Vitamin D deficiency in children with acute bronchiolitis: a prospective cross-sectional case- control study

Inbal Golan-Tripto, Neta Loewenthal, Asher Tal, Yotam Dizitzer, Yael Baumfeld, Aviv Goldbart, Inbal Golan-Tripto, Neta Loewenthal, Asher Tal, Yotam Dizitzer, Yael Baumfeld, Aviv Goldbart

Abstract

Background: 25(OH) vitamin D levels are inversely associated with respiratory infections and childhood wheezing.

Objective: To evaluate serum 25(OH) vitamin D levels in infants and toddlers with acute bronchiolitis, compared to subjects with non-respiratory febrile illness.

Methods: A prospective cross-sectional case-control study which compared serum 25(OH) vitamin D levels between infants and toddlers diagnosed with acute bronchiolitis to subjects with non-respiratory febrile illness. Multivariate logistic regression, adjusted for age, sex, ethnicity and nutrition was performed. Correlation between serum vitamin D levels and bronchiolitis severity was assessed via Modified Tal Score and length of hospital stay (LOS).

Results: One hundred twenty-seven patients aged < 24 months were recruited; 80 diagnosed with acute bronchiolitis and 47 patients with non- respiratory febrile illnesses. Both groups had similar demographics aside from age (median [IQR] 5 [3-9] vs. 9 [5-16] months in the bronchiolitis group compared to control group (p = 0.002)). Serum 25(OH) vitamin D levels were significantly lower in the bronchiolitis group; median [IQR] 28[18-52] vs. 50[25-79] nmol/L, respectively, (p = 0.005). Deficient vitamin D levels (< 50 nmol/L) was found more frequently in the bronchiolitis group than controls; 73% vs. 51% (p = 0.028). Multivariate logistic regression showed vitamin D deficiency was more probable in bronchiolitis patients; OR [95% CI] 3.139[1.369-7.195]. No correlation was found between serum vitamin D levels and bronchiolitis severity, which was assessed via Modified Tal Score and by length of hospital stay.

Conclusion: Children with acute bronchiolitis displayed significantly lower vitamin D levels than children with non-respiratory acute febrile illnesses.

Keywords: Bronchiolitis; Children; Vitamin D deficiency; Vitamin D status.

Conflict of interest statement

the authors have no conflicts of interest to declare that are relevant to the content of this article.

Figures

Fig. 1
Fig. 1
Forest plot for multivariate logistic regression assessing Odds Ratio for Vitamin D deficiency among the bronchiolitis and control group adjusted for age, sex, ethnicity and means of nutrition. Results are presented as odds ratio (OR) with 95% confidence interval (CI)
Fig. 2
Fig. 2
Different 25(OH) vitamin D levels within grouped modified Tal score in the bronchiolitis group (n = 79)
Fig. 3
Fig. 3
a Different 25(OH) vitamin D levels, grouped by length of stay in bronchiolitis group (n = 79). b Different 25(OH) vitamin D levels, grouped by length of stay in non-bronchiolitis group (n = 47)

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