Low Serum Levels of Vitamins A, D, and E Are Associated with Recurrent Respiratory Tract Infections in Children Living in Northern China: A Case Control Study

Abstract

Background: This study aimed to investigate the association of serum concentrations of vitamin A, D, and E with recurrent respiratory tract infections (RRTIs).

Methods: A total of 1200 children aged at 0.5-14 years were selected via a face-to-face survey in Harbin, China. Among the participants, 600 children with RRTIs comprised the symptomatic group (RRTI group), whereas 600 healthy children were used as controls (control group). Blood samples were collected to measure serum levels of vitamins A and E by HPLC; the serum level of 25-hydroxycholecalciferol (25(OH)D), was measured by HPLC-MS/MS.

Results: Serum levels of vitamins A and E, as well as 25(OH)D, were significantly lower in the RRTI group than the control group. The conditional logistic regression model and the receiver-operating characteristic curve showed that the insufficiency or deficiency of vitamins A, D, and E was positively correlated with RRTI occurrence (p < 0.05).

Conclusions: Low serum concentrations of vitamins A, D, and E were associated with RRTIs in children from northern China.

Fig 1. ROC curve for the predictive model of RRTIs with serum levels of vitamin A, 25(OH)D, and vitamin E.

(a) Vitamin A, (b) 25(OH)D, and (c) vitamin E. The high level of agreement among the RRTIs and vitamin A, 25(OH)D, and vitamin E assays are indicated by the large AUC.