Vitamin D Deficiency Associated With Sepsis Mortality

This article is part of Infectious Disease Advisor‘s coverage of IDWeek 2018, taking place in San Francisco, CA. Our on-site staff will be reporting on the latest breaking research and clinical advances in infectious diseases. Check back regularly for highlights from IDWeek 2018.

SAN FRANCISCO — “Vitamin D deficiency is associated with increased risk of sepsis mortality in postmenopausal women, which was seen in all ages,” reported Paulette Pinargote, MD and her team, who presented their study via a poster presentation at IDWeek 2018, held October 3-7 in San Francisco, California. Vitamin D deficiencies have been associated with increased mortality and morbidity rates in patients admitted to the hospital with sepsis.

Sepsis is known to be a major cause of admission to the intensive care unit (ICU), accounting for approximately 250,000 deaths every year. According to Pinargote, “Dyhydroxidevitamin D can inhibit the production of interleukins, tumor necrosis factor, and can also increase the expression of endogenous antimicrobial peptides.” As a result, Pinargote and her team set out to discover and assess whether higher mortality rates in cases of sepsis were affected by low serum concentrations of vitamin D (25[OH]D).

To evaluate this association, a prospective study was conducted composed of women who participated in the Women’s Health Initiative Vitamin D/Calcium trial who have been followed for an average of 15 years. The sample consisted of 10,814 women who had 25(OH)D measured at baseline. The study excluded patients with kidney disease and self-reported cancer in order to reduce possible irregularities. The team defined “severe” vitamin D deficiency levels as 25(OH)D <12ng/ml and moderate deficiency levels as 25(OH)D 12 to 20ng/ml. The association between serum vitamin D and sepsis mortality was analyzed using a Cox proportional hazard model.

Vitamin D deficiency was seen in 49.26% of the participants, and 57.7% of participants who suffered sepsis-driven mortality were found to be vitamin D-deficient. The team found “statistically significant hazard ratios (HR) for sepsis mortality in mild (HR,1.19; 95% CI, 1-1.41) and severe vitamin D deficiency (HR, 1.82; 95% CI, 1.50-2.21) in age-adjusted and fully adjusted models.” Pinargote does, however, recommend a clinical trial to evaluate adequate supplementation in patients with sepsis to assess clinical significance.

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Reference

Pinargote P, Qureshi R, Salazar W, et al. Prospective association of serum vitamin D level with sepsis-mortality in postmenopausal women: Results from the Woman’s Health Initiative. Presented at IDWeek 2018; October 3-7; San Francisco, California.