Department of Pulmonary, Allergy, and Critical Care Medicine, Hallym University Dongtan Sacred Heart Hospital, Hwaseong, Korea.
Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
Korean J Intern Med. 2018 Nov;33(6):1129-1136. doi: 10.3904/kjim.2017.380. Epub 2018 Jun 20.
BACKGROUND/AIMS: Vitamin D modulates innate and adaptive immune responses, and vitamin D deficiency is associated with increased mortality in hospitalized patients with pneumonia. We evaluated the prevalence of vitamin D deficiency in Korean patients with acute respiratory distress syndrome (ARDS) and its effect on the clinical outcomes of ARDS.
We retrospectively analyzed the data of 108 patients who had a measured serum level of 25-hydroxy vitamin D3 (25(OH)D3) at the time of diagnosis with ARDS. The clinical outcomes were evaluated based on 25(OH)D3 levels of 20 ng/mL and stratified by quartiles of 25(OH)D3 levels.
The mean age of patients was 59.4 years old; 77 (71.3%) were male. Vitamin D deficiency was found in 103 patients (95.4%). The mean 25(OH)D3 level was 8.3 ± 7.0 ng/mL. Neither in-hospital mortality (40.0% vs. 68.0%) nor 6-month mortality (40.0% vs. 71.8%) significantly differed between groups. There were no significant differences in 25(OH)D3 level between survivors (8.1 ± 7.6 ng/mL) and non-survivors (8.5 ± 6.8 ng/mL, p = 0.765). There were no trends toward a difference in mortality among quartiles of 25(OH)D3 levels. However, 25(OH)D3 levels were inversely related with length of hospital stay and intensive care unit stay among in-hospital survivors.
Vitamin D deficiency was prevalent in Korean patients with ARDS. However, levels of vitamin D were not associated with mortality. A large, prospective study is needed to evaluate the effects of vitamin D deficiency on clinical outcomes of ARDS.
背景/目的：维生素 D 可调节先天和适应性免疫反应，维生素 D 缺乏与住院肺炎患者的死亡率增加有关。我们评估了维生素 D 缺乏在韩国急性呼吸窘迫综合征（ARDS）患者中的发生率及其对 ARDS 临床结局的影响。
我们回顾性分析了 108 例在诊断为 ARDS 时检测血清 25-羟维生素 D3（25(OH)D3）水平的患者的数据。根据 25(OH)D3 水平的 20ng/ml 和 25(OH)D3 水平的四分位距进行分层，评估临床结局。
患者的平均年龄为 59.4 岁；77 例（71.3%）为男性。103 例（95.4%）存在维生素 D 缺乏。平均 25(OH)D3 水平为 8.3±7.0ng/ml。住院死亡率（40.0% vs. 68.0%）和 6 个月死亡率（40.0% vs. 71.8%）在两组之间均无显著差异。幸存者（8.1±7.6ng/ml）和非幸存者（8.5±6.8ng/ml，p=0.765）之间的 25(OH)D3 水平无显著差异。25(OH)D3 水平与病死率之间无明显差异趋势。然而，在住院幸存者中，25(OH)D3 水平与住院时间和重症监护病房停留时间呈反比。
韩国 ARDS 患者普遍存在维生素 D 缺乏。然而，维生素 D 水平与死亡率无关。需要进行大规模的前瞻性研究，以评估维生素 D 缺乏对 ARDS 临床结局的影响。
