High Serum 25-Hydroxyvitamin D Levels Are Associated with Pediatric Sepsis

Aydemir, Gökhan; Çekmez, Ferhat; Kalkan, Gökhan; Fidanci, Muzaffer Kursat; Kaya, Güven; Karaoğlu, Abdülbaki; Meral, Cihan; Arziman, Ibrahim; Karademır, Ferhan; Ayar, Ganime; Gündüz, Ramiz Coşkun; Süleymanoğlu, Selami

doi:10.1620/tjem.234.295

Cited by 20 publications

(12 citation statements)

References 22 publications

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“…In contrary to our results, Gokhanet et al [29] reported that high serum 25-OH vitamin D levels are associated with pediatric sepsis, and this difference may be due to the age group and the different sample size. In addition, Ratzinger et al [30] reported that 1,25-OH D but not 25-OH D can predict bacteraemia and both of them failed to predict sepsis and mortality in a prospective cohort study, but this difference between our results and Ratzinger’s may be attributed to the age group of patients, as all of Ratzinger’s patients were above 41 years old, the different types of infections recruited in his study (respiratory, gastrointestinal (GIT), urological and central nervous system (CNS) infections), and, lastly, the methodology and the time for assay of vitamin D levels.…”

Section: Discussioncontrasting

confidence: 99%

Neonatal and Maternal 25-OH Vitamin D Serum Levels in Neonates with Early-Onset Sepsis

et al. 2017

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Vitamin D is a fat-soluble vitamin that is important for calcium metabolism and plays an important role in the immune functions. The aim of this study was to measure neonatal and maternal 25-OH vitamin D serum levels in neonates with early onset sepsis. The study included fifty neonates with early onset sepsis (25 full-term and 25 preterm infants) and thirty age and sex matched healthy neonates as controls. After history taking and clinical examination, complete blood count, C-reactive protein and 25-OH vitamin D serum levels (neonatal and maternal) were measured for all neonates. The mean gestational age for neonates with sepsis was (37.5 ± 0.98 for full term and 34.1 ± 1.26 for preterm neonates). Neonatal and maternal 25-OH vitamin D serum levels were significantly lower in patients (6.4 ± 1.8 and 24.6 ± 2.2 nmol/L) than controls (42.5 ± 20.7 and 50.4 ± 21.4 nmol/L). Significant negative correlations between neonatal and maternal 25-OH vitamin D serum levels and all sepsis markers and significant positive correlations between neonatal and maternal 25-OH vitamin D levels were present. At cut-off values <20 nmol/L for neonatal and <42 nmol/L for maternal 25-OH vitamin D for detection of neonatal sepsis, the sensitivity, specificity, positive predicted value (PPV) and negative predicted value (NPV) were 84%, 79%, 94.7% and 82.3% for neonatal and 82%, 77%, 91.4% and 80.6% for maternal 25-OH vitamin D, respectively. Positive correlations between neonatal and maternal 25-OH Vitamin D serum levels are present and they are negatively correlated with all sepsis markers. They can be sensitive early predictors for early onset sepsis in neonates.

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Section: Discussioncontrasting

confidence: 99%

Neonatal and Maternal 25-OH Vitamin D Serum Levels in Neonates with Early-Onset Sepsis

et al. 2017

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“…In an USA study a similar association was observed between skin or soft tissue infections by Staphylococcus aureus strains and vitamin D levels [25(OH)D < 30 ng/ml] in 202 children [ 276 ]. Other authors reported similar findings in children with acute diarrhea [ 277 ], otitis [ 277 ], rotavirus infection [ 278 ], malaria [ 279 ], leishmaniosis [ 280 ], hepatitis C [ 281 ], or sepsis [ 282 ]. However, it is unclear whether the observed vitamin D deficiency/insufficiency is to be considered a consequence of the infection itself or if it plays a role in determining susceptibility to infections or the severity of the disease.…”

Section: Extraskeletal Actions Of Vitamin Dmentioning

confidence: 60%

Vitamin D in pediatric age: consensus of the Italian Pediatric Society and the Italian Society of Preventive and Social Pediatrics, jointly with the Italian Federation of Pediatricians

Vierucci²,

et al. 2018

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Vitamin D plays a pivotal role in the regulation of calcium-phosphorus metabolism, particularly during pediatric age when nutritional rickets and impaired bone mass acquisition may occur.Besides its historical skeletal functions, in the last years it has been demonstrated that vitamin D directly or indirectly regulates up to 1250 genes, playing so-called extraskeletal actions. Indeed, recent data suggest a possible role of vitamin D in the pathogenesis of several pathological conditions, including infectious, allergic and autoimmune diseases. Thus, vitamin D deficiency may affect not only musculoskeletal health but also a potentially wide range of acute and chronic conditions. At present, the prevalence of vitamin D deficiency is high in Italian children and adolescents, and national recommendations on vitamin D supplementation during pediatric age are lacking. An expert panel of the Italian Society of Preventive and Social Pediatrics reviewed available literature focusing on randomized controlled trials of vitamin D supplementation to provide a practical approach to vitamin D supplementation for infants, children and adolescents.

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“…Peningkatan kadar 25-hydroxyvitamin D pada sepsis untuk memicu produksi peptida antimikroba yang berperan pada sistem pertahanan tubuh. 5 Terjadi perbedaan antara penelitian kami (kadar 25-hydroxyvitamin D ≤24 ng/mL dikatakan sepsis) dengan di Turki (kadar 25-hydroxyvitamin D >20 ng/mL dikatakan sepsis). Perbedaan tersebut disebabkan kriteria sepsis yang dipakai pada penelitian di Turki menggunakan kriteria sepsis neonatus, sedangkan subjek penelitian kami bukan neonatus.…”

Section: Pembahasanunclassified

“…Diagnosis dini sangat penting untuk sepsis pada anak karena sepsis bisa lebih fatal pada anak dibandingkan pada orang dewasa. 1,5 Vitamin D berperan penting dalam banyak fungsi fisiologis yang berbeda. Banyak penelitian telah difokuskan pada peran baru vitamin D dalam metabolisme glukosa, fungsi endotel, dan modulasi sistem imun.…”

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Kadar 25-hydroxyvitamin D sebagai penanda sepsis pada anak

Tjowanta¹,

Yoel²,

Lubis³

2018

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Latar belakang. Sepsis merupakan penyebab tersering morbiditas dan mortalitas pada anak. Vitamin D memiliki peran penting dalam mengoptimalkan sistem imun bawaan serta memodulasi respon imun adaptif pada sepsis. Tujuan. Untuk mengevaluasi nilai diagnostik dari kadar 25-hydroxyvitamin D sebagai penanda sepsis pada anak. Metode. Penelitian diagnostik dengan desain potong lintang dilakukan terhadap 50 anak di PICU RSUP Haji Adam Malik dari Februari sampai Maret 2016. Duapuluh lima anak didiagnosis sepsis dan 25 non sepsis. Kriteria inklusi adalah pasien anak berusia 1 bulan sampai <18 tahun. Sensitivitas, spesifisitas, nilai duga positif, nilai duga negatif, rasio kemungkinan positif dan negatif dinilai pada penelitian ini. Hasil. Rerata kadar 25-hydroxyvitamin D pada kelompok sepsis (24 ng/mL) relatif lebih rendah dibandingkan dengan kelompok non sepsis (29,7 ng/mL). Nilai batas ambang kadar 25-hydroxyvitamin D 24 ng/mL. Kami menemukan 15 orang dengan sepsis dan 2 orang non sepsis dengan nilai batas ambang ini. Dari uji diagnostik diperoleh sensitivitas 60%, spesifisitas 92%, nilai duga positif 88%, nilai duga negatif 70%, rasio kemungkinan positif 7,5 dan rasio kemungkinan negatif 0,43. 25-Hydroxyvitamin D Level as a Marker of Sepsis in ChildrenAustin Simon Tjowanta, Chairul Yoel, Munar Lubis Background. Sepsis is the major cause of morbidity and mortality among children. Vitamin D plays an important roles in optimazing the innate immune system and the adaptive immune response in sepsis. Objective. To evaluate diagnostic values of 25-hydroxyvitamin D level as a marker for sepsis in children. Methods. A diagnostic study with cross-sectional design was conducted in 50 children, 25 with sepsis and 25 without sepsis in the PICU, Haji Adam Malik Hospital from February to March 2016. Children aged 1 month to <18 years were included. Sensitivity, specificity, positive predictive value, negative predictive value, positive likelihood ratio, and negative likelihood ratio were evaluated in this study. Results. The mean level of 25-hydroxyvitamin D in the sepsis group (24 ng/mL) was lower than in the non-sepsis group (29.7 ng/ mL). The 25-hydroxyvitamin D level had a cut-off point of 24 ng/mL. Using this cut-off point, we identified 15 patients with sepsis and 2 patients without sepsis. The diagnostic study showed 60% sensitivity, 92% specificity, 88% positive predictive value, 70% negative predictive value, 7.5 positive likelihood ratio, and 0.43 negative likelihood ratio. Conclusion. The 25-hydroxyvitamin D level has high specificity but low sensitivity, for it can be used as additional sepsis marker in children. Sari Pediatri 2017;19(3):150-5

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High Serum 25-Hydroxyvitamin D Levels Are Associated with Pediatric Sepsis

Cited by 20 publications

References 22 publications

Neonatal and Maternal 25-OH Vitamin D Serum Levels in Neonates with Early-Onset Sepsis

Neonatal and Maternal 25-OH Vitamin D Serum Levels in Neonates with Early-Onset Sepsis

Vitamin D in pediatric age: consensus of the Italian Pediatric Society and the Italian Society of Preventive and Social Pediatrics, jointly with the Italian Federation of Pediatricians

Kadar 25-hydroxyvitamin D sebagai penanda sepsis pada anak

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