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Clin Infect Dis. Low Serum 25-hydroxyvitamin D Level and Risk of Upper Respiratory Tract Infection in Children and Adolescents
[Source: Clinical Infectious Diseases, full text: (LINK). Abstract, edited.]
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Low Serum 25-hydroxyvitamin D Level and Risk of Upper Respiratory Tract Infection in Children and Adolescents
Michelle Science 1,2, Jonathon L. Maguire 3,4,5,6, Margaret L. Russell 7, Marek Smieja 2,8, Stephen D. Walter 2, and Mark Loeb 2,8,9
Author Affiliations: <SUP>1</SUP>Division of Infectious Diseases, The Hospital for Sick Children, 555 University Avenue, Toronto, Ontario, Canada M5G 1X8 <SUP>2</SUP>Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton Health Sciences, 1200 Main Street West, Hamilton, Ontario, Canada L8N 3Z5 <SUP>3</SUP>Applied Health Research Centre, Li Ka Shing Knowledge Institute of St. Michael's Hospital, 30 Bond Street, Toronto, Ontario, Canada M5B 1W8 <SUP>4</SUP>Department of Paediatrics, St Michael's Hospital, 30 Bond Street, Toronto, Ontario, Canada M5B 1W8 <SUP>5</SUP>Institute for Health Policy, Management and Evaluation, University of Toronto, 155 College Street, Toronto, Ontario, Canada M5T 3M6 <SUP>6</SUP>Department of Pediatrics, University of Toronto, 27 King's College Circle, Toronto, Ontario, Canada M5S 1A1 <SUP>7</SUP>Department of Community Health Sciences, University of Calgary, 3280 Hospital Drive NW, Calgary, Alberta, Canada T2N 4Z6 <SUP>8</SUP>Department of Pathology and Molecular Medicine, McMaster University, 1200 Main Street West, Hamilton, Ontario, Canada L8N 3Z5 <SUP>9</SUP>Michael G DeGroote Institute for Infectious Disease Research, McMaster University, 1200 Main Street West, Hamilton, Ontario, Canada L8N 3Z5
Corresponding Author: Mark Loeb, MD, MSc, McMaster University, 1200 Main St. West, Hamilton, Ontario, L8N 3Z5 Email: loebm@mcmaster.ca
Alternate Corresponding Author: Michelle Science, MD, The Hospital for Sick Children, 555 University Avenue, Toronto, M5G 1X8, Email: michelle.science@sickkids.ca
Abstract
Background.
Vitamin D may be important for immune function. Studies to date have shown an inconsistent association between vitamin D and infection with respiratory viruses. The purpose of this study was to determine if serum 25-hydroxyvitamin D (25[OH]D) was associated with laboratory confirmed viral respiratory tract infections (RTIs) in children.
Methods.
Serum 25(OH)D levels were measured at baseline and children from Canadian Hutterite communities were followed prospectively during the respiratory virus season. Nasopharyngeal specimens were obtained if symptoms developed and infections were confirmed using polymerase chain reaction. The association between serum 25(OH)D and time to laboratory confirmed viral RTI was evaluated using a Cox proportional hazards model.
Results.
743 children aged 3 to 15 years were followed between December 22, 2008 and June 23, 2009. The median serum 25(OH)D level was 62.0 nmol/L (interquartile range [IQR] 51.0, 74.0). A total of 229 participants (31%) developed at least one laboratory confirmed viral RTI. Younger age and lower serum 25(OH)D levels were associated with increased risk of viral RTI. Serum 25(OH)D levels lower than 75 nmol/L increased the increased the risk of viral RTI by 50% (Hazard ratio [HR] 1.51, 95% CI 1.10, 2.07, p=0.011) and levels lower than 50 nmol/L increased the risk by 70% (HR 1.67, 95% CI 1.16, 2.40, P=0.006).
Conclusion.
Lower serum 25(OH)D levels were associated with increased risk of laboratory confirmed viral RTI in children from Canadian Hutterite communities. Intervention studies evaluating the role of vitamin D supplementation to reduce the burden of viral RTIs are warranted.
Received January 5, 2013. Accepted April 24, 2013.
? The Author 2013. Published by Oxford University Press on behalf of the Infectious Diseases Society of America. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.
-Michelle Science 1,2, Jonathon L. Maguire 3,4,5,6, Margaret L. Russell 7, Marek Smieja 2,8, Stephen D. Walter 2, and Mark Loeb 2,8,9
Author Affiliations: <SUP>1</SUP>Division of Infectious Diseases, The Hospital for Sick Children, 555 University Avenue, Toronto, Ontario, Canada M5G 1X8 <SUP>2</SUP>Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton Health Sciences, 1200 Main Street West, Hamilton, Ontario, Canada L8N 3Z5 <SUP>3</SUP>Applied Health Research Centre, Li Ka Shing Knowledge Institute of St. Michael's Hospital, 30 Bond Street, Toronto, Ontario, Canada M5B 1W8 <SUP>4</SUP>Department of Paediatrics, St Michael's Hospital, 30 Bond Street, Toronto, Ontario, Canada M5B 1W8 <SUP>5</SUP>Institute for Health Policy, Management and Evaluation, University of Toronto, 155 College Street, Toronto, Ontario, Canada M5T 3M6 <SUP>6</SUP>Department of Pediatrics, University of Toronto, 27 King's College Circle, Toronto, Ontario, Canada M5S 1A1 <SUP>7</SUP>Department of Community Health Sciences, University of Calgary, 3280 Hospital Drive NW, Calgary, Alberta, Canada T2N 4Z6 <SUP>8</SUP>Department of Pathology and Molecular Medicine, McMaster University, 1200 Main Street West, Hamilton, Ontario, Canada L8N 3Z5 <SUP>9</SUP>Michael G DeGroote Institute for Infectious Disease Research, McMaster University, 1200 Main Street West, Hamilton, Ontario, Canada L8N 3Z5
Corresponding Author: Mark Loeb, MD, MSc, McMaster University, 1200 Main St. West, Hamilton, Ontario, L8N 3Z5 Email: loebm@mcmaster.ca
Alternate Corresponding Author: Michelle Science, MD, The Hospital for Sick Children, 555 University Avenue, Toronto, M5G 1X8, Email: michelle.science@sickkids.ca
Abstract
Background.
Vitamin D may be important for immune function. Studies to date have shown an inconsistent association between vitamin D and infection with respiratory viruses. The purpose of this study was to determine if serum 25-hydroxyvitamin D (25[OH]D) was associated with laboratory confirmed viral respiratory tract infections (RTIs) in children.
Methods.
Serum 25(OH)D levels were measured at baseline and children from Canadian Hutterite communities were followed prospectively during the respiratory virus season. Nasopharyngeal specimens were obtained if symptoms developed and infections were confirmed using polymerase chain reaction. The association between serum 25(OH)D and time to laboratory confirmed viral RTI was evaluated using a Cox proportional hazards model.
Results.
743 children aged 3 to 15 years were followed between December 22, 2008 and June 23, 2009. The median serum 25(OH)D level was 62.0 nmol/L (interquartile range [IQR] 51.0, 74.0). A total of 229 participants (31%) developed at least one laboratory confirmed viral RTI. Younger age and lower serum 25(OH)D levels were associated with increased risk of viral RTI. Serum 25(OH)D levels lower than 75 nmol/L increased the increased the risk of viral RTI by 50% (Hazard ratio [HR] 1.51, 95% CI 1.10, 2.07, p=0.011) and levels lower than 50 nmol/L increased the risk by 70% (HR 1.67, 95% CI 1.16, 2.40, P=0.006).
Conclusion.
Lower serum 25(OH)D levels were associated with increased risk of laboratory confirmed viral RTI in children from Canadian Hutterite communities. Intervention studies evaluating the role of vitamin D supplementation to reduce the burden of viral RTIs are warranted.
Received January 5, 2013. Accepted April 24, 2013.
? The Author 2013. Published by Oxford University Press on behalf of the Infectious Diseases Society of America. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.
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