Nutr Res Pract.  2020 Feb;14(1):12-19. 10.4162/nrp.2020.14.1.12.

Association of vitamin D deficiency with clinical outcomes in critically ill Korean children

Affiliations
  • 1Division of Pediatric Critical Care medicine, Department of Pediatrics, Asan Medical Center Children's Hospital, University of Ulsan College of Medicine, 88, Olympic-ro-43-gil, Songpa-gu, Seoul 05505, Korea. drpsj@amc.seoul.kr

Abstract

BACKGROUND/OBJECTIVES
Vitamin D is a pleiotropic hormone that affects various body organ systems. We evaluated the prevalence of a vitamin D deficiency (VDD) and its potential role in the clinical condition of critically ill Korean children.
SUBJECTS/METHODS
Patients under 18 years old with a 25(OH) vitamin D measurement on the first day of PICU admission were included from among the children admitted to the pediatric intensive care unit (PICU) of our tertiary children's hospital between October 2017 and January 2019.
RESULTS
A total of 172 pediatric patients were enrolled. The mean 25(OH) vitamin D level was 17.5 ± 12.8 ng/mL. There was a 65.1% prevalence of VDD (25(OH) vitamin D level < 20 ng/mL). VDD was associated with age at PICU admission, gastrointestinal/hepatobiliary disorders, International Society of Thrombosis and Hemostasis disseminated intravascular coagulation (ISTH DIC) score, pediatric multiple organ dysfunction syndrome (pMODS) score and with several laboratory test findings including hemoglobin, platelet, C-reactive protein, serum albumin, total bilirubin, prothrombin time, and anti-thrombin III levels. Most of these parameters also showed significant linear correlations with the 25(OH) vitamin D level (P < 0.05). However, no statistically meaningful association was found between VDD and other clinical conditions such as the need for a mechanical ventilator, requirement for vasoactive drugs, duration of the PICU and hospital stays, or PICU mortality.
CONCLUSION
There is a high prevalence of VDD in critically ill Korean children. There were significant associations between the 25(OH) vitamin D level and gastrointestinal/hepatobiliary disorders, the pMODS score and with coagulation related factors. Further large-scale studies with more specific subgroup analyses are required to more precisely assess the clinical implications of VDD in critically ill pediatric patients.

Keyword

Vitamin D; pediatrics

MeSH Terms

Bilirubin
Blood Platelets
C-Reactive Protein
Child*
Critical Illness*
Disseminated Intravascular Coagulation
Hemostasis
Humans
Intensive Care Units
Length of Stay
Mortality
Multiple Organ Failure
Pediatrics
Prevalence
Prothrombin Time
Serum Albumin
Thrombosis
Ventilators, Mechanical
Vitamin D Deficiency*
Vitamin D*
Vitamins*
Bilirubin
C-Reactive Protein
Serum Albumin
Vitamin D
Vitamins

Figure

  • Fig. 1 Comparisons of the mean values for several parameters among the severe VDD, VDD and non-VDD groups.VDD, vitamin D deficiency; CRP, C-reactive peptide; ISTH DIC score, International Society on Thrombosis and Hemostasis disseminated intravascular coagulation score; pMODS, pediatric multiple organ dysfunction syndrome.


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