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Vitamin D levels in patients admitted to the intensive care unit and the association with organ dysfunction and glutamine levels

F Seedat, G K Schleicher, P Gaylard, R Blaauw

Abstract


Background. Vitamin D deficiency is common in intensive care unit (ICU) patients (50 - 82%) and is associated with multi-organ dysfunction. Vitamin D deficiency alters pathways of glutamine metabolism in critical illness, but the impact of vitamin D status on glutamine levels is poorly characterised.

Objectives. To assess the prevalence of vitamin D deficiency and its association with organ dysfunction and glutamine levels in a South African (SA) ICU.

Methods. Records of 103 adult patients admitted to the Wits Donald Gordon Medical Centre ICU, Johannesburg, SA were retrospectively reviewed. 25-hydroxyvitamin D (25(OH)D) and glutamine levels were measured on admission. The association between admission vitamin D levels and glutamine levels, illness severity scores, organ support and outcomes was examined.

Results. On ICU admission, 66% (68/103) of patients were vitamin D deficient (<20 ng/mL) (95% confidence interval (CI) 56 - 75). Vitamin D deficiency was significantly associated with mechanical ventilation (40% v. 14%) (p=0.013) and a higher median sequential organ failure assessment (SOFA) score on admission (6 (interquartile range (IQR) 3 - 8) v. 4 (IQR 2 - 6)) (p=0.047) and on day 7 (5 (IQR 2 - 10) v. 2 (IQR 1 - 4)) (p=0.017). Median admission serum glutamine levels were 481 μmol/L, with 38% deficient (<420 μmol/L) (95% CI 28 - 48). Vitamin D deficiency status on admission was not significantly associated with median admission glutamine levels (p=0.66).

Conclusions. Vitamin D deficiency is common in ICU patients in SA. Deficient patients were more severely ill and required more respiratory support. No significant relationship between deficiency and median glutamine levels was noted.


Authors' affiliations

F Seedat, Wits Donald Gordon Medical Centre ICU, Johannesburg, South Africa

G K Schleicher, Wits Donald Gordon Medical Centre ICU, Johannesburg, South Africa

P Gaylard, Data Management and Statistical Analysis, Johannesburg, South Africa

R Blaauw, Division of Human Nutrition, Department of Global Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa

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Keywords

Vitamin D; Glutamine; Organ dysfunction; ICU; Critical illness

Cite this article

South African Medical Journal 2020;110(11):1128-1133. DOI:10.7196/SAMJ.2020.v110i11.14726

Article History

Date submitted: 2020-10-28
Date published: 2020-10-28

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