Food, drug, insect sting allergy, and anaphylaxis
Vitamin D levels and food and environmental allergies in the United States: Results from the National Health and Nutrition Examination Survey 2005-2006

https://doi.org/10.1016/j.jaci.2011.01.017Get rights and content

Background

Previous research supports a possible link between low vitamin D levels and atopic disease. However, the association between low vitamin D levels and total and allergen-specific IgE levels has not been studied.

Objective

We sought to test the association between serum 25-hydroxyvitamin D (25[OH]D) deficiency (<15 ng/mL) and insufficiency (15-29 ng/mL) and allergic sensitization measured by serum IgE levels in a US nationally representative sample of 3136 children and adolescents and 3454 adults in the National Health and Nutrition Examination Survey 2005-2006.

Methods

The association of 25(OH)D deficiency with 17 different allergens was assessed after adjustment for potential confounders, including age; sex; race/ethnicity; obesity, low socioeconomic status; frequency of milk intake; daily hours spent watching television, playing videogames, or using a computer; serum cotinine levels; and vitamin D supplement use.

Results

In children and adolescents allergic sensitization to 11 of 17 allergens was more common in those with 25(OH)D deficiency. Compared with sufficient vitamin D levels of greater than 30 ng/mL, after multivariate adjustment, 25(OH)D levels of less than 15 ng/mL were associated with peanut (odds ratio [OR], 2.39; 95% CI, 1.29-4.45), ragweed (OR, 1.83; 95% CI, 1.20-2.80), and oak (OR, 4.75; 95% CI, 1.53-4.94) allergies (P < .01 for all). Eight other allergens were associated with 25(OH)D deficiency, with P values of less than .05 but greater than .01. There were no consistent associations seen between 25(OH)D levels and allergic sensitization in adults.

Conclusion

Vitamin D deficiency is associated with higher levels of IgE sensitization in children and adolescents. Further research is needed to confirm these findings.

Section snippets

Study population

The population of NHANES 2005-2006 is the civilian noninstitutionalized population of the United States. The survey used a complex, multistage, clustered, and stratified probability sample design to select participants. Non-Hispanic blacks and Mexican Americans were oversampled17 to obtain accurate estimates in these subpopulations. Data from the survey and details of the plan and operation of NHANES 2005-2006 are publicly available on the Centers for Disease Control/ National Center for Health

Participants’ characteristics

In children, adolescents, and adults 25(OH)D levels of less than 15 ng/mL were associated with being non-Hispanic black and Mexican American; having a low SES; television, videogame, or computer use for more than 4 h/d; a lower frequency of milk drinking; and not taking vitamin D supplements (Table I, Table II). Additionally, in children and adolescents older age and female sex were also associated with lower 25(OH)D levels.

Prevalence of positive IgE test results by 25(OH)D levels

Overall IgE sensitization was more common in children and adolescents

Discussion

We found consistent associations between vitamin D deficiency and the presence of allergies in children and adolescents. Although there were some protective associations between 25(OH)D deficiency and allergic sensitization in adults, these were not as consistent as in children. This is the first large study evaluating a relationship between 25(OH)D levels and allergic sensitization.

Vitamin D and its immunologic functions have been implicated in a variety of inflammatory and allergic diseases.

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    M. L. M. is supported by K23-DK078774 and J. K. is supported by K23 DK084339 from the National Institutes of Health.

    Disclosure of potential conflict of interest: M. L. Melamed has received research support from the National Institutes of Health. The rest of the authors have declared that they have no conflict of interest.

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