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Saad et al
Korean National Health and Nutrition Examination 2009 Survey. They reported lower mean vitamin D levels in patients
with AR when compared to the healthy adult group, after
adjusting demographic data, body mass index, sun exposure,
socioeconomic status, exercise, and body fat percentage. Arshi
et al16 measured vitamin D levels in adult patients with AR and
compared their data to the general population (no control
group). The prevalence of severe 25(OH)D deficiency was
significantly higher in patients with AR than the normal population, (30% vs 5.1% respectively; p ¼ .03). Inconsistent with
our results and the previous studies, there were few studies that
reported no association between AR and vitamin D levels or
positive association with the use of vitamin D.21-23 Hyppo¨nen
et al21 found that regular use of vitamin D supplementation was
associated with an increased risk of atopy and AR. Other studies22,23 observed no significant association between serum vitamin D levels and AR. Our data were not consistent with the
previous findings; this may be due to differences in study
designs, the age of the patients selected, different methods of
clinical assessment of AR, and laboratory investigations of
vitamin D levels.
Recently, Aryan et al2 performed a systematic review and
meta-analysis about vitamin D status and AR. They found that
the association of vitamin D status with AR was age- and sex
specific. Children with serum 25(OH)D more than 30 ng/mL
had lower odds for having AR. However, this was not significant (OR: 0.91, 95% CI: 0.81-1.01), while this figure was
significant in adults (OR: 0.64; 95% CI: 0.51-0.81).

Conclusions and Recommendations
Vitamin D deficiency is a frequent finding among Egyptian
children with AR when compared to the healthy group. A
significant inverse association was observed between vitamin
D levels and AR disease severity, therefore determining vitamin D levels should be considered in the assessment of children
with AR. Additional studies are required to determine the
effects, dose, and duration of vitamin D therapy for the management of AR. Moreover, more studies are essential to fully
elucidate the actual mechanism of action of vitamin D in AR.
Authors' Note
All authors have read and agreed with the content of this study and no
portion of this work has been published previously or is under consideration for publication elsewhere and is an original article. Khaled
Saad, Abobakr Abdelmoghny, Mohamed Diab Aboul-Khair, Yasser
Farouk Abdel-Raheem, Bahaa Hawary conceptualized the study
design, writing of the paper, collection of sample and interpretation
of data. Asmaa M. Zahran and Mohamd A. Alblihed did all the laboratory tests for our studied children. Amira Elhoufey and Ahmed
El-Sayed Hammour did the statistical analysis of data. The protocol
of this study was in accordance with the regulations of the relevant
clinical research Ethics Committee and with those of the code of ethics
of the world medical association Declaration of Helsinki. Written
informed consents of caregivers of all children were taken according
to the Ethical Committee of Faculty of Medicine, Assiut University,
Egypt, the date of approval January 2, 2015 (number 126-1-2015).

511
Conflict of Interest Statement
The author(s) declared no potential conflicts of interest with respect to
the research, authorship, and/or publication of this article.

Funding
The author(s) received no financial support for the research, authorship, and/or publication of this article.

ORCID iD
Khaled Saad

https://orcid.org/0000-0002-8473-6116

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https://www.orcid.org/0000-0002-8473-6116 https://www.orcid.org/0000-0002-8473-6116 https://www.orcid.org/0000-0002-8473-6116

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