Vitamin D status at birth and acute respiratory infection hospitalisation during infancy

The Role of Vitamins in the Pathogenesis of Asthma

Vitamins play a crucial role in the proper functioning of organisms. Disturbances of their levels, seen as deficiency or excess, enhance the development of various diseases, including those of the cardiovascular, immune, or respiratory systems. The present paper aims to summarize the role of vitamins in one of the most common diseases of the respiratory system, asthma. This narrative review describes the influence of vitamins on asthma and its main symptoms such as bronchial hyperreactivity, airway inflammation, oxidative stress, and airway remodeling, as well as the correlation between vitamin intake and levels and the risk of asthma in both pre- and postnatal life.

Vitamin D supplementation and hospitalization for infection in older adults: A post-hoc analysis of data from the Australian D-Health Trial

BACKGROUND

Evidence suggests that vitamin D influences the immune system. Recent studies indicate that vitamin D supplementation may reduce the severity of infections, but this has not been confirmed.

OBJECTIVES

The objective of this study was to assess the effect of vitamin D supplementation on hospitalization for infection.

METHODS

The D-Health Trial was a randomized, double-blind, placebo-controlled trial of monthly 60,000 international units of vitamin D₃ for 5 y among 21,315 Australians aged 60-84 y. Hospitalization for infection, ascertained through linkage with hospital admitted patient data, is a tertiary outcome of the trial. The primary outcome for this post-hoc analysis was hospitalization for any infection. Secondary outcomes were extended hospitalization for infection (length of stay >3 d and >6 d) and hospitalization for respiratory tract, skin, and gastrointestinal infections. We used negative binomial regression to estimate the effect of vitamin D supplementation on outcomes.

RESULTS

Participants (46% women, mean age: 69 y), were followed up for a median of 5 y. Vitamin D supplementation had little or no effect on the incidence of hospitalization for any infection [incidence rate ratio (IRR): 0.95; 95% CI: 0.86, 1.05], respiratory tract (IRR: 0.93; 95% CI: 0.81, 1.08), skin (IRR: 0.95; 95% CI: 0.76, 1.20), gastrointestinal infections (IRR: 1.03; 95% CI: 0.84, 1.26), or hospitalizations lasting >3 d (IRR: 0.94; 95% CI: 0.81, 1.09), with all CIs consistent with a null finding. People supplemented with vitamin D had fewer hospitalizations lasting >6 d (IRR: 0.80; 95% CI: 0.65, 0.99).

CONCLUSIONS

We did not find a protective effect of vitamin D on hospitalization for infection, but it reduced the number of extended hospitalizations. In populations where few people are vitamin D deficient, the effect of population-wide supplementation is likely to be small, but these findings support previous studies suggesting that vitamin D plays a role in infectious disease. The D-Health Trial is registered at the Australian New Zealand Clinical Trials Registry as ACTRN12613000743763.

Dental Consequences of Vitamin D Deficiency during Pregnancy and Early Infancy-An Observational Study

Vitamin D (25OHD) status during pregnancy is closely correlated with foetal and new-born 25OHD. Calcification for primary teeth begins from the fourth month of intrauterine life and from birth for permanent teeth. Dental consequences of severe 25OHD deficiency are well documented; however, consequences are less documented for milder degrees of 25OHD deficiency. This study examined the dental consequences of vitamin D deficiency/insufficiency during gestation and infancy in a cohort of 81 New Zealand children. Pregnancy and birth data for the children and their mothers and 25OHD status during gestation, birth and at five months were obtained, and dental examinations were conducted. Associations between 25OHD and enamel defects or caries experience were investigated. Of the 81 children, 55% had experienced dental caries and 64% had at least one enamel defect present. Vitamin D insufficiency (25OHD < 50 nmol/L) at all timepoints was not associated with enamel defect prevalence, but during third trimester pregnancy it was associated with an increased caries risk IRR of 3.55 (CI 1.15–10.92) by age 6. In conclusion, maternal 25OHD insufficiency during the third trimester of pregnancy was associated with greater caries experience in primary dentition. No association was found between early life 25OHD and enamel defect prevalence or severity.