25OHD Concentrations Research Articles

Sun Exposure Score and Vitamin D Levels in Moroccan Women of Childbearing Age.

Sunlight exposure is an essential source of vitamin D for many humans. However, hypovitaminosis D is a global public health problem. This study aimed to develop and validate a sun exposure score (SES) and correlate it with serum 25-hydroxyvitamin D levels in women of childbearing age. One hundred and sixty women aged 18 to 45 years residing in Meknes, Morocco, were included. A questionnaire estimating the sun exposure score and blood analysis of serum 25-OHD concentration were performed. The questionnaire's reliability and construct validity were evaluated using Cronbach's alpha and factor analysis. Spearman's test was used to assess the correlation between SES and 25-OHD levels. The score's reliability and construct validity were good, with Cronbach's alpha values >0.70 and factorial saturation ranging from 0.696 to 0.948. Serum 25-OHD levels were significantly associated with the total sun exposure score, and all SES domains (Rho was 0.615 (p < 0.0001), 0.307 (p < 0.0001), 0.605 (p < 0.0001), and 0.424 (p < 0.0001) for total SES, indoor exposure domain, outdoor exposure domain, and sun protection practice domain, respectively). In addition, median 25-OHD levels increased significantly when sun exposure was changed from insufficient to sufficient (p < 0.0001). The results suggest that the sun exposure score could be used as a clinical tool to assess vitamin D levels in women of childbearing age.

Concentrations of total, bioavailable, and free 25OHD in individuals with and without primary hyperparathyroidism and their correlations to DXA and trabecular bone score.

This study aimed to investigate the association between 25OHD (total, bioavailable and free) with bone mass and microarchitecture among primary hyperparathyroidism (PHPT) patients and controls. Sixty-four patients in the preoperative period of PHPT and 63 matched controls, who had not taken vitamin D in the last three months. To calculate the bioavailable and free 25OHD, the genetic variants of the vitamin D-binding protein (DBP) were determined. Bone mineral density (BMD) was determined by dual-energy X-ray absorptiometry (DXA). The distributions of total, bioavailable and free 25OHD and their correlation with TBS and DXA were evaluated. PHPT showed BMD and TBS values lower than CTRL in all locations (p < 0.05). There were no statistical differences in the levels of free, bioavailable and total 25OHD between the PHPT and CTRL groups [mean, min-max: 3.4 (1.4-8.6) vs. 3.1 (1.0- 9.8) pg/mL, 1.51 (0.43-3.58) vs. 1.41 (0.38-3.48) ng/mL, 22.6 (11.0-39.9) vs. 20.6 (8.9-35.3) ng/dL, respectively; (p > 0.05). The distribution of DBP haplotypes was similar between groups. DXA showed no correlation with any form of 25OHD in both groups. TBS presented a weak correlation with the total 25OHD in PHPT (r = 0.28; p = 0.02) and a moderate correlation with the total, free and bioavailable 25OHD in CTRL (r = 0.42; r = 0.42; r = 0.43; respectively, p < 0.01). The concentrations of total, free and bioavailable 25OHD were similar in both the PHPT and control groups. 25OHD concentrations correlated positively with TBS and not with DXA, especially in controls, suggesting that this method may be more sensitive to assessing the consequences of vitamin D deficiency on bone quality in individuals without PHPT.

Effects of maternal and offspring treatment with two dietary sources of vitamin D on the mineral homeostasis, bone metabolism and locomotion of offspring fed protein- and phosphorus-reduced diets

ABSTRACT The present study aims to compare the effects of maternal and offspring treatment with 25-hydroxycholecalciferol (25-OHD3) and vitamin D3 on vitamin D status, mineral homoeostasis, bone metabolism and locomotion in the offspring. Either vitamin D3 (50 μg/kg diet) or 25-OHD3 (50 μg/kg diet) was supplemented to the gestation and lactation diets of 49 multiparous sows and/or to the diets of their growing offspring. Treatment of the sows did not affect plasma concentrations of 25-OHD3 of the offspring. Pigs fed 25-OHD3 had higher plasma concentrations of 25-OHD3 than pigs that received vitamin D3 during rearing and fattening. However, neither plasma concentrations of calcium, phosphate and bone markers during the observation period nor bone ash and bone mineral density at slaughter were clearly affected by the treatment. Maternal and offspring treatment with 25-OHD3 instead of vitamin D3 resulted in a slight reduction in the prevalence of leg swelling. In addition, more pigs walked with even steps and normal stride length. Further studies are needed to test whether the slight effects observed in the present experiment are reproducible and of relevance for animal health and welfare. In that case, the underlying mechanisms should be revealed in order to take advantage of potentially beneficial influences especially under certain feeding regimes.

Outcomes of young children hospitalized with acute wheezing.

Wheezing in preschool children is a common symptom. The study aimed to determine an incidence of recurrent wheezing among young children who had been hospitalized with acute wheezing after 12 months. Factors associated with recurrent wheezing were explored. A longitudinal study was conducted among 236 children, aged between 6 months and 5 years, who were hospitalized with acute wheezing in 4 hospitals located in Bangkok and adjacent provinces, Thailand. Demographics, house environments and clinical characteristic data were collected at entry. Serum specific IgE levels against common food and inhalant allergens and serum 25-hydroxyvitamin D (25OHD) concentrations were measured. At entry, the mean age was 24.4 months (SD = 15.7 months). Of 236 hospitalized children with acute wheezing, ninety-four cases (39.8%) were the first wheezing episode of life. By laboratory results, 197 (83.5%) and 56 (23.7%) children were atopic and had vitamin D insufficiency respectively. There were 195 cases completely followed for 12 months. One-year risk of emergency visits and hospitalization due to recurrent wheezing were 49.7% and 23.1% respectively. By multivariable analysis, being the second born child or more, vitamin D insufficiency, "ever wheeze", and allergic rhinitis were significantly associated with recurrent wheezing within 12 months with adjusted odds ratios of 2.5 (95% confidence interval: 1.3-5.3), 2.3 (95% confidence interval: 1.1-4.4), 1.9 (95% confidence interval: 1.2-3.5), and 1.6 (95% confidence interval: 1.3-2.9) respectively. Being the second born child or more, vitamin D insufficiency, ever wheeze, and allergic rhinitis were significant risks of recurrent wheezing.

Preoperative vitamin D level is significantly associated with hypocalcemia after total thyroidectomy

BackgroundTo evaluate the association of preoperative vitamin D levels with postoperative hypocalcaemia after total thyroidectomy.MethodsThe medical records of patients who underwent total thyroidectomy between May 2020 and January 2022 and who had a documented preoperative serum 25-hydroxyvitamin D (25-OHD) concentration were retrospectively reviewed. Vitamin D levels were categorized into four groups: <10 ng/mL (severe vitamin D deficiency), 10–20 ng/mL (vitamin D deficiency), 20–30 ng/mL (vitamin D insufficiency), and > 30 ng/mL (vitamin D sufficiency). Multivariate logistic regression was performed to analyse the association of vitamin D levels with the risk of hypocalcaemia after controlling for potential confounding factors.ResultsA total of 196 patients were included in this study. Of these, 47 (24.0%) had preoperative 25-OHD < 10 ng/mL, 62 (31.6%) had 25-OHD of 10–20 ng/mL, 51 (26.0%) had 25-OHD of 20–30 ng/mL and the remaining 36 (18.4%) had 25-OHD > 30 ng/mL. The incidence of postoperative hypocalcemia was highest in the group of patients with severe vitamin D deficiency (42.6% and 23.4% for postoperative laboratory and symptomatic hypocalcaemia, respectively), followed by the group with vitamin D deficiency (29.0% and 16.1%), the group with vitamin D insufficiency (19.6% and 5.9%) and the group with vitamin D sufficiency (5.6% and 2.8%). Multivariate logistic regression indicated that the odds of postoperative laboratory hypocalcaemia for patients with severe vitamin D deficiency and vitamin D deficiency were 13.20 times (95% CI: 2.69–64.79, P < 0.01) and 6.32 times (95% CI: 1.32–30.28, P = 0.02) greater than for those with vitamin D sufficiency, respectively; while the odds of symptomatic hypocalcaemia for patients with severe vitamin D deficiency was 10.18 times (95% CI: 1.14–90.86, P = 0.04) greater than for those with vitamin D sufficiency.ConclusionPreoperative vitamin D deficiency (< 20 ng/mL), especially severe vitamin D deficiency (< 10 ng/mL), is an independent predictive factor of postoperative hypocalcaemia after total thyroidectomy.

Longitudinal Stability of Vitamin D Status and Its Association With Bone Mineral Density in Middle-aged Australians.

The skeletal effects of vitamin D remain controversial and it is uncertain whether variation in serum 25-hydroxyvitamin D (25OHD) levels over time influences bone mineral density (BMD). We evaluated longitudinal stability of serum 25OHD and associations with changes in BMD in participants aged 46-70 years at baseline. We studied 3698 Busselton Healthy Ageing Study participants (2040 female) with serum 25OHD and dual-energy x-ray absorptiometry (DXA) BMD assessments at baseline and at ∼6 years follow-up. Restricted cubic splines were used to evaluate associations between changes in 25OHD and BMD. Mean season-corrected serum 25OHD was 81.3 ± 22.7 and 78.8 ± 23.1 nmol/L at baseline and 6 years, respectively, and showed moderate correlation (intraclass correlation coefficient: 0.724). Significant predictors of change in 25OHD concentration (Δ25OHD) included baseline 25OHD, change in body mass index and vitamin D supplementation at follow-up. Greater decline in serum 25OHD over time was associated with significantly greater reduction in BMD at total hip and femoral neck, but the magnitude of the differences was small (estimated differences 0.004 g/cm2 and 0.005-0.007 g/cm2, respectively, for lowest quartile of Δ25OHD compared with higher quartiles, adjusted for sex, baseline BMD, 25OHD, and demographics). No significant associations between Δ25OHD and lumbar spine BMD were observed. Increase in 25OHD levels was not associated with change in BMD. In this predominantly vitamin D-replete middle-aged cohort, serum 25OHD showed moderate longitudinal stability. Declining serum 25OHD over time was associated with greater reduction in BMD at the total hip and femoral neck.

Vitamin D Deficiency Among Medical Students in Osijek, Croatia

Aim: This study aimed to evaluate serum levels of 25-OH D3 (calcidiol) among students of the Faculty of Medicine Osijek, Croatia, thereby determining to what extent vitamin D deficiency is present. Methods: The present cross-sectional analysis was based on data collected from 60 participants. Blood sampling was done in March 2021. Concentrations of 25-OH D3 were measured using LC/MSMS procedure on Shimadzu LCMS 8050 and RECIPE kit for serum levels of 25-OH-D3. Results: The study was conducted on a sample of 60 respondents aged 19 to 28, of whom 16 were men and 44 were women. All subjects had a 25-OH D3 deficiency (&amp;lt;20 ng/ml), while 11 had an extreme deficiency. Mean 25-OH D3 concentration was 11.36 ng/ml, ranging from 7.70 ng/ml to 16.70 ng/ml. There was no statistical significance of 25-OH D3 concentration levels between the sexes (Student’s t-test, P&amp;gt;0.05). Conclusion: Vitamin D deficiency was detected in all subjects. In addition to the results of several other studies conducted worldwide that evaluated vitamin D status among medical students, this study further highlights the problem affecting this student subgroup.

Vitamin D Levels in Pediatric Patients Undergoing Chemotherapy

Background: Vitamin D has important roles in bone health, immune function, metabolic regulation, and cancer. Children with cancer may be especially vulnerable to fluctuating Vitamin D levels due to their disease itself, chemotherapy, and limited nutrition and sun exposure. However, most US-based literature addresses only childhood cancer survivors after therapy concluded, so it remains unclear if children with cancer are at risk of vitamin D deficiency during treatment. Methods: This study investigated (i) if children with cancer are vitamin D deficient compared to matched controls, (ii) if their vitamin D levels worsen throughout the course of their cancer treatment, and (iii) if vitamin D levels correlate with the number of fever episodes or fever severity score, as surrogate for infectious disease, in cancer patients. The serum levels of 25-hydroxycholecalciferol vitamin D (25OHD) were assessed at baseline (T1, both cancer and control groups) and 3-4 months and 6-8 months later (T2 and T3, cancer group only). Any incidence of fever experienced in patients with cancer during the study period was recorded and a previously-validated fever severity score was calculated for each episode. Results: This prospective cohort study enrolled 47 cancer-affected children (<21 yr) expected to receive chemotherapy for at least 6 months and 53 age-and-ethnicity-matched controls. Analysis showed participants were 8.6 ± 5.2 yr, with BMI of 19.1 ± 5.0 kg/m2. Most participants were male (63.6%) and Hispanic (52.5%). The cancer and control groups were comparable in terms of age, gender, ethnicity, BMI, and 25OHD at baseline (all p>0.05). Of note, a few cancer patients missed some of their planned draws due to COVID-19 related precautions. The level of 25OHD did not differ between the cancer and control groups at T1, with or without controlling for age, gender, BMI, and season of measurement (both p > 0.05). The 25OHD level among patients with cancer was significantly different for different seasons (p = 0.0047). Levels of 25OHD significantly increased over time among children with cancer (p = 0.0040). However, when patients' age, gender, ethnicity, BMI, and season were controlled for, it was found that the 25OHD level did not change over time (p = 0.1817). Among the cancer patients, the concentrations of 25OHD did not significantly correlate with the number of fever episodes and fever severity scores (all p>0.05). Conclusion: 25OHD levels were not lower in patients with cancer compared to their matched controls even when adjusting for variables associated with vitamin D deficiency. When controlling for these variables, the levels of 25OHD did not change significantly over time in children with cancer. Finally, lower 25OHD did not correlate with a higher incidence of fever or higher fever score, as a surrogate marker for infectious disease. Our findings dispute previous studies suggesting that children with cancer are at higher risk of vitamin D deficiency and that lower levels of vitamin D correlate with incidence or severity of infectious disease, when using fever as a surrogate marker. Larger studies are needed to better understand the role of vitamin D status in children with cancer.

Influence of maternal socioeconomic deprivation and living environment on newborn bloodspot 25-hydroxyvitamin D levels.

Vitamin D deficiency in neonates can have life-threatening consequences, hence the knowledge of risk factors is essential. This study aimed to explore the effect of maternal socioeconomic status (SES) on newborn 25-hydroxyvitamin D (25OHD) concentrations. Over two 1-week periods (winter and summer of 2019), 3000 newborn heel prick dried blood spots (DBS) and additional data of newborns, from a regional newborn screening laboratory (52° N) in the West Midlands, UK, were gathered. Post code was replaced with lower layer super output area (LSOA). Index of Multiple Deprivation (IMD) quintiles for the corresponding LSOA was used to assess SES [quintile one (Q1): most deprived 20%, quintile five (Q5): least deprived 20%]. Each of the seven domains of deprivation were examined (income, employment, education, health, barriers to housing and services, crime and living environment). 25OHD was measured on 6mm sub-punch from DBS using quantitative liquid chromatography tandem mass spectrometry and equivalent plasma values were derived. In total 2999 (1500 summer-born, 1499 winter-born) newborn DBS (1580 males) were analysed. Summer-born newborns had significantly higher 25OHD (IQR) concentrations [49.2 (34.3; 64.8) nmol/l] than winter-born newborns [29.1 (19.8; 40.6) nmol/l, p<0.001].25OHD levels varied significantly between the different IMD quintiles in the whole (p<0.001) and summer-born cohort (p<0.001), but not in the winter-born cohort (p=0.26), whereby Q1 had the lowest 25OHD concentrations. Among the domains of deprivation, living environment had a significant influence on 25OHD levels (β=0.07, p=0.002). In this subdomain, 25OHD levels varied significantly between quintiles in the whole (p<0.001) and summer-born cohort (mean 25OHD Q1 46.45 nmol/l, Q5 54.54 nmol/l; p<0.001) but not in the winter-born cohort (mean 25OHD Q1 31.57 nmol/l, Q5 31.72 nmol/l; p=0.16). In a regression model, living environment was still significant (p=0.018), albeit less than season of birth and ethnicity. Among the seven domains of deprivation, maternal living environment had the greatest effect on newborn 25OHD levels. Whilst improved living environment positively influenced vitamin D status in the summer-born babies, winter-born had low 25OHD levels irrespective of the environment. Strategies such as enhanced supplementation and food fortification with vitamin D should be considered to overcome the non-modifiable main risk factors for vitamin D deficiency.

CURRENT ISSUES OF VITAMIN D IN JUVENILE IDIOPATHIC ARTHRITIS

Background. Children with juvenile idiopathic arthritis (JIA) represent a special cohort of patients with chronic somatic pathology, characterized by severe damage to the musculoskeletal system and other vital organs and systems, which is associated with immune and metabolic changes in the body. Data regarding the provision of vitamin D (VD) in patients with JIA and the significance of its deficiency in the initiation, activation of the autoimmune process, the prognosis of the course of the disease, the risk of developing complications and the effectiveness of protocol therapy are contradictory. Objective. To investigate the body's supply of vitamin D in patients with juvenile idiopathic arthritis with the determination of the trigger factors of its deficiency, the assessment of the immune status and changes in the nucleotide sequence in the genes of innate immunity. Materials and methods. Research was conducted during 2016-2021 at the Institute in 119 patients with JIA aged 6 to 12 years. The concentration of 25OHD was determined in blood serum using commercial Vitamin D3 kits (Screeningkit, Switzerland). Immunological studies were performed by flow cytofluorimetry and enzyme immunoassay. For panel sequencing of 407 genes regulating immune functions, high-throughput panel exome sequencing was used on Illumina's HiSeq machine (made in the USA) at the Invitae laboratory (USA). The obtained digital data were processed by methods of statistical analysis using the Microsoft Excel computer package. Results. A high frequency of low supply of vitamin D in patients with JIA was revealed: vitamin D insufficiency was diagnosed in 96 (80.6 %), and its deficiency - in 38 (31.9 %) children. The lowest levels of 25ОНD concentration in blood serum (less than 15 ng/ml) are observed in patients with stage II–III disease activity, especially at the beginning of the pathological process. Vitamin D deficiency (DVD) was associated with the activity and severity of the clinical course, frequent exacerbation of the joint syndrome, the expressiveness of changes in the humoral and cellular immunity of patients. The main risk factors for reducing the body's supply of WD in patients with JIA have been determined, which must be taken into account during their observation and treatment. High activity of JIA in patients with VD deficiency in the body was associated with a significant increase in the number of CD3+ T-cells, CD3+CD4+ helper-inducer T-cells, activated HLA-DR+/CD3+ T-cells, ESR, C-reactive protein concentration (CRP), tumor necrosis factor (TNF), circulating immune complexes (CIC), immunoglobulins, which allows considering DWD as a likely predictor of severe and prognostically unfavorable course of rheumatic disease. Nucleotide sequence changes in the NOD2 gene were detected in 18.1 % of patients with JIA: c.2104C&gt;T (p.Arg702Trp), c.3019dupC (p.Leu1007Profs*2). The of variable changes in patients with JIA is statistically significantly different from the population [VSh = 11.39; 95 % CI (2.39-54.22)]. DVD was detected in all children with mutations in the NOD2 gene – (17.2 ± 3.29) ng/ml, and in children without changes in the nucleotide sequence - in 23 (85.1 %) children [SS = 0.097; DI (0.03-0.31)], the concentration of VD is significantly higher - [(26.68 ± 2.34) ng/ml, p = 0.026]. Conclusions. The conducted studies confirm the presence of a decrease in the body's supply of vitamin D in patients with JIA, which is associated with a high activity of the pathological process and pronounced immunological changes in the body, which allows us to consider its deficiency as a likely predictor of a severe and prognostically unfavorable course of the disease. It has been proven that the concentration of vitamin D in JIA is higher in patients without changes in the nucleotide sequence in the NOD2 gene, which must be taken into account when predicting and evaluating the body's response to the treatment of juvenile arthritis. Key words: juvenile idiopathic arthritis, vitamin D, immunological status, genetic sequencing, children.

Free, bioavailable 25-hydroxyvitamin D levels and their association with diabetic ketoacidosis in children with type 1 diabetes at diagnosis.

Considering the roles of 25-hydroxyvitamin D (25OHD) in glucose homeostasis and immune modulation, vitamin D deficiency may be related to the development of type 1 diabetes (T1DM) and diabetic ketoacidosis (DKA). We evaluated the total, free, bioavailable 25OHD levels and vitamin D binding protein (VDBP) levels and genotypes between T1DM patients and controls. This retrospective, cross-sectional study included 84 children with T1DM (38 boys and 46 girls, 8.0 ± 3.6 years) and 1:1 age- and sex-matched healthy controls. A multiplex liquid chromatography-tandem mass spectrometry-based assay was used to simultaneously measure vitamin D metabolites. Patients with T1DM had lower levels of total 25OHD (16.3 ± 5.1 vs. 19.9 ± 6.5 ng/mL, P< 0.001) and VDBP (146.0 ± 27.8 vs. 224.9 ± 36.1 µg/mL, P = 0.001), but higher free 25OHD (8.0 ± 2.5 vs. 6.5 ± 2.3 pg/mL, P< 0.001) than controls. Patients who presented with DKA had lower levels of 25OHD in the total (15.0 ± 4.6 vs. 17.6 ± 5.2 ng/mL, P = 0.020), free (7.5 ± 2.6 vs. 8.4 ± 2.4 pg/mL, P = 0.059), and bioavailable (2.3 ± 0.9 vs. 2.8 ± 0.8 ng/mL, P = 0.014) forms than those without DKA at the T1DM diagnosis. The lower the total, free, and bioavailable 25OHD levels at diagnosis, the lower the pH and HCO3-. The proportions of the VDBP genotypes did not differ between the patients and controls. Patients with T1DM had higher levels of free 25OHD than healthy children, despite lower levels of total 25OHD. However, patients with DKA exhibited lower levels of bioavailable 25OHD than those without DKA at the T1DM diagnosis. The lower the concentrations of free and bioavailable 25OHD, the more severe the acidosis at the initial T1DM presentation.

The causal association between genetically regulated 25OHD and chronic obstructive pulmonary disease: A meta-analysis and Mendelian randomization study

Backgrounds and objectives: Chronic obstructive pulmonary disease (COPD) is a multifactorial disease under genetic control. We present a meta-analysis to examine the associations of vitamin D binding protein (VDBP) gene rs7041 polymorphism with the risk of COPD and changes in circulating 25OHD concentrations. Methods: A literature search, quality assessment, and data extraction were conducted independently by two investigators. Data are expressed as odds ratio (OR) or weighted mean difference (WMD) with a 95% confidence interval (CI). The inverse variance weighted method (IVW) in R (version 1.1.456) was applied to calculate the Mendelian randomization coefficient. Results: A total of 13 articles with 3,667 participants were meta-analyzed. The rs7041-GT genotype was associated with a 49% reduced COPD risk (OR: 0.51, 95% CI: 0.30 to 0.88, p = 0.014) compared to the rs7041-TT genotype. Carriers of the rs7041-GT genotype had significantly higher concentrations of circulating 25OHD than those with the rs7041-TT genotype (WMD: 0.32ng/ml, 95% CI: 0.09 to 0.55, p = 0.006). Under the assumptions of Mendelian randomization, and assuming a linear logistic relationship between circulating 25OHD and COPD, an inverse association was noted after using VDBP gene rs7041 polymorphism as an instrument (WMD: -2.07, 95% CI: -3.72 to -0.41, p = 0.015). There was a low probability of publication bias. Conclusion: We observed significant associations of VDBP gene rs7041 polymorphism with the risk of COPD and changes in circulating 25OHD concentrations. Importantly, we found a causal relationship between genetically regulated 25OHD concentrations and COPD risk.

Vitamin D Concentration and Motoric Cognitive Risk in Older Adults: Results from the Gait and Alzheimer Interactions Tracking (GAIT) Cohort.

Background. Motoric Cognitive Risk (MCR) syndrome, which combines subjective memory complaint (SMC) and slower gait speed, is a newly-described predementia stage. Based on the involvement of vitamin D in the biology of both gait and cognition, we hypothesized that nondemented individuals with MCR would exhibit hypovitaminosis D more often compared to Cognitively Healthy Individuals (CHI). The objective of this cross-sectional analysis was to determine whether hypovitaminosis D was associated with MCR. Methods. Participants without dementia from the GAIT (Gait and Alzheimer Interactions Tracking) cohort study were classified into MCR or Cognitively Healthy Individuals (CHI) groups. Hypovitaminosis D was defined as the lowest quartile of serum 25-hydroxyvitamin D (25OHD) concentration compared to the other three combined. Age, sex, body mass index (BMI), the Frontal Assessment Battery (FAB) score, the Mini-Mental Short Examination (MMSE) score, education level, use of psychoactive drugs, and the number of chronic diseases were used as covariates. Results. Among 244 nondemented and nonMCInonMCR participants from the GAIT cohort (mean age 71.4 ± 3.7 years, 40.6% women), 66 participants were classified as MCR (36.9%) and 178 as CHI (63.1%). The lowest quartile of 25OHD concentration was directly associated with MCR (unadjusted OR = 2.85, p = 0.003) even after adjustment for studied potential confounders (fully adjusted OR = 2.61, p = 0.025). The BMI (adjusted OR = 6.65, p < 0.001), MMSE score (adjusted OR = 0.74, p = 0.009), FAB score (adjusted OR = 0.51, p < 0.001), number of chronic diseases (adjusted OR = 1.29, p = 0.043) and use of psychoactive drugs (adjusted OR = 2.55, p = 0.044) were also associated with MCR. Conclusions. Hypovitaminosis D was associated with MCR in older community-dwellers without dementia.

Particulate matter may have a limited influence on maternal vitamin D levels

Evidence for an association between the amount of particulate matter (PM) in the atmosphere and vitamin D status of pregnant women is limited. We aimed to examine the independent association between PM and maternal levels of serum 25-hydroxyvitamin D (25OHD) during the second trimester and to explore possible modifications to the association by meteorological factors. 27,768 pregnant women presenting for prenatal examination who were tested for serum 25OHD concentration during the second trimester between January 1, 2016, and December 31, 2020, were included in this retrospective analysis. Exposure to PM was evaluated based on daily average PM with an aerodynamic diameter of ≤ 2.5 μm (PM2.5) and PM with an aerodynamic diameter of ≤ 10 μm (PM10). Corresponding meteorological data for daily average atmospheric temperature, atmospheric pressure, relative humidity, sunshine duration, and wind speed were collected. The maximum cumulative effects of PM2.5 occurred at lag 45 days, and the maximum cumulative effects of PM10 occurred at lag 60 days. In crude models, 45-day moving daily average PM2.5 concentrations were negatively associated with 25OHD levels (β, − 0.20; 95% CI − 0.21 to − 0.19), as were 60-day moving daily average PM10 concentrations (β, − 0.14; 95% CI − 0.15 to − 0.14). After adjusting for temporal and meteorological factors, the effect values were drastically reduced (adjusted β of PM2.5, − 0.032; 95% CI − 0.046 to − 0.018; adjusted β of PM10, − 0.039; 95% CI − 0.049 to − 0.028). Our study showed there was a small, independent, negative association between PM in the atmosphere and maternal serum 25OHD levels during the second trimester of pregnancy after adjusting for temporal and/or meteorological factors, which indicates that PM may have a limited influence on maternal serum 25OHD levels. Besides taking vitamin D supplements, pregnant women should keep participating in outdoor activities while taking PM protection measures to improve their vitamin D levels when PM levels are high in winter and spring.

Genetic factors help explain the variable responses of young children with cystic fibrosis to vitamin D supplements.

Children with cystic fibrosis (CF) are susceptible to fat-soluble vitamin deficiencies unless supplemented, but even large doses of vitamin D may not prevent low 25-hydroxyvitamin D (25OHD) concentrations. The explanation for these vitamin D non-responders has been elusive. We utilized data from whole genome sequencing (WGS) to test the hypothesis that genetic variations predict responsiveness to vitamin D supplementation in a prospective cohort study of children with CF in the first 3 years of life. One hundred and one infants born during 2012-2017 and diagnosed with CF through newborn screening were studied. Serum 25OHD concentrations and vitamin D supplement doses were assessed during early infancy and annually thereafter. WGS was performed, the resultant variant calling files processed, and the summary statistics from a recent genome-wide association study were utilized to construct a polygenic risk score (PRS) for each subject. Overall, the prevalence of vitamin D insufficiency (<30ng/mL) was 21% in the first 3 years of life. Among the 70 subjects who always adhered to vitamin D supplement doses recommended by the US CF Foundation guidelines, 89% were responders (achieved vitamin D sufficiency) by 3 years of age, while 11% were transient or non-responders. Multiple regression analysis revealed that PRS was a significant predictor of 25OHD concentrations (p<0.001) and the likelihood of being an earlier responder in the first 3 years of life (p<0.01). A limited SNP analysis revealed variants in four important genes (GC, LIPC, CYP24A1, and PDE3B) that were shown to be associated with 25OHD concentrations and vitamin D responder status. Other determinants included vitamin D supplement dose, season at 25OHD measurement, and pancreatic functional status. Applying WGS in conjunction with utilizing a PRS approach revealed genetic variations that partially explain the unresponsiveness of some children with CF to vitamin D supplementation. Our findings suggest that a nutrigenomics strategy could help promote personalized treatment in CF.

Associations between Serum 25-Hydroxyvitamin D Levels and Health-Related Quality-of-Life Measures in Patients with Breast Cancer: A Longitudinal Study.

Recent evidence suggests that vitamin D might lower breast cancer mortality. There is also growing interest in vitamin D's potential association with health-related quality-of-life (HRQoL). Associations between circulating 25-hydroxyvitamin D (25OHD) concentrations and HRQoL were examined prospectively among breast cancer survivors at the time of diagnosis and 1 year later. 504 women with incident early-stage breast cancer at Roswell Park Comprehensive Cancer Center were included, and 372 patients provided assessments 1 year later. At each timepoint, participants provided blood samples and completed the SF-36 Health Survey, and surveys on perceived stress, depression, and fatigue. Season-adjusted serum 25OHD concentrations were analyzed in relation to HRQoL measures using multivariable logistic regression models. Approximately 32% of participants had deficient vitamin D levels at diagnosis, which decreased to 25% at 1 year. Concurrently, although SF-36 physical health summary scores were lower at 1 year, mental health summary scores improved, and levels of depression and perceived stress were lower. In comparison with women with sufficient 25OHD levels (>30 ng/mL) at diagnosis, those who were deficient (<20 ng/mL) had significantly worse HRQoL at diagnosis and 1 year later. Vitamin D deficiency 1 year post-diagnosis was also associated with worse HRQoL, particularly among breast cancer survivors who took vitamin D supplements. Breast cancer survivors with vitamin D deficiency were more likely to report lower HRQoL than those with sufficient levels at the time of diagnosis and 1 year post-diagnosis. Our results indicate a potential benefit of vitamin D supplementation for improving breast cancer survivorship.

The association between metals, vitamin D and preterm birth in the MIREC Cohort Study

BACKGROUND Toxic metals, like lead, are risk factors for preterm birth (PTB), but few studies have explored this association at the low levels currently found in the Canadian population. Conversely, studies suggest that vitamin D may have antioxidant activity and protect against PTB. In this study, we sought to investigate associations between toxic metals (lead, mercury, cadmium and arsenic) and PTB, and to determine if maternal plasma vitamin D concentrations modify these associations. METHODS We investigated whether metals in whole blood measured in early and late pregnancy were associated with PTB (&amp;#x3c;37 weeks) and spontaneous PTB (a subset of PTBs with spontaneous labour) in 1,851 pregnancies resulting in live births from the Maternal-Infant Research on Environmental Chemicals Study (MIREC) using discrete time survival analysis. In addition, we investigated whether the risk of PTB was modified by plasma 25OHD concentration measured in the 1st trimester. RESULTS Six percent (n=117) of live births in the MIREC study were PTBs; 4% (n=89) were spontaneous PTBs. A 1 &amp;#x3bc;g/dL increase in blood lead concentrations during pregnancy was associated with increased risk of PTB (OR=1.5, 95% CI: 1.0, 2.3) and spontaneous PTB (OR=1.7, 95% CI: 1.1, 2.8). In stratified analysis, the risk of PTB (OR=2.7, 95% CI: 1.0, 7.2) and spontaneous PTB (OR=3.4, 95% CI: 1.1, 10.8) was higher in women with insufficient vitamin D concentrations (25OHD &amp;#x3c;50 nmol/L). However, a statistical interaction was not seen. Arsenic was associated with a higher risk of PTB (OR=1.1, 95% CI: 1.0, 1.2) and spontaneous PTB (OR=1.1, 95% CI: 1.0, 1.2) per µg/L, but these associations were not modified by vitamin D. CONCLUSIONS Low levels of lead and arsenic may increase the risk of PTB and spontaneous PTB; the association with lead was stronger in participants with insufficient plasma vitamin D. Replication of these findings is warranted.

The effects of season (spring versus autumn) on diagnosis ofnormocalcemic primary hyperparathyroidism.

BackgroundRaised parathormone (PTH) and normal calcium concentrations can be observed both in normocalcemic primary hyperparathyroidism (nPHPT) and in secondary hyperparathyroidism, e.g. due to vitamin D deficiency. We assessed the impact of season on the validity of diagnosis of nPHPT in terms of screening investigations to be performed in the primary care settings.Material and methodsOn two occasions (March/April & September/October) we measured vitamin D (25OHD), PTH and total calcium in 125 healthy subjects, age range 6-50, not taking any vitamin D supplements.ResultsIn autumn there was an increase in 25OHD concentrations (from 18.1 ± 7.37ng/ml to 24.58 ± 7.72ng/ml, p<0.0001), a decline in PTH from 44.40 ± 17.76pg/ml to 36.63 ± 14.84pg/ml, p<0.001), without change in calcium levels. Only 45 subjects (36%) were vitamin D sufficient (25OHD>20/ml) in spring versus 83 (66.4%) in autumn, p<0.001. Elevated PTH concentrations were noted in 10 subjects in spring (8%) and in six subjects (4.8%) (p<0.05) in autumn. In spring, however, eight out of ten of these subjects (80%) had 25OHD<20 ng/ml, versus one in six (16.7%) in autumn (p<0.01). Normalization of PTH was observed in seven out ten subjects (70%), and all of them had 25-OHD<20 ng/ml in spring.ConclusionsIn spring elevated PTH concentrations in the setting of normocalcemia are more likely to be caused by 25OHD deficiency rather by nPHPT. In contrast, in autumn, increased PTH concentrations are more likely to reflect nPHPT. We postulate that screening for nPHPT should be done in 25OHD replete subjects, i.e. in autumn rather than in spring.

Relationships of Serum 25-Hydroxyvitamin D Concentrations, Diabetes, Genetic Susceptibility, and New-Onset Chronic Kidney Disease.

The prospective relation of vitamin D status with the risk of chronic kidney diseases (CKD) remains uncertain. We aimed to examine the association of serum 25-hydroxyvitamin D (25OHD) with new-onset CKD in participants with and without diabetes at baseline and examine the potential modifications by genetic susceptibility on the association. Included were 348,243 adults from the UK Biobank without prior CKD at baseline. Serum 25OHD concentrations were measured by chemiluminescent immunoassay method. Genetic risk score of CKD was calculated by 263 single nucleotide polymorphisms, which showed significant associations with estimated glomerular filtration rate. The primary outcome was new-onset CKD. During a median follow-up duration of 12.1 years, 9,344 new-onset CKD were documented. Overall, there was a significant inverse association between baseline serum 25OHD and new-onset CKD in participants with diabetes (per SD increment, adjusted hazard ratio [HR] 0.91; 95% CI 0.86-0.96), but not in those without diabetes (per SD increment, adjusted HR 0.98; 95% CI 0.96-1.01; P-interaction between serum 25OHD and diabetes = 0.004). Accordingly, among participants with diabetes, compared with those baseline serum 25OHD <25 nmol/L, a significantly lower risk of new-onset CKD was found in those with 25OHD ≥50 nmol/L (adjusted HR 0.77; 95% CI 0.67-0.89). Moreover, the genetic risk of CKD did not significantly modify the association between baseline serum 25OHD and new-onset CKD among participants with diabetes (P-interaction = 0.127). There was an inverse association between baseline serum 25OHD and new-onset CKD in participants with diabetes. The inverse association was not found in participants without diabetes.

Effect of Vitamin D Concentration on Course of COVID-19.

BackgroundThe course of COVID-19 disease is associated with immune deregulation and excessive release of pro-inflammatory cytokines. Vitamin D has an immunomodulatory effect. We aimed to assess the possible correlation between the incidence and severity of SARS-CoV-2 infection and serum vitamin D concentration.Material/MethodsA total of 505 successive patients admitted to a COVID-19-dedicated hospital were included in the retrospective analysis. Serum 25-hydroxyvitamin D (25-OHD) levels and SARS-CoV-2 RT-PCR throat swab test results were determined for each patient. The course of COVID-19 was assessed on the basis of the serum Vitamin Modified Early Warning Score (MEWS), which includes respiratory rate, systolic blood pressure, heart rate, temperature, and state of consciousness), as well as number of days spent in the intensive care unit (ICU) and need for oxygen therapy.ResultsThere was no difference in 25-OHD concentration between COVID-19-confirmed and negative results of the PCR tests. No correlation was found between serum 25-OHD in the COVID(+) group and the need for and time spend in the ICU, as well as the MEWS score. Multivariate analyses showed a positive correlation between need for oxygen therapy and lower 25-OHD concentration, as well as older age (P<0.001) and similar positive correlation between need for ventilation therapy with lower 25-OHD concentration, as well as older age (P=0.005).ConclusionsOur findings do not support a potential link between vitamin D concentrations and the incidence of COVID-19, but low vitamin D serum level in COVID-19 patients might worsen the course of the disease and increase the need for oxygen supplementation or ventilation therapy.