Vitamin D deficiency in young children with severe acute lower respiratory infection

Rationale Acute lower respiratory infection (ALRI) is one of the most common reasons for hospitalization and intensive care unit admission among children. Season related decreases in the immunomodulatory molecule, vitamin D, remain an unexplored factor that might contribute to the increased occurren...

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Published in:	Pediatric pulmonology Vol. 44; no. 10; pp. 981 - 988
Main Authors:	McNally, J. Dayre, Leis, Karen, Matheson, Loren A., Karuananyake, Chandima, Sankaran, Koravangattu, Rosenberg, Alan M.
Format:	Journal Article
Language:	English
Published:	Hoboken Wiley Subscription Services, Inc., A Wiley Company 01-10-2009 Wiley-Liss
Subjects:	Acute Disease Age Distribution Biological and medical sciences bronchiolitis Bronchiolitis - epidemiology Bronchiolitis - etiology Bronchiolitis - physiopathology Case-Control Studies Child, Preschool Chronic obstructive pulmonary disease, asthma Female Follow-Up Studies General aspects Humans Incidence Infant Male Medical sciences Odds Ratio pediatrics Pneumology pneumonia Pneumonia - epidemiology Pneumonia - etiology Pneumonia - physiopathology Probability Reference Values Respiratory system : syndromes and miscellaneous diseases Respiratory Tract Infections - epidemiology Respiratory Tract Infections - etiology Risk Assessment Saskatchewan Severity of Illness Index Sex Distribution vitamin D Vitamin D - analogs & derivatives Vitamin D - blood Vitamin D Deficiency - complications Vitamin D Deficiency - diagnosis Human Lung disease Pediatrics Pneumonia Respiratory disease Acute Nutrition disorder Bronchiolitis Infection Vitamin D Bronchus disease Severe Child Nutritional status Pneumology
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Summary:	Rationale Acute lower respiratory infection (ALRI) is one of the most common reasons for hospitalization and intensive care unit admission among children. Season related decreases in the immunomodulatory molecule, vitamin D, remain an unexplored factor that might contribute to the increased occurrence of ALRI in children. Objective To investigate a possible association between vitamin D deficiency and respiratory infection by comparing serum 25 hydroxyvitamin D [25(OH)D] levels in a group of young children with ALRI to an age‐matched group without respiratory infection. Patients and Methods Participants with a diagnosis of bronchiolitis or pneumonia (n = 55 or 50, respectively), as well as control subjects without respiratory symptoms (n = 92), were recruited at the Royal University Hospital, Saskatoon, Saskatchewan, Canada from November 2007 to May 2008. 25(OH)D levels were measured in patient serum using a competitive enzyme linked immunoassay. Results The mean vitamin D level for the entire ALRI group was not significantly different from the control group (81 ± 40 vs. 83 ± 30 nmol/L, respectively). The mean vitamin D level for the ALRI subjects admitted to the pediatric intensive care unit (49 ± 24 nmol/L) was significantly lower than that observed for both control (83 ± 30 nmol/L) and ALRI subjects admitted to the general pediatrics ward (87 ± 39 nmol/L). Vitamin D deficiency remained statistically related to pediatric intensive care unit admission in the multivariate analysis. Conclusion No difference was observed in vitamin D levels between the entire ALRI group and control groups; however, significantly more children admitted to the pediatric intensive care unit with ALRI were vitamin D deficient. These findings suggest that the immunomodulatory properties of vitamin D might influence ALRI disease severity. Pediatr Pulmonol. 2009; 44:981–988. ©2009 Wiley‐Liss, Inc.
Bibliography:	Pediatric Rheumatic Disease Research Laboratory, University of Saskatchewan Department of Pediatrics, University of Saskatchewan istex:E44BD4BE5C44EC31481A3A4CF770C7EFC5F6C2C5 Royal University Hospital Foundation Grant ArticleID:PPUL21089 The authors declare no conflict of interest. ark:/67375/WNG-P8WDDVL2-L ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	8755-6863 1099-0496
DOI:	10.1002/ppul.21089