Objective. The association between vitamin D status and inflammation remains unclear in hospitalized patients. Materials and Methods. We performed the current study based on real-world data from two teaching hospitals. Serum level of vitamin D (assessed by 25-hydroxyvitamin D) was evaluated within 2 days after admission. All the patients were further classified into three groups: deficiency (<12 ng/mL), insufficiency (12–20 ng/mL), and adequate (≥20 ng/mL). White blood cell (WBC) count, serum level of C-reactive protein (CRP), and procalcitonin were also measured and used to evaluate inflammation. Other potential covariates were abstracted from medical records. Charlson comorbidity index (CCI) was calculated to assess the severity of disease. Results. A total number of 35,528 hospitalized adult patients (21,171 men and 14,357 women) were included. The average age and BMI were 57.5 ± 16.2 years and 23.4 ± 3.7 kg/m², respectively, while medium vitamin D level was 16.1 ng/mL (interquartile range: 11.4 ng/mL, 21.6 ng/mL) and median CCI was one point (interquartile range: 0 point, two points). The prevalence of deficiency and insufficiency was 28.0% and 40.5%. Multivariate linear regression model showed that serum level of vitamin D was significantly associated with WBC and CRP but not associated with procalcitonin. Each standard deviation (≈7.4 ng/mL) increase in vitamin D was associated with a decrease in WBC by 0.13 × 10⁹/mL (95% CI: 0.2 × 10⁹/mL, 0.06 × 10⁹/mL) and 0.62 mg/L (95% CI: 0.88 mg/L, 0.37 mg/L) for CRP. Subgroup analysis and sensitivity analysis (excluding those whose eGFR <60 ml/min/1.73 m², those whose daily calorie intake <1,000 kcal, and those who were recruited from Xin Hua hospital) generated similar results. Conclusions. The deficiency and insufficiency of vitamin D in the hospitalized adult patients was very common. However, the results should be interpreted with caution for limited representation of the whole inpatients. Low level of vitamin D was associated with inflammatory biomarkers, which provide the evidences to early intervention for lower the risk of infection.

中文翻译：

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住院成人患者血清维生素 D 水平与炎症生物标志物之间的关联：基于真实世界数据的横断面研究

客观的。住院患者中维生素 D 状态与炎症之间的关系仍不清楚。材料和方法。我们根据两家教学医院的真实数据进行了当前的研究。入院后 2 天内评估血清维生素 D 水平（通过 25-羟基维生素 D 评估）。所有患者进一步分为三组：缺乏（<12 ng/mL）、不足（12-20 ng/mL）和充足（≥20 ng/mL）。还测量了白细胞（WBC）计数、C反应蛋白（CRP）和降钙素原的血清水平，并用于评估炎症。其他潜在的协变量是从医疗记录中提取的。计算查尔森合并症指数（CCI）来评估疾病的严重程度。结果。总共纳入了 35,528 名住院成人患者（21,171 名男性和 14,357 名女性）。平均年龄和 BMI 分别为 57.5 ± 16.2 岁和 23.4 ± 3.7 kg/m ²，而中等维生素 D 水平为 16.1 ng/mL（四分位距：11.4 ng/mL、21.6 ng/mL），中位 CCI 为 1点（四分位距：0 点、2 点）。缺乏和不足的患病率分别为28.0%和40.5%。多元线性回归模型显示，血清维生素D水平与WBC和CRP显着相关，但与降钙素原无关。维生素 D 每增加一个标准差（约 7.4 ng/mL），WBC 就会减少 0.13 × 10 ⁹ /mL（95% CI：0.2 × 10 ⁹ /mL，0.06 × 10 ⁹ /mL）和 0.62 mg CRP 的 /L（95% CI：0.88 mg/L，0.37 mg/L）。亚组分析和敏感性分析（排除eGFR <60 ml/min/1.73 m ²、每日热量摄入<1,000 kcal的患者以及新华医院招募的患者）得出相似的结果。结论。住院成人患者维生素D缺乏和不足的情况十分普遍。然而，由于整个住院患者的代表性有限，因此应谨慎解释结果。低水平的维生素D与炎症生物标志物相关，这为早期干预以降低感染风险提供了证据。