Vitamin D: a negative acute phase reactant
JL Waldron, HL Ashby, MP Cornes… - Journal of clinical …, 2013 - jcp.bmj.com
JL Waldron, HL Ashby, MP Cornes, J Bechervaise, C Razavi, OL Thomas, S Chugh…
Journal of clinical pathology, 2013•jcp.bmj.comObjective We evaluated the effect of the systemic inflammatory response (SIR), as provoked
by elective orthopaedic surgery, on serum vitamin D [25-(OH) D]. Methods Serum 25-(OH) D,
serum vitamin D binding protein (VDBP) and urinary VDBP were measured in 30 patients
before and 48-hours after knee or hip arthroplasty. C-reactive protein (CRP) was measured
to assess the SIR. Results The mean (SD) CRP increased following surgery [5.0 (5.5) vs
116.0 (81.2) mg/L; P< 0.0001] as did urine VDBP/Creatinine ratio [8 (9) vs 20 (25) pg/mmol; …
by elective orthopaedic surgery, on serum vitamin D [25-(OH) D]. Methods Serum 25-(OH) D,
serum vitamin D binding protein (VDBP) and urinary VDBP were measured in 30 patients
before and 48-hours after knee or hip arthroplasty. C-reactive protein (CRP) was measured
to assess the SIR. Results The mean (SD) CRP increased following surgery [5.0 (5.5) vs
116.0 (81.2) mg/L; P< 0.0001] as did urine VDBP/Creatinine ratio [8 (9) vs 20 (25) pg/mmol; …
Objective
We evaluated the effect of the systemic inflammatory response (SIR), as provoked by elective orthopaedic surgery, on serum vitamin D [25-(OH)D].
Methods
Serum 25-(OH)D, serum vitamin D binding protein (VDBP) and urinary VDBP were measured in 30 patients before and 48-hours after knee or hip arthroplasty. C-reactive protein (CRP) was measured to assess the SIR.
Results
The mean (SD) CRP increased following surgery [5.0 (5.5) vs 116.0 (81.2) mg/L; P<0.0001] as did urine VDBP/Creatinine ratio [8 (9) vs 20 (25) pg/mmol; p=0.0004]. Serum 25-(OH)D [56.2 (30.3) vs 46.0 (27.6) nmol/L; p = 0.0006] and serum VDBP [334 (43) vs 298 (37) mg/L]; P<0.0001] decreased.
Conclusions
Serum 25-(OH)D is a negative acute phase reactant, which has implications for acute and chronic inflammatory diseases. Serum 25-(OH)D is an unreliable biomarker of vitamin D status after acute inflammatory insult. Hypovitaminosis D may be the consequence rather than cause of chronic inflammatory diseases.
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