Abstract
Plasma levels of 25-hydroxyvitamin D [25(OH)D] were measured by competitive Electrochemiluminescence Immunoassay (ECLIA) in 92 children (67 boys, 25 girls) aged 3 months to 12 years at admission to hospital (timepoint 1, T1) and at discharge (timepoint 2, T2). There was a significant fall in the mean 25(OH)D from T1 (71.87 ± 27.25 nmol/L) to T2 (49.03 ± 22.25 nmol/L) (mean change = 22.84 nmol/L, P value = 0.0004). Proportion of patients having VDD (levels <50 nmol/L) at admission (25%, 23/92) increased significantly at the time of discharge (51.09%, 47/92) (P = 0.0004). There was a trend towards longer duration of hospital stay, requirement of ventilation and inotropes, development of healthcare-associated infection, and mortality in vitamin D deficient as compared to nondeficient patients though the difference was statistically insignificant. In conclusion, vitamin D levels fall significantly and should be monitored during hospital stay in children. Large clinical studies are needed to prospectively evaluate the effect of vitamin D supplementation in vitamin D deficient hospitalized children on various disease outcome parameters.
Highlights
Hospitalized children are prone to vitamin D deficiency (VDD) or exacerbate their existing deficiency due to multitude of reasons; many have VDD at the time of hospitalization due to widespread VDD, no additional vitamin D source due to poor oral intake and any sun exposure, and lack of practice of supplementation during hospitalization
The data on prevalence of VDD obtained in this study is similar to the data in control subjects of a previously conducted study by us on vitamin D levels in type 1 diabetes patients [13]
The mean 25(OH)D levels fell by almost one-third and the proportion of vitamin D deficient patients doubled over a hospital duration of approximately 2 weeks
Summary
Hospitalized children are prone to vitamin D deficiency (VDD) or exacerbate their existing deficiency due to multitude of reasons; many have VDD at the time of hospitalization due to widespread VDD, no additional vitamin D source due to poor oral intake and any sun exposure, and lack of practice of supplementation during hospitalization. A few intervention trials suggest some beneficial effect of vitamin D supplementation on outcomes in hospitalized vitamin D deficient patients definite evidence is lacking [6, 7]. These studies have predominantly been conducted on patients admitted to intensive care units (ICUs). A few studies in pediatric population have shown similar results underlining the importance of estimating vitamin D levels in children with critical illness [8, 9]. We planned to study the prevalence of VDD in children at the time of admission and the change in levels after a variable period of stay in a general pediatrics unit of our hospital
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