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

Effect of vitamin D deficiency in Korean patients with acute respiratory distress syndrome

Sojung Park  1 , Min Gee Lee  2 , Sang-Bum Hong  3 , Chae-Man Lim  3 , Younsuck Koh  3 , Jin Won Huh  3
Affiliations

Effect of vitamin D deficiency in Korean patients with acute respiratory distress syndrome

Sojung Park et al. Korean J Intern Med. 2018 Nov.

Erratum in

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.

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Conflict of interest statement

No potential conflict of interest relevant to this article was reported.

Figures

Figure 1.
Figure 1.
Distribution of serum concentrations of 25-hydroxy vitamin D3 (25(OH)D3) in subjects with acute respiratory distress syndrome. Subjects were stratified by quartiles, with cutoff values of 3.9, 6.5, and 9.9 ng/mL. Q, quartile.
Figure 2.
Figure 2.
Odds ratio of mortality among quartiles of 25-hydroxy vitamin D3 levels. No mortality trends were found (A) 28-day mortality, (B) in-hospital mortality, (C) 6-month mortality, and (D) 1-year mortality. Q, quartile; CI, confidence interval.
Figure 3.
Figure 3.
Length of stay in the hospital (A) and intensive care unit (B) among all subjects and those among in-hospital survivors (C, D). There was a trend towards decreasing lengths of stay in the hospital and in the intensive care unit (ICU) among in-hospital survivors. IQR, interquartile range; Q, quartile; 25(OH)D3, 25-hydroxy vitamin D3.
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