Korwutthikulrangsri Manassawee, Mahachoklertwattana Pat, Lertbunrian Rojjanee, Chailurkit La-Or, Poomthavorn Preamrudee
J Med Assoc Thai. 2015 Apr;98(4):365-72.
Data on interrelationship between vitamin D deficiency (VDD) and adrenal insufficiency in critically ill children are limited.
To determine vitamin D status in critically ill children and its relationship with adrenal function.
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.
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.
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.
关于危重症儿童维生素D缺乏（VDD）与肾上腺功能不全之间相互关系的数据有限。
确定危重症儿童的维生素D状态及其与肾上腺功能的关系。
纳入32例患者和36例对照。测量血清25-羟维生素D（25-OHD）水平。收集儿科死亡风险（PRISM）III评分、结局以及通过1微克促肾上腺皮质激素试验评估的肾上腺功能。
患者的血清25-OHD中位数（四分位间距）低于对照组（16.6（13.3 - 19.5）对24.2（21.0 - 27.9）ng/mnL，p < 0.001）。25例（78%）患者和7例（19%）对照存在VDD。有VDD和无VDD的患者在PRISM III评分、休克患者比例和使用血管活性药物情况、重症监护病房住院时间和使用呼吸机情况以及肾上腺功能方面无差异。血清25-OHD低于12 ng/mL的患者PRISM III评分中位数（四分位间距）更高（14（6 - 20）对5（2 - 10），p = 0.033），且死亡率高于血清25-OHD为12 ng/mL或更高的患者。
与对照组相比，危重症儿童中VDD的比例更高。血清25-OHD与肾上腺功能无关。
