Association Between Serum Vitamin A Levels and Recurrent Respiratory Tract Infections in Children

Abstract

To evaluate the association between serum vitamin A levels and the prevalence of recurrent respiratory tract infections (RRTIs) in children and adolescents and to provide evidence that would help decrease the prevalence of respiratory tract infections (RTIs) in children. This cross-sectional study included 8034 children and adolescents in Beijing aged 6 months to 17 years. RRTI and RTI symptoms were diagnosed according to the Clinical Concept and Management of Recurrent Respiratory Tract Infections in Children. Multivariate logistic regression models were used to evaluate the association between serum vitamin A levels and RRTIs after adjusting for potential confounders. Among the included children, 721 (8.97%) were diagnosed with vitamin A deficiency, whereas 3,073 (38.25%) were diagnosed with subclinical vitamin A deficiency. Only 28.8% (208/721) of children with vitamin A deficiency and 53.1% (1,631/3,073) of children with subclinical vitamin A deficiency had no RRTI and RTI symptoms, respectively. Compared with children with normal vitamin A levels, those with vitamin A deficiency and subclinical vitamin A deficiency had a greater risk for RRTIs, with an odds ratio (OR) of 6.924 [95% confidence interval (CI): 5.433–8.824] and 2.140 (95% CI: 1.825–2.510), respectively]. Vitamin A levels were also positively associated with RTI symptoms, with those having vitamin A deficiency and subclinical vitamin A deficiency showing an OR of 1.126 (95% CI: 0.773–1.640) and 1.216 (95% CI: 1.036–1.427), respectively. The present cross-sectional study found that low serum vitamin A levels were significantly associated with RRTI or RTI prevalence in children and adolescents.

Clinical Monitoring of Serum Levels of Vitamins A, D and E in Children with Recurrent Respiratory Tract Infections of Different Ages: A Clinical Controlled Trial

“…Moreover, the results of this study showed that the proportions of premature infants, low body weight infants, special physique, hospitalization history, hypocalcemia, living in a bungalow, and daily outdoor activities less than 30 minutes in the case group were higher than those in the control group, which was in line with the prior scholars 8,9 who argued that children of different ages with recurrent respiratory tract infections are directly affected by the deficiencies of vitamins A, D and E, with those aged 0 to 1 most likely to suffer from deficiencies of there vitamins. The main risk factors for children with recurrent respiratory tract infections are lack of vitamins A, D and E, hypocalcemia, special physique, hospitalization history, living in a bungalow, and daily activity time of less than half an hour.…”

Frequency of Vitamin a Deficiency in Children Hospitalized for Pneumonia: An Integrative Review

“…Table 3 shows that the classification of vitamin A deficiency differed in some studies, Julien et al [ 30 ], Moreira et al [ 25 ] and Wang et al [ 35 ], categorized subclinical and clinical vitamin A deficiency serum retinol levels below <0.7 μmol/L and 0.35 μmol/L, respectively. Kjolhede et al [ 24 ], Nacul et al [ 31 , 32 ], Zuo et al [ 34 ], Kuti et al [ 36 ], and Li et al [ 37 ], classified vitamin A deficiency values below <0.7 μmol/L without categorizing it into subclinical or clinical deficiency, as well as Silva et al [ 33 ], who used another cutoff point to classify the inadequate serum retinol level (<1.05 μmol/L).…”

How Micronutrients Fuel Immune System At the Molecular Level: An Approach to the Immune Response Against Respiratory Viruses

“…Indeed, micronutrient imbalance is associated with the risk of complicated respiratory tract infections, as has been reported for vitamins A, D, E, and C and the trace elements zinc and magnesium [12][13][14][15][16][17][18][19][20]; therefore, their supplementation improves the effector function of the immune system, as has been excellently reviewed elsewhere [21,22]. Here we will focus on how those micronutrients mentioned above, in which deficiency or supplementation impacts immune function, participate at the molecular level in each step of the immune response against respiratory viruses.…”