Siuka Darko, Rakuša Matej, Vodenik Aleš, Vodnik Lana, Štabuc Borut, Štubljar David, Drobne David, Jerin Aleš, Matelič Helena, Osredkar Joško
Department of Gastroenterology, University Medical Centre Ljubljana, 1000 Ljubljana, Slovenia.
Faculty of Medicine, University of Ljubljana, 1000 Ljubljana, Slovenia.
Int J Mol Sci. 2025 Jun 13;26(12):5695. doi: 10.3390/ijms26125695.
Acute pancreatitis (AP) is primarily caused by inflammation and immunological responses, both of which are regulated by vitamin D. The purpose of this study was to examine the correlation between the severity of AP and vitamin D levels, including its total, free, and bioavailable forms. Eighty individuals with AP were enrolled in this study. Serum levels of free 25(OH)D, bioavailable 25(OH)D, and total 25-hydroxyvitamin D 25(OH)D were assessed. The severity of the disease course was assessed by scoring systems (Revised Atlanta classification, Ranson score, CTSI). Vitamin D deficiency was common in AP patients, with 31.3% being categorized as deficient (<50 nmol/L) and 27.5% having a severe deficiency (<30 nmol/L). Compared to patients with adequate vitamin D status, those with lower vitamin D levels had a significantly higher risk of developing moderate-to-severe AP (44.7% vs. 14.3%, = 0.029). Patients with severe vitamin D insufficiency were the only ones who experienced severe AP. Clinical outcomes showed similar correlations: patients with significant vitamin D deficiency had longer hospital stays (mean of 12.1 ± 5.3 days vs. 7.8 ± 3.4 days, = 0.018) and higher rates of ICU admission (31.8% vs. 8.0%, = 0.007). Low levels of total, free, and bioavailable vitamin D were significantly associated with the severity of AP and ICU admission. Free, bioavailable, and total vitamin D were correlated with the severity of acute pancreatitis. All severe cases occurred in patients with severe vitamin D deficiency. Given the observational design, these associations require confirmation in interventional or mechanistic studies.
急性胰腺炎（AP）主要由炎症和免疫反应引起，而这两者均受维生素D调节。本研究的目的是探讨AP严重程度与维生素D水平之间的相关性，包括其总量、游离形式和生物可利用形式。本研究纳入了80例AP患者。评估了血清游离25（OH）D、生物可利用25（OH）D和总25-羟基维生素D 25（OH）D水平。通过评分系统（修订版亚特兰大分类、兰森评分、CTSI）评估疾病进程的严重程度。维生素D缺乏在AP患者中很常见，31.3%被归类为缺乏（<50 nmol/L），27.5%存在严重缺乏（<30 nmol/L）。与维生素D水平充足的患者相比，维生素D水平较低的患者发生中重度AP的风险显著更高（44.7%对14.3%，P = 0.029）。严重维生素D不足的患者是唯一发生重症AP的患者。临床结局显示出类似的相关性：维生素D严重缺乏的患者住院时间更长（平均12.1±5.3天对7.8±3.4天，P = 0.018），入住ICU的比例更高（31.8%对8.0%，P = 0.007）。总维生素D、游离维生素D和生物可利用维生素D水平低与AP严重程度及入住ICU显著相关。游离、生物可利用和总维生素D与急性胰腺炎的严重程度相关。所有重症病例均发生在维生素D严重缺乏的患者中。鉴于本研究为观察性设计，这些关联需要在干预性研究或机制性研究中得到证实。
