Association Between Vitamin D Levels and Psychological Stress-Induced Asthma Prevalence: An Untargeted Metabolomics Study Combined with the NHANES Database

Why It Matters

The findings suggest vitamin D deficiency may be a modifiable risk factor for asthma that co‑occurs with anxiety or depression, opening avenues for preventive nutrition strategies and integrated asthma‑mental health care.

Key Takeaways

• Higher serum vitamin D reduces PSA odds (OR ≈ 0.99).
• Vitamin D < 67 nmol/L sharply raises PSA‑depression risk.
• Daily intake below 9 µg vitamin D increases PSA prevalence.
• Calcidiol levels inversely linked to PSA (OR 0.14).
• Association holds across age, sex, race, and activity subgroups.

Pulse Analysis

The link between vitamin D and respiratory health has long been debated, but this study provides the first large‑scale evidence that deficiency may specifically exacerbate asthma triggered by psychological stress. By leveraging the nationally representative NHANES database, researchers identified a modest yet statistically robust inverse relationship between serum 25‑hydroxyvitamin D and PSA, especially when levels fall below the 67 nmol/L threshold. The analysis also highlighted that lower dietary vitamin D intake—under 9 µg per day—correlates with higher PSA prevalence, suggesting that both circulating levels and nutritional intake matter.

Mechanistically, vitamin D influences immune modulation, dampening Th1/IL‑17 pathways and enhancing corticosteroid responsiveness, which could mitigate airway inflammation aggravated by stress‑related neuroendocrine signals. The metabolomics validation in a Chinese cohort reinforced this biological plausibility, pinpointing calcidiol as a key metabolite inversely associated with PSA risk. Such cross‑population consistency strengthens the argument that vitamin D status is not merely a confounder but may play a causal role in the psychophysiological asthma phenotype.

For clinicians and public‑health policymakers, the implications are twofold. First, routine assessment of vitamin D levels in asthmatic patients—particularly those reporting anxiety or depressive symptoms—could identify individuals at heightened risk for stress‑induced exacerbations. Second, targeted supplementation strategies aimed at achieving serum concentrations above 67 nmol/L and daily intakes exceeding 9 µg may serve as an adjunct to standard inhaled therapies, potentially reducing reliance on high‑dose corticosteroids. Future prospective trials are needed to confirm causality and to define optimal dosing regimens, but the current evidence positions vitamin D as a promising, low‑cost intervention in the integrated management of asthma with mental‑health comorbidities.