Relationship between serum 25-hydroxyvitamin D, total antioxidant capacity and pneumonia incidence, severity and outcome in Nigerian children

Abstract

Abstract Background The pathologic basis of childhood community-acquired pneumonia (CAP) involves the generation of reactive oxygen species by immune cells leading to cellular damage and lung congestion. Serum antioxidants and vitamin D with immunomodulatory properties therefore hold prospects in the prevention and management of pneumonia in children. This case–control study set out to compare the serum 25-hydroxyvitamin D (25-OHD) and total antioxidant capacity (TAC) in Nigerian children with CAP and age- and sex-matched controls and to relate these parameters with pneumonia severity and outcome—length of hospital stay (LOH). Results A total of 160 children (80 each for CAP and controls) were recruited. The median (IQR) age was 1.8 (0.6–4.0) years, male:female 1.7:1, 63 (78.8%) and 11 (13.8%) of CAP group had severe pneumonia and parapneumonic effusions, respectively. Serum 25-OHD (33.8 (18.3) ng/ml vs. 41.9 (12.3) ng/ml; p = 0.010) and TAC (6.1 (4.4–8.1) ng/dl vs. 7.2 (4.7–17.5) ng/dl; p = 0.023) were lower in children with CAP than controls. Lower serum 25-OHD was observed in severe than non-severe pneumonia (30.5(17.1) ng/ml vs. 46.3 (17.6) ng/ml; p = 0.001) but LOH did not correlate with serum 25-OHD and TAC. Conclusion Children with CAP had lower serum vitamin D and antioxidants than controls, and severe pneumonia was significantly associated with suboptimal serum vitamin D. They however were not related to pneumonia outcome. Optimal serum vitamin D and antioxidants may play a role in reducing the incidence of childhood CAP in Nigerian children.