Association between vitamin D status and sepsis in children: A meta-analysis of observational studies

Background: The consequences of vitamin D deficiency regarding sepsis in children remain controversial. We conducted a meta-analysis of studies evaluating the association between vitamin D status and sepsis in children. Methods: We used EMBASE, Ovid Medline and Cochrane Library to conduct a meta-analysis of studies published in English before November 21, 2017. Results: Among 1146 initially identified studies, we included 13 studies according to predefined inclusion criteria comprising 975 patients and 770 control participants. According to a random effects model, the mean difference in 25(OH)D levels (nmol/L) between participants with sepsis (444) and controls (528) was (mean difference, -18.55; 95% confidence interval (CI), -19.45 to -17.66, p < 0.05). The association between vitamin D deficiency and sepsis was significant, with an odds ratio (OR) = 1.13 (95% CI, 1.18 to 1.50, p < 0.05). Factors that could explain differences in the results include the study location/medical conditions, study design, 25(OH)D assay methods, diagnostic sepsis at different ages, diagnostic criteria for sepsis, and sepsis with comorbidities. Conclusions: The association between vitamin D deficiency/lower 25(OH)D levels and sepsis was significant in children and neonates. Further studies are required to confirm the results by considering more confounders. (C) 2019 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.