Volume 12, Issue 3 (Vol.12 No.3 Oct 2023)                   rbmb.net 2023, 12(3): 366-373 | Back to browse issues page

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Ananta Kahar L, Yusrawati Y, Jamsari J, Maskoen T, Aribowo K, Monika Sari W. The Role of Vitamin D Binding Protein and Vitamin D Level in Mortality of Sepsis Patients. rbmb.net 2023; 12 (3) :366-373
URL: http://rbmb.net/article-1-1213-en.html
Department of Anesthesiology and Intensive Care, Faculty of Medicine, Andalas University, Dr. M. Djamil General Hospital, Padang, 25171, Indonesia.
Abstract:   (917 Views)
Background: Vitamin D plays crucial roles in immune cell function, including macrophage activation, immune response modulation, and antimicrobial peptide production. Low vitamin D levels can result in reduced immune response, heightened inflammation, and impaired organ function, thereby exacerbating sepsis severity and impacting patient prognosis. This study investigates the influence of vitamin D binding protein expression and vitamin D levels on the mortality of septic patients.

Methods: This analytical observational study employs a case-control approach and involves patients at the Critical Care Unit of Dr. M. Djamil General Hospital in Padang, Indonesia. The study comprises 40 patients in the case group and 40 patients in the control group. Vitamin D and vitamin D binding protein levels are assessed using the enzyme-linked immunosorbent assay method.

Results: Vitamin D and vitamin D binding protein levels were observed to be lower in the case group compared to the control group. In the case group, the majority of patients had vitamin D binding protein levels below 200 µg/mL. A significant association was found between vitamin D levels and mortality in sepsis patients (P< 0.05). Patients with vitamin D levels below 20 µg/mL faced a 2.54 times higher risk of mortality than those with levels exceeding 20 µg/mL.

Conclusions: Diminished levels of vitamin D binding protein and vitamin D contribute to an increased risk of mortality in septic patients.
Full-Text [PDF 217 kb]   (445 Downloads)    
Type of Article: Original Article | Subject: Molecular Biology
Received: 2023/07/25 | Accepted: 2023/09/15 | Published: 2024/02/25

1. Shojaei M, Sabzeghabaei A, Barhagh HV, Soltani S. The correlation between serum level of vitamin D and outcome of sepsis patients: a cross-sectional study. Arch Acad Emerg Med. 2019;7(1):e1.
2. Fleischmann C, Scherag A, Adhikari NK, Hartog CS, Tsaganos T, Schlattmann P, et al. Assessment of global incidence and mortality of hospital-treated sepsis Current estimates and limitations. Am J Resp Crit Care Med. 2016;193(3):259-72. [DOI:10.1164/rccm.201504-0781OC] [PMID]
3. Vanichkulbodee A, Romposra M, Inboriboon PC, Trongtakul K. Effects of vitamin D insufficiency on sepsis severity and risk of hospitalisation in emergency department patients: a cross-sectional study. BMJ Open. 2023;13(1):e064985. [DOI:10.1136/bmjopen-2022-064985] [PMID] []
4. Anetakis C, Mitka S, Chatzidimitriou M, Anagnostopoulos K, Eleftherious P, Lialiaris T. Vitamin D status in osteoporotic and diabetic patients and athletic healthy individuals from Northern Greece. Rep Biochem Mol Biol. 2023;11(4):565-76. [DOI:10.52547/rbmb.11.4.565] [PMID] []
5. Talebi F, Nejad MR, Yaseri M, Hadadi A. Association of vitamin D status with the severity and mortality of community-acquired pneumonia in Iran during 2016-2017: a prospective cohort study. Rep Biochem Mol Biol. 2019;8(1):85-90.
6. Guan J, Shichen M, Liang Z, Yu S, Zhao M, Zhang L, et al. Potential benefits of vitamin D for sepsis prophylaxis in critical ill patients. Front Nutr. 2023;10:1073894. [DOI:10.3389/fnut.2023.1073894] [PMID] []
7. Charoenngam N, Holick MF. Immunologic effects of vitamin D on human health and disease. Nutrients. 2020;12:2097. [DOI:10.3390/nu12072097] [PMID] []
8. Quraishi SA, de Pascale G, Needleman JS, Nakazawa H, Kaneki M, Bajwa EK, et al. Effect of cholecalciferol supplementation on vitamin D status and cathelicidin levels in sepsis: a randomized, placebo-controlled trial. Crit Care Med. 2015;43:1928-37. [DOI:10.1097/CCM.0000000000001148] [PMID] []
9. Xiao K, Zhang DC, Hu Y, Song LC, Xu JQ, He WX, et al. Potential roles of vitamin D binding protein in attenuating liver injury in sepsis. Mil Med Res. 2022;9:4. [DOI:10.1186/s40779-022-00365-4] [PMID] []
10. Hollis BW. Vitamin D-binding protein deficiency and homozygous deletion of the GC gene. N Engl J Med. 2019;380(26):2583-2584. [DOI:10.1056/NEJMc1905282] []
11. Delanghe JR, Speeckaert R, Speeckaert MM. Behind the scenes of vitamin D binding protein: more than vitamin D binding. Best Pract Res Clin Endocrinol Metab. 2015;29(5):773-86. [DOI:10.1016/j.beem.2015.06.006] [PMID]
12. Holick MF. The vitamin D deficiency pandemic: approaches for diagnosis, treatment and prevention. Rev Endocr Metab Disord. 2017;18(2):153-65. [DOI:10.1007/s11154-017-9424-1] [PMID]
13. Upala S, Sanguankeo A, Permpalung N. Significant association between vitamin D deficiency and sepsis: a systematic review and meta-analysis. BMC Anesthesiol. 2015;15:84. [DOI:10.1186/s12871-015-0063-3] [PMID] []
14. Suberviola B, Lavin BA, Jimenez AF, Perez-San Martin S, Garcia-Unzueta M, Santibañez M. Vitamin D binding protein, but not vitamin D or vitamin D-related peptides, is associated with septic shock mortality. Enferm Infec Microbiol Clin (Engl). 2019;37(4):239-43. [DOI:10.1016/j.eimc.2018.06.011] [PMID]
15. Yoo JW, Jung YK, Ju S, Lee SJ, Cho YJ, Jeong YY, et al. Serum vitamin D binding protein level, but not serum total, bioavailable, free vitamin D, is higher in 30-days survivors than in nonsurvivors with sepsis. Medicine (Baltimore). 2020;99(25):e20756. [DOI:10.1097/MD.0000000000020756] [PMID] []
16. Zacharioudaki M, Messaritakis I, Galanakis E. Vitamin D receptor, vitamin D binfing protein dan CYP27B1 single nucleotide polymorphisms and susceptibility to viral infections in infants. Sci Rep. 2021;11:13835. [DOI:10.1038/s41598-021-93243-3] [PMID] []
17. Herwig R, Erlbacher K, Ibrahimagic A, Kacar M, Brajshori N, et al. Vitamin D-dimer: a possible biomolecule modulator in cytotoxic and phagocytosis processes. Biomedicines. 2022;10(8):1785. [DOI:10.3390/biomedicines10081785] [PMID] []
18. Rezaei A, Shayan N, Shirazinia S, Mollazadeh S, Ghiyasi-Moghaddam N. The prognostic significance of P16 immunohistochemical expression pattern in women with invasive ductal breast carcinoma. Rep Biochem Mol Biol. 2023;12(1): 84-91.
19. Pop TL, Sirbe C, Benta G, Mititelu A, Grama A. The role of vitamin D and vitamin D binding protein in chronic liver diseases. Int J Mol Sci. 2022;23(18):10705. [DOI:10.3390/ijms231810705] [PMID] []
20. Zhang D, Xiao K, Guan W, Su L, Xie L. Clinical and experimental significance of vitamin D binding protein in patients with sepsis and the mouse sepsis model. Chest J. 2016;143(4):A181. [DOI:10.1016/j.chest.2016.02.187]
21. Zhu A, Kuznia S, Niedermaier T, Holleczek B, Schottker B, Brenner H. Vitamin D-binding protein, total, nonbioavailable, bioavailable and free 25-hydroxyvitamin D and mortality in a large population-based cohort of older adults. J Int Med. 2022;292(3):463-76. [DOI:10.1111/joim.13494] [PMID]
22. Alharbi A. A potential role of vitamin D on platelet leukocyte aggregation and pathological events in sepsis: an updated review. J Inflamm Res. 2021;14:3651:3664. [DOI:10.2147/JIR.S321362] [PMID] []
23. Delrue C, Speeckaert R, Delanghe JR, Speeckaert MM. Vitamin D deficiency: an underestimated factor in sepsis? Int J Mol Sci. 2023;24(3):2924. [DOI:10.3390/ijms24032924] [PMID] []
24. Ratzinger F, Haslacher H, Stadlberger M, Schmidt RLJ, Obermuller M, Schmetterer KG, et al. 25(OH)D and 1,25(OH)D vitamin D fails to predict sepsis and mortality in a prospective cohort study. Sci Rep. 2017;7:40646. [DOI:10.1038/srep40646] [PMID] []
25. Jeng T, Yamschikov AV, Judd SE, Blumberg HM, Martin GS, Ziegler TR, et al. Alterations in vitamin D status and antimicrobial peptide levels in patients in the intensive care unit with sepsis. J Translat Med. 2009;7:28. [DOI:10.1186/1479-5876-7-28] [PMID] []

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