Effect of vitamin D deficiency in Korean patients with acute respiratory distress syndrome

Background/Aims: Vitamin D modulates innate and adaptive immune responses, and vitamin D deficiency is associated with increased mortality in hospitalized patients with pneumonia. We evaluated the prevalence of vitamin D deficiency in Korean patients with acute respiratory distress syndrome (ARDS) and its effect on the clinical outcomes of ARDS. Methods: We retrospectively analyzed the data of 108 patients who had a measured serum level of 25-hydroxy vitamin D3 (25(OH)D-3) at the time of diagnosis with ARDS. The clinical outcomes were evaluated based on 15(OH)D-3 levels of 20 ng/mL and stratified by quartiles of 25(OH)D-3 levels. Results: The mean age of patients was 59.4 years old; 77 (71.3%) were male. Vitamin D deficiency was found in 103 patients (95.4%). The mean 25(OH)D-3 level was 8.3 +/- 7.0 ng/mL. Neither in-hospital mortality (40.0% vs. 68.0%) nor 6-month mortality (40.0% vs. 71.8%) significantly differed between groups. There were no significant differences in 25(OH)D-3 level between survivors (8.1 +/- 7.6 ng/mL) and non-survivors (8.5 +/- 6.8 ng/mL, p = 0.765). There were no trends toward a difference in mortality among quartiles of 25(OH)D-3 levels. However, 25(OH)D-3 levels were inversely related with length of hospital stay and intensive care unit stay among in-hospital survivors. Conclusions: Vitamin D deficiency was prevalent in Korean patients with ARDS. However, levels of vitamin D were not associated with mortality. A large, prospective study is needed to evaluate the effects of vitamin D deficiency on clinical outcomes of ARDS.