Serum vitamin D level variation in SIRS, sepsis and septic shock

Abstract

Objectives: Vitamin D has potent immunomodulatory effects with the capability of acting as an autocrine and paracrine agent,and inhibits inflammatory signaling. In this study, our aim was to evaluate the relationship between vitamin D levels in systemicinflammatory response syndrome (SIRS), sepsis and, septic shock patients and outcomes.Patients and Methods: A total of 45 patients whose vitamin D levels were measured within the first 48 hours of Intensive Care Unit(ICU) admission and 20 healthy controls were studied prospectively. The patients were grouped as, SIRS (Group-I,n=10), sepsis(Group-II,n=25), septic shock (Group-III,n=10) and healthy subjects (Group-IV,n=20). Serum vitamin D levels were categorized asa deficiency (≤15ng/mL), insufficiency (16-29ng/mL) and sufficiency (≥30ng/mL). Demographic characteristics, Acute Physiologyand Chronic Health Assessment II (APACHE-II) scores, and biochemical parameters were noted.Results: Vitamin D levels were significantly lower in all study groups compared to the control group (p<0.01), but were similar amongthe study groups. The hospital and ICU length of stay (LOS), and biochemical parameters were similar among the study groups. Themortality rates were 40% in Group I, 57 % in Group II, and 80 % in Group III.Conclusion: In our study patients with SIRS, sepsis and septic shock had lower serum 25-OH vitamin D levels compared to thecontrol group. Our results are in line with the literature that supports a relationship between vitamin D deficiency and inflammation.