Long-term vitamin D insufficiency and associated risk factors for paediatric burns patients
Donna Langley,
Pawel Sadowski,
Zoe Dettrick,
Giorgio Stefanutti,
Roy Kimble,
Craig Munns,
Tuo Zang,
Andrew J.A. Holland,
Mark W. Fear,
Lisa J. Martin,
Fiona M. Wood,
Leila Cuttle
Affiliations
Donna Langley
School of Biomedical Sciences, Faculty of Health, Queensland University of Technology (QUT), Centre for Children’s Health Research, South Brisbane, Queensland, Australia; Corresponding author at: Queensland University of Technology, Centre for Children’s Health Research, 62 Graham St, South Brisbane, Queensland, Australia.
Pawel Sadowski
Central Analytical Research Facility (CARF), Queensland University of Technology (QUT), Brisbane, Queensland, Australia
Zoe Dettrick
Research Methods Group, Faculty of Health, Queensland University of Technology (QUT), Brisbane, Queensland, Australia
Giorgio Stefanutti
Department of Paediatric Surgery, Urology, Burns and Trauma, Children’s Health Queensland, Queensland Children’s Hospital, South Brisbane, Queensland, Australia
Roy Kimble
Department of Paediatric Surgery, Urology, Burns and Trauma, Children’s Health Queensland, Queensland Children’s Hospital, South Brisbane, Queensland, Australia; The University of Queensland, Faculty of Medicine, Centre for Children’s Health Research, South Brisbane, Queensland, Australia
Craig Munns
The University of Queensland, Faculty of Medicine, Centre for Children’s Health Research, South Brisbane, Queensland, Australia
Tuo Zang
School of Biomedical Sciences, Faculty of Health, Queensland University of Technology (QUT), Centre for Children’s Health Research, South Brisbane, Queensland, Australia
Andrew J.A. Holland
The Children’s Hospital at Westmead Burns Unit, Kids Research Institute, Department of Paediatrics and Child Health, Sydney Medical School, The University of Sydney, New South Wales, Australia
Mark W. Fear
Burn Injury Research Unit, School of Biomedical Sciences, The University of Western Australia, Perth, WA, Australia
Lisa J. Martin
Burn Injury Research Unit, School of Biomedical Sciences, The University of Western Australia, Perth, WA, Australia; Burns Service of Western Australia, Perth Children’s Hospital and Fiona Stanley Hospital, Perth, WA, Australia
Fiona M. Wood
Burn Injury Research Unit, School of Biomedical Sciences, The University of Western Australia, Perth, WA, Australia; Burns Service of Western Australia, Perth Children’s Hospital and Fiona Stanley Hospital, Perth, WA, Australia
Leila Cuttle
School of Biomedical Sciences, Faculty of Health, Queensland University of Technology (QUT), Centre for Children’s Health Research, South Brisbane, Queensland, Australia
The most recognised role of vitamin D in the body is for calcium absorption, and sufficiency is defined as a vitamin D blood serum level greater than 20 ng/mL (50 nmol/L). In growing children, hypovitaminosis D is associated with bone and muscle weakness, fractures, and osteoporosis. Burns patients are at a greater risk of low vitamin D levels due to lack of ultraviolet rays reaching the skin during prolonged hospital admission and sun avoidance post-burn injury. This study aimed to identify any individual, seasonal or burn injury characteristics in paediatric patients that were associated with low total vitamin D levels. Three different vitamin D metabolites were analysed to identify if, and where, in the synthesis pathway any insufficiencies may be occurring. Liquid Chromatography Mass Spectrometry (LCMS) was used to concurrently assess vitamin D3 (25OHD3 or Calcifediol), its epimer (3epi-25(OH)D3), and its precursor Pre Vitamin D3 (Cholecalciferol), in the plasma from 193 Australian paediatric burn patients, compared to 46 healthy controls. The results indicated that 61 % of healthy controls and up to 76 % of all burn patients had below normal clinical ranges of Total 25OHD3 (25(OH)D3 + 3epi-25(OH)D3). However, there were no significant differences between patient groups (control, acute, scarring, and reconstructive). The season of sample collection contributed significantly to total vitamin D levels but patients who were undergoing reconstructive surgery 1–17 years post-burn had consistently low vitamin D levels across all seasons. Routine screening, dietary monitoring, and potential supplementation of vitamin D in the burns population is recommended as it may impact recovery, growth and development of the child post-burn.
