Lymphocyte subpopulations in children with vitamin D deficient rickets

Yener, Erdal; Çöker, Canan; Cura, Alphan; Keskınoğlu, Ahmet; Mır, Sevgı

doi:10.1111/j.1442-200x.1995.tb03362.x

Cited by 17 publications

(13 citation statements)

References 11 publications

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“…12 1,25(OH)2D 3 plays an important role in immune modulation. 11 It was noted that most of the children 38(70.4%) were exclusively breast fed up to six months and none of them received vitamin D supplements, these results are comparable with other studies. 13,14 .…”

Section: Discussionsupporting

confidence: 80%

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Nutritional rickets among children of Northern Kerala, India

Jose¹,

A²

2017

Int J Contemp Pediatr

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Background: Vitamin D deficiency is a very common micronutrient deficiency in our country and ranks among the 5 most common disease in children worldwide.Methods: To study the presentation and predisposing factors of rickets among children in Northern Kerala.Results: This study was conducted in the department of Pediatrics in a tertiary care hospital in Northern Kerala. Nutritional rickets diagnosis was based on clinical, radiological and biochemical parameters and appearance of provisional zone of calcification after vitamin D therapy. Data was analyzed and presented as percentage and mean. Student t-test was used for statistical analysis of the results.Conclusions: A total of 54 children having a variety of clinical presentations of rickets were seen during the study period. There were 46.3% males and 53.7% females. The mean age of diagnosis was 24 months.70.4% children were exclusively breast fed up to 6 months. None of the breast-fed infants had received vitamin D supplementation according to current guidelines. 66.7% children were not exposed to sunlight. Rickets was commonly found in children with no protein energy malnutrition. Genu varum and wrist widening were the most frequent clinical features observed in 92.6% patients. The radiological and biochemical characteristics of cases were ascertained before and after therapy. The biochemical changes were analyzed by student (t) test. There was a significant decrease in the ALP activity after vitamin D therapy (P= 0.000). Out of these 54 children with rickets 47(87.03%) responded to treatment with vitamin D3 and 7 (12.96%) were resistant to treatment with vitamin D3.

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Section: Discussionsupporting

confidence: 80%

“…Yener et al have reported more episodes of bacterial infections in children with vitamin D deficiency as compared to healthy children. 11 In fact T and B lymphocytes have receptors for 1,25(OH)2D. Vitamin D deficiency may predispose to different bacterial infections including pneumonia.…”

Section: Discussionmentioning

confidence: 99%

Nutritional rickets among children of Northern Kerala, India

Jose¹,

A²

2017

Int J Contemp Pediatr

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“…(57–58) Severe vitamin D deficiency is reported to be related to susceptibility to upper respiratory tract infections(59), tuberculosis(60) and infection in general. (61–62) A meta-analysis of 18 trials involving 57,311 subjects, demonstrated a 7% reduction of all-cause mortality in those supplemented with vitamin D.(5) These observations and others suggest that vitamin D deficiency is likely to play a key role in infection, and cardiac and metabolic dysfunctions in critically ill patients.…”

Section: Discussionmentioning

confidence: 96%

Low serum 25-hydroxyvitamin D at critical care initiation is associated with increased mortality*

Braun

Gibbons

Litonjua

et al. 2012

Critical Care Medicine

188

180

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Objective We hypothesized that deficiency in 25-hydroxy vitamin D at critical care initiation would be associated with all cause mortality. Design Two-center observational study. Setting Two teaching hospitals in Boston, Massachusetts Patients 1,325 patients, age ≥ 18 years, in whom 25-hydroxy vitamin D was measured 7 days prior to or after critical care initiation between 1998 and 2009. Measurements 25-hydroxy vitamin D was categorized as deficiency in 25-hydroxy vitamin D (≤15 ng/mL), insufficiency (16–29 ng/mL) and sufficiency (≥30 ng/mL). Logistic regression examined death by days 30, 90 and 365 post-critical care initiation and in hospital mortality. Adjusted odds ratios were estimated by multivariable logistic regression models. Interventions None Key Results 25-hydroxy vitamin D deficiency is predictive for short term and long term mortality. 30 days following critical care initiation, patients with 25-hydroxy vitamin D deficiency have an OR for mortality of 1.85 (95% CI, 1.15–2.98;P=0.01) relative to patients with 25-hydroxy vitamin D sufficiency. 25-hydroxy vitamin D deficiency remains a significant predictor of mortality at 30 days following critical care initiation following multivariable adjustment for age, gender, race, Deyo-Charlson index, sepsis, season, and surgical versus medical patient type (adjusted OR 1.94; 95% CI, 1.18–3.20;P=0.01). Results were similarly significant at 90 and 365 days following critical care initiation and for in hospital mortality. The association between vitamin D and mortality was not modified by sepsis, race, or Neighborhood poverty rate, a proxy for socioeconomic status. Conclusion Deficiency of 25-hydroxy vitamin D at the time of critical care initiation is a significant predictor of all cause patient mortality in a critically ill patient population.

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“…(33) In another study, patients with severe vitamin D deficiency were abnormally susceptible to infections such as tuberculosis(34) and infection in general. (35–36) Similarly, in a Meta-analysis of 18 trials involving 57,311 randomly assigned subjects, Autier found that vitamin D supplementation reduced all-cause mortality by 7% (CI, 1% to 13%). (5) These observations and others suggest that hypovitaminosis D is likely to play a key role in infection, and cardiac and metabolic dysfunctions in critically ill patients.…”

Section: Discussionmentioning

confidence: 99%

Association of low serum 25-hydroxyvitamin D levels and mortality in the critically ill*

Braun

Chang

Mahadevappa

et al. 2011

Critical Care Medicine

261

225

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Objective We hypothesized that deficiency in 25-hydroxy vitamin D (25(OH)D) prior to hospital admission would be associated with all cause mortality in the critically ill. Design Multicenter observational study of patients treated in medical and surgical intensive care units. Setting 209 medical and surgical intensive care beds in two teaching hospitals in Boston, Massachusetts Patients 2,399 patients, age ≥ 18 years, in whom 25(OH)D was measured prior to hospitalization between 1998 and 2009. Measurements Pre-admission 25(OH)D was categorized as deficiency in 25(OH)D (≤15ng/mL), insufficiency (16–29ng/mL) and sufficiency (≥30ng/mL). Logistic regression examined death by days 30, 90 and 365 post-ICU admission, in hospital mortality and blood culture positivity. Adjusted odds ratios were estimated by multivariable logistic regression models. Interventions None Key Results Pre-admission 25(OH)D deficiency is predictive for short term and long term mortality. 30 days following ICU admission, patients with 25(OH)D deficiency have an OR for mortality of 1.69(95%CI, 1.28–2.23;P<.0001) relative to patients with 25(OH)D sufficiency. 25(OH)D deficiency remains a significant predictor of mortality at 30 days following ICU admission following multivariable adjustment (adjusted OR 1.69; 95%CI, 1.26–2.26;P<.0001). 30 days following ICU admission, patients with 25(OH)D insufficiency have an OR of 1.32(95%CI, 1.02–1.72; P=0.036) and an adjusted OR of 1.36(95%CI, 1.03–1.79;P=0.029) relative to patients with 25(OH)D sufficiency. Results were similar at 90 and 365 days following ICU admission and for in hospital mortality. In a subgroup analysis of patients who had blood cultures drawn (n=1,160), 25(OH)D deficiency was associated with increased risk of blood culture positivity. Patients with 25(OH)D insufficiency have an OR for blood culture positivity of 1.64(95%CI, 1.05–2.55;P=0.03) relative to patients with 25(OH)D sufficiency which remains significant following multivariable adjustment: OR 1.58(95%CI, 1.01–2.49;P=0.048). Conclusion Deficiency of 25(OH)D prior to hospital admission is a significant predictor of short and long term all cause patient mortality and blood culture positivity in a critically ill patient population.

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Lymphocyte subpopulations in children with vitamin D deficient rickets

Cited by 17 publications

References 11 publications

Nutritional rickets among children of Northern Kerala, India

Nutritional rickets among children of Northern Kerala, India

Low serum 25-hydroxyvitamin D at critical care initiation is associated with increased mortality*

Association of low serum 25-hydroxyvitamin D levels and mortality in the critically ill*

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