Department of Pediatrics, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India.
Eur J Pediatr. 2024 Jun;183(6):2717-2723. doi: 10.1007/s00431-024-05513-7. Epub 2024 Mar 26.
Vitamin D's role in immune system regulation and its contribution to host defenses against respiratory infections may have implications for bronchiolitis pathophysiology. This cross-sectional study aimed to determine the association between the clinical severity of bronchiolitis and serum vitamin D levels in infants. Infants aged 1 month to 12 months, diagnosed with bronchiolitis, and healthy controls attending routine immunization were enrolled. Baseline characteristics were recorded, including clinical details, bronchiolitis severity, and course during hospital stay. Bronchiolitis severity score (BSS) was used to score the severity. A 1-2 ml serum sample was obtained for vitamin D levels estimation. The median age of cases (n = 64; 65.6% male) was 5 [3, 8] months, and that of the control group (n = 30) was 3 [2, 9] months. No statistically significant differences were observed between the two groups in age, gender, weight, mode of delivery, family history of atopy/asthma, feeding pattern, smoke exposure, and daily vitamin D supplementation. The median vitamin D levels were not significantly different between the groups (p = 0.68). Among infants with bronchiolitis, 62.5% had vitamin D insufficiency (≤ 20 ng/ml). A significantly higher median BSS indicates that infants with vitamin D insufficiency exhibited more severe disease (p = 0.019). Although a negative correlation between BSS and vitamin D levels was noted, it did not reach statistical significance [r = (-)0.17; p = 0.16].
Infants with Vitamin D insufficiency experienced more severe bronchiolitis with elevated BSS scores. It highlights the potential role of vitamin D deficiency in severe bronchiolitis.
• Vitamin D level is low in infants with bronchiolitis.
• Infant with low vitamin D level experienced more severe bronchiolitis.
本研究旨在确定毛细支气管炎患儿临床严重程度与血清维生素 D 水平之间的相关性。
本研究为横断面研究，纳入了 1 月龄至 12 月龄被诊断为毛细支气管炎且住院的患儿，以及接受常规免疫接种的健康对照者。记录了基线特征，包括临床细节、毛细支气管炎严重程度和住院期间的病程。使用毛细支气管炎严重程度评分（BSS）对严重程度进行评分。采集 1-2ml 血清样本用于维生素 D 水平的估计。
病例组（n=64；65.6%为男性）的中位年龄为 5[3,8]个月，对照组（n=30）的中位年龄为 3[2,9]个月。两组间在年龄、性别、体重、分娩方式、特应性/哮喘家族史、喂养方式、烟雾暴露和每日维生素 D 补充方面无统计学差异。两组间的维生素 D 水平中位数无显著差异（p=0.68）。在患有毛细支气管炎的患儿中，62.5%存在维生素 D 不足（≤20ng/ml）。BSS 中位数较高表明维生素 D 不足的患儿疾病更严重（p=0.019）。虽然 BSS 与维生素 D 水平之间存在负相关，但未达到统计学意义[r=（-）0.17;p=0.16]。
维生素 D 不足的患儿发生毛细支气管炎时病情更严重，BSS 评分升高。这提示维生素 D 缺乏在严重毛细支气管炎中可能发挥作用。
毛细支气管炎患儿的维生素 D 水平较低。
维生素 D 水平低的婴儿发生毛细支气管炎时病情更严重。
