The median age of the present healthy children

cohort was

The median age of the present healthy children

cohort was 3 years, much younger than the adolescent sample from the United States and Australia. The incidence of vitamin JAK inhibitor D deficiency was compared between healthy and PICU children in different age groups (Table 2). As expected, incidence of vitamin D deficiency increased with age in both group of patients. PICU patients had double incidence of hypovitaminosis D in all age groups, but the differences were clearly statistically significant in the older age group, and were almost significant in the medium age group. The probable reason is that the fragmentation of the sample produced a small sample size in the younger age group. Regarding the season of the year, there were no significant differences in 25(OH)vitD levels in the present study, although values tended to be

lower in fall and winter, which agree with previous studies performed in the North of Spain18 and in other countries.20 In healthy children, factors consistently associated with 25(OH)vitD levels were age, season of the year, and dietary calcium intake.22 Unfortunately, data regarding children’s calcium intake was not available. Regarding admission diagnosis, a lower respiratory diagnosis rate was observed in patients with vitamin D deficiency. In the few published pediatric studies,23 an association was found between vitamin D deficiency and lung function, as well as with the risk for upper respiratory tract infections. Sorafenib concentration A higher metabolic‐renal diagnosis rate in patients with vitamin D deficiency was also observed. Metabolic‐renal diseases can negatively influence the vitamin D metabolic pathways, affecting ISRIB in vivo 25(OH)vitD levels.17 In the present sample, patients

with underlying disease had lower levels of 25(OH)vitD. These patients are at a higher risk for reduced vitamin D levels through abnormal diets, altered metabolism, or reduced environmental exposure. Vitamin D deficiency has recently been shown to be associated with mortality in critically ill adults.11, 12, 13, 24 and 25 Other recent investigations have not observed this relationship.26 and 27 Considering that the present study was not sufficiently powered to observe differences in survival, other surrogate markers of PICU outcome were used, such as mortality scores. In accordance with Rippel et al.,14 no associations were observed between vitamin D status and predicted PRISM III and PIM 2 mortality. However, Madden et al.15 and McNally et al.16 demonstrated that 25(OH)vit D levels at admission were inversely associated with PRISM III in North American children. Furthermore, duration of mechanical or non‐invasive ventilation and length of PICU stay did not show differences between low and normal 25(OH)vitD groups in the present sample, in agreement with the data observed by Rippel et al.14 in Australian children. However, McNally et al.16 found an association of vitamin D deficiency with longer length of stay.

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