A decreased serum concentration of 1,25-dihydroxy vitamin D3 might indicate an elevated risk of acute exacerbation in idiopathic pulmonary fibrosis (IPF), whereas a high level of serum procalcitonin may point out poor overall survival, according to a study published in the International Journal of General Medicine.

For the purpose of this prospective study, the researchers recruited 31 patients with stable IPF and 41 with acute IPF exacerbation and continued to monitor their disease progression for at least 12 months. All participants received treatment in accordance with the clinical practice guidelines.

With the goal of understanding the role of relevant metabolites in IPF, the study authors analyzed all the collected blood samples. They used the enzyme-linked immunosorbent assay method to measure serum concentrations of 1,25-dihydroxy vitamin D3 and transforming growth factor beta-1. A statistical multivariate analysis was used to assess the risk factors for IPF acute exacerbation, paired with Kaplan-Meier and Cox regression analyses aimed at identifying the prognostic factors.

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An increase in baseline values of alveolar-arterial oxygen difference, white blood cell counts, percentage of monocytes, C-reactive protein, and procalcitonin was associated with the acute exacerbation of the condition. The researchers also discovered higher baseline levels of serum calcium and 1,25-dihydroxy vitamin D3 in IPF patients with stable disease.

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A multivariate analysis concluded that a higher proportion of patients with lower serum 1,25-dihydroxy vitamin D3 levels went through acute exacerbations, while Kaplan-Meier and Cox regression analyses showed that those with serum procalcitonin concentration higher than 0.05 ng/mL experienced an increased mortality risk.

“We recommend that serum 1,25-dihydroxy vitamin D3 and procalcitonin should be routinely measured to stratify patients at diagnosis who are at risk of more AE and worse prognosis,“ Yang and colleagues noted.

The clinical course of IPF is highly variable. As most severe and rapid disease progression is characterized by acute exacerbations and poor prognosis, it is essential to identify reliable biomarkers.


Yang L, Zhai Z, Zhang J. The role of serum 1,25-dihydroxy vitamin D3 and PCT in idiopathic pulmonary fibrosisInt J Gen Med. Published on November 8, 2022. doi:10.2147/IJGM.S386984