The relation between acute changes in the systemic inflammatory response and plasma 25-hydroxyvitamin D concentrations after elective knee arthroplasty

Reid, D., Toole, B.J., Knox, S., Talwar, D., Harten, J., O'Reilly, D.S.J., Blackwell, S., Kinsella, J., McMillan, D.C. and Wallace, A.M. (2011) The relation between acute changes in the systemic inflammatory response and plasma 25-hydroxyvitamin D concentrations after elective knee arthroplasty. American Journal of Clinical Nutrition, 93(5), pp. 1006-1011. (doi:10.3945/ajcn.110.008490)

Full text not currently available from Enlighten.

Publisher's URL: http://dx.doi.org/10.3945/ajcn.110.008490

Abstract

Background: Studies indicate that low plasma 25-hydroxyvitamin D [25(OH)D] is associated with a range of disease processes, many of which are inflammatory. However, other lipid-soluble vitamins decrease during the systemic inflammatory response, and this response may confound the interpretation of plasma 25(OH)D. Objective: The objective was to examine whether plasma 25(OH)D concentrations change during evolution of the systemic inflammatory response. Design: Patients (n = 33) who underwent primary knee arthroplasty had venous blood samples collected preoperatively and postoperatively (beginning 6-12 h after surgery and on each morning for 5 d) for the measurement of 25(OH)D, vitamin D-binding protein, parathyroid hormone (PTH), calcium, C-reactive protein, and albumin. A final sample was collected at 3 mo. Results: Preoperatively, most patients were 25(OH)D deficient (<50 nmol/L) and had secondary hyperparathyroidism (PTH. 5 pmol/L). Age, sex, body mass index, season, medical history, and medication use were not associated with significant differences in preoperative plasma 25(OH)D concentrations. By day 2 there was a large increase in C-reactive protein concentrations (P < 0.001) and a significant decrease in 25(OH)D of approximate to 40% (P < 0.001). C-reactive protein, 25(OH)D, and calculated free 25(OH)D had not returned to preoperative concentrations by 5 d postoperatively (all P < 0.001). At 3 mo, 25(OH)D and free 25(OH)D remained significantly lower (20% and 30%, respectively; P < 0.01). Conclusion: Plasma concentrations of 25(OH)D decrease after an inflammatory insult and therefore are unlikely to be a reliable measure of 25(OH)D status in subjects with evidence of a significant systemic inflammatory response.

Item Type:Articles
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:Harten, Dr Johann and O'Reilly, Dr Denis and McMillan, Professor Donald and Kinsella, Professor John and Wallace, Dr Alan and Reid, Mr David
Authors: Reid, D., Toole, B.J., Knox, S., Talwar, D., Harten, J., O'Reilly, D.S.J., Blackwell, S., Kinsella, J., McMillan, D.C., and Wallace, A.M.
College/School:College of Medical Veterinary and Life Sciences > School of Medicine, Dentistry & Nursing
Journal Name:American Journal of Clinical Nutrition
ISSN:0002-9165

University Staff: Request a correction | Enlighten Editors: Update this record