Low Serum Levels of Vitamins A, D, and E Are Associated with Recurrent Respiratory Tract Infections in Children Living in Northern China: A Case Control Study

Zhang, Xuguang; Ding, Fengshu; Li, Huaining; Zhao, Wenfeng; Hong, Jing Lan; Yan, Yageng; Chen, Yanping

doi:10.1371/journal.pone.0167689

Cited by 29 publications

(32 citation statements)

References 36 publications

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“…11 Past studies have noted a relationship between vitamin D deficiency and recurrent respiratory infections. 27,28 However, there are few publications on the relationship between recurrent UTIs and decreased vitamin D level. 29 We did not find such a relationship in our study.…”

Section: Discussionmentioning

confidence: 99%

Do low vitamin D levels facilitate renal parenchymal injury?

Bekdaş

Çalışkan²,

Karabörk³

et al. 2020

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Background Decreased vitamin D levels lead to an increase in infectious diseases, including urinary tract infections (UTIs). Objective To assess serum vitamin D levels in children with renal parenchymal injury secondary to UTIs. Methods Forty-three upper UTI patients and 24 controls, aged 1–15 years, were included. Vitamin D levels and other laboratory tests were obtained when they first admitted to hospital. 99mTc-labeled dimercaptosuccinic acid (DMSA) scans were performed to evaluate renal parenchymal injury. Results Mean serum 25-hydroxyvitamin D (25(OH)D) was lower in the upper UTI group compared to the control group [18 (SD 9) vs. 23 (SD 10.6) ng/mL, respectively; P=0.045]. The upper UTI group was sub-divided into two groups, those with 22 (51.1%) and without 21 (48.8%) renal parenchymal injury. Mean 25(OH)D was significantly lower in patients with renal parenchymal injury [15.1 (SD 7.1) vs. 21 (SD 9.9) ng/mL, respectively; P=0.03]. The renal parenchymal injury cases were further sub-divided into two groups: 8 patients (36.3%) with acute renal parenchymal injury and 14 (63.6%) with renal scarring (RS), but there was no significant difference in 25(OH)D between these two groups [12.5 (SD 8.9) vs. 16.6 (SD 5.7) ng/mL, respectively; P=0.14). Conclusion Decreased vitamin D is associated with renal parenchymal injury in children with upper UTIs. However, vitamin D is not significantly decreased in renal scarring patients compared to acute renal parenchymal injury patients.

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Section: Discussionmentioning

confidence: 99%

Do low vitamin D levels facilitate renal parenchymal injury?

Bekdaş

Çalışkan²,

Karabörk³

et al. 2020

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“…However, they may also reflect a diet deficient in other micronutrients affecting both growth and immunity. Evidence from other studies suggest that deficiency of vitamins A, D, and E can occur concurrently and are associated with risk of respiratory tract infections (Zhang et al, ). Children with clinical signs of rickets were more stunted and wasted; however, clinical rickets was associated with risk of mortality and serious infections requiring hospitalization even after adjusting for these anthropometrics measurements.…”

Section: Discussionmentioning

confidence: 99%

The impact of rickets on growth and morbidity during recovery among children with complicated severe acute malnutrition in Kenya: A cohort study

Ngari

Thitiri

Mwalekwa

et al. 2017

Maternal & Child Nutrition

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The effects of rickets on children recovery from severe acute malnutrition (SAM) are unknown. Rickets may affect both growth and susceptibility to infectious diseases. We investigated the associations of clinically diagnosed rickets with life‐threatening events and anthropometric recovery during 1 year following inpatient treatment for complicated SAM. This was a secondary analysis of clinical trial data among non‐human immunodeficiency virus‐infected Kenyan children with complicated SAM (2–59 months) followed for 1 year posthospital discharge (ClinicalTrials.gov ID NCT00934492). The outcomes were mortality, hospital readmissions, and growth during 12 months. The main exposure was clinically diagnosed rickets at baseline. Of 1,778 children recruited, 230 (12.9%, 95% CI [11.4, 14 .6]) had clinical signs of rickets at baseline. Enrolment at an urban site, height‐for‐age and head circumference‐for‐age z scores were associated with rickets. Rickets at study enrolment was associated with increased mortality (adjusted Hazard Ratio [aHR] 1.61, 95% CI [1.14, 2.27]), any readmission (aHR 1.37, 95% CI [1.09, 1.72]), readmission for severe pneumonia (aHR 1.37, 95% CI [1.05, 1.79]), but not readmission with diarrhoea (aHR 1.05, 95% CI [0.73, 1.51]). Rickets was associated with increased height gain (centimetres), adjusted regression coefficient 0.19 (95% CI [0.10, 0.28]), but not changes in head circumference, mid‐upper arm circumference, or weight. Rickets was common among children with SAM at urban sites and associated with increased risks of severe pneumonia and death. Increased height gain may have resulted from vitamin D and calcium treatment. Future work should explore possibility of other concurrent micronutrient deficiencies and optimal treatment of rickets in this high‐risk population.

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“…Vitamin D de ciency is a disorder mainly induced disorders of calcium and phosphorus metabolism, which causes defective chondrocyte differentiation, mineralization in growth plate and defects in osteoid mineralization among children [1] . Vitamin D de ciency is also related to functions of muscles and immune organs, and hematopoiesis, which are associated with multiple extra-skeletal disorders, such as myopathy, anemia, and recurrent respiratory tract infections in children [2][3][4] .…”

Section: Introductionmentioning

confidence: 99%

Effect of Vitamin D Intervention and outdoor activity on serum 25-Hydroxyvitamin D among children in North China: an observational study

Zhang

Chen

Jin

et al. 2020

Preprint

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Background: Living at high latitudes is one of the risk factors for vitamin D deficiency in children. However, evidence on vitamin D improvement for this pediatric population to date is limited. This study aims at evaluating the effect of different vitamin D intervention methods and outdoor activity on the vitamin D status of children in North China. Methods: A total of 55,925 children aged 1 month to 18 years old were recruited from pediatric outpatient departments from July 2016 to June 2017. Data on demographics, anthropometric measurements, vitamin D intervention, and outdoor activity were recorded. The serum levels of 25-hydroxycholecalciferol (25(OH)D) were determined by high performance liquid chromatography tandem–mass spectrometry. Logistic regression analysis was performed to assess the association of vitamin D intervention or outdoor activity with blood vitamin D status, adjusted for age, gender, BMI for age, and seasons.Results: The overall rate of hypovitaminosis D was 65.60%. Of the children’s outdoor activity, 35.63%, 31.95%, and 32.42% were below 30min/d, 30-60 min/d and over 60min/d, respectively. Furthermore, the proportion of therapeutic intervention, supplementation intervention and no vitamin D intervention among the children was 16.48%, 32.87%, and 50.65%, respectively. After adjusted for confounding factors, vitamin D intervention was associated with a lower risk of hypovitaminosis D, with OR (95% CI) of 0.191 (0.180, 0.202) in children with therapeutic doses and 0.423 (0.404, 0.443) in those with supplementation doses, compared with children without vitamin D intervention. In addition, longer outdoor time was associated with a lower risk of hypovitaminosis D [0.479 (0.456, 0.504) for 60 min/d, 0.737 (0.701, 0.776) for 30–60 min/d], independent of vitamin D intervention. Conclusions: High prevalence of vitamin D deficiency was found in children living at high latitudes. Vitamin D intervention and outdoor activity are all negatively associated with children’s vitamin D deficiency. Routine vitamin D intervention combined with increased outdoor time might be an effective approach to prevent hypovitaminosis D among children, especially those at school, living at high latitudes.

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Low Serum Levels of Vitamins A, D, and E Are Associated with Recurrent Respiratory Tract Infections in Children Living in Northern China: A Case Control Study

Cited by 29 publications

References 36 publications

Do low vitamin D levels facilitate renal parenchymal injury?

Do low vitamin D levels facilitate renal parenchymal injury?

The impact of rickets on growth and morbidity during recovery among children with complicated severe acute malnutrition in Kenya: A cohort study

Effect of Vitamin D Intervention and outdoor activity on serum 25-Hydroxyvitamin D among children in North China: an observational study

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