25(OH)D and 1,25(OH)D vitamin D fails to predict sepsis and mortality in a prospective cohort study

Ratzinger, Franz; Haslacher, Helmuth; Stadlberger, Markus; Schmidt, Ralf; Obermüller, Markus; Schmetterer, Klaus G.; Perkmann, Thomas; Makristathis, Athanasios; Marculescu, Rodrig; Burgmann, Heinz

doi:10.1038/srep40646

Cited by 20 publications

(18 citation statements)

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“…Serum 25(OH)D was less than 20ng/mL in 1,233 of 1,745 samples (70.7%), and 8.0% (139 of 1,745 samples) showed even less than 10 ng/mL which is characterized as severe vitamin D deficiency. Consistent with previous reports, there was a clear seasonal change with a peak at the end of summer and a trough in early spring[18] (Fig 3), both in allergic and non-allergic pregnant women (S1 and S2 Figs). The median level of serum 25(OH)D in each season was 15, 14, 19, and 20 ng/mL in winter (Dec-Feb), spring (Mar-May), summer (Jul-Aug) and autumn (Sep-Nov), respectively.…”

Section: Resultssupporting

confidence: 91%

Association between vitamin D deficiency and allergic symptom in pregnant women

et al. 2019

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Background Vitamin D has been reported to affect both innate, and acquired immunity with immune cells such as dendritic cells having the vitamin D receptors. The co-occurrence of the high prevalence of allergic diseases and vitamin D deficiency globally documented in recent decades, has prompted a hypothesis on whether there is a reasonable association between them. Objective To investigate the association between serum vitamin D deficiency and allergic symptoms. Methods Historical cohort. On a cohort study for the association between desert dust exposure and allergic symptoms in 3,327 pregnant women during spring and fall in 2011–2013 in Japan conducted as an adjunct study to the Japan Environment and Children’s Study, we promptly acquired subjects’ daily allergic symptom scores by sending a web-based questionnaire to each participant on some days. Of the 29,434 answers provided by 3,327 participating pregnant women, we extracted 13,356 answers from 1,475 pregnant women that were answered within a 3-month period after blood samplings. And we measured 25(OH)D levels on those samples to investigate the association between their vitamin D deficiency (serum 25(OH)D < 20ng/mL) and the occurrence of any allergic symptom (allergic symptom score> 0) within 3 months. Results Serum 25(OH)D was less than 20ng/mL in 1,233 of 1,745 samples (70.7%). The adjusted odds ratio (aOR) for occurrence of any allergic symptom in deficient cases compared with non-deficient cases was 1.33 (95% CI: 1.07–1.64, p = 0.01). Further, vitamin D deficiency significantly enhanced the risk increase at desert dust events and at pollen exposure (p-values for interaction <0.1). Conclusion We confirmed the association between serum vitamin D deficiency and allergic symptoms in Japanese pregnant women.

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Section: Resultssupporting

confidence: 91%

Association between vitamin D deficiency and allergic symptom in pregnant women

et al. 2019

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“…Researchers have reported that low plasma 25(OH)D at admission predicts unfavorable outcomes such as need for mechanical ventilation (Ardehali et al, 2018;Ebenezer et al, 2016), organ failure (Braun et al, 2011) Lucidarme et al, 2010), systemic bloodstream infection (Amrein et al, 2014;Braun et al, 2011), ICU-AI (Ebenezer et al, 2016;Quraishi et al, 2013), VAP (De Pascale et al, 2016;Vassiliou et al, 2018), and all-cause mortality (Braun et al, 2011;Moraes et al, 2015;Moromizato et al, 2014) in critically ill patients. However, others studies have shown no significant association of plasma 25(OH)D with unfavorable outcomes such as organ failure (Ala-Kokko et al, 2016), septic shock (Ratzinger et al, 2017;Shojaei et al, 2019), acute/severe sepsis (Ala-Kokko et al, 2016), systemic bloodstream infection (Moraes et al, 2015), ICU-AI (Ala-Kokko et al, 2016;Flynn et al, 2012;Kempker et al, 2015;Vosoughi et al, 2016), VAP (Flynn et al, 2012), and all-cause mortality (Alizadeh et al, 2015;Barnett et al, 2014;Cecchi et al, 2011;Kempker et al, 2015;Kvaran et al, 2016;Ratzinger et al, 2017;Vassiliou et al, 2018;Vosoughi et al, 2016) in critically ill patients. Likewise, researchers have reported that length of stay was (Alizadeh et al, 2015;Amrein et al, 2014;Ardehali et al, 2018;Ebenezer et al, 2016)…”

Section: Discussionmentioning

confidence: 99%

Plasma 25-Hydroxyvitamin D Level at Admission Predicts Unfavorable Outcome in Intensive Care Unit Patients

Maamer

Trifi

Fradj

et al. 2020

Biological Research For Nursing

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Introduction: Patients in intensive care units (ICUs) are at high risk of unfavorable outcomes. Considering the role of vitamin D (Vit D) in cardiovascular and immune functions, Vit D deficiency could affect ICU patients’ outcomes. This study aimed to evaluate Vit D status and its predictive value for outcome in ICU patients. Patients and Methods: A total of 169 ICU patients were followed during ICU stay. Primary outcome was the occurrence of at least one major adverse event; secondary outcomes were organ failure, septic shock, ICU-acquired infection, other adverse events, and ICU mortality. Plasma 25-hydroxyvitamin D (25(OH)D) was assessed by immunoassay. Multivariate Cox regression analyses were performed to test the associations of low 25(OH)D levels with poor outcomes. Results: Around 75% of patients had 25(OH)D levels <12 ng/ml. During their ICU stay, 114 patients experienced a major adverse event, 85 patients presented an ICU-acquired infection, and 22 patients died. Plasma 25(OH)D levels <12 ng/ml were associated with higher risk of major adverse events, Hazard ratio [95% CI], 4.47 [1.77, 11.3], p = .020, and ICU-acquired infection, 2.67 [1.01, 7.42], p = .049, but not with increased risk of ICU mortality. Conclusions: Hypovitaminosis D is very common in ICU patients. Results of the present study show that low plasma 25(OH)D levels are associated with increased risk of unfavorable outcomes in these patients. Additional research is needed to investigate the impact of Vit D status and effect of Vit D supplementation in ICU patients.

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“…In contrary to our results, Gokhanet et al [ 29 ] reported that high serum 25-OH vitamin D levels are associated with pediatric sepsis, and this difference may be due to the age group and the different sample size. In addition, Ratzinger et al [ 30 ] reported that 1,25-OH D but not 25-OH D can predict bacteraemia and both of them failed to predict sepsis and mortality in a prospective cohort study, but this difference between our results and Ratzinger’s may be attributed to the age group of patients, as all of Ratzinger’s patients were above 41 years old, the different types of infections recruited in his study (respiratory, gastrointestinal (GIT), urological and central nervous system (CNS) infections), and, lastly, the methodology and the time for assay of vitamin D levels.…”

Section: Discussionmentioning

confidence: 99%

Neonatal and Maternal 25-OH Vitamin D Serum Levels in Neonates with Early-Onset Sepsis

et al. 2017

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Vitamin D is a fat-soluble vitamin that is important for calcium metabolism and plays an important role in the immune functions. The aim of this study was to measure neonatal and maternal 25-OH vitamin D serum levels in neonates with early onset sepsis. The study included fifty neonates with early onset sepsis (25 full-term and 25 preterm infants) and thirty age and sex matched healthy neonates as controls. After history taking and clinical examination, complete blood count, C-reactive protein and 25-OH vitamin D serum levels (neonatal and maternal) were measured for all neonates. The mean gestational age for neonates with sepsis was (37.5 ± 0.98 for full term and 34.1 ± 1.26 for preterm neonates). Neonatal and maternal 25-OH vitamin D serum levels were significantly lower in patients (6.4 ± 1.8 and 24.6 ± 2.2 nmol/L) than controls (42.5 ± 20.7 and 50.4 ± 21.4 nmol/L). Significant negative correlations between neonatal and maternal 25-OH vitamin D serum levels and all sepsis markers and significant positive correlations between neonatal and maternal 25-OH vitamin D levels were present. At cut-off values <20 nmol/L for neonatal and <42 nmol/L for maternal 25-OH vitamin D for detection of neonatal sepsis, the sensitivity, specificity, positive predicted value (PPV) and negative predicted value (NPV) were 84%, 79%, 94.7% and 82.3% for neonatal and 82%, 77%, 91.4% and 80.6% for maternal 25-OH vitamin D, respectively. Positive correlations between neonatal and maternal 25-OH Vitamin D serum levels are present and they are negatively correlated with all sepsis markers. They can be sensitive early predictors for early onset sepsis in neonates.

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25(OH)D and 1,25(OH)D vitamin D fails to predict sepsis and mortality in a prospective cohort study

Cited by 20 publications

References 61 publications

Association between vitamin D deficiency and allergic symptom in pregnant women

Association between vitamin D deficiency and allergic symptom in pregnant women

Plasma 25-Hydroxyvitamin D Level at Admission Predicts Unfavorable Outcome in Intensive Care Unit Patients

Neonatal and Maternal 25-OH Vitamin D Serum Levels in Neonates with Early-Onset Sepsis

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