Abstracts from CIPP XVI Meeting Libon june 2017.pdf

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Patients and Methods

Objective: To assess asthma control and its association with vitamin D

37 asthmatic children (5 − 17 years; median: 11 years) were evaluated.

levels and spirometry in children and adolescents.

Children were recruited during scheduled follow-up visits or


exacerbations. Exhaled breath temperature (EBT), atopic status

We selected all children and adolescents with asthma from 7 to

including food allergy and medication used in the previous four weeks

17 years old, who were attended in the Pediatric Pulmonology

were assessed in each child.

Outpatient Clinic of the University of Campinas, Brazil, between

EBT was measured using the hand–held X-Halo® device

March and October/2016. In order to evaluate the asthma control

(Delmedica, Singapore). Children were inhaling through the nose

level, the Asthma Control Test was applied and the patients were

and exhaling into the thermal chamber of the device through the

classified into 3 Groups, Controlled Asthma(CA) when the question-

mouthpiece while tidal breathing. The average of two maneuvers

naire score was 25 points, Partially Controlled Asthma(PCA) with

taken 15 minutes apart was recorded. Prior to the maneuver, axillary

20–24 points and Uncontrolled Asthma (UNA) with scores less than 20

body temperature was recorded and the measurements were

points. A blood sample was taken to measure 25-hidroxivitamin

performed at a room temperature of 22–28 °C.

D(vitD) levels and the patients were classified in Sufficient Group-

Statistical Analysis

(greater than 30 ng/ml), Insufficient Group (20–29.9 ng/ml) and

SPSS 20 (IBM Corporation, USA) and STATISTICA 12 (StatSoft,

Deficient Group(less than 20 ng/ml). Questions regarding frequency

Poland) were used for statistical analysis. The results are

and time of sun exposure, use of sunscreen and vitD supplementation

expressed as mean ± SD for numerical data with normal distribu-

were administered. Sun exposure above 2 hours per week was

tion or as medians with interquartile range (IQR). Differences

considered sufficient for suitable metabolism of vitD. Patients also

between groups were analyzed using Student’s t-test for

underwent lung function measurement by spirometry. Data analysis

normally-distributed data. Within-group differences were evalu-

was performed using Chi-square, Fisher-Freeman-Halton and Krus-

ated with the paired t-test or Wilcoxon rank sum test where

kall-Wallis tests (p = 5%).

appropriate. Statistical significance was accepted at a level of



We included 85 children and adolescents with asthma, of whom 48

The study was approved by the Ethics Committee of Poznan

(56.5%) were male and the mean age was 10.99 ± 2.82 years, with a

University of Medical Sciences. Parental written informed consent was

median age of 11.00 (7–17) years. According to asthma control level,

obtained in each case.

14 (16.5%) patients were classified in the CA Group, 35 (41.3%) in the


PCA Group and 36 (42.4%) in the UNA Group. Regarding vitD level, 20

We performed 95 measurements in 37 children (19 males): 67

(23.5%) asthmatics were classified in the Sufficient Group, 55 (74.7%)

measurements were performed in stable condition and 28 measurements

in the Insufficient Group and 10 (11.8%) in the Deficient Group. There

during exacerbation. 27 children (72.9%) were sensitized to aeroallergens.

were no differences between age, height and body mass index

31 children (83.8%) were treated with inhaled glucocorticosteroids (ICS)

between groups. We did not find an association between vitD levels

and 2 (5.4%) received systemic steroids (SCS). The median [IQR] EBT in

and asthma control groups (p = 0.294). Our patients presented a mean

the whole group was 32.7 [1.7] °C; in stable patients 32.3 [1.1] °C and in

frequency of 3.16 ± 2.35 days per week and 59.76 ± 86.69 minutes per

exacerbations 33.3 [1.7] °C (p < 0.001). There was no difference in mean

day of sun exposure in activities such as playing football, playing on the

EBT in atopic and non-atopic children (33.6 ± 1.2 vs. 33.8 ± 1.1°C;

street, walking to and from school. However, only 15 (17.6%) patients

p = 0.78 in exacerbation and 32.6 ± 0.8 vs. 32.6 ± 1.2°C; p = 0.9 while

presented sufficient sun exposure. We also did not find association

stable). There was also no difference in mean EBT in children treated with

between frequency and time of sun exposure and groups of vitD level

either ICS or SCS and corticosteroids naive (32.7 ± 1.5 vs. 32.5 ± 2.2°C;

(p = 0.546). In our study, 78 (91.8%) children and adolescents did not

p = 0.83 and 33.0 ± 1.4 vs. 32.6 ± 1.8°C; p = 0.45 respectively).

use sunscreen daily and 5 (5.8%) asthmatics took vitD supplementa-

Neither atopy nor anti-inflammatory treatment influenced EBT in
asthmatic children, rendering it a valuable marker of asthma

tion. Regarding lung function measurement, there were no significant
differences between groups in vitD levels and spirometric values, such
as FEV1 (p = 0.501), FEV1/FVC (p = 0.984) and FEF25-75%
(p = 0.866).

exacerbation regardless of atopic status or current treatment.
In this study, we did not find an association between asthma control,

#A85 − Is there an Association of Asthma Control with
Vitamin D Levels and Spirometry in Children and
Matsunaga NY., Oliveira MS., Ribeiro MA., Morcillo AM., Ribeiro JD.,
Toro AA.
Pediatrics, University of Campinas − Campinas, Brazil

vitD levels and spirometry in children and adolescents.
Reflections and Proposals
This is the first announcement of our study. There is a lack of studies
regarding the relationship between asthma control and vitD levels in
children and adolescents, hence we expect to contribute to the
improvement on the knowledge with regard to this theme.