Division of Renal Diseases and Hypertension, University of Colorado Denver, Denver, CO 80045 USA.
Department of Emergency Medicine, University of Colorado Denver, Denver, CO 80045 USA.
Nutrients. 2014 Jun 10;6(6):2196-205. doi: 10.3390/nu6062196.
Previous research has reported reduced serum 25-hydroxyvitamin D (25(OH)D) levels is associated with acute infectious illness. The relationship between vitamin D status, measured prior to acute infectious illness, with risk of community-acquired pneumonia (CAP) and sepsis has not been examined. Community-living individuals hospitalized with CAP or sepsis were age-, sex-, race-, and season-matched with controls. ICD-9 codes identified CAP and sepsis; chest radiograph confirmed CAP. Serum 25(OH)D levels were measured up to 15 months prior to hospitalization. Regression models adjusted for diabetes, renal disease, and peripheral vascular disease evaluated the association of 25(OH)D levels with CAP or sepsis risk. A total of 132 CAP patients and controls were 60 ± 17 years, 71% female, and 86% Caucasian. The 25(OH)D levels <37 nmol/L (adjusted odds ratio (OR) 2.57, 95% CI 1.08-6.08) were strongly associated with increased odds of CAP hospitalization. A total of 422 sepsis patients and controls were 65 ± 14 years, 59% female, and 91% Caucasian. The 25(OH)D levels <37 nmol/L (adjusted OR 1.75, 95% CI 1.11-2.77) were associated with increased odds of sepsis hospitalization. Vitamin D status was inversely associated with risk of CAP and sepsis hospitalization in a community-living adult population. Further clinical trials are needed to evaluate whether vitamin D supplementation can reduce risk of infections, including CAP and sepsis.
先前的研究报告称，血清 25-羟维生素 D（25（OH）D）水平降低与急性传染病有关。然而，维生素 D 状态（在急性传染病发生之前测量）与社区获得性肺炎（CAP）和败血症风险之间的关系尚未得到检验。因 CAP 或败血症住院的社区居民与对照组在年龄、性别、种族和季节方面相匹配。ICD-9 代码确定了 CAP 和败血症；胸部 X 光片证实了 CAP。血清 25（OH）D 水平在住院前最多可测量 15 个月。回归模型调整了糖尿病、肾病和外周血管疾病，评估了 25（OH）D 水平与 CAP 或败血症风险的关联。共有 132 名 CAP 患者和对照组的年龄为 60 ± 17 岁，女性占 71%，白种人占 86%。25（OH）D 水平<37 nmol/L（调整后的优势比（OR）为 2.57，95%可信区间（CI）为 1.08-6.08）与 CAP 住院的几率增加密切相关。共有 422 名败血症患者和对照组的年龄为 65 ± 14 岁，女性占 59%，白种人占 91%。25（OH）D 水平<37 nmol/L（调整后的 OR 为 1.75，95%CI 为 1.11-2.77）与败血症住院的几率增加相关。在社区居住的成年人群中，维生素 D 状态与 CAP 和败血症住院风险呈负相关。需要进一步的临床试验来评估维生素 D 补充是否可以降低感染风险，包括 CAP 和败血症。
