Liyanage Guwani, Kaneshapillai Anusha, Kanthasamy Suthesan
Department of Paediatrics, Faculty of Medical Sciences, University of Sri Jayewardenepura, Nugegoda, Sri Lanka.
Department of Biochemistry, Faculty of Medical Sciences, University of Sri Jayewardenepura, Nugegoda, Sri Lanka.
Interdiscip Perspect Infect Dis. 2021 Nov 28;2021:2157337. doi: 10.1155/2021/2157337. eCollection 2021.
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.
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.
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 (=0.694). In unconditional logistic regression, 25(OH)D concentration was not a determinant of CAP (OR: 0.99, CI: 0.937-1.044, =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, =0.973). Household income was significantly associated with CAP (OR: 0.11, 95% CI: 0.021-0.567, =0.008).
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.
最近的研究表明，关于儿童维生素D缺乏与社区获得性肺炎（CAP）之间的联系，证据相互矛盾。因此，我们推测维生素D缺乏可能是CAP的一个危险因素。
将年龄在2至60个月之间、经医生诊断并经放射学证实为重症社区获得性肺炎（CAP）的住院儿童纳入病例组。从免疫接种和称重诊所选取年龄匹配的对照组。采集血样以评估血清25-(OH)D浓度。采用非条件逻辑回归分析来检验维生素D水平与社区获得性肺炎的独立关联。
共纳入74名儿童（女性占68%）。总体而言，27%的儿童维生素D缺乏（<20 ng/mL），37.8%的儿童维生素D不足（20 - 29 ng/mL）。维生素D水平范围为8.67至46.2 ng/mL。对照组和病例组的25(OH)D水平无统计学显著差异（P = 0.694）。在非条件逻辑回归中，25(OH)D浓度不是CAP的决定因素（OR：0.99，CI：0.937 - 1.044，P = 0.689）。在对年龄、性别、收入、拥挤程度和被动吸烟暴露进行调整后，这种缺乏关联的情况仍然存在（OR：0.99，CI：0.937 - 1.065，P = 0.973）。家庭收入与CAP显著相关（OR：0.11，95%CI：0.021 - 0.567，P = 0.008）。
三分之二的CAP患儿存在维生素D缺乏/不足。与健康对照组相比，维生素D水平不是社区获得性肺炎的显著决定因素。这表明需要采用更严格的科学方法进行进一步的多中心研究，以获取关于维生素D与CAP关系的确凿证据。
