BACKGROUND Vitamin D deficiency has been related to the risk of sepsis. However, previous studies showed inconsistent results regarding the association between serum 25-hydroxyvitamin D (25 (OH) D) and mortality risk in septic patients. We aimed to evaluate the relationship between serum 25 (OH) D at admission and mortality risk in adult patients in a meta-analysis. METHODS Follow-up studies that provided data of multivariate adjusted relative risk (RR) between serum 25 (OH) D and mortality risk in septic patients were retrieved via systematic search of PubMed and Embase databases. A random effect model was used to pool the results. RESULTS Eight studies with 1736 patients were included. Results of overall meta-analysis showed that lower 25 (OH) D at admission was independently associated with increased risk or mortality (adjusted RR: 1.93, p < 0.001; I2 = 63%) in patients with sepsis. Exploring subgroup association showed that patients with severe vitamin D deficiency (25 (OH) D < 10 ng/ml) was significantly associated with higher mortality risk (adjusted RR: 1.92, p < 0.001), but the associations were not significant for vitamin D insufficiency (25 (OH) D 20~30 ng/ml) or deficiency (25 (OH) D 10~20 ng/ml). Further analyses showed that the association between lower serum 25 (OH) D and higher mortality risk were consistent in studies applied different diagnostic criteria for sepsis (systemic inflammatory response syndrome, Sepsis-2.0, or Sepsis-3.0), short-term (within 1 month) and long-term studies (3~12 months), and in prospective and retrospective studies. CONCLUSIONS Severe vitamin D deficiency may be independently associated with increased mortality in adult patients with sepsis. Large-scale prospective studies are needed to validate our findings.

中文翻译：

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成年脓毒症患者血清25-羟维生素D和死亡风险：一项荟萃分析。

背景技术维生素D缺乏症与败血症的风险有关。但是，先前的研究表明败血症患者血清25-羟基维生素D（25（OH）D）与死亡风险之间的相关性不一致。我们旨在通过荟萃分析评估入院时血清25（OH）D与成年患者死亡风险之间的关系。方法通过系统化的PubMed和Embase数据库检索，提供了败血症患者血清25（OH）D与死亡风险之间的多元校正相对风险（RR）数据的后续研究。使用随机效应模型汇总结果。结果纳入八项研究，共1736名患者。总体荟萃分析结果显示，入院时降低25（OH）D与风险或死亡率增加独立相关（调整后的RR：1.93，p <0.001；I2 = 63％）。对亚组关联性的研究显示，严重维生素D缺乏症（25（OH）D <10 ng / ml）与较高的死亡风险显着相关（校正后的RR：1.92，p <0.001），但对于维生素D的关联性不显着。不足（25（OH）D 20〜30 ng / ml）或不足（25（OH）D 10〜20 ng / ml）。进一步的分析表明，在针对脓毒症（全身性炎症反应综合征，脓毒症-2.0或脓毒症-3.0），短期（1岁以内）应用不同诊断标准的研究中，较低的血清25（OH）D与较高的死亡风险之间的相关性一致。月）和长期研究（3〜12个月），以及前瞻性和回顾性研究。结论严重的维生素D缺乏可能与成人败血症患者的死亡率增加独立相关。需要进行大规模的前瞻性研究来验证我们的发现。