Association between vitamin D levels and psychological stress-induced asthma prevalence: an untargeted metabolomics study combined with the NHANES database

Background: The incidence of psychological stress-induced asthma (PSA) is increasing annually, and numerous studies have shown that vitamin D is associated with the development of asthma, anxiety, and depression. However, to date, no studies have clarified the relationship between vitamin D levels and the prevalence of PSA. Therefore, this study aimed to integrate an analysis based on the National Health and Nutrition Examination Survey (NHANES) database with untargeted metabolomics to explore the potential association between vitamin D and PSA. Methods: This study integrates a cross-sectional analysis based on the NHANES database with a prospective cohort study incorporating untargeted metabolomics. A total of 2165 adults with asthma and 2331 adults with PSA from the NHANES cycles (2007-2012 and 2015-2018) were included to evaluate the association between vitamin D levels and the incidence of PSA. Multivariable logistic regression, restricted cubic spline modeling, and subgroup analyses were performed. For external validation, 60 adults with asthma and PSA were recruited, and untargeted metabolomics was used to measure plasma calcidiol levels. The association between vitamin D levels and PSA was assessed using regression models. Results: = 0.0404), which warrants further validation in future studies. Sensitivity analyses confirmed the robustness of these findings with respect to PSA levels. Conclusion: Our findings suggest that lower vitamin D status may be associated with a higher likelihood of PSA. Specifically, lower circulating vitamin D levels and lower daily vitamin D intake were associated with higher odds of PSA. These observations may provide a potential basis for future research on the clinical evaluation and management of PSA levels.