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Association Between Severe Vitamin D Deficiency, Lung Function and Asthma Control
Asociación del déficit grave de vitamina D con la función pulmonar y el control del asma
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Recent reports have shown how decreased vitamin D levels may adversely influence asthma outcomes.</p><p id="par0010" class="elsevierStylePara elsevierViewall">Vitamin D plays a key role in regulating the innate immune system, and is a major player in the production of antimicrobial peptides that kill microorganisms. Vitamin D deficiency has been linked to a predisposition to respiratory infections, which are major triggers for asthma attacks.<a class="elsevierStyleCrossRefs" href="#bib0165"><span class="elsevierStyleSup">1,2</span></a> Previous studies have shown that children with mild to moderate asthma who also had low serum vitamin D levels had poor asthma control, more exacerbations,<a class="elsevierStyleCrossRef" href="#bib0175"><span class="elsevierStyleSup">3</span></a> more hospitalizations in the previous year, decreased lung function, reduced responses to inhaled corticosteroids (ICS), and consequently, increased ICS use.<a class="elsevierStyleCrossRefs" href="#bib0180"><span class="elsevierStyleSup">4–8</span></a> Furthermore, it has been reported that serum vitamin D levels are positively related with FEV<span class="elsevierStyleInf">1</span>% predicted and the ratio of FEV<span class="elsevierStyleInf">1</span> to FVC. In addition, serum Vitamin D is inversely related with increased airway responsiveness, airway remodeling, and response to glucocorticosteroids.<a class="elsevierStyleCrossRefs" href="#bib0205"><span class="elsevierStyleSup">9,10</span></a></p><p id="par0015" class="elsevierStylePara elsevierViewall">Little is known of the effect of severity of vitamin D deficiency in asthma patients. The aim of this cross-sectional study was to investigate the potential relationship between severe vitamin D deficiency, pulmonary function, and asthma control in Turkish adult patients with asthma.</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">Methods</span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Study Subjects</span><p id="par0020" class="elsevierStylePara elsevierViewall">This cross-sectional, prospective study included individuals aged 18 years and older who were seen at the Asthma Clinic of Marmara University Hospital in Istanbul, Turkey for bronchial asthma. Entry criteria included physician diagnosed asthma and evidence of disease from a bronchodilator reversibility test.<a class="elsevierStyleCrossRef" href="#bib0215"><span class="elsevierStyleSup">11</span></a> Approval for the study was obtained from the institutional review board and all patients provided written informed consent prior to taking part in the study. A power analysis was carried out to determine sample size.</p><p id="par0025" class="elsevierStylePara elsevierViewall">One hundred twenty-four patients meeting the above criteria were screened between September 2012 and April 2013. Patients were excluded due to pregnancy or evidence in their medical records of comorbidities, including diabetes mellitus, coronary artery disease, cancer, and chronic obstructive pulmonary disease (COPD), or reported use of vitamin D supplements, ≥10 pack years of cigarette smoke exposure that could overlap with COPD, or hospitalization for asthma in the previous month. Additionally, 3 individuals refused to provide informed consent, leaving a final study population of 106 participants.</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Study Measurements</span><p id="par0030" class="elsevierStylePara elsevierViewall">All patients agreed to provide their medical history, undergo a physical examination, and then perform spirometry in line with the American Thoracic Society criteria<a class="elsevierStyleCrossRef" href="#bib0220"><span class="elsevierStyleSup">12</span></a> to assess forced expiratory volume in 1<span class="elsevierStyleHsp" style=""></span>s (FEV<span class="elsevierStyleInf">1</span>) and other pulmonary function parameters (MIR Spirolab II, ITALY). We assessed current medication (ICS, long-acting beta-2 agonists, anti-leukotrienes, and theophyllines) and whether the patient had been treated in the emergency department or had required inpatient care for asthma in the previous year. The patient's height (cm), weight (kg), and body mass index (BMI, kg/m<span class="elsevierStyleSup">2</span>) were determined.</p><p id="par0035" class="elsevierStylePara elsevierViewall">During the physical examination, blood samples for vitamin D measurements were collected in EDTA tubes, then centrifuged, aliquoted, and stored at −80<span class="elsevierStyleHsp" style=""></span>°C. Plasma 25-hydroxyvitamin D was measured using the Tandem test (liquid chromatography/mass spectrometry–mass spectrometry, Zivak Technologies, Turkey). Patients were divided into 2 subgroups (vitamin D level <10<span class="elsevierStyleHsp" style=""></span>ng/ml and vitamin D level ≥10<span class="elsevierStyleHsp" style=""></span>ng/ml).</p><p id="par0040" class="elsevierStylePara elsevierViewall">A skin prick test was defined as positive when a wheal measuring >3<span class="elsevierStyleHsp" style=""></span>mm was produced in response to aeroallergens (SAY ILAC, Turkey). An IgE level of >100<span class="elsevierStyleHsp" style=""></span>IU/l was defined as high, measured by chemiluminescence immunometric assay (Immulite 2000, Siemens Healthcare Diagnostics, USA). Peripheral blood eosinophil counts were determined on peripheral blood smears, and patients with counts ≥3% were categorized as ≥eosinophilic.</p><p id="par0045" class="elsevierStylePara elsevierViewall">Asthma control was assessed using the Turkish translation of the asthma control test (ACT).<a class="elsevierStyleCrossRef" href="#bib0225"><span class="elsevierStyleSup">13</span></a> The ACT is a standardized, validated questionnaire that assesses asthma control on a scale of 5 to 25.<a class="elsevierStyleCrossRef" href="#bib0230"><span class="elsevierStyleSup">14</span></a></p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Statistical Analyses</span><p id="par0050" class="elsevierStylePara elsevierViewall">A one-way analysis of variance (ANOVA) was used to compare mean values of continuous variables between groups, and categorical variables were compared using Pearson Chi-square analyses. After adjusting for the potential confounding effects of sex, age, BMI, smoking, and allergic status, we conducted a linear regression assessment of the correlation between vitamin D levels, asthma control and pulmonary function parameters. Strengths of association were assessed using the Pearson correlation test. IgE levels were logarithmically transformed. All <span class="elsevierStyleItalic">P</span> values were two-tailed, and <span class="elsevierStyleItalic">P</span><.05 was accepted as statistically significance. Stata version 20 was used for statistical analyses.</p></span></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0090">Results</span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0095">Characteristics of the Subjects</span><p id="par0055" class="elsevierStylePara elsevierViewall">The main characteristics of the study participants are summarized in <a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>, stratified according to vitamin D levels. Thirteen percent of subjects had intermittent asthma and were being treated only with beta-2 agonists as required. The remaining patients had persistent asthma and were using ICS, with or without a long-acting beta-2 agonist, alongside rescue medication. Four patients had a clinical history of emergency department visits/hospitalizations, and 1 patient had used a systemic corticosteroid in the previous year. Based on the GINA guidelines, 53 patients (50%) were determined to have controlled and partly controlled asthma and the remaining 53 had uncontrolled asthma. Allergic rhinitis was reported in 58.5% of the patients. Thirty-seven of the 106 patients (35%) were allergic to at least 1 common allergen, determined by skin prick testing.</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0060" class="elsevierStylePara elsevierViewall">Patients were divided into 2 subgroups, according to vitamin D levels: subgroup I: severe vitamin D deficiency (vitamin D level <10<span class="elsevierStyleHsp" style=""></span>ng/ml); subgroup II: no severe vitamin D deficiency (vitamin D level ≥10<span class="elsevierStyleHsp" style=""></span>ng/ml). According to stratification of vitamin D levels, 70 patients had severe vitamin D deficiency.</p></span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0100">Pulmonary Function Parameters</span><p id="par0065" class="elsevierStylePara elsevierViewall">There was a significant trend toward lower absolute FEV<span class="elsevierStyleInf">1</span> (L) (<span class="elsevierStyleItalic">P</span>=.001) values in patients with lower vitamin D levels (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>).</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia></span><span id="sec0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0105">Asthma Control</span><p id="par0070" class="elsevierStylePara elsevierViewall">Serum vitamin D levels were not correlated with ACT.</p><p id="par0075" class="elsevierStylePara elsevierViewall">Patients were divided into 2 subgroups according to vitamin D levels (vitamin D level <10<span class="elsevierStyleHsp" style=""></span>ng/ml and vitamin D level ≥10<span class="elsevierStyleHsp" style=""></span>ng/ml). ACT scores were significantly lower in the severe deficiency group than the second group (<span class="elsevierStyleItalic">P</span>=.02). A greater number of patients had uncontrolled asthma (ACT scores <20) with severe vitamin D deficiency (<span class="elsevierStyleItalic">P</span>=.040). However, serum vitamin D levels were not correlated with ACT, even when considered separately as vitamin D level <10<span class="elsevierStyleHsp" style=""></span>ng/ml and vitamin D level ≥10<span class="elsevierStyleHsp" style=""></span>ng/ml. Forty of the 53 patients with uncontrolled asthma had severe vitamin D deficiency (<a class="elsevierStyleCrossRef" href="#fig0010">Fig. 2</a>). Patients with severe vitamin D deficiency had significantly higher usage of ICS than the group without severe vitamin D deficiency (<span class="elsevierStyleItalic">P</span>=.015, <a class="elsevierStyleCrossRef" href="#fig0015">Fig. 3</a>).</p><elsevierMultimedia ident="fig0010"></elsevierMultimedia><elsevierMultimedia ident="fig0015"></elsevierMultimedia></span><span id="sec0050" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0110">Association Between Serum Vitamin D LEVELS and FEV<span class="elsevierStyleInf">1</span>, Body Mass Index, Sex, Allergic Status</span><p id="par0080" class="elsevierStylePara elsevierViewall">There was a significant trend toward lower absolute FEV<span class="elsevierStyleInf">1</span> (L) (<span class="elsevierStyleItalic">P</span>=.005, <span class="elsevierStyleItalic">r</span>=0.272) values in patients with lower vitamin D levels (<a class="elsevierStyleCrossRef" href="#fig0020">Fig. 4</a>). There was an inverse relationship between BMI (kg/m<span class="elsevierStyleSup">2</span>) and serum vitamin D levels (<span class="elsevierStyleItalic">P</span><.046; <a class="elsevierStyleCrossRef" href="#fig0025">Fig. 5</a>). There was a significant difference between female and male patients in terms of severity of vitamin D deficiency: 90% of females had severe vitamin D deficiency (<span class="elsevierStyleItalic">P</span>=.001).</p><elsevierMultimedia ident="fig0020"></elsevierMultimedia><elsevierMultimedia ident="fig0025"></elsevierMultimedia><p id="par0085" class="elsevierStylePara elsevierViewall">Thirty-seven of the 106 patients (35%) were allergic to at least 1 common allergen (mite, aspergillus, grass, etc.), determined by skin prick testing. There was no clear association between serum vitamin D level and age, smoking status, or skin prick test positivity. However, IgE levels were positively correlated with vitamin D (<span class="elsevierStyleItalic">P</span>=.025). Similarly, patients without severe vitamin D deficiency were more prone to allergic rhinitis than patients with severe vitamin D deficiency (<span class="elsevierStyleItalic">P</span>=.04).</p></span></span><span id="sec0055" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0115">Discussion</span><p id="par0090" class="elsevierStylePara elsevierViewall">We found that a high prevalence of Turkish adult asthmatics suffered from severe vitamin D deficiency. We believe that this is the only study to have assessed the effect of vitamin D levels on asthma control in Turkish adult asthmatics. Lower vitamin D levels were associated with uncontrolled asthma and higher ICS usage in Turkish adults with asthma. We observed correlations between serum vitamin D level and FEV<span class="elsevierStyleInf">1</span> (L) pulmonary parameters. In addition, vitamin D levels were inversely related with BMI.</p><p id="par0095" class="elsevierStylePara elsevierViewall">Several previous epidemiologic investigations have shown a link between low serum vitamin D and asthma in pediatric patients, but few have examined the immediate effects of vitamin D levels in adult asthmatics.<a class="elsevierStyleCrossRefs" href="#bib0175"><span class="elsevierStyleSup">3,4,6–9,15,16</span></a> Turkish pediatric asthmatics have lower vitamin D levels than control subjects, and 90.6% of pediatric asthmatics have a deficiency or insufficiency of vitamin D.<a class="elsevierStyleCrossRef" href="#bib0170"><span class="elsevierStyleSup">2</span></a> The high prevalence found in our series is similar to that previously reported in Chinese and Costa Rican adult asthmatic populations, and is consistent with reported epidemics of hypovitaminosis D in developing countries.<a class="elsevierStyleCrossRefs" href="#bib0235"><span class="elsevierStyleSup">15,16</span></a> It is arguable that without the use of supplements, the threshold of 30<span class="elsevierStyleHsp" style=""></span>ng/ml for vitamin D sufficiency would not be attainable for most of the sun-averse population of Turkey.</p><p id="par0100" class="elsevierStylePara elsevierViewall">The mechanisms underlying the role of vitamin D in the pathogenesis of asthma are unclear. Vitamin D has been related to innate and adaptive immunity and airway remodeling.<a class="elsevierStyleCrossRefs" href="#bib0210"><span class="elsevierStyleSup">10,17–20</span></a> Higher vitamin D levels were associated with better FEV<span class="elsevierStyleInf">1</span> and FVC values in adults in the USA (16). Similarly, we found that low vitamin D levels were associated with lower FEV<span class="elsevierStyleInf">1</span> (L). Conversely, the relationship between vitamin D and FEV<span class="elsevierStyleInf">1</span> (L) was not statistically significant in a Costa Rican study (<span class="elsevierStyleItalic">P</span><.07).<a class="elsevierStyleCrossRef" href="#bib0240"><span class="elsevierStyleSup">16</span></a> These variations may be due to different sample sizes and different ethnic populations. Vitamin D is known to effect the muskulosketal system, and it also plays a role in cancer, infectious diseases, cardiovascular diseases, diabetes, and respiratory diseases. In a recent study, the authors reviewed the physiology of vitamin D, the pathophysiological effects associated with its deficiency, and its role in respiratory diseases.<a class="elsevierStyleCrossRef" href="#bib0265"><span class="elsevierStyleSup">21</span></a></p><p id="par0105" class="elsevierStylePara elsevierViewall">Elevated serum IgE levels are known to be a risk factor for asthma.<a class="elsevierStyleCrossRef" href="#bib0270"><span class="elsevierStyleSup">22</span></a> The National Health and Nutrition Examination Survey of children and adults in the USA (2005–2006) reported that vitamin D deficiency was associated with higher levels of IgE sensitization in both the pediatric and adolescent groups, but not in adult asthmatics.<a class="elsevierStyleCrossRefs" href="#bib0275"><span class="elsevierStyleSup">23,24</span></a> Furthermore, the association between vitamin D and total IgE was subsequently reported in adult asthmatics in China, Costa Rica, and Germany.<a class="elsevierStyleCrossRefs" href="#bib0235"><span class="elsevierStyleSup">15,16,25</span></a> Similarly, we found no inverse correlation between vitamin D and IgE levels; we found a positive correlation. The discrepancy between this finding and previous studies can be mainly attributed to a non-linear link between vitamin D and IgE levels, with a cut-off effect in which abnormal vitamin D levels are associated with elevated IgE concentrations.<a class="elsevierStyleCrossRef" href="#bib0275"><span class="elsevierStyleSup">23</span></a></p><p id="par0110" class="elsevierStylePara elsevierViewall">Importantly, patients with severe vitamin D deficiency had lower ACT scores. Similarly, several studies noted a positive association between vitamin D levels and asthma control in children, as set out by the ACT and the Global Initiative for Asthma (GINA) guidlines.<a class="elsevierStyleCrossRefs" href="#bib0195"><span class="elsevierStyleSup">7,10</span></a> Vitamin D insufficiency has been shown to put patients at greater risk of severe asthma exacerbations and hospitalization.<a class="elsevierStyleCrossRefs" href="#bib0180"><span class="elsevierStyleSup">4,8</span></a> In addition, children with insufficient serum vitamin D levels have an increased risk of hospitalization, emergency department visits, and severe asthma exacerbations, regardless of their use of ICS.<a class="elsevierStyleCrossRefs" href="#bib0180"><span class="elsevierStyleSup">4–6,8,9</span></a> A study of Turkish pediatric asthmatic patients found that asthma severity increased in parallel with a decrease in vitamin D levels, and emergency department visits and hospitalization rates increased.<a class="elsevierStyleCrossRef" href="#bib0170"><span class="elsevierStyleSup">2</span></a> These associations were also observed in adult asthmatic patients. One explanation for these previously reported results and those from this study is that lower vitamin D levels may contribute to increasing asthma severity, resulting in the increased use of pharmacological agents, and an increase in the number of hospitalizations. We found lower ACT scores in patients in the vitamin D <10<span class="elsevierStyleHsp" style=""></span>ng/ml group than in the vitamin D ≥10<span class="elsevierStyleHsp" style=""></span>ng/ml group; however, this association did not show any linear correlation. It is hard to pinpoint the reasons for this discrepancy, but it may be due to the wide range of vitamin D values in the study population. Unfortunately, we found few studies in severe vitamin D deficiency in asthma patients.</p><p id="par0115" class="elsevierStylePara elsevierViewall">The VIDA (Vitamin D Add-on Therapy Enhances Corticosteroid Responsiveness in Asthma) trial was a randomized, double-blind, parallel-group, placebo-controlled trial that studied adult patients with symptomatic asthma and serum 25-hydroxyvitamin D levels less of below 30<span class="elsevierStyleHsp" style=""></span>ng/ml. The VIDA results indicated that therapeutic vitamin D3 supplementation failed to improve asthma control in adults.<a class="elsevierStyleCrossRef" href="#bib0290"><span class="elsevierStyleSup">26</span></a> Nevertheless, little is known about vitamin D levels and their impact on disease control and airway function in Turkish adults with asthma.</p><p id="par0120" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleItalic">In vitro</span> studies have demonstrated how the vitamin D pathway “cross-talks” with the corticosteroid pathway.<a class="elsevierStyleCrossRefs" href="#bib0205"><span class="elsevierStyleSup">9,27,28</span></a> In this study, we showed that lower vitamin D levels are associated with increased use of ICS. Most patients with low vitamin D levels used inhaled corticosteroids. The use of daily maintenance ICS, oral corticosteroids, oral theophyllines, and leukotriene antagonists was significantly associated with lower vitamin D in children and adults.<a class="elsevierStyleCrossRef" href="#bib0210"><span class="elsevierStyleSup">10</span></a> In another study, low vitamin D levels were weakly associated with greater lung function decline in adults with asthma, and stronger associations were observed in never smokers and non-ICS users.<a class="elsevierStyleCrossRef" href="#bib0305"><span class="elsevierStyleSup">29</span></a></p><p id="par0125" class="elsevierStylePara elsevierViewall">Population studies in North America and Europe have shown an association between BMI and lower vitamin D levels across all age groups in adults.<a class="elsevierStyleCrossRef" href="#bib0310"><span class="elsevierStyleSup">30</span></a> In addition, BMI has a significant inverse correlation with serum vitamin D levels in children and adults with asthma.<a class="elsevierStyleCrossRefs" href="#bib0205"><span class="elsevierStyleSup">9,25,27,31</span></a> Similarly, in our study, we showed that lower vitamin D levels were linked with higher BMI values. Low vitamin D levels were not associated with airway obstruction in most asthma adults, with the exception of men with asthma but with no allergic rhinitis.<a class="elsevierStyleCrossRef" href="#bib0320"><span class="elsevierStyleSup">32</span></a> It is also interesting to note that vitamin D concentrations were higher in men in a National Health Survey in the USA.<a class="elsevierStyleCrossRef" href="#bib0315"><span class="elsevierStyleSup">31</span></a> Among all patients with asthma, patients with vitamin D insufficiency have a greater likelihood of being female.<a class="elsevierStyleCrossRefs" href="#bib0180"><span class="elsevierStyleSup">4,15</span></a> The results from our study have shown that female gender and overweight were both associated with low vitamin D. This may be because female and obese patients often spend less time engaged in outdoor activities.</p><span id="sec0060" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0120">Study Limitation</span><p id="par0130" class="elsevierStylePara elsevierViewall">One limitation of our study is that vitamin D levels were measured between December and February, which is a time when skin production of vitamin D is low. This may have biased the results. It is also possible that people with reduced lung function have physical limitations and therefore spend less time exercising outdoors, and because of this, may have shorter periods of sun exposure. This may result in reverse causation. In addition, the number of subjects enrolled in this study was small, they may have constituted a selected population, and there was an imbalance in the number of females and males. We did not have detailed information on the socioeconomic and sociocultural status of the participants.</p></span></span><span id="sec0065" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0125">Conclusion</span><p id="par0135" class="elsevierStylePara elsevierViewall">We found a high incidence of severe vitamin D deficiency among Turkish adult asthmatics (approximately 90%). We believe that this is the only study to have assessed the effect of vitamin D levels on asthma control and pulmonary function in Turkish adult asthmatics. Our results indicate that lower levels of vitamin D are linked to uncontrolled asthma, lower absolute FEV<span class="elsevierStyleInf">1</span> values, female sex and increased ICS use in Turkish adults with asthma. Further randomized controlled trials are required to demonstrate that vitamin D supplementation in asthmatics with vitamin D deficiency will lead to improved asthma outcomes.</p></span><span id="sec0070" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0130">Conflict of Interests</span><p id="par0145" class="elsevierStylePara elsevierViewall">The authors declare that they have no conflicts of interest.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:11 [ 0 => array:3 [ "identificador" => "xres825542" "titulo" => "Abstract" "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0005" "titulo" => "Introduction" ] 1 => array:2 [ "identificador" => "abst0010" "titulo" => "Methods" ] 2 => array:2 [ "identificador" => "abst0015" "titulo" => "Results" ] 3 => array:2 [ "identificador" => "abst0020" "titulo" => "Conclusion" ] ] ] 1 => array:2 [ "identificador" => "xpalclavsec822014" "titulo" => "Keywords" ] 2 => array:3 [ "identificador" => "xres825543" "titulo" => "Resumen" "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0025" "titulo" => "Introducción" ] 1 => array:2 [ "identificador" => "abst0030" "titulo" => "Métodos" ] 2 => array:2 [ "identificador" => "abst0035" "titulo" => "Resultados" ] 3 => array:2 [ "identificador" => "abst0040" "titulo" => "Conclusión" ] ] ] 3 => array:2 [ "identificador" => "xpalclavsec822013" "titulo" => "Palabras clave" ] 4 => array:2 [ "identificador" => "sec0005" "titulo" => "Introduction" ] 5 => array:3 [ "identificador" => "sec0010" "titulo" => "Methods" "secciones" => array:3 [ 0 => array:2 [ "identificador" => "sec0015" "titulo" => "Study Subjects" ] 1 => array:2 [ "identificador" => "sec0020" "titulo" => "Study Measurements" ] 2 => array:2 [ "identificador" => "sec0025" "titulo" => "Statistical Analyses" ] ] ] 6 => array:3 [ "identificador" => "sec0030" "titulo" => "Results" "secciones" => array:4 [ 0 => array:2 [ "identificador" => "sec0035" "titulo" => "Characteristics of the Subjects" ] 1 => array:2 [ "identificador" => "sec0040" "titulo" => "Pulmonary Function Parameters" ] 2 => array:2 [ "identificador" => "sec0045" "titulo" => "Asthma Control" ] 3 => array:2 [ "identificador" => "sec0050" "titulo" => "Association Between Serum Vitamin D LEVELS and FEV, Body Mass Index, Sex, Allergic Status" ] ] ] 7 => array:3 [ "identificador" => "sec0055" "titulo" => "Discussion" "secciones" => array:1 [ 0 => array:2 [ "identificador" => "sec0060" "titulo" => "Study Limitation" ] ] ] 8 => array:2 [ "identificador" => "sec0065" "titulo" => "Conclusion" ] 9 => array:2 [ "identificador" => "sec0070" "titulo" => "Conflict of Interests" ] 10 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2016-04-12" "fechaAceptado" => "2016-09-07" "PalabrasClave" => array:2 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Keywords" "identificador" => "xpalclavsec822014" "palabras" => array:4 [ 0 => "Asthma control" 1 => "FEV<span class="elsevierStyleInf">1</span>" 2 => "Pulmonary function" 3 => "Severe vitamin D deficiency" ] ] ] "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec822013" "palabras" => array:4 [ 0 => "Control del asma" 1 => "FEV<span class="elsevierStyleInf">1</span>" 2 => "Función pulmonar" 3 => "Déficit grave de vitamina D" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "en" => array:3 [ "titulo" => "Abstract" "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Introduction</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">To examine the relationship between severe vitamin D deficiency, asthma control, and pulmonary function in Turkish adults with asthma.</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Methods</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">One hundred six asthmatic patients underwent pulmonary function tests (PFT) skin prick test, peripheral blood eosinophil counts, IgE, body mass index (BMI) and vitamin D levels were determined. Patients were divided into 2 subgroups according to vitamin D levels (vitamin D level <10<span class="elsevierStyleHsp" style=""></span>ng/ml and vitamin D level ≥10<span class="elsevierStyleHsp" style=""></span>ng/ml). Asthma control tests (ACTs) were performed.</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Results</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">The mean age of subgroup <span class="elsevierStyleSmallCaps">I</span> (vitamin D level <10) was 37±10 and the mean age of subgroup <span class="elsevierStyleSmallCaps">II</span> (vitamin D level ≥10<span class="elsevierStyleHsp" style=""></span>ng/ml) was 34±8. Sixty-six percent of patients had severe vitamin D deficiency (vitamin D level <10<span class="elsevierStyleHsp" style=""></span>ng/ml). There was a significant trend toward lower absolute FEV<span class="elsevierStyleInf">1</span> (L) values in patients with lower vitamin D levels (<span class="elsevierStyleItalic">P</span>=.001). ACT scores were significantly low in the severe deficiency group than the other group (<span class="elsevierStyleItalic">P</span>=.02). There were a greater number of patients with uncontrolled asthma (ACT scores <20) in the severe vitamin D deficiency group (<span class="elsevierStyleItalic">P</span>=.040). Patients with severe vitamin D deficiency had a higher usage of inhaled corticosteroids than the group without severe vitamin D deficiency (<span class="elsevierStyleItalic">P</span>=.015). There was a significant trend toward lower absolute FEV<span class="elsevierStyleInf">1</span> (L) (<span class="elsevierStyleItalic">P</span>=.005, <span class="elsevierStyleItalic">r</span>=0.272) values in patients with lower vitamin D levels. Vitamin D levels were inversely related with body mass index (BMI) (<span class="elsevierStyleItalic">P</span>=.046).</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Conclusion</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">The incidence of severe vitamin D deficiency was high in adult Turkish asthmatics. In addition, lower vitamin D levels were associated with poor asthma control and decreased pulmonary function.</p></span>" "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0005" "titulo" => "Introduction" ] 1 => array:2 [ "identificador" => "abst0010" "titulo" => "Methods" ] 2 => array:2 [ "identificador" => "abst0015" "titulo" => "Results" ] 3 => array:2 [ "identificador" => "abst0020" "titulo" => "Conclusion" ] ] ] "es" => array:3 [ "titulo" => "Resumen" "resumen" => "<span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Introducción</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Examinar la relación existente entre el déficit grave de vitamina D, el control del asma y la función pulmonar en adultos turcos asmáticos.</p></span> <span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Métodos</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Ciento seis pacientes asmáticos se sometieron a pruebas de función pulmonar (PFP), pruebas intraepidérmicas y determinaciones de eosinófilos en sangre periférica, IgE, índice de masa corporal (IMC) y concentraciones de vitamina D. Las concentraciones de vitamina D se dividieron en 2 grupos (concentración de vitamina D <10<span class="elsevierStyleHsp" style=""></span>ng/ml y ≥10<span class="elsevierStyleHsp" style=""></span>ng/ml). Se practicaron pruebas de control del asma (ATC).</p></span> <span id="abst0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Resultados</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">La media de edad de los pacientes fue de 37<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>10<span class="elsevierStyleHsp" style=""></span>años en el primer grupo (concentración de vitamina D <10<span class="elsevierStyleHsp" style=""></span>ng/ml) y de 34<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>8<span class="elsevierStyleHsp" style=""></span>años en el segundo (concentración de vitamina D ≥10<span class="elsevierStyleHsp" style=""></span>ng/ml). El 66% de los pacientes presentaban déficit grave de vitamina D (concentración de vitamina D <10<span class="elsevierStyleHsp" style=""></span>ng/ml). Los pacientes con concentraciones bajas de vitamina D mostraron una tendencia significativa a presentar valores absolutos más bajos de FEV<span class="elsevierStyleInf">1</span> (l) (p=0,001). Las puntuaciones ATC fueron significativamente más bajas en el grupo con déficit grave de vitamina D que en el segundo grupo (p=0,02). En el grupo con déficit grave hubo un mayor número de pacientes con asma incontrolada (puntuaciones ACT<20) (p=0,040). Los pacientes con déficit grave de vitamina D habían utilizado muchos más corticoides inhalados que los que no presentaban déficit grave (p=0,015). En los pacientes con concentraciones más bajas de vitamina D se observó una tendencia significativa a presentar valores absolutos más bajos de FEV<span class="elsevierStyleInf">1</span> (l) (p=0,005, r=0,272). Se observó una relación inversa entre las concentraciones de vitamina D y el IMC (p=0,046).</p></span> <span id="abst0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Conclusión</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">La incidencia de déficit grave de vitamina D fue elevada en adultos asmáticos turcos. Además, las concentraciones más bajas de vitamina D se asociaron con descensos del control del asma y de la función pulmonar.</p></span>" "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0025" "titulo" => "Introducción" ] 1 => array:2 [ "identificador" => "abst0030" "titulo" => "Métodos" ] 2 => array:2 [ "identificador" => "abst0035" "titulo" => "Resultados" ] 3 => array:2 [ "identificador" => "abst0040" "titulo" => "Conclusión" ] ] ] ] "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as: Beyhan-Sagmen S, Baykan O, Balcan B, Ceyhan B. Asociación del déficit grave de vitamina D con la función pulmonar y el control del asma. Arch Bronconeumol. 2017;53:186–191.</p>" ] ] "multimedia" => array:6 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1287 "Ancho" => 1603 "Tamanyo" => 58811 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Association between vitamin D levels and FEV<span class="elsevierStyleInf">1</span> values (<span class="elsevierStyleItalic">P</span>=.001).</p>" ] ] 1 => array:7 [ "identificador" => "fig0010" "etiqueta" => "Fig. 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 1751 "Ancho" => 1460 "Tamanyo" => 91489 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">Association between controlled and uncontrolled group and vitamin D level (<span class="elsevierStyleItalic">P</span>=.040).</p>" ] ] 2 => array:7 [ "identificador" => "fig0015" "etiqueta" => "Fig. 3" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr3.jpeg" "Alto" => 1793 "Ancho" => 1458 "Tamanyo" => 85417 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">Association between ICS use and vitamin D level (<span class="elsevierStyleItalic">P</span>: .015).</p>" ] ] 3 => array:7 [ "identificador" => "fig0020" "etiqueta" => "Fig. 4" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr4.jpeg" "Alto" => 1047 "Ancho" => 1600 "Tamanyo" => 81623 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0060" class="elsevierStyleSimplePara elsevierViewall">Correlation between serum vitamin D level and FEV<span class="elsevierStyleInf">1</span> (L) (<span class="elsevierStyleItalic">P</span>: .005; <span class="elsevierStyleItalic">r</span>=0.272).</p>" ] ] 4 => array:7 [ "identificador" => "fig0025" "etiqueta" => "Fig. 5" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr5.jpeg" "Alto" => 1322 "Ancho" => 1660 "Tamanyo" => 57567 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0065" class="elsevierStyleSimplePara elsevierViewall">Association between vitamin D and BMI (<span class="elsevierStyleItalic">P</span>=.046).</p>" ] ] 5 => array:8 [ "identificador" => "tbl0005" "etiqueta" => "Table 1" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at1" "detalle" => "Table " "rol" => "short" ] ] "tabla" => array:2 [ "leyenda" => "<p id="spar0075" class="elsevierStyleSimplePara elsevierViewall">The statistically significant parametres are in bold.</p>" "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head " align="" valign="top" scope="col"> \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " colspan="2" align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Vitamin D</th><th class="td" title="table-head " align="left" valign="top" scope="col"><span class="elsevierStyleItalic">P</span> \t\t\t\t\t\t\n \t\t\t\t</th></tr><tr title="table-row"><th class="td" title="table-head " align="" valign="top" scope="col" style="border-bottom: 2px solid black"> \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black"><10 (ng/ml) \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">≥10 (ng/ml) \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="" valign="top" scope="col" style="border-bottom: 2px solid black"> \t\t\t\t\t\t\n \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Number of patients (<span class="elsevierStyleItalic">n</span>) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">70 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">36 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top"><span class="elsevierStyleBold">.001</span> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Age (yr) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">37±10 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">34±8 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">.148 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Male % \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">30% \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">70% \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top"><span class="elsevierStyleBold">.001</span> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">BMI, kg/m<span class="elsevierStyleSup">2</span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">29±6 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">27±5 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top"><span class="elsevierStyleBold">.046</span> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">ACT \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">18±4 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">20±4 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top"><span class="elsevierStyleBold">.02</span> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">ICS <span class="elsevierStyleItalic">n</span> (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">65 (93%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">27 (75%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top"><span class="elsevierStyleBold">.015</span> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">FEV<span class="elsevierStyleInf">1</span> (L) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">2.75±0.7 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">3.40±0.9 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top"><span class="elsevierStyleBold">.001</span> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">FEV<span class="elsevierStyleInf">1</span> (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">98±19 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">101±19 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top"><span class="elsevierStyleBold">.041</span> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">FEV<span class="elsevierStyleInf">1</span>/FVC (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">78.6±8.8 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">80.4±8.6 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">.306 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">FEF25–75 (l/s) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">2.67±1.2 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">3.41±1.2 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top"><span class="elsevierStyleBold">.004</span> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">FEF25–75 (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">72±31 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">83±18 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">.078 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Allergic rhinitis (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">51 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">62 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top"><span class="elsevierStyleBold">.040</span> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Skin prick test positive (number) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">24 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">13 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top"><span class="elsevierStyleBold">.046</span> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Eosinophil % \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">2±1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">2±1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">.075 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">IgE (IU/l) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">50 (30–80) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">88 (50–110) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top"><span class="elsevierStyleBold">.025</span> \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab1388508.png" ] ] ] ] "descripcion" => array:1 [ "en" => "<p id="spar0070" class="elsevierStyleSimplePara elsevierViewall">Body Mass Index, Lung Function Parameters, Asthma Control Test Scores, Inhaled Corticosteroid Use and Atopy in Patients with Asthma.</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:32 [ 0 => array:3 [ "identificador" => "bib0165" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Association between serum 25-hydroxyvitamin D level and upper respiratory tract infection in the Third National Health and Nutrition Examination Survey" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "A.A. Ginde" 1 => "J.M. Mansbach" 2 => "C.A. Camargo Jr." ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1001/archinternmed.2008.560" "Revista" => array:6 [ "tituloSerie" => "Arch Intern Med" "fecha" => "2009" "volumen" => "169" "paginaInicial" => "384" "paginaFinal" => "390" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19237723" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0170" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Childhood asthma and vitamin D deficiency in Turkey: is there cause and effect relationship between them?" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "M. Uysalol" 1 => "L.C. Mutlu" 2 => "G.V. Saracoglu" 3 => "E. Karasu" 4 => "S. Guzel" 5 => "S. Kayaoglu" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1186/1824-7288-39-78" "Revista" => array:5 [ "tituloSerie" => "Ital J Pediatr" "fecha" => "2013" "volumen" => "39" "paginaInicial" => "78" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24330502" "web" => "Medline" ] ] ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0175" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Childhood asthma may be a consequence of vitamin D deficiency" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "A.A. Litonjua" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1097/ACI.0b013e32832b36cd" "Revista" => array:6 [ "tituloSerie" => "Curr Opin Allergy Clin Immunol" "fecha" => "2009" "volumen" => "9" "paginaInicial" => "202" "paginaFinal" => "207" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19365260" "web" => "Medline" ] ] ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib0180" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Vitamin D insufficiency and severe asthma exacerbations in Puerto Rican children" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "J.M. Brehm" 1 => "E. Acosta-Perez" 2 => "L. Klei" 3 => "K. Roeder" 4 => "M. Barmada" 5 => "N. Boutaoui" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1164/rccm.201203-0431OC" "Revista" => array:6 [ "tituloSerie" => "Am J Respir Crit Care Med" "fecha" => "2012" "volumen" => "186" "paginaInicial" => "140" "paginaFinal" => "146" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22652028" "web" => "Medline" ] ] ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib0185" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Effect of vitamin D and inhaled corticosteroid treatment on lung function in children" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "A.C. Wu" 1 => "K. Tantisira" 2 => "L. Li" 3 => "A.L. Fuhlbrigge" 4 => "S.T. Weiss" 5 => "A. Litonjua" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1164/rccm.201202-0351OC" "Revista" => array:6 [ "tituloSerie" => "Am J Respir Crit Care Med" "fecha" => "2012" "volumen" => "186" "paginaInicial" => "508" "paginaFinal" => "513" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22798322" "web" => "Medline" ] ] ] ] ] ] ] ] 5 => array:3 [ "identificador" => "bib0190" "etiqueta" => "6" "referencia" => array:1 [ 0 => array:3 [ "comentario" => "52.e5–58.e5" "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Serum vitamin D levels and severe asthma exacerbations in the Childhood Asthma Management Program study" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "J.M. Brehm" 1 => "B. Schuemann" 2 => "A.L. Fuhlbrigge" 3 => "B.W. Hollis" 4 => "R.C. Strunk" 5 => "R.S. Zeiger" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:3 [ "tituloSerie" => "Curr Opin Allergy Clin Immunol" "fecha" => "2010" "volumen" => "126" ] ] ] ] ] ] 6 => array:3 [ "identificador" => "bib0195" "etiqueta" => "7" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Vitamin D serum levels and markers of asthma control in Italian children" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "I. Chinellato" 1 => "M. Piazza" 2 => "M. Sandri" 3 => "D. Peroni" 4 => "G. Piacentini" 5 => "A.L. Boner" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.jpeds.2010.08.043" "Revista" => array:6 [ "tituloSerie" => "J Pediatr" "fecha" => "2011" "volumen" => "158" "paginaInicial" => "437" "paginaFinal" => "441" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/20870246" "web" => "Medline" ] ] ] ] ] ] ] ] 7 => array:3 [ "identificador" => "bib0200" "etiqueta" => "8" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Serum vitamin D levels and markers of severity of childhood asthma in Costa Rica" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "J.M. Brehm" 1 => "J.C. Celedon" 2 => "M.E. Soto-Quiros" 3 => "L. Avila" 4 => "G.M. Hunninghake" 5 => "E. Forno" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1164/rccm.200808-1361OC" "Revista" => array:6 [ "tituloSerie" => "Am J Respir Crit Care Med" "fecha" => "2009" "volumen" => "179" "paginaInicial" => "765" "paginaFinal" => "771" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19179486" "web" => "Medline" ] ] ] ] ] ] ] ] 8 => array:3 [ "identificador" => "bib0205" "etiqueta" => "9" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Decreased serum vitamin D levels in children with asthma are associated with increased corticosteroid use" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "D.A. Searing" 1 => "Y. Zhang" 2 => "J.R. Murphy" 3 => "P.J. Hauk" 4 => "E. Goleva" 5 => "D.Y. Leung" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.jaci.2010.03.008" "Revista" => array:6 [ "tituloSerie" => "J Allergy Clin Immunol" "fecha" => "2010" "volumen" => "125" "paginaInicial" => "995" "paginaFinal" => "1000" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/20381849" "web" => "Medline" ] ] ] ] ] ] ] ] 9 => array:3 [ "identificador" => "bib0210" "etiqueta" => "10" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Relationship between serum vitamin D, disease severity, and airway remodeling in children with asthma" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "A. Gupta" 1 => "A. Sjoukes" 2 => "D. Richards" 3 => "W. Banya" 4 => "C. Hawrylowicz" 5 => "A. Bush" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1164/rccm.201107-1239OC" "Revista" => array:6 [ "tituloSerie" => "Am J Respir Crit Care Med" "fecha" => "2011" "volumen" => "184" "paginaInicial" => "1342" "paginaFinal" => "1349" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21908411" "web" => "Medline" ] ] ] ] ] ] ] ] 10 => array:3 [ "identificador" => "bib0215" "etiqueta" => "11" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "A summary of the new GINA strategy: a roadmap to asthma control" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "H.K. Reddel" 1 => "E.D. Bateman" 2 => "A. Becker" 3 => "L.P. Boulet" 4 => "A.A. Cruz" 5 => "J.M. Drazen" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1183/13993003.00853-2015" "Revista" => array:6 [ "tituloSerie" => "Eur Respir J" "fecha" => "2015" "volumen" => "46" "paginaInicial" => "622" "paginaFinal" => "639" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26206872" "web" => "Medline" ] ] ] ] ] ] ] ] 11 => array:3 [ "identificador" => "bib0220" "etiqueta" => "12" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Standardization of spirometry, 1994 update" "autores" => array:1 [ 0 => array:2 [ "colaboracion" => "American Thoracic Society" "etal" => false ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1164/ajrccm.152.3.7663792" "Revista" => array:6 [ "tituloSerie" => "Am J Respir Crit Care Med" "fecha" => "1995" "volumen" => "152" "paginaInicial" => "1107" "paginaFinal" => "1136" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/7663792" "web" => "Medline" ] ] ] ] ] ] ] ] 12 => array:3 [ "identificador" => "bib0225" "etiqueta" => "13" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "The validation of the Turkish version of asthma control test" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "M.A. Uysal" 1 => "D. Mungan" 2 => "A. Yorgancioglu" 3 => "F. Yildiz" 4 => "M. Akgun" 5 => "B. Gemicioglu" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1007/s11136-012-0309-1" "Revista" => array:6 [ "tituloSerie" => "Qual Life Res" "fecha" => "2013" "volumen" => "22" "paginaInicial" => "1773" "paginaFinal" => "1779" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23143589" "web" => "Medline" ] ] ] ] ] ] ] ] 13 => array:3 [ "identificador" => "bib0230" "etiqueta" => "14" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Asthma control test: reliability, validity, and responsiveness in patients not previously followed by asthma specialists" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "M. Schatz" 1 => "C.A. Sorkness" 2 => "J.T. Li" 3 => "P. Marcus" 4 => "J.J. Murray" 5 => "R.A. Nathan" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.jaci.2006.01.011" "Revista" => array:6 [ "tituloSerie" => "J Allergy Clin Immunol" "fecha" => "2006" "volumen" => "117" "paginaInicial" => "549" "paginaFinal" => "556" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16522452" "web" => "Medline" ] ] ] ] ] ] ] ] 14 => array:3 [ "identificador" => "bib0235" "etiqueta" => "15" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Vitamin D deficiency is associated with decreased lung function in Chinese adults with asthma" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "F. Li" 1 => "M. Peng" 2 => "L. Jiang" 3 => "Q. Sun" 4 => "K. Zhang" 5 => "F. Lian" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1159/000322008" "Revista" => array:6 [ "tituloSerie" => "Respiration" "fecha" => "2011" "volumen" => "81" "paginaInicial" => "469" "paginaFinal" => "475" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21124013" "web" => "Medline" ] ] ] ] ] ] ] ] 15 => array:3 [ "identificador" => "bib0240" "etiqueta" => "16" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Vitamin D insufficiency and asthma severity in adults from Costa Rica" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "F. Montero-Arias" 1 => "G. Sedo-Mejia" 2 => "A. Ramos-Esquivel" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.4168/aair.2013.5.5.283" "Revista" => array:6 [ "tituloSerie" => "Allergy Asthma Immunol Res" "fecha" => "2013" "volumen" => "5" "paginaInicial" => "283" "paginaFinal" => "288" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24003384" "web" => "Medline" ] ] ] ] ] ] ] ] 16 => array:3 [ "identificador" => "bib0245" "etiqueta" => "17" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Vitamin D in asthma: Panacea or true promise" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "A.A. Ginde" 1 => "E.R. Sutherland" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.jaci.2010.05.030" "Revista" => array:6 [ "tituloSerie" => "J Allergy Clin Immunol" "fecha" => "2010" "volumen" => "126" "paginaInicial" => "59" "paginaFinal" => "60" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/20620566" "web" => "Medline" ] ] ] ] ] ] ] ] 17 => array:3 [ "identificador" => "bib0250" "etiqueta" => "18" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Vitamin D, the immune system and asthma" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "N.E. Lange" 1 => "A. Litonjua" 2 => "C.M. Hawrylowicz" 3 => "S. Weiss" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1586/eci.09.53" "Revista" => array:6 [ "tituloSerie" => "Expert Rev Clin Immunol" "fecha" => "2009" "volumen" => "5" "paginaInicial" => "693" "paginaFinal" => "702" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/20161622" "web" => "Medline" ] ] ] ] ] ] ] ] 18 => array:3 [ "identificador" => "bib0255" "etiqueta" => "19" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Vitamin D inhibits growth of human airway smooth muscle cells through growth factor-induced phosphorylation of retinoblastoma protein and checkpoint kinase 1" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "G. Damera" 1 => "H.W. Fogle" 2 => "P. Lim" 3 => "E.A. Goncharova" 4 => "H. Zhao" 5 => "A. Banerjee" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1111/j.1476-5381.2009.00428.x" "Revista" => array:6 [ "tituloSerie" => "Br J Pharmacol" "fecha" => "2009" "volumen" => "158" "paginaInicial" => "1429" "paginaFinal" => "1441" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19814732" "web" => "Medline" ] ] ] ] ] ] ] ] 19 => array:3 [ "identificador" => "bib0260" "etiqueta" => "20" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Airway remodeling and persistent airway obstruction in asthma" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "J.E. Fish" 1 => "S.P. Peters" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "J Allergy Clin Immunol" "fecha" => "1999" "volumen" => "104" "paginaInicial" => "509" "paginaFinal" => "516" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10482819" "web" => "Medline" ] ] ] ] ] ] ] ] 20 => array:3 [ "identificador" => "bib0265" "etiqueta" => "21" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "The role of vitamin D in chronic obstructive pulmonary disease, asthma and other respiratory diseases" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "J. Garcia de Tena" 1 => "A. el Hachem Debek" 2 => "C. Hernandez Gutierrez" 3 => "J.L. Izquierdo Alonso" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.arbres.2013.11.023" "Revista" => array:6 [ "tituloSerie" => "Arch Bronconeumol" "fecha" => "2014" "volumen" => "50" "paginaInicial" => "179" "paginaFinal" => "184" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24447429" "web" => "Medline" ] ] ] ] ] ] ] ] 21 => array:3 [ "identificador" => "bib0270" "etiqueta" => "22" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Total serum immunoglobulin e in children with asthma" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "M. Lama" 1 => "M. Chatterjee" 2 => "T.K. Chaudhuri" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1007/s12291-012-0247-2" "Revista" => array:6 [ "tituloSerie" => "Indian J Clin Biochem" "fecha" => "2013" "volumen" => "28" "paginaInicial" => "197" "paginaFinal" => "200" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24426210" "web" => "Medline" ] ] ] ] ] ] ] ] 22 => array:3 [ "identificador" => "bib0275" "etiqueta" => "23" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Serum 25-hydroxyvitamin D and IgE—a significant but nonlinear relationship" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "E. Hypponen" 1 => "D.J. Berry" 2 => "M. Wjst" 3 => "C. Power" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1111/j.1398-9995.2008.01865.x" "Revista" => array:6 [ "tituloSerie" => "Allergy" "fecha" => "2009" "volumen" => "64" "paginaInicial" => "613" "paginaFinal" => "620" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19154546" "web" => "Medline" ] ] ] ] ] ] ] ] 23 => array:3 [ "identificador" => "bib0280" "etiqueta" => "24" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Influence of body mass index on the response to asthma controller agents" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "M. Peters-Golden" 1 => "A. Swern" 2 => "S.S. Bird" 3 => "C.M. Hustad" 4 => "E. Grant" 5 => "J.M. Edelman" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1183/09031936.06.00077205" "Revista" => array:6 [ "tituloSerie" => "Eur Respir J" "fecha" => "2006" "volumen" => "27" "paginaInicial" => "495" "paginaFinal" => "503" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16507848" "web" => "Medline" ] ] ] ] ] ] ] ] 24 => array:3 [ "identificador" => "bib0285" "etiqueta" => "25" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Severe, uncontrolled adult asthma is associated with vitamin D insufficiency and deficiency" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "S. Korn" 1 => "M. Hubner" 2 => "M. Jung" 3 => "M. Blettner" 4 => "R. Buhl" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1186/1465-9921-14-25" "Revista" => array:5 [ "tituloSerie" => "Respir Res" "fecha" => "2013" "volumen" => "14" "paginaInicial" => "25" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23432854" "web" => "Medline" ] ] ] ] ] ] ] ] 25 => array:3 [ "identificador" => "bib0290" "etiqueta" => "26" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Effect of vitamin D3 on asthma treatment failures in adults with symptomatic asthma and lower vitamin D levels: the VIDA randomized clinical trial" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "M. Castro" 1 => "T.S. King" 2 => "S.J. Kunselman" 3 => "M.D. Cabana" 4 => "L. Denlinger" 5 => "F. Holguin" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1001/jama.2014.5052" "Revista" => array:6 [ "tituloSerie" => "JAMA" "fecha" => "2014" "volumen" => "311" "paginaInicial" => "2083" "paginaFinal" => "2091" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24838406" "web" => "Medline" ] ] ] ] ] ] ] ] 26 => array:3 [ "identificador" => "bib0295" "etiqueta" => "27" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Vitamin D levels, lung function, and steroid response in adult asthma" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "E.R. Sutherland" 1 => "E. Goleva" 2 => "L.P. Jackson" 3 => "A.D. Stevens" 4 => "D.Y. Leung" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1164/rccm.200911-1710OC" "Revista" => array:6 [ "tituloSerie" => "Am J Respir Crit Care Med" "fecha" => "2010" "volumen" => "181" "paginaInicial" => "699" "paginaFinal" => "704" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/20075384" "web" => "Medline" ] ] ] ] ] ] ] ] 27 => array:3 [ "identificador" => "bib0300" "etiqueta" => "28" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "1 alpha, 25-dihydroxy-vitamin D3 stimulation of bronchial smooth muscle cells induces autocrine, contractility, and remodeling processes" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "Y. Bosse" 1 => "K. Maghni" 2 => "T.J. Hudson" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1152/physiolgenomics.00134.2006" "Revista" => array:6 [ "tituloSerie" => "Physiol Genomics" "fecha" => "2007" "volumen" => "29" "paginaInicial" => "161" "paginaFinal" => "168" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17213369" "web" => "Medline" ] ] ] ] ] ] ] ] 28 => array:3 [ "identificador" => "bib0305" "etiqueta" => "29" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Vitamin D and lung function decline in adults with asthma: the HUNT Study" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "B.M. Brumpton" 1 => "A. Langhammer" 2 => "A.H. Henriksen" 3 => "C.A. Camargo Jr." 4 => "Y. Chen" 5 => "P.R. Romundstad" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1093/aje/kwv243" "Revista" => array:6 [ "tituloSerie" => "Am J Epidemiol" "fecha" => "2016" "volumen" => "183" "paginaInicial" => "739" "paginaFinal" => "746" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26994061" "web" => "Medline" ] ] ] ] ] ] ] ] 29 => array:3 [ "identificador" => "bib0310" "etiqueta" => "30" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Causal relationship between obesity and vitamin D status: bi-directional Mendelian randomization analysis of multiple cohorts" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "K.S. Vimaleswaran" 1 => "D.J. Berry" 2 => "C. Lu" 3 => "E. Tikkanen" 4 => "S. Pilz" 5 => "L.T. Hiraki" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1371/journal.pmed.1001383" "Revista" => array:5 [ "tituloSerie" => "PLoS Med" "fecha" => "2013" "volumen" => "10" "paginaInicial" => "e1001383" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23393431" "web" => "Medline" ] ] ] ] ] ] ] ] 30 => array:3 [ "identificador" => "bib0315" "etiqueta" => "31" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Relationship between serum 25-hydroxyvitamin D and pulmonary function in the third national health and nutrition examination survey" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "P.N. Black" 1 => "R. Scragg" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1378/chest.128.6.3792" "Revista" => array:6 [ "tituloSerie" => "Chest" "fecha" => "2005" "volumen" => "128" "paginaInicial" => "3792" "paginaFinal" => "3798" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16354847" "web" => "Medline" ] ] ] ] ] ] ] ] 31 => array:3 [ "identificador" => "bib0320" "etiqueta" => "32" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Serum 25-hydroxyvitamin D levels and lung function in adults with asthma: The HUNT Study" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "T.L. Larose" 1 => "A. Langhammer" 2 => "Y. Chen" 3 => "C.A. Camargo Jr." 4 => "P. Romundstad" 5 => "X.M. Mai" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1183/09031936.00069714" "Revista" => array:6 [ "tituloSerie" => "Eur Respir J" "fecha" => "2015" "volumen" => "45" "paginaInicial" => "1019" "paginaFinal" => "1026" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25395037" "web" => "Medline" ] ] ] ] ] ] ] ] ] ] ] ] "agradecimientos" => array:1 [ 0 => array:3 [ "titulo" => "Acknowledgements" "texto" => "<p id="par0140" class="elsevierStylePara elsevierViewall">The authors gratefully acknowledge Hatce Senol for helping to recruit subjects and for her assistance with testing, and William Vollmer for his help with statistical analyses and preparation of this manuscript.</p>" "vista" => "all" ] ] ] "idiomaDefecto" => "en" "url" => "/15792129/0000005300000004/v1_201704070039/S1579212916302634/v1_201704070039/en/main.assets" "Apartado" => array:4 [ "identificador" => "9374" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Original Articles" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/15792129/0000005300000004/v1_201704070039/S1579212916302634/v1_201704070039/en/main.pdf?idApp=UINPBA00003Z&text.app=https://archbronconeumol.org/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1579212916302634?idApp=UINPBA00003Z" ]
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| 2024 October | 62 | 29 | 91 |
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| 2022 February | 66 | 36 | 102 |
| 2022 January | 53 | 57 | 110 |
| 2021 December | 69 | 48 | 117 |
| 2021 November | 45 | 47 | 92 |
| 2021 October | 65 | 65 | 130 |
| 2021 September | 48 | 58 | 106 |
| 2021 August | 46 | 47 | 93 |
| 2021 July | 47 | 32 | 79 |
| 2021 June | 266 | 39 | 305 |
| 2021 May | 93 | 49 | 142 |
| 2021 April | 222 | 141 | 363 |
| 2021 March | 113 | 40 | 153 |
| 2021 February | 93 | 45 | 138 |
| 2021 January | 82 | 36 | 118 |
| 2020 December | 68 | 31 | 99 |
| 2020 November | 46 | 27 | 73 |
| 2020 October | 73 | 28 | 101 |
| 2020 September | 68 | 16 | 84 |
| 2020 August | 57 | 18 | 75 |
| 2020 July | 67 | 40 | 107 |
| 2020 June | 55 | 16 | 71 |
| 2020 May | 77 | 25 | 102 |
| 2020 April | 68 | 38 | 106 |
| 2020 March | 73 | 26 | 99 |
| 2020 February | 83 | 38 | 121 |
| 2020 January | 75 | 38 | 113 |
| 2019 December | 67 | 34 | 101 |
| 2019 November | 76 | 34 | 110 |
| 2019 October | 65 | 28 | 93 |
| 2019 September | 69 | 21 | 90 |
| 2019 August | 40 | 32 | 72 |
| 2019 July | 38 | 27 | 65 |
| 2019 June | 69 | 21 | 90 |
| 2019 May | 59 | 15 | 74 |
| 2019 April | 65 | 26 | 91 |
| 2019 March | 51 | 30 | 81 |
| 2019 February | 49 | 25 | 74 |
| 2019 January | 37 | 29 | 66 |
| 2018 December | 33 | 30 | 63 |
| 2018 November | 66 | 23 | 89 |
| 2018 October | 92 | 32 | 124 |
| 2018 September | 63 | 17 | 80 |
| 2018 May | 14 | 0 | 14 |
| 2018 April | 31 | 28 | 59 |
| 2018 March | 14 | 13 | 27 |
| 2018 February | 28 | 14 | 42 |
| 2018 January | 24 | 11 | 35 |
| 2017 December | 43 | 16 | 59 |
| 2017 November | 33 | 10 | 43 |
| 2017 October | 28 | 14 | 42 |
| 2017 September | 39 | 18 | 57 |
| 2017 August | 27 | 17 | 44 |
| 2017 July | 31 | 14 | 45 |
| 2017 April | 0 | 1 | 1 |
Show all
