Study Title:

Pneumonia Mortality Linked to Vitamin D Deficiency

Study Abstract

Background and objective: Vitamin D regulates the production of the antimicrobial peptides cathelicidin and beta-defensin-2, which play an important role in the innate immune response to infection. We hypothesized that vitamin D deficiency would be associated with lower levels of these peptides and worse outcomes in patients admitted to hospital with community acquired pneumonia.

Methods: Associations between mortality and serum levels of 25-hydroxyvitamin D, cathelicidin and beta-defensin-2 were investigated in a prospective cohort of 112 patients admitted with community acquired pneumonia during winter.

Results: Severe 25-hydroxyvitamin D deficiency (<30 nmol/L) was common in this population (15%) and was associated with a higher 30-day mortality compared with patients with sufficient 25-hydroxyvitamin D (>50 nmol/L) (odds ratio 12.7, 95% confidence interval: 2.2–73.3, P = 0.004). These associations were not explained by differences in age, comorbidities, or the severity of the acute illness. Neither cathelicidin nor beta-defensin-2 levels predicted mortality, although there was a trend towards increased mortality with lower cathelicidin (P = 0.053). Neither cathelicidin nor beta-defensin-2 levels correlated with 25-hydroxyvitamin D.

Conclusions: 25-hydroxyvitamin D deficiency is associated with increased mortality in patients admitted to hospital with community acquired pneumonia during winter. Contrary to our hypothesis, 25-hydroxyvitamin D levels were not associated with levels of cathelicidin or beta-defensin-2.

From press release:

A new study published in the journal Respirology reveals that adult patients admitted to the hospital with pneumonia are more likely to die if they have vitamin D deficiency.

Vitamin D is known to be involved in the innate immune response to infection.

The team of researchers at Waikato Hospital and the Universities of Waikato and Otago, measured vitamin D in the blood samples of 112 adult patients admitted with community acquired pneumonia during the winter at the only acute-care hospital in Hamilton, New Zealand.

The researchers found that vitamin D deficiency was associated with higher mortality within the first 30 days after hospital admission for pneumonia. The association between vitamin D deficiency was not explained by patient age, sex, comorbidities, the severity of the systemic inflammatory response, or other known prognostic factors.

The authors conclude that "improved understanding of Vitamin D and its role in immunity may lead to better ways to prevent and/or treat pneumonia. We now need to investigate whether Vitamin D supplements could be a useful addition to pneumonia treatment and whether using supplements could help to prevent or reduce the severity of pneumonia among high-risk populations."

Study Information

LEONG LEOW, TALIA SIMPSON, RAY CURSONS, NOEL KARALUS, ROBERT J. HANCOX.
Vitamin D, innate immunity and outcomes in community acquired pneumonia.
Respirology
2011 May

Full Study