Division of Infectious Diseases, Department of Medicine, Korea University Ansan Hospital, Korea University College of Medicine, Ansan 15355, Republic of Korea.
Nutrients. 2023 Oct 10;15(20):4309. doi: 10.3390/nu15204309.
A prospective cohort study was conducted to evaluate the effect of vitamin D deficiency on sepsis. A total of 129 patients were enrolled. The median age was 74 years old, with a median SOFA score of 7; septic shock was observed in 60 patients. The median vitamin D level in the overall population was 13 ng/mL. A total of 96 patients had vitamin D deficiency, whereas 62 patients were described to have severe vitamin D deficiency. Severe vitamin D deficiency significantly increased the 14-day mortality (adjusted hazard ratio (aHR) 2.57; 95% confidence interval [CI]: 1.03-6.43; = 0.043), 28-day mortality (aHR 2.28; 95% CI: 1.17-4.45; = 0.016), and in-hospital mortality (aHR 2.11; 95% CI: 1.02-4.36; = 0.044). In Kaplan-Meier analysis, the severe vitamin D deficiency group had significantly higher 14-day and 28-day mortality rates compared with the non-deficient group. Evaluating the vitamin D levels in sepsis patients may become necessary in an aging society. Severe vitamin D deficiency can independently affect poor prognosis related to sepsis. Further studies are needed to evaluate whether vitamin D supplementation in sepsis patients with vitamin D deficiency can help improve the prognosis of sepsis in addition to improving bone mineral metabolism.
一项前瞻性队列研究评估了维生素 D 缺乏对脓毒症的影响。共纳入 129 例患者。中位年龄为 74 岁,中位 SOFA 评分为 7 分;60 例患者发生感染性休克。总体人群的中位维生素 D 水平为 13ng/ml。共有 96 例患者存在维生素 D 缺乏,其中 62 例患者存在严重维生素 D 缺乏。严重维生素 D 缺乏显著增加 14 天死亡率(校正后危险比[aHR]2.57;95%置信区间[CI]:1.03-6.43;P=0.043)、28 天死亡率(aHR 2.28;95%CI:1.17-4.45;P=0.016)和住院死亡率(aHR 2.11;95%CI:1.02-4.36;P=0.044)。在 Kaplan-Meier 分析中,严重维生素 D 缺乏组的 14 天和 28 天死亡率明显高于非缺乏组。在老龄化社会中,评估脓毒症患者的维生素 D 水平可能变得必要。严重维生素 D 缺乏可独立影响与脓毒症相关的不良预后。需要进一步研究来评估脓毒症伴维生素 D 缺乏的患者补充维生素 D 是否除改善骨代谢外,还能改善脓毒症的预后。