The Association Between Vitamin D and Urinary Tract Infection in Children: A Case-Control Study

Abstract

Background and objectiveUrinary tract infection (UTI) is one of the common causes of febrile illness in young children. Vitamin D influences the levels of endogenous cathelicidin, an antimicrobial peptide, which improves bladder wall immunity and prevents UTIs. In light of this, we conducted this study to determine the association between vitamin D deficiency and UTIs in children and to identify whether vitamin D deficiency is one of the risk factors for UTIs. Materials and methodsThis was a case-control study of children aged between one to five years. Eighty-two children with the first episode of febrile culture-proven UTI as cases and 82 healthy children as a control group were included in this study. The sera were analyzed for 25-hydroxy vitamin D levels and classified as vitamin-D deficient if their level was below 30 ng/mL. Descriptive statistics were presented as numbers and percentages. Continuous data were expressed as means and standard deviations (SD). Pearson's chi-square test was used to test the significance of the differences in variables between the two groups. Multiple logistic regression equation methods were used to predict the relationship between the dependent and independent variables. ResultsThe mean age of the study and the control group was 2.36 ±1.42 years and 2.57 ±1.26 years, respectively. The mean serum 25-hydroxy vitamin D levels in the patients and controls were 24.27 ±9.70 ng/mL and 31.97 ±10.7 ng/mL (p<0.001), respectively. Vitamin D deficiency was present in 34 (41.5%) patients and 10 (2.2%) in the control group (p<0.001). ConclusionBased on our findings, vitamin D deficiency might be one of the risk factors for UTIs in children. Vitamin D deficiency is significantly associated with febrile UTIs in children between one to five years of age.

The Association between Serum Vitamin D Levels and Urinary Tract Infection Risk in Children: A Systematic Review and Meta-Analysis

“…Twelve case–control studies and one cross-sectional study were included, reporting on 839 children with UTI and 929 controls, aged 3 months to 12 years. Five studies were conducted in Iran [ 23 , 27 , 28 , 34 , 35 ], three in Turkey [ 22 , 25 , 39 ], and one each in China [ 33 ], South India [ 24 ], Romania [ 30 ], Egypt [ 29 ], and Sweden [ 26 ]. Serum 25(OH)D or 25(OH)D3, as markers for vitamin D levels, were measured using chemiluminescent immunoassay [ 24 , 25 , 26 , 27 , 30 ], ELISA [ 22 , 23 , 28 , 39 ], radioimmunoassays [ 33 , 35 ], liquid chromatography [ 34 ], and enzyme immunoassays [ 29 ].…”

“…Five studies were conducted in Iran [ 23 , 27 , 28 , 34 , 35 ], three in Turkey [ 22 , 25 , 39 ], and one each in China [ 33 ], South India [ 24 ], Romania [ 30 ], Egypt [ 29 ], and Sweden [ 26 ]. Serum 25(OH)D or 25(OH)D3, as markers for vitamin D levels, were measured using chemiluminescent immunoassay [ 24 , 25 , 26 , 27 , 30 ], ELISA [ 22 , 23 , 28 , 39 ], radioimmunoassays [ 33 , 35 ], liquid chromatography [ 34 ], and enzyme immunoassays [ 29 ]. Serum vitamin D levels were evaluated after the patients were diagnosed with a UTI while hospitalized [ 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 33 , 34 , 35 , 39 ].…”

“…Serum 25(OH)D or 25(OH)D3, as markers for vitamin D levels, were measured using chemiluminescent immunoassay [ 24 , 25 , 26 , 27 , 30 ], ELISA [ 22 , 23 , 28 , 39 ], radioimmunoassays [ 33 , 35 ], liquid chromatography [ 34 ], and enzyme immunoassays [ 29 ]. Serum vitamin D levels were evaluated after the patients were diagnosed with a UTI while hospitalized [ 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 33 , 34 , 35 , 39 ]. Different criteria were used to define deficient, insufficient, and sufficient levels of serum vitamin D. For example, several studies defined vitamin D deficiency as less than 20 ng/mL [ 23 , 24 , 25 , 26 , 27 , 28 , 30 , 33 , 35 , 39 ].…”

“…Serum vitamin D levels were evaluated after the patients were diagnosed with a UTI while hospitalized [ 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 33 , 34 , 35 , 39 ]. Different criteria were used to define deficient, insufficient, and sufficient levels of serum vitamin D. For example, several studies defined vitamin D deficiency as less than 20 ng/mL [ 23 , 24 , 25 , 26 , 27 , 28 , 30 , 33 , 35 , 39 ]. However, two studies defined it as less than 10 ng/mL or 12 ng/mL [ 22 , 29 ], whereas another study did not define it [ 34 ].…”

“…Many clinical studies have reported a relationship between serum vitamin D levels and UTI in children, demonstrating that vitamin D insufficiency or deficiency may be a risk factor for UTI [ 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 ]. Vitamin D supplementation may prevent UTI [ 33 ].…”