Abstracts from CIPP XVI Meeting Libon june 2017.pdf
CIPP XVI ABSTRACTS
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-
(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.,
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.