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Meta-Analysis
. 2015 Jun 4:15:84.
doi: 10.1186/s12871-015-0063-3.

Significant association between vitamin D deficiency and sepsis: a systematic review and meta-analysis

Sikarin Upala  1   2 , Anawin Sanguankeo  3   4 , Nitipong Permpalung  5
Affiliations
Meta-Analysis

Significant association between vitamin D deficiency and sepsis: a systematic review and meta-analysis

Sikarin Upala et al. BMC Anesthesiol. .

Abstract

Background: A number of observational studies have found an association between low vitamin D levels and risk of sepsis. We conducted a systematic review and meta-analysis to determine the overall estimate of risk.

Methods: This was a systematic review and meta-analysis conducted by online searches (CENTRAL, PubMed/MEDLINE, and EMBASE) was registered in PROSPERO (CRD42014014767). Primary outcome was incidence, prevalence, relative risk or odds ratio of having sepsis or bloodstream infection between patients with vitamin D deficiency and controls.

Results: The initial search yielded 647 articles. Twenty-one articles underwent full-length review and data were extracted from 10 observational studies. Pooled odds ratio of sepsis in participants with vitamin D deficiency was 1.78 (95% confidence interval [CI] = 1.55 to 2.03, p < 0.01) compared with controls in studies that reported participant numbers and was 1.45 (95% CI = 1.26 to 1.66, p < 0.01) in studies that reported an adjusted odds ratio of vitamin D deficiency for developing sepsis. Statistical between-study heterogeneity was low (I(2) = 0% and 5%, respectively). Standardized mean difference of 25-hydroxyvitamin D levels in patients with sepsis and controls was -0.24 (95% CI = -0.49 to 0.00, p = 0.05) and lower in the sepsis group compared with non-sepsis or control participants. The statistical between-study heterogeneity (I(2)) was 0%.

Conclusion: Vitamin D deficiency were associated with an increased susceptibility of sepsis.

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Figures

Fig. 1
Fig. 1
Results of the information search
Fig. 2
Fig. 2
Forest plot of comparison of participants with sepsis between vitamin D deficiency (<20 ng/mL) and optimal groups (>30 ng/mL). CI, confidence interval; SE, standard error; Vit D, vitamin D
Fig. 3
Fig. 3
Forest plot of pooled odds ratio of included studies comparing vitamin D deficiency (<20 ng/mL) and optimal groups (>30 ng/mL). CI, confidence interval; Vit D, vitamin D
Fig. 4
Fig. 4
Forest plot of comparison of 25-hydroxyvitamin D (ng/mL) between sepsis and controls. CI, confidence interval; SD, standard deviation
Fig. 5
Fig. 5
Funnel plots showing publication bias in the studies reporting number of participants with sepsis in vitamin D deficiency and optimal groups. Circles represent observed published studies
See this image and copyright information in PMC

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