Vitamin D Serum Level in Subjects with Critical Illness Polyneuropathy and Myopathy

Overview

Journal J Musculoskelet Neuronal Interact

Specialties Neurology
Orthopedics
Physiology

Date 2020 Mar 6

PMID 32131367

Authors

Domenico Intiso

Andrea Fontana

Massimiliano Copetti

Luigi Amoruso

Michelangelo Bartolo

Andrea Santamato

Filomena Di Rienzo

Affiliations

Soon will be listed here.

Abstract

Background: Critical illness polyneuropathy and myopathy (CIPNM) is a disabling neuropathy that occurs in intensive care unit (ICU) subjects. It was hypothesized that a low serum level or deficiency of 25(OH)D might be associated with CIPNM. The aim of the present study was to ascertain the 25(OH)D serum level in subjects with CIPNM.

Method: Consecutive ICU patients admitted to neuro-rehabilitation were prospectively enrolled. At admission, vitamin D serum levels were measured and EMG examination was performed to ascertain those with CIPNM. 25(OH)D was stratified as sufficient (≥30 ng/mL) insufficient (20-29.9 ng/mL), and deficient (<20 ng/mL).

Results: Eighty-four patients (31 F, 53 M; mean age 51.7±12.6) were identified and 63 (21 F, 42 M) enrolled. CIPNM was detected in 38 (9 F, 29 M) patients. A deficient mean serum level of vitamin D was observed in the whole population: 18.1 ± 9.2 ng/mL. No difference of vitamin D serum levels was detected in subjects with and without CIPNM: 17.5 ± 8.4 and 19.0 ± 10.5 ng/mL (p=0.58), respectively.

Conclusion: Almost all subjects showed Vitamin D deficiency. No difference was detected between those with and without CIPNM. The condition might represent a secondary phenomenon resulting from the inflammatory process as well as from conditions that could interfere with vitamin D metabolism.

References

Bednarik J, Lukas Z, Vondracek P . Critical illness polyneuromyopathy: the electrophysiological components of a complex entity. Intensive Care Med. 2003; 29(9):1505-14. DOI: 10.1007/s00134-003-1858-0. View

Wu F, Juonala M, Pitkanen N, Jula A, Lehtimaki T, Sabin M . Both youth and long-term vitamin D status is associated with risk of type 2 diabetes mellitus in adulthood: a cohort study. Ann Med. 2017; 50(1):74-82. DOI: 10.1080/07853890.2017.1399446. View

Druschky A, Herkert M, Radespiel-Troger M, Druschky K, Hund E, Becker C . Critical illness polyneuropathy: clinical findings and cell culture assay of neurotoxicity assessed by a prospective study. Intensive Care Med. 2001; 27(4):686-93. DOI: 10.1007/s001340100890. View

de Haan K, Groeneveld A, de Geus H, Egal M, Struijs A . Vitamin D deficiency as a risk factor for infection, sepsis and mortality in the critically ill: systematic review and meta-analysis. Crit Care. 2014; 18(6):660. PMC: 4277653. DOI: 10.1186/s13054-014-0660-4. View

Nie Z, Ji X, Wang J, Zhang H . Serum levels of 25-hydroxyvitamin D predicts infarct volume and mortality in ischemic stroke patients. J Neuroimmunol. 2017; 313:41-45. DOI: 10.1016/j.jneuroim.2017.10.002. View

Schneider A, Lutsey P, Selvin E, Mosley T, Sharrett A, Carson K . Vitamin D, vitamin D binding protein gene polymorphisms, race and risk of incident stroke: the Atherosclerosis Risk in Communities (ARIC) study. Eur J Neurol. 2015; 22(8):1220-7. PMC: 4496275. DOI: 10.1111/ene.12731. View

Mokry L, Ross S, Ahmad O, Forgetta V, Davey Smith G, Goltzman D . Correction: Vitamin D and Risk of Multiple Sclerosis: A Mendelian Randomization Study. PLoS Med. 2016; 13(3):e1001981. PMC: 4775038. DOI: 10.1371/journal.pmed.1001981. View

Pennisi M, Di Bartolo G, Malaguarnera G, Bella R, Lanza G, Malaguarnera M . Vitamin D Serum Levels in Patients with Statin-Induced Musculoskeletal Pain. Dis Markers. 2019; 2019:3549402. PMC: 6452565. DOI: 10.1155/2019/3549402. View

Intiso D, Amoruso L, Zarrelli M, Pazienza L, Basciani M, Grimaldi G . Long-term functional outcome and health status of patients with critical illness polyneuromyopathy. Acta Neurol Scand. 2010; 123(3):211-9. DOI: 10.1111/j.1600-0404.2010.01414.x. View

10.

Lee P, Nair P, Eisman J, Center J . Vitamin D deficiency in the intensive care unit: an invisible accomplice to morbidity and mortality?. Intensive Care Med. 2009; 35(12):2028-32. DOI: 10.1007/s00134-009-1642-x. View

11.

Salzer J, Hallmans G, Nystrom M, Stenlund H, Wadell G, Sundstrom P . Vitamin D as a protective factor in multiple sclerosis. Neurology. 2012; 79(21):2140-5. DOI: 10.1212/WNL.0b013e3182752ea8. View

12.

Bettica P, Bevilacqua M, Vago T, Norbiato G . High prevalence of hypovitaminosis D among free-living postmenopausal women referred to an osteoporosis outpatient clinic in northern Italy for initial screening. Osteoporos Int. 1999; 9(3):226-9. DOI: 10.1007/s001980050141. View

13.

Annweiler C, Bartha R, Karras S, Gautier J, Roche F, Beauchet O . Vitamin D and white matter abnormalities in older adults: a quantitative volumetric analysis of brain MRI. Exp Gerontol. 2015; 63:41-7. DOI: 10.1016/j.exger.2015.01.049. View

14.

Shepherd S, Newman R, Brett S, Griffith D . Pharmacological Therapy for the Prevention and Treatment of Weakness After Critical Illness: A Systematic Review. Crit Care Med. 2016; 44(6):1198-205. DOI: 10.1097/CCM.0000000000001652. View

15.

Marrero H, Stalberg E . Optimizing testing methods and collection of reference data for differentiating critical illness polyneuropathy from critical illness MYOPATHIES. Muscle Nerve. 2015; 53(4):555-63. DOI: 10.1002/mus.24886. View

16.

Mpandzou G, Ait Ben Haddou E, Regragui W, Benomar A, Yahyaoui M . Vitamin D deficiency and its role in neurological conditions: A review. Rev Neurol (Paris). 2016; 172(2):109-22. DOI: 10.1016/j.neurol.2015.11.005. View

17.

Lee P, Eisman J, Center J . Vitamin D deficiency in critically ill patients. N Engl J Med. 2009; 360(18):1912-4. DOI: 10.1056/NEJMc0809996. View

18.

Santos R, Brandao-Lima P, Tete R, Freire A, Pires L . Vitamin D ratio and glycaemic control in individuals with type 2 diabetes mellitus: A systematic review. Diabetes Metab Res Rev. 2017; 34(3). DOI: 10.1002/dmrr.2969. View

19.

Wang L, Evatt M, Maldonado L, Perry W, Ritchie J, Beecham G . Vitamin D from different sources is inversely associated with Parkinson disease. Mov Disord. 2014; 30(4):560-6. PMC: 4390412. DOI: 10.1002/mds.26117. View

20.

Romagnoli E, Caravella P, Scarnecchia L, Martinez P, Minisola S . Hypovitaminosis D in an Italian population of healthy subjects and hospitalized patients. Br J Nutr. 1999; 81(2):133-7. View