Vitamin D status optimization could cut pneumonia cases

A large US population-based study confirms that serum 25-hydroxyvitamin D (25[OH]D) levels are associated with the risk for community-acquired pneumonia (CAP).

“While others have also hypothesized that vitamin D status may play an important protective role against various pulmonary diseases, our work provides important evidence to suggest that vitamin D supplementation may offer a novel approach to lowering the risk of CAP,” comment authors Sadeq Quraishi (Harvard Medical School, Boston, Massachusetts, USA) and colleagues.

The team analyzed data from the Third National Health and Nutrition Examination Survey (NHANES III), which took place between 1988 and 1994.

Among 16,975 participants with reported 25(OH)D levels, those with levels below 30 ng/mL were 56% more likely to have had CAP within the past year than those with higher levels, at respective rates of 2.13% and 1.36%.

There was a rough dose–response relationship between serum 25(OH)D levels and CAP risk. For example, participants with levels below 10 ng/mL had a 125% increased risk compared with those with levels at 30 ng/mL or above.

However, there was little additional benefit with regard to CAP risk when levels increased beyond this high threshold.

The findings confirm previous observations from small- and moderate-sized cohorts of elderly adults. In this study, the median age of the participants was 43 years, the median serum 25(OH)D level was 24 ng/mL, and the rate of CAP was 2.1% in the past year.

Also in accordance with earlier research, the team found that the presence of asthma, chronic obstructive pulmonary disease, congestive heart failure, and Type 2 diabetes all independently associated with CAP risk.

“Longitudinal studies are required to confirm our findings and establish the mechanisms underlying these observations,” comment Quraishi et al in PLoS One.

“If confirmed, high-quality randomized, controlled trials will be necessary to determine whether vitamin D supplementation therapy among adults with low vitamin D status may affect the incidence and severity of CAP in the general population.”

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