Respiratory Research Unit, Waikato Hospital Department of Molecular Genetics, University of Waikato, Hamilton Department of Preventive and Social Medicine, University of Otago, Dunedin, New Zealand.
Respirology. 2011 May;16(4):611-6. doi: 10.1111/j.1440-1843.2011.01924.x.
Vitamin D regulates the production of the antimicrobial peptides cathelicidin and beta-defensin-2, which play an important role in the innate immune response to infection. We hypothesized that vitamin D deficiency would be associated with lower levels of these peptides and worse outcomes in patients admitted to hospital with community acquired pneumonia.
Associations between mortality and serum levels of 25-hydroxyvitamin D, cathelicidin and beta-defensin-2 were investigated in a prospective cohort of 112 patients admitted with community acquired pneumonia during winter.
Severe 25-hydroxyvitamin D deficiency (<30nmol/L) was common in this population (15%) and was associated with a higher 30-day mortality compared with patients with sufficient 25-hydroxyvitamin D (>50nmol/L) (odds ratio 12.7, 95% confidence interval: 2.2-73.3, P=0.004). These associations were not explained by differences in age, comorbidities, or the severity of the acute illness. Neither cathelicidin nor beta-defensin-2 levels predicted mortality, although there was a trend towards increased mortality with lower cathelicidin (P=0.053). Neither cathelicidin nor beta-defensin-2 levels correlated with 25-hydroxyvitamin D.
25-hydroxyvitamin D deficiency is associated with increased mortality in patients admitted to hospital with community acquired pneumonia during winter. Contrary to our hypothesis, 25-hydroxyvitamin D levels were not associated with levels of cathelicidin or beta-defensin-2.
维生素 D 可调节抗菌肽（如 cathelicidin 和 β-防御素-2）的产生，这些肽在感染的先天免疫反应中起着重要作用。我们假设维生素 D 缺乏与这些肽水平降低以及因社区获得性肺炎入院的患者预后不良有关。
在冬季因社区获得性肺炎入院的 112 例患者前瞻性队列中，研究了死亡率与血清 25-羟维生素 D、cathelicidin 和 β-防御素-2 水平之间的关系。
该人群中严重的 25-羟维生素 D 缺乏症（<30nmol/L）很常见（15%），与 25-羟维生素 D 充足（>50nmol/L）的患者相比，30 天死亡率更高（比值比 12.7，95%置信区间：2.2-73.3，P=0.004）。这些关联不能用年龄、合并症或急性疾病的严重程度差异来解释。cathelicidin 或 β-防御素-2 水平均不能预测死亡率，尽管 cathelicidin 水平降低与死亡率升高呈趋势相关（P=0.053）。cathelicidin 或 β-防御素-2 水平与 25-羟维生素 D 均无相关性。
冬季因社区获得性肺炎入院的患者中，25-羟维生素 D 缺乏与死亡率增加有关。与我们的假设相反，25-羟维生素 D 水平与 cathelicidin 或 β-防御素-2 水平无关。
