Low Serum Levels of Vitamins A, D, and E Are Associated with Recurrent Respiratory Tract Infections in Children Living in Northern China: A Case Control Study.

Xuguang Zhang,Wenfeng Zhao,Huaining Li,Yageng Yan,Fengshu Ding,Hong Jing,Yanping Chen,Bernhard Ryffel

doi:10.1371/journal.pone.0167689

Abstract

BackgroundThis study aimed to investigate the association of serum concentrations of vitamin A, D, and E with recurrent respiratory tract infections (RRTIs).MethodsA total of 1200 children aged at 0.5–14 years were selected via a face-to-face survey in Harbin, China. Among the participants, 600 children with RRTIs comprised the symptomatic group (RRTI group), whereas 600 healthy children were used as controls (control group). Blood samples were collected to measure serum levels of vitamins A and E by HPLC; the serum level of 25-hydroxycholecalciferol (25(OH)D), was measured by HPLC-MS/MS.ResultsSerum levels of vitamins A and E, as well as 25(OH)D, were significantly lower in the RRTI group than the control group. The conditional logistic regression model and the receiver-operating characteristic curve showed that the insufficiency or deficiency of vitamins A, D, and E was positively correlated with RRTI occurrence (p < 0.05).ConclusionsLow serum concentrations of vitamins A, D, and E were associated with RRTIs in children from northern China.

Highlights

Respiratory tract infections (RTIs) are common diseases worldwide, especially in low- and middle-income countries; these infections are the major causes of high pediatric morbidity and mortality among children [1]
This study aimed to investigate the association of serum concentrations of vitamin A, D, and E with recurrent respiratory tract infections (RRTIs)
The conditional logistic regression model and the receiveroperating characteristic curve showed that the insufficiency or deficiency of vitamins A, D, and E was positively correlated with Recurrent RTIs (RRTIs) occurrence (p < 0.05)

Summary

Introduction

Respiratory tract infections (RTIs) are common diseases worldwide, especially in low- and middle-income countries; these infections are the major causes of high pediatric morbidity and mortality among children [1]. Recurrent RTIs (RRTIs) often prolong the recovery period, increase the required health care, and cause more frequent complications, such as autoimmune disorders and septicemia [2]. RRTIs are attributed to deficiencies in local or systemic host defense, as well as pulmonary disorders caused by structural, functional, or environmental factors [5]. The environmental factors involved in RRTIs include the nutrient deficiency, such as that of zinc, heavy metal pollution, a history of allergies, and the maternal health during pregnancy; these factors may affect the resistance of children against pathogenic microorganisms [3, 5]. This study aimed to investigate the association of serum concentrations of vitamin A, D, and E with recurrent respiratory tract infections (RRTIs)

Objectives

Methods

Conclusion