Maternal free vitamin D linked to offspring asthma risk
Photo by Trust "Tru" Katsande / Unsplash
Key Takeaway
Maternal free vitamin D during pregnancy may better predict offspring asthma risk than total vitamin D, especially in mothers with asthma.
This post hoc analysis of the Vitamin D Antenatal Asthma Reduction Trial (VDAART) investigated the roles of maternal vitamin D-binding protein (DBP), total 25-hydroxyvitamin-D (total 25OHD), and estimated free 25OHD in relation to offspring asthma or recurrent wheeze by age 3 years. The study included 518 mother-offspring pairs, with maternal plasma DBP and total 25OHD measured at two time points during pregnancy.
In mothers without asthma, a significant positive interaction between DBP and total 25OHD was observed, suggesting that higher DBP may reduce the protective effect of total vitamin D. Conversely, in mothers with asthma, estimated free 25OHD showed a significant negative association with offspring asthma/recurrent wheeze, and this association was stronger than that of DBP or total 25OHD alone.
These findings indicate that free vitamin D may be a more biologically relevant marker for offspring respiratory health, particularly in mothers with asthma. The study highlights the need to consider maternal asthma status when evaluating vitamin D's effects during pregnancy.
Limitations include the post hoc design and stratification by maternal asthma, which may affect generalizability. Further research is needed to confirm these results and explore clinical applications.
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View Original Abstract ↓
BACKGROUND: Vitamin D-binding protein (DBP) transports vitamin D metabolites and regulates vitamin D levels in circulation. Additionally, maternal vitamin D levels during pregnancy play an important role in lung development and childhood asthma occurrence.
OBJECTIVES: In this post hoc analysis of a randomized controlled trial, the joint associations of maternal 25-hydroxyvitamin-D (25OHD) and DBP with offspring asthma/recurrent wheeze, for both the full cohort and stratified by maternal asthma status, are analyzed. Additionally, associations between estimated maternal free 25OHD and offspring asthma/recurrent wheeze are investigated.
METHODS: A total of 518 participants from the Vitamin D Antenatal Asthma Reduction Trial were included in this analysis. The primary outcome was offspring asthma/recurrent wheeze by age 3 y. Maternal plasma DBP levels were measured for 517 and 516 participants at 10-18 and 32-38 wk of gestation, respectively. Total 25OHD and DBP levels were compared across haplotypes of the group-specific component (GC) gene, which codes for DBP. Logistic regression models estimated the relationships between maternal DBP, total 25OHD, and offspring asthma/recurrent wheeze. In addition, offspring asthma/recurrent wheeze was modeled as a function of estimated maternal free 25OHD.
RESULTS: Maternal DBP levels generally increased as pregnancy progressed. Maternal DBP and total 25OHD levels varied significantly across GC haplotypes. A significant positive interaction effect between maternal DBP and total 25OHD on offspring asthma/recurrent wheeze risk was observed for the subset of mothers without asthma. For the subset of mothers with asthma, we observed a significant negative association between estimated maternal free 25OHD and offspring asthma/recurrent wheeze, surpassing the effects of DBP or total 25OHD individually.
CONCLUSIONS: Our study gives insight into the interplay between vitamin D metabolites during pregnancy and their associations with offspring asthma/recurrent wheeze. These results also suggest that maternal free vitamin D during pregnancy may be more biologically relevant than total vitamin D for offspring's respiratory health. This trial was registered at clinicaltrials.gov for VDAART as NCT00920621.
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