People with diabetic foot infections often lack vitamin D, and low vitamin D is linked to lower levels of the antimicrobial peptide LL‑37, more inflammation, longer hospital stays and more bacterial biofilm in wounds. Raising vitamin D could boost LL‑37 and help healing, but the study only shows associations, not proof that supplements work.

Aims/IntroductionVitamin D deficiency is prevalent among individuals with diabetic foot infections (DFIs) and can influence a range of patient-related parameters. Hence, we aimed to find the association of serum vitamin D levels with various clinical, biochemical, and inflammatory parameters, as well as the microbial environment in the wounds of DFI patients.Materials and MethodsFrom September 2022 to March 2024, 169 DFI patients participated in cross-sectional research at the hospital. Utilising an electrochemiluminescence immunoassay, vitamin D levels were determined. Vitamin D receptor (VDR) and Cathelicidin (LL-37) were estimated using ELISA Kits. The tissue culture plate technique was used to analyze biofilm formation. Patient-related parameters were obtained from medical records.ResultsThe vitamin D status of DFI patients indicated that 70.4% were deficient, 19.5% were insufficient, and 10.1% were sufficient. The median vitamin D, VDR protein, and LL-37 values were 15.3&#x2005;ng/mL, 0.832&#x2005;ng/mL, and 1.54&#x2005;ng/mL, respectively. Biofilm formation was seen in 84.36% of bacteria from vitamin D-deficient DFI patients (<i>P</i>&#x2009;&lt;&#x2009;.001). Vitamin D levels were negatively correlated with ulcer duration, hospital stay, white blood cell count, neutrophil-lymphocyte ratio, C-reactive protein, and systemic inflammation index (r&#x2009;=&#x2009;-0.787, -0.849, -0.6, -0.475, -0.402, and -0.521, respectively; <i>P</i>&#x2009;&lt;&#x2009;.001). However, vitamin D levels were positively correlated with VDR and LL-37 levels (r&#x2009;=&#x2009;0.988 and 0.944, respectively; <i>P</i>&#x2009;&lt;&#x2009;.001).ConclusionsThe majority of DFI patients exhibited vitamin D deficiency, which was significantly associated with most of the clinical, biochemical, and inflammatory parameters, in addition to the microbial environment within the wound.