Hafsa Bashir, Muhammad Omar Malik, Sabahat Amir, Habiba Ahmad, Syed Kaleem-ur Rehman.
Effect of oral vitamin D3 on thymic index in malnourished children.
J Med Sci Jan ;32(1):59-64.

Objectives: To compare the thymic Index, vitamin D3 level, and T cell receptor excision circle (TREC) of healthy and malnourished infants. To evaluate the effect of oral vitamin D3 supplementation on the Thymic Index and TREC in malnourished children. Material and Methods: This quasi-experimental study (non-equivalent control group design) included 44 infants within the age range of 2 to 6 months. The cases were 22 malnourished infants, and 22 were healthy infants (controls) based on WHO Z scores classification (weight for length). Weight, age, thymic Index (TI), Vitamin D levels, and TRECs were recorded for cases and controls(pre-test). The cases were given Vitamin D supplementation for 8 weeks. The weight for length (z-score), thymic Index (TI), vitamin D levels, and TRECs were checked in these malnourished children on follow-up (post-test). Thymic Index (TI) was checked by ultrasonography (length multiplied by breadth). ELISA was performed to check Vitamin D levels and RT-PCR was done to compare TRECs. Results: The malnourished infants had a mean thymic index of 8.015 +-3.2192 as compared to controls of 11.667 +-3.2730. Post Vit D supplementation TI increased (8.459 +-3.2191) in cases. Weight, length, and Z scores were found to be directly related to TI values. Pre and Post supplementation TI were strongly correlated to each other (r= 0.985, p= <0.001). The thymic index increased significantly (p= 0.001) after intervention. There was a statistically non-significant rise in TRECS (809 vs 4242) (p= 0.075) after vitamin D supplementation. The Pearson Correlation showed no significant correlation of TRECS to any of the variables including the Thymic index. Conclusion: TI (thymic size) and vitamin D levels increase with vitamin D supplementation in malnourished children. However, Vitamin D supplementation has no significant effect on TRECS.

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