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Serum Vitamin D Level and Risk of Community-Acquired Pneumonia: A Case-Control Study
Guwani Liyanage1, Anusha Kaneshapillai2, Suthesan Kanthasamy3
1Department of Paediatrics, Faculty of Medical Sciences, University of Sri Jayewardenepura, Nugegoda, Sri Lanka.
Insights
Vitamin D deficiency is common in children with community-acquired pneumonia (CAP), but this study found no direct link between low vitamin D levels and CAP risk in children. Further research is needed to confirm these findings.
Area of Science:
- Pediatrics
- Nutritional Science
- Infectious Diseases
Background:
- Conflicting evidence exists regarding the association between vitamin D deficiency and community-acquired pneumonia (CAP) in children.
- Vitamin D deficiency is prevalent, affecting over half the children studied.
Purpose of the Study:
- To investigate whether vitamin D deficiency is an independent risk factor for severe community-acquired pneumonia (CAP) in hospitalized children.
- To analyze the association between serum 25-(OH)D levels and CAP in pediatric patients.
Main Methods:
- A case-control study involving hospitalized children aged 2-60 months with severe CAP (cases) and age-matched healthy children (controls).
- Serum 25-(OH)D concentrations were measured.
- Unconditional logistic regression analysis was performed to assess the association between vitamin D levels and CAP, adjusting for potential confounders.
Main Results:
- No statistically significant difference in serum 25-(OH)D levels was observed between children with CAP and healthy controls (p=0.694).
- Vitamin D concentration was not found to be a determinant of CAP (OR: 0.99, p=0.689), even after adjusting for covariates.
- Household income was significantly associated with CAP (OR: 0.11, p=0.008).
Conclusions:
- While a high prevalence of vitamin D deficiency/insufficiency was noted among children with CAP, vitamin D levels did not significantly predict CAP in this cohort.
- The study suggests that vitamin D deficiency is not a significant determinant of CAP in children.
- Further multisite research with more rigorous methodologies is recommended to establish a conclusive relationship between vitamin D and CAP.
Introduction:
Recent research has shown conflicting evidence on the connection between vitamin D deficiency and community-acquired pneumonia (CAP) in children. Thus, we hypothesized that vitamin D deficiency could be a risk factor for CAP.
Methods:
Hospitalized children between 2 and 60 months with physician-diagnosed, radiologically confirmed severe community-acquired pneumonia (CAP) were enrolled as cases. Age-matched controls were enrolled from immunization and weighing clinics. A blood sample was collected to assess serum 25-(OH)D concentration. Unconditional logistic regression was done to examine the independent association of vitamin D level with community-acquired pneumonia.
Results:
Seventy-four children (females: 68%) were included. Overall, 27% had vitamin D deficiency (<20 ng/mL) and 37.8% had insufficiency (20-29 ng/mL). The vitamin D level ranged from 8.67 to 46.2 ng/mL. There was no statistically significant difference in 25(OH)D levels in controls and cases (p=0.694). In unconditional logistic regression, 25(OH)D concentration was not a determinant of CAP (OR: 0.99, CI: 0.937-1.044, p=0.689). This lack of association remained after adjustment for age, gender, income, crowding, and exposure to passive smoke (OR: 0.99, CI: 0.937-1.065, p=0.973). Household income was significantly associated with CAP (OR: 0.11, 95% CI: 0.021-0.567, p=0.008).
Conclusion:
Two-thirds of the children with CAP had vitamin D deficiency/insufficiency. In comparison with healthy controls, vitamin D level was not a significant determinant of community-acquired pneumonia. It informs that further multisite research is required using more rigorous scientific methods for conclusive evidence on the relationship between vitamin D and CAP.
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