Study On The Relationship Between Vitamin A,D,K Levels And Recurrent Respiratory Tract Infection

Objective:To study the serum levels and clinical significance of vitamin A,D and K in children with recurrent respiratory tract infection;to observe the distribution rule of vitamin A,D and K in children with recurrent respiratory tract infection;to explore the correlation between vitamin A,D and K levels and recurrent respiratory tract infection in TCM,and further lung,spleen and kidney,in order to provide a new theoretical basis for the study of the etiology of recurrent respiratory tract infection,and also provides new ideas for clinical prevention and treatment of the disease.Methods:A total of 201 children with recurrent respiratory tract infection(RRTI)aged 3-7 years who visited the Department of Pediatrics of the Second Affiliated Hospital of Shandong University of Traditional Chinese Medicine from January 2020 to December2021 were selected as the study subjects.The relevant clinical symptom data of the children were collected and TCM syndrome diferentiation was performed.At the same time,49 children without RRTI of the same age group at the same time were included as the control group.Serum vitamin A,D,and K levels were measured by HPLC and LC-MS techniques in the included children.To compare the levels and deficiency rate of vitamin A,D and K in children with RRTI and children without RRTI;to compare the levels and deficiency rate of vitamin A,D and K in children with common RRTI TCM syndrome types,and to explore the correlation between vitamin A,D and K and TCM syndrome,then to divide the children with RRTI in deficiency into three groups: lung deficiency,spleen deficiency and kidney deficiency,and then to explore the correlation between vitamin A,D and K and the lung,spleen and kidney.The data were statistically analyzed using the statistical software SPSS 23.0.Results:1.Comparison of vitamin A,D,and K levels and deficiency rates between children with RRTI and children without RRTI: vitamin A and D levels in the RRTI group were lower than those in the non-RRTI group(P < 0.05),and there was no significant difference in vitamin K levels between the two groups(P > 0.05);the detection rates of vitamin A,D,and K deficiency in the RRTI group were higher than those in the non-RRTI group,separately vitamin A deficiency:(51.19% vs.32.61%),vitamin D deficiency:(38.00%vs.18.37%),and vitamin K deficiency:(43.35% vs.25.00%)(all P < 0.05).2.Correlation between serum vitamin A,D,K levels and RRTI TCM syndrome type: 1)Distribution of RRTI TCM: lung and spleen qi deficiency syndrome(39.30%)> spleen and kidney deficiency syndrome(22.39%)> gastrointestinal accumulation heat syndrome(21.39%)> Ying Wei imbalance syndrome(8.96%)> lung and spleen qi yin deficiency syndrome(7.96%),of which lung and spleen qi deficiency syndrome,spleen and kidney deficiency syndrome and gastrointestinal accumulation heat syndrome are common.2)Comparison of vitamin A,D and K levels in children with RRTI: vitamin A levels from low to high were in lung and spleen qi deficiency type,spleen and kidney deficiency type,and gastrointestinal accumulation heat type;vitamin D levels from low to high were in spleen and kidney deficiency type,lung and spleen qi deficiency type,and gastrointestinal accumulation heat type;vitamin K levels from low to high were in gastrointestinal accumulation heat type,lung and spleen qi deficiency type,and spleen and kidney deficiency type,and the differences were statistically significant(all P < 0.05).3)Comparison of the detection rates of vitamin A,D and K deficiency in children with RRTI:the vitamin A deficiency rates from high to low were in lung and spleen qi deficiency type(65.15%),spleen and kidney deficiency type(45.71%),and gastrointestinal accumulation fever type(35.00%);the vitamin D deficiency rates from high to low were in spleen and kidney deficiency type(62.22%),lung and spleen qi deficiency type(34.62%),and gastrointestinal accumulation fever type(32.60%);the vitamin K deficiency rates from high to low were in gastrointestinal accumulation fever type(65.63%),spleen and kidney deficiency type(45.45%),and lung and spleen qi deficiency type(39.44%),and the differences were statistically significant(all P < 0.05).4)Correlation between vitamin A,D,K levels and TCM: The results of logistics regression analysis showed that serum vitamin A levels were negatively correlated with the incidence of RRTI(lung and spleen qi deficiency syndrome),serum vitamin D levels were negatively correlated with the incidence of RRTI(spleen and kidney yang deficiency syndrome),and serum vitamin K levels were negatively correlated with the incidence of RRTI(gastrointestinal accumulation heat syndrome).3.The correlation between serum vitamin A,D,and K levels and lung,spleen and kidney: Children with RRTI(lung and spleen qi deficiency syndrome,spleen and kidney yang deficiency syndrome)were divided into three groups: lung deficiency,spleen deficiency,and kidney deficiency,and logistics regression analysis showed that,serum vitamin D levels were negatively correlated with the incidence of kidney deficiency(P <0.05).4.Correlation between serum vitamin A,D and K: Pearson correlation analysis showed that there was a positive correlation between serum vitamin A and vitamin D in children with RRTI(correlation coefficient r = 0.342,P < 0.01);and there was no correlation between serum vitamin A,vitamin D and vitamin K in children without RRTI(P > 0.05).Conclusion: 1.The serum levels of vitamin A and D in children with RRTI were significantly lower than those without RRTI,and the detection rates of vitamin A,D and K deficiency were higher than those in children without RRTI.2.According to the distribution of RRTI in TCM syndrome types,it can be seen that lung and spleen qi deficiency type,spleen and kidney deficiency type,gastrointestinal accumulation heat type are common.3.There are differences in vitamin A,D,K levels and deficiency detection rate among the three common types of RRTI;and serum vitamin A levels are correlated with RRTI(lung and spleen qi deficiency syndrome),serum vitamin D levels are correlated with RRTI(spleen and kidney yang deficiency syndrome),and serum vitamin K levels are correlated with RRTI(gastrointestinal accumulation heat syndrome).4.To study the correlation between vitamin levels and the three viscera of the lung,spleen,and kidney,it can be seen that serum vitamin D levels are associated with the incidence of kidney deficiency.5.There was a positive correlation between serum vitamin A levels and vitamin D levels in laboratory parameters of children with RRTI.