D3 Levels In Patients Research Articles

003 Is Vitamin D3 an Independent Marker of Endothelial Dysfunction?

Vitamin D deficiency has emerged as a risk factor in a range of condition, from diabetes to hypertension, and heart disease all of which are related to ED. Endothelial dysfunction has been demonstrated to play an important role in pathogenesis of erectile dysfunction (ED) and vitamin D deficiency is deemed to promote endothelial dysfunctions. Low levels of vitamin D are significantly and independently associated with low levels of testosterone in otherwise healthy middle-aged men which can also be a reason for ED. To assess serum vitamin D3 levels in patients with erectile dysfunction and also to correlate vitamin D3 levels with severity of endothelial dysfunction. 90 Patients presenting to OPD with complaints of erectile dysfunction were assessed based on history and clinical examination. Once the diagnosis was confirmed, IIEF- 5 was administered by the doctor himself based on which the severity of ED was graded. The degree of endothelial dysfunction in these patients was measured by using VENDYS (endothelial function test) and the vascular reactivity index was noted. Serum Vitamin D3 levels were assessed in all of these patients following which the values were statistically analyzed with vascular reactivity index and then correlated.

Assessment of Serum Vitamin D3 Level in Patients with Type 2 Diabetes Mellitus

Background: The aim of this article is to determine the association between serum vitamin D level and newly diagnosed type 2 diabetes mellitus in Erbil city. Methods: This is a case-controle study involving 100 subjects which included 2 groups, 50 type 2 diabetic patients diagnosed recently, 50 healthy individuals as control group. The study is conducted from Aprilto December -2015 in Layla Qasim diabetic center. The data collected from all cases including history and examination all recorded on specially designed questionnaire. From all cases blood sample sent for serum vitamin D3 level. Results: From the total of 100 subjects, the mean age ofcases was48.8 years and of controls 48.1 The male: female ratio was 1:1 in both cases and controls. The mean serum vitamin D3 level of cases was (9.88 ±6.12) ng/ml and it was significantly lower than the control (14.34±6.4)ng/ml, (p-value=0.001) although both groups lied within the deficient range. Within the cases the vitamin D3 were deficient in 47(94%) of cases in compared to 44(88%) of control group , The serum vitamin D3 level was insufficient in 2(4%) cases in comparing to 4(8%) of control and sufficient in 1(2%) case in comparing to 2(4%) of control. Conclusion: The mean serum level of vitamin D3 in newly diagnosed type 2 diabetic patients was significantly lower than that of control group, vitamin D deficiency could contribute to etiology of type 2 diabetes mellitus.

Association of Plasma Levels of Vitamin D With Chronic Hepatitis B Infection.

Dear Editor, Vitamin D has been identified as an immune-modulator due to its immunomodulatory effects on cells of the immune system during the last decade. Research on vitamin D level in patients with HBV is a relatively new subject, which has been investigated in many studies. As the first step, the beneficial role of vitamin D in patients with HBV was suggested by Luong and Nguyen in 2012 (1). In the following year, Mahamid et al. (2) concluded that normal serum vitamin D levels are associated with spontaneous clearance of HBsAg in chronic inactive HBV patients. In the same year, the levels of vitamin D in chronic hepatitis B (CHB) patients compared with naturally immunized individuals and control individuals, which resulted in lower vitamin D levels in CHB patients (3). In another attempt, association of vitamin D level with HBV replication was analyzed in CHB patients and only 19% of CHB patients had adequate vitamin D serum levels. However, 81% of them had severe vitamin D deficiency or vitamin D insufficiency. Lower serum 25-OH vitamin D3 levels in patients with hepatitis B and C were shown to influence mortality risk in hepatitis virus (4). This deficiency of vitamin D was confirmed among patients with CHB in another study (5). Recently, the levels of vitamin D amongst 128 naive CHB patients, including those with positive and negative hepatitis B virus e antigen (HBeAg) were analyzed (6). In general, 25-OH vitamin D3 in CHB patients was significantly lower than control group. This deficiency was more intensive in patients with positive HBeAg than negative HBeAg. Lower levels of vitamin have been reported in patients with HBeAg in many investigations (7). Additionally, younger aged and normal alanine transaminase (ALT) were associated with relatively low and relatively high levels of vitamin D, respectively. Almost all studies reported low levels of vitamin D amongst chronically infected patients. Additionally, lower vitamin D levels in negative HBeAg compared with positive HBeAg patients was reported in two studies. Although, these studies are limited, it can be found that patients with CHB may have decreased levels of vitamin D. In all reviewed studies, vitamin D levels were measured in chronically infected patients. However, for identification of vitamin D deficiency or insufficiency, as the biomarker of CHB or other outcomes of HBV infection, new designed studies may be required. Considering all these evidences, further studies are needed to understand the real association of vitamin D levels and HBV associated factors.

Patients with type 2 diabetes have reduced levels of plasma vitamin D3 and are well correlated with the oxidative stress parameters

Background: Diabetes has emerged as an epidemic in this country as well as worldwide. Increased oxidative stress and decreased antioxidant defense are established etiological factors of this multifactorial disease. Some of the recent studies reported deficiency of vitamin-D3 in type-2 diabetic patients. Aims and Objectives: This study was aimed to estimate the total oxidative stress (TOS), the total antioxidant defense (TAD) and the plasma 25-hydroxy vitamin D3 levels in patients of type-2 diabetes patients with an objective to elucidate if there is any significant correlation between the TOS, TAD and vitamin D3 levels.Materials and Methods: The study was conducted in forty patients recently diagnosed type-2 diabetic and the findings were compared with age/sex matched healthy controls. Total oxidative stress and TAD values was estimated by two simple colorimetric tests developed and standardized in our laboratory, plasma 25-hydroxy vitamin D3 by standardized ELISA method.Results and Discussion: The levels of vitamin D3 in patients was found to be 50.17 ± 15.85ng/ml which was significantly decreased (P<0.001) when compared to healthy control group (75.42 ± 9.59 ng/ml). The plasma vitamin D3 levels show a significant positive correlation (r=0.564, P<0.001) with the TAD values and a significant negative correlation (r=-0.561, P<0.001) with the TOS values in the study subjects. There is significant positive correlation of 25-OH vitamin-D3 with antioxidant defense and significant negative correlation with oxidative stress observed in the current study, and the levels of vitamin D3 were significantly decreased in type-2 diabetes when compared to the healthy controls.Conclusion: The type-2 diabetes patients are usually associated with vitamin D3 deficiency which is significantly correlated with the oxidative stress conditions in this group of patients.Asian Journal of Medical Sciences Vol. 7(3) 2016 35-40

Serum Vitamin D3 Level in Patients with Female Pattern Hair Loss.

Background:Female pattern hair loss (FPHL) is the most common cause of alopecia in women, characterized by diffuse nonscarring hair loss in frontal, central, and parietal areas of the scalp. Pathophysiology of FPHL is still not well known, and it is probably a multifactorial genetic trait. FPHL is also observed in women without increased androgen levels, which raises the likelihood of androgen-independent mechanisms and explains the lack of response to antiandrogen treatments in some patients. Vitamin D is a factor that has recently been considered in dealing with these patients. The purpose of this study was to evaluate the serum levels of Vitamin D in patients with FPHL and compare it with healthy controls.Methods:In this case-control study, 45 women with FPHL were evaluated as well as the same number of healthy women matched for age, hours spent under sunlight per day, and body mass index. Serum 25(OH) D3 level was measured using ELISA.Results:60% of FPHL patients were in 15–30 years old age group with the mean standard deviation (SD) age of 29.11 (7.30) years. In the majority of patients (66.7%), severity of hair loss was Ludwig I. Mean (SD) serum Vitamin D3 level in patient and control group was 13.45 (8.40) and 17.16 (8.96), respectively. T-test showed a significant difference between the two groups in terms of Vitamin D3 serum levels (P = 0.04).Conclusions:This study indicated the correlation between the incidence of FPHL and decreased serum levels of Vitamin D3. It is recommended to evaluate serum Vitamin D3 levels as well as other hormone assays in these patients.

Evaluation of 25 hydroxy vitamin D3 levels in patients with alopecia areata

Evaluation of 25 hydroxy vitamin D3 levels in patients with alopecia areata

Serum vitamin D levels are inversely related with non-alcoholic fatty liver disease independent of visceral obesity in Chinese postmenopausal women.

The aim of the present study was to investigate the association between serum vitamin D levels and both visceral adipose and with non-alcoholic fatty liver disease (NAFLD) in Chinese postmenopausal women. Four hundred and fifty-one postmenopausal women between 45 and 74 years of age (mean (± SD) age 57.3 ± 4.6 years) were enrolled in the study. All subjects participated in the Shanghai Obesity Study between June and August 2011 and underwent abdominal magnetic resonance imaging and an abdominal ultrasonography. Patients with a visceral fat area (VFA) ≥ 80 cm(2) were classified as abdominally obese. Serum 25-hydroxyvitamin D3 (25(OH)D3 ) levels were measured with an electrochemiluminescence immunoassay. The prevalence of NAFLD in the study population was 34.8% (n = 157). Women with abdominal obesity had significantly lower serum 25(OH)D3 levels than those without abdominal obesity (median (interquartile range) 11.23 (8.64-14.12) vs 12.56 (9.41-15.98) ng/mL, respectively; P < 0.01). Regardless of abdominal obesity status, serum 25(OH)D3 levels in patients with NAFLD were lower than those without non-NAFLD (11.14 (8.63-13.81) vs 12.92 (9.48-16.37) ng/mL (P < 0.05) for those without abdominal obesity; 10.86 (8.61-13.56) vs 11.55 (8.82-16.38) ng/mL (P < 0.05) for those with abdominal obesity). Partial correlation analyses demonstrated a negative correlation between serum 25(OH)D3 levels and VFA (P < 0.05). Logistic regression analysis revealed that high serum 25(OH)D3 levels were a protective factor against NAFLD after adjusting for risk factors such as VFA. In conclusion, independent of visceral obesity, vitamin D is inversely correlated with NAFLD in Chinese postmenopausal women.

Serum 25(OH)D3 levels affect treatment outcomes for telaprevir/peg-interferon/ribavirin combination therapy in genotype 1b chronic hepatitis C.

Close relationships between chronic hepatitis C and vitamin D levels have been reported. For genotype 1b infection, the current standard of care is pegylated interferon/ribavirin therapy combined with a protease inhibitor. The present study analyzed the relationship between outcomes of triple therapy and serum 25(OH)D3 levels. Factors contributing to sustained virological response were investigated in 177 patients with chronic hepatitis C who received telaprevir-based triple therapy in this prospective study. The sustained virological response rate was 86.9% in patients with 25(OH)D3 levels of >18 ng/ml; this was higher than the 66.7% in patients with 25(OH)D3 levels of ≤ 18 ng/ml (P=0.003). 25(OH)D3 levels and IL28B genotype were identified as significantly independent factors contributing to sustained virological response. The sustained virological response rate did not differ according to 25(OH)D3 levels in patients with the IL28B major genotype. The sustained virological response rate was 64.9% in patients with the IL28B minor genotype and 25(OH)D3 levels of >18 ng/ml, and was 38.5% in those with decreased 25(OH)D3 levels (P=0.045). In triple therapy, 25(OH)D3 levels were an independent factor contributing to sustained virological response. Of particular note, the sustained virological response rate was significantly lower in patients with the IL28B minor genotype.

Narrowband ultraviolet B irradiation increases the serum level of vitamin D3 in patients with neurofibromatosis 1

The serum vitamin D₃ levels in patients with neurofibromatosis 1 has been reported to be significantly lower than that in control subjects, and the level of vitamin D₃ reversely correlates with the severity of neurofibroma formation. We found that narrowband ultraviolet B (NB-UVB) irradiation increased the serum level of 1,25(OH)₂ vitamin D₃ in patients with neurofibromatosis 1. The difference in the 1,25(OH)₂ vitamin D₃ levels between patients who had received irradiation for more than 18 months and those who had no irradiation was highly significant. Time-course analyses of the serum vitamin D₃ levels in the patients who were enrolled after informed consent revealed that the levels became higher significantly after 6 months of irradiation. It is suggested that NB-UVB irradiation is effective for increasing the serum level of vitamin D₃ in patients with neurofibromatosis 1, which may be of benefit for skin symptoms such as pigmented macules or neurofibromas.

AB0475 Vitamin d status analysis in behçet syndrome patients. a case-control study

BackgroundVitamin D has newly well-proven immunomodulatory effects (1, 2). This vitamin inhibits TH1 proliferation and cytokine’s production and activates TH2 functions. It also regulates toll like receptors expression on blood...

Liver vitamin D receptor, CYP2R1, and CYP27A1 expression: relationship with liver histology and vitamin D3 levels in patients with nonalcoholic steatohepatitis or hepatitis C virus

Evidence suggests an association between low serum 25-hydroxy-vitamin D(3) [25(OH)D(3) ] levels and the presence and prognosis of liver disease. Vitamin D receptor (VDR) has been widely detected in the liver, but its expression in the course of liver disease has never been investigated. We evaluated the hepatic expression of VDR along with that of vitamin D 25-hydroxylases in patients with nonalcoholic steatohepatitis (NASH) or chronic hepatitis C (CHC) and its relationship with hepatic histological features and serum 25(OH)D(3) levels. We evaluated 61 patients (25 NASH and 36 CHC) who had undergone liver biopsy for clinical purposes and 20 subjects without liver disease. Serum 25(OH)D(3) was measured via colorimetric assay. Expression of VDR, CYP2R1, and CYP27A1 was evaluated via immunohistochemistry in hepatocytes, cholangiocytes, and liver inflammatory cells. Parenchymal and inflammatory cells from liver biopsies of patients with NASH and CHC expressed VDR, CYP2R1, and CYP27A1. In NASH patients, VDR expression on cholangiocytes was inversely correlated with steatosis severity (P < 0.02), lobular inflammation (P < 0.01), and nonalcoholic fatty liver disease score (P < 0.03). Moreover, expression of CYP2R1 in hepatocytes correlated strongly with VDR positivity on liver inflammatory cells. In CHC subjects, fibrosis stage was associated with low hepatic CYP27A1 expression, whereas portal inflammation was significantly higher in patients with VDR-negative inflammatory cells (P < 0.009) and low VDR expression in hepatocytes (P < 0.03). VDR is widely expressed in the liver and inflammatory cells of chronic liver disease patients and its expression is negatively associated with the severity of liver histology in both NASH and CHC patients. These data suggest that vitamin D/VDR system may play a role in the progression of metabolic and viral chronic liver damage. (HEPATOLOGY 2012;56:2180-2187).

Vitamin D may not be a good marker of disease activity in Korean patients with systemic lupus erythematosus

Vitamin D is a pleiotrophic hormone with immunoregulatory properties. Low levels of vitamin D have been discovered in various autoimmune diseases. Here, we investigated serum vitamin D levels in Koreans with systemic lupus erythematosus (SLE) and examined whether levels correlate with disease activity of SLE. Blood samples were prospectively collected from patients with SLE (n = 104) and normal controls (NC, n = 49) during the spring from March to May 2008. The level of serum 25-hydroxyvitamin D (25(OH)D3) was measured by radioimmunoassay. The serum 25(OH)D3 levels of patients with SLE (42.49 ± 15.08 ng/ml) were significantly lower than NC (52.72 ± 15.19 ng/ml, P < 0.001). Additionally, 17 patients with SLE (16.3%) had vitamin D insufficiency, while two NC had vitamin D insufficiency (4.1%). The risk of vitamin D insufficiency was 4.6-fold increased in SLE (P = 0.032). The serum 25(OH)D3 levels, adjusted with BMI, were positively correlated only with hemoglobin (β = 0.256, P = 0.018) and serum complement 3 (β = 0.365, P = 0.002). Serum vitamin D levels were lower, and vitamin D insufficiency was more common in Korean patients with SLE, however, our study demonstrated that vitamin D levels might not be a good marker of disease activity.

Loss via peritoneal fluid as a factor for low 25(OH)D3 level in peritoneal dialysis patients

In patients with end-stage renal disease (ESRD), the 25-hydroxyvitamin D3 (25(OH)D3) level is known to be lower compared to that of the normal population. In the present study, we evaluated the influences of dialysis methods on the serum 25(OH)D3 level in patients with ESRD who are treated with hemodialysis and peritoneal dialysis. Thirty-nine peritoneal dialysis (PD), 49 hemodialysis (HD) patients, and 33 healthy controls were included in the present study. The mean HD period was 30.38 +/- 21.81 months and the mean PD period was 26.35 +/- 24.04 months. Serum samples from the HD and PD patients and healthy controls were examined in terms of 25(OH)D3, intact parathyroid hormone (iPTH), and other biochemical laboratory tests. Additionally, the 25(OH)D3 level in the peritoneal fluid was analyzed in the PD group. The mean 25(OH)D3 levels in the control, HD, and PD groups were 26.63 +/- 10.89, 21.65 +/- 12.38, and 13.46 +/- 9.41 nmol/l, respectively (P < 0.001). The mean peritoneal fluid 25(OH)D3 level was 28.53 +/- 7.66 nmol/l. Moreover, blood and PD fluid 25(OH)D3 levels were 34 compared in the PD group. The 25(OH)D3 level in dialysate was higher than that of serum in PD patients (P < 0.001). The significantly lower blood levels of 25(OH)D3 in PD patients compared to those of HD patients were thought to be due to 25(OH)D3 loss via peritoneal fluid.

The association between ketoacidosis and 25(OH)-vitamin D3levels at presentation in children with type 1 diabetes mellitus

There is considerable evidence supporting the role of vitamin D deficiency in the pathogenesis of type 1 diabetes mellitus (T1DM). Vitamin D deficiency is also associated with impairment of insulin synthesis and secretion. There have been no formal studies looking at the relationship between 25(OH)-vitamin D(3) and the severity of diabetic ketoacidosis (DKA) in children at presentation with T1DM. To determine the relationship between measured 25(OH)-vitamin D(3) levels and the degree of acidosis in children at diagnosis with T1DM. Children presenting with new-onset T1DM at a tertiary children's hospital. 25(OH)-vitamin D(3) and bicarbonate levels were measured in children at presentation with newly diagnosed T1DM. Those with suboptimal 25(OH)-vitamin D(3) levels (<50 nmol/L) had repeat measurements performed without interim vitamin D supplementation. Fourteen of the 64 children had low 25(OH)-vitamin D(3) levels at presentation, and 12 of these had low bicarbonate levels (<18 mmol/L) (p = 0.001). Bicarbonate explained 20% of the variation in vitamin D level at presentation (partial r(2) = 0.20, p < 0.001) and ethnic background a further 10% (partial r(2) = 0.10, p = 0.002). The levels of 25(OH)-vitamin D(3) increased in 10 of the 11 children with resolution of the acidosis. Acid-base status should be considered when interpreting 25(OH)-vitamin D(3) levels in patients with recently diagnosed T1DM. Acidosis may alter vitamin D metabolism, or alternatively, low vitamin D may contribute to a child's risk of presenting with DKA.

Detection of medulloblastoma and astrocytoma-associated ganglioside G D3 in cerebrospinal fluid

Shedding of gangliosides by tumor cells may enhance tumor development. We recently showed that cells of the human brain tumor, medulloblastoma, shed gangliosides in vitro and have therefore examined ganglioside shedding by pediatric brain tumors into the cerebrospinal fluid (CSF). G D3, a major ganglioside in medulloblastoma and astrocytoma, was the target for detection in the CSF by immunostaining using the monoclonal antibody R24 and enhanced chemiluminescence detection. Mean CSF G D3 levels in patients with medulloblastomas ( n=9) and astrocytomas ( n=10) were significantly higher than those of controls (mean±SD 44.7±8.4 versus 18.2±1.9 pmol/ml, n=20, P<0.0002). Mass spectrometric analysis showed that tumor-derived ganglioside G D3 contained heterogeneous ceramide structures and, interestingly, the ceramide subspecies with shorter fatty acyl chains were selectively shed. The elevated CSF G D3 concentrations in patients with medulloblastoma and astrocytoma support the concept that ganglioside shedding, which may have significant biological consequences, is characteristic of human brain tumors.