title: Serum concentrations of vitamin D and organ dysfunction in patients with severe sepsis and septic shock.
abstract: OBJECTIVE
  To evaluate the serum concentrations of vitamin D and their variations in patients with severe sepsis or septic shock and in control subjects upon admission and after 7 days of hospitalization in the intensive care unit and to correlate these concentrations with the severity of organ dysfunction.
  
  
  METHODS
  This case-control, prospective, observational study involved patients aged > 18 years with severe sepsis or septic shock paired with a control group. Serum vitamin D concentrations were measured at inclusion (D0) and on the seventh day after inclusion (D7). Severe deficiency was defined as vitamin D levels < 10ng/ml, deficiency as levels between 10 and 20ng/ml, insufficiency as levels between 20 and 30ng/ml, and sufficiency as levels ≥ 30ng/mL. We considered a change to a higher ranking, together with a 50% increase in the absolute concentration, to represent an improvement.
  
  
  RESULTS
  We included 51 patients (26 with septic shock and 25 controls). The prevalence of vitamin D concentration ≤ 30ng/ml was 98%. There was no correlation between the serum concentration of vitamin D at D0 and the SOFA score at D0 or D7 either in the general population or in the group with septic shock. Patients with improvement in vitamin D deficiency had an improved SOFA score at D7 (p = 0.013).
  
  
  CONCLUSIONS
  In the population studied, patients with septic shock showed improvement in the serum concentrations of vitamin D on the seventh day compared with the controls. We also found a correlation between higher vitamin D concentrations and a greater decrease in the severity of organ dysfunction.
authors.affiliation: Disciplina de Anestesiologia, Dor e Terapia Intensiva, Universidade Federal de São Paulo, São Paulo, SP, Brazil.
authors.forename: Fernanda Sampaio
authors.initials: FS
authors.lastname: Alves
authors.affiliation: Disciplina de Anestesiologia, Dor e Terapia Intensiva, Universidade Federal de São Paulo, São Paulo, SP, Brazil.
authors.forename: Flavio Geraldo Resende
authors.initials: FG
authors.lastname: Freitas
authors.affiliation: Disciplina de Anestesiologia, Dor e Terapia Intensiva, Universidade Federal de São Paulo, São Paulo, SP, Brazil.
authors.forename: Antonio Tonete
authors.initials: AT
authors.lastname: Bafi
authors.affiliation: Disciplina de Anestesiologia, Dor e Terapia Intensiva, Universidade Federal de São Paulo, São Paulo, SP, Brazil.
authors.forename: Luciano Cesar Pontes
authors.initials: LC
authors.lastname: Azevedo
authors.affiliation: Disciplina de Anestesiologia, Dor e Terapia Intensiva, Universidade Federal de São Paulo, São Paulo, SP, Brazil.
authors.forename: Flavia Ribeiro
authors.initials: FR
authors.lastname: Machado
mesh_terms: D000368:Aged; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D007362:Intensive Care Units; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D018805:Sepsis / Q000097:blood* / Q000503:physiopathology; D012720:Severity of Illness Index; D012772:Shock, Septic / Q000097:blood* / Q000503:physiopathology; D014807:Vitamin D / Q000097:blood*; D014808:Vitamin D Deficiency / Q000453:epidemiology*
chemical_list: D014807:Vitamin D