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<p>Low vitamin D (VD) status is prevalent in children with atopic dermatitis (AD) and, in some populations, is associated with disease severity. Circulating bioavailable and free 25-hydroxyvitamin D (25(OH)D) may associate more strongly with clinically relevant health outcomes than total 25(OH)D. We aimed to evaluate determinants of total, bioavailable and free 25(OH)D in children with AD, and their association with AD severity and immune biomarkers. We performed a cross-sectional study nested in a randomized trial using baseline data of 101 children aged 2–17 years with AD, not previously using VD supplements. VD intake was estimated through food frequency questionnaire. Bioavailable and free 25(OH)D were calculated using 25(OH)D, VD-binding protein and albumin concentrations. Mean serum 25(OH)D was 46.8 ± 20.2 nmol/L; 54% had 25(OH)D &lt; 50 nmol/L. Median dietary VD intake was 87 IU/day; 98% were below the estimated average requirement. Spring sampling and older age associated with low VD status (aOR = 8.84, <i>p</i> = 0.006, and aOR = 1.17, <i>p</i> = 0.01, respectively); children with higher dietary VD intake were less likely to have low VD status (aOR = 0.37 per 100 IU, <i>p</i> = 0.007). No correlation was found between the different 25(OH)D forms and clinical severity. Regarding immune biomarkers, while total 25(OH)D levels (&lt; 50 nmol/L vs. ≥50 nmol/L) showed no significant differences, low bioavailable 25(OH)D was linked to higher eosinophil counts , and low free 25(OH)D was associated with higher eosinophil counts and IgE. In conclusion, in children with AD, low VD status is associated with spring season sampling, older age, and lower dietary VD intake. Although 25(OH)D forms were not correlated with clinical severity, bioavailable and free 25(OH)D associated with AD immune biomarkers.</p>

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Determinants and clinical associations of total, bioavailable, and free 25-hydroxyvitamin D in children with atopic dermatitis

  • 期刊论文

  • 发表日期：

    2026年6月30日

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  • Juan Pablo Fraga,
  • María Francisca Bustos,
  • Carolina Iturriaga,
  • Guillermo Pérez‑Mateluna,
  • Carolina Cabalín,
  • Carla Leiva,
  • Carlos A. Camargo Jr.,
  • Arturo Borzutzky

摘要

Low vitamin D (VD) status is prevalent in children with atopic dermatitis (AD) and, in some populations, is associated with disease severity. Circulating bioavailable and free 25-hydroxyvitamin D (25(OH)D) may associate more strongly with clinically relevant health outcomes than total 25(OH)D. We aimed to evaluate determinants of total, bioavailable and free 25(OH)D in children with AD, and their association with AD severity and immune biomarkers. We performed a cross-sectional study nested in a randomized trial using baseline data of 101 children aged 2–17 years with AD, not previously using VD supplements. VD intake was estimated through food frequency questionnaire. Bioavailable and free 25(OH)D were calculated using 25(OH)D, VD-binding protein and albumin concentrations. Mean serum 25(OH)D was 46.8 ± 20.2 nmol/L; 54% had 25(OH)D < 50 nmol/L. Median dietary VD intake was 87 IU/day; 98% were below the estimated average requirement. Spring sampling and older age associated with low VD status (aOR = 8.84, p = 0.006, and aOR = 1.17, p = 0.01, respectively); children with higher dietary VD intake were less likely to have low VD status (aOR = 0.37 per 100 IU, p = 0.007). No correlation was found between the different 25(OH)D forms and clinical severity. Regarding immune biomarkers, while total 25(OH)D levels (< 50 nmol/L vs. ≥50 nmol/L) showed no significant differences, low bioavailable 25(OH)D was linked to higher eosinophil counts , and low free 25(OH)D was associated with higher eosinophil counts and IgE. In conclusion, in children with AD, low VD status is associated with spring season sampling, older age, and lower dietary VD intake. Although 25(OH)D forms were not correlated with clinical severity, bioavailable and free 25(OH)D associated with AD immune biomarkers.