Department of Microbiology, Innlandet Hospital Trust, Lillehammer, Norway.
Department of Child Health, Institute of Medicine, Tribhuvan University, Kathmandu, Nepal.
Pediatr Res. 2017 Dec;82(6):986-993. doi: 10.1038/pr.2017.71. Epub 2017 Aug 16.
BackgroundThere is no consensus on optimal Vitamin D status. The objective of this study was to estimate the extent to which vitamin D status predicts illness duration and treatment failure in children with severe pneumonia by using different cutoffs for vitamin D concentration.MethodsWe measured the plasma concentration of 25(OH)D in 568 children hospitalized with World Health Organization-defined severe pneumonia. The associations between vitamin D status, using the most frequently used cutoffs for vitamin D insufficiency (25(OH)D<50 and <75 nmol/l), and risk for treatment failure and time until recovery were analyzed in multiple logistic regression and Cox proportional hazards models, respectively.ResultsOf the 568 children, 322 (56.7%) had plasma 25(OH)D levels ≥75 nmol/l, 179 (31.5%) had levels of 50-74.9 nmol/l, and 67 (%) had levels <50 nmol/l. Plasma 25(OH)D <50 nmol/l was associated with increased risk for treatment failure and longer time until recovery.ConclusionOur findings indicate that low vitamin D status (25(OH)D<50 nmol/l) is an independent risk factor for treatment failure and delayed recovery from severe lower respiratory infections in children.
目前对于维生素 D 的最佳状态仍没有共识。本研究的目的是使用不同的维生素 D 浓度切点,评估维生素 D 状态对严重肺炎患儿疾病持续时间和治疗失败的预测程度。
我们测量了 568 名患有世界卫生组织定义的严重肺炎住院儿童的血浆 25(OH)D 浓度。使用最常使用的维生素 D 不足切点(25(OH)D<50 和 <75 nmol/l)来评估维生素 D 状态与治疗失败风险和恢复时间之间的关系,分别采用多元逻辑回归和 Cox 比例风险模型进行分析。
在 568 名儿童中,322 名(56.7%)的血浆 25(OH)D 水平≥75 nmol/l,179 名(31.5%)的水平为 50-74.9 nmol/l,67 名(11.8%)的水平<50 nmol/l。血浆 25(OH)D<50 nmol/l与治疗失败风险增加和严重下呼吸道感染恢复时间延长相关。
我们的研究结果表明,低维生素 D 状态(25(OH)D<50 nmol/l)是儿童严重下呼吸道感染治疗失败和恢复延迟的独立危险因素。