Effects of Vitamin D Deficiency on Sepsis

Hyeri Seok; Jiwoon Kim; Won Suk Choi; Dae Won Park

doi:10.3390/nu15204309

journal article Open Access Oct 10, 2023

Effects of Vitamin D Deficiency on Sepsis

Hyeri Seok

Jiwoon Kim Won Suk Choi

Dae Won Park

Nutrients Vol. 15 No. 20 pp. 4309 · MDPI AG

View at Publisher Save 10.3390/nu15204309

Abstract

A prospective cohort study was conducted to evaluate the effect of vitamin D deficiency on sepsis. A total of 129 patients were enrolled. The median age was 74 years old, with a median SOFA score of 7; septic shock was observed in 60 patients. The median vitamin D level in the overall population was 13 ng/mL. A total of 96 patients had vitamin D deficiency, whereas 62 patients were described to have severe vitamin D deficiency. Severe vitamin D deficiency significantly increased the 14-day mortality (adjusted hazard ratio (aHR) 2.57; 95% confidence interval [CI]: 1.03–6.43; p = 0.043), 28-day mortality (aHR 2.28; 95% CI: 1.17–4.45; p = 0.016), and in-hospital mortality (aHR 2.11; 95% CI: 1.02–4.36; p = 0.044). In Kaplan–Meier analysis, the severe vitamin D deficiency group had significantly higher 14-day and 28-day mortality rates compared with the non-deficient group. Evaluating the vitamin D levels in sepsis patients may become necessary in an aging society. Severe vitamin D deficiency can independently affect poor prognosis related to sepsis. Further studies are needed to evaluate whether vitamin D supplementation in sepsis patients with vitamin D deficiency can help improve the prognosis of sepsis in addition to improving bone mineral metabolism.

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References

32

[1]

Singer "The third international consensus definitions for sepsis and septic shock (sepsis-3)" JAMA (2016) 10.1001/jama.2016.0287

[2]

Bosmann "The inflammatory response in sepsis" Trends Immunol. (2013) 10.1016/j.it.2012.09.004

[3]

Rudd "Global, regional, and national sepsis incidence and mortality, 1990–2017: Analysis for the global burden of disease study" Lancet (2020) 10.1016/s0140-6736(19)32989-7

[4]

Im "Time-to-antibiotics and clinical outcomes in patients with sepsis and septic shock: A prospective nationwide multicenter cohort study" Crit. Care (2022) 10.1186/s13054-021-03883-0

[5]

Seok "Timing of antibiotics in septic patients: A prospective cohort study" Clin. Microbiol. Infect. (2020) 10.1016/j.cmi.2020.01.037

[6]

Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021

Laura Evans, Andrew Rhodes, Waleed Alhazzani et al.

Intensive Care Medicine 2021 10.1007/s00134-021-06506-y

[7]

Mankowski "Older sepsis survivors suffer persistent disability burden and poor long-term survival" J. Am. Geriatr. Soc. (2020) 10.1111/jgs.16435

[8]

Ginde "Demographic differences and trends of vitamin d insufficiency in the US population, 1988–2004" Arch. Intern. Med. (2009) 10.1001/archinternmed.2008.604

[9]

Forrest "Prevalence and correlates of vitamin d deficiency in us adults" Nutr. Res. (2011) 10.1016/j.nutres.2010.12.001

[10]

Park, H.Y., Lim, Y.H., Park, J.B., Rhie, J., and Lee, S.J. (2020). Environmental and occupation factors associated with vitamin d deficiency in korean adults: The korea national health and nutrition examination survey (knhanes) 2010–2014. Int. J. Environ. Res. Public Health, 17. 10.3390/ijerph17249166

[11]

Vitamin D Deficiency

Michael F. Holick

New England Journal of Medicine 2007 10.1056/nejmra070553

[12]

Jung "Vitamin d deficiency in nursing home elderly in korea" J. Korean Geriatr. Soc. (2016) 10.4235/jkgs.2016.20.2.102

[13]

Hahn "Vitamin d and marine omega 3 fatty acid supplementation and incident autoimmune disease: Vital randomized controlled trial" BMJ (Clin. Res. Ed.) (2022)

[14]

Li, X., Liu, Y., Zheng, Y., Wang, P., and Zhang, Y. (2018). The effect of vitamin d supplementation on glycemic control in type 2 diabetes patients: A systematic review and meta-analysis. Nutrients, 10. 10.3390/nu10030375

[15]

Ghaderi "Immunomodulatory actions of vitamin d in various immune-related disorders: A comprehensive review" Front. Immunol. (2023) 10.3389/fimmu.2023.950465

[16]

Sassi, F., Tamone, C., and D’Amelio, P. (2018). Vitamin d: Nutrient, hormone, and immunomodulator. Nutrients, 10. 10.3390/nu10111656

[17]

Gois, P.H.F., Ferreira, D., Olenski, S., and Seguro, A.C. (2017). Vitamin d and infectious diseases: Simple bystander or contributing factor?. Nutrients, 9. 10.3390/nu9070651

[18]

Yang "Efficacy of high-dose vitamin d supplementation as an adjuvant treatment on pneumonia: Systematic review and a meta-analysis of randomized controlled studies" Nutr. Clin. Pract. (2021) 10.1002/ncp.10585

[19]

Urashima "Randomized trial of vitamin d supplementation to prevent seasonal influenza a in schoolchildren" Am. J. Clin. Nutr. (2010) 10.3945/ajcn.2009.29094

[20]

Braun "Association of low serum 25-hydroxyvitamin d levels and mortality in the critically ill" Crit. Care Med. (2011) 10.1097/ccm.0b013e318206ccdf

[21]

Braun "Low serum 25-hydroxyvitamin d at critical care initiation is associated with increased mortality" Crit. Care Med. (2012) 10.1097/ccm.0b013e31822d74f3

[22]

Xiao "Association between vitamin d status and sepsis in children: A meta-analysis of observational studies" Clin. Nutr. (2020) 10.1016/j.clnu.2019.08.010

[23]

Lee "Vitamin d deficiency in critically ill patients" N. Engl. J. Med. (2009) 10.1056/nejmc0809996

[24]

Amrein "Effect of high-dose vitamin d3 on hospital length of stay in critically ill patients with vitamin d deficiency: The vitdal-icu randomized clinical trial" JAMA (2014) 10.1001/jama.2014.13204

[25]

"Novel biomarker for predicting sepsis mortality: Vitamin d receptor" J. Int. Med. Res. (2021) 10.1177/03000605211034733

[26]

Han "Risk factors for vitamin d deficiency in sickle cell disease" Br. J. Haematol. (2018) 10.1111/bjh.15270

[27]

Subramanian "Vitamin d promotes pneumococcal killing and modulates inflammatory responses in primary human neutrophils" J. Innate Immun. (2017) 10.1159/000455969

[28]

Wang "Association of vitamin d deficiency with covid-19 infection severity: Systematic review and meta-analysis" Clin. Endocrinol. (2022) 10.1111/cen.14540

[29]

Ginde "Early high-dose vitamin d(3) for critically ill, vitamin d-deficient patients" N. Engl. J. Med. (2019) 10.1056/nejmoa1911124

[30]

Gayat "Reversal of neutrophil-to-lymphocyte count ratio in early versus late death from septic shock" Crit. Care (2015) 10.1186/s13054-015-1144-x

[31]

Gaieski "Benchmarking the incidence and mortality of severe sepsis in the united states" Crit. Care Med. (2013) 10.1097/ccm.0b013e31827c09f8

[32]

Brady "Role of the adaptive immune response in sepsis" Intensive Care Med. Exp. (2020) 10.1186/s40635-020-00309-z

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References

Details

Published: Oct 10, 2023
Vol/Issue: 15(20)
Pages: 4309
License: View

Authors

H

Hyeri Seok

Division of Infectious Diseases, Department of Medicine, Korea University Ansan Hospital, Korea University College of Medicine, Ansan 15355, Republic of Korea

J

Jiwoon Kim

Division of Infectious Diseases, Department of Medicine, Korea University Ansan Hospital, Korea University College of Medicine, Ansan 15355, Republic of Korea

W

Won Suk Choi

Division of Infectious Diseases, Department of Medicine, Korea University Ansan Hospital, Korea University College of Medicine, Ansan 15355, Republic of Korea

D

Dae Won Park

Division of Infectious Diseases, Department of Medicine, Korea University Ansan Hospital, Korea University College of Medicine, Ansan 15355, Republic of Korea

Funding

National Research Foundation of Korea Award: O2000351

Korea University Ansan Hospital Award: O2000351

Cite This Article

Hyeri Seok, Jiwoon Kim, Won Suk Choi, et al. (2023). Effects of Vitamin D Deficiency on Sepsis. Nutrients, 15(20), 4309. https://doi.org/10.3390/nu15204309

Effects of Vitamin D Deficiency on Sepsis

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