title: Vitamin D: a negative acute phase reactant.
abstract: 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.
authors: Department of Clinical Chemistry, New Cross Hospital, Wolverhampton, West Midlands, UK. jenna.waldron@nhs.net
authors: Jenna Louise
authors: JL
authors: Waldron
authors: Helen L
authors: HL
authors: Ashby
authors: Michael P
authors: MP
authors: Cornes
authors: Julia
authors: J
authors: Bechervaise
authors: Cyrus
authors: C
authors: Razavi
authors: Osmond L
authors: OL
authors: Thomas
authors: Sanjiv
authors: S
authors: Chugh
authors: Shreeram
authors: S
authors: Deshpande
authors: Clare
authors: C
authors: Ford
authors: Rousseau
authors: R
authors: Gama
mesh_terms: D000209:Acute-Phase Proteins / Q000378:metabolism*; D019644:Arthroplasty, Replacement, Hip; D019645:Arthroplasty, Replacement, Knee; D015415:Biomarkers / Q000378:metabolism / Q000652:urine; D002097:C-Reactive Protein / Q000378:metabolism; D006801:Humans; D011183:Postoperative Complications / Q000097:blood* / Q000652:urine; D014807:Vitamin D / Q000097:blood*; D014808:Vitamin D Deficiency / Q000097:blood / Q000209:etiology
chemical_list: D000209:Acute-Phase Proteins; D015415:Biomarkers; D014807:Vitamin D; D002097:C-Reactive Protein
keywords: ACUTE PHASE PROTEINS; INFLAMMATION; VITAMIN D