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J Clin Pathol. 2013 Jul;66(7):620-2. doi: 10.1136/jclinpath-2012-201301. Epub 2013 Mar 1.

Vitamin D: a negative acute phase reactant.

Author information

1
Department of Clinical Chemistry, New Cross Hospital, Wolverhampton, West Midlands, UK. jenna.waldron@nhs.net

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.

KEYWORDS:

ACUTE PHASE PROTEINS; INFLAMMATION; VITAMIN D

PMID:
23454726
DOI:
10.1136/jclinpath-2012-201301
[Indexed for MEDLINE]

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