Correction Of Vitamin Research Articles

Is it necessary to diagnose and correct vitamin D deficiency in malignant neoplasms? Analytical review

BACKGROUND: Although the critical role of vitamin D in mineral homeostasis regulation is widely recognized, the global prevalence of vitamin D deficiency is exceedingly high. The substantial number of population-based studies that examine the correlation between the concentration of circulating vitamin D levels and the risk of developing cancer may be attributed to the growing interest of researchers in this vitamin as a suppressor of proliferating epithelial cells. However, the data collected are contradictory. AIM: To ascertain the necessity of diagnosing and rectifying vitamin D deficiency in cancer patients. MATERIALS AND METHODS: The keywords “vitamin D,” “vitamin D deficiency,” “cancer,” and “survival” were employed to identify publications in the e-Library, PubMed, and ScienceDirect databases from January 2014 to January 2024. Based on the data obtained, an analytical review of the literature was conducted. RESULTS: The global prevalence of vitamin D deficiency, including among cancer patients, is exceedingly high and does not vary by sex, age, or ethnicity. Decreased serum vitamin D levels are linked to an elevated incidence of colorectal cancer, breast cancer, melanoma, prostate, and pancreatic cancer. Addressing vitamin D deficiency helped mitigate the risk of developing breast cancer. Data on the effect of vitamin D deficiency and its correction on patient survival are inconsistent. CONCLUSION: Currently, there is no consensus regarding the impact of vitamin D supplementation on the incidence of diverse malignancies, as well as tumor-specific and overall survival. Additional research is required to address the necessity of diagnosing and correcting vitamin D deficiency.

Metabolic phenotypes and vitamin D response in the critically ill: A metabolomic cohort study

Background & AimsAlthough vitamin D deficiency is common in critically ill patients, randomized controlled trials fail to demonstrate benefits of supplementation. We aimed to identify distinct vitamin D3 responsive metabolic phenotypes prior to trial intervention of high-dose vitamin D3 by applying machine learning clustering method to metabolomics data from the Correction of Vitamin D Deficiency in Critically Ill Patients (VITdAL-ICU) trial. MethodsIn the randomized, placebo-controlled VITdAL-ICU trial, critically ill adults received placebo or high-dose vitamin D3. To distinguish vitamin D3 responsive metabolic phenotypes prior to intervention, we implemented consensus clustering with partitioning around medoids algorithm to the plasma metabolome data before randomization. Individual metabolite differences were determined utilizing linear mixed-effects regression models stratified for metabolomic phenotypes with false discovery rate adjustment. The association between vitamin D3 supplementation and 180-day mortality was evaluated in each metabolic phenotype, applying multivariable logistic regression analysis. ResultsIn 453 critically ill adults, the study identified 4 distinct metabolic phenotypes (clusters A. N=134; B. N=123; C. N=92; D. N=104). We found differential metabolic pathway patterns in the four clusters. Specifically, branched chain amino acid catabolic metabolites, long-chain acylcarnitines and diacylglycerol species are significantly increased in a specific metabolic phenotype (cluster D) following high-dose vitamin D3. Further, in cluster D high-dose vitamin D3 supplementation had a significantly lower adjusted odds of 180-day mortality after controlling age, sex, Simplified Acute Physiology Score II, admission diagnosis, and baseline 25-hydroxyvitamin D (OR 0.28 (95%CI, 0.09–0.89); P=0.03). In metabotype A, B, and C, high-dose vitamin D3 supplementation was not significantly associated with lower 180-day mortality following multivariable adjustment. ConclusionIn this post-hoc cohort study of the VITdAL-ICU trial, the clustering analysis of plasma metabolome data identified biologically distinct metabolic phenotypes. Among clusters, we found the different associations between high-dose vitamin D3 supplementation and specific metabolite pathways as well as 180-day mortality. Our findings facilitate further research to validate metabolic phenotype-targeted strategies for critical illness treatments.

Content of ascorbic acid in different skin phototypes in children with vitiligo

Aim. To evaluate the blood level of ascorbic acid in children with vitiligo according to skin phototype.Material and Methods. Blood ascorbic acid levels were analysed in children of different ages (6-15 years) with different types of vitiligo, depending on skin phototype. Patients were divided into two groups according to the degree and localisation of the vitiligo lesions: with non-segmental (n=116) and with segmental (n=134) vitiligo. The area of distribution of the dermatosis and its stage of development were calculated using the VIMAN and VIDA indices, respectively. Serum ascorbic acid levels were determined by liquid chromatography-mass spectrometry. Patients were classified by phototype according to T. Fitzpatrick’s classification.Results and discussion. Among the children with vitiligo studied, skin phototypes II, III and IV were identified, with a predominance of phototype III over the others. Their percentages differed in the two groups studied. In non-segmental vitiligo, there were more children with a light phototype and fewer with a dark phototype compared to the group of children with segmental vitiligo. Ascorbic acid levels were significantly reduced in children with vitiligo compared to a group of healthy children. The most pronounced decrease was observed in the group with non-segmental vitiligo in the 7-9 year age group. In both groups of patients, there was a tendency for ascorbic acid levels to decrease with age.Conclusion. The data obtained indicate that children with vitiligo have lower ascorbic acid levels than healthy children. The tendency to decrease increases with age, especially in patients with a dark phototype. This fact indicates the need to correct vitamin C levels in the body of children with vitiligo.

Different Regimens of Vitamin D in treatment of children with chronic liver disease

Abstract Background Vitamin D is a steroid based hormone that has crucial role in calcium metabolism and bone homeostasis and potential role in fibrosis including liver. Patients with chronic liver disease has tendency for vitamin D deficiency with possible sequalae including hepatic osteodystrophy. Safe and effective regime of vitamin D that can be used in children with chronic liver disease is still not well established. Moreover, the potentiality of reversing fibrosis process or halting it by correction of vitamin D is still not well studied. Aim of work The primary aim of the study is to assess the efficacy and safety of vitamin D regime using two different mode of administration. The secondary aim is to assess the possible antifibrotic effect of vitamin D therapy by assessment of fibroscan. Methodology Twenty four children with different etiologies of chronic liver disease but age and sex matched as well as anthropometric measures are enrolled in the study. They were distributed randomly among the two arms of the study and followed up for 6 months using different laboratory and imaging variables. The two regimes were group A who received intramuscular stoss dose once (200.000 IU) vitamin D therapy while group B received oral vitamin D therapy with dose 50.000 IU for four weeks. All children received maintenance vitamin D (600 IU) and Ca doses thereafter for the whole follow up period. All patients were subjected to complete history taking, complete clinical examination including abdominal examination, signs of liver decompensation and signs of vitamin D deficiency. As regard laboratory investigations done were CBC, liver function tests, serum calcium and phosphorous. Serum vitamin D level and fibroscan were also done at the beginning and the end. Results There were significant improvement of vitamin D level in both arms with no development of toxic s/o of vitamin D toxicity with p-value of < 0.001 and 0.000 respectively in group A and B. The difference of improvements between both arms were not significant display the equal efficacy of both regimes (P = 0.885). There were no significant improvement of fibroscan parameters following vitamin D treatment in either group A or B with p-value 0.637 and 0.931 respectively. Conclusion Stoss and oral vitamin D regimes suggested in the study are both equally effective and safe in the treatment of vitamin D deficiency among children with chronic liver disease. Despite no proof of antifibrotic effect upon vitamin D correction, further study is required to evaluate this issue.

Vitamin D Supplementation Improves Physical Performance in Athletes and Healthy Aging in Physically Active Adults

Vitamin D deficiency is a significant global public health issue, even in regions with all year sun exposure. Currently, the scientific community has not yet reached a unanimous agreement regarding the optimum levels of vitamin D and the precise threshold values. Additional efforts are required to standardize the evaluation of vitamin D insufficiency and deficiency and to provide uniform treatment guidelines. Epidemiological studies have identified a broad spectrum of estimated prevalences in athletes. Their performance when participating in sports. depend on their muscles, heart and lung function. It seems that athletes have significantly lower levels of vitamin D compared to the general population. However, there is a lack of comprehensive studies and systematic reviews on this subject, making it challenging to reach conclusions due to variations in laboratory techniques and cut-off values. While there is an abundant of research on the supplementation of vitamin D and its benefits, it is challenging to provide general recommendations for athletes due to the limitations of extrapolation. However, there is a rather high occurrence of Vitamin D deficiency among individuals who engage in regular physical activity. Supplementing with Vitamin D helps prevents osteoporosis, bone fractures, enhances muscle strength, avoids lung infections, heart failure, and arrhythmias. It is generally safe when used in appropriate quantities, given its wide therapeutic range. Athletes can decrease the occurrence of training dropouts caused by infection, arrhythmias, muscular weakness and potentially prevent the inability to participate in competitions through correct nutrition and vitamin D supplementation. Keywords: vitamin D; sports; muscle; heart, athletes rehabilitation, vitamin D, ventricular premature contractions, physical activity

Effect of Vitamin D Deficiency on Periprosthetic Joint Infection and Complications After Primary Total Joint Arthroplasty

BackgroundVitamin D deficiency is a global problem, and 13 to 75% of patients undergoing total joint arthroplasty (TJA) have vitamin D deficiency. Several studies have shown that low preoperative vitamin D levels may increase the risk of postoperative complications, including periprosthetic joint infection (PJI), in patients undergoing primary TJA. Most of the studies are underpowered. This study aimed to investigate the relationship between vitamin D deficiency and surgical and medical complications after primary TJA, with a specific focus on PJI. MethodsProspectively collected institutional multicenter arthroplasty databases were reviewed to identify patients who underwent primary total knee and hip arthroplasty. The study group was defined as patients whose vitamin D level is < 30 ng/dL and who received a single oral dose of 7.5 mg (300,000 IU) D3 within two weeks before index surgery (n = 488; mean age 63 years). Patients in the control group were those whose preoperative vitamin D levels were unknown and who did not receive vitamin D supplementation (n = 592, mean age 66). The groups were compared regarding 90-day medical and surgical complications, including PJI, mortality, and readmission rates. ResultsThe total number of complications (8.6 and 4.3%; respectively; P = .005), superficial wound infection (2.5 and 0.2%, respectively; P < .001), and postoperative cellulitis (2.2 and 0% respectively; P < .001) were statistically significantly higher in the patient group who did not receive vitamin D supplementation. However, 90-day mortality (P = .524), PJI (P = .23), and readmission rate (P = .683) were similar between the groups. ConclusionsThis study demonstrated that preoperative optimization of vitamin D levels may be beneficial in reducing postoperative complications, including superficial wound infection and postoperative cellulitis. Administering an oral 300,000 U single-dose vitamin D regimen to correct vitamin D deficiency can positively impact outcomes following primary TJA.

The impact of vitamin D on the etiopathogenesis and the progression of type 1 and type 2 diabetes in children and adults.

Diabetes is a common chronic metabolic disease with complex causes and pathogenesis. As an immunomodulator, vitamin D has recently become a research hotspot in the occurrence and development of diabetes and its complications. Many studies have shown that vitamin D can reduce the occurrence of diabetes and delay the progression of diabetes complications, and vitamin D can reduce oxidative stress, inhibit iron apoptosis, promote Ca2+ influx, promote insulin secretion, and reduce insulin resistance. Therefore, the prevention and correction of vitamin D deficiency is very necessary for diabetic patients, but further research is needed to confirm what serum levels of vitamin D3 are maintained in the body. This article provides a brief review of the relationship between vitamin D and diabetes, including its acute and chronic complications.

Calcifediol in patients with hip fractures

Vitamin D deficiency has a high prevalence in the elderly population. This condition can cause sarcopenia and osteoporomalacia, which are associated with an increased risk of falls and fractures, especially of the proximal femur. These fractures have devastating consequences in terms of mortality, disability, and healthcare and social costs. Considering that 60% of hip fracture patients have hypovitaminosis D, and a serum 25(OH)D₃ increase of 10 ng/ml reduces the risk of hip fracture by 20%, correction of vitamin D status is clearly essential. Among the available preparations of vitamin D, calcifediol is preferred in cases with liver disease, malabsorption, obesity, and concomitant use of corticosteroids. Calcifediol administration corrects vitamin D deficiency and suppresses parathyroid hormone within 1 week, reaching the serum 25(OH)D₃ threshold of 30 ng/ml in 2 weeks. Correction of hypovitaminosis D with calcifediol also improves muscle strength and physical performance, reducing the risk of falls. Evidence about the role of calcifediol in the management of hip fracture patients is still scarce. Compared with placebo, administration of calcifediol in combination with strengthening exercise led to increased overall survival in patients with hip fracture. The efficacy of calcifediol in rapidly normalizing vitamin D status might be particularly useful in patients at imminent risk of fracture, such as those with hip fracture who need to receive immediate treatment with anti-osteoporotic drugs. KEY WORDS: Hip fractures, vitamin D deficiency, calcifediol, osteoporosis.

Total 25-Hydroxyvitamin D Is an Independent Marker of Left Ventricular Ejection Fraction in Heart Failure with Reduced and Mildly Reduced Ejection Fraction.

Vitamin D emerged as an important prognostic biomarker in heart failure (HF), with currently highly debated therapeutic implications. Several trials on vitamin D supplementation in HF showed improvements in left ventricular (LV) remodeling and function and health-related quality of life (HRQoL), which did not translate into mid- to long-term beneficial effects regarding physical performance and mortality. We addressed total 25-hydroxyvitamin D (25(OH)D), serum albumin, and uric acid (UA) levels, focusing mainly on vitamin D deficiency, as potential markers of LV systolic dysfunction in HF with reduced and mildly reduced ejection fraction (HFrEF, HFmrEF). Seventy patients with LVEF < 50% were comprehensively evaluated using ECG, echocardiography, lung ultrasound (LUS), blood sampling, and the six-minute walk test (6MWT). HRQoL was also assessed using the Minnesota Living with Heart Failure Questionnaire (MLHFQ). Statistically significant positive correlations were found between LVEF, 25(OH)D, serum UA, and albumin, respectively (p = 0.008, p = 0.009, and p = 0.001). Serum UA (7.4 ± 2.4 vs. 5.7 ± 2.1, p = 0.005), NT-proBNP levels (1090.4 (675.2-2664.9) vs. 759.0 (260.3-1474.8), p = 0.034), and MLHFQ scores (21.0 (14.0-47.0) vs. 14.5 (4.5-25.5), p = 0.012) were significantly higher, whereas 25(OH)D concentrations (17.6 (15.1-28.2) vs. 22.7 (19.5-33.8), p = 0.010) were lower in subjects with severely reduced LVEF. Also, 25(OH)D was independently associated with LVEF in univariate and multiple regression analysis, maintaining its significance even after adjusting for confounders such as age, NT-proBNP, the presence of chronic coronary syndrome, hypertension, and anemia. According to our current findings, 25(OH)D is closely associated with LVEF, further supporting the need to establish correct vitamin D supplementation schemes and dietary interventions in HF. The changes in LVEF, 25(OH)D, serum UA, and albumin levels in HFrEF and HFmrEF indicate a similar pathophysiological background.

Unlocking the mystery of the role of Vitamin D in iron deficiency anemia in antenatal women: a case control study in a tertiary care hospital in New Delhi

BackgroundVitamin D deficiency and anemia are clinical conditions that coexist during pregnancy. A high prevalence of Vitamin D deficiency ranging from 50 to 94% is seen throughout the country. The aim of the study was to discover the association between Vitamin D status and iron deficiency anemia during pregnancy. Improving the vitamin D status of pregnant women is crucial to prevent iron deficiency anemia and can improve maternal and fetal outcomes.MethodsA case–control study including 94 primigravida women of age within the age group 18 to 30 years, divided into two groups: a Case Group of 48 patients with already diagnosed iron deficiency anemia (mild to moderate) and a Control Group of 46 antenatal women with normal hemoglobin levels. Data on sociodemographic, clinical characteristics, and the levels of 25(OH) Vitamin D was estimated in both the groups. The association of 25(OH)D levels and anemia was then determined using suitable statistical analysis.ResultsAmong pregnant women affected with anemia, 75% of women had serum Vitamin D concentrations < 20 ng/ml compared to 52.2% of women in the controls. Maternal serum vitamin D level was significantly lower in pregnant women affected with anemia (19.61 ± 13.12) as compared to control (29.43 ± 24.05); (p = 0.024). A positive correlation was found between hemoglobin and vitamin D levels in pregnant women (Pearson’s r = 0.200, p = 0.05).ConclusionsThese findings provide evidence suggesting that Vitamin D deficiency or insufficiency during pregnancy may be a risk factor for anemia and correction of Vitamin D levels can improve hemoglobin levels. Educational efforts should be made to include safe vitamin D intake in antenatal care.

Comparison of the level of vitamin D in preterm infected and uninfected infants

Introduction. Despite the substantial progress in intensive cares, sepsis is still an important cause of neonatal mortality. Given the role of vitamin D in infection control, this study was conducted to compare vitamin D level in infected and uninfected preterm infants. Materials and methods. This cross-sectional study was carried out on 87 preterm infants (45 infected infants and 42 uninfected infants) hospitalized in Mashhad Ghaem Hospital, Iran, during 20152017. The subjects were selected by using convenience sampling. The infected infants (n = 45) included babies with clinical and laboratory findings compatible with infection and/or positive blood or cerebrospinal fluid cultures. The serum levels vitamin D were measured in all infants. A researcher-made questionnaire containing demographic, clinical and laboratory features of infants was used. In addition, independent t-test and chi-square test were applied. SPSS was used to perform the statistical data analysis. Results. 83% of infants had vitamin D deficiency 34.5%, 26.4%, and 21.8% of whom exhibited severe (less than 10 ng/ml), moderate (10.120 ng/ml), mild deficiency (20.130 ng/ml), respectively. The mean vitamin D level of infants was 23.319.40 ng/ml in the control group and 11.028.64 ng/ml in the case group (p = 0.000). In the case group, the mean vitamin D was 8.145.53 ng/ml in early sepsis and 12.629.75 ng/ml in late-onset sepsis (p = 0.121). 95% of infected infants and 71% of uninfected infants had vitamin D less than 30 ng/ml (p = 0.003). Conclusion. Vitamin D deficiency is very common in preterm infants. Serum vitamin D levels in infants with sepsis were lower than those in uninfected infants. Therefore, the correction of vitamin D deficiency may contribute to better control of neonatal infection.

SAT168 Cholecalciferol - Cause Of Hypoglycemia In Patients With Insulin Dependent Diabetes Mellitus

Abstract Disclosure: S. Kalinchenko: None. L. Vorslov: None. T. Sviderskaya: None. S. Timofeeva: None. O. Samburskaya: None. Hypoglycemia is a dangerous complication in patients with diabetes mellitus receiving insulin drugs. We found a previously undescribed cause of hypoglycemia caused by prescription of cholecalciferol. Materials and Methods. Five patients (ages 6, 14, 28, 37, and 45 years) with medically subcompensated insulin-dependent diabetes mellitus (HbA1c &amp;gt; 7%) with vitamin D deficiency (25(OH)D &amp;lt; 30 ng/mL) were under observation. To compensate for vitamin D deficiency, cholecalciferol preparations were prescribed in individually selected doses (2,000 to 20,000 IU), considering age and weight. Findings. As a result of using cholecalciferol (without changing diet and physical activity level) all patients had episodes of hypoglycemia at different terms of treatment - from one to two weeks (younger patients 6 and 14 years old) to 6-8 months (patients of older age groups 28, 37 and 45), which were recorded by the continuous glucose monitoring system FreeStyle Libre: glucose level less than 3.0 mmol/L was accompanied by associated symptoms (tremor, tachycardia, cold clammy sweats, and intense hunger), which necessitated a reduction in the dose of insulin drugs. Interpretation. Vitamin D deficiency is a pandemic of modern society. Overweight, obesity, arterial hypertension, metabolic syndrome, and diabetes mellitus are the clinical manifestations of vitamin D deficiency. Vitamin D regulates the expression of over 5,000 genes, and compensating for its deficiency not only increases the number of insulin receptors, but also increases their sensitivity, leveling out insulin resistance and preventing its development. On achieving an adequate vitamin D level (25(OH)D not less than 65 ng/ml and parathormone levels closer to the lower limit of normal ranges of 16-25 ng/ml) against the background of reduced or completely discontinued insulin drugs, glycated hemoglobin in the blood was determined after three months and its values were within the reference values in all five patients (HbA1c not more than 5.6%). Conclusion. In patients with diabetes receiving insulin therapy, correction of vitamin D deficiency should be accompanied by daily glucose monitoring and under strict medical supervision, with dose adjustment of insulin drugs to prevent the development of hypoglycemia. Presentation: Saturday, June 17, 2023

The relationship between cardiovascular pathology and impaired glucose metabolism with vitamin D deficiency (literature review and own data)

Background. Vitamin D plays a significant role in many processes in the human body, which diversifies the symptoms of its insufficiency, so it is not always possible to diagnose its deficiency in a timely manner. At the same time, according to a number of clinical studies, an inverse relationship has been proven between a reduced level of vitamin D and mortality from all causes and cardiovascular diseases, the course of diabetes mellitus (DM), hypertension, chronic kidney disease, atherosclerosis, coronary heart disease; and the mechanisms of the influence of vitamin D deficiency on various metabolic processes have been revealed. The development and progression of cardiovascular diseases and vascular complications of DM are currently the main causes of disability and mortality of patients. All this substantiates the need to control and monitor the vitamin D supply in patients with this comorbid pathology. Aim of the study is to investigate the presence and severity of vitamin D deficiency in patients with type 2 DM and the presence of concomitant cardiac pathology. Materials and methods. Main group included 31 patients (17 men and 14 women aged 51.51 ± 1.73 years, with duration of DM of 8.59 ± 1.70 years) who were treated in the endocrinology clinic from October 2022 to May 2023. The comparison group consisted of 27 patients with type 2 DM who stayed in this clinic in 2020–2021. Serum level of 25-hydroxycholecalciferol (25(OH)D) was studied using the enzyme-linked immunosorbent assay. The level of vitamin D less than 20–30 ng/ml was considered as its insufficiency, and the level below 20 ng/ml as deficiency. Statistical processing was carried out using Microsoft Excel and Statistica 6.0. Results. In the main group, cardiac pathology manifested itself by the presence of hypertension detected in all patients (stage I — 6 cases; stage II — 21 and stage IІI — 4); coronary heart disease and cardiosclerosis — in 7 patients; heart failure of the first or second degree — in all individuals. All patients in the main group were vitamin D deficient or insufficient: 15 had a deficiency (12.96 ± 1.06 ng/ml), and 16 had an insufficiency (23.68 ± 0.72 ng/ml). In contrast to the comparison group, patients from the main group had a significantly lower average level of vitamin D (18.49 ± 1.16 ng/ml vs 28.98 ± 1.02 ng/ml, p &lt; 0.001). Taking into account a decrease in the level of vitamin D supply of patients, including those with comorbid pathology examined in 2022–2023, which is obviously associated with a long stay in shelters and a stressful situation caused by the state of war, and its impact on the course of cardiovascular diseases and diabetes, it is necessary to pay more attention to the detection and timely appropriate correction of vitamin D deficiency. Conclusions. In patients with type 2 diabetes and comorbid cardiovascular pathology, there is a decrease in the level of vitamin D supply. During the war in Ukraine, there is a probable deepening of vitamin D deficiency. The negative impact of vitamin D deficiency on the course of diabetes and cardiovascular pathology justifies the need to monitor vitamin D supply in such patients.

Supplements and Their Role in Reducing Chronic Kidney Disease Progression

Conservative treatment of chronic kidney disease, apart from simply treating symptoms and associated complications, consists in slowing chronic kidney disease progression, in order to improve patient and family quality of life, to postpone the need for renal replacement therapy and to reduce the treatment costs. Slowing chronic kidney disease progression involves therapeutic strategies, aiming to avoid/treat malnutrition and inflammation, correct anemia, treat mineral bone disorders of CKD and correct vitamin, mineral and microelement’s deficit. This review aims to shed light to the rationale behind these strategies through evidence from clinical studies and the recent guideline recommendations for use of ketoanalogues, essential aminoacids, calcium, Vit D3, iron, Vit B12, folates and unsaturated fatty acid supplements.

Vitamin D status, vitamin D receptor gene polymorphism, and haplotype in patients with cutaneous leishmaniasis: Correlation with susceptibility and parasite load index.

CL endemicity was reported worldwide including in Saudi Arabia, imposing a major challenge on the health authorities. Vitamin D and its receptor (VDR) are key modulators of the immune response where the VDR is expressed. A remarkable lack of data exists in humans about the contribution of vitamin D and polymorphisms of the VDR gene in protozoan infections, especially cutaneous leishmaniasis (CL). This is the first work conducted to assess the relationship between vitamin D status, polymorphisms of the VDR gene (BsmI, ApaI, TaqI, and FokI), and VDR haplotype with parasite tissue load and susceptibility to CL. Fifty-two patients with confirmed CL (21 patients receiving vitamin D medication and 31 patients not receiving it) and 46 control subjects participated in this cross-sectional investigation. VDR genotyping was determined by restriction fragment length polymorphism analysis. Serum levels of 25-OH vitamin D were assessed using the ELISA method in all participants. The skin biopsy quantified the parasite load based on the Ridley parasitic index. The mean serum level of 25-OH vitamin D in CL patients who were not receiving vitamin D therapy was significantly lower compared to CL patients on vitamin D therapy and controls (p <0.001 for both) and CL patients with no history of vitamin D therapy had a significantly higher frequency of vitamin D deficiency compared to CL patients on vitamin D therapy and controls (p < 0.05). Compared to CL patients with no history of vitamin D therapy, CL patients receiving vitamin D therapy had a significantly lower mean size of the lesion and RPI (p = 0.02, .03 respectively). The frequency of genotype "aa" and its "a" allele in ApaI SNP of VDR was significantly lower in CL patients compared to controls (p = 0.006 and 0.03 respectively). However, patients with CL had a considerably greater frequency of the "A" allele than the controls (p = 0.03), suggesting its role in CL susceptibility. There was no statistically significant difference between the two groups in the genotype and allele frequency distributions of BsmI, TaqI, and FokI (p > 0.05). When compared to controls, CL cases had a considerably greater frequency of the "B-A-T-F" haplotype (p = 0.04), and a significantly lower frequency of the "B-a-T-F" haplotype (p = 0.01) suggesting that these haplotypes may have the potential susceptibility or protection against CL respectively. The "Aa" genotype in ApaI SNP of VDR had considerably lower levels of vitamin D with higher parasite load compared to the "AA" and: aa" genotypes (p = 0.02,0.02 respectively). A significant negative correlation was found between the parasite load and 25-OH vitamin D levels (r2 = -0.53, p< 0.001). According to these findings, vitamin D levels and "ApaI" VDR gene polymorphisms could affect the parasite load and susceptibility to infection, whereas BsmI, FokI, and TaqI polymorphisms did not. Correction of vitamin D levels may aid in CL management.

Physiological Basis for Using Vitamin D to Improve Health.

Vitamin D is essential for life-its sufficiency improves metabolism, hormonal release, immune functions, and maintaining health. Vitamin D deficiency increases the vulnerability and severity of type 2 diabetes, metabolic syndrome, cancer, obesity, and infections. The active enzyme that generates vitamin D [calcitriol: 1,25(OH)2D], CYP27B1 (1α-hydoxylase), and its receptors (VDRs) are distributed ubiquitously in cells. Once calcitriol binds with VDRs, the complexes are translocated to the nucleus and interact with responsive elements, up- or down-regulating the expression of over 1200 genes and modulating metabolic and physiological functions. Administration of vitamin D3 or correct metabolites at proper doses and frequency for longer periods would achieve the intended benefits. While various tissues have different thresholds for 25(OH)D concentrations, levels above 50 ng/mL are necessary to mitigate conditions such as infections/sepsis, cancer, and reduce premature deaths. Cholecalciferol (D3) (not its metabolites) should be used to correct vitamin D deficiency and raise serum 25(OH)D to the target concentration. In contrast, calcifediol [25(OH)D] raises serum 25(OH)D concentrations rapidly and is the agent of choice in emergencies such as infections, for those who are in ICUs, and for insufficient hepatic 25-hydroxylase (CYP2R1) activity. In contrast, calcitriol is necessary to maintain serum-ionized calcium concentration in persons with advanced renal failure and hypoparathyroidism. Calcitriol is, however, ineffective in most other conditions, including infections, and as vitamin D replacement therapy. Considering the high costs and higher incidence of adverse effects due to narrow therapeutic margins (ED50), 1α-vitamin D analogs, such as 1α-(OH)D and 1,25(OH)2D, should not be used for other conditions. Calcifediol analogs cost 20 times more than D3-thus, they are not indicated as a routine vitamin D supplement for hypovitaminosis D, osteoporosis, or renal failure. Healthcare workers should resist accepting inappropriate promotions, such as calcifediol for chronic renal failure and calcitriol for osteoporosis or infections-there is no physiological rationale for doing so. Maintaining the population's vitamin D sufficiency (above 40 ng/mL) with vitamin D3 supplements and/or daily sun exposure is the most cost-effective way to reduce chronic diseases and sepsis, overcome viral epidemics and pandemics, and reduce healthcare costs. Furthermore, vitamin D sufficiency improves overall health (hence reducing absenteeism), reduces the severity of chronic diseases such as metabolic and cardiovascular diseases and cancer, decreases all-cause mortality, and minimizes infection-related complications such as sepsis and COVID-19-related hospitalizations and deaths. Properly using vitamin D is the most cost-effective way to reduce chronic illnesses and healthcare costs: thus, it should be a part of routine clinical care.

Metabolic syndrome components and vitamin D availability relationship in late postmenopausal women

BACKGROUND: The global prevalence of vitamin D deficiency is currently a real threat due to association with major chronic non-communicable diseases. Abdominal obesity, hypertension, dyslipidemia, and hyperglycemia contribute significantly to cardiometabolic risk in late postmenopausal women.AIM: to assess the frequency of deficiency and insufficiency of 25(OH)D in late postmenopausal residents of Yekaterinburg; to establish associations of 25(OH)D serum concentration with components of metabolic syndrome and severity of menopausal symptoms.MATERIALS AND METHODS: During the period from October 2018 to March 2020 145 independently living late postmenopausal residents of Yekaterinburg were enrolled in a cross-sectional study. The following scope of data regarding each of the subjects was collected: complaints and anamnesis, anthropometry, diagnosis of metabolic syndrome, arterial hypertension and diabetes mellitus, assessment of 25 (OH)D level by the ECLIA method, LDL-C, HDL-C levels, serum TG by the enzymatic colorimetric method, as well as the evaluation of the modified menopausal index.RESULTS: Adequate serum level of 25(OH)D was detected in 20.6% patients, insufficiency and deficiency were found in 33.1 and 46.2% cases, respectively. In patients with vitamin D deficiency and insufficiency, the most frequent metabolic syndrome components were arterial hypertension (p=0.02; OR 3.5; CI 1.2–10.6) and abdominal obesity (p=0.03; OR 2.8; CI 1.1–7.2). Vitamin D deficient subjects had significantly lower serum HDL and increased TG levels (p=0.04), compared to the adequately provided 25(OH)D patients. Vitamin D levels were not associated with the severity of menopausal symptoms in late postmenopausal women. Regular daily intake of 400–2000 IU of colecalciferol contributed to higher serum 25(OH)D level.CONCLUSION: a high prevalence of vitamin D deficiency among postmenopausal women of Yekaterinburg was detected. Diagnosis and correction of vitamin D levels are necessary for timely reduction of cardiometabolic risk, primarily due to the potential pleiotropic effects of D-hormone on the renin-angiotensin-aldosterone system, carbohydrate and lipid metabolism.

Untargeted metabolomics reveals the preventive effect of quercetin on nephrotoxicity induced by four organophosphorus pesticide mixtures.

This research aimed to explore the protective effect of quercetin against nephrotoxicity induced by four organophosphate pesticide mixtures (PM) using untargeted metabolomics technology in rat kidneys. Sixty male Wistar rats were randomly divided into six groups: control, low-dose quercetin treated (10mg/kg bw), high-dose quercetin treated (50mg/kg bw), PM-treated, and two dosages of quercetin+PM-treated. Metabolomics results showed that 17 differential metabolites were identified in the PM-treated group, and pathway analysis revealed that renal metabolic disorders include purine metabolism, glycerophospholipid metabolism, and vitamin B6 metabolism. When high-dose quercetin and PM-treated were administered to rats concurrently, the intensities of differential metabolites were substantially restored (p<0.01), suggesting that quercetin can improve renal metabolic disorders caused by organophosphate pesticides (OPs). Mechanistically, quercetin could regulate the purine metabolism disorder and endoplasmic reticulum stress (ERS)-mediated autophagy induced by OPs by inhibiting XOD activity. Moreover, quercetin inhibits PLA2 activity to regulate glycerophospholipid metabolism and it could also exert antioxidant and anti-inflammatory effects to correct vitamin B6 metabolism in rat kidneys. Taken together, the high dose of quercetin (50mg/kg. bw) has a certain protective effect on OPs-induced nephrotoxicity in rats, which provides a theoretical basis for quercetin against nephrotoxicity caused by OPs.

Greater Gestational Vitamin D Status is Associated with Reduced Childhood Behavioral Problems in the Environmental Influences on Child Health Outcomes Program

BackgroundVitamin D deficiency is common in pregnancy. Vitamin D plays an important role in the developing brain, and deficiency may impair childhood behavioral development. ObjectivesThis study examined the relationship between gestational 25(OH)D concentrations and childhood behavior in the Environmental influences on Child Health Outcomes (ECHO) Program. MethodsMother-child dyads from ECHO cohorts with data available on prenatal (first trimester through delivery) or cord blood 25(OH)D and childhood behavioral outcomes were included. Behavior was assessed using the Strengths and Difficulties Questionnaire or the Child Behavior Checklist, and data were harmonized using a crosswalk conversion. Linear mixed-effects models examined associations of 25(OH)D with total, internalizing, and externalizing problem scores while adjusting for important confounders, including age, sex, and socioeconomic and lifestyle factors. The effect modification by maternal race was also assessed. ResultsEarly (1.5–5 y) and middle childhood (6–13 y) outcomes were examined in 1688 and 1480 dyads, respectively. Approximately 45% were vitamin D deficient [25(OH)D < 20 ng/mL], with Black women overrepresented in this group. In fully adjusted models, 25(OH)D concentrations in prenatal or cord blood were negatively associated with externalizing behavior T-scores in middle childhood [−0.73 (95% CI: −1.36, −0.10) per 10 ng/mL increase in gestational 25(OH)D]. We found no evidence of effect modification by race. In a sensitivity analysis restricted to those with 25(OH)D assessed in prenatal maternal samples, 25(OH)D was negatively associated with externalizing and total behavioral problems in early childhood. ConclusionsThis study confirmed a high prevalence of vitamin D deficiency in pregnancy, particularly among Black women, and revealed evidence of an association between lower gestational 25(OH)D and childhood behavioral problems. Associations were more apparent in analyses restricted to prenatal rather than cord blood samples. Interventions to correct vitamin D deficiency during pregnancy should be explored as a strategy to improve childhood behavioral outcomes.

Examination of correlations between vitamin D and melatonin levels with sleep among women aged 18-49 years.

Although clinical research is still going on to determine any relationship between vitamin D and sleep regulation, only few studies have identified the role of vitamin D metabolism in sleep disorders. The current study aims to examine the incidence of vitamin D deficiency/insufficiency in the sample group and its effects on sleep quality and melatonin level. A cross-sectional study was designed. A total of 79 women aged 18-49 years who applied to the research and training hospital between 1 October and 30 November 2021 participated in the study. Data were collected using a socio-demographic questionnaire prepared by the authors and the Pittsburgh Sleep Quality Index (PSQI). Blood samples were taken from the participants, also, 25-OH-vitamin D3 and melatonin levels in serum samples were measured by ELISA. The participants (n = 79) were aged 29.61 ± 11.14 years. The mean total PSQI scores of the participants were calculated as 5.77 ± 2.70. We determined that 64.6% of the participants had vitamin D deficiency, 21.5% had vitamin D insufficiency, and 13.9% of the participants were vitamin D sufficient. The mean melatonin level was found to be 24.77 ± 27.77 ng/L. We determined that an increase in the melatonin levels decreases the risk of vitamin D deficiency. Besides, our findings showed a good positive correlation between serum melatonin and 25 OH vitamin D3 levels (r = 0.544, p < 0.001). Our results indicate that the correction of vitamin D insufficiency can positively affect melatonin levels, therefore, it may positively contribute to the treatment of sleep disorders related to melatonin deficiency.