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

Sonali Bose, Gregory B. Diette, Han Woo, Kirsten Koehler, Karina Romero, A. M. Rule, Barbara Detrick, E. Brigham, Meredith C. McCormack, Nadia N. Hansel

Research output: Contribution to journalArticlepeer-review

41 Scopus citations


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.

Original languageEnglish
Pages (from-to)1815-1822.e2
JournalJournal of Allergy and Clinical Immunology: In Practice
Issue number6
StatePublished - 1 Jul 2019
Externally publishedYes


  • Asthma
  • Obesity
  • Particulate matter
  • Vitamin D


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