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Vitamin D: a negative acute phase reactant
  1. Jenna Louise Waldron1,
  2. Helen L Ashby1,
  3. Michael P Cornes1,
  4. Julia Bechervaise1,
  5. Cyrus Razavi1,
  6. Osmond L Thomas2,
  7. Sanjiv Chugh2,
  8. Shreeram Deshpande2,
  9. Clare Ford1,
  10. Rousseau Gama1,3
  1. 1Department of Clinical Chemistry, New Cross Hospital, Wolverhampton, West Midlands, UK
  2. 2Department of Orthopaedics, New Cross Hospital, Wolverhampton, West Midlands, UK
  3. 3Department of Healthcare Sciences, Research Institute, Wolverhampton University, Wolverhampton, West Midlands, UK
  1. Correspondence to Jenna Louise Waldron, Department of Clinical Chemistry, New Cross Hospital, Wolverhampton, West Midlands WV10 0QP, UK; jenna.waldron{at}


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.


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