Vitamin D and Molecules Related to Vitamin D Metabolism in Children with Sepsis.

OBJECTIVE: This study aimed to evaluate the association between vitamin D and molecules related to vitamin D metabolism in children with sepsis. METHODS: A total of 98 hospitalized children with sepsis were included in this study. Blood samples were collected within the first 4 h of admission. Blood vitamin D; molecules related to vitamin D metabolism including vitamin-D-binding protein (VDBP), 7-dehydrocholesterol reductase (DHCR7), 25-hydroxylase (CYP2R1), 24-hydroxylase (CYP24A1), and cathelicidin (CATH); and other inflammatory markers including interleukin-6 (IL-6), procalcitonin (PCT), C-reactive protein (CRP), and white blood cell count (WBC) were measured. RESULTS: Of the enrolled children, 23.47% (23/98) were confirmed to have severe sepsis, and 10.20% (10/98) died. The prevalence of hypovitaminosis D was 46.94% (46/98) in the children with sepsis. Children with hypovitaminosis D had lower levels of CYP2R1 and CATH and higher levels of CYP24A1, PCT, and IL-6 compared to children with vitamin D sufficiency. Blood vitamin D level was positively correlated with blood VDBP, CYP2R1, and CATH and negatively correlated with CYP24A1, PCT, and IL-6. Blood vitamin D was not independently associated with severe sepsis and mortality, but it was independently associated with the requirement of intensive care unit (ICU) stay. CONCLUSION: Molecules related to vitamin D metabolism such as VDBP, CYP2R1, and CYP24A1 are involved in regulating the levels of circulating vitamin D. Children with sepsis had a high prevalence of hypovitaminosis D. Hypovitaminosis D was independently associated with the requirement of ICU stay in children with sepsis.