Children with lower respiratory tract infections and serum 25-hydroxyvitamin D3 levels: A case-control study

BackgroundPneumonia is the leading cause of death in children under age of 5 years worldwide. The role of vitamin D in respiratory infections including pneumonia is unclear; therefore, we aimed to determine if children with lower respiratory tract infections had low serum 25-hydroxyvitamin D-3. MethodsWe performed a case-control study of children ages 3-60 months from the Guatemala City metropolitan area, hospitalized with community-acquired pneumonia between September and December 2012. Controls were selected from the well-baby/care immunization clinics serving the population from which cases emerged. We analyzed serum 25-hydroxyvitamin D-3 levels and conducted parental interviews to assess subject age, sex, race, feeding type, vitamin D supplementation, frequency of sun exposure, and maternal education. Height and weight were ascertained from medical records. Complete information was available for 70 (83%) of 84 eligible cases and 68 (60%) of 113 eligible controls. ResultsThe median (IQR) serum 25-hydroxyvitamin D-3 concentration for cases was 23.2ng/ml (14.4-29.9) compared to 27.5ng/ml (21.4-32.3) in controls (P=0.006). Multiple regression analysis using an a priori cut-point for vitamin D of <20ng/ml showed that children with lower respiratory tract infections were more likely to have low 25-hydroxyvitamin D-3 levels than controls (adjusted odds ratio 2.4, 95% confidence interval 1.1-5.2, P=0.02). ConclusionsChildren with lower respiratory tract infections in Guatemala had low 25-hydroxyvitamin D-3 levels. Pediatr Pulmonol. 2016;51:1080-1087. (c) 2016 Wiley Periodicals, Inc.