The Change in Vitamin D Levels during the Early Days of Intensive Care Unit Admission and Factors Affecting Change
- 1. Department of Pulmonology, Erciyes University Faculty of Medicine, Kayseri, Turkey.
- 2. Department of Internal Medicine, Division of Intensive Care, Ankara University Faculty of Medicine, Ankara, Turkey.
Description
Abstract
In the last decade, vitamin D has an increasing importance due to its demonstrated pleotropic, antimicrobial, and immunomodulatory effects, and has been a subject of interest especially in critically ill patients due to its role on immune functions. The aim of this study is to determine whether vitamin D levels change during the first days of intensive care unit (ICU) admission and to study factors that may affect these variations. Patients admitted to the ICU between March 2014 and December 2014 were included in the study. Blood samples were obtained on the admission day, and the following three days and 25-hydroxyvitamin D levels were measured by high pressure liquid chromatography (HPLC) technique. Changes over time were analyzed with variance analysis if they were normally distributed, otherwise by Friedman tests. A total of 31 patients were enrolled. Of those, 17 (54.8%) patients were women. On admission median vitamin D level for all was 8.52 (5-37) ng/mL. On the third day median vitamin D level for all was 8.85 (5-35.1) ng/mL. There was no statistically significant difference between vitamin D levels which were measured on the consequent 3 days (p=0.553). There was no significant correlation between daily vitamin D levels and changes in levels of CRP, procalcitonin, and albumin (p=0.061, p=0.61, p=0.179 respectively) or daily fluid balance (first day p=0.31, second day p=0.65, third day p=0.13). Our presented data revealed that repeated measurements of early vitamin D levels on consequent days did not have significant differences and CRP, procalcitonin, albumin levels, and fluid balance parameters do not seem to affect early serum vitamin D levels in critically ill patients.
Özet
D vitamini son on yılda gösterilmiş pleotropik, antimikrobial ve immünmodülatör etkileri sebebi ile giderek artan bir öneme sahip olup kritik hastalarda özellikle immün fonksiyonlar üzerindeki rolü sebebi ile de ilgi konusu olmuştur. Bu çalışmanın amacı; yoğun bakım ünitesine (YBÜ) kabulün ilk günlerinde D vitamini düzeylerinin değişip değişmediğini belirlemek ve bu değişiklikleri etkileyebilecek faktörleri araştırmaktır. Çalışmaya Mart 2014 ile Aralık 2014 tarihleri arasında yoğun bakım ünitesine alınan hastalar dahil edildi. Hastaların yatış gününde ve takip eden üç gün içinde kan örnekleri alındı ve HPLC (yüksek basınç sıvı kromatografisi) yöntemi ile 25-hidroksivitamin D düzeyleri ölçüldü. Zamana göre değişimler, dağılım normal ise varyans analizi ile, dağılım normal değilse Friedman testi ile araştırıldı. Toplamda 31 hasta çalışmaya dahil edilmiştir. Bu hastaların 17’si (%54.8) kadındır. Hastaların yoğun bakıma alınması esnasında ortanca vitamin D düzeyi 8.52 (5-37) ng/mL idi. Üçüncü günde ise ortanca D vitamini düzeyi 8.85 (5-35.1) ng/mL olarak saptandı. Hastaların D vitamini düzeylerinde birbirini takip eden üç gün arasında anlamlı bir değişiklik saptanmadı (p=0.553). D vitamininin günlük düzeyleri ile CRP, prokalsitonin ve albümin düzeylerindeki (sırası ile p=0.061, p=0.61, p=0.179) veya sıvı balansındaki (birinci gün p=0.31, ikinci gün p=0.65, üçüncü gün p=0.13) değişimler arasında anlamlı bir korelasyon görülmedi. Çalışma verilerimiz yoğun bakıma yatışın ilk günlerinde tekrarlayan ölçümlerde D vitamini düzeyinin anlamlı bir değişiklik göstermediğini ve kritik hastalığı olan bireylerde CRP, prokalsitonin, albümin ve sıvı balansı parametrelerinin D vitamini düzeylerini etkilemediğini göstermektedir.
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