Vitamin D Status at the Time of Hospitalization for Bronchiolitis and Its Association with Disease Severity
To investigate the association between circulating 25-hydroxyvitamin D [25(OH)D] status at admission and disease severity among infants hospitalized for bronchiolitis and to determine whether the association differs by the form of 25(OH)D—total, bioavailable or free 25(OH)D. We conducted a 17-center...
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| Veröffentlicht in: | The Journal of pediatrics 2018-12, Vol.203, p.416-422.e1 |
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| container_title | The Journal of pediatrics |
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| creator | Vo, Phuong Koppel, Claire Espinola, Janice A. Mansbach, Jonathan M. Celedón, Juan C. Hasegawa, Kohei Bair-Merritt, Megan Camargo, Carlos A. |
| description | To investigate the association between circulating 25-hydroxyvitamin D [25(OH)D] status at admission and disease severity among infants hospitalized for bronchiolitis and to determine whether the association differs by the form of 25(OH)D—total, bioavailable or free 25(OH)D.
We conducted a 17-center prospective cohort study of 1016 US infants |
| doi_str_mv | 10.1016/j.jpeds.2018.07.097 |
| format | Article |
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We conducted a 17-center prospective cohort study of 1016 US infants <12 months old hospitalized with bronchiolitis. Vitamin D status was defined by total 25(OH)D levels, and by calculated levels of bioavailable and free 25(OH)D. Bronchiolitis severity was defined by requirement for intensive care and hospital length-of-stay (LOS). Logistic and Poisson regression were used for unadjusted and multivariable analyses.
The median age of hospitalized infants was 3.2 months (IQR 1.6-6.0). The median total 25(OH)D was 26.5 ng/mL (IQR 18.0-33.1); 298 (29%) infants had total 25(OH)D <20 ng/mL. In multivariable models, infants with total 25(OH)D <20 ng/mL had higher risk of requiring intensive care (aOR 1.72, 95% CI 1.12-2.64) and longer LOS (adjusted rate ratio 1.39, 95% CI 1.17-1.65) compared with infants with total 25(OH)D ≥30 ng/mL. Infants with the lowest tertile of bioavailable 25(OH)D, compared with those with the highest tertile, had longer LOS (adjusted rate ratio 1.32, 95% CI 1.07-1.62); admission to the intensive care unit was not statistically significant in the adjusted model (aOR 1.39, 95% CI 0.96-2.64). Free 25(OH)D level was not associated with severity of bronchiolitis in either unadjusted or adjusted models.
In a large, multicenter cohort of US infants hospitalized for bronchiolitis, infants with total 25(OH)D <20 ng/mL had increased risk of intensive care and longer hospital LOS.</description><identifier>ISSN: 0022-3476</identifier><identifier>EISSN: 1097-6833</identifier><identifier>DOI: 10.1016/j.jpeds.2018.07.097</identifier><identifier>PMID: 30243543</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>acute respiratory infection ; bioavailable vitamin D ; free vitamin D ; infants ; intensive care ; length of hospitalization ; total vitamin D</subject><ispartof>The Journal of pediatrics, 2018-12, Vol.203, p.416-422.e1</ispartof><rights>2018 Elsevier Inc.</rights><rights>Copyright © 2018 Elsevier Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c359t-6696ec386a73696795ec3fd40811a79e24e4a9b34cdc6e0f28585295d632ff003</citedby><cites>FETCH-LOGICAL-c359t-6696ec386a73696795ec3fd40811a79e24e4a9b34cdc6e0f28585295d632ff003</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.jpeds.2018.07.097$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,780,784,3550,27924,27925,45995</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/30243543$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Vo, Phuong</creatorcontrib><creatorcontrib>Koppel, Claire</creatorcontrib><creatorcontrib>Espinola, Janice A.</creatorcontrib><creatorcontrib>Mansbach, Jonathan M.</creatorcontrib><creatorcontrib>Celedón, Juan C.</creatorcontrib><creatorcontrib>Hasegawa, Kohei</creatorcontrib><creatorcontrib>Bair-Merritt, Megan</creatorcontrib><creatorcontrib>Camargo, Carlos A.</creatorcontrib><title>Vitamin D Status at the Time of Hospitalization for Bronchiolitis and Its Association with Disease Severity</title><title>The Journal of pediatrics</title><addtitle>J Pediatr</addtitle><description>To investigate the association between circulating 25-hydroxyvitamin D [25(OH)D] status at admission and disease severity among infants hospitalized for bronchiolitis and to determine whether the association differs by the form of 25(OH)D—total, bioavailable or free 25(OH)D.
We conducted a 17-center prospective cohort study of 1016 US infants <12 months old hospitalized with bronchiolitis. Vitamin D status was defined by total 25(OH)D levels, and by calculated levels of bioavailable and free 25(OH)D. Bronchiolitis severity was defined by requirement for intensive care and hospital length-of-stay (LOS). Logistic and Poisson regression were used for unadjusted and multivariable analyses.
The median age of hospitalized infants was 3.2 months (IQR 1.6-6.0). The median total 25(OH)D was 26.5 ng/mL (IQR 18.0-33.1); 298 (29%) infants had total 25(OH)D <20 ng/mL. In multivariable models, infants with total 25(OH)D <20 ng/mL had higher risk of requiring intensive care (aOR 1.72, 95% CI 1.12-2.64) and longer LOS (adjusted rate ratio 1.39, 95% CI 1.17-1.65) compared with infants with total 25(OH)D ≥30 ng/mL. Infants with the lowest tertile of bioavailable 25(OH)D, compared with those with the highest tertile, had longer LOS (adjusted rate ratio 1.32, 95% CI 1.07-1.62); admission to the intensive care unit was not statistically significant in the adjusted model (aOR 1.39, 95% CI 0.96-2.64). Free 25(OH)D level was not associated with severity of bronchiolitis in either unadjusted or adjusted models.
In a large, multicenter cohort of US infants hospitalized for bronchiolitis, infants with total 25(OH)D <20 ng/mL had increased risk of intensive care and longer hospital LOS.</description><subject>acute respiratory infection</subject><subject>bioavailable vitamin D</subject><subject>free vitamin D</subject><subject>infants</subject><subject>intensive care</subject><subject>length of hospitalization</subject><subject>total vitamin D</subject><issn>0022-3476</issn><issn>1097-6833</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2018</creationdate><recordtype>article</recordtype><recordid>eNp9kE1v1DAQhi0EokvhFyAhH7kkHX_ESQ4cSktppUo9tOVquc5EO0sSL7a3qPz6umzLkdPMSM87o3kY-yigFiDM0abebHFItQTR1dDW0Lev2EqUUplOqddsBSBlpXRrDti7lDYA0GuAt-xAgdSq0WrFfv6g7GZa-Cm_zi7vEneZ5zXyG5qRh5Gfh7QtyER_XKaw8DFE_jWGxa8pTJSpBJaBX-TEj1MKnvbUb8prfkoJXUJ-jfcYKT-8Z29GNyX88FwP2e3Zt5uT8-ry6vvFyfFl5VXT58qY3qBXnXGtKm3bN2UaBw2dEK7tUWrUrr9T2g_eIIyya7pG9s1glBxHAHXIPu_3bmP4tcOU7UzJ4zS5BcMuWSmEaHVZbgqq9qiPIaWIo91Gml18sALsk2W7sX8t2yfLFlpb9JbUp-cDu7sZh3-ZF60F-LIHsLx5Txht8oSLx4Ei-myHQP898Ag8MI8Y</recordid><startdate>201812</startdate><enddate>201812</enddate><creator>Vo, Phuong</creator><creator>Koppel, Claire</creator><creator>Espinola, Janice A.</creator><creator>Mansbach, Jonathan M.</creator><creator>Celedón, Juan C.</creator><creator>Hasegawa, Kohei</creator><creator>Bair-Merritt, Megan</creator><creator>Camargo, Carlos A.</creator><general>Elsevier Inc</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>201812</creationdate><title>Vitamin D Status at the Time of Hospitalization for Bronchiolitis and Its Association with Disease Severity</title><author>Vo, Phuong ; Koppel, Claire ; Espinola, Janice A. ; Mansbach, Jonathan M. ; Celedón, Juan C. ; Hasegawa, Kohei ; Bair-Merritt, Megan ; Camargo, Carlos A.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c359t-6696ec386a73696795ec3fd40811a79e24e4a9b34cdc6e0f28585295d632ff003</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2018</creationdate><topic>acute respiratory infection</topic><topic>bioavailable vitamin D</topic><topic>free vitamin D</topic><topic>infants</topic><topic>intensive care</topic><topic>length of hospitalization</topic><topic>total vitamin D</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Vo, Phuong</creatorcontrib><creatorcontrib>Koppel, Claire</creatorcontrib><creatorcontrib>Espinola, Janice A.</creatorcontrib><creatorcontrib>Mansbach, Jonathan M.</creatorcontrib><creatorcontrib>Celedón, Juan C.</creatorcontrib><creatorcontrib>Hasegawa, Kohei</creatorcontrib><creatorcontrib>Bair-Merritt, Megan</creatorcontrib><creatorcontrib>Camargo, Carlos A.</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>The Journal of pediatrics</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Vo, Phuong</au><au>Koppel, Claire</au><au>Espinola, Janice A.</au><au>Mansbach, Jonathan M.</au><au>Celedón, Juan C.</au><au>Hasegawa, Kohei</au><au>Bair-Merritt, Megan</au><au>Camargo, Carlos A.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Vitamin D Status at the Time of Hospitalization for Bronchiolitis and Its Association with Disease Severity</atitle><jtitle>The Journal of pediatrics</jtitle><addtitle>J Pediatr</addtitle><date>2018-12</date><risdate>2018</risdate><volume>203</volume><spage>416</spage><epage>422.e1</epage><pages>416-422.e1</pages><issn>0022-3476</issn><eissn>1097-6833</eissn><abstract>To investigate the association between circulating 25-hydroxyvitamin D [25(OH)D] status at admission and disease severity among infants hospitalized for bronchiolitis and to determine whether the association differs by the form of 25(OH)D—total, bioavailable or free 25(OH)D.
We conducted a 17-center prospective cohort study of 1016 US infants <12 months old hospitalized with bronchiolitis. Vitamin D status was defined by total 25(OH)D levels, and by calculated levels of bioavailable and free 25(OH)D. Bronchiolitis severity was defined by requirement for intensive care and hospital length-of-stay (LOS). Logistic and Poisson regression were used for unadjusted and multivariable analyses.
The median age of hospitalized infants was 3.2 months (IQR 1.6-6.0). The median total 25(OH)D was 26.5 ng/mL (IQR 18.0-33.1); 298 (29%) infants had total 25(OH)D <20 ng/mL. In multivariable models, infants with total 25(OH)D <20 ng/mL had higher risk of requiring intensive care (aOR 1.72, 95% CI 1.12-2.64) and longer LOS (adjusted rate ratio 1.39, 95% CI 1.17-1.65) compared with infants with total 25(OH)D ≥30 ng/mL. Infants with the lowest tertile of bioavailable 25(OH)D, compared with those with the highest tertile, had longer LOS (adjusted rate ratio 1.32, 95% CI 1.07-1.62); admission to the intensive care unit was not statistically significant in the adjusted model (aOR 1.39, 95% CI 0.96-2.64). Free 25(OH)D level was not associated with severity of bronchiolitis in either unadjusted or adjusted models.
In a large, multicenter cohort of US infants hospitalized for bronchiolitis, infants with total 25(OH)D <20 ng/mL had increased risk of intensive care and longer hospital LOS.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>30243543</pmid><doi>10.1016/j.jpeds.2018.07.097</doi></addata></record> |
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| subjects | acute respiratory infection bioavailable vitamin D free vitamin D infants intensive care length of hospitalization total vitamin D |
| title | Vitamin D Status at the Time of Hospitalization for Bronchiolitis and Its Association with Disease Severity |
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