Does systemic inflammatory response provoked by elective orthopaedic surgery reduce serum vitamin D levels in patients?
Serum 25-(OH)D acts as a negative acute phase reactant, decreasing significantly after acute inflammatory insult, suggesting it is an unreliable biomarker of vitamin D status in acute inflammation.
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.
Waldron et al. (Fri,) studied this question.
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