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Vitamin D deficiency and adrenal function in critically ill children
Insights
Critically ill children often have vitamin D deficiency (VDD). While VDD was more common in these patients, it did not correlate with adrenal function, though severe deficiency indicated worse outcomes.
Area of Science:
- Pediatric critical care medicine
- Endocrinology
- Nutritional science
Background:
- Limited data exist on the relationship between vitamin D deficiency (VDD) and adrenal insufficiency in critically ill children.
- Vitamin D plays a crucial role in various physiological processes, and its deficiency is a growing concern in pediatric populations.
Purpose of the Study:
- To investigate vitamin D status in critically ill children.
- To determine the association between vitamin D status and adrenal function in this patient group.
Main Methods:
- Serum 25-hydroxyvitamin D (25-OHD) levels were measured in 32 critically ill children and 36 controls.
- Adrenal function was assessed using a 1-microgram adrenocorticotropic hormone test.
- Pediatric Risk of Mortality (PRISM) III scores and clinical outcomes were collected.
Main Results:
- Critically ill children exhibited significantly lower serum 25-OHD levels compared to controls, with 78% having VDD.
- No significant difference in adrenal function was observed between patients with and without VDD.
- Patients with serum 25-OHD levels below 12 ng/mL had higher PRISM III scores and increased mortality rates.
Conclusions:
- Critically ill children have a higher prevalence of vitamin D deficiency compared to healthy controls.
- Vitamin D status was not found to be associated with adrenal function in critically ill children.
- Severe vitamin D deficiency (<12 ng/mL) is linked to poorer prognosis and higher mortality in critically ill children.
Background:
Data on interrelationship between vitamin D deficiency (VDD) and adrenal insufficiency in critically ill children are limited.
Objective:
To determine vitamin D status in critically ill children and its relationship with adrenal function.
Material And Method:
Thirty-two patients and 36 controls were included. Serum 25-hydroxyvitamin D (25-OHD) levels were measured. Pediatric Risk of Mortality (PRISM) III score, outcome and adrenal function assessed by 1-microgram adrenocorticotropic hormone test were collected.
Results:
Median (IQR) serum 25-OHD of thepatients was less than that of the controls (16.6 (13.3-19.5) vs. 24.2 (21.0-27.9) ng/mnL, p < 0.001). Twenty-five (78%) patients and seven (19%) controls had VDD. PRISM III score, proportions of patients with shock and vasopressive drug used, length of intensive care unit stay and ventilator used, and adrenal function were not different between patients with and without VDD. Patients with serum 25-OHD of less than 12 ng/mL had higher median (IQR) PRISM III score (14 (6-20) vs. 5 (2-10), p = 0.033) and higher proportion of mortality than those with serum 25-OHD of 12 ng/mL or greater.
Conclusion:
A greater proportion of VDD in critically ill children as compared with that of the controls was demonstrated. Serum 25-OHD was not associated with adrenal function.
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