Vitamin D Status in Critically Ill Patients with SIRS and Its Relationship with Circulating Zn and Related Parameters during ICU Stay.

Abstract

Critically ill patients are exposed to different stressors which may generate Systemic Inflammatory Response Syndrome (SIRS). This situation hinders the assessment of micronutrients status, such as vitamin D or Zinc (Zn), potentially affecting patients' treatment and recovery. The aim of the present study was to assess the evolution of circulating 25-Hydroxyvitamin D (25-OH-D) levels after seven days of Intensive Care Unit (ICU) stay and the influence on changes in plasma and erythrocyte Zn levels, as well as other parameters related to phosphorus-calcium metabolism. A prospective analytical study was conducted on 65 critically ill patients (42% women) aged 31-77 years with SIRS. Total 25-OH-D levels were measured in plasma samples by liquid chromatography-tandem mass spectrometry, and Zn content was analyzed by flame atomic absorption spectrometry. Both 25-OH-D and 25-OH-D3 levels were directly associated with erythrocyte Zn concentration at follow-up (p = 0.046 and p = 0.011, respectively). A relationship between erythrocyte and plasma Zn was also found at this follow-up point. No such clear associations were found when considering 25-OH-D2. Different disturbances in levels of phosphorus-calcium metabolism parameters were found, suggesting a relationship between the changes of 25-OH-D3 levels and parathormone (p = 0.019) and phosphorus (p = 0.005). The findings of the present study suggest an interaction between vitamin D and Zn, in which the correct status of these micronutrients could be a potentially modifiable factor and a beneficial approach in the recovery of critically ill patients.