{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,28]],"date-time":"2026-10-28T00:57:24Z","timestamp":1793149044149,"version":"4.5.0"},"reference-count":22,"publisher":"American Medical Association (AMA)","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Otolaryngol Head Neck Surg"],"published-print":{"date-parts":[[2025,1,1]]},"abstract":"<jats:sec id=\"ab-ooi240082-4\"><jats:title>Importance<\/jats:title><jats:p>Prior research has demonstrated an association between vitamin D deficiency and obstructive sleep apnea (OSA) in adults; however, its association with pediatric OSA is emerging.<\/jats:p><\/jats:sec><jats:sec id=\"ab-ooi240082-5\"><jats:title>Objective<\/jats:title><jats:p>To evaluate the association of vitamin D levels with obstructive Apnea-Hypopnea Index (AHI) in children with OSA.<\/jats:p><\/jats:sec><jats:sec id=\"ab-ooi240082-6\"><jats:title>Design, Settings, and Participants<\/jats:title><jats:p>This was a cross-sectional study of children aged 2 to 16 years with severe obstructive OSA (AHI \u226520 on polysomnogram) who were undergoing adenotonsillectomy at a tertiary care pediatric otolaryngology clinic from 2017 to 2022. Age, sex, race, body mass index, history of asthma, and season were considered in the analyses. Data were analyzed from September 3, 2021, to October 8, 2021.<\/jats:p><\/jats:sec><jats:sec id=\"ab-ooi240082-7\"><jats:title>Main Outcomes and Measures<\/jats:title><jats:p>Serum 25-hydroxyvitamin D (25[OH]D) levels were measured and assessed for correlation with polysomnography metrics. Fasting blood samples were collected and vitamin D deficiency was defined as 25(OH)D level less than 20 ng\/mL.<\/jats:p><\/jats:sec><jats:sec id=\"ab-ooi240082-8\"><jats:title>Results<\/jats:title><jats:p>The consecutive sample included 72 patients (mean [SD] age, 6.7 [3.9] years; 34 [47.2%] females and 38 [52.8%] males). The mean (SD) AHI was 42.8 (25.5), and 35 participants (49.0%) had obesity. Vitamin D deficiency was present in 27 participants (37.5%). In univariate analysis, vitamin D deficiency was associated with younger age (difference,\u2009\u22125.0; 95% CI, \u22127.2 to \u22122.8), Black race (odds ratio [OR], 4.3; 95% CI, 1.4 to 14.3), female sex (OR, 4.8; 95% CI, 1.7 to 12.5), and higher obstructive AHI (difference,\u200913.8; 95% CI, 1.2 to 26.4). In multivariable analysis, vitamin D deficiency remained significantly associated with AHI. A 1.0-unit decrease in serum 25(OH)D levels was associated with an AHI increase of 0.7 (95% CI, 0.04 to 1.40).<\/jats:p><\/jats:sec><jats:sec id=\"ab-ooi240082-9\"><jats:title>Conclusions<\/jats:title><jats:p>The findings of this cross-sectional study indicate that vitamin D deficiency was common in children undergoing adenotonsillectomy for severe OSA and is significantly associated with increased OSA severity. Future research is needed on vitamin D supplementation and its association with any improvements in pediatric OSA treatment outcomes.<\/jats:p><\/jats:sec>","DOI":"10.1001\/jamaoto.2024.3737","type":"journal-article","created":{"date-parts":[[2024,10,31]],"date-time":"2024-10-31T15:33:09Z","timestamp":1730388789000},"page":"72","source":"Crossref","is-referenced-by-count":11,"title":["Vitamin D Deficiency and Pediatric Obstructive Sleep Apnea Severity"],"prefix":"10.1001","volume":"151","author":[{"given":"Andrew E.","family":"Bluher","sequence":"first","affiliation":[{"name":"Division of Pediatric Otolaryngology, Nemours Children\u2019s Hospital, Wilmington, Delaware"},{"name":"Department of Otolaryngology, Thomas Jefferson University, Philadelphia, Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Timothy","family":"Kearney","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, MedStar Health Georgetown University Hospital, Washington, DC"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Turaj","family":"Vazifedan","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Children\u2019s Hospital of The King\u2019s Daughters, Norfolk, Virginia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cristina M.","family":"Baldassari","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology, Eastern Virginia Medical School, Norfolk, Virginia"},{"name":"Division of Sleep Medicine, The Children\u2019s Hospital of The King\u2019s Daughters, Norfolk, Virginia"},{"name":"Deputy Editor, JAMA Otolaryngology\u2013Head & Neck Surgery"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"10","reference":[{"issue":"3","key":"ooi240082r1","doi-asserted-by":"publisher","first-page":"576","DOI":"10.1542\/peds.2012-1671","article-title":"Diagnosis and management of childhood obstructive sleep apnea syndrome.","volume":"130","author":"Marcus","year":"2012","journal-title":"Pediatrics"},{"issue":"3","key":"ooi240082r2","doi-asserted-by":"publisher","first-page":"265","DOI":"10.1016\/j.otohns.2007.11.003","article-title":"Pediatric obstructive sleep apnea and quality of life: a meta-analysis.","volume":"138","author":"Baldassari","year":"2008","journal-title":"Otolaryngol Head Neck Surg"},{"issue":"3","key":"ooi240082r3","doi-asserted-by":"publisher","first-page":"e714","DOI":"10.1542\/peds.2012-1672","article-title":"Diagnosis and management of childhood obstructive sleep apnea syndrome.","volume":"130","author":"Marcus","year":"2012","journal-title":"Pediatrics"},{"issue":"6","key":"ooi240082r4","doi-asserted-by":"publisher","first-page":"827","DOI":"10.1016\/j.otohns.2004.07.002","article-title":"Can history and physical examination reliably diagnose pediatric obstructive sleep apnea\/hypopnea syndrome? 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