The Determinants of Vitamin D Status in Barbados
Asthma rates for Barbados are among the highest in the world. It is estimated that approximately 10,000 episodes of asthma occur on the island yearly, and result in enough deaths to rank it ninth in per capita asthma-related mortality (32 per million) globally. Environmental factors such as meteorological variables and exposures to aeroallergens and pollutants, including African dust clouds carried over by trade winds, have been proposed as possible contributors to rising rates of asthma in this region. However, host factors which may be specific to this genetically homogeneous population of African descent, may also confer an increased susceptibility to developing asthma symptoms. In particular, vitamin D has gained recent attention as being protective against asthma and allergy, with several compelling studies showing that insufficiency is associated with greater asthma morbidity and resistance to pharmacologic therapy. Furthermore, studies have revealed that a significant proportion of asthmatics do not meet the current guidelines for vitamin D sufficiency, even in sun-replete areas such as Costa Rica and the southern US states. Blacks have been found to be at a higher risk for vitamin D-deficiency compared to whites, partly due to differences in skin pigmentation blocking vitamin D production. However, in Barbados, where the majority of inhabitants are black and acute episodes of asthma are epidemic, the impact of improving vitamin D status upon asthma morbidity has not yet been studied. In order to properly plan future intervention trials to determine whether repleting vitamin D in such a population will improve individual asthma status, characterizing the determinants of vitamin D is a necessary first step.
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