Serum Vitamin D, Calcium and Phosphate among children with pneumonia
DOI:
https://doi.org/10.30442/ahr.0501-10-40Keywords:
Calcium, Children, Phosphate, Pneumonia, Vitamin DAbstract
Background: Vitamin D is partly responsible for maintaining calcium and phosphate homeostasis but has been shown to have immune modulatory functions.
Objective: To measure serum levels of vitamin D, and plasma levels of calcium and phosphate in children with pneumonia and compare with those of apparently healthy controls.
Methods: A cross-sectional study involving seventy-six children with pneumonia, matched with 76 apparently healthy controls.
Results: There was no statistically significant difference in the mean serum vitamin D levels between the cases and the controls (t = 1.190, p = 0.236). The mean serum vitamin D level was significantly higher in children with non-severe pneumonia than in those with severe pneumonia (t = 3.299, p = .002). The mean serum vitamin D level was higher among the controls than those with severe pneumonia (t = 2.674, p = 0.009). The mean plasma calcium and phosphate levels in the controls were significantly higher than in the cases (t = 2.528, p = .013 and t = 4.594, p < .001 respectively). Plasma calcium and phosphate levels did not vary with the severity of pneumonia. Pneumonia was independently associated with the occurrence of hypocalcaemia and hypophosphataemia (OR = 4.366, 95% CI = 1.851-10.295, p = 0.001; OR = 7.355, 95% CI = 1.545-35.027, p = 0.01 respectively).
Conclusion: Children with severe pneumonia had lower levels of vitamin D than those with the non-severe disease. Derangements in plasma levels of calcium and phosphate are common in children with pneumonia, and these abnormalities occur independently of low vitamin D levels.
References
Johnson AW, Abdulkarim AA. Childhood pneumonia in developing countries. Afr J Resp Med 2013; 8: 4-9.
Liu L, Oza S, Hogan D, Perin J, Rudan I, Lawn JE, et al. Global, regional, and national causes of child mortality in 2000-13, with projections to inform post-2015 priorities: an updated systematic analysis. Lancet 2014; 385: 430-440.
McNally J, Leis K, Matheson L, Karuananyake C, Sankaran K, Rosenberg A. Vitamin D deficiency in young children with severe acute lower respiratory infection. Pediatr Pulmonol 2009; 44: 981-988.
Wayse V, Yousafzai A, Mogale K, Filteau S. Association of subclinical vitamin D deficiency with severe acute lower respiratory infections in Indian children under-5 y. Eur J Clin Nutr 2004; 58: 563-567.
Ren J, Sun B, Miao P, Feng X. Correlation between serum vitamin D level and severity of community-acquired pneumonia in young children. Zhongguo Dang Dai Er Ke Za Zhi 2013; 15: 519-521.
Oduwole AO, Renner JK, Disu E, Ibitoye E, Emokpae E. Relationship between vitamin D levels and outcome of pneumonia in children. West Afr J Med 2010; 29: 373-378.
Ahmed P, Babaniyi IB, Yusuf KK, Dodd C, Langdon G, Steinhoff M, et al. Vitamin D status and hospitalisation for childhood acute lower respiratory tract infections in Nigeria. Paediatr Int Child Health 2015; 35: 151-156.
Adams JS, Hewison M. Unexpected actions of vitamin D: new perspectives on the regulation of innate and adaptive immunity. Nat Clin Pract Endocrinol Metab 2008; 4: 80-90.
Durr H, Sudheendra US, Ramamoorthy A. LL-37, the only human member of the cathelicidin family of antimicrobial peptides. Biochim Biophys Acta 2006; 1758: 1408-1425.
Ulasi TO, Ebenebe J. Nutritional disorders in childhood. In: Azubuike JC, Nkanginieme KE (Editors). Paediatrics and Child Health in a Tropical Region. 2nd ed. Owerri: African Educational Services; 2007. p. 250-67.
Haider N, Nagi AM, Khan KM. Frequency of nutritional rickets in children admitted with severe pneumonia. J Pak Med Assoc 2010; 60: 729-732.
World Health Organization. Revised WHO classification and treatment of childhood pneumonia at health facilities. Evidence summaries. In: https://apps.who.int/iris/handle/10665/137319. (Accessed on April 8, 2019)
Vitamin D ELISA kit. In: www.gentaur.com (Accessed on January 15, 2015).
Payne RB, Little AJ, Williams RB, Milner JR. Interpretation of serum calcium in patients with abnormal serum proteins. Br Med J 1973; 4: 643-646.
Albanna EAM, Ali YF, Reayid AM. Vitamin D and LL-37 in children with pneumonia. Egypt J Paediatr Allergy Immunol 2010; 8: 81-86.
Pfitzner MA, Thacher TD, Pettifor JM, Zoakah AI, Lawson JO, Isichei CO, et al. Absence of vitamin D deficiency in young Nigerian children. J Pediatr 1998; 133: 740-744.
Inamo Y, Hasegawa M, Saito K, Hayashi R, Ishikawa T, Yoshino Y, et al. Serum vitamin D concentrations and associated severity of acute lower respiratory tract infections in Japanese hospitalized children. Pediatr Int 2011; 53: 199-201.
Akpede GO, Ekanem EE, Thacher TD. Nutritional and non-nutritional rickets in the tropics and subtropics. In: Azubuike JC, Nkanginieme KE (Editors). Paediatrics and Child Health in a Tropical Region. 2nd ed. Owerri: African Educational Services; 2007. p. 684-96.
Thacher TD, Aliu O, Griffin IJ, Pam SD, O'Brien KO, Imade GE, et al. Meals and dephytinization affect calcium and zinc absorption in Nigerian children with rickets. J Nutr 2009; 139: 926-932.
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