J Clin Res Pediatr Endocrinol. 2016; 8(3): 325-329 | DOI: 10.4274/jcrpe.2563

The Association between Serum 25-Hydroxy Vitamin D Level and Urine Cathelicidin in Children with a Urinary Tract Infection

Duygu Övünç Hacýhamdioðlu¹, Demet Altun², Bülent Hacýhamdioðlu¹, Ferhat Çekmez¹, Gökhan Aydemir¹, Mustafa Kul¹, Tuba Müftüoðlu³, Selami Süleymanoðlu¹, Ferhan Karademir^1
1Gülhane Military Medical Academy, Haydarpaþa Training And Research Hospital, Clinic Of Pediatrics, Ýstanbul, Turkey
²Etimesgut Military Hospital, Clinic Of Pediatrics, Ankara, Turkey
³Gülhane Military Medical Academy, Haydarpaþa Training And Research Hospital, Clinic Of Biochemistry, Ýstanbul, Turkey

Objective: Cathelicidin is an important antimicrobial peptide in the urinary tract. Cathelicidin expression is strongly stimulated by 1,25-dihydroxy vitamin D in epithelial cells, macrophages/monocytes, and neutrophils. Vitamin D and cathelicidin status in children with urinary tract infection (UTI) caused by Escherichia coli is unknown. To establish the relationship between serum vitamin D and urine cathelicidin levels in children with a UTI caused by Escherichia coli.
Methods: Serum 25-hydroxy vitamin D and urine cathelicidin levels were measured in 36 patients with UTI (mean age 6.8±3.6 years, range: 0.25-12.6 years) and 38 controls (mean age 6.3±2.8 years, range: 0.42-13 years).
Results: There were no significant differences in urine cathelicidin levels between the study and control groups (p>0.05). Eight (22.2%) patients in the study group and 21 (58.3%) children in the control group were found to have sufficient vitamin D (?20 ng/mL). Patients with sufficient vitamin D had higher urine cathelicidin levels than the controls with sufficient vitamin D (respectively 262.5±41.1 vs. 168±31.6 ng/mL, p=0.001). There were no significant differences between the patients and controls with insufficient vitamin D (p>0.05).
Conclusion: The children with vitamin D insufficiency may not be able to increase their urine cathelicidin level during UTI caused by Escherichia coli. There is a need of prospective studies in order to prove a beneficial effect of vitamin D supplementation for the restoration of cathelicidin stimulation and consequently for prevention of UTI recurrence.

Keywords: Urinary tract infection,Escherichia coli,children,Vitamin D,cathelicidin

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