Çocuklarda akut bakteriyel enfeksiyonlarda akut faz reaktanı olarak D vitamini düzeylerinin kullanımı

Year 2025, Volume: 8 Issue: 4, 635 - 639, 30.07.2025

Ahmet Sarı , Elif Ünver Korğalı

https://doi.org/10.32322/jhsm.1673556

Abstract

Giriş: Literatürdeki birçok çalışma D vitamini eksikliği ve farklılaşmaları odaklanmıştır. Bu çalışmamızda amacımız ‘D vitamini akut faz reaktanı mıdır?’ ya da ‘geçirilen akut bakteriyel enfeksiyonlardan etkilenir mi?’ sorularına yanıt aramaktır.
Yöntemler: Çalışmamız Cumhuriyet Üniversitesi Tıp Fakültesi Hastanesi Çocuk Sağlığı ve Hastalıkları Klinğinde, Nisan- Aralık 2016 tarihleri arasında akut bakteriyel enfeksiyon ile takip edilen hastalar ile yapıldı. Bu çalışma da, 2-7 yaş arası çocuklarda kültür ile kanıtlanmış akut bakteriyel enfeksiyon varlığında, tedavi öncesi ve sonrasında enfeksiyon ile D vitamini düzeyleri arasındaki ilişki incelenmesi ve D vitamini düzeylerinin diğer akut faz reaktanları ile ilişkisinin araştırılması amaçlanmıştır.
Sonuçlar: Hasta ve kontrol gruplarının her biri 35 çocuk katılımcıdan oluşuyordu. Hem çalışma hem de kontrol grubunda 18 (%51,4) kız ve 17 (%48,6) erkek çocuk bulunmaktaydı. Çalışma ve kontrol grubunun yaş ortalamaları sırasıyla 4,51 ± 1,57 ve 4,98 ± 1,79 yıl idi. Hastaların ortalama D vitamini düzeyleri tedavi öncesi 21,83 ± 18,16 ng/ml, tedavinin 5. gününde 20,16 ± 10,52 ng/ml iken kontrol grubunda 21,08 ± 8,44 ng/ml idi. Her iki grup arasında tedavi öncesi ve tedavinin 5. gününde ölçülen D vitamini düzeyleri açısından anlamlı fark bulunmadı (p=0,625).
Sonuç: Çalışmamızda enfeksiyon ve kontrol grupları arasında D vitamini düzeyleri arasında fark yoktu. Akut bakteriyel enfeksiyonlarda D vitamininin önemini daha iyi anlamak için daha fazla sayıda hasta ile yapılan çalışmalara ihtiyaç vardır.
Anahtar sözcükler: vitamin D, enfeksiyon, çocuk

Keywords

vitamin D , enfeksiyon , çocuk

Project Number

t-667

Use of vitamin D as an acute phase reactant in acute bacterial infections in children

Abstract

Aims: Many studies in the literature have focused on the relationship between vitamin D deficiency and infection. Our aim in this study is to provide responses to the questions “Is vitamin D an acute phase reactant?” or “Is it affected by acute bacterial infections suffered?’’
Methods: Study was conducted with patients who were followed up with acute bacterial infection between April and December 2016 in the Pediatrics Clinic of Sivas Cumhuriyet University Faculty of Medicine Hospital. And investigate both the relationship between infection and vitamin D levels before and after treatment in the presence of culture-proven acute bacterial infection in children aged 2-7 years and the correlation between vitamin D levels and other acute phase reactants.
Results: Patient and control groups each included 35 child participants. Both the study and control groups contained 18 (51.4%) female and 17 (48.6%) male children. The mean ages of the study, and the control group were 4.51±1.57 and 4.98±1.79 years. the mean vitamin D levels of the patients were 21.83±18.16 ng/ml before treatment and 20.16±10.52 ng/ml on the 5th day of treatment and it was 21.08±8.44 ng/ml in the control group. There was no significant difference between both groups in terms of vitamin D levels measured both before and on the 5th day of treatment (p=0.625).
Conclusion: In our study, there was no difference in vitamin D levels between the infection and control groups. Studies with a larger number of patients are needed to better understand the importance of vitamin D in acute bacterial infections.

Keywords

Vitamin D , infections , child , acute phase reactant

Ethical Statement

The study was approved by the decision of the Ethics Committee of Cumhuriyet University Faculty of Medicine, number 2015-11/01, dated 24.11.2015.

Supporting Institution

SIVAS CUMHURIYET UNIVERSITY Scientific Research Projects Coordination Unit

Project Number

t-667

References

• Urbach J, Rotstein R, Fusman R, et al. Reduced acute phase response to differentiate between viral and bacterial infections in children. Pediatr Pathol Mol Med. 2002;21(6):557-567. doi:10.1080/15227950290112815
• Huttunen R, Syrjänen J, Vuento R, Aittoniemi J. Current concepts in the diagnosis of blood stream infections. Are novel molecular methods useful in clinical practice? Int J Infect Dis. 2013;17(11):e934-e938. doi:10. 1016/j.ijid.2013.04.018
• Walker VP, Modlin RL. The vitamin D connection to pediatric infections and immune function. Pediatr Res. 2009;65(5 Pt 2):106R-113R. doi:10. 1203/PDR.0b013e31819dba91
• Jones G. 100 years of vitamin D: historical aspects of vitamin D. Endocr Connect. 2022;11(4):e210594. doi:10.1530/EC-21-0594
• Dal NE, İşlekel H. Vitamin D as an immunomodulatory and antioxidant molecule: association between vitamin D deficiency and systemic sclerosis. Turk J Immunol. 2019;7(1):57-68.
• Gunville CF, Mourani PM, Ginde AA. The role of vitamin D in prevention and treatment of infection. Inflamm Allergy Drug Targets. 2013;12(4):239-245. doi:10.2174/18715281113129990046
• Aydemir G, Cekmez F, Kalkan G, et al. High serum 25-hydroxyvitamin D levels are associated with pediatric sepsis. Tohoku J Exp Med. 2014; 234(4):295-298. doi:10.1620/tjem.234.295
• Binfield A, Aird C, Murdoch DR, Elder P, Walls T. Are vitamin D levels affected by acute bacterial infections in children? J Paediatr Child Health. 2014;50(8):643-646. doi:10.1111/jpc.12620
• Hocaoğlu-Emre FS, Sarıbal D, Oğuz O. Vitamin D deficiency and insufficiency according to the current criteria for children: vitamin D status of elementary school children in Turkey. J Clin Res Pediatr Endocrinol. 2019;11(2):181-188. doi: 10.4274/jcrpe.galenos.2018.2018. 0272
• Liyanage G, Kaneshapillai A, Kanthasamy S. Serum vitamin D level and risk of community acquired pneumonia: a case-control study. Interdiscip Perspect Infect Dis. 2021;2021:2157337. doi:10.1155/2021/2157337
• Zhou YF, Luo BA, Qin LL. The association between vitamin D deficiency and community acquired pneumonia: a meta-analysis of observational studies. Medicine (Baltimore). 2019;98(38):e17252. doi:10.1097/MD.000 0000000017252
• Yang J, Chen G, Wang D, Chen M, Xing C, Wang B. Low serum 25-hydroxyvitamin D level and risk of urinary tract infection in infants. Medicine (Baltimore). 2016;95(27):e4137. doi:10.1097/MD.0000000000 004137
• Jorde R, Sollid ST, Svartberg J, Joakimsen RM, Grimnes G, Hutchinson MY. Prevention of urinary tract infections with vitamin D supplementation 20,000 IU per week for five years. Results from an RCT including 511 subjects. Infect Dis (Lond). 2016;48(11-12):823-828. doi:10. 1080/23744235.2016.1201853
• Katikaneni R, Ponnapakkam T, Ponnapakkam A, Gensure R. Breastfeeding does not protect against urinary tract infection in the first 3 months of life, but vitamin D supplementation increases the risk by 76%. Clin Pediatr (Phila). 2009;48(7):750-755. doi:10.1177/0009922809332588
• Guo LY, Li W, Cheng XF, et al. Relationship between vitamin D status and viral pneumonia in children. Pediatr Allergy Immunol Pulmonol. 2017;30(2):86-91. doi:10.1089/ped.2017.075
• Sarhan TS, Elrifai A. Serum level of vitamin D as a predictor for severity and outcome of pneumonia. Clin Nutr. 2021;40(4):2389-2393. doi:10. 1016/j.clnu.2020.10.035
• Nseir W, Taha M, Nemarny H, Mograbi J. The association between serum levels of vitamin D and recurrent urinary tract infections in premenopausal women. Int J Infect Dis. 2013;17(12):e1121-e1124. doi:10. 1016/j.ijid.2013.06.007
• Tekin M, Konca C, Celik V, et al. The Association between vitamin D levels and urinary tract infection in children. Horm Res Paediatr. 2015; 83(3):198-203. doi:10.1159/000370046
• Liu PT, Stenger S, Li H, et al. Toll-like receptor triggering of a vitamin D-mediated human antimicrobial response. Science. 2006;311(5768): 1770-1773. doi:10.1126/science.1123933
• Grant WB. Solar ultraviolet-B irradiance and vitamin D may reduce the risk of septicemia. Dermatoendocrinol. 2009;1(1):37-42. doi:10.4161/derm.1.1.7250
• Van den Berghe G, Van Roosbroeck D, Vanhove P, Wouters PJ, De Pourcq L, Bouillon R. Bone turnover in prolonged critical illness: effect of vitamin D. J Clin Endocrinol Metab. 2003;88(10):4623-4632. doi:10. 1210/jc.2003-030358
• Jeng L, Yamshchikov AV, Judd SE, et al. Alterations in vitamin D status and anti-microbial peptide levels in patients in the intensive care unit with sepsis. J Transl Med. 2009;7:28. doi:10.1186/1479-5876-7-28
• Oren Y, Shapira Y, Agmon-Levin N, et al. Vitamin D insufficiency in a sunny environment: a demographic and seasonal analysis. Isr Med Assoc J. 2010;12(12):751-756.
• Chi A, Wildfire J, McLoughlin R, et al. Umbilical cord plasma 25-hydroxy vitamin D concentration and immune function at birth: the urban environment and childhood asthma study. Clin Exp Allergy. 2011;41(6):842-850. doi:10.1111/j.1365-2222.2011.03712.x