The Role of the Micronutrients; Vitamin A, Vitamin B12, Iron, Zinc, Copper Levels of Children with Lower Respiratory Tract Infections

Abstract

Objective: Lower respiratory tract infection is common in children younger than 5 years and is the leading infection cause of childhood mortality and hospitalization. Deficiencies in vitamin A, zinc (ZN), copper (Cu), iron (Fe), and micronutrients, such as vitamin B12, are thought to be causes of respiratory tract infections as a trigger. We aimed to detect levels of the micronutrients vitamin A, Zn, Cu, Fe, and vitamin B12 in children with lower respiratory tract infections. Material and Methods: A total of 98 patients between 1 month and 5 years of age with a diagnosis of lower respiratory tract infection were enrolled between February 2011-2012 at Ankara Eğitim ve Araştırma Hospital, Clinic of Child Health and Diseases. The control group included 47 healthy children with the same age who did not have any pathologic findings and history of chronic diseases. In these patients, the clinical and radiological findings of acute phase reactants, vitamin A, vitamin B12, Zn, Cu, and Fe levels were studied, and the groups were compared. Results: Of the patients in the study, 63 (64.3%) were men and 35 (35.7%) were females; mean age was 21.4 (±17.6) (1-60) months. The most common findings on physical examination were tachypnea in 85 (86.7%), cracles 73 (74.5%), and rhonchi 59 (60.2%), respectively. White blood cell (WBC) (p=0.001), sedimentation (Sed) (p<0.001), and CRP (p=0.010) levels were significantly higher in the patient group. Vitamin A levels in all patients (p=0.001) and Fe levels (p=0.001) were found to be significantly lower than the control group. Zn level was lower in the patient group than in the control group but was not statistically significant. C and vitamin B12 levels in terms of the difference between groups was detected. Conclusion: In patients with lower respiratory tract infection, vitamin A, Zn, and Fe levels were lower. In patients diagnosed with lower respiratory tract infections vitamin A and Zn supplementation is recommended. Fe is recommended to prevent lower respiratory tract infections. (J Pediatr Inf 2014; 8: 105-9)

Evidence to Underpin Vitamin A Requirements and Upper Limits in Children Aged 0 to 48 Months: A Scoping Review

“…Alongside these we noted 12 recent cohort or case–control studies, 15 earlier studies, nine recent cross-sectional studies, 25 older studies, and nine non-systematic reviews. For studies assessing the relationship between vitamin A status and health, growth or development outcomes we identified no systematic reviews, two recent RCTs (with additional data extraction), 39 older RCTs, 17 recent observational studies of which eight appeared particularly relevant [ 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 ], 42 earlier cohort or case–control studies, 19 recent cross-sectional studies, 56 earlier cross-sectional studies and eight potentially relevant non-systematic reviews.…”

“…As expected from the nature of the question, most of the studies available to address the relationship between vitamin A status and health outcomes were observational, assessing relationships between markers of vitamin A status and autism spectrum disorders [ 39 ], acute or recurrent respiratory infection [ 40 , 43 , 44 , 46 ], asthma [ 42 ], malaria [ 41 ], infectious diseases generally [ 45 ] and mortality [ 41 ] (Excel sheet 2C Status Outcome) .…”