Custódio Geisiane, Schwarz Patrícia, Crispim Daisy, Moraes Rafael B, Czepielewski Mauro, Leitão Cristiane B, Rech Tatiana H
Graduate Program in Medical Sciences: Endocrinology, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil.
Graduate Program in Medical Sciences: Endocrinology, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil; Intensive Care Unit, Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, Brazil.
Transpl Immunol. 2018 Jun;48:65-69. doi: 10.1016/j.trim.2018.02.014. Epub 2018 Feb 28.
Vitamin D insufficiency is linked to several common inflammatory disorders. Brain death (BD) causes a massive catecholamine release, leading to intense inflammatory activity. We aimed to evaluate vitamin D serum levels in brain-dead individuals in comparison to critically ill patients without BD to assess the correlation between vitamin D and cytokine levels.
Sixteen brain-dead patients and 32 critically ill controls were prospectively enrolled. Blood samples from 25 brain-dead patients from a previous study were also used for vitamin D quantification. Plasma TNF, IL-1β, IL-6, IL-8, IL-10, IFN-γ and serum vitamin D levels were compared using Student's t-test or one-way ANOVA. Spearman's test was used to assess the correlation between vitamin D and cytokine levels.
Mean vitamin D levels were 16.4 ± 7.9 ng/mL, with 52 patients (71.2%) classified as vitamin D deficient (serum levels < 20 ng/mL). Vitamin D levels were similar in 41 brain-dead patients as compared to control subjects (15.6 ± 6.9 ng/mL vs 17.4 ± 9.0 ng/mL; p = 0.383). Moderate direct correlations were observed between vitamin D and IL-8, IL-10, and IFN-γ in the prospective group of 16 brain-dead patients (IL-8: r = 0.5, p = 0.049; IL-10 r = 0.67, p = 0.005; IFN-γ r = 0.6, p = 0.015). Vitamin D was inversely correlated with IL-6 (r = -0.36, p = 0.044) in critically ill controls.
Vitamin D serum levels were similarly low in brain-dead and critically ill patients. In brain-dead patients, vitamin D serum levels correlated with plasma IL-8, IL-10 and IFN-γ.
维生素D不足与多种常见的炎症性疾病有关。脑死亡（BD）会导致大量儿茶酚胺释放，引发强烈的炎症活动。我们旨在评估脑死亡个体与无BD的重症患者相比的血清维生素D水平，以评估维生素D与细胞因子水平之间的相关性。
前瞻性纳入16例脑死亡患者和32例重症对照。来自先前研究的25例脑死亡患者的血样也用于维生素D定量。使用学生t检验或单因素方差分析比较血浆TNF、IL-1β、IL-6、IL-8、IL-10、IFN-γ和血清维生素D水平。使用Spearman检验评估维生素D与细胞因子水平之间的相关性。
维生素D平均水平为16.4±7.9 ng/mL，52例患者（71.2%）被归类为维生素D缺乏（血清水平<20 ng/mL）。41例脑死亡患者的维生素D水平与对照受试者相似（15.6±6.9 ng/mL对17.4±9.0 ng/mL；p = 0.383）。在16例脑死亡患者的前瞻性队列中，观察到维生素D与IL-8、IL-10和IFN-γ之间存在中度直接相关性（IL-8：r = 0.5，p = 0.049；IL-10 r = 0.67，p = 0.005；IFN-γ r = 0.6，p = 0.015）。在重症对照中，维生素D与IL-6呈负相关（r = -0.36，p = 0.044）。
脑死亡患者和重症患者的血清维生素D水平同样较低。在脑死亡患者中，血清维生素D水平与血浆IL-8、IL-10和IFN-γ相关。
