Association of subclinical vitamin D deficiency with severe acute lower respiratory infection in Indian children under 5 y

Wayse, V; Yousafzai, Aisha K.; Mogale, K; Filteau, Suzanne

doi:10.1038/sj.ejcn.1601845

Cited by 386 publications

(341 citation statements)

References 20 publications

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“…In Finland soldiers with low vitamin D status (,40 nmol/l) at entry into military service have a higher risk for subsequent respiratory infections (31) . Similar results are reported also in Turkey (32) and India (33) , where levels below 50 nmol/l significantly increased the risk of respiratory infections in children and neonates. A recent American study reports 55 % higher odds of developing respiratory infections if 25(OH)D concentration is below 25 nmol/l compared with above 75 nmol/l (34) .…”

Section: Discussionsupporting

confidence: 88%

Vitamin D status in healthy Romanian caregivers and risk of respiratory infections

Porojnicu¹,

Moroti-Constantinescu²,

Laslau³

et al. 2012

Public Health Nutr.

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Conclusions: Vitamin D status is alarmingly poor in active, relatively young women residing in Romania. If our results are reproduced by other investigations, action to improve vitamin D status at the population level is necessary. We were not able to show a statistically significant relationship between vitamin D status and infection risk in our material. Keywords Vitamin D Romania Infections riskThe important role of vitamin D in Ca metabolism and bone health is well accepted (1) . The discovery that most human tissues are able to produce and use active vitamin D triggered extensive research of vitamin D's biological functions beyond bone health. Experimental and epidemiological work has shown that vitamin D reduces risk and improves prognosis of cancer (2) . Moreover, vitamin D plays important roles in the regulation of innate and adaptive immunity and seems to decrease the risk and modulate the course of various infections (3)(4)(5)(6) . Vitamin D itself has low biological activity, but undergoes activation by successive hydroxylations: in the liver with the formation of 25-hydroxyvitamin D (25(OH)D) and in the kidney with the production of 1,25-dihydroxyvitamin D (1,25(OH) 2 D) (7) . It is becoming increasingly clear that 1,25(OH) 2 D also can be produced outside the kidney. This local production may have very important implications for the effects of vitamin D on health.The body is able to synthesize vitamin D upon sufficient UV exposure. In fact, skin synthesis is the main source of vitamin D in most populations, proving a high efficiency of this reaction when the oral intake (from regular poor diet) is low (8) . It is believed that a whole-body exposure at one MED (minimal erythema dose) generates 250-500 mg (10 000-20 000 IU) of vitamin D, which is equivalent to the vitamin D content of 250 ml of cod-liver oil (9)(10)(11) .Since man is to a high degree dependent on the skin production of vitamin D, factors altering either the fluence rate of UV radiation (like altitude, latitude, cloud cover, clothing habits, use of sun screens) or skin properties (like skin colour, age) are the main predictors of vitamin D status.Romania is located at a latitude of 458N which ensures a sufficient UV fluence rate to efficiently produce vitamin D from March to October (12) . At the same time, Romanians have no practice of vitamin D food fortification or tradition of cod-liver oil consumption. This means that their

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Section: Discussionsupporting

confidence: 88%

Vitamin D status in healthy Romanian caregivers and risk of respiratory infections

Porojnicu¹,

Moroti-Constantinescu²,

Laslau³

et al. 2012

Public Health Nutr.

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“…The ocular signs of VAD include night blindness, conjunctival xerosis, Bitot spots, corneal ulceration, keratomalacia and total blindness. Several studies have revealed that there is a positive association between VAD and increased respiratory infections (2,3) , diarrhoea, measles and childhood mortality (4)(5)(6)(7)(8)(9) . VAD compromises the immune system in 40 % of children in the developing world and contributes to one million deaths of young children each year (10,11) .…”

mentioning

confidence: 99%

Prevalence of ocular signs and subclinical vitamin A deficiency and its determinants among rural pre-school children in India

Laxmaiah

Nair

Arlappa

et al. 2011

Public Health Nutr.

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Objective: To assess the magnitude and determinants of vitamin A deficiency (VAD) and coverage of vitamin A supplementation (VAS) among pre-school children. Design: A community-based cross-sectional study was carried out by adopting a multistage, stratified, random sampling procedure. Setting: Rural areas of eight states in India. Subjects: Pre-school children and their mothers were covered. Results: A total of 71 591 pre-school children were clinically examined for ocular signs of VAD. Serum retinol concentrations in dried blood spots were assessed in a sub-sample of 3954 children using HPLC. The prevalence of Bitot spots was 0?8 %. The total ocular signs were significantly higher (P , 0?001) among boys (2?6 %) compared with girls (1?9 %) and in older children (3-4 years) compared (P , 0?001) with younger (1-2 years), and were also high in children of labourers, scheduled castes and illiterate mothers. The odds of having Bitot spots was highest in children of scheduled caste (OR 5 3?8; 95 % CI 2?9, 5?0), labourers (OR 5 2?9; 95 % CI 2?1, 3?9), illiterate mothers (OR 5 2?7; 95 % CI 2?2, 2?3) and households without a sanitary latrine (OR 5 5?9; 95 % CI 4?0, 8?7). Subclinical VAD (serum retinol level ,20 mg/dl) was observed in 62 % of children. This was also relatively high among scheduled caste and scheduled tribe children. The rate of coverage of VAS was 58 %. Conclusions: The study revealed that VAD is a major nutritional problem and coverage of VAS was poor. The important determinants of VAD were illiteracy, low socio-economic status, occupation and poor sanitation. Strengthening the existing VAS programme and focused attention on dietary diversification are essential for prevention of VAD.

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“…In recent years there have been several reports on the associations between subclinical vitamin D deficiency and risk for respiratory infections and development of more severe disease (2)(3)(4). Different immunomodulatory effects may explain these associations (5).…”

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confidence: 99%

Vitamin D status is associated with treatment failure and duration of illness in Nepalese children with severe pneumonia

et al. 2017

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BACKGROUND: There 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. METHODS:We 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)Do50 and o75 nmol/l), and risk for treatment failure and time until recovery were analyzed in multiple logistic regression and Cox proportional hazards models, respectively. RESULTS: Of 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 o50 nmol/l. Plasma 25(OH)D o50 nmol/l was associated with increased risk for treatment failure and longer time until recovery. CONCLUSION: Our findings indicate that low vitamin D status (25(OH)Do50 nmol/l) is an independent risk factor for treatment failure and delayed recovery from severe lower respiratory infections in children.

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Association of subclinical vitamin D deficiency with severe acute lower respiratory infection in Indian children under 5 y

Cited by 386 publications

References 20 publications

Vitamin D status in healthy Romanian caregivers and risk of respiratory infections

Vitamin D status in healthy Romanian caregivers and risk of respiratory infections

Prevalence of ocular signs and subclinical vitamin A deficiency and its determinants among rural pre-school children in India

Vitamin D status is associated with treatment failure and duration of illness in Nepalese children with severe pneumonia

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