Nasal airway resistance in moderately severe allergic rhinitis and impact of Vitamin D deficiency

Abstract: BACKGROUND: Rhinomanometry has been used earlier in patients with allergic rhinitis (AR) for quantification of nasal airway resistance (NR). Although there is a difference between subjective symptoms and NR of mild and moderate-severe forms of AR, it is not known if there is a difference between intermittent and persistent categories of AR, and if this difference correlates with the subjective nasal symptoms scores or not. OBJECTIVES: To elucidate any such difference and to look for the impact of Vitamin D deficiency on NR as various studies have shown an association between AR and Vitamin D deficiency. METHOD: A total of 145 (87 males; 58 females) patients, aged 10–70 years, diagnosed clinically with moderate–severe AR as per AR and its Impact on Asthma guidelines were recruited and were categorized into intermittent and persistent groups. SNOT-22 score was calculated in all the patients. Active anterior rhinomanometry (AAR) and posterior rhinomanometry were used to measure inspiratory and expiratory NR in intermittent and persistent groups and also as per Vitamin D levels in these groups. RESULTS: There was no significant difference between the intermittent and persistent categories for NR or SNOT-22 scores. There was no significant correlation between the SNOT-22 score and any of the NR parameter in either group. However, there was a significant difference in inspiratory and expiratory NR during AAR between intermittent and persistent groups of patients with severe Vitamin D deficiency ( P ≤ 0.0001). CONCLUSION: There is no difference in objective NR or SNOT-22 score between intermittent and persistent categories of patients with moderately severe AR and there is no correlation between this objective and subjective score within these groups. However, if there is severe Vitamin D deficiency, the NR during AAR differs significantly between intermittent and persistent groups of patients with moderately severe AR.