Association between serum 25-hydroxyvitamin D, nutritional status, and inflammatory markers in sepsis patients with and without sarcopenia

血清25-羟基维生素D、营养状况和炎症标志物与伴有和不伴有肌少症的脓毒症患者之间的关联

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Abstract

BACKGROUND: Sepsis, a critical infectious syndrome, frequently presents with sarcopenia and is typified by an inflammatory cascade and vitamin D (VD) deficiency. The interrelation between these conditions remains to be fully elucidated. VD, known for its immunomodulatory properties, is suspected to play a role in the pathogenesis of both sepsis and sarcopenia. The significance of serum VD levels in diagnosing sepsis and sarcopenia is well-recognized. This study was designed to scrutinize the relationships among VD, nutritional status, and inflammatory profiles in individuals with sepsis and concurrent sarcopenia, and to explore potential VD cut-off values. METHODS: The study cohort comprised two principal groups: a sepsis group and a control group. The sepsis group was further bifurcated into those with and without sarcopenia. The study enrolled 100 patients diagnosed with sepsis from February 2022 to February 2023, and 92 healthy controls. Of the sepsis patients, 46 had comorbid sarcopenia. Serum 25(OH)D levels, along with nutritional and inflammatory biomarkers, were assessed, and receiver operating characteristic (ROC) curve analysis was performed to determine the optimal cut-off values. RESULTS: Notable disparities in 25(OH)D levels and markers of nutrition and inflammation were observed between the sepsis and control groups, as well as between the subgroups with and without sarcopenia. The optimal cut-off values of serum 25(OH)D derived from ROC analysis were 22.55 ng/mL for sepsis and 14.31 ng/mL for sepsis with sarcopenia. CONCLUSION: Serum 25(OH)D levels were significantly associated with nutritional status and inflammatory responses in patients with sepsis, particularly in those with sarcopenia, and may serve as a potential biomarker reflecting these clinical features.

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