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Association between vitamin D and urinary tract infection in children

  • Mahyar, Abolfazl (Qazvin Children Hospital, Qazvin University of Medical Sciences) ;
  • Ayazi, Parviz (Qazvin Children Hospital, Qazvin University of Medical Sciences) ;
  • Safari, Sara (Qazvin Children Hospital, Qazvin University of Medical Sciences) ;
  • Dalirani, Reza (Mofid Children Hospital, Pediatric Nephrology Department, Shahid Beheshti University of Medical Sciences) ;
  • Javadi, Amir (Statistic Department, Qazvin University of Medical Sciences) ;
  • Esmaeily, Shiva (Statistic Department, Qazvin University of Medical Sciences)
  • Received : 2017.09.14
  • Accepted : 2017.12.29
  • Published : 2018.03.15

Abstract

Purpose: The present study aimed to determine the relationship between serum 25-hydroxyvitamin D (25(OH)D) level and Urinary tract infections (UTIs) in children. Methods: In this case-control study, 70 children with UTI (case group) were compared with 70 healthy children (control group) in terms of serum 25(OH)D levels. The children were between 1 month and 12 years of age. Serum 25(OH)D levels were measured using enzyme-linked immunosorbent assay (ELISA). The results were analyzed and compared between both groups. Results: Among 70 children with UTI (case group), 5 children (7.2%) were male and 65 (92.8%) were female. Among the healthy children (control group), 9 (12.8%) and 61 children (87.2%) were male and female, respectively (P=0.39). The $mean{\pm}standard$ deviation of age in the case and control groups were $53.2{\pm}35.6$ and $36.1{\pm}60.2months$, respectively (P=0.24). The mean level of serum 25(OH)D in the case group was significantly higher than that of the control group ($20.4{\pm}8.6ng/mL$ vs. $16.9{\pm}7.4ng/mL$, P=0.01) Conclusion: This study showed that there was a relationship between serum 25(OH)D levels and UTI in children. It seems that 25(OH)D plays a role in the pathogenesis of UTI.

Keywords

References

  1. Elder JS. Urinary tract infections. In: Kliegman RM, Stanton BF, St. Geme JW III, Schor NF, Behrman RE, editors. Nelson textbook of pediatrics. 20th ed. Philadelphia (PA): Elsevier Saunders, 2016:2554-63.
  2. Bensman A, Dunand O, Ulinski T. Urinary tract infection. In: Avner ED, Harman WE, Niaudet P, Yoshikawa N, editors. Pediatric nephrology. 6th ed. Berlin: Springer, 2009:1007-25.
  3. Wald ER. Cystitis and pyelonephritis. In: Feigin RD, Cherry J, Demmler-Harrison GL, Kaplan SL, editors. Feigin and Cherry's text book of infectious diseases. 6th ed. Philadelphia (PA): Elsevier Saunders, 2009:554-69.
  4. Ayazi P, Mahyar A, Daneshi MM, Jahani Hashemi H, Pirouzi M, Esmailzadehha N. Comparison of procalcitonin and C-reactive protein tests in children with urinary tract infection. Iran J Pediatr 2009;19:381-6.
  5. Ayazi P, Moshiri SA, Mahyar A, Moradi M. The effect of vitamin A on renal damage following acute pyelonephritis in children. Eur J Pediatr 2011;170:347-50. https://doi.org/10.1007/s00431-010-1297-1
  6. Stokland E, Hellstrom M, Jacobsson B, Jodal U, Sixt R. Renal damage one year after first urinary tract infection: role of dimercaptosuccinic acid scintigraphy. J Pediatr 1996;129:815-20. https://doi.org/10.1016/S0022-3476(96)70024-0
  7. Rushton HG. Urinary tract infections in children. Epidemiology, evaluation, and management. Pediatr Clin North Am 1997;44:1133-69. https://doi.org/10.1016/S0031-3955(05)70551-4
  8. Leonardo CR, Filgueiras MF, Vasconcelos MM, Vasconcelos R, Marino VP, Pires C, et al. Risk factors for renal scarring in children and adolescents with lower urinary tract dysfunction. Pediatr Nephrol 2007;22:1891-6. https://doi.org/10.1007/s00467-007-0564-5
  9. Yang J, Chen G, Wang D, Chen M, Xing C, Wang B. Low serum 25-hydroxyvitamin D level and risk of urinary tract infection in infants. Medicine (Baltimore) 2016;95:e4137. https://doi.org/10.1097/MD.0000000000004137
  10. Jorde R, Sollid ST, Svartberg J, Joakimsen RM, Grimnes G, Hutchinson MY. Prevention of urinary tract infections with vitamin D supplementation 20,000 IU per week for five years. Results from an RCT including 511 subjects. Infect Dis (Lond) 2016;48:823-8. https://doi.org/10.1080/23744235.2016.1201853
  11. Katikaneni R, Ponnapakkam T, Ponnapakkam A, Gensure R. Breastfeeding does not protect against urinary tract infection in the first 3 months of life, but vitamin D supplementation increases the risk by 76%. Clin Pediatr (Phila) 2009;48:750-5. https://doi.org/10.1177/0009922809332588
  12. Guillot X, Semerano L, Saidenberg-Kermanac'h N, Falgarone G, Boissier MC. Vitamin D and inflammation. Joint Bone Spine 2010;77:552-7. https://doi.org/10.1016/j.jbspin.2010.09.018
  13. Holick MF. Vitamin D: extraskeletal health. Endocrinol Metab Clin North Am 2010;39:381-400. https://doi.org/10.1016/j.ecl.2010.02.016
  14. Lagishetty V, Liu NQ, Hewison M. Vitamin D metabolism and innate immunity. Mol Cell Endocrinol 2011;347:97-105. https://doi.org/10.1016/j.mce.2011.04.015
  15. Hewison M. Antibacterial effects of vitamin D. Nat Rev Endocrinol 2011;7:337-45. https://doi.org/10.1038/nrendo.2010.226
  16. Wilkinson RJ, Llewelyn M, Toossi Z, Patel P, Pasvol G, Lalvani A, et al. Influence of vitamin D deficiency and vitamin D receptor polymorphisms on tuberculosis among Gujarati Asians in west London: a case-control study. Lancet 2000;355:618-21. https://doi.org/10.1016/S0140-6736(99)02301-6
  17. Muhe L, Lulseged S, Mason KE, Simoes EA. Case-control study of the role of nutritional rickets in the risk of developing pneumonia in Ethiopian children. Lancet 1997;349:1801-4. https://doi.org/10.1016/S0140-6736(96)12098-5
  18. Laaksi I, Ruohola JP, Tuohimaa P, Auvinen A, Haataja R, Pihlajamaki H, et al. An association of serum vitamin D concentrations <40 nmol/L with acute respiratory tract infection in young Finnish men. Am J Clin Nutr 2007;86:714-7. https://doi.org/10.1093/ajcn/86.3.714
  19. McNally JD, Leis K, Matheson LA, Karuananyake C, Sankaran K, Rosenberg AM. Vitamin D deficiency in young children with severe acute lower respiratory infection. Pediatr Pulmonol 2009;44:981-8. https://doi.org/10.1002/ppul.21089
  20. Schluter P, Carter S, Kokaua J. Indices and perception of crowding in Pacific households domicile within Auckland, New Zealand: findings from the Pacific Islands Families Study. N Z Med J 2007;120:U2393.
  21. Holick MF. Vitamin D deficiency. N Engl J Med 2007;357:266-81. https://doi.org/10.1056/NEJMra070553
  22. Nseir W, Taha M, Nemarny H, Mograbi J. The association between serum levels of vitamin D and recurrent urinary tract infections in premenopausal women. Int J Infect Dis 2013;17:e1121-4. https://doi.org/10.1016/j.ijid.2013.06.007
  23. Nielsen KL, Dynesen P, Larsen P, Jakobsen L, Andersen PS, Frimodt-Moller N. Role of urinary cathelicidin LL-37 and human ${\beta}$-defensin 1 in uncomplicated Escherichia coli urinary tract infections. Infect Immun 2014;82:1572-8. https://doi.org/10.1128/IAI.01393-13
  24. Kwon YE, Kim H, Oh HJ, Park JT, Han SH, Ryu DR, et al. Vitamin D deficiency is an independent risk factor for urinary tract infections after renal transplants. Medicine (Baltimore) 2015;94:e594. https://doi.org/10.1097/MD.0000000000000594
  25. Tekin M, Konca C, Celik V, Almis H, Kahramaner Z, Erdemir A, et al. the association between vitamin D levels and urinary tract infection in children. Horm Res Paediatr 2015;83:198-203. https://doi.org/10.1159/000370046
  26. Ovunc Hacihamdioglu D, Altun D, Hacihamdioglu B, Cekmez F, Aydemir G, Kul M, et al. The association between serum 25-hydroxy vitamin D level and urine cathelicidin in children with a urinary tract infection. J Clin Res Pediatr Endocrinol 2016;8:325-9. https://doi.org/10.4274/jcrpe.2563
  27. Liu PT, Stenger S, Li H, Wenzel L, Tan BH, Krutzik SR, et al. Toll-like receptor triggering of a vitamin D-mediated human antimicrobial response. Science 2006;311:1770-3. https://doi.org/10.1126/science.1123933
  28. Wang TT, Nestel FP, Bourdeau V, Nagai Y, Wang Q, Liao J, et al. Cutting edge: 1,25-dihydroxyvitamin D3 is a direct inducer of antimicrobial peptide gene expression. J Immunol 2004;173:2909-12. https://doi.org/10.4049/jimmunol.173.5.2909
  29. Cantorna MT, Yu S, Bruce D. The paradoxical effects of vitamin D on type 1 mediated immunity. Mol Aspects Med 2008;29:369-75. https://doi.org/10.1016/j.mam.2008.04.004
  30. White JH. Vitamin D as an inducer of cathelicidin antimicrobial peptide expression: past, present and future. J Steroid Biochem Mol Biol 2010;121:234-8. https://doi.org/10.1016/j.jsbmb.2010.03.034
  31. Chromek M, Slamova Z, Bergman P, Kovacs L, Podracka L, Ehren I, et al. The antimicrobial peptide cathelicidin protects the urinary tract against invasive bacterial infection. Nat Med 2006;12:636-41. https://doi.org/10.1038/nm1407
  32. Lai Y, Gallo RL. AMPed up immunity: how antimicrobial peptides have multiple roles in immune defense. Trends Immunol 2009;30:131-41. https://doi.org/10.1016/j.it.2008.12.003
  33. Zasloff M. Antimicrobial peptides, innate immunity, and the normally sterile urinary tract. J Am Soc Nephrol 2007;18:2810-6. https://doi.org/10.1681/ASN.2007050611
  34. White JH. Vitamin D signaling, infectious diseases, and regulation of innate immunity. Infect Immun 2008;76:3837-43. https://doi.org/10.1128/IAI.00353-08
  35. Deluca HF, Cantorna MT. Vitamin D: its role and uses in immunology. FASEB J 2001;15:2579-85. https://doi.org/10.1096/fj.01-0433rev

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