Allergy is associated with bone quality and quantity

Authors

  • Alexandra Hozáková Department of Anthropology, Faculty of Natural Sciences, Comenius University in Bratislava https://orcid.org/0009-0000-7341-5539
  • Simona Sulis Department of Anthropology, Faculty of Natural Sciences, Comenius University in Bratislava https://orcid.org/0000-0002-1570-1470
  • Darina Falbová Department of Anthropology, Faculty of Natural Sciences, Comenius University in Bratislava https://orcid.org/0000-0003-2672-0965
  • Veronika Mundoková Csibová Immuno-allergology Outpatient Clinic, Šamorín Polyclinic, Šamorín, Slovakia
  • Lenka Vorobeľová Department of Anthropology, Faculty of Natural Sciences, Comenius University in Bratislava https://orcid.org/0009-0009-2211-1581

DOI:

https://doi.org/10.52905/hbph2026.114

Keywords:

bone quality, bone quantity, vitamin D, allergic diseases, Slovak adult population

Abstract

Background Research increasingly suggests that vitamin D plays a significant role in the development and severity of allergic diseases. However, less is known about how vitamin D status and allergic sensitization may jointly influence bone health.

Objective The aim of this study was to investigate the relationship between allergies, vitamin D levels and bone quality and quantity in a Slovak adult population.

Sample and Methods The sample consisted of 198 participants aged 19–57, 53 men with a mean age of 36.6±9.6 years (16 without allergy, 37 with allergy) and 145 women with a mean age of 36.1±10.0 years (48 without allergy, 97 with allergy). Allergy diagnosis was confirmed by a physician in an immunoallergology outpatient clinic. Health data (medical history, lifestyle, allergy history/treatment and vitamin supplementation) were collected by questionnaire and bone tissue quality and quantity parameter (T-score, Z-score) were assessed using a Sunlight MiniOmni ultrasound densitometer.

Results Among women, Mann–Whitney U tests showed lower vitamin D with grass (p=0.006; rrb=0.375) and animal allergy (p=0.011; rrb=0.453). Moreover, in t tests, Z-scores were lower in women with animal allergy (p=0.047; 0.26 vs 0.76). Among men, animal allergy was associated with reduced T- and Z-scores (p=0.035 for both) and showed negative correlations with T-score (p=0.035; r=−0.297) and Z-score (p=0.035; r=−0.296).

Conclusions Specific allergic conditions may be associated with lower vitamin D levels and reduced bone tissue quality and quantity, with notable sex-specific patterns.

References

Alblewi, S. M. S./Alenazi, L. M./Alshahrani, R. S./Alharbi, R. T./Alotaibi, N. A./Albalawi, H. M. D./Albalawi, D. L. S./Alfaidi, A. A./Abu Sabir, D. A. H. (2024). Prevalence of Allergic Rhinitis and its Impact on Quality of Life Among Pediatric Patients in Tabuk, Saudi Arabia. Oman medical journal 39 (6), e696. https://​doi.​org/​10.​5001/​omj.​2024.​118.

Baroncelli, G. I. (2008). Quantitative ultrasound methods to assess bone mineral status in children: technical characteristics, performance, and clinical application. Pediatric Research 63 (3), 220–228. https://​doi.​org/​10.​1203/​PDR.​0b013e318163a286.

Bjerg, A./Winberg, A./Berthold, M./Mattsson, L./Borres, M. P./Rönmark, E. (2015). A population‐based study of animal component sensitization, asthma, and rhinitis in schoolchildren. Pediatric Allergy and Immunology 26 (6), 557–563. https://​doi.​org/​10.​1111/​pai.​12422.

Bora, S. A./Kennett, M. J./Smith, P. B./Patterson, A. D./Cantorna, M. T. (2018). Regulation of vitamin D metabolism following disruption of the microbiota using broad spectrum antibiotics. The Journal of Nutritional Biochemistry 56, 65–73. https://​doi.​org/​10.​1016/​j.​jnutbio.​2018.​01.​011.

Bouillon, R./Marcocci, C./Carmeliet, G./Bikle, D./White, J. H./Dawson-Hughes, B./Lips, P./Munns, C. F./Lazaretti-Castro, M./Giustina, A./Bilezikian, J. (2019). Skeletal and Extraskeletal Actions of Vitamin D: Current Evidence and Outstanding Questions. Endocrine Reviews 40 (4), 1109–1151. https://​doi.​org/​10.​1210/​er.​2018-00126.

Chen, S./Patel, J./Katzmeyer, T./Pei, M. (2025). Sex-dependent variation in bone adaptation: from degeneration to regeneration. Journal of Orthopaedic Translation 52, 325–343. https://​doi.​org/​10.​1016/​j.​jot.​2025.​04.​011.

Choi, H. G./Kong, I. G. (2019). Association between chronic rhinosinusitis and osteoporosis: a case‐control study using a national sample cohort. International Forum of Allergy & Rhinology 9 (9), 1010–1016. https://​doi.​org/​10.​1002/​alr.​22365.

Doulgeraki, A. E./Manousakis, E. M./Papadopoulos, N. G. (2017). Bone health assessment of food allergic children on restrictive diets: a practical guide. Journal of Pediatric Endocrinology and Metabolism 30 (2). https://​doi.​org/​10.​1515/​jpem-2016-0162.

Douros, K./Loukou, I./Boutopoulou, B./Fouzas, S. (2015). Does Vitamin D Deficiency Epidemic Parallel with Allergy and Asthma Epidemic? Mini-Reviews in Medicinal Chemistry 15 (12), 967–973. https://​doi.​org/​10.​2174/​138955751512150731110827.

Gelardi, M./Barbara, F./Covelli, I./Damiani, M. A./Plantone, F./Notarnicola, A./Moretti, B./Quaranta, N./Ciprandi, G. (2019). Long-Term Therapy with Corticosteroids in Nasal Polyposis: A Bone Metabolism Assessment. Indian Journal of Otolaryngology and Head & Neck Surgery 71 (Suppl 3), 2050–2056. https://​doi.​org/​10.​1007/​s12070-018-1466-5.

Ginaldi, L./Martinis, M. de (2016). Osteoimmunology and Beyond. Current Medicinal Chemistry 23 (33), 3754–3774. https://​doi.​org/​10.​2174/​0929867323666160907162546.

Groth, D. (2023). GitHub –mittelmark/snha:St. Nicolas House Algorithm implementation in R –predicting correlation networks using association chains 2023. Available online at https://​github.​com/​mittelmark/​snha.

Groth, D./Scheffler, C./Hermanussen, M. (2019). Body height in stunted Indonesian children depends directly on parental education and not via a nutrition mediated pathway – Evidence from tracing association chains by St. Nicolas House Analysis. Anthropologischer Anzeiger 76 (5), 445–451. https://​doi.​org/​10.​1127/​anthranz/​2019/​1027.

Hewison, M. (2012). An update on vitamin D and human immunity. Clinical Endocrinology 76 (3), 315–325. https://​doi.​org/​10.​1111/​j.​1365-2265.​2011.​04261.​x.

Hossein-nezhad, A./Holick, M. F. (2013). Vitamin D for Health: A Global Perspective. Mayo Clinic Proceedings 88 (7), 720–755. https://​doi.​org/​10.​1016/​j.​mayocp.​2013.​05.​011.

Jung, J.-W./Kang, H.-R./Kim, J.-Y./Lee, S.-H./Kim, S. S./Cho, S. H. (2014). Are asthmatic patients prone to bone loss? Annals of Allergy, Asthma & Immunology 112 (5), 426–431. https://​doi.​org/​10.​1016/​j.​anai.​2014.​02.​013.

Kajal, S./Shrestha, P./Gupta, Y./Deepak, R./Verma, H. (2022). Vitamin D Deficiency and Interleukin Levels in Allergic Rhinitis: A Case–Control Study. Indian Journal of Otolaryngology and Head & Neck Surgery 74 (Suppl 2), 1720–1724. https://​doi.​org/​10.​1007/​s12070-021-02897-y.

Krajewska, M./Witkowska-Sędek, E./Rumińska, M./Stelmaszczyk-Emmel, A./Sobol, M./Majcher, A./Pyrżak, B. (2022). Vitamin D Effects on Selected Anti-Inflammatory and Pro-Inflammatory Markers of Obesity-Related Chronic Inflammation. Frontiers in Endocrinology 13, 920340. https://​doi.​org/​10.​3389/​fendo.​2022.​920340.

Laird, E./Ward, M./McSorley, E./Strain, J. J./Wallace, J. (2010). Vitamin D and Bone Health; Potential Mechanisms. Nutrients 2 (7), 693–724. https://​doi.​org/​10.​3390/​nu2070693.

Lipińska-Opałka, A./Tomaszewska, A./Kubiak, J. Z./Kalicki, B. (2021). Vitamin D and Immunological Patterns of Allergic Diseases in Children. Nutrients 13 (1), 177. https://​doi.​org/​10.​3390/​nu13010177.

Lohman, T. G./Roche, A. F./Martorell, R. (1988). Anthropometric standardization reference manual. Champaign, Ill., Human Kinetics Books.

Lombardi, C./Passalacqua, G./Italian Vitamin D Allergy Group (2017). Vitamin D levels and allergic diseases. An italian cross-sectional multicenter survey. European Annals of Allergy and Clinical Immunology 49 (2), 75–79.

Lu, R./Zhang, Y./Chen, Y./Lyu, J./Li, R./Kang, W./Zhao, A./Ning, Z./Hu, Y./Lin, X./Tong, S./Lu, Z./Li, S. (2025). The Joint Association of Sleep Quality and Outdoor Activity with Asthma and Allergic Rhinitis in Children: A Cross-Sectional Study in Shanghai. Journal of Asthma and Allergy 18, 101–111. https://​doi.​org/​10.​2147/​JAA.​S494662.

Ma, Y./Liu, Y./Li, X./Qiu, J./Fang, P. (2020). Low serum 25‐hydroxyvitamin D levels are associated with perennial allergic rhinitis but not disease severity. Journal of Clinical Laboratory Analysis 34 (12), e23516. https://​doi.​org/​10.​1002/​jcla.​23516.

Martinis, M. de/Allegra, A./Sirufo, M. M./Tonacci, A./Pioggia, G./Raggiunti, M./Ginaldi, L./Gangemi, S. (2021). Vitamin D Deficiency, Osteoporosis and Effect on Autoimmune Diseases and Hematopoiesis: A Review. International Journal of Molecular Sciences 22 (16), 8855. https://​doi.​org/​10.​3390/​ijms22168855.

Martinis, M. de/Sirufo, M. M./Ginaldi, L. (2020). Osteoporosis: Current and Emerging Therapies Targeted to Immunological Checkpoints. Current Medicinal Chemistry 27 (37), 6356–6372. https://​doi.​org/​10.​2174/​0929867326666190730113123.

Mirzakhani, H./Al‐Garawi, A./Weiss, S. T./Litonjua, A. A. (2015). Vitamin D and the development of allergic disease: how important is it? Clinical & Experimental Allergy 45 (1), 114–125. https://​doi.​org/​10.​1111/​cea.​12430.

Murdaca, G./Allegra, A./Tonacci, A./Musolino, C./Ricciardi, L./Gangemi, S. (2022). Mast Cells and Vitamin D Status: A Clinical and Biological Link in the Onset of Allergy and Bone Diseases. Biomedicines 10 (8), 1877. https://​doi.​org/​10.​3390/​biomedicines10081877.

Mvoundza Ndjindji, O./Minto’o Rogombe, S./Mveang-Nzoghe, A./Leboueny, M./Ouloungou, M./Abougono Ekogha, N./Maloupazoa Siawaya, A. C./Kuissi Kamgaing, É./Ndeboko, B./Ategbo, S./Djoba Siawaya, J. F. (2024). Vitamin D deficiency may be associated with allergies in sub-Saharan Africa. Journal of Allergy and Hypersensitivity Diseases 2, 100011. https://​doi.​org/​10.​1016/​j.​jahd.​2024.​100011.

O'Neill, C. M./Kazantzidis, A./Ryan, M. J./Barber, N./Sempos, C. T./Durazo-Arvizu, R. A./Jorde, R./Grimnes, G./Eiriksdottir, G./Gudnason, V./Cotch, M. F./Kiely, M./Webb, A. R./Cashman, K. D. (2016). Seasonal Changes in Vitamin D-Effective UVB Availability in Europe and Associations with Population Serum 25-Hydroxyvitamin D. Nutrients 8 (9). https://​doi.​org/​10.​3390/​nu8090533.

Özdemir, Ö. (2016). Vitamin D and Allergy. MedCrave Online Journal of Immunology 3 (2). https://​doi.​org/​10.​15406/​moji.​2016.​03.​00084.

Ponzetti, M./Rucci, N. (2019). Updates on Osteoimmunology: What’s New on the Cross-Talk Between Bone and Immune System. Frontiers in Endocrinology 10, 236. https://​doi.​org/​10.​3389/​fendo.​2019.​00236.

Rueter, K./Siafarikas, A./Palmer, D. J./Prescott, S. L. (2022). Pre- and Postnatal Vitamin D Status and Allergy Outcomes in Early Childhood. Biomedicines 10 (5), 933. https://​doi.​org/​10.​3390/​biomedicines10050933.

Saad, K./Abdelmoghny, A./Aboul-Khair, M. D./Abdel-Raheem, Y. F./Gad, E. F./Hammour, A. E.-S./Hawary, B./Zahran, A. M./Alblihed, M. A./Elhoufey, A. (2020). Vitamin D Status in Egyptian Children With Allergic Rhinitis. Ear, Nose & Throat Journal 99 (8), 508–512. https://​doi.​org/​10.​1177/​0145561319850814.

Sirufo, M. M./Suppa, M./Ginaldi, L./Martinis, M. de (2020). Does Allergy Break Bones? Osteoporosis and Its Connection to Allergy. International Journal of Molecular Sciences 21 (3), 712. https://​doi.​org/​10.​3390/​ijms21030712.

Takkouche, B./González‐Barcala, F.-J./Etminan, M./FitzGerald, M. (2008). Exposure to furry pets and the risk of asthma and allergic rhinitis: a meta‐analysis. Allergy 63 (7), 857–864. https://​doi.​org/​10.​1111/​j.​1398-9995.​2008.​01732.​x.

Thuesen, B. H./Skaaby, T./Husemoen, L. L. N./Fenger, M./Jørgensen, T./Linneberg, A. (2015). The association of serum 25-OH vitamin D with atopy, asthma, and lung function in a prospective study of Danish adults. Clinical & Experimental Allergy 45 (1), 265–272. https://​doi.​org/​10.​1111/​cea.​12299.

Wang, J./Zhou, Y./Zhang, H./Hu, L./Liu, J./Wang, L./Wang, T./Zhang, H./Cong, L./Wang, Q. (2023). Pathogenesis of allergic diseases and implications for therapeutic interventions. Signal Transduction and Targeted Therapy 8 (1), 138. https://​doi.​org/​10.​1038/​s41392-023-01344-4.

Wee, J. H./Min, C./Park, M. W./Byun, S. H./Lee, H.-J./Park, B./Choi, H. G. (2020). The association of asthma and its subgroups with osteoporosis: a cross-sectional study using KoGES HEXA data. Allergy, Asthma & Clinical Immunology 16 (1), 84. https://​doi.​org/​10.​1186/​s13223-020-00482-6.

Wu, C.-Y./Lu, Y.-Y./Lu, C.-C./Su, Y.-F./Tsai, T.-H./Wu, C.-H./van Nguyen, T. (2017a). Osteoporosis in adult patients with atopic dermatitis: A nationwide population-based study. PLOS One 12 (2), e0171667. https://​doi.​org/​10.​1371/​journal.​pone.​0171667.

Wu, H.-Y./Chen, J.-X./Tian, H.-Q./Zhang, X.-L./Bian, H.-Y./Cheng, L. (2017b). Serum 25-hydroxyvitamin D inversely associated with blood eosinophils in patients with persistent allergic rhinitis. Asia Pacific Allergy 7 (4), 213–220. https://​doi.​org/​10.​5415/​apallergy.​2017.​7.​4.​213.

Zhang, P./Xu, Q./Zhu, R. (2024). Vitamin D and allergic diseases. Frontiers in Immunology 15, 1420883. https://doi.org/10.3389/fimmu.2024.1420883.

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Published

2026-05-22

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Section

International Student Summer School

How to Cite

Hozáková, A., Sulis, S., Falbová, D., Mundoková Csibová, V., & Vorobeľová, L. (2026). Allergy is associated with bone quality and quantity. Human Biology and Public Health, 1-16. https://doi.org/10.52905/hbph2026.114