Abstract
Previous research has reported reduced serum 25-hydroxyvitamin D (25(OH)D) levels is associated with acute infectious illness. The relationship between vitamin D status, measured prior to acute infectious illness, with risk of community-acquired pneumonia (CAP) and sepsis has not been examined. Community-living individuals hospitalized with CAP or sepsis were age-, sex-, race-, and season-matched with controls. ICD-9 codes identified CAP and sepsis; chest radiograph confirmed CAP. Serum 25(OH)D levels were measured up to 15 months prior to hospitalization. Regression models adjusted for diabetes, renal disease, and peripheral vascular disease evaluated the association of 25(OH)D levels with CAP or sepsis risk. A total of 132 CAP patients and controls were 60 ± 17 years, 71% female, and 86% Caucasian. The 25(OH)D levels <37 nmol/L (adjusted odds ratio (OR) 2.57, 95% CI 1.08–6.08) were strongly associated with increased odds of CAP hospitalization. A total of 422 sepsis patients and controls were 65 ± 14 years, 59% female, and 91% Caucasian. The 25(OH)D levels <37 nmol/L (adjusted OR 1.75, 95% CI 1.11–2.77) were associated with increased odds of sepsis hospitalization. Vitamin D status was inversely associated with risk of CAP and sepsis hospitalization in a community-living adult population. Further clinical trials are needed to evaluate whether vitamin D supplementation can reduce risk of infections, including CAP and sepsis.
Highlights
Vitamin D status was inversely associated with risk of community-acquired pneumonia (CAP) and sepsis hospitalization in a Nutrients 2014, 6 community-living adult population
Little progress has been made in improving mortality associated with community-acquired pneumonia (CAP) [1] which is a leading cause of death in the United States [2]
Adjustments made for diabetes, renal disease, peripheral vascular disease; CAP, community-acquired pneumonia; 25(OH)D, 25 hydroxyvitamin D
Summary
Little progress has been made in improving mortality associated with community-acquired pneumonia (CAP) [1] which is a leading cause of death in the United States [2]. The vitamin D receptor (VDR) is essentially ubiquitous, including immune cells. It responds to 1,25(OH)2D [4,5] and regulates antimicrobial peptides cathelicidin and beta-defensing [5]. When measured during hospital admission for acute illness, 25(OH)D deficiency is associated with increased risk of mortality in patients with CAP [14], more severe sepsis [15], and mortality in septic patients [16]. There are no data assessing existing 25(OH)D deficiency with risk of hospital admission for CAP or sepsis In this case-control study of community-living adults, serum 25(OH)D levels and the risk of hospital admission for CAP and sepsis was evaluated
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