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Published on: August 7, 2017
Association between serum 25-hydroxyvitamin D concentrations and respiratory infections in US preschool children: a
Yingli Lin1, Li Tian2, Qi Chen3
1Department of Early Childhood Education, Shaoxing Vocational & Technical College, Shaoxing, Zhejiang, China.
Insights
Vitamin D deficiency increases respiratory infection risk in preschool children. Targeted screening and supplementation can help reduce illness in vulnerable groups.
Area of Science:
- Pediatric Health
- Nutritional Immunology
- Public Health
Background:
- Vitamin D deficiency is linked to pediatric respiratory issues, but evidence in preschoolers is inconsistent.
- Understanding the role of vitamin D in young children's respiratory health is crucial for public health initiatives.
Purpose of the Study:
- To investigate the association between serum 25-hydroxyvitamin D [25(OH)D] levels and respiratory infections in US preschool children.
- To identify specific subgroups of preschool children at higher risk for respiratory infections due to vitamin D deficiency.
Main Methods:
- Cross-sectional analysis of 3316 children aged 2-6 years from the NHANES 2007-2016 cohort.
- Categorization of vitamin D status (deficiency, insufficiency, sufficiency) and assessment of respiratory outcomes (colds, severe infections).
- Multivariable logistic regression adjusted for confounders, with rigorous assessment of dose-response and subgroup heterogeneity.
Main Results:
- Vitamin D deficiency (8.1% prevalence) was associated with a 56% increased odds of respiratory infections (aOR: 1.56).
- Higher risks were observed for head/chest colds (aOR: 1.47) and in specific subgroups: 4-6 year olds, females, low-income households, and underweight children.
- Secondhand smoke exposure amplified deficiency-related risks, while adequate vitamin D intake showed a trend towards risk attenuation.
Conclusions:
- Vitamin D deficiency is an independent risk factor for increased respiratory infections in preschool children.
- Targeted screening and vitamin D supplementation strategies are supported to reduce early childhood morbidity, especially in vulnerable populations.
Abstract:
Vitamin D deficiency has been implicated in pediatric respiratory health, yet evidence regarding its role in preschool children remains inconsistent. This study investigated the association between serum 25-hydroxyvitamin D [25(OH)D] concentrations and respiratory infections in a nationally representative cohort of US preschool children. Cross-sectional analysis included 3316 children aged 2-6 years from NHANES (2007-2016). Vitamin D status was categorized as deficiency (< 50 nmol/L), insufficiency (50-74.9 nmol/L), and sufficiency (≥ 75 nmol/L). Respiratory outcomes included caregiver-reported head/chest colds and severe infections (influenza/pneumonia/ear infections) within 30 days. Multivariable logistic regression adjusted for sociodemographic, lifestyle, dietary, and clinical confounders. Dose-response relationships and subgroup heterogeneity were rigorously assessed. Vitamin D deficiency prevalence was 8.1%, with 52% of the cohort exhibiting suboptimal status (< 75 nmol/L). Deficient children had 56% higher odds of respiratory infections versus sufficient counterparts (adjusted OR: 1.56; 95% CI: 1.17-2.09). Stronger associations emerged for head/chest colds (OR: 1.47; 95% CI: 1.09-1.97) than severe infections (OR: 1.24; 95% CI: 0.70-2.18). Subgroup analyses revealed elevated risks in children aged 4-6 years (OR: 1.93; 95% CI: 1.35-2.76), female children (OR: 1.81; 95% CI: 1.17-2.80), low-income households (OR: 1.59; 95% CI: 1.10-2.30), and underweight individuals (OR: 1.61; 95% CI: 1.13-2.31). Exposure to secondhand smoke further amplified deficiency-related infection risks (OR: 1.54; 95% CI: 1.12-2.10). Adequate vitamin D intake (≥ 6.7 mcg/day) attenuated deficiency-related risks (OR: 1.37; 95% CI: 0.68-2.76). Conclusions: Vitamin D deficiency is independently associated with increased respiratory infection risk in preschool children, particularly in vulnerable subgroups. These findings support targeted screening and supplementation strategies to mitigate early childhood morbidity.
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