Vitamin D deficiency in community-acquired pneumonia: low levels of 1,25(OH)2 D are associated with disease severity

Respiratory Research

Robert Bals¹  Tobias Welte¹  Hartwig Schütte¹  Gernot Rohde¹  Ulrike Schumacher³  Christoph Terkamp⁴  Mathias W Pletz² 

[1] CAPNETZ Foundation, Hannover, Germany;Center for Sepsis Control and Care, Jena University Hospital, Jena, Germany;Center for Clinical Studies, Jena University Hospital, Jena, Germany;Department of Gastroenterology and Hepatology, Hannover Medical School, Hannover, Germany

关键词: Viral infection;    Pneumonia;    Bacterial infection;   

Others  :  790289
DOI  :  10.1186/1465-9921-15-53

 received in 2014-01-27, accepted in 2014-04-22,  发布年份 2014

【 摘 要 】

Objectives

We aimed to explore the association between vitamin D levels and the severity, mortality and microbiological etiology of community-acquired pneumonia.

Methods

Vitamin D levels (both, the reservoir form 25-OH and the activated form 1,25-OH2) of 300 randomly selected patients with community-acquired pneumonia due to pre-specified pathogens included in the German competence network (CAPNETZ) study were measured. Prior to statistical analysis, values of 25-OH and 1,25-OH2 were power-transformed to achieve parametric distribution. All further analyses were performed with seasonally and age adjusted values.

Results

There was only a modest (Spearman Coefficient 0.38) positive correlation between 25-OH and 1,25-OH2. For 1,25-OH2 but not 25-OH, the general linear model revealed a significant inverse correlation between serum concentration and CURB score (p = 0.011). Liver and respiratory co-morbidity were associated with significantly lower 25-OH values and renal co-morbidity with significantly lower 1,25-OH2 values. No significant differences of 1,25-OH2 or 25-OH between different pathogens (influenza virus, Legionella spp., Streptococcus pneumoniae) were detected.

Conclusion

For 1,25-OH2, we found a significant and independent (controlled for age, season and pathogen) negative correlation to pneumonia severity. Therefore, supplementation of non-activated vitamin D to protect from pneumonia may be non-sufficient in patients that have a decreased capacity to hydroxylate 25-OH to 1,25-OH2.

【 授权许可】

   
2014 Pletz et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

Figure 2.

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