Endocrine Abstracts

Depending on definition and population, vitamin D deficiency (usually 25(OH)D ≤20 ng/ml) is present in 30–60% of ICU patients worldwide. Since 2009, observational studies have clearly shown that vitamin D deficiency is linked to excess morbidity and mortality in adults and children including increased organ failure. Preliminary data using metabolomics suggest that several biochemical pathways, which are important for redox regulation and immunomodulation, are affected by vitamin D status. So far, worldwide <700 patients have been treated in a very limited number of randomized controlled intervention trials, recently summarized in three different meta-analyses. The largest published study to date, the VITdAL-ICU study (n=475) did not find a difference in the primary outcome length of hospital stay between groups, but there was a significant reduction in mortality in the predefined subgroup of patients with severe vitamin D deficiency. The VIOLET study (USA) and our own VITDALIZE study will together recruit more than 5000 acutely ill patients and answer the question if vitamin D is benefitial in critical illness in the next few years. If the results are positive this would have a huge positive impact on the outcome of critically ill patients worldwide and maybe even change the current inconclusive judgment of the importance of vitamin D for the health of human beings in general.