic rhinitis (AR). Therefore, the correlation between the serum 25-hydroxyvitamin D levels and the severity of AR symptoms must be investigated.
METHODS: This research utilized a cross-sectional approach, focusing on patients aged 18 years and above diagnosed with AR at the Vajira Hospital, Navamindradhiraj University, Bangkok, Thailand from August 15, 2023, to January 15, 2024. The relationship between AR severity and serum vitamin D levels was analyzed using Pearson correlation coefficient. AR severity on symptoms and quality of life was assessed using the Thai version of Sinonasal Outcome Test-22 (SNOT-22) and Rhinoconjunctivitis Quality of Life questionnaire-36 (RCQ-36) questionnaires. Serum-specific immunoglobulin E (IgE) and total IgE levels were also measured to examine their relationship with the serum vitamin D level.
RESULTS: Among the 58 participants, 34 (58.60%) had vitamin D deficiency. These individuals with vitamin D deficiency exhibited significantly higher AR severity compared with those without vitamin D deficiency. The mean difference between these groups was 21.90 points for SNOT-22 scores (95%CI: 17.71–26.69, p-value < 0.001) and 19.17 points for RCQ-36 scores (95%CI: 12.08–27.34, p-value < 0.001). Further analysis revealed a significant inverse correlation between serum vitamin D level and AR severity, with Pearson correlation coefficients of −0.72 for RCQ-36 (95%CI: −0.82 to −0.56, p-value < 0.001) and 0.80 for SNOT-22 (95%CI: −0.88 to −0.68, p-value < 0.001). No correlation with serum vitamin D level was found for serum-specific IgE and total IgE levels.
CONCLUSION: A significant inverse relationship existed between serum vitamin D levels and AR severity. No correlation with serum vitamin D level was found for serum-specific IgE and total IgE levels.
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References
Wise SK, Lin SY, Toskala E, Orlandi RR, Akdis CA, Alt JA, et al. International consensus statement on allergy and rhinology: allergic rhinitis. Int Forum Allergy Rhinol 2018;8(2):108-352.
Ciprandi G, Klersy C, Cirillo I, Marseglia GL. Quality of life in allergic rhinitis: relationship with clinical, immunological, and functional aspects. Clin Exp Allergy 2007;37(10):1528-35.
Wang DY. Risk factors of allergic rhinitis: genetic or environmental? Ther Clin Risk Manag 2005;1(2):115-23.
Bousquet J, Khaltaev N, Cruz AA, Denburg J, Fokkens WJ, Togias A, et al. Allergic rhinitis and its impact on asthma (ARIA) 2008 update (in collaboration with the World Health Organization, GA(2)LEN and AllerGen). Allergy 2008;63 Suppl 86:8-160.
Pawankar R, Bunnag C, Khaltaev N, Bousquet J. Allergic rhinitis and its impact on asthma in Asia Pacific and the ARIA update 2008. World Allergy Organ J 2012;5 Suppl 3:S212-7.
Bunnag C, Jareoncharsri P, Tantilipikorn P, Vichyanond P, Pawankar R. Epidemiology and current status of allergic rhinitis and asthma in Thailand -- ARIA Asia-Pacific workshop report. Asian Pac J Allergy Immunol 2009;27(1):79-86.
Jablonski NG, Chaplin G. The roles of vitamin D and cutaneous vitamin D production in human evolution and health. Int J Paleopathol 2018;23:54-9.
Kumar R, Rathi H, Haq A, Wimalawansa SJ, Sharma A. Putative roles of vitamin D in modulating immune response and immunopathology associated with COVID-19. Virus Res 2021;292:198235.
Mirzakhani H, Al-Garawi A, Weiss ST, Litonjua AA. Vitamin D and the development of allergic disease: how important is it? Clin Exp Allergy 2015;45(1):114-25.
The Endocrine Society of Thailand 2017. Recommendations for vitamin D insufficiency in the Thai population [internet]. 2017 [cited 2023 May 20]. Available from:http: //www.thaiendocrine.org/th/wp-content/uploads/2017/10/Vit-D-Booklet-20page_update-9Sep17-2.pdf>
Kim YH, Kim KW, Kim MJ, Sol IS, Yoon SH, Ahn HS, et al. Vitamin D levels in allergic rhinitis: a systematic review and meta-analysis. Pediatr Allergy Immunol 2016;27(6):580-90.
Aryan Z, Rezaei N, Camargo CA Jr. Vitamin D status, aeroallergen sensitization, and allergic rhinitis: a systematic review and meta-analysis. Int Rev Immunol 2017;36(1):41-53.
Sudiro M, Lestari BW, Madiadipoera T, Setiabudiawan B, Boesoirie TS. Vitamin D deficiency is correlated with severity of allergic rhinitis. OALib 2017;04(08):1-9.
Bailey BA, Manning T, Peiris AN. The impact of living in rural and urban areas: vitamin D and medical costs in veterans. J Rural Health 2012;28(4):356-63.
Siwamogsatham O, Ongphiphadhanakul B, Tangpricha V. Vitamin D deficiency in Thailand. J Clin Transl Endocrinol 2015;2(1):48-9.
Thai Rhinologic Society. Thai clinical practice guideline for allergic rhinitis (revised 2022). rcotJ 2022;23(1).
Cohen J. Statistical power analysis for the behavioral sciences. 2nd ed. Hillsdale: Lawrence Erlbaum Associates; 1977.
Bunnag C, Leurmarnkul W, Jareoncharsri P, Ungkanont K, Tunsuriyawong P, Kosrirukvongs P, et al. Development of a health-related quality of life questionnaire for Thai patients with rhinoconjunctivitis. Asian Pac J Allergy Immunol 2004;22(2-3):69-79.
Lumyongsatien J, Yangsakul W, Bunnag C, Hopkins C, Tantilipikorn P. Reliability and validity study of Sino-nasal outcome test 22 (Thai version) in chronic rhinosinusitis. BMC Ear Nose Throat Disord 2017;17:14.
Nimitphong H, Chailurkit LO, Chanprasertyothin S, Sritara P, Ongphiphadhanakul B. The association of vitamin D status and fasting glucose according to body fat mass in young healthy Thais. BMC Endocr Disord 2013;13:60.
Awan NU, Sohail SK, Naumeri F, Niazi S, Cheema K, Qamar S, et al. Association of serum vitamin D and immunoglobulin E levels with severity of allergic rhinitis. Cureus 2021;13(1):e12911.
Alnori H, Alassaf FA, Alfahad M, Qazzaz ME, Jasim M, Abed MN. Vitamin D and immunoglobulin E status in allergic rhinitis patients compared to healthy people. J Med Life 2020;13(4):463-8.
Bunjean K, Sukkasem K, Noppacroh N, Yamkaew N, Janthayanont D, Theerapancharern W, et al. Prevalence of allergic rhinitis and types of sensitized allergen in adult at Wat Intaram community, Hua Raeu, Phra Nakhon Si Ayutthaya District, Phra Nakhon Si Ayutthaya Province, Thailand. J Med Assoc Thai 2012;95 Suppl 5:S63-8.