Correlation Between Vitamin D Status And Immune Function Of Children With Community Acquired Pneumonia

Objectives To explorer the correlation between the vitamin D status and immune functions,inflammation index and the length of hospital stay of children with community-acquired pneumonia.MethodsA retrospective observational study was performed.1.Totally 367 children with CAP aged from 29 days to 16 years old were enrolled in the study from January 2011 to December 2012.The levels of serum25(OH)D,IgG,IgA,IgM,CD3,CD4,CD8,CD4/CD8,CDI9,Thl,Th2,Thl 7,WBC,CRP and PCT were measured within 24-48 hours on the day of hospitalization.The length of hospital stay of patients included in the study were recorded.2.According to the serum level of 25(OH)D,the children with CAP were divided into adequate group,inadequate group,deficiency group,and severe deficiency group.3.The difference of immunological indexes among the different groups were analyzed and the relationship between the serum 25(OH)D level and immunological index were evaluated.4.The difference of the index of inflammation and the length of hospital stay were analyzed.Results1.A total of 367 children were included in the study,mean age was 3.5 ±3.3 years old,male 244 cases,female 123 cases.2.The median(Q25,Q75)of serum 25(OH)D levels of adequate group,inadequate group,deficiency group and severe deficiency group were 35.0(36.6,40.3)ng/ml,24.5(24.0,25.1)ng/ml,14.8(14.2,15.2)ng/ml and 7.0(6.3,7.4)ng/ml respectively.3.The CD 19 of adequate group,inadequate group,deficiency group and severe deficiency group were 25.5± 11,7%,24.2± 10.8%,22,3± 12.3%and 20.5± 12.5%respectively.The general difference among 4 groups were found.The CD 19 of severe deficiency group was lower than adequate group,p<0.05.The CD3 of adequate group,inadequate group,deficiency group and severe deficiency group were 63.7± 11.5%,63.5± 13.0%,66.6± 12.5%and 66.7 ± 15.7%respectively,the general difference among 4 groups were found.The CD3 of severe deficiency group was higher than adequate group,p<0.05.The Th17 of adequate group,inadequate group,deficiency group and severe deficiency group were 0.4±0.4%,0.4 ±0.3%,0.6 ±0.5%and 0.7 ±0.8%respectively,the general difference among 4 groups were found.The Th17of deficiency group and severe deficiency group were were higher than adequate group,p<0.01 and p<0.05.No significant differences were found in other immunological index.4.The CRP of adequate group,inadequate group,deficiency group and severe deficiency group were 22.1 ±35.4mg/L,23.9±38.2mg/L 37.9±56.2mg/L and 50.6±71.0mg/L respectively.The general difference among 4 groups were found.The CRP of severe deficiency group was higher than the other three groups,all p<0.05.The PCT of adequate group,inadequate group,deficiency group and severe deficiency group were 0.6±0.9ng/dl,1.9±3.8ng/dl,1.6±3.6ng/dl.8.8±33.9dg/ml respectively.The PCT of severe deficiency group was higher than the other three groups,all p<0.05.5.The average length of hospital stay of severe deficiency group was longer than adequate group(12.5 ± 7.2 days vs 9.4 ±5.6 days),P<0.001.Conclusions1.The CD 19 of severe deficiency group was lower than adequate group,the CD3 of severe deficiency group was higher than adequate group.2.Th17 of severe deficiency group and deficiency group were higher than adequate group.3.The CRP and PCT of severe deficiency group were higher than the other three groups.4.The length of hospital stay of severe deficiency group was longer than adequate group.