Vitamin D Status Modifies the Response to Indoor Particulate Matter in Obese Urban Children with Asthma

J Allergy Clin Immunol Pract. Jul-Aug 2019;7(6):1815-1822.e2. doi: 10.1016/j.jaip.2019.01.051. Epub 2019 Feb 11.


Background: Indoor fine particulate air pollution (PM2.5) is linked to asthma morbidity; however, whether vitamin D status influences individual susceptibility to airborne exposures is unclear.

Objective: We aimed to determine if vitamin D modifies the effects of indoor PM2.5 on asthma symptoms in urban children.

Methods: A total of 120 children aged 5 to 12 years with physician-diagnosed asthma were evaluated at baseline and every 3 months for 9 months. Indoor PM2.5, serum 25-hydroxy vitamin D (25-OH D) levels, and asthma symptoms were simultaneously assessed at each time point. Adjusting for confounders, generalized estimating equations assessed the 3-way interaction effects of 25-OH D, obesity, and PM on asthma symptoms.

Results: Children were of mean (standard deviation [SD]) age 9.7 (2.2) years, 36% were obese, and 95% self-reported black race. Mean (SD) PM2.5 indoor exposure was 38.2 (42.9) μg/m3 and 25-OH D was 19.1 (7.5) ng/mL. Three-way interaction models demonstrated significantly greater PM2.5-associated effects on daytime asthma symptoms only among obese children with low 25-OH D levels (odds ratio [OR]PM2.5 = 1.26, P = .049 at vitamin D = 15.5 ng/mL, increasingly stronger PM effects at levels <15.5 ng/mL). In homes with increased PM2.5, higher 25-OH D was associated with decreased symptom odds (eg, ORVitamin D = 0.87; P = .049 at PM2.5 = 52.5 μg/m3, increasingly protective effects >52.5 μg/m3) among obese children.

Conclusions: Among obese urban children with asthma, low individual 25-OH D enhanced adverse respiratory effects associated with indoor PM2.5. In high PM2.5 environments, 25-OH D was protective against asthma symptoms. Optimizing vitamin D status in children may help reduce asthma morbidity driven by indoor air pollution.

Keywords: Asthma; Obesity; Particulate matter; Vitamin D.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Air Pollutants / adverse effects*
  • Air Pollution, Indoor / adverse effects*
  • Asthma / blood*
  • Child
  • Child, Preschool
  • Female
  • Humans
  • Male
  • Obesity / blood*
  • Particulate Matter / adverse effects*
  • Urban Population
  • Vitamin D / blood*
  • Vitamins / blood*


  • Air Pollutants
  • Particulate Matter
  • Vitamins
  • Vitamin D