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Impact of Hospital‐Acquired Infection on Vitamin D Status in Critically Ill Patients
Author(s) -
Peterson B,
Alvarez J,
Jones J,
Hebbar G,
Griffith D,
Dave N,
Hao L,
Easley K,
Shenvi N,
Tangpricha V,
Ziegler T
Publication year - 2015
Publication title -
the faseb journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.709
H-Index - 277
eISSN - 1530-6860
pISSN - 0892-6638
DOI - 10.1096/fasebj.29.1_supplement.757.1
Subject(s) - vitamin d and neurology , medicine , vitamin d binding protein , vitamin , pneumonia , immune system , vitamin d deficiency , gastroenterology , immunology
Background Vitamin D appears to have important effects on human immune functions, including ex vivo upregulation of the antimicrobial peptide LL‐37 in monocytes. Vitamin D depletion is common in critical illness (CI), but little is known about the inter‐relationships between hospital‐acquired infection and vitamin D status.
Objective: Examine changes in blood levels of 25‐hydroxyvitamin D [25(OH)D], vitamin D binding protein (VDBP), and LL‐37 over time in critically ill patients with or without new bloodstream infections (BSI) or pneumonia (PNA). Methods Fifty‐four subjects were dichotomized based on the presence or absence of new BSI (n=13) or PNA (n=12) diagnosed within 28 days of entry. Plasma 25(OH)D (chemiluminescence), VDBP and LL‐37 (ELISA) were measured at baseline, 14 and 28 days. Mixed linear models were used for analyses. Results Subjects (age: 60 ± 13.6 yr) had severe CI (APACHE II: 21.3 ± 8.0) and 76% were vitamin D deficient (25(OH)D < 20 ng/mL). Baseline plasma 25(OH)D, LL‐37 and VDBP were similar in those ± infection. However, 25(OH)D levels decreased significantly over time in subjects with PNA (P=0.002). LL‐37 levels were unaltered over time ± infection and were unrelated to 25(OH)D levels. VDBP levels were unchanged in subjects with BSI, but increased over time in those without BSI (P<0.0001). VDBP levels remained unchanged in subjects with PNA, but rose over time in those without PNA (P=0.0003). Conclusions Changes in plasma 25(OH)D and VDBP were associated with prevalence of hospital‐acquired infection in CI and may be an acute‐phase response. Further study should investigate if such changes influence vitamin D bioavailability or susceptibility to infection.