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Vitamin D and Risk of Respiratory Tract Infections in Children: A Systematic Review and Meta-analysis of Randomized Controlled Trials

비타민 D와 소아 호흡기 감염의 위험성: 무작위 대조 연구에 대한 체계적 문헌고찰 및 메타분석

  • Ahn, Jong Gyun (Department of Pediatrics, Ewha Medical Research Institute, Ewha Womans University School of Medicine) ;
  • Lee, Dokyung (Department of Pediatrics, Ewha Medical Research Institute, Ewha Womans University School of Medicine) ;
  • Kim, Kyung-Hyo (Department of Pediatrics, Ewha Medical Research Institute, Ewha Womans University School of Medicine)
  • 안종균 (이화여자대학교 의과대학 소아과학교실) ;
  • 이도경 (이화여자대학교 의과대학 소아과학교실) ;
  • 김경효 (이화여자대학교 의과대학 소아과학교실)
  • Received : 2015.11.04
  • Accepted : 2016.04.05
  • Published : 2016.08.25

Abstract

Purpose: Recent observational studies have found that vitamin D deficiency is associated with respiratory tract infections. However, randomized controlled trials (RCTs) regarding the efficacy of vitamin D in childhood respiratory tract infection (RTI) have yield inconsistent results. We performed a systematic review and meta-analysis to evaluate the association between vitamin D supplementation and the risk of RTI. Methods: A comprehensive search was conducted using MEDLINE, EMBASE, and the Cochrane Central Register of Controlled Trial. Randomized controlled trials of vitamin D supplementation for prevention of RTI in children were included for the analysis. Cochrane Collaboration's tool for assessing the risk of bias was used to assess the quality of the studies. Pooled risk ratios with 95% confidence intervals (CIs) were meta-analyzed using Review Manager 5.3. Results: A total of seven RCTs were included in the meta-analysis. According to a random-effects model, the risk ratio for vitamin D supplementation was 0.82 (95% CI: 0.69-0.98) and $I^2=62%$ for heterogeneity. On subgroup analysis, heterogeneity decreased in the subgroup with follow-up less than 1 year, participants ${\geq}5years$ of age, patients subgroup, and subgroup with dosing daily. Funnel plot showed that there might be publication bias in the field. Conclusions: The present meta-analysis supports a beneficial effect of vitamin D supplementation for the prevention of RTI in children. However, the result should be interpreted with caution due to limitations including a small number of available RCTs, heterogeneity among the studies, and potential publication bias.

Acknowledgement

Supported by : 대한소아감염학회

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