TY - JOUR
T1 - Serum folate concentrations, asthma, atopy, and asthma control in Peruvian children
AU - Nicholson, Andrew
AU - Pollard, Suzanne L.
AU - Lima, John J.
AU - Romero, Karina M.
AU - Tarazona-Meza, Carla
AU - Malpartida-Guzmán, Gary
AU - Mougey, Edward
AU - Hansel, Nadia N.
AU - Checkley, William
N1 - Funding Information:
This project was funded by a grant from the National Institute of Environmental Health Sciences, National Institutes of Health ( R01ES018845 , R01ES018845-S1 ) and Biomedical Research, Nemours Children's Health System . Suzanne Pollard was further supported by a grant from the Fogarty International Center , Office of AIDS Research , National Cancer Center , National Heart, Blood, and Lung Institute , and the NIH Office of Research for Women’s Health through the Fogarty Global Health Fellows Program Consortium comprised of the University of North Carolina , Johns Hopkins University , Morehouse School of Medicine , and Tulane University ( 5R25TW009340 ). William Checkley was supported by a Pathway to Independence Award ( R00HL096955 ) from the National Heart, Lung and Blood Institute, National Institutes of Health . Andrew Nicholson was supported by the Johns Hopkins Center for Global Health . Sponsors had no role in the design of the study, the collection of the data, the data analysis, or in the preparation of the manuscript.
Publisher Copyright:
© 2017 Elsevier Ltd
PY - 2017/12
Y1 - 2017/12
N2 - Background The relationship between folate status and asthma-related outcomes has not been carefully examined in low- and middle-income countries where folate deficiency is common. Methods Ancillary analysis of an unmatched case-control study in which we analyzed serum folate concentrations in 412 children with asthma and 342 controls living in peri-urban communities in Lima, Peru. We examined baseline associations between folate and asthma, atopy, total serum IgE, pulmonary function, and fractional exhaled nitric oxide. We then followed children with asthma longitudinally for 6–9 months and assessed associations between folate and odds of uncontrolled asthma (defined as Asthma Control Test score ≤ 19) and of ≥1 emergency visits during follow-up. Results A 10 ng/mL decrease in serum folate was associated with 45% higher adjusted odds of asthma (OR = 1.45, 95% CI 1.05–2.02). The folate-asthma relationship differed by atopic status: a 10 ng/mL decrease in serum folate was associated with a 2.4-fold higher odds of asthma among children without atopy (2.38, 1.20–4.72) and 23% higher odds of asthma in children with atopy (1.23, 0.85–1.80). Among children with asthma, a 10 ng/mL decrease in serum folate was associated with 62% higher odds of uncontrolled asthma (1.62, 1.02–2.56) and 73% higher odds of ≥1 emergency visits during follow-up (1.73, 1.05–2.85). Conclusions Serum folate concentrations were inversely associated with asthma, but this effect was stronger in children without atopy. Among children with asthma, lower serum folate concentrations were associated with higher risk of uncontrolled asthma.
AB - Background The relationship between folate status and asthma-related outcomes has not been carefully examined in low- and middle-income countries where folate deficiency is common. Methods Ancillary analysis of an unmatched case-control study in which we analyzed serum folate concentrations in 412 children with asthma and 342 controls living in peri-urban communities in Lima, Peru. We examined baseline associations between folate and asthma, atopy, total serum IgE, pulmonary function, and fractional exhaled nitric oxide. We then followed children with asthma longitudinally for 6–9 months and assessed associations between folate and odds of uncontrolled asthma (defined as Asthma Control Test score ≤ 19) and of ≥1 emergency visits during follow-up. Results A 10 ng/mL decrease in serum folate was associated with 45% higher adjusted odds of asthma (OR = 1.45, 95% CI 1.05–2.02). The folate-asthma relationship differed by atopic status: a 10 ng/mL decrease in serum folate was associated with a 2.4-fold higher odds of asthma among children without atopy (2.38, 1.20–4.72) and 23% higher odds of asthma in children with atopy (1.23, 0.85–1.80). Among children with asthma, a 10 ng/mL decrease in serum folate was associated with 62% higher odds of uncontrolled asthma (1.62, 1.02–2.56) and 73% higher odds of ≥1 emergency visits during follow-up (1.73, 1.05–2.85). Conclusions Serum folate concentrations were inversely associated with asthma, but this effect was stronger in children without atopy. Among children with asthma, lower serum folate concentrations were associated with higher risk of uncontrolled asthma.
KW - Asthma
KW - Asthma control
KW - Atopy
KW - Folate
KW - Pediatric asthma
KW - Peruvians
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U2 - 10.1016/j.rmed.2017.10.026
DO - 10.1016/j.rmed.2017.10.026
M3 - Article
C2 - 29173446
AN - SCOPUS:85034063679
VL - 133
SP - 29
EP - 35
JO - British Journal of Tuberculosis and Diseases of the Chest
JF - British Journal of Tuberculosis and Diseases of the Chest
SN - 0954-6111
ER -