Erythrocyte concentrations of B1, B2, B6 but not plasma C and E are reliable indicators of nutrition status in the presence of systemic inflammation

Background & aim: There is increasing evidence that the plasma concentration of vitamin D, carotenoids, zinc and selenium are associated with the magnitude of the systemic inflammatory response. In order to examine whether other vitamins may be affected and whether red cell concentrations are less affected by systemic inflammation the aim of the present study was to examine the effect of the systemic inflammatory response on red cell measurements of vitamins B1, B2 and B6, and plasma concentration of vitamin C and E in a large cohort of patients referred for a nutritional screen. Methods: Patients referred for nutritional assessment of B1 (n = 551), B2 (n = 251), B6 (n = 313), ascorbic acid (n = 494) and α-tocopherol (n = 395) concentrations. These vitamins were measured using routine laboratory methods. Results: The median concentrations of vitamin B1 grouped according to C-reactive protein concentrations ≤10, 11–80 and >80 mg/L were 543, 664 and 766 ng/g Hb respectively (p < 0.001, 41% higher). The median concentration of vitamin B1 grouped according to albumin concentrations ≥35, 25–34 and <25 g/l were 547, 664 and 701 ng/g Hb respectively (p < 0.001, 28% higher). The median concentrations of red cell vitamin B2 grouped according to CRP concentrations ≤10, 11–80 and >80 mg/L were 2.2, 2.3 and 2.4 nmol/g Hb respectively (p < 0.001, 9% higher). The median red cell concentrations of vitamin B2 grouped according to albumin concentrations ≥35, 25–34 and <25 g/l were 2.1, 2.4 and 2.3 nmol/g Hb respectively (p < 0.001, 14% higher). The median concentrations of red cell vitamin B6 grouped according to CRP concentrations ≤10, 11–80 and >80 mg/L were 534, 548 and 767 pmol/g Hb respectively (p < 0.001, 44% higher). The median red cell concentrations of vitamin B6 grouped according to albumin concentrations ≥35, 25–34 and <25 g/l were 462, 644 and 840 pmol/g Hb respectively (p < 0.001, 82% higher). In contrast, the median plasma concentrations of ascorbic acid grouped according to CRP concentrations ≤10, 11–80 and >80 mg/L were 25.0, 15.0 and 6.0 μmol/l respectively (78% lower, p < 0.001). The median plasma concentrations of ascorbic acid grouped according to albumin concentrations ≥35, 25–34 and <25 g/l were 32.0, 13.0 and 5.0 μmol/l respectively (84% lower, p < 0.001). The median α-tocopherol/cholesterol grouped according to CRP concentrations ≤10, 11–80 and >80 mg/L were 5.9, 4.6 and 2.1 μmol/l respectively (64% lower, p < 0.001). The median α-tocopherol/cholesterol grouped according to albumin concentrations ≥35, 25–34 and <25 g/l were 6.0, 5.5 and 2.1 μmol/l respectively (65% lower, p < 0.001). Conclusion: Red cell concentrations of vitamins B1, B2 and B6 were not lower with an increasing systemic inflammatory response. In contrast, plasma concentrations of vitamin C and E were lower. Therefore, compared with plasma concentration, red cell concentrations of B1, B2 and B6 are likely to be more reliable measures of status in the presence of a systemic inflammatory response

The relationship between the severity and mortality of SARS-CoV-2 infection and 25-hydroxyvitamin D concentration — a metaanalysis

Introduction: There is increasing scientific interest in the possible association between hypovitaminosis D and the risk of SARS-CoV-2 infection severity and/or mortality.  Objective: To conduct a metanalysis of the association between 25-hydroxyvitamin D (25(OH)D) concentration and SARS-CoV-2 infection severity or mortality.Material and methods: We searched PubMed, EMBASE, Google scholar and the Cochrane Database of Systematic Reviews for studies published between December 2019 and December 2020. Effect statistics were pooled using random effects models. The quality of included studies was assessed with the Newcastle–Ottawa Scale (NOS). Targeted outcomes: mortality and severity proportions in COVID-19 patients with 25(OH)D deficiency, defined as serum 25(OH)D < 50 nmol/L.  Results: In the 23 studies included (n = 2692), the mean age was 60.8 (SD ± 15.9) years and 53.8% were men. Results suggested that vitamin 25(OH)D deficiency was associated with increased risk of severe SARS-CoV-2 disease (RR 2.00; 95% CI 1.47–2.71, 17 studies) and mortality (RR 2.45; 95% CI 1.24–4.84, 13 studies). Only 7/23 studies reported C-reactive protein values, all of which were > 10 mg/L.Conclusions 25(OH)D deficiency seems associated with increased SARS-CoV-2 infection severity and mortality. However, findings do not imply causality, and randomized controlled trials are required, and new studies should be designed to determine if decreased 25(OH)D is an epiphenomenon or consequence of the inflammatory process associated with severe forms of SARS-CoV-2. Meanwhile, the concentration of 25(OH)D could be considered as a negative acute phase reactant and a poor prognosis in COVID-19 infection

The effect of the systemic inflammatory response on plasma vitamin 25 (OH) D concentrations adjusted for albumin

<b>Aim</b><p></p> To examine the relationship between plasma 25(OH)D, CRP and albumin concentrations in two patient cohorts.<p></p> <b>Methods</b><p></p> 5327 patients referred for nutritional assessment and 117 patients with critical illness were examined. Plasma 25 (OH) D concentrations were measured using standard methods. Intra and between assay imprecision was <10%.<p></p> <b>Result</b><p></p> In the large cohort, plasma 25 (OH) D was significantly associated with CRP (rs = −0.113, p<0.001) and albumin (rs = 0.192, p<0.001). 3711 patients had CRP concentrations ≤10 mg/L; with decreasing albumin concentrations ≥35, 25–34 and <25 g/l, median concentrations of 25 (OH) D were significantly lower from 35 to 28 to 14 nmol/l (p<0.001). This decrease was significant when albumin concentrations were reduced between 25–34 g/L (p<0.001) and when albumin <25 g/L (p<0.001). 1271 patients had CRP concentrations between 11–80 mg/L; with decreasing albumin concentrations ≥35, 25–34 and <25 g/l, median concentrations of 25 (OH) D were significantly lower from 31 to 24 to 19 nmol/l (p<0.001). This decrease was significant when albumin concentration were 25–34 g/L (p<0.001) and when albumin <25 g/L (p<0.001). 345 patients had CRP concentrations >80 mg/L; with decreasing albumin concentrations ≥35, 25–34 and <25 g/l, median concentrations of 25 (OH) D were not significantly altered varying from 19 to 23 to 23 nmol/l. Similar relationships were also obtained in the cohort of patients with critical illness.<p></p> <b>Conclusion</b><p></p> Plasma concentrations of 25(OH) D were independently associated with both CRP and albumin and consistent with the systemic inflammatory response as a major confounding factor in determining vitamin D status.<p></p&gt

Relationship between serum 25-hydroxyvitamin D concentration and acute inflammatory markers in hospitalized patients with SARS-CoV-2 infection

INTRODUCTION: There is experimental and clinical evidence that the serum concentration of 25-hydroxyvita­min D [25(OH)D)] may decrease in acute systemic inflammatory responses; in this context, low values may not necessarily indicate a pre-existing deficiency. This may also apply to low 25(OH)D levels found in the context of the systemic inflammatory response caused by SARS-CoV-2 infection. To conduct a systematic review of the relationship between serum 25(OH)D and the concentrations of C-re­active protein (CRP), interleukin 6 (IL-6) and tumour necrosis factor a (TNF-a) in acutely hospitalized patients with SARS-CoV-2 infection.   MATERIAL AND METHODS: We searched PubMed, EMBASE, Google Scholar and the Cochrane Database of Systematic Reviews for studies published between January 2020 and February 2021. In each study, the au­thors compared levels of inflammatory markers between patients reported as having low levels of 25(OH) D and those above the study cut-off. RESULTS: 18 studies were included (n = 3482, mean age 63.5 ± 9.3 years, 56.9% men). The cut-off for the definition of low 25(OH)D varied across studies. In all studies, mean values for inflammatory markers were higher in the low 25(OH)D groups. These differences were statistically significant (p < 0.05) in 6/15 studies with CRP, 4/8 with IL-6 and 0/1 with TNF-a.   CONCLUSIONS: Markers of acute systemic inflammatory response were elevated in patients with SARS-CoV-2 infection and low concentrations of 25(OH)D. Therefore, the vitamin D status in those patients should be interpreted with caution, and studies should be designed to assess whether hypovitaminosis D could be an epiphenomenon

Association between low serum vitamin D and increased mortality and severity due to COVID-19: reverse causality?

We are very close to completing two years since the start of the COVID-19 pandemic. Even though vaccines have been developed and applied to more than 4 billion people in the world, SARS-CoV-2 continues to be a challenge for humanity. Therefore, it is important to study modifiable risk factors that may increase the severity of COVID-19, and one of the most discussed has been vitamin D. Currently, there is some evidence of association between low serum 25-hydroxyvitamin D [25(OH)D3] and increased mortality and severity due to SARS-CoV-2 infection. Before the pandemic, experimental evidence in animal and human studies had reported that an acute inflammatory process can cause a secondary decrease in 25(OH)D3. COVID-19 can be associated with a severe inflammatory process with an elevation of inflammatory markers; in this light, the reported association between low 25(OH)D3 and COVID-19 severity and/or mortality may be an epiphenomenon of the inflammatory process induced by SARS-CoV-2 and be an example of reverse causality

Untersuchungen von Zugriffen auf den Arbeitsspeicher in Vektorrechnersystemen

TIB: RA 831 (1994)+a / FIZ - Fachinformationszzentrum Karlsruhe / TIB - Technische InformationsbibliothekSIGLEDEGerman

The effect of the systemic inflammatory response on plasma zinc and selenium adjusted for albumin

Item not available in this repository.Katerina Vasilaki – ORCID: 0000-0003-2669-5691 https://orcid.org/0000-0003-2669-5691Background & aim: The magnitude of systemic inflammatory response, as evidenced by C-reactive protein (CRP), is a major factor associated with lower zinc and selenium. They may also be influenced by their binding proteins, such as albumin. The aim of the present study was to examine the relationships between plasma zinc, selenium and the systemic inflammatory response in a large cohort of patients referred for nutritional screen and also to examine these relationships in patients with critical illness. Methods: Patients referred for nutritional assessment of zinc (n ¼ 743) and selenium (n ¼ 833) and 114 patients with critical illness were examined. Intra-assay imprecision was <10% for these analytes. Results: In the nutritional screen cohort, plasma zinc was significantly associated with CRP (rs ¼ 0.404, p 80 mg/l) the zinc/ albumin ratio x100 was similar (31, 33 and 32 respectively, p ¼ 0.029). Plasma selenium was significantly associated with CRP (rs ¼ 0.489, p < 0.001) and albumin (rs ¼ 0.600, p < 0.001). With increasing CRP category ( 10, 11e80, >80 mg/l) the selenium/albumin ratio 100 was lower (2.3, 2.1 and 1.8 respec- tively, p < 0.001). Similar relationships were also observed in the cohort of patients with critical illness. Conclusion: Plasma zinc was associated with both CRP and albumin. The impact of the systemic in- flammatory response could be largely adjusted by albumin concentrations. Plasma selenium was asso- ciated with both CRP and albumin. The impact of the systemic inflammatory response on plasma selenium concentrations could not be reasonably adjusted by albumin concentrations.The authors acknowledge the Libyan government for the funding.https://doi.org/10.1016/j.clnu.2015.02.01035pubpub

The effect of the systemic inflammatory response on plasma zinc and selenium adjusted for albumin

Background &#38; aim: The magnitude of systemic inflammatory response, as evidenced by C-reactive protein (CRP), is a major factor associated with lower zinc and selenium. They may also be influenced by their binding proteins, such as albumin. The aim of the present study was to examine the relationships between plasma zinc, selenium and the systemic inflammatory response in a large cohort of patients referred for nutritional screen and also to examine these relationships in patients with critical illness. Methods: Patients referred for nutritional assessment of zinc (n = 743) and selenium (n = 833) and 114 patients with critical illness were examined. Intra-assay imprecision was &#60;10% for these analytes. Results: In the nutritional screen cohort, plasma zinc was significantly associated with CRP (rs = −0.404, p &#60; 0.001) and albumin (rs = 0.588, p &#60; 0.001). For each CRP category (&#8804;10, 11–80, &#62;80 mg/l) the zinc/albumin ratio x100 was similar (31, 33 and 32 respectively, p = 0.029). Plasma selenium was significantly associated with CRP (rs = −0.489, p &#60; 0.001) and albumin (rs = 0.600, p &#60; 0.001). With increasing CRP category (&#8804;10, 11–80, &#62;80 mg/l) the selenium/albumin ratio ×100 was lower (2.3, 2.1 and 1.8 respectively, p &#60; 0.001). Similar relationships were also observed in the cohort of patients with critical illness. Conclusion: Plasma zinc was associated with both CRP and albumin. The impact of the systemic inflammatory response could be largely adjusted by albumin concentrations. Plasma selenium was associated with both CRP and albumin. The impact of the systemic inflammatory response on plasma selenium concentrations could not be reasonably adjusted by albumin concentrations

Assessment of asymmetrical dimethylarginine metabolism in patients with critical illness

Background Critically ill patients experience metabolic disorders including hypercatabolic state and hyperglycaemia and these are associated with poor outcome. Hyperglycaemia and asymmetric dimethylarginine (ADMA) are reported to have significant influences on endothelial dysfunction. The aim of the present study was to examine the relationship between plasma asymmetric dimethylarginine (ADMA) and related arginine metabolism in patients with critical illness. Materials and Methods Two venous blood samples (EDTA) (104 patients), on admission and follow up sample in the last day in ICU (died or discharge sample median 7, IQR 6-8, range 5-15). Plasma ADMA, arginine, homoarginine and symmetrical dimethylarginine (SDMA) were measured by high-performance liquid chromatography (HPLC). Result ADMA (p&lt;0.01) and SDMA (p&lt;0.05) were elevated and homoarginine was decreased (p&lt;0.05) in non-survivors and were directly associated with predicted mortality rate (p&lt;0.05 and p&lt;0.001), SOFA (p&lt;0.05, p&lt;0.001), ICU stay (p&lt;0.05, p&lt;0.001) and mortality (p&lt;0.01, p&lt;0.05). ADMA was directly associated with SDMA (p&lt;0.001), albumin (p&lt;0.05), ICU stay and mortality (p&lt;0.01). SDMA was directly associated with creatinine (p&lt;0.001) and APACHE II score (p&lt;0.001). In the follow up measurements there was a significant decrease in SOFA score (p&lt;0.01), homoarginine (p&lt;0.01), ALT (p&lt;0.01), Lab-Glucose (p&lt;0.01), and albumin (p&lt;0.01). In contrast, there was an increase in arginine ((p&lt;0.01), ADMA (p&lt;0.01), ADMA:SDMA ratio (p&lt;0.01), and the norepinephrine administration (p&lt;0.01). Conclusion In the present longitudinal study ADMA metabolism was altered in patients with critical illness and was associated with disease severity and mortality

Figure 2

<p><b>2a</b>. The relationship between CRP (log 10) and 25 (OH) D in patients with critical illness (<i>r_s</i> = −0.221, p = 0.017). <b>2b</b>. The relationship between albumin and 25 (OH) D in patients with critical illness (<i>r_s</i> = 0.166, p = 0.073). <b>2c</b>. The relationship between CRP (log 10) and 25 (OH) D adjusted to albumin in patients with critical illness (<i>r_s</i> = 0.016, p = 0.863). <b>2d</b>. The relationship between albumin and 25 (OH) D adjusted to CRP in patients with critical illness (<i>r_s</i> = 0.363, p<0.001).</p