ABSTRACT
Objective:
Vitamin D deficiency is known to have important effects on the musculoskeletal system, immune system and many other mechanisms, and vitamin B12 deficiency has different effects on several mechanisms and various diseases, especially neurocognitive functions. Therefore, the levels of these vitamins must be within the desired limits in children in the rapid development stage. Our objective in this study was to investigate vitamin D and vitamin B12 levels in children aged 1 month to 14 years who were hospitalized with a lower respiratory tract infection.
Methods:
A total of 103 patients with lower respiratory tract infection diagnoses between January 2018 and April 2018 at Bahçelievler State Hospital, Department of Pediatrics were included in this study. In the study conducted with 103 children aged between 1 month and 14 years without any chronic or systemic diseases, patients whose cases were examined for values of serum 25 (OH) vitamin D and vitamin B12, were evaluated retrospectively.
Results:
The study was carried out between January 2018 and April 2018 at Bahçelievler State Hospital Children’s Clinic with a total of 103 children, 38.8% (n=40) of whom were female and 61.2% (n=63) were male. The average in vitamin D measurements was 23.9±13.7 ng/mL. While 2.9% of the children had severe vitamin D deficiency, the vitamin D levels in 13.6% of children were deficient, and in 32.0% they were insufficient. The average in vitamin B12 measurements of the children was 301.7±153.8 pg/mL. Vitamin B12 levels of 51.5% of the children were found to be lower than the desired level. Moreover, vitamin B12 levels were not found to be statistically significant in association to the presence of vitamin D deficiency in children.
Conclusion:
Since 25 (OH) vitamin D deficiency, which is also known to have immunomodulatory effects, may be a risk factor in patients hospitalized due to infectious diseases, giving vitamin D replacement to patients who measure low in serum 25 (OH) vitamin D levels should be considered. Vitamin B12 deficiency is still considerably high in developing countries like our country. The fact that vitamin D deficiency and vitamin B12 deficiency are not statistically associated might be due to differences in their primary intake sources (sunlight and nutrition).
Keywords:
25 (OH) vitamin D, vitamin B12, pneumonia, children
References
1Jaaskelainen T, Knekt P, Marniemi J, Sares-Jaske L, Mannistö S, Heliövaara M, et al. Vitamin D status is associated with sociodemographic factors, lifestyle and metabolic health. Eur J Nutr 2013;52:513-25.
2Fayet F, Flood V, Petocz P, Samman S. Avoidance of meat and poultry decreases intakes of omega-3 fatty acids, vitamin B12, selenium and zinc in young women. J Hum Nutr Diet 2014;27 Suppl 2:135-42.
3Champe PC, Harvey RA, Ferrier DR. Biyokimya. Çeviri Editörü: Ulukaya E. Lippincott’s Illustrated Reviews Serisinden. 3. Baskı. Nobel Tıp Kitapevleri; 2007.
4Bringhurst FR, Demay MB, Krane SM, Kronenberg HM. Bone and Mineral Metabolism in Health and Disease. In: Kasper DL, Braunwald E, Fauci AS, Hauser SL, Longo DL, Jameson JL, editors. Harrison’s Principles of Internal Medicine. 16th edition. New York:MCGraw-Hill Companies; 2005. p. 2238-86.
5Holick MF. Vitamin D: a D-lightful health perspective. Nutr Rev 2008;66:182-94.
6Hyppönen E, Boucher BJ, Berry DJ, Power C. 25-hydroxyvitamin D, IGF-1, and metabolic syndrom at 45 years of age: a cross-sectional study in the 1958 British Birth Cohort. Diabetes 2008;57:298-305.
7Burgaz A, Akesson A, Oster A, Michaëlsson K, Wolk A. Associations of diet, supplement use, and ultraviolet B radiation exposure with vitamin D status in Swedish women during winter. Am J Clin Nutr 2007;86:1399-404.
8Holick MF. Vitamin D: Extraskeletal health. Endocrinol Metab Clin North Am 2010;39:381-400.
9Holick MF. Chen TC. Vitamin D deficiency: a worldwide problem with health consequnces. Am J Clin Nutr 2008;87:1080S-6S.
10Ogier de Baulny H, Gerard M, Saudubray JM, Zittoun J. Remethylation defects: guidelines for clinical diagnosis and treatment. Eur J Pediatr 1998;157 (SuppI 2):577-583.
11Shils ME. Vitamin B12 ‘Cobalamin’. In: Shils ME, Olson JA, Shike M, Ross AC, eds. Modern Nutrition in Health and Disease. 9th ed. Philadelphia, Lippincott Williams&Wilkins 1999; 447-1.
12Healton EB, Savage DG, Brust JCM, Garrett TJ, Lindenbaum J. Neurologic aspects of cobalamin deficiency. Medicine (Baltimore) 1991;70:229-45.
13Giedd JN, Blumenthal J, Jeffries NO, Castellanos FX, Liu H, Zijdenbos A, et al. Brain development during childhood and adolescence: a longitudinal MRI study. Nat Neurosci 1999;2:861-3.
14Craik FI, Bialystok E. Cognition through the lifespan: mechanisms of change. Trends Cogn Sci 2006;10:131-8.
15Bikle D. Vitamin D: Newly discovered actions require reconsideration of physiologic requirements. Trends Endocrinol Metab 2010;21:375-84.
16Edfelt K, Liu PT, Chun R, Fabri M, Schenk M, Wheelwright M, et al. T cell cytokines differently control human monocyte antimicrobial responses by regulating vitamin D metabolism. Proc Natl Acad Sci U S A 2010;107:22593-8.
17Doğan M, Erol M, Cesur Y, Yuca SA, Doğan Z. The effect of 25-hydroxy-vitamin D3 on the immunsystem. J Pediatr Endocrinol Metab 2009;22:929-35.
18Bouillon R, Carmeliet G, Verlinden L, van Etten E, Verstuyf A, Luderer HF, et al. Vitamin D nad human health: Lessons from vitamin D receptor null mice. Endocr Rev 2008;29:726-76.
19Ni Cheallaigh C, Keane J, Lavelle EC, Hope JC, Harris J. Autophagy in the immun response to tuberculosis:clinical perspectives. Clin Exp Immunol 2011;164:291-300.
20Muhe L, Lulseged S, Mason KE, Simoes EA. Case-control study of the role of nutritional rickets in the risk of developing pnömonia in Ethiopian children. Lancet 1997;349:1801-4.
21Oren Y, Shapira Y, Agmon-Levin N, Kivity S, Zafrir Y, Altman A, et al. Vitamin D insufficiency in a sunny environment: A demographic and seasonal analysis. Isr Med Assoc J 2010;12:751-6.
22Davies PD, Brown RC, Woodhead JS. Serum concentrations vitamin D metabolits in untreated tuberculosis. Thorax 1985;40:187-90.
23Rehman PK. Subclinic rickets and recurrent infections. J Trop Pediatr 1994;40:58.
24Onal H, Adal E, Oner T, Onal Z, Aydın A. Gelişmekte olan ülkelerde önemli bir sorun: annede ve yenidoğanda B12 vitamini eksikliği. Türk Ped Arş 2010;45:242-5.
25Bay A, Oner AF, Nalbantoglu O, Demirtas M, Acikgoz M. Megaloblastik anemili 45 olgunun klinik ve hematolojik yönden değerlendirilmesi. Van Tıp Dergisi 2006;13:46-8.
26Demir N, Koc A, Üstyol L, Peker E, Abuhandan M. Clinical and neurological findings of severe vitamin B12 deficiency in infancy and importance of early diagnosis and treatment. J Paediatr Child Health 2013;10:820-4.