Department of Veterinary Medicine and Surgery, Veterinary Health Center, University of Missouri, Columbia, Missouri, United States of America.
PLoS One. 2018 Mar 28;13(3):e0194062. doi: 10.1371/journal.pone.0194062. eCollection 2018.
Hypovitaminosis D has been extensively documented in critically ill humans. However, whether or not critically ill dogs have alterations in vitamin D concentrations remains unconfirmed. The primary aims of our study were to compare serum 25-hydroxycholecalciferol [25(OH)D] concentrations in critically ill dogs with healthy control dogs, determine the prognostic utility of serum 25(OH)D concentration as a biomarker in critically ill dogs, and to assess if serum 25(OH)D concentrations in critically ill dogs are associated with length of stay in the intensive care unit or illness severity. Serum concentrations of 25(OH)D together with a range of other clinical, biochemical, and hematological parameters, were measured in 99 dogs within 24 hours of admission to the Intensive Care Unit (ICU). Critically ill dogs (P = 0.001) and dogs with sepsis (P = 0.002) had significantly lower serum 25(OH)D concentrations compared to healthy control dogs. In addition, serum 25(OH)D concentration was an independent predictor of in-hospital and 30 day survival. Using a cut-off of 33 ng/mL, serum 25(OH)D concentrations had excellent sensitivity (0.94; 95% CI, 0.71-1.00), but poor specificity (0.41; 95% CI, 0.31-0.53) for detection of survival. Serum 25(OH)D concentrations were inversely associated with acute patient physiologic and laboratory evaluation (APPLE) fast score but were not associated with ICU length of stay. Hospitalized dogs with critical illness have decreased serum 25(OH)D concentrations compared to healthy dogs and can be used to predict survival in this cohort.
维生素 D 缺乏症在危重病患者中已被广泛记录。然而,危重病犬的维生素 D 浓度是否发生改变仍未得到证实。本研究的主要目的是比较危重病犬和健康对照犬的血清 25-羟胆钙化醇[25(OH)D]浓度,确定血清 25(OH)D 浓度作为危重病犬生物标志物的预后价值,并评估危重病犬的血清 25(OH)D 浓度是否与 ICU 住院时间或疾病严重程度相关。在入住 ICU 24 小时内,对 99 只犬测量了血清 25(OH)D 浓度以及一系列其他临床、生化和血液学参数。与健康对照犬相比,危重病犬(P = 0.001)和脓毒症犬(P = 0.002)的血清 25(OH)D 浓度显著降低。此外,血清 25(OH)D 浓度是住院和 30 天生存的独立预测因子。使用 33ng/mL 的截止值,血清 25(OH)D 浓度对检测生存的敏感性为 0.94(95%CI,0.71-1.00),特异性为 0.41(95%CI,0.31-0.53)。血清 25(OH)D 浓度与急性患者生理和实验室评估(APPLE)快速评分呈负相关,但与 ICU 住院时间无关。与健康犬相比,患有危重病的住院犬的血清 25(OH)D 浓度降低,可用于预测该队列的生存情况。