Vitamin D Level and Risk of Community-Acquired Pneumonia and Sepsis
Abstract
:1. Introduction
2. Experimental Section
2.1. Data Source
2.2. Cohort Definition
2.3. 25(OH) D Measurements
2.4. Statistical Analysis
3. Results
3.1. Community-Acquired Pneumonia
Case | Control | |
---|---|---|
Number | ||
CAP | 66 | 66 |
Sepsis | 211 | 211 |
Age in years | ||
CAP | 60 ± 17 | 60 ± 17 |
Sepsis | 65 ± 14 | 65 ± 14 |
Females | ||
CAP | 47 | 47 |
Sepsis | 125 | 125 |
Race—White | ||
CAP | 57 | 57 |
Sepsis | 189 | 189 |
Race—Hispanic | ||
CAP | 6 | 6 |
Sepsis | 13 | 13 |
Race—Other | ||
CAP | 3 | 3 |
Sepsis | 5 | 5 |
Diabetes | ||
CAP | 24 (36.4%) | 19 (28.8%) |
Sepsis * | 97 (46.0%) | 64 (30.3%) |
Renal Disease | ||
CAP * | 21 (31.8%) | 7 (10.6%) |
Sepsis * | 76 (36.0%) | 46 (21.8%) |
Peripheral Vascular | ||
CAP | 13 (19.7%) | 9 (13.6%) |
Sepsis | 61 (28.9%) | 45 (21.3%) |
25(OH)D (nmol/L) ** | ||
CAP | 70.1 [62.2–79.6] | 79.3 [71.1–88.1] |
Sepsis | 61.2 [55.9–66.4] | 69.1 [64.2–74.1] |
25(OH)D >75 nmol/L | ||
CAP | 34 (52.3%) | 35 (53.0%) |
Sepsis | 84 (39.8%) | 99 (46.9%) |
25(OH)D 51–75 nmol/L | ||
CAP | 19 (28.8%) | 19 (28.8%) |
Sepsis | 56 (26.5%) | 60 (28.4%) |
25(OH)D 37–50 nmol/L | ||
CAP | 7 (10.6%) | 10 (15.2%) |
Sepsis | 31 (14.7%) | 29 (13.7%) |
25(OH)D <37 nmol/L | ||
CAP | 9 (9.1%) | 2 (3.0%) |
Sepsis * | 40 (19.0%) | 23 (10.9%) |
Model § | OR (95% CI) | p-Value |
---|---|---|
25(OH)D <75 nmol/L vs. ≥75 nmol/L | ||
CAP | 1.03 (0.51–2.09) | 0.93 |
Sepsis | 1.24 (0.84–1.83) | 0.28 |
25(OH)D <50 nmol/L vs. ≥50 nmol/L | ||
CAP | 0.96 (0.35–2.61) | 0.94 |
Sepsis | 1.75 (1.11–2.77) | 0.02 |
25(OH)D <37 nmol/L vs. ≥37 nmol/L | ||
CAP | 2.57 (1.08–6.08) | 0.03 |
Sepsis | 1.89 (1.09–3.31) | 0.02 |
3.2. Sepsis
4. Discussion
5. Conclusions
Acknowledgments
Author Contributions
Conflicts of Interest
References
- Mandell, L.A.; Wunderink, R.G.; Anzueto, A.; Bartlett, J.G.; Campbell, G.D.; Dean, N.C.; Dowell, S.F.; File, T.M., Jr.; Musher, D.M.; Niederman, M.S.; et al. Infectious Diseases Society of America/American Thoracic Society consensus guidelines on the management of community-acquired pneumonia in adults. Clin. Infect. Dis. 2007, 44, S27–S72. [Google Scholar] [CrossRef]
- Deaths: Preliminary Data for 2009. National Vital Statistics Reports. In CDC; 2011. Available online: http://www.cdc.gov/nchs/data/nvsr/nvsr59/nvsr59_04.pdf (accessed on 16 March 2011). [Google Scholar]
- Martin, G.S.; Mannino, D.M.; Eaton, S.; Moss, M. The epidemiology of sepsis in the United States from 1979 through 2000. N. Engl. J. Med. 2003, 348, 1546–1554. [Google Scholar] [CrossRef]
- Liu, P.T.; Stenger, S.; Li, H.; Wenzel, L.; Tan, B.H.; Krutzik, S.R.; Ochoa, M.T.; Schauber, J.; Wu, K.; Meinken, C.; et al. Toll-like receptor triggering of a vitamin d-mediated human antimicrobial response. Science 2006, 311, 1770–1773. [Google Scholar] [CrossRef]
- White, J.H. Vitamin D metabolism and signaling in the human immune system. Rev. Endocr. Metab. Disord. 2012, 13, 21–29. [Google Scholar] [CrossRef]
- Ginde, A.A.; Liu, M.C.; Camargo, C.A., Jr. Demographic differences and trends of vitamin D insufficiency in the US population, 1988–2004. Arch. Intern. Med. 2009, 169, 626–632. [Google Scholar] [CrossRef]
- Holick, M.F. Vitamin D for health and in chronic kidney disease. Semin. Dial. 2005, 18, 266–275. [Google Scholar] [CrossRef]
- Scragg, R.; Sowers, M.; Bell, C. Third National Health and Nutrition Examination Survey. Serum 25-hydroxyvitamin D, diabetes, and ethnicity in the Third National Health and Nutrition Examination Survey. Diabetes Care 2004, 27, 2813–2818. [Google Scholar] [CrossRef]
- Chonchol, M.; Scragg, R. 25-Hydroxyvitamin D, insulin resistance, and kidney function in the Third National Health and Nutrition Examination Survey. Kidney Int. 2007, 71, 134–139. [Google Scholar] [CrossRef]
- Melamed, M.L.; Muntner, P.; Michos, E.D.; Uribarri, J.; Weber, C.; Sharma, J.; Raggi, P. Serum 25-hydroxyvitamin D levels and the prevalence of peripheral arterial disease: Results from NHANES 2001 to 2004. Arterioscler. Thromb. Vasc. Biol. 2008, 28, 1179–1185. [Google Scholar] [CrossRef]
- Ginde, A.A.; Mansbach, H.M.; Camargo, C.A., Jr. Association between serum 25-hydroxyvitamin D level and upper respiratory tract infection in the Third National Health and Nutrition Examination Survey. Arch. Intern. Med. 2009, 169, 384–390. [Google Scholar] [CrossRef]
- Sabetta, J.R.; DePetrillo, P.; Cipriani, R.J.; Smardin, J.; Burns, L.A.; Landry, M.L. Serum 25-hydroxyvitamin D and the incidence of acute viral respiratory tract infection in healthy adults. PLoS One 2010, 5, e11088. [Google Scholar]
- Laaksi, I.; Ruohola, J.P.; Tuohimaa, P.; Auvinen, A.; Haataja, R.; Pihajamaki, H.; Ylikomi, T. An association of serum vitamin D concentrations <40 nmol/L with acute respiratory tract infection in young Finnish men. Am. J. Clin. Nutr. 2007, 86, 714–717. [Google Scholar]
- Leow, L.; Simpson, T.; Cursons, R.; Karalus, N.; Hancox, R.J. Vitamin D, innate immunity and outcomes in community acquired pneumonia. Respirology 2011, 16, 611–616. [Google Scholar] [CrossRef]
- Ginde, A.A.; Camargo, C.A., Jr.; Shapiro, N.I. Vitamin D insufficiency and sepsis severity in emergency department patients with suspected infection. Acad. Emerg. Med. 2011, 18, 551–554. [Google Scholar] [CrossRef]
- Braun, A.B.; Gibbons, F.K.; Litonjua, A.A.; Giovannucci, E.; Christopher, K.B. Low serum 25-hydroxyvitamin D at critical care initiation is associated with increased mortality. Crit. Care Med. 2012, 40, 63–72. [Google Scholar] [CrossRef]
- Intermoutain Healthcare Annual Report. Intermountain Healthcare 2010. Available online: http://intermountainhealthcare.org/about/overview/Documents/annualreport2010.pdf (accessed on 12 December 2012).
- Mehrotra, R.; Kermah, D.A.; Salusky, I.B.; Wolf, M.S.; Thadhani, R.I.; Chiu, Y.W.; Martins, D.; Adler, S.G.; Norris, K.C. Chronic kidney disease, hypovitaminosis D, and mortality in the United States. Kidney Int. 2009, 76, 977–983. [Google Scholar] [CrossRef]
- Institute of Medicine. Dietary References Intakes for Calcium and Vitamin D. Available online: http://www.iom.edu/Activities/Nutrition/DRIVitDCalcium/2010-Nov-30.aspx (accessed on 12 December 2012).
- Anderson, J.L.; May, H.T.; Horne, B.D.; Bair, T.L.; Hall, N.L.; Carlquist, J.F.; Lappé, D.L.; Muhlestein, J.B.; Intermountain Heart Collaborative (IHC) Study Group. Relation of vitamin d deficiency to cardiovascular risk factors, disease status, and incident events in a general healthcare population. Am. J. Cardiol. 2010, 106, 953–958. [Google Scholar]
- Sterling, K.A.; Eftekhari, P.; Girndt, M.; Kimmel, P.L.; Raj, D.S. The immunoregulatory function of vitamin D: Implications in chronic kidney disease. Nat. Rev. Nephrol. 2012, 8, 403–412. [Google Scholar] [CrossRef]
- Wu, S.; Ren, S.; Nguyen, L.; Adams, J.S.; Hewison, M. Splice variants of the CYP27b1 gene and the regulation of 1,25-dihydroxyvitamin D3 production. Endocrinology 2007, 148, 3410–4318. [Google Scholar] [CrossRef]
- Van Etten, E.; Stoffels, K.; Gysemans, C.; Mathieu, C.; Overbergh, L. Regulation of vitamin D homeostasis: Implications for the immune system. Nutr. Rev. 2008, 66, S125–S134. [Google Scholar] [CrossRef]
- Jeng, L.; Yamshchikov, A.V.; Judd, S.E.; Blumberg, H.M.; Martin, G.S.; Ziegler, T.R.; Tangpricha, V. Alterations in vitamin D status and anti-microbial peptide levels in patients in the intensive care unit with sepsis. J. Transl. Med. 2009, 7, 28. [Google Scholar] [CrossRef]
- Moller, S.; Laigaard, F.; Olgaard, K.; Hemmingsen, C. Effect of 1,25-dihydroxy-vitamin D3 in experimental sepsis. Int. J. Med. Sci. 2007, 4, 190–195. [Google Scholar]
- Bukoski, R.D.; Xue, H. On the vascular inotropic action of 1,25-(OH)2 vitamin D3. Am. J. Hypertens. 1993, 6, 388–396. [Google Scholar]
- Walters, M.R.; Wicker, D.C.; Riggle, P.C. 1,25-Dihydroxyvitamin D3 receptors identified in the rat heart. J. Mol. Cell. Cardiol. 1986, 18, 67–72. [Google Scholar] [CrossRef]
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Jovanovich, A.J.; Ginde, A.A.; Holmen, J.; Jablonski, K.; Allyn, R.L.; Kendrick, J.; Chonchol, M. Vitamin D Level and Risk of Community-Acquired Pneumonia and Sepsis. Nutrients 2014, 6, 2196-2205. https://doi.org/10.3390/nu6062196
Jovanovich AJ, Ginde AA, Holmen J, Jablonski K, Allyn RL, Kendrick J, Chonchol M. Vitamin D Level and Risk of Community-Acquired Pneumonia and Sepsis. Nutrients. 2014; 6(6):2196-2205. https://doi.org/10.3390/nu6062196
Chicago/Turabian StyleJovanovich, Anna J., Adit A. Ginde, John Holmen, Kristen Jablonski, Rebecca L. Allyn, Jessica Kendrick, and Michel Chonchol. 2014. "Vitamin D Level and Risk of Community-Acquired Pneumonia and Sepsis" Nutrients 6, no. 6: 2196-2205. https://doi.org/10.3390/nu6062196