Effect of Vitamin D Deficiency in Korean Patients With Acute Respiratory Distress Syndrome

Korean J Intern Med. 2018 Nov;33(6):1129-1136. doi: 10.3904/kjim.2017.380. Epub 2018 Jun 20.

Abstract

Background/aims: Vitamin D modulates innate and adaptive immune responses, and vitamin D deficiency is associated with increased mortality in hospitalized patients with pneumonia. We evaluated the prevalence of vitamin D deficiency in Korean patients with acute respiratory distress syndrome (ARDS) and its effect on the clinical outcomes of ARDS.

Methods: We retrospectively analyzed the data of 108 patients who had a measured serum level of 25-hydroxy vitamin D3 (25(OH)D3) at the time of diagnosis with ARDS. The clinical outcomes were evaluated based on 25(OH)D3 levels of 20 ng/mL and stratified by quartiles of 25(OH)D3 levels.

Results: The mean age of patients was 59.4 years old; 77 (71.3%) were male. Vitamin D deficiency was found in 103 patients (95.4%). The mean 25(OH)D3 level was 8.3 ± 7.0 ng/mL. Neither in-hospital mortality (40.0% vs. 68.0%) nor 6-month mortality (40.0% vs. 71.8%) significantly differed between groups. There were no significant differences in 25(OH)D3 level between survivors (8.1 ± 7.6 ng/mL) and non-survivors (8.5 ± 6.8 ng/mL, p = 0.765). There were no trends toward a difference in mortality among quartiles of 25(OH)D3 levels. However, 25(OH)D3 levels were inversely related with length of hospital stay and intensive care unit stay among in-hospital survivors.

Conclusion: Vitamin D deficiency was prevalent in Korean patients with ARDS. However, levels of vitamin D were not associated with mortality. A large, prospective study is needed to evaluate the effects of vitamin D deficiency on clinical outcomes of ARDS.

Keywords: Acute respiratory distress syndrome; Mortality; Prognosis; Vitamin D.

MeSH terms

  • Aged
  • Biomarkers / blood
  • Calcifediol / blood
  • Calcifediol / deficiency*
  • Female
  • Hospital Mortality
  • Humans
  • Length of Stay
  • Male
  • Middle Aged
  • Prevalence
  • Prognosis
  • Republic of Korea / epidemiology
  • Respiratory Distress Syndrome, Adult / diagnosis
  • Respiratory Distress Syndrome, Adult / epidemiology*
  • Respiratory Distress Syndrome, Adult / mortality
  • Respiratory Distress Syndrome, Adult / therapy
  • Retrospective Studies
  • Risk Factors
  • Time Factors
  • Vitamin D Deficiency / blood
  • Vitamin D Deficiency / diagnosis
  • Vitamin D Deficiency / epidemiology*
  • Vitamin D Deficiency / therapy

Substances

  • Biomarkers
  • Calcifediol