title: Vitamin D status and acute respiratory infection: cross sectional results from the United States National Health and Nutrition Examination Survey, 2001-2006.
abstract: Vitamin D is a promising, though under-explored, potential modifiable risk factor for acute respiratory infections (ARIs). We sought to investigate the association of vitamin D status with ARI in a large, nationally-representative sample of non-institutionalized individuals from the United States. We analyzed 14,108 individuals over 16 years of age in the National Health and Nutrition Survey (NHANES) 2001-2006 in this cross-sectional study. We used locally weighted scatterplot smoothing (LOWESS) to depict the relationship between increasing 25-hydroxyvitamin D (25OHD) levels and ARI. We then performed a multivariable regression analysis to investigate the association of 25OHD levels with ARI, while adjusting for known confounders. The median serum 25OHD level was 21 (IQR 15-27) ng/mL. Overall, 4.8% (95% CI: 4.5-5.2) of participants reported an ARI within 30 days before their participation in the national survey. LOWESS analysis revealed a near-linear relationship between vitamin D status and the cumulative frequency of ARI up to 25OHD levels around 30 ng/mL. After adjusting for season, demographic factors, and clinical data, 25OHD levels <30 ng/mL were associated with 58% higher odds of ARI (OR 1.58; 95% CI: 1.07-2.33) compared to levels ≥30 ng/mL. Among the 14,108 participants in NHANES 2001-2006, 25OHD levels were inversely associated with ARI. Carefully designed, randomized, controlled trials are warranted to determine the effect of optimizing vitamin D status on the risk of ARI.
authors.affiliation: Tulane School of Public Health & Tropical Medicine, New Orleans, LA 70112, USA. dmonlezu@tulane.edu.|Tulane University School of Medicine, New Orleans, LA 70112, USA. dmonlezu@tulane.edu.
authors.forename: Dominique J
authors.initials: DJ
authors.lastname: Monlezun
authors.affiliation: Harvard Medical School, Boston, MA 02115, USA. eabittner@bics.bwh.harvard.edu.|Massachusetts General Hospital, Boston, MA 02114, USA. eabittner@bics.bwh.harvard.edu.
authors.forename: Edward A
authors.initials: EA
authors.lastname: Bittner
authors.affiliation: Harvard Medical School, Boston, MA 02115, USA. kbchristopher@partners.org.|Brigham and Women's Hospital, Boston, MA 02115, USA. kbchristopher@partners.org.
authors.forename: Kenneth B
authors.initials: KB
authors.lastname: Christopher
authors.affiliation: Harvard Medical School, Boston, MA 02115, USA. dmonlezu@tulane.edu.|Massachusetts General Hospital, Boston, MA 02114, USA. dmonlezu@tulane.edu.|Harvard School of Public Health, Boston, MA 02115, USA. dmonlezu@tulane.edu.
authors.forename: Carlos A
authors.initials: CA
authors.lastname: Camargo
authors.affiliation: Harvard Medical School, Boston, MA 02115, USA. squraishi@mgh.harvard.edu.|Massachusetts General Hospital, Boston, MA 02114, USA. squraishi@mgh.harvard.edu.
authors.forename: Sadeq A
authors.initials: SA
authors.lastname: Quraishi
mesh_terms: D000293:Adolescent; D000328:Adult; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009749:Nutrition Surveys; D012141:Respiratory Tract Infections / Q000097:blood / Q000209:etiology*; D012307:Risk Factors; D014481:United States; D014807:Vitamin D / Q000031:analogs & derivatives* / Q000097:blood; D014808:Vitamin D Deficiency / Q000097:blood / Q000150:complications*; D055815:Young Adult
chemical_list: D014807:Vitamin D; C104450:25-hydroxyvitamin D