25-OH Vitamin Research Articles

Diverse approaches to the diagnosis and treatment of paediatric vitiligo: a survey of paediatric dermatologists

Abstract There is a paucity of research concerning the diagnosis and treatment of paediatric vitiligo. This reality parallels published patient reports of profound dissatisfaction with the state of knowledge and available treatments. This study was meant to assess the attitudes of paediatric dermatologists towards the therapeutics of paediatric vitiligo. A survey was designed and approved by the survey committee of the Pediatric Dermatology Research Alliance to be distributed to the members. The study was exempted by the IRB of the Mount Sinai Hospital and posted to an online survey system. A total of 56 dermatologists completed the survey, a majority of whom practiced in the US (n = 44, 78·6%), followed by Mexico (n = 6, 10·7%). Most were board-certified (n = 48, 85·7%). Practitioners reported seeing an average of eight paediatric and adolescent vitiligo patients per month. Providers surveyed reported feeling most comfortable treating older patients 13–17 (n = 48, 85·7%), 9–12 (n = 47, 84%), 5–8 (n = 40, 71·4%), 2–4 years (n = 18, 32·1%), 13–23 months (n = 12, 21·4%), 7–12 months (n = 4, 7·1%), and 0–6 months (n = 1, 1·7%). Among the 8 (14·3%) respondents who used an oral JAK inhibitor, the age of the patients ranged from 4 months to 16 years. Most providers surveyed (n = 50, 89·3%) used an interview with the patient and parents to assess for quality-of-life impairments in children and adolescents. Bloodwork was performed always or usually (n = 25, 44·6%), sometimes (n = 11, 19·6%), and rarely (n = 9, 16·1%). Full thyroid panels (n = 38, 67·8%) and 25-OH vitamin D levels (n = 27, 48·2%) led tests ordered. For children under 8 years with <25% +/− eyelid localization TCI (n = 52, 92·9%; n = 46, 82%), TCS (n = 17, 30·3%; n = 29, 51·7%), Narrow band UVB (NB-UVB, n = 11, 19·6%; n = 5, 8·9%), topical JAK inhibitors (tJAK-i) (n = 6, 10·2%, n = 5, 8·9%), cover-up makeup (n = 7, 11·9%; n = 6, 10·7%), and excimer laser (n = 5, 8·5%; n = 9, 16·1%) were prescribed. For <8 with >25% vitiligo +/− eyelid involvement TCI (n = 48, 85·7%; n = 45, 80·3%), TCS (n = 21, 37·5%; n = 30, 53·6%), excimer laser (n = 8, 85·7%; n = 11, 19·6%), NB-UVB (n = 6, 10·7%; n = 7, 12·5%), and cover-up makeup (n = 7, 11·9%; n = 8, 14·3%) were used. For 8+ with body depigmentation <25% or 25%+, TCI (n = 29, 51·8%, n = 22, 39·3%), TCS Class 1 (n = 24, 42·8%), and NB-UVB (n = 17, 30·4%; n = 31, 55·4%), oral steroids (n = 10, 17·9%; n = 12, 21·4%), tJAK-i (n = 5, 8·9%; n = 16, 28·6%); TCS (n = 13, 23·2%), NB-UVB/home phototherapy units (n = 8, 14·3%; n = 22, 39·2%), oral methotrexate (25%+ only; n = 10, 17·9%), TCS (n = 9, 16·1%), and Class 3 TCS (n = 5, 8·9%). Paediatric segmental vitiligo localized to the face was predominantly treated by TCI (n = 46, 82·1%), excimer laser (n = 14, 25%), and occasional tJAKi (n = 8, 14·3%). Treatments identified for segmental vitiligo of the body included TCS (n = 48, 85·7%), TCI (n = 24, 42·9%), NB-UVB (n = 15, 26·8%), and tJAKi (n = 5, 8·9%). Methodologies for assessing vitiligo improvement were clinical photographs, measurement of lesion size (n = 48 each, 85·7%), subjective patient-reported satisfaction (n = 41, 73·2%) and percent re-pigmentation (n = 34, 60·7%). A total of 94·6% reported occasional to constant frustration due to a lack of treatment options and insurance barriers and always or often experiencing challenges in procuring appropriate therapies for patients, including tJAKi and TCI. Parental phobia of topical corticosteroid in paediatric patients was noted at least occasionally (n = 29, 51·8%) to regularly (n = 10, 17·8%). Topical calcineurin inhibitors are favoured for the youngest patients as well as for segmental vitiligo. Topical steroids and UVB light sources are used for older children with more extensive and body disease. The diverse treatment modalities represented underscore the need for a systemized approach to this disease. Even paediatric dermatologists are uncomfortable with infants and small children with vitiligo and more data are needed for guidance in all children, especially infants and toddlers.

Prevalence of Osteoporosis in Cirrhosis: A Systematic Review and Meta-Analysis.

The prevalence of osteoporosis in individuals with cirrhosis varies based on the diagnostic approach and etiology of the underlying liver disease. This systematic review aims to evaluate the prevalence of osteoporosis in individuals with cirrhosis. Electronic databases were searched for studies reporting the prevalence of osteoporosis among patients with cirrhosis. The primary outcome was the presence of osteoporosis, as determined by a dual-energy x-ray absorptiometry (DEXA) scan. Secondary outcomes were levels of biochemical markers of bone metabolism, including calcium, vitamin D, phosphorus, and parathormone (PTH) levels. A cohort of 836 patients from 10 studies was included in the final analysis. The pooled rate of osteoporosis was 14.80% (95% CI: 14.19-15.49). Pooled levels of biochemical markers of bone metabolism were as follows: calcium 9.09 mg/dL (95% CI: 8.73-9.45), 25-hydroxyvitamin D (25-OH vitamin D) 15.41 ng/mL (95% CI: 14.79-16.03), phosphorus 15.41 mg/dL (95% CI: 2.99-3.51), and PTH 26.58 pg/mL (95% CI: 25.45-27.71). Pooled levels of liver biochemistries were: bilirubin 3.04 mg/dL (95% CI: 2.84-3.25), aspartate aminotransferase (AST) 65.35 U/L (95% CI: 61.39-69.31), alanine aminotransferase (ALT) 50.17 U/L (95% CI: 46.18-54.10), alkaline phosphatase 133.31 U/L (95% CI: 124.89-141.73), and albumin 3.25 g/dL (95% CI: 3.05-3.45). Cirrhosis appears to be associated with an increased risk for osteoporosis, with a pooled prevalence of 15%. This can include men and individuals younger than 50 years of age, a cohort not typically considered to be at an increased risk of osteoporosis.Levels of 25-hydroxyvitamin D and insulin-like growth factor-1 (IGF-1) were also significantly low.Further studies are required to evaluate the risk of osteoporosis based on the etiology and stage of cirrhosis, especially in younger males, to incorporate this into future prediction models for fragility fractures.

Estimation of Vitamin D Levels Using a Chairside Diagnostic Test Kit in Patients with Gingivitis and Periodontitis: A Cross-Sectional Study.

Periodontitis is an inflammatory condition of the periodontium that is instigated by microbial biofilms developed on the teeth. The purpose of the study was to ascertain the vitamin D status of gingivitis and periodontitis patients while maintaining a healthy group as the control using simple low-cost chairside pre-coated with 25-OH Vitamin D antigen rapid test kits. From outpatients visiting the college's periodontics clinics, a total of 101 patients were screened. The study sample includes 38 patients in the periodontitis group, 32 in the gingivitis group, and 31 in the healthy group. A middle-digit needle was used to collect blood samples, which were put into a test cassette with membrane that had been coated with 25-OH Vitamin D antigen on the test line area of the strip. Vitamin D Quick Test (Natejah) Semi-quantitatively detects 25-hydroxyvitamin D (25 (OH) D) in human finger-stick complete blood at a cutoff convergence of 30 ± 4 ng/mL. Vitamin D blood levels below 80 nmol/L are considered to have deficient vitamin 25(OH)D levels. Clinical parameters between healthy, gingivitis, and different stages of periodontitis subjects were compared using one-way ANOVA and Tukey's multiple comparison. Fisher's exact test was done to compare vitamin D levels in the three groups. Fisher's exact test revealed that there was a statistically significant increase in the number of subjects with stages 4 and stage 3 periodontitis who lacked vitamin D levels (less than 80 nmol/L). Whereas least deficient in Vit D were noticed among Healthy and Gingivitis subjects. When compared to healthy individuals, gingivitis, and various stages of periodontitis had significantly higher mean PI values in a Tukey's multiple comparison. Vitamin D deficiency was found to be 27.5% in subjects with gingivitis and 71.5% in subjects with periodontitis. Periodontitis is associated with vitamin D deficiency, in contrast to gingivitis and healthy subjects. The severity of periodontitis was likewise linked to the amount of vitamin D in the individual's blood. When compared to expensive, time-consuming, and laborious laboratory methods, the findings of this study suggest that a simple inexpensive chairside pre-coated with 25-OH Vitamin D antigen rapid test kits can be considered a viable alternative for determining vitamin D levels.

Determination of vitamin D level in chicken eggs from conventional and free range systems

This study aimed to investigate the vitamin D levels and some quality features of eggs. A total of 150 eggs (75 conventional and 75 free-range) were selected for the study. The levels of 25-OH vitamin D were determined by liquid chromatography with tandem mass spectrometry (LC-MS/MS) in egg yolks. Furthermore, we evaluated the weights of egg, yolk, albumen, and yolk color as well as shape index, shell thickness, and percentages of albumen, yolk, and shell. The 25-OH vitamin D levels were significantly higher (P < 0.01) in the conventional than in the free-range eggs. Furthermore, the weights of egg, albumen, yolk, percentage of yolk and yolk color were significantly higher (P < 0.01) in the conventional than in the free-range eggs. However, the shape index, percentage of albumen, percentage of shell and shell thickness were significantly higher (P < 0.01) in the free-range than the conventional eggs. It can be concluded that vitamin D levels in eggs can be related to yolk color. However, egg quality characteristics can also be influenced by various environmental factors.

Vitamin D status in a case series of Armenian population: one center cohort datA

Documenting the current status of vitamin D and its trends is one of goals of nutritional assessment and monitoring for the health agencies. The purpose of current study was to examine the prevalence of vitamin D insufficiency in a case-series of Armenian population based on one center cohort data, and to reveal its association with season, age and sex. In 2018, 1525 patients were evaluated. Vitamin D insufficiency was defined as a serum 25-OH vitamin D concentration (25-OHD) &lt;20ng/ml. The season was detected as “sunny season” – from May to October inclusively, and “non-sunny” season – from November to April. All analyses were performed using statistical software (IBM SPSS Statistics for Windows, Version 21.0; IBM Corp., USA). Values of p&lt;0.05 were considered statistically significant. The male/female ratio of investigated patients was 1/2.5, and mean age was 35.14±17.66. No significant difference in vitamin D insufficiency prevalence was found between 3 age groups (p&gt;0.05). The average 25-OH vitamin D level of all investigated patients was 24.11±9.66. The overall prevalence rate of vitamin D insufficiency was 29.3% (n=447), having a significant link with the winter “non-sunny” season (p&lt;0.01), when the sun exposure on the skin is not enough, regardless the sex (p&gt;0.05). No correlation was found between 25-OHD insufficiency and age of patients (p&gt;0.05). In summary, we conclude that 25-OHD insufficiency is common in Armenian population and is linked with seasonal period. It is important, that health care providers and government health agencies in Armenia are aware of this prevalence of vitamin D insufficiency and develop and re-evaluate over time the country-specific health policy and programs

The impact of vitamin D deficiency on clinical, biochemical and metabolic parameters in primary hyperparathyroidism

BackgroundIt has been suggested that vitamin D deficiency is associated with worse clinical outcomes in primary hyperparathyroidism (PHPT). We aimed to evaluate the relationship between vitamin D deficiency and clinical, biochemical and metabolic parameters in PHPT patients. MethodsA total of 128 patients with biochemically confirmed PHPT were included. Patients were categorized as vitamin D deficient if 25-OH vitamin D was <50nmol/L, or normal if vitamin D was ≥50nmol/L. Biochemical parameters, bone mineral densitometry (BMD), and urinary tract and neck ultrasonography were assessed. ResultsIn the study group, 66 (51.6%) patients had vitamin D deficiency and 60 (48.4%) had normal vitamin D levels. Nephrolithiasis and osteoporosis were found in 26.6% and 30.5% of subjects, respectively. The prevalence of metabolic syndrome (MetS), obesity (BMI≥30kg/m2) and hypertension (HTN) were higher in the vitamin D deficient group when compared to the normal group (p=0.04, p=0.01 and p=0.03, respectively). There was no difference regarding the presence of nephrolithiasis and osteoporosis between the groups. The mean adenoma size was similar in both groups. ConclusionsVitamin D deficiency was not associated with osteoporosis, nephrolithiasis, adenoma size or biochemical parameters in PHPT. However, vitamin D deficiency may be a risk factor for developing HTN and MetS in PHPT.

Vitamin D status in a case series of Armenian population: one center cohort datA

Documenting the current status of vitamin D and its trends is one of goals of nutritional assessment and monitoring for the health agencies. The purpose of current study was to examine the prevalence of vitamin D insufficiency in a case-series of Armenian population based on one center cohort data, and to reveal its association with season, age and sex. In 2018, 1525 patients were evaluated. Vitamin D insufficiency was defined as a serum 25-OH vitamin D concentration (25-OHD) &lt;20ng/ml. The season was detected as “sunny season” – from May to October inclusively, and “non-sunny” season – from November to April. All analyses were performed using statistical software (IBM SPSS Statistics for Windows, Version 21.0; IBM Corp., USA). Values of p&lt;0.05 were considered statistically significant. The male/female ratio of investigated patients was 1/2.5, and mean age was 35.14±17.66. No significant difference in vitamin D insufficiency prevalence was found between 3 age groups (p&gt;0.05). The average 25-OH vitamin D level of all investigated patients was 24.11±9.66. The overall prevalence rate of vitamin D insufficiency was 29.3% (n=447), having a significant link with the winter “non-sunny” season (p&lt;0.01), when the sun exposure on the skin is not enough, regardless the sex (p&gt;0.05). No correlation was found between 25-OHD insufficiency and age of patients (p&gt;0.05). In summary, we conclude that 25-OHD insufficiency is common in Armenian population and is linked with seasonal period. It is important, that health care providers and government health agencies in Armenia are aware of this prevalence of vitamin D insufficiency and develop and re-evaluate over time the country-specific health policy and programs.

Evaluation of 25 OH Vitamin D Levels and Clinical Findings in Patients with Traumatic Brain Injury

Evaluation of 25 OH Vitamin D Levels and Clinical Findings in Patients with Traumatic Brain Injury

Serum 25-Hydroxy Vitamin D Levels in Patients with Polymorphic Light Eruptions: A Case-control Study

Introduction: Polymorphic Light Eruptions (PMLE) are immune mediated dermal maculopapular eruptions that occurs after sun exposure. Vitamin D deficiency has been gaining attention in many dermatological diseases of varied pathologies. Research studies on vitamin D levels in PMLE are lacking despite it being an immuno modulator. Aim: To estimate the levels of serum 25-OH Vitamin D among patients with PMLE disease and also to compare its level with healthy controls Materials and Methods: A case-control study was conducted during January 2022 to June 2022 in Melmaruvathur Adhiparasakthi Institute of Medical Sciences and Research Hospital, Tamil Nadu, India. Total 80 participants (40 patients with PMLE eruptions and 40 normal healthy volunteers), of both sexes aged between 40-60 years were included. Serum 25-OH Vitamin D levels were estimated for participants and the data obtained were analysed by using Student’s t-test and Chi-square test as tests for significance and Odds ratio by logistic regression as test for outcome association. Results: Amongst the total 80 participants, 40 in each case and control group, mean age in case group was 50.08±5.21 years and in control group was 49.80±5.68 years. The results of the study showed significantly reduced serum 25-OH vitamin D levels (30.13±7.39 ng/mL) among cases compared to controls (34.50±6.05 ng/mL) (p=0.005). It further showed significant positive B (0.160) slope for sunlight exposure and significant negative B (-0.556) slope for serum vitamin D levels with odds of occurrence to PMLE disease state increases by 17.4% for every unit increase in sunlight Ultraviolet (UV) exposure {Odds ratio: 1.174 (C.I: 1.088-1.266)} and decreases by 42.6% for every unit increase in Vitamin D levels {Odds ratio: 0.574 (C.I: 0.446-0.738)}. Conclusion: Most PMLE patients were found to have significantly lower Vitamin D levels with majority in the pre- deficient zones. These findings suggest Vitamin D could be a cost effective alternative prospect in both PMLE diagnostics and therapeutics in future after thorough trial validations.

Clinicopathological Profile of Primary Hyperparathyroidism with Special Reference to Ki-67 Labelling Index.

Primary hyperparathyroidism (PHPT) can occur due to a neoplastic process or hyperplasia. While the disease presentation is predominantly asymptomatic in developed countries, this is not the case yet in India. Differentiation of the type of lesion can only be done based on histomorphology but has its own challenges. Immunohistochemical markers like Ki-67 have been studied to aid in diagnosis but data on this is sparse from India. The aim of this study is to assess the clinical, biochemical and pathological profile of PHPT and to analyse the differences in immunohistochemical marker Ki-67 among the various lesions. A descriptive study was carried out on 38 PHPT patients who were treated at our institute from January 2011 to March 2021. Post-surgery, the causative lesions were categorised as adenoma (31), hyperplasia (5) and carcinoma (2). Clinical, biochemical, radiological and histopathological features of all lesions were collected and analysed. Ki-67 proliferation index was calculated. The various parameters were compared across the three groups of lesions and correlated with Ki-67 index. Out of 38 patients, 37 were symptomatic with skeletal symptoms being the most common followed by renal symptoms. There was no difference in clinical or biochemical parameters among the three types of lesions. Significant negative correlation was seen between serum iPTH and serum 25-OH Vitamin D levels (P0.006) The median Ki-67 index was found to be 0.40% in hyperplasia, 0.49% in adenoma and 5.84% in carcinoma. PHPT still presents as an overtly symptomatic disease in India. Diagnosis of the nature of lesion depends on the accurate application of morphological criteria. A high Ki-67 index was not found to be an absolute marker of carcinoma, as it was also seen in a small proportion of atypical adenomas.

Assessment of Serum 25-Hydroxy Vitamin D Level Among Hypothyroidism with and without Thyroid Peroxidase Antibodies

The association between serum 25-Hydroxy vitamin D (25-OH vitamin D) levels in hypothyroid subjects with and without thyroid peroxidase (TPO) antibodies is controversial. There is increasing evidence that 25-OH vitamin D level is associated with autoimmune diseases. The analytical cross-sectional case-control and hospital-based study were conducted at Professor Al-Mahdi M. Ali Center for Diabetes and Endocrinology in Khartoum from February to October 2020. Sixty subjects with hypothyroidism were recruited from the follow-up clinic. Thirty age and sex-matched subjects were used as control. Thyroid Function Tests [Thyroid-stimulating hormone (TSH), Free Thyroxine (FT4), and Free triiodothyronine (FT3)] were measured using TOSOH AIA 360system analyzer, and serum 25-OH vitamin D level was measured using semiautomatic I-Chroma-II reader and thyroid peroxidase antibodies (TPO antibodies) were measured in both cases and controls was estimated using ELISA. The results were analyzed using SPSS version 21. TSH was significantly increased in both TPO antibodies positive and TPO antibodies negative hypothyroid subjects than in the controls (22.3±4.44), (10.5±2.55) (3.42±0.75) with a P-value of 0.000. FT4 has decreased in both TPO antibodies positive and TPO antibodies negative subjects than in the control (0.51±0.21) (0.56±0.19) (2.0±0.55) with a P-value of 0.002. FT3 has significantly decreased in both TPO antibodies positive and TPO antibodies negative subjects than in the control (0.73±0.31)(0.73±0.49)(3.67±0.81) with a p-value of 0.0001. 25-OH Vitamin D level was lower among hypothyroid subjects than in the control. Subjects with positive TPO antibodies had lower 25-OH vitamin D levels than the TPO-antibody negative subjects compared to control (7.45±4.50̽) (10.5±7.18)(48.8±10.0) with P-value 0.000. Females 46(77%) were more than males 14(23%) and geographically most subjects were coming from the central part of Khartoum state.

COVİD 19'DA ÖNE ÇIKAN BİYOKİMYASAL PARAMETRELERİN VE D VİTAMİNİNİN DEĞERLENDİRİLMESİ

Aim: We aimed to evaluate potential coagulation and inflammatory biomarkers. The recently discussed vitamin D levels predict the course ef the disease and determine the patients to be admitted to the intensive care unit in advance. &#x0D; Materials and Methods: This retrospective case-control study was conducted on 121 patients diagnosed and treated with COVID-19 disease, from March 2020 to June 2020 at the Amasya Sabuncuoğlu Şerefeddin Training and Research Hospital, Amasya, Turkey. D-dimer, Fibrinogen, Ferritin, and 25-OH Vitamin D levels that could be associated with COVID-19 infections were evaluated. The patients were divided into three groups: only Polymerase Chain Reaction positivity (PCR+), only Computerized Tomography positivity (CT+) and both PCR+ and CT+ among COVID-19 cases. &#x0D; Results: 121 patients with at mean age of 53 were investigated (52% male). Only CT+ cases were significantly older than other patients, p

Comparison of Umbilical Cord and Postnatal Fourth Month Serum 25-OH Vitamin D Levels of Late Preterm and Term Infants

Comparison of Umbilical Cord and Postnatal Fourth Month Serum 25-OH Vitamin D Levels of Late Preterm and Term Infants

Association of vitamin D deficiency with diabetic gastroparesis and its intramuscular vitamin D treatment

Introduction: Diabetic gastroparesis (DGp) is a component of autonomic neuropathy resulting from long-standing poorly controlled type 1 and type 2 diabetes. There are currently no approved vitamin D supplementation recommendations for people with DGp. Objectives: To investigate the relationship between vitamin D insufficiency and DGp, as well as the efficacy of intramuscular vitamin D therapy. Methodology: 71 patients (18 DM Gp &amp; 53 Non-DM Gp) seeking treatment for gastroparesis symptoms were studied. The blood levels of vitamin D, homocysteine, gastric emptying test (GET) at 1, 2, and 4 h were recorded. 25-OH vitamin D levels were detected by kit. Potential clinical and statistical correlations between all results, symptoms, and GET data were explored. Descriptive statistics were used to investigate etiologic differences at baseline while multiple linear regression models were employed to explore relationships of vitamin D deficiency with diabetic gastroparesis and its intramuscular vitamin D treatment. Results: Majority of DGp patients were older than 18 years (88%) and were non-smokers (83%). The majority of those with and without diabetes were married (11; 71% vs. 34; 64%). The majority of participants in the DM group had only completed elementary school (n=7/18; 38.8%).

Study of left ventricular systolic dysfunction, left ventricular diastolic dysfunction and pulmonary hypertension in CKD 3b-5ND patients—A single centre cross-sectional study

IntroductionCardiovascular diseases are associated with increased morbidity and mortality among CKD (chronic kidney disease) population. Recent studies have found increasing prevalence of PH (pulmonary hypertension) in CKD population. Present study was done to determine prevalence and predictors of LV (left ventricular) systolic dysfunction, LVDD (left ventricular diastolic dysfunction) and PH in CKD 3b-5ND (non-dialysis) patients. MethodsA cross sectional observational study was done from Jan/2020 to April/2021. CKD 3b-5ND patients aged ≥15 yrs were included. Transthoracic 2D (2 dimensional) echocardiography was done in all patients. PH was defined as if PASP (pulmonary artery systolic pressure) value above 35mm Hg, LV systolic dysfunction was defined as LVEF (left ventricular ejection fraction)≤50% and LVDD as E/e′ ratio >14 respectively. Multivariate logistic regression model was done to determine the predictors. ResultsA total of 378 patients were included in the study with 103 in stage 3b, 175 in stage 4 and 100 patients in stage 5ND. Prevalence of PH was 12.2%, LV systolic dysfunction was 15.6% and LVDD was 43.65%. Predictors of PH were duration of CKD, haemoglobin, serum 25-OH vitamin D, serum iPTH (intact parathyroid hormone) and serum albumin. Predictors of LVDD were duration of CKD and presence of arterial hypertension. Predictors of LV systolic dysfunction were eGFR (estimated glomerular filtration rate), duration of CKD, serum albumin and urine protein. ConclusionIn our study of 378 CKD 3b-5ND patients prevalence of PH was 12.2%, LV systolic dysfunction was 15.6% and LVDD was 43.65%.

Consensus and Controversial Aspects of Vitamin D and COVID-19.

This work aims to review and discuss controversial topics in the field of vitamin D, SARS-CoV-2 infection, and COVID-19. The International Conferences "Controversies in Vitamin D" are a series of workshops that started in 2017 featuring international experts and leaders in vitamin D research and clinical practice. The fifth annual conference was held in Stresa, Italy, September 15 to 18, 2021. Before the event, participants reviewed available studies on their assigned topic, drafted a related abstract, and presented their findings at the time of the conference. Relevant literature that became available since was also discussed within the panel and updated accordingly. Before the event, the drafted abstracts had been merged to prepare a preliminary document. After the conference presentations, in-depth discussions in open sessions led to consensus. The document was subsequently modified according to discussions and up-to-date literature inclusion. There is quite consistent evidence for an association between low 25 OH vitamin D (25(OH)D) levels and poor COVID-19 outcomes, despite heterogeneous publications of variable quality. However, the low vitamin D status in COVID-19 patients might also reflect reverse causality. Vitamin D supplementation might have a positive role in COVID-19 prevention. The evidence supporting a beneficial effect of vitamin D treatment in decreasing the risk of COVID-19 complications is conflicting. Conclusive statements regarding the beneficial effect of vitamin D in this context await high-quality, randomized controlled trials.

Association between 25-OH Vitamin D Deficiency and COVID-19 Severity in Pregnant Women.

Evidence from studies in the general population suggests an association between vitamin D insufficiency/deficiency and COVID-19 susceptibility and disease severity. The present study was performed on 165 third-trimester pregnant women at the time of delivery. Seventy-nine women tested negative for SARS-CoV-2. From 86 women testing positive, 32 were asymptomatic, 44 presented a mild form of the disease, and 10 experienced severe symptoms. Serum 25-OH vitamin D levels were measured on blood samples collected on admission. Low vitamin D levels were detected in symptomatic but not asymptomatic COVID-19 patients compared to healthy women (p = 0.0227). In addition, 20 (45.4%) pregnant women in the mild COVID-19 group and 6 (60%) in the severe group were vitamin D deficient (p = 0.030). On the other hand, lasso regression analysis showed that 25-OH vitamin D deficiency is an independent predictor of severe COVID-19 with an odds ratio (OR) of 5.81 (95% CI: 1.108-30.541; p = 0.037). These results show the relationship between vitamin D deficiency in pregnant women and the severity of COVID-19 infection and support the recommendation to supplement with vitamin D to avoid worse COVID-19 outcomes during pregnancy.

Association between Serum Biomarkers with Postoperative Complications and Delay of Adjuvant Chemotherapy Initiation in Ovarian Cancer Patients Undergoing Primary Cytoreductive Surgery: A Pilot Study

This study sought to describe and relate the factors associated with complications and delays in adjuvant chemotherapy in patients with ovarian cancer treated with primary cytoreductive surgery. Serum from patients diagnosed with ovarian cancer scheduled for primary cytoreductive surgery were analyzed for prealbumin, 25-OH Vitamin D, intracellular adhesion molecule 1 (ICAM-1), interleukin 6 (IL-6), interleukin 8 (IL-8), monocyte chemoattractant protein 1 (MCP-1), monocyte chemoattractant protein 2 (MCP-2), macrophage derived chemokine (MDC). Postoperative complications were identified using common terminology criteria for adverse events 4.0 and 30 day after surgery. Delays in adjuvant chemotherapy were defined as >1 week interval between surgery and initiation. Patients with postoperative complications (39.6%) were significantly older, had lower serum prealbumin levels, and higher serum IL-6 and IL-8 than those without. Univariate logistic regression found that age (OR: 1.12, 95%CI: 1.00-1.35) and IL-6 (OR: 1.02, 95%CI: 0.99-1.05) were associated with postoperative complications, whereas age remained significant after multivariate analysis (OR:1.14, 95%CI: 1.00-1.29). Patients with delays in chemotherapy exhibited greater BMI and lower 25-OH Vitamin D than those without. Multivariate analysis found that increasing levels of 25-OH Vitamin D were associated with a lower risk of delayed chemotherapy initiation after controlling for age, body mass index, and tumor grade (OR: 0.93, 95%CI:0.87-0.99). This work suggests that in addition to age being predictive of postoperative complications, serum 25-OH Vitamin D may a provide insight into a patient’s risk for postsurgical delays in chemotherapy initiation. These findings should, however, be confirmed in a larger study including robust survival analysis.

Laboratory indicators of nutritional status in children with cerebral palsy

Children with cerebral palsy are at high risk of developing nutritional disorders: malnutrition, osteopenia, micronutrient deficiency. This is facilitated by motor disorders, restriction of actual nutrition, the presence of concomitant drug therapy, and metabolic features.Purpose. The study aims at evaluation of laboratory markers of nutritional status in children with cerebral palsy.Material and methods: for a comprehensive assessment of nutritional status disorders, a cross-sectional analytical study of 175 children with cerebral palsy was carried out. Laboratory studies included the determination in blood of: total protein, glucose, ALT, AST, total and direct bilirubin, cholesterol, creatinine, urea, vitamins A, E, B12, folic acid, magnesium, phosphorus, calcium, serum iron, zinc, total iron-binding ability, ferritin, 25-OH vitamin D, parathyroid hormone.Results. Only in 5 (3%) children all the studied laboratory parameters were within the reference values. The most frequently observed in children with cerebral palsy were: 25-OH vitamin D insufficiency/deficiency in 68% of children, a decrease in folic acid levels in 32%, an increase in vitamin B12 in 32%, a decrease in cholesterol in 26% and creatinine in 16.6%, a decrease in phosphorus in 14.5%, serum iron in 12.4% and an increase in magnesium in 10.3%.Conclusion. The detected deficiency of some indicators is most likely associated with an unbalanced actual diet of patients with cerebral palsy, although the reduced intake of certain vitamins and microelements was not always reflected in their blood concentrations (vitamin A, E, magnesium, calcium). The levels of zinc, vitamin B12 and A did not decrease in any of the examined children, which casts doubt on the recommendations of ESPGHAN experts in terms of prescribing them to all children with cerebral palsy in routine clinical practice.

The influence of ESR1 polymorphisms on selected hormonal, metabolic and mineral balance markers in women with hyperandrogenism

Hyperandrogenism is the most common endocrine disorder in women, characterized by an imbalance in normal estrogen and androgen levels in the blood. Androgens influence bone mineral density, body mass composition, muscle mass, mental state, and the regulation of sexual function.. The aim of the study was to assess the effect of estrogen receptor α gene (ESR1) polymorphisms on selected markers of bone metabolism and hormonal parameters in women with hyperandrogenism. The study group included 80 young women with hyperandrogenism who underwent measurements of bone mineral density (BMD), and determination of hormonal and metabolic parameters. Enzyme immunoassays were used to measure leptin, sRANKL (soluble receptor activator of nuclear factor-kB ligand), osteoprotegerin and 25-OH vitamin D total levels. An analysis of ESR1 gene polymorphisms was performed using the real-time PCR method. A relationship was demonstrated between the concentration of free estradiol (FEI) and the concentration of 17-OH-progesterone, and the ESR1 gene polymorphisms: rs3020314 (p = 0.031, p = 0.026 respectively) and rs1884051 (p = 0.033, p = 0.026 respectively). In conclusion, the ESR gene polymorphisms may be associated with hormonal disturbances in the concentration of estrogens and androgens, in hyperandrogenism in young women which may indirectly affect bone mineral density. However, no statistically significant relationships between the studied polymorphisms and the selected parameters of mineral metabolism have been demonstrated..