- The role of vitamin D and the VDR gene polymorphism in sepsis risk and mortality: a systematic review
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Wiwi Jaya, Sumarno Reto Prawiro, Hani Susianti, Aswoco Andyk Asmoro
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Received January 14, 2025 Accepted March 17, 2025 Published online April 29, 2025
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DOI: https://doi.org/10.24171/j.phrp.2025.0006
[Epub ahead of print]
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 Abstract
 PDF Supplementary Material
- Objectives
Vitamin D regulates immune function, cell proliferation, and differentiation. Its deficiency is linked to sepsis, although the causal relationship remains unclear. Studies suggest a strong correlation between FokI polymorphism and sepsis in the context of vitamin D deficiency. This study examined the association between vitamin D levels, the VDR FokI polymorphism, and sepsis risk through a systematic review and meta-analysis. Methods: Relevant articles from 2014–2024 were identified from various databases, including PubMed, Scopus, and Cochrane. A meta-analysis was conducted to assess the difference in vitamin D levels between the sepsis and control groups, as well as the relationship between VDR FokI genotypes (TT, CT, CC) and sepsis risk.
Results
Vitamin D levels in sepsis patients were consistently lower than in the control group, with a mean difference of –4.17 ng/mL (95% confidence interval, –7.87 to –0.47; p=0.03). However, the relationship between VDR FokI genotype and sepsis risk was not statistically significant (p>0.05), although several individual studies showed a positive correlation. High heterogeneity was found in the analysis of vitamin D levels (I²=100%) and FokI genotypes (I²=91%), which affected the interpretation of the results.
Conclusion
Vitamin D deficiency is a potential risk factor for sepsis, while the relationship between the VDR FokI polymorphism and sepsis risk requires further investigation. These findings highlight the importance of early detection of vitamin D deficiency as a preventive strategy in at-risk populations, although additional studies with more standardized designs are needed to definitively confirm this relationship.
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