Effects of Lactobacillus reuteri DSM 17938 and vitamin D combination on the level of 25(OH)D in blood serum of young children
Authors:   Shupyk National Medical Academy of Postgraduate Education, Kyiv, Ukraine, Mamenko M.E. , Romanko M.R. ,   Shupyk National Medical Academy of Postgraduate Education, Kyiv, Ukraine
Published: October 2020

Background. The search for optimal vitamin D levels and supplementation approaches to provide a wide range of preventive effects on the human body remains the focus of the world’s specialists. One of the promising directions is to improve the absorption of vitamin D in the gastrointestinal tract by using probiotics. Objective: to study the effect of using a combination of Lactobacillus reuteri DSM 17938 with vitamin D on the serum level of 25(OH)D in young children. Materials and methods. A total of 56 children from 1 to 36 months of age with the signs of functional gastrointestinal disorders were examined; 45 of them were randomized to participate in the comparative efficacy study of using a combination of 400 IU of cholecalciferol and 108 CFU of viable Lactobacillus reuteri DSM 17938 bacteria and an oily vitamin D solution at a dose of 500 IU for 12 weeks. At the start and the end of the study, the indicators of calcium and phosphorus metabolism (25(OH)D, total and ionized calcium, inorganic phosphorus, alkaline phosphatase) and the serum levels of total IgE were determined in all children, and the dynamics of the functional status of the gastrointestinal tract was assessed. Results. At baseline, the median serum concentration of 25(OH)D in children was 30.3 ng/mL (23.2–41.2); this indicator exceeded 30 ng/mL only in 53.3±7.4% (24/45) of cases. The use of a combination of vitamin D3 with Lactobacillus reuteri DSM 17938 made it possible to reach a statistical difference in the median concentration of 25(OH)D after 12 weeks of use compared to the same indicator at baseline: 37.4 ng/mL (30.2–52.3) versus 28.3 ng/mL (20.8–42.9), p=0.000. The level of 25(OH)D in all these children exceeded 20 ng/mL; the concentration level of 25(OH)D exceeded 30 ng/mL in 75.0±8.8% (18/24) of these. The use of 400 IU of vitamin D supplements in combination with L. reuteri for 12 weeks made it possible to reduce the median concentration of total IgE by almost half — from 64.1 IU/mL (9.2–120.0) to 31.9 IU/mL (6.4–143.6) but with significant individual variability of data. The use of vitamin D supplements in combination with Lactobacillus reuteri DSM 17938 had a positive effect on the functional activity of the gastrointestinal tract in young children and significantly reduced the frequency of parents’ complaints of stool retention and anxiety during defecation in their children. Conclusions. The use of vitamin D3 supplements at a dose of 400 IU in combination with the probiotic strain Lactobacillus reuteri DSM 17938 has a positive effect on the functional status of the gastrointestinal tract in young children and increases the serum level of 25(OH)D. The effects of vitamin D in combination with L. reuteri in children with a burdened history of allergies require further study. Key words: vitamin D; Lactobacillus reuteri DSM 17938; young children; supplementation.