Correlation analysis between different vitamin D levels and immune inflammatory indicators in elderly patients with sepsis

Congxin LI; Haidong YUE; Pengxi ZHU; Guangxian HUANG; Lingjie MU; Yanan PENG; Yijie WANG; Yang YANG

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Congxin LI, Haidong YUE, Pengxi ZHU, Guangxian HUANG, Lingjie MU, Yanan PENG, Yijie WANG, Yang YANG. Correlation analysis between different vitamin D levels and immune inflammatory indicators in elderly patients with sepsis[J]. Journal of Kunming Medical University.

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Correlation analysis between different vitamin D levels and immune inflammatory indicators in elderly patients with sepsis

1.
Dept. of Intensive Care Medicine
2.
Dept. of Geriatric Intensive Care Medicine，The 1st Affiliated Hospital of Kunming Medical University; Kunming Yunnan 650032，China

Received Date: 2024-05-26

Abstract

Abstract

Objective To explore the correlation between serum vitamin D （VD3） level differences and immune inflammatory markers in elderly sepsis patients, aiming to identify new therapeutic targets for immune function in these patients. Method A total of 103 elderly patients with sepsis（aged 65-99 years） in the ICU of the First Affiliated Hospital of Kunming Medical University from January 2020 to December 2022 were collected and divided into two groups according to the diagnostic criteria for VD3 deficiency: VD3 deficiency group （42 cases） and VD3 severe deficiency group （61 cases）. Correlation analysis was conducted by comparing the differences in serum 25- （OH） - D3 （VD3） levels , immune function-related indicators upon admission （blood routine, infection-related proteins, combined detection of 12 cytokines, absolute count analysis of lymphocytes and subgroups, quantitative determination of infection-related immune cells, immunoglobulin, and complement）, illness severity, and prognostic indicators （APACHE-II score, SOFA score, duration of ICU stay, and 28-day mortality rate）. Result （1） Serum VD3 levels were lower in elderly patients with sepsis, with 42 cases in the VD3 deficiency group, 61 cases in the the VD3 severe deficiency group. No patient was in the VD3 normal or insufficient group. Patients with severe VD3 deficiency had higher APACHE-II scores, SOFA scores, and 28- day mortality rates than those with VD3 deficiency, and these scores were negatively correlated with serum VD3 levels （P < 0.001）, while the difference in ICU stay duration between the two groups was not statistically significant; （2） WBC, PCT, CRP, and CD4/CD8 in the VD3 deficiency group were all lower than those in the VD3 severe deficiency group （P values < 0.05）, while IL-6, IL-10, CD45+, CD3+/CD45+, and CD19+Abs were all higher than those in the VD3 severe deficiency group （P values < 0.05）; In the VD3 deficiency group, VD3 levels were positively correlated with CD45+（P values < 0.05 for all）, while negatively correlated with IL-6, IL-10, PCT, and CRP （P values < 0.05 for all）; In the VD3 severe deficiency group, there were fewer correlation indicators and the correlation strength was not as strong as that in the VD deficiency group. Conclusion （1） Elderly patients with sepsis generally have lower levels of VD3, with lower levels associated with more severe illness and poorer prognosis; （2） In elderly sepsis patients, compared to patients with severe VD3 deficiency, patients with VD3 deficiency have lower levels of inflammation, stronger cellular immune response, and stronger correlation, suggesting that the effects of different VD3 levels on immune inflammatory responses may vary in elderly sepsis patients.
- 25-hydroxyvitamin D3,
- Immune function,
- Sepsis,
- Elderly patients,
- Prognosis

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References(34)

References

[1]	Huang M,Cai S,Su J. The pathogenesis of sepsis and potential therapeutic targets[J]. International Journal of Molecular Sciences,2019,20(21):109-337.
[2]	廖云海,卢静,肖章武,等. 维生素D水平与脓毒症免疫功能相关性的临床研究[J]. 创伤与急诊电子杂志,2021,9(1):15-18.
[3]	Liu P T,STenger S,Li H,et al. Toll-like receptor triggering of a vitamin D-mediated human antimicrobial response[J]. International Journal of Molecular Sciences,2021,311(57):1770-1773.
[4]	Flynn L,Zimmerman LH,McNorTon K,et al. Effects of vitamin D deficiency in critically ill surgical patients[J]. American Journal of Surgery,2022,203(3):379-382.
[5]	Yang X,Ru J,Li Z,et al. Lower vitamin D levels and VDR FokI variants are associated with susceptibility to sepsis: a hospital-based case-control study[J]. International Journal of Molecular Sciences,2022,27(2):188-195.
[6]	Keum N,Lee D H,Greenwood D C,et al. Vitamin D supplementation and total cancer incidence and mortality: a meta-analysis of randomized controlled trials. [J]. Annals of Oncology : Official Journal of The European Society for Medical Oncology,2019,30(5): 733-743.
[7]	Caccamo D,Ricca S,Currò M,et al. Health risks of hypovitaminosis D: A review of new molecular insights[J]. International Journal of Molecular Sciences,2018,19(3):101-105.
[8]	SuTherland J P,Zhou A,Hyppأ٦nen E. ViTamin D deficiency increases mortality risk in the uk biobank : A nonlinear mendelian randomization study[J]. Annals of Internal Medicine,2022,175(11): 1552-1559.
[9]	Sikora-Klak J,Narvy S J,Yang J,et al. The effect of abnormal vitamin D levels in athletes[J] . The Permanente Journal,2018,22(9): 17-21.
[10]	Charoenngam N,Holick M F. Immunologic effects of vitamin D on human health and disease.[J]. Nutrients,2020,12(7):214-218.
[11]	Gunville C F,Mourani P M,Ginde A A. The role of vitamin D in prevention and treatment of infection.[J]. Inflammation & Allergy Drug Targets,2018,12(4):239-245.
[12]	SuTherland JP,Zhou A,Hyppönen E. Vitamin D deficiency increases mortality risk in the UK biobank : A nonlinear mendelian randomization study[J]. Annals of Internal Medicine,2022,175(11): 1552-1559.
[13]	Su L X,Jiang Z X,Cao L C,et al. Significance of low serum vitamin D for infection risk disease severity and mortality in critically ill patients[J]. Chinese Medical Journal,2017,126(14):2725-2730.
[14]	Sanaie S,Mahmoodpoor A,Hamishehkar H,et al. The relationship of serum vitamin D level with the outcome in surgical intensive care unit patients[J]. Iranian Journal of Pharmaceutical Research,2019,18(2):1052-1059.
[15]	Martineau A R,Jolliffe D A,Hooper R L,et al. Vitamin D supplementation to prevent acute respiratory tract infections: systematic review and meta-analysis of individual participant data[J]. Clinical Researched,2017,35(6):65-83.
[16]	Di Rosa M,Malaguarnera M,NicoleTti F,et al. ViTamin D3: A helpful immuno-modulator[J]. Immunology,2021,134(2):123-139.
[17]	Khashim Alswailmi F,Shah SIA,Nawaz H,et al. Molecular mechanisms of vitamin D-mediated immunomodulation[J]. Galen Medical Ournal,2021,10(3):20-34.
[18]	Hewison M. Vitamin D and the immune system: new perspectives on an old theme[J]. Endocrinology and Metabolism Clinics of North America,2021,39(2):365-379.
[19]	Zhou Q,Qin S,Zhang J,et al. 1,25(OH)(2)D(3) induces regulatory T cell differentiation by influencing the VDR/PLC-γ1/TGF-β1/pathway[J]. Molecular Immunology,2017,91(5):156-164.
[20]	Dauletbaev N,Herscovitch K,Das M,et al. Down-regulation of IL-8 by high-dose vitamin D is specific to hyperinflammatory macrophages and involves mechanisms beyond up-regulation of DUSP1[J]. British Journal of Pharmacology,2019,172(19):4757-4771.
[21]	Bivona G,Agnello L,Ciaccio M. Vitamin D and immunomodulation: Is it time to change the reference values[J]. Annals of Clinical and Laboratory Science,2017,47(4):508-510.
[22]	Chauss D,Freiwald T,McGregor R,et al. Autocrine vitamin D signaling switches off pro-inflammatory programs of T cells[J]. Nature Immunology,2022,23(1):62-74. doi: 10.1038/s41590-021-01080-3
[23]	Miroliaee A E,Salamzadeh J,Shokouhi S,et al. Effect of vitamin D supplementation on procalcitonin as prognostic biomarker in patients with ventilator associated pneumonia complicated with vitamin D deficiency[J]. Iranian Journal of Pharmaceutical Research,2019,16(3):1254-1263.
[24]	Eckard A R,O'Riordan M A,Rosebush J C,et al. Vitamin D supplementation decreases immune activation and exhaustion in HIV-1-infected youth[J]. Antiviral Therapy,2020,23(4):315-324.
[25]	Jaroslawska J,Ghosh DasTidar R,Carlberg C. Invivo vitamin D target genes interconnect key signaling pathways of innate immunity[J]. Plos one,2024,19(7):30-44
[26]	SilbersTein M. Correlation between premorbid IL-6 levels and COVID-19 mortality: Potential role for vitamin D[J]. International Immunopharmacology,2020,88(6):106-109.
[27]	Wimalawansa S J. Infections and Autoimmunity-the immune system and vitamin D: A systematic review[J]. Nutrients,2023,15(17):224-235
[28]	Lemire JM,Adams JS,Kermani-Arab V,et al. 1,25-Dihydroxyvitamin D3 suppresses human T helper/inducer lymphocyte activity in vitro. [J].International Immunopharmacology,2018,134(5): 3032-3035.
[29]	Hur S,Kim J,RaTnam L,et al. Lymphatic intervention,the fdrontline of modern lymphatic medicine: Part I. history,anatomy,physiology,and diagnostic imaging of the lymphatic system.[J]. Korean Journal of Radiology,2023,24(2):95-103. doi: 10.3348/kjr.2022.0688
[30]	WhiTe J H. Regulation of intracrine production of 1,25-dihydroxyvitamin D and its role in innate immune defense against infection[J]. Archives of Biochemistry and Biophysics,2019,523(1):58-63.
[31]	Yazdchi R,Gargari B P,Asghari-Jafarabadi M,et al. Effects of vitamin D supplementation on metabolic indices and hs-CRP levels in gestational diabetes mellitus patients: a randomized,double-blinded,placebo-controlled clinical trial.[J]. Nutrition Research and Practice,2016,10(3):328-335. doi: 10.4162/nrp.2016.10.3.328
[32]	TabaTabaeizadeh SA,Avan A,Bahrami A,et al. High dose supplementation of vitamin D affects measures of systemic inflammation: Reductions in high sensitivity C-reactive protein level and neutrophil to lymphocyte ratio (NLR) distribution[J]. Journal of Cellular Biochemistry,2017,118(12):4317-4322. doi: 10.1002/jcb.26084
[33]	Zhou A,Hyppönen E. Vitamin D deficiency and C-reactive protein: A bidirectional mendelian randomization study[J]. Nternational Journal of Epidemiology,2023,52(1):260-271.
[34]	ReinharT,K. Recognizing sepsis as a global health priority - A WHO Resolution[J]. Annals of InTernal Medicine,2017,377(9):414-417.

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