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Neonatal Sepsis 4.8 X more likely if poor Vitamin D receptor – June 2018

Vitamin D deficiency and vitamin D receptor variants in mothers and their neonates are risk factors for neonatal sepsis

Steroids, Volume 134, June 2018, Pages 37-42, https://doi.org/10.1016/j.steroids.2018.03.003
I.TayelaShimaa E.Solimansa Hanan M.Elsayedb

Highlights
• Mothers of cases had significantly lower vitamin D levels compared with healthy ones.
• Neonatal septic cases had also significantly lower vitamin D level compared with healthy ones.
• VDR polymorphisms at FOKI showed that neonatal sepsis cases had significantly higher TT genotype and T allele.
•VDR polymorphism at TAQI CC and CT genotypes and C allele frequencies were predominant in cases
  however they were not significantly different versus healthy control.
•Also, a strong LD between FOKI and TAQI in cases, in control group and in total sample.

Background and aim
Increasing prevalence of neonatal sepsis in recent years catch attention to early prevention and management. Vitamin D receptor (VDR) polymorphism can modulate VDR expression level that greatly influences immunity and susceptibility to microbial infections. We aimed to investigate the association of VDR polymorphism at FokI, rs2228570 T/C, and TaqI, rs731236 C/T gene with serum 25-hydroxyvitamin D level and risk of neonatal sepsis.

Methods
This work carried on 160 subjects classified into 80 cases (40 mothers and their 40 septic neonates) and 80 healthy controls (40 volunteer mothers and their 40 healthy neonates). Genotyping of VDR polymorphisms were assayed by real-time PCR and serum 25-hydroxyvitamin D level and hs-CRP were measured by ELISA.

Results
Vitamin D deficiency was observed in mothers of cases compared with healthy ones (p = <0.001) and in septic neonates versus healthy ones (p = <0.001). Septic neonates had much higher VDR FokI TT genotype (p = 0.014) and T allele (p = 0.003) versus healthy ones.
TT genotype and T allele could increase the risk of sepsis with OR 95% CI 4.804 (1.4–16.4) and 2.786 (1.4–5.7) respectively while VDR TaqI showed no association with sepsis. There was a strong LD between FokI and TaqI in sepsis cases. In sepsis, T/T genotype at FokI had significantly lower vitamin D (p = <0.001).

Conclusion
Vitamin D deficiency in mothers/neonates is a risk factor for neonatal sepsis. VDR FokI T allele had lower 25-hydroxyvitamin D level that may predispose to sepsis hazards.

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