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Abstract
Objective To determine the prevalence and risk factors for suboptimal vitamin D status in Korean adolescents and to assess its relationship with atopic dermatitis (AD) and asthma at a national level.
Design This is a cross-sectional study with data from the Korean National Health and Nutrition Examination Survey. Information regarding socioeconomic characteristics, clinical data and environmental factors was collected. Blood and urine samples were taken for vitamin D and cotinine, respectively. Descriptive and multivariable logistic regression was performed on the data.
Setting South Korea (nationwide).
Participants 2515 individuals aged 10–18 years who participated in the Korean National Health and Nutrition Examination Survey from 2008 to 2011.
Main outcome measures Vitamin D status was determined through measurement of serum 25-hydroxyvitamin D (25OHD). Smoking status was classified based on the urine cotinine level. Physician diagnosed with AD and asthma were assessed using a questionnaire.
Results Overall, 73.3% of the subjects were vitamin D deficient (25OHD <20 ng/mL) and 24.4% of the subjects were vitamin D insufficient (25OHD, 20–29.9 ng/mL). Older age (p<0.001), female gender (p<0.001), urban residence (p=0.019), higher body mass index (p=0.003) and sampling in winter months (November–March) (p<0.001) were independently associated with low serum 25OHD levels. With cotinine verification, 18.2% of the participants were classified as active smokers, and 43.4% were classified as passive smokers. After adjusting for potential confounders, serum 25OHD status showed no association with AD or asthma.
Conclusion Vitamin D deficiency is highly prevalent in Korean adolescents. Cotinine-verified prevalence of smoking was also high, but its relationship with vitamin D deficiency was not confirmed in our study. Above all, our results provide epidemiological evidence against the association of vitamin D status with AD and asthma at the national level among Korean adolescents.
- vitamin D deficiency
- atopic dermatitis
- cotinine
- smoking
- adolescent
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Footnotes
Contributors EJB, SHC, JDL and HSK made substantial contributions to the conception or design of the work. JYH and HSK had role in the acquisition, analysis and interpretation of data tor the work. EJB, SHC, JDL and HSK drafted and revised the work and all authors gave final approval and agreed to be accountable for all aspects of the work.
Funding This study was supported by a grant from the Korean Healthcare Technology R&D project, Ministry of Health and Welfare, Republic of Korea (grant no HN15C0105).
Disclaimer The funders of this study had no role in study design, collection, analysis and interpretation of data, writing of the manuscript or decision to submit for publication.
Competing interests None declared.
Patient consent Detail has been removed from this case description/these case descriptions to ensure anonymity. The editors and reviewers have seen the detailed information available and are satisfied that the information backs up the case the authors are making.
Ethics approval The institutional review board at the Korea Centers for Disease Control and Prevention/Incheon St. Mary’s Hospital, The Catholic University of Korea (IRB number: OC17ZESI0055) approved the protocol.
Provenance and peer review Not commissioned; externally peer reviewed.
Data sharing statement All data from the study, published and unpublished, are available with the principle investigators. The data are managed under the Department of Dermatology, Incheon St. Mary’s Hospital, The Catholic University of Korea, Incheon, Korea.