Department of Respiratory Medicine, Shanghai Children's Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.
Department of Nephrology, Shanghai Children's Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.
Front Public Health. 2023 Jan 26;11:1099683. doi: 10.3389/fpubh.2023.1099683. eCollection 2023.
BACKGROUND: The relationship between vitamin D nutritional status and the formation of bronchial mucus plugs (BMPs) is unclear. The aims of the current study were to investigate associations between serum 25(OH)D levels, serum inflammatory factors, and clinical characteristics in children with mycoplasma pneumonia (MPP), and to summarize the risk factors for BMPs in children with MPP. METHODS: Clinical data from 175 children with MPP were collected and analyzed, the children were divided into a BMP group and a non-BMP group. Serum 25(OH)D levels, IL-8, and various inflammatory factors were compared in the two groups. Associations between 25(OH)D levels and IL-8, various inflammatory factors, and clinical characteristics were analyzed, and the diagnostic value of serum 25(OH)D levels was assessed. RESULTS: Serum 25(OH)D level was significantly lower in the BMP group ( < 0.05). Serum IL-8 level, percentages of neutrophils, and some inflammatory factors were significantly higher in the BMP group ( < 0.05). Serum 25(OH)D level was negatively correlated with IL-8, neutrophil percentage, various inflammatory factors (all < 0.05). It was also associated with lobular infection, pleural effusion, mechanical ventilation, and mycoplasma 2,063/2,064 mutation (all < 0.05). In multivariate regression analysis 25(OH)D [odds ratio (OR) 0.98, 95% confidence interval (CI) 0.97-0.99, = 0.003], IL-8 (OR 1.02, 95% CI 1.00-1.04, = 0.002), polylobular infection (OR 1.75, 95% CI 1.17-2.64, = 0.007), and MP DNA copies (OR 0.98, 95% CI 1.04-1.01, = 0.022) were independent risk factors for BMPs, and the area under the curve value was 0.915 (95% CI 0.895-0.935). If the serum 25(OH)D level was <50 nmol/L, the respective percentages for sensitivity, specificity, positive predictive value, and negative predictive value were 97, 81, 78.9, and 97.6%. CONCLUSIONS: Vitamin D deficiency is common in children with MPP, and 25(OH)D levels are closely associated with inflammatory factors and disease severity in children. The serum 25 (OH) D level of MPP children with BMPs was lower than that of children without BMPs. Serum 25(OH)D can be used as a marker for the diagnosis of MPP in children with BMPs.
背景：维生素 D 营养状况与支气管黏液栓（BMP）形成之间的关系尚不清楚。本研究旨在探讨肺炎支原体（MPP）患儿血清 25（OH）D 水平、血清炎症因子与临床特征之间的关系，并总结 MPP 患儿发生 BMP 的危险因素。
方法：收集并分析了 175 例 MPP 患儿的临床资料，将患儿分为 BMP 组和非 BMP 组。比较两组患儿血清 25（OH）D 水平、IL-8 及各项炎症因子。分析 25（OH）D 水平与 IL-8、各项炎症因子及临床特征的相关性，并评估血清 25（OH）D 水平的诊断价值。
结果：BMP 组患儿血清 25（OH）D 水平明显低于非 BMP 组（P<0.05）。BMP 组患儿血清 IL-8 水平、中性粒细胞百分比及多项炎症因子水平明显高于非 BMP 组（P<0.05）。血清 25（OH）D 水平与 IL-8、中性粒细胞百分比、各项炎症因子均呈负相关（均 P<0.05）。25（OH）D 水平还与小叶性感染、胸腔积液、机械通气、支原体 2063/2064 突变有关（均 P<0.05）。多因素回归分析显示，25（OH）D[比值比（OR）0.98，95%置信区间（CI）0.97-0.99，P=0.003]、IL-8（OR 1.02，95%CI 1.00-1.04，P=0.002）、多小叶感染（OR 1.75，95%CI 1.17-2.64，P=0.007）、MP DNA 拷贝数（OR 0.98，95%CI 1.04-1.01，P=0.022）是 BMP 的独立危险因素，曲线下面积为 0.915（95%CI 0.895-0.935）。当血清 25（OH）D 水平<50 nmol/L 时，其敏感度、特异度、阳性预测值、阴性预测值分别为 97%、81%、78.9%、97.6%。
结论：维生素 D 缺乏在 MPP 患儿中较为常见，25（OH）D 水平与患儿炎症因子和疾病严重程度密切相关。BMP 患儿血清 25（OH）D 水平低于非 BMP 患儿。血清 25（OH）D 可作为 BMP 患儿 MPP 的诊断标志物。
BMC Infect Dis. 2020-7-22
Int J Mol Sci. 2022-10-9
Biomolecules. 2021-11-3
Nutrients. 2021-10-14
Zotero 插件
