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Relationship between vitamin D levels and outcome of pneumonia in children
A O Oduwole1, J K Renner, E Disu
1Department of Paediatrics, Lagos University Teaching Hospital, Idi-Araba, Lagos. bioodu@yahoo.com
Insights
Vitamin D insufficiency is linked to severe outcomes in Nigerian children with pneumonia, including complications like empyema thoracis and death. This highlights the importance of vitamin D status for pediatric respiratory health.
Area of Science:
- Pediatric Infectious Diseases
- Nutritional Immunology
- Clinical Biochemistry
Background:
- Pneumonia is a significant cause of childhood illness and mortality in Nigeria.
- Vitamin D plays a crucial role in modulating the immune system, particularly T lymphocyte function.
- Vitamin D deficiency has been implicated in various childhood infections and their complications.
Purpose of the Study:
- To investigate the association between vitamin D levels and the clinical outcomes of pneumonia in Nigerian children.
- To determine if vitamin D insufficiency or deficiency impacts the severity and complications of childhood pneumonia.
Main Methods:
- A case-control study was conducted with 24 children diagnosed with pneumonia (cases) and 10 healthy children (controls).
- Data collected included background information, anthropometric measurements for nutritional status, and serum 25-hydroxycholecalciferol (25OHD) levels.
- Statistical analysis compared vitamin D concentrations and the incidence of complications between groups.
Main Results:
- Children with pneumonia had lower mean serum 25OHD levels compared to controls.
- A significant proportion of pneumonia cases (54%) exhibited serum 25OHD below 70 nmol/L.
- Hypocalcaemia and anaemia were more prevalent in children with lower vitamin D levels (below 70 nmol/L).
- Severe outcomes, including empyema thoracis and death, occurred in children with very low 25OHD levels (27.5-40 nmol/L).
Conclusions:
- Vitamin D insufficiency, not just deficiency, appears to play a critical role in the immune and hematopoietic systems of children.
- Suboptimal vitamin D levels may impair a child's response to infections like pneumonia.
- Maintaining adequate vitamin D status is crucial for mitigating the severity and complications of pneumonia in children.
Background:
Pneumonia, a common childhood infection in Nigerian children with a number of debilitating complications such as empyema thoracis, has been linked to vitamin D deficiency due to its ability to modulate the T lymphocyte of the immune system .
Objective:
To determine the relationship between vitamin D and outcome of pneumonia in children.
Methods:
This was a case-control study involving 24 children, admitted for pneumonia as subjects and 10 children without pneumonia as controls. Pre-formatted questionnaire was utilized to obtain background information, anthropometric measurements were made to determine nutritional status and estimation of 25- hydroxy cholecalciferol (25OHD) done for all those studied.
Results:
The mean (SD) serum 25OHD concentration was 104 (59) nmol/L and 130 (107) nmol/L for subjects and controls respectively. Amongst the subjects 15 (54%) had serum 25OHD less than 70 nmol/L and 11 (46%) serum 25OHD greater than 70 nmol/L. Hypocalcaemia was present in 15 (54%) of the subjects. Further analysis of hypocalcaemia with regards to the concentration of serum 25OHD showed that 2 (13%) had levels below 40 nmol/L, 10 (67%) had levels below 70 nmol/L and 3 (20%) above 70 nmol/L. Hypocalcaemia was more frequent among subjects with 25OHD below 70nmol/L compared with those above 70nmol/L, (p =0.01). Empyema thoracis and death occurred amongst the two subjects with 25OHD between 27.5 and 40 nmol/L. Anaemia was more frequent among subjects with 25OHD below 70 nmol/L compared with those above 70 nmol/L (p = 0.03).
Conclusion:
The study showed that Vitamin D insufficiency, and not solely its deficiency, may have an important role to play in the immune and haemopoetic system. It may therefore affect the response of a child to infections especially pneumonia.
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