Study of the role of 25-dihyroxy vitamin DConcentration in critically Ill neonates

الملخص EN

Vitamin D has a role in innate immunity, including the prevention of respiratory tract infections.

Adequate concentrations of vitamin D stimulate genetic expression of antimicrobial peptides in human monocytes, neutrophils and other human cell lines.

Objective: To assess serum level of vitamin D and to evaluate the role of vitamin D deficiency in critically ill neonates with respiratory distress syndrome (RDS), neonatal sepsis, pneumonia and bronchopulmonary dysplasia.

Methods: The study included one hundred neonates (full term and preterm) of both sex admitted with Respiratory Distress Syndrome (RDS), neonatal sepsis, pneumonia and bronchopulmonary dysplasia.

Additionally, one hundred healthy neonates aged from 0 to 28 days were recruited.

A commercial radioimmunoassay was used to measure the serum (25 -OH vitamin D) in both patients and control for assessing vitamin D status.

Sample: Patients group had highly significant lower gestational age, birth weight, length and head circumference than control group.

Patients group were divided into 4 subgroups: 1.

Subgroup 1: RDS was 39% of cases.

2.

Subgroup 2: neonatal sepsis was 24% of cases.

3.

Subgroup 3: pneumonia was 31% 4.

Subgroup 4: BPD was 6%.

Results: The mean of serum (25 -OH vitamin D) of patients group was significantly lower than that of control group which was 10.84± 2.08ng/ ml and 31.87± 3.19 ng/ ml, respectively (P value< 0.01).

There was no significant difference between the mean value of serum (25 -OH vitamin D) in the four different subgroups of patients (P value> 0.05).

As regard vitamin D status in patients group, 90% had moderate vitamin D deficiency serum (25 -OH vitamin D) was 8- 14 ng/ ml, mild deficiency serum (25-OH vitamin D) 14- 20 ng/ ml was 7% while 2% had severe vitamin D deficiency serum (25 -OH vitamin D)< 8 ng/ ml) and 1% had no deficiency serum (25 -OH vitamin D)> 20 ng/ ml).

There was a significant positive correlation between serum (25 -OH vitamin D) and gestational age and anthropometric measurements in patient group (P< 0.01).

In control group, serum 25 OH- vitamin D positively correlated only with birth weight (P value< 0.01).

As regard the correlation between serum25 -OH vitamin D and different subgroups of patients, there was only significant negative correlation between serum 25 -OH vitamin D and pneumonic subgroup (P value< 0.05).

As regard the outcome of patients, 83% was improved while 17% was died, from the improved cases 84% had moderate vitamin D deficiency (S.25OH- vitamin D 8- 14 ng/ ml).

There was no significant difference between improved and died cases as regard grades of vitamin D.

Conclusion: The mean serum (25 -OH vitamin D) of patients group was significantly lower than that of control group.

There was no significant difference between the mean of serum (25 -OH vitamin D) in patients with respiratory distress syndrome (RDS), neonatal sepsis, pneumonia and bronchopulmonary dysplasia.

There was highly significant positive correlation between serum (25 -OH vitamin D) and gestational age and anthropometric measurements in patients group, while in control group, serum (25 -OH vitamin D) positively correlated only with birth weight (p value< 0.01).

There was significant negative correlation between serum (25 -OH vitamin D) and pneumonia.

There was no significant difference between improved and died cases as regard grades of vitamin D.

Keywords: (25 -OH vitamin D), vitamin D deficiency, respiratory distress syndrome, neonatal sepsis, pneumonia, bronchpulmonary dysplasia.