ASSOCIATION OF 25 (OH) VITAMIN D LEVELS WITH INCREASED PROCALCITONIN LEVELS IN SEPTIC PATIENTS AT H. ADAM MALIK GENERAL HOSPITAL MEDAN

Maruhum Nur, Adi K. Aman, Achsanuddin Hanae

Abstract


Introduction: Sepsis is a complex syndrome caused by an uncontrolled systemic inflammatory response, caused infection. One factor that plays a role in the prognosis of sepsis is vitamin D.  While Procalcitonin (PCT),  a biomarker response to infection, and PCT levels can be increased in septic patients. The purpose of this study was to determine the association of 25 (OH) Vitamin D levels with increased PCT levels in septic patients.

Methods: This study was conducted with cross sectional design, from August to December 2016. The subjects of this study were septic patients who admitted to the intensive care unit at H. Adam Malik General Hospital Medan, aged >18 years.  25 (OH) vitamin D total and Procalcitonin (PCT) were measured by means of MINI VIDAS BRAHMS, correlation of 25 (OH) Vitamin D and PCT levels was tested using Spearman correlation test, statistical tests with p values <0.05 were considered significant.

Results and Discussions: A sample of 33 people consisted of 20 (60.6%) men and 13 (39.4%) women, with an average (SD) age of 53.6 (11.7) years. There were 27 (81.8%) patients reporting hypovitaminosis Vitamin D. That was found a significant negative correlation of total 25 (OH) vitamin D levels with procalcitonin levels (r = - 0.434, p = 0.012).

Conclusions: In this study concluded that 81.8% of patients who treated in the ICU had hypovitaminosis Vitamin D. There was a negative correlation between 25 (OH) vitamin D levels and increased procalcitonin levels of septic patients who admitted to the ICU.

 


Keywords


Sepsis, Vitamin D, Procalcitonin

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References


Singer M, et al. The Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3). JAMA. 2016;315:801–10.

Munford RS. Severe Sepsis and Sepsis Shock. Harrison's Infectious Diseases. 17th ed. The McGraw-Hill Companies. 2016: 162-73.

Bataar, et al.World Health Organization. 2010. [Online] Available at: http://www.who.int/bulletin/volumes/88/11/10-077073/en/ [Accessed 10 April2016].

Pradipta IS, et al. Antibiotic Resistance in Septic patients: Evaluation and Recommendation of Antibiotic Use. North American J of Med Sci. 2013:344-52.

Medical Record RSUP Haji Adam Malik. 2015.

Wacker C, Prkno A, Brunkhorst FM, Schlattmann P. Procalcitonin as a diagnostic marker for sepsis: a systematic review and meta-analysis. Lancet Infectious Diseases. 2013;13(5): 426-35.

Meisner M, Dresden-Neustadt SK. Procalcitonin-Biochemistry and Clinical Analaysis. UNI-MED Science.1st Ed. 2010:128.

Castelli GP, Pognani C, Meisner M, Stuani A, Bellomi D, Sgarbi L. Procalcitonin and C-reactive protein during systemic inflamatory response syndrome, sepsis and organ dysfunction. Crit Care. 2004;8(4):234-42.

Chen Z, Luo Z, Zhao X,et.al. Association Vitamin D Status of Septic Patients in Intensive Care Units With Altered Procalcitonin Levels and Mortality. Jclin Endocrinol Metab. 2015;100(2):516-23.

Holick MF, Binkley NC, Bischoff-Ferrari HA, Gordon CM, Hanley DA, Heaney RP, et al. Evaluation, treatment, and prevention of vitamin D deficiency: An endocrine society clinical practice guideline. J Clin Endocrinol Metab. 2011; 96:1911-30.

Ginde AA, Camargo CA, Shapiro NIJ. Vitamin D insufficiency and sepsis severity in emergency department patients with suspected infection. Acad Emerg Med. 2011;18(5):551-4.

Dellinger RP, Levy MM, Rhodes A, Annane D, Gerlach H, Opal SM, et.al. Surviving Sepsis Campaign: International Guidlines for Management of Severe Sepsis and septic shock. Critical Care Medicine. 2013;41(2):580-637.

Lucidarme O, Messai E, Mazzoni T, Arcade M, Cheyron DD. Incidence and risk factors of vitamin D deficiency in critical ill patients: result from a prospective observational study.Intensive Care Med. 2010;36:1609-11.

Zuniga S, Firrincieli D, Housset C, Chignard N. Vitamin D and The Vitamin D Receptor in Liver Pathophysiology.Clin Res Hepatol Gastroenterol. 2011;35:259-302.

Sari DK, Damanik HA, Lipoeto NI, Lubis Z. Is Micro Evolution in Tropical Country Women Resulting Low 25(OH)D Level?: A Cross Sectional Study in Indonesia. J Nutr Food Sci. 2013;4:246.

Claushuis TAM, Vught LAV, Scicluna BP, et al.Thrombocytopenia is associated with a dysregulated host response in critically ill septic patients.Blood. 2016;127(24):3062-72.

Guclu E, Durmaz Y,Karabay O. Effect of severe sepsis on platelet count and their indices.African Health Sciences. 2013;13(2):333-8.

Mayr FB, Yende S, Angus C. Epidemiology of severe sepsis. Virulence. 2014; 5(1):4-11.

Gynther P, Tropainen S, Matilainen JM, Seuter S, Carlberg C. Vaisanen S Mechanism of 1α,25-dihydroxivitamin D3-dependent repression of interleukin-12B. Biochim Biophys Acta. 2011;1813:810-818.

Zhang Y, Leung DY, Richer BN, et al. Vitamin D inhibit monocytes/macrophage proinflammatory cytokine production by targeting MAPK phosphatase-1. J Immunol. 2012;188:2127-35.

Schleithoff SS, Zittermann A, Tenderich G, et al. Vitamin D Suplementation Improves Cytokines Profiles in Patients with Congestive Heart Failure: a double blind, randomized, placebo controlled trial. Am J Clin Nutr. 2006; 83:754-56.

Schuezt P, Albrich W, Mueller B. Procalcitonin for Diagnosis of Infection and Guide to Antibiotic Decision: past, present, and future. BMC Medicine. 2011; 9:107.


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