In conclusion , this review supports the hypothesis that hypovitaminosis D is associated with adverse outcomes after diverse surgical procedures .
The importance of vitamin D for musculoskeletal health has long been recognized , and awareness of significant extra-skeletal effects in health and disease is rapidly emerging .
Although it has been possible for many decades to quantify serum markers of vitamin D deficiency , and to correct deficiency at low cost and with high safety , the influence of vitamin D status on post-surgical outcomes has only recently been identified as a research topic of interest .
To the present , these data have not been the subject matter of formal review .
Accordingly , we conducted a systematic review to assess the association between perioperative vitamin D status and outcomes after surgery .
1,25-Dihydroxyvitamin D fluctuations in cardiac surgery are related to age and clinical outcome*
Objective : To investigate the interrelationship between cardiac surgery , age , circulating concentrations of the vitamin D hormone 1,25-dihydroxyvitamin D , and clinical outcome . Design : Prospect i ve , monocentric , two-arm parallel study . Setting : Tertiary Heart and Diabetes Center in the Federal State of North Rhine-Westphalia , Germany . Patients : Twenty-nine cardiac surgical patients aged ⩽65 yrs and 30 patients ≥75 yrs . Measurements : We assessed  1,25-dihydroxyvitamin D and other biochemical parameters of mineral metabolism ( calcium , phosphate , 25-hydroxyvitamin D , and parathyroid hormone ) , various inflammatory markers ( C-reactive protein , interleukin-6 and 8) , and different immunological parameters ( CD4 and CD8 cells , monocyte HLA-DR expression ) . We collected blood sample s preoperatively , immediately after surgery , and on postoperative days 1 , 5 , and 30 . In addition , we assessed adverse outcome until discharge as a composite of myocardial infa rct ion , low cardiac output syndrome , infection , stroke , or in-hospital death . Results : There were significant transient cardiac surgery-related fluctuations in 1,25-dihydroxyvitamin D and the aforementioned parameters of mineral metabolism , inflammation , and immune status . Compared to younger patients , older patients had consistently lower 1,25-dihydroxyvitamin D and phosphate levels ( p = .013 and p = .036 , respectively ) and significantly higher interleukin 6 and 8 levels ( p = .008 and p < .001 , respectively ) . Circulating 1,25-dihydroxyvitamin D was directly related to glomerular filtration rate ( R2 = .227 ; p < .001 ) and inversely related to interleukin 6 ( R2 = .105 ; p = .012 ) . The rate of adverse outcome tended to be higher in older than in younger patients ( 20.0 % vs. 3.5 % ; p = .081 ) . In risk score-adjusted logistic regression analysis , adverse outcome risk decreased by 7.7 % ( SE : 3.7 % ) for each pmol/L increment in 1,25-dihydroxyvitamin D ( p = .037 ) . Conclusions : Circulating 1,25-dihydroxyvitamin D levels fluctuate in relation to cardiac surgery . Low 1,25-dihydroxyvitamin D levels are associated with inflammatory processes and age-related differences in clinical outcome . Future studies should determine whether therapies aim ed at treating low 1,25-dihydroxyvitamin D levels can improve the outcome in older cardiac surgery patients
In conclusion , this review supports the hypothesis that hypovitaminosis D is associated with adverse outcomes after diverse surgical procedures .
The importance of vitamin D for musculoskeletal health has long been recognized , and awareness of significant extra-skeletal effects in health and disease is rapidly emerging .
Although it has been possible for many decades to quantify serum markers of vitamin D deficiency , and to correct deficiency at low cost and with high safety , the influence of vitamin D status on post-surgical outcomes has only recently been identified as a research topic of interest .
To the present , these data have not been the subject matter of formal review .
Accordingly , we conducted a systematic review to assess the association between perioperative vitamin D status and outcomes after surgery .