(C-024) Plasma Vitamin D Status and Its Association with Biochemical, Clinical and Humanistic Outcomes in Diabetic Foot Infection Patients: A Prospective Observational Study in a Tertiary Healthcare Facility

Background: Vitamin D is essential for wound healing because it affects the immune system, inflammation, and tissue repair processes.

Objectives: To determine the association of vitamin D3 status with biochemical, clinical, and quality of life (QoL) in diabetic foot infection (DFI) patients.
To determine the effect of vitamin D3 supplementation on wound outcomes in DFI patients.

Methods: A longitudinal study was conducted during 2022 to 2024 in a tertiary care hospital in South-India. Baseline biochemical (glycemic, renal, plasma vitamin D3), clinical, and QoL data of the DFI patients were collected. They were followed up telephonically for four months to assess clinical outcomes (healed/not healed). A subgroup analysis was performed to assess the effect of vitamin D3 supplementation. The Fisher exact test was used to evaluate the association of plasma vitamin D3 in DFI patients with wound outcome and QoL. The association of plasma vitamin D3 with various biochemical parameters was assessed using the Spearman correlation test. In the subgroup analysis, one-way ANOVA and Kruskal Wallis tests were used to compare the reference group (RG) and study group (SG). Chi-squared test was used to study the association between vitamin D3 supplementation and wound outcome.

Results: A total of 89 DFI patients were enrolled, with a median age of 55 years and a male predominance (89.9%). A significant association between vitamin D3 levels and clinical outcome was not observed (p = 0.66). A moderate correlation was observed with the neutrophil-lymphocyte ratio (r = 0.24, p= 0.02). Regarding QoL, emotions (domain) were significantly associated with vitamin D3 levels (p < 0.01). The subgroup analysis showed in the RG (n=20) and SG (n=20), 9 and 8 participants healed, respectively, indicating no statistically significant difference between the groups in terms of healing outcomes (X2 = 0.102; p > 0.05). However, during follow-up, the SG showed a substantial increase in vitamin D3 levels (SG: 40.64 ± 11.78 ng/ml) compared to RG (24.76 ± 6.84 ng/ml), with a statistically significant change (p=0.006).

Conclusions: The plasma vitamin D3 levels and vitamin D3 supplements do not significantly affect the biochemical, clinical, and humanistic outcomes, indicating vitamin D3 did not have a positive effect on DFI patients. On the other hand, the supplementation significantly improved the vitamin D3 levels.