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Pneumonia elderly death 12X more likely when vitamin D less than 12 ng – 2011

Vitamin D, Innate Immunity and Outcomes in Community Acquired Pneumonia

1. Leong Leow1, 2. Talia Simpson3, 3. Ray Cursons3, 4. Noel Karalus1, 5. Robert J Hancox1,2,*
DOI: 10.1111/j.1440-1843.2011.01924.x
© 2011 The Authors. Respirology © 2011 Asian Pacific Society of Respirology, Respirology

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 hypothesised 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 (<30nmol/L) was common in this population (15%) and was associated with a higher 30-day mortality compared to patients with sufficient 25-hydroxyvitamin D(>50nmol/L) (OR 12.7, 95%CI 2.2-73.3, p = 0.004).

These associations were not explained by differences in age, co-morbidities, 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 = 0.09).
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.

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Graph shows a 40% chance of wheezing at age 80 if have less than 10 nanograms of vitamin D
Children and Pneumonia

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