Vitamin D status in critically ill patients: the evidence is now bioavailable!
نویسندگان
چکیده
We read with great interest the recent article by Amrein and colleagues demonstrating an association between 25-hydroxyvitamin D (25(OH)D) levels and adjusted hospital mortality (hazard ratio 2.05; 95% confidence interval 1.31 to 3.22) [1]. Interestingly, in this large cohort of ICU patients, no individual with 25(OH)D levels ≥30 ng/ml died from sepsis. However, the investigators did not appreciate an association of 25(OH)D levels with hospital length of stay, ICU mortality, blood culture positivity, or inflammatory markers. We hypothesize that these negative findings may be explained by the fact that only total serum 25(OH)D levels were available for the analysis. Circulating 25(OH)D levels are considered the best indicator of vitamin D status in the general population [2]. However, 25(OH)D is predominantly bound to vitamin D binding protein in a very stable complex; indeed, only
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