Vitamin D deficiency in community-acquired pneumonia: low levels of 1,25(OH)2 D are associated with disease severity
Respiratory Research 2014, 15:53 doi:10.1186/1465-9921-15-53
Mathias W Pletz, Christoph Terkamp, Ulrike Schumacher, Gernot Rohde, Hartwig Schütte, Tobias Welte and Robert Bals
We aimed to explore the association between vitamin D levels and the severity, mortality and microbiological etiology of community-acquired pneumonia.
Vitamin D levels (both, the reservoir form 25-OH and the activated form 1,25-OH2) of 300 randomly selected patients with community-acquired pneumonia due to pre-specified pathogens included in the German competence network (CAPNETZ) study were measured. Prior to statistical analysis, values of 25-OH and 1,25-OH2 were power-transformed to achieve parametric distribution. All further analyses were performed with seasonally and age adjusted values.
There was only a modest (Spearman Coefficient 0.38) positive correlation between 25-OH and 1,25-OH2. For 1,25-OH2 but not 25-OH, the general linear model revealed a significant inverse correlation between serum concentration and CURB score (p = 0.011). Liver and respiratory co-morbidity were associated with significantly lower 25-OH values and renal co-morbidity with significantly lower 1,25-OH2 values. No significant differences of 1,25-OH2 or 25-OH between different pathogens (influenza virus, Legionella spp., Streptococcus pneumoniae) were detected.
For 1,25-OH2, we found a significant and independent (controlled for age, season and pathogen) negative correlation to pneumonia severity. Therefore, supplementation of non-activated vitamin D to protect from pneumonia may be non-sufficient in patients that have a decreased capacity to hydroxylate 25-OH to 1,25-OH2.
- “After seasonal adjustment, age had a significant impact on 1,25-OH2 levels (F1,297= 6.06, p = 0.0144) but not on 25-OH levels (F1,297= 0.03, p = 0.8588).”
VitaminDWiki interpretation: Seniors have kidney problems, thus reducing the activation of vitamin D
As much as 50% variation in activated levels between individuals with the same serum level
Kidney problems did, as expected, reduce the activated level without reducing the serum level much
|Influenza A||11 ng||64|
|Influenza B||13 ng||31|
VitaminDWiki speculation: Influenza B degrades the Kidney function.
- Search VitaminDWiki for INFLUENZA 2150 hits as of April 2014
- Reduce probability of getting the Flu
- Influenza, seniors and vitamin D – Jan 2012
- Colds and flu - Overview
- Overview Influenza and vitamin D
- Search VitaminDWiki for pneumonia 508 hits as of June 2017
- Pneumonia in seniors was 2.5X more likely if low vitamin D – June 2014
- What blocks vitamin D from getting to cells - in addition to genes and diseases has the following chart
Overview Kidney and vitamin D contains the following summary
- FACT: Kidney is the primary way to activate vitamin D
- FACT: When the Kidney has problems, there is less active vitamin D (Calcitriol) for the body
- FACT: When the Kidney has problems, there is increased death due to many factors - many of which are associated with lack of Calcitriol
- FACT: There are many on-going intervention clinical trials trying to determine how much of what kind of vitamin D is needed to treat the problem
- FACT: One Randomized Controlled Trial has proven that Vitamin D treats CKD
- FACT: Taking extra Vitamin D, in various forms, does not cause health problems - even if poor kidney
- Suggestion: Increase vitamin D getting into body now - and increase co-factors so that the vitamin D can be better used
Sun, UV lamp, Vitamin D supplement - probably > 5,000 IU,
Calcitriol - which bypasses the need for the kidney to activate vitamin D
Problems with Calcitriol however: typically only lasts for a few hours, also, possible complications
Update: Pre-cursor of active vitamin D made from plants is better than calcitriol – Sept 2012
- Category Kidney and Vitamin D contains