Department of Physiology, School of Pharmacy, Institute of Nutrition and Food Technology "José Mataix", University of Granada, 18071 Granada, Spain.
Faculty of Education, Psychology and Sports Sciences, University of Huelva, 21007 Huelva, Spain.
Nutrients. 2022 Aug 30;14(17):3580. doi: 10.3390/nu14173580.
Critically ill patients are exposed to different stressors which may generate Systemic Inflammatory Response Syndrome (SIRS). This situation hinders the assessment of micronutrients status, such as vitamin D or Zinc (Zn), potentially affecting patients' treatment and recovery. The aim of the present study was to assess the evolution of circulating 25-Hydroxyvitamin D (25-OH-D) levels after seven days of Intensive Care Unit (ICU) stay and the influence on changes in plasma and erythrocyte Zn levels, as well as other parameters related to phosphorus-calcium metabolism. A prospective analytical study was conducted on 65 critically ill patients (42% women) aged 31-77 years with SIRS. Total 25-OH-D levels were measured in plasma samples by liquid chromatography-tandem mass spectrometry, and Zn content was analyzed by flame atomic absorption spectrometry. Both 25-OH-D and 25-OH-D levels were directly associated with erythrocyte Zn concentration at follow-up ( = 0.046 and = 0.011, respectively). A relationship between erythrocyte and plasma Zn was also found at this follow-up point. No such clear associations were found when considering 25-OH-D. Different disturbances in levels of phosphorus-calcium metabolism parameters were found, suggesting a relationship between the changes of 25-OH-D levels and parathormone ( = 0.019) and phosphorus ( = 0.005). The findings of the present study suggest an interaction between vitamin D and Zn, in which the correct status of these micronutrients could be a potentially modifiable factor and a beneficial approach in the recovery of critically ill patients.
危重症患者会面临不同的应激源，这些应激源可能引发全身炎症反应综合征（SIRS）。这种情况会影响对微量营养素（如维生素 D 或锌（Zn））状态的评估，从而可能影响患者的治疗和康复。本研究旨在评估入住重症监护病房（ICU） 7 天后循环 25-羟维生素 D（25-OH-D）水平的变化，并探讨其对血浆和红细胞 Zn 水平以及其他与磷钙代谢相关参数变化的影响。对 65 名患有 SIRS 的危重症患者（42%为女性）进行了前瞻性分析研究，年龄为 31-77 岁。采用液相色谱-串联质谱法测定血浆样本中的总 25-OH-D 水平，火焰原子吸收光谱法分析 Zn 含量。在随访时，25-OH-D 和 25-OH-D 水平与红细胞 Zn 浓度直接相关（=0.046 和=0.011）。在随访时还发现了红细胞和血浆 Zn 之间的关系。当考虑 25-OH-D 时，并未发现如此明确的关联。还发现了磷钙代谢参数水平的不同程度的紊乱，这表明 25-OH-D 水平的变化与甲状旁腺激素（=0.019）和磷（=0.005）之间存在关系。本研究的结果表明维生素 D 和 Zn 之间存在相互作用，这些微量营养素的正确状态可能是一个潜在的可调节因素，并有助于危重症患者的康复。
