Deficiency Of 25-hydroxyvitamin Research Articles

Correlation of Maternal Vitamin D Status in Early Pregnancy and Vitamin D Supplementation during Pregnancy with Atopic Dermatitis in Infants: A Prospective Birth Cohort Study.

This study aimed to investigate the association of maternal first-trimester vitamin D levels and vitamin D supplementation during pregnancy with infant atopic dermatitis (AD) and to determine the effect of variables such as mode of conception on the association. This study was based on the Shanghai sub-cohort of the International Birth Cohort of China. A total of 4051 woman-infant pairs with singleton pregnancies were recruited. Vitamin D deficiency and insufficiency were defined as serum 25-hydroxyvitamin D concentrations of 25 and 50 nmol/L, respectively. AD in infants was assessed during the first six months using a standardized questionnaire based on the British Working Party criteria. Modified Poisson regression estimated the association between maternal vitamin D status and infant AD. The risk of AD in infants was higher in women with deficient 25-hydroxyvitamin D levels in the first trimester (RR: 1.77, 95% CI: 1.41-2.23). This increased risk was seen in naturally conceived pregnancies, but not in those conceived using assisted reproductive technology (ART). The incidence of AD decreased in infants of mothers who took multi-vitamin (RR: 0.79, 95% CI: 0.67-1.98) and vitamin D supplements (RR: 0.51, 95% CI: 0.37-0.71) compared to those whose mothers did not take any supplements. Maternal vitamin D deficiency had varying effects on AD risk based on passive smoking exposure and breastfeeding patterns. Our findings highlight the importance of monitoring and supplementing vitamin D during pregnancy, especially in specific maternal populations, to reduce the risk of AD in offspring.

Predictors of Gastrointestinal Involvement in Children with IgA Vasculitis: Results from a Single-Center Cohort Observational Study.

Background and objective: IgA vasculitis (IgAV), a predominantly pediatric leukocytoclastic disease, has an unpredictable, though largely benign, evolution. The aim of this study was to retrospectively investigate any potential clinical or laboratory predictors of gastrointestinal involvement in a single-center cohort of children with IgAV. Patients and methods: A total of 195 children with a history of IgAV, regularly followed-up for an average period of 1 ± 2.6 years via outpatients clinics of the pediatric rheumatology unit in our University, were assessed, analyzing their clinical and laboratory variables in relationship with their disease evolution and outcome. Results: Univariate analysis showed that a higher neutrophil granulocyte count and lower lymphocyte count (expressed as a percentage of the total white blood cells) were significantly associated with the presence of gastrointestinal involvement at the first examination (65.2 ± 13% versus 58.8 ± 12%, p = 0.02, and 26.4 ± 11% versus 32.1 ± 11%, p = 0.02, respectively). A positive pharyngeal swab for Streptococcus pyogenes, a deficiency of 25-hydroxyvitamin D, a persistence of purpuric rash for more than 1 month, and purpuric lesions in the genital area were also associated with gastrointestinal involvement (p = 0.0001, p = 0.0001, p = 0.007 and p = 0.001, respectively). However, multiple logistic regressions with correction for the patients' sex and age showed that lower 25-hydroxyvitamin D levels, persistent rash, and genital lesions were independently and significantly associated with signs of gastrointestinal involvement. We then performed a secondary analysis (both univariate and multivariate) to investigate whether vitamin D deficiency was associated with other IgAV manifestations: we found that only 25-hydroxyvitamin D deficiency remained significantly associated with gastrointestinal involvement in IgAV. Conclusions: Patients with IgAV and vitamin D deficiency might be more prone to developing gastrointestinal manifestations of variable severity.

The Correlation between Serum Vitamin D and Total IgE Levels and Chronic Spontaneous Urticaria among Chinese Population: A Retrospective Study.

This study aims to investigate the relationship between serum vitamin D, total IgE levels and chronic spontaneous urticaria (CSU). We collected data from 101 patients with chronic spontaneous urticaria (experimental group) and 115 healthy normal subjects (control group) in the same period of physical examination. The results showed that the number of deficient and absolute deficient 25-hydroxyvitamin D in the experimental group was significantly lower than in the control group (P < 0.05). Pearson correlation analysis showed that the activity score of CSU patients was negatively correlated with serum vitamin D (r = -0.2278, P = 0.0220) and positively correlated with IgE (r = 0.2078, P = 0.0380). It was observed that serum vitamin D in CSU patients was negatively correlated with their activity (r = -0.2278, P = 0.0220) and positively correlated with age (r = 0.2675, P = 0.0069). The Point-biserial correlation analysis revealed that gender was positively correlated with serum vitamin D (Pearson correlation coefficient = 0.286, P = 0.004) and UAS score (Pearson correlation coefficient = 0.273, P = 0.006). Ordinal logistic regression analysis showed that only serum vitamin D was correlated to activity scores (P = 0.008). In addition to activity scores, age (P = 0.005) and gender (P = 0.04) were correlated to serum vitamin D. The activity score of CSU patients was negatively correlated with serum vitamin D and positively correlated with IgE. Serum vitamin D in CSU patients was negatively correlated with activity score and disease duration and positively correlated with age and gender.

Association of serum 25-hydroxyvitamin D concentrations with all-cause mortality among individuals with kidney stone disease: the NHANES database prospective cohort study.

The purpose of this study was to investigate the correlation between serum 25(OH)D concentrations and all-cause mortality in patients with kidney stone disease (KSD) as the effects of a deficiency in 25-hydroxyvitamin D on KSD patients are currently unclear. For our prospective cohort study, we included 2,916 participants from the National Health and Nutrition Examination Survey (NHANES) 2007-2018. The National Death Index (NDI) was utilized to identify all causes of death and cause-specific mortality until December 31, 2018. We calculated hazard ratios (HR) and 95% confidence intervals (CIs) using multivariate Cox regression models. During the 18,859 person-years of follow-up, a total of 375 fatalities occurred, including 83 deaths from cardiovascular disease (CVD) and 79 deaths from cancer. At baseline, individuals with higher blood 25(OH)D concentrations had lower levels of glucose, glycohemoglobin, CRP, and insulin, as well as higher levels of HDL cholesterol (P < 0.01). In the fully adjusted model (Model 3), compared to the group with the lowest 25(OH)D concentrations, those with serum 25(OH)D concentrations ≥75 nmol/L had hazard ratios (HRs) and 95% confidence intervals (CIs) of 0.48 (0.26, 0.87) for all-cause mortality (P=0.02, P for trend = 0.02). The association between serum 25(OH)D concentrations and all-cause mortality in KSD patients was found to be significantly non-linear. A 7% decrease in the risk of death from all causes was observed for each unit-nmol/L increase in serum 25(OH)D concentrations when the concentrations were below 27.7 nmol/L (P < 0.05). Based on the findings, KSD patients with insufficient serum 25(OH)D concentrations were at a higher risk of all-cause mortality. Therefore, it is crucial to maintain sufficient blood 25(OH)D concentrations and prevent 25(OH)D insufficiency in order to extend the lifespan of KSD patients.

Low Serum Level of Vitamin D is Associated with Uterine Leiomyoma in the Chinese Population

Background: The goal of this work was to compare the serum vitamin D level in women with uterine leiomyoma to that of controls, and to examine its association with the etiopathogenesis of this disease. Methods: This case-control study included 110 premenopausal women referred to a university hospital from January 2020 to December 2020. The study group consisted of 55 cases who underwent surgery for uterine fibroids, while the control group was comprised of 55 subjects without uterine fibroids. The number and volume of existing fibroids in each subject was assessed by transvaginal ultrasonography. Serum vitamin D status was determined by radioimmunoassay for 25-hydroxyvitamin D. Results: Average serum 25-hydroxyvitamin D levels in patients with uterine fibroids (20.52 ± 6.17 ng/mL) were significantly lower than in controls (24.18 ± 6.88 ng/mL; p = 0.004). Deficiency in 25-hydroxyvitamin D (i.e., &lt;20 ng/mL) was more frequent in women with uterine fibroids (28/55, 50.91%) compared to controls (13/55, 23.64%; p = 0.001). A trend for negative correlation was found between serum 25-hydroxyvitamin D levels and total uterine fibroid volume (r = –0.18) in the study group (p = 0.20). No significant associations were found between serum 25-hydroxyvitamin D level and the number of fibroids (p = 0.38) or their location (p = 0.89). Conclusions: The serum vitamin D concentration is lower in Chinese women with uterine leiomyomas compared to controls. Vitamin D deficiency could therefore be a risk factor for uterine leiomyoma in the Chinese population.

Frequency of Vitamin D Deficiency among Patients Presenting with Stroke

Background: Stroke is the leading cause of both mortality and disability on a global scale. The documented incidence of cerebral hemorrhages at Pakistan's CT scan facilities varies from 31-40% of cases, whereas ischemic stroke is claimed to be responsible for 60-90% of cases Objectives: The objective of the study was to assess the prevalence of vitamin D deficiency in patients presenting with stroke Methodology: The current study was descriptive and cross-sectional carried out at the Medicine Department, Hayatabad Medical Complex Peshawar for duration of six months February 2018 to August 2018. Patients were enrolled from both the emergency and accident department and outpatient department. The blood samples were taken and transferred to the hospital diagnostic laboratory for the assessment of deficiency of vitamin D in serum. The data analysis was done by using IBM SPSS version 16. Results: In this study, totally 341 patients were enrolled. There were 239 (70.09%) male patients while female patients were 102 (29.91%). The vitamin D deficiency in serum was observed in 50.1% patients. Conclusion: Stroke is still a calamity, and vitamin D could have played pivotal role in the pathogenesis of stroke. Since most of our population is already deficiency in 25-hydroxyvitamin D, therefore, relationship between stroke and vitamin D deficiency cannot be studied at hospital settings. We recommend more analytical research projects not only at hospital level but also at community level to draw conclusions about the relationship between vitamin D status and occurrence of stroke. Keywords: Stroke, Cerebrovascular accident, acute ischemic stroke, hypertension, vitamin D, 25-hydroxyvitamin D

Correlation Between Tic Disorders and Serum 25-Hydroxyvitamin D Levels in Chinese Children

ObjectiveTo explore the correlation between serum 25-hydroxyvitamin D levels and tic disorders (TDs) in Chinese children.MethodsWe selected 2960 children with TD and 2665 healthy controls, aged 5–14 years, from the Department of Neurology of the Shanghai Children’s Hospital. Serum 25-hydroxyvitamin D levels and degrees of vitamin D deficiency were compared between patients with TD and healthy children.ResultsThe mean serum 25-hydroxyvitamin D level in the TD group was significantly lower than that in the control group (P < 0.001). The proportion of patients with 25-hydroxyvitamin D deficiency in the TD group was significantly higher than that in the control group. However, there was no correlation between 25-hydroxyvitamin D deficiency and the severity of TD. In addition, for age-wise comparison, mean levels of 25-hydroxyvitamin D and its deficiency in the TD group were the most significant in children over 9 years of age.ConclusionThere is a correlation between 25-hydroxyvitamin D deficiency and TD in Chinese children, but not between 25-hydroxyvitamin D deficiency and the severity of TD. There was a correlation between age and deficiency of 25-hydroxyvitamin D; this deficiency was most pronounced among those over the age of 9 years.

Association between serum vitamin D level and uterine fibroid in premenopausal women in Indian population.

We aim to evaluate the association between serum 25-hydroxyvitamin D3 levels and total number, volume and location of uterine fibroids (UFs) in premenopausal women in North Indian population. This case control study was undertaken in 310 women between 18 years and 45 years of age. Cases comprised of 102 women with fibroid lesion and the control group included 208 women with normal uterine morphology on ultrasonography. Blood samples were taken for measuring 25-hydroxyvitamin D3 levels. The mean serum 25-hydroxyvitamin D3 level in the study and control group was 14.52 ± 7.89 ng/mL and 26.6 ± 14.36 ng/mL respectively (p < 0.05). There was significant inverse correlation between serum 25-hydroxyvitamin D3 levels and total volume of fibroids (p = 0.000) while none between 25-hydroxyvitamin D3 levels with location, number of fibroids. 25-hydroxyvitamin D3 deficiency was more common in the study group (54.90%) compared to healthy controls (6.7%) while sufficiency was more common among controls (67.8% vs. 27.45) (p < 0.05). Women with deficient 25-hydroxyvitamin D3 levels have an odds of 18.36 for developing uterine fibroid. Women with low parity, those belonging to higher socioeconomic status and having less than 1-hour sun exposure per day were independently found to have high risk for development of UFs. Vitamin D may have a role in growth of UFs. Women not able to get adequate sun exposure due to indoor working conditions may need evaluation and supplementation as prophylaxis for development of fibroid.

Correlation of 25-Hydroxy Vitamin D and Serum Lipid Profile amongst Asymptomatic Adults in Mumbai City: A Cross-sectional Study

Introduction: Deficiency of 25-Hydroxy Vitamin D (25-OH Vitamin) is prevalent globally. Vitamin D and cholesterol metabolism are known to be linked with each other. Few International studies have attempted to relate low Vitamin D level and altered serum lipid levels. However, Indian studies are lacking, hence there is a need to conduct the studies in Indian population. Aim: To study the correlation of the serum Vitamin D level with lipid profile amongst asymptomatic Indian adults in a tertiary care hospital, Mumbai, India. Materials and Methods: This cross-sectional study was conducted in SevenHills Hospital, Mumbai, Maharashtra, India (tertiary care hospital), from December 2016 to August 2017. A total of 243 asymptomatic adults, visiting the wellness clinic for routine assessment of health status were randomly selected. Study participants were divided into two groups based on Vitamin D levels. Group A (n=139) with Vitamin D level &lt;20 ng/mL, group B (n=104) with Vitamin D ≥20 ng/mL. Group B was further segregated into sub group B1 (n=60) with Vitamin D level ≥20 ng/mL to &lt;30 ng/mL and sub group B2 (n=44) with Vitamin D level ≥30 ng/mL. Fasting blood samples were collected to measure levels of serum Vitamin D and lipid profile. The measured values of Vitamin D and serum lipids were statistically analysed for any significant relationship using Chi-square test and Unpaired t-test and Pearson’s correlation. Results: Mean age of the participants of group A was 39.94±11.59 years and group B was 47.78±11.53 years. The difference in gender distribution and average BMI of both groups was not statistically significant (p-value=0.8599 and p-value=0.4497, respectively). On comparison of group A and group B2, average High Density Lipoprotein Cholesterol (HDL-C) level was comparatively higher amongst group B2 (52.18±11.87 mg/dL vs 45.81±12.76 mg/dL; p-value=0.0038) and average Triglyceride (TG) level was higher amongst group A (104.58±70.35 mg/dL vs 129.38±64.34 mg/dL; p-value=0.0308). There was no statistically significant linear correlation found between lipid profile parameters and Vitamin D. Conclusion: In present study, no significant correlation between Vitamin D deficiency and serum lipid profile was found. However, a statistically significant difference was found in average levels of HDL-C and TG amongst adults with adequate Vitamin D and those with Vitamin D deficiency.

Vitamin D indicators in pregnancy dynamics in women with different types of infertility in their history

The objective: to study the level of vitamin D in the dynamics of pregnancy in women with various types of infertility in history. Materials and methods. 127 women were examined: I group – 35 pregnant women who had a history of endocrine infertility; II group – 37 women with tubal-peritoneal infertility; III group – 30 pregnant women who had a history of tubal-peritoneal infertility with endocrine factor; IV (control) group – 25 healthy pregnant women without a history of infertility. To determine the level of 25-hydroxyvitamin D, a two-stage ELISA method was used. Results. Insufficiency and deficiency of vitamin D in the I trimester of pregnancy had 5 (20.0%) women without a history of infertility each, in the III trimester – 40% and 28% persons, respectively. Deficiency of 25-hydroxyvitamin D in the I group was detected in 15 (42.9%) patients in the I trimester and in 20 (57.1%) patients in the III trimester, in the II group – 10 (27.0%) and 17 (45.9%) persons, respectively, in the III group – 15 (50.0%) and 18 (60.0%) women, respectively.The number of patients with vitamin D deficiency during pregnancy in the groups of patients with a history of infertility was significantly higher compared with pregnant women without a history of infertility. Also, an increased rate of persons with vitamin D deficiency was determined among patients of the I, II and III groups compared with women of the IV group. Conclusions. In the dynamics of pregnancy an increase frequency of persons with insufficiency and deficiency of vitamin D was found among the women with a history of infertility, the largest rate of which was determined in pregnant women with endocrine infertility and tubal-peritoneal infertility in combination with an endocrine factor.

Вплив вітаміну D на показники компенсації цукрового діабету 2-го типу

Актуальність. Цукровий діабет (ЦД) призводить до порушення всіх видів обміну речовин (насамперед вуглеводного), ураження судин, нервів, різних органів і тканин. Проте вплив ЦД на рівень вітамінів та мікроелементів залишається недостатньо висвітленим. Попри достатній арсенал лікарських середників, досягти компенсації ЦД вдається менше ніж у 30 % пацієнтів. Саме тому пошук нових шляхів покращення вуглеводного обміну залишається актуальним. Мета дослідження: виявлення дефіциту 25-гідроксивітаміну D та встановлення його кореляційного зв’язку з рівнем глікованого гемоглобіну (HbA1c) у хворих на ЦД 2-го типу. Матеріали та методи. Обстежено 35 хворих на ЦД 2-го типу віком 55–74 роки з тривалістю захворювання від двох до чотирьох років. Контрольну групу становили 35 практично здорових осіб такого ж віку. Показники 25-гідроксивітаміну D вимірювали за допомогою радіоімунологічного аналізу. Рівень HbA1c вимірювали за допомогою рідинної хроматографії. Результати. У 37,1 % хворих на ЦД 2-го типу виявлено недостатність вітаміну D. При цьому в 61,5 % з них компенсація ЦД була задовільною (рівень HbA1с становив 7,5–8,5 %), а в 38,5 % — незадовільною (рівень HbA1с &gt; 8,5 %). Встановлено обернену кореляцію між підвищенням рівня HbA1с та зниженням вмісту 25(OH)D (r = –0,39, p &lt; 0,05). Висновки. Встановлено вірогідне покращання стану компенсації цукрового діабету 2-го типу після медикаментозної корекції рівня вітаміну D.

Is Deficiency of 25-Hydroxy Vitamin D A Risk Factor for Autism? A Preliminary Study

Objective: To investigate the status of 25-hydroxy-vitamin-D [25-(OH)-D] in autistic children and to correlate with their mothers vitamin statuses and autism severity.Methods: In this case-control study, serum 25(OH)-D was measured in autistic children and controls (n=36 each) and in mothers of autistics and control mothers (n=24 each). Comparison and correlation studies were performed.Results: Both autistic children and their mothers have lower 25-(OH)-D compared to their controls with significant differences (PConclusion: Deficiency of 25(OH)-D is common in autistic children and related to the severity of symptoms. Vitamin D deficiency in children might be maternal-dependent. Deficiency of 25(OH)-D in autistic children and their mothers could be the primary predisposing factor for autism. This may find a common link among the genetic, immunological, anatomical, biochemical and physiological factors putting the puzzles together. Early supplementation of vitamin D could improve autistic manifestations.

Vitamin D Levels in Mother-Baby Pairs: A Cross-Sectional Prospective Study in a Rwandan Tertiary Hospital.

Exposure to the sunlight contributes largely to the production of vitamin D. However, vitamin D deficiency is a reality in tropical countries, despite enjoying enough sunlight, especially bearing women in their last trimester whose foetuses exclusively depend on their reserves. This work aimed at demonstrating the state of vitamin D in mother-baby pairs and associated factors in one of the University Hospitals in Rwanda. This cross-sectional prospective study was performed on mother-baby pairs at Kigali University Hospital. Mother's serum 25-hydroxyvitamin D levels were considered as outcomes compared with demographic, clinical and biological markers. Correlation analysis was conducted in order to assess the association between serum 25-hydroxyvitamin D levels for the couple mothers-babies. Approximately 38% of women and 65% of neonates had deficiency in 25-hydroxyvitamin D (<20 ng/ml). The use of a vitamin D rich diet within 24 h recall (p < 0.01) or 1 week recall (p < 0.001) before delivery was associated with appropriate vitamin D levels in mothers. Interestingly, a strong positive correlation was found between maternal and neonatal serum 25-hydroxyvitamin D levels (r = 0.760). There was a high rate of vitamin D deficiency in mothers and their babies. Babies born from women with deficiency were likely to develop low levels of vitamin D. This stresses on the need to strengthen the interventions for preventing vitamin D deficiency in the couple mothers-babies such as supplement in vitamin D before and after delivery, improving the quality of meals and regular contact with sunlight.

Low Serum 25-Hydroxy Vitamin D (25-OHD) and Hepatic Encephalopathy in HCV-Related Liver Cirrhosis.

Background Patients with liver cirrhosis experience a large variety of metabolic disorders associated with more hepatic decompensation. Hepatic encephalopathy (HE) is a significant complication in liver cirrhosis patients, presenting a wide spectrum of neuropsychological symptoms. A deficiency of 25-hydroxy vitamin D (25-OHD) in the general population is associated with a loss of cognitive function, dementia, and Alzheimer's disease. Aim of the Study. Our study aims to check the relationship between low serum 25-OHD and HE in patients with HCV-related liver cirrhosis and assess its link with patient mortality. Patients and Methods. This study was observationally carried out on 100 patients with HCV-related liver cirrhosis. The patients were divided into 2 groups: Group A—included 50 HCV-related cirrhotic patients with HE, and Group B—included 50 HCV-related cirrhotic patients without HE. Assessment of disease severity using the end-stage liver disease (MELD) model and Child Turcotte Pugh (CTP) scores were done, and 25-OHD levels were measured. Comparison of vitamin D levels in different etiologies and different CTP categories was made using one-way ANOVA. Pearson's correlation between the level of vitamin D and other biomarkers was applied. Results There was a statistically significant Vitamin D level difference between the two groups. A lower level of vitamin D was observed in the HE group where the severe deficiency was 16%, while it was 6% in the other group and the moderate deficiency was 24% in HE group as compared to 10% in the other group. The insufficient vitamin D level represented 46% of the non-HE group while none of the HE group falls in this category. Vitamin D level was statistically higher in Grade 1 HE than in Grade 2 which is higher than in Grades 3 to 4. Vitamin D level was also significantly higher in those who improved from HE as compared to those who died. Conclusion The lower levels of 25-OHD were associated with the higher incidence of HE in cirrhotic HCV patients. The worsening vitamin D deficiency was associated with increased severity of the liver disease, so vitamin D may be considered a prognostic factor for the severity of liver cirrhosis and high mortality rate in HE patients.

The Relationship of Vitamin D Insufficiency with Low-Energy Fractures in Children

BACKGROUND: Approximately 50% of the world population are suffering from Vitamin D insufficiency. Vitamin D is one of the steroid hormones, which is a fat soluble vitamin that has a critical role in maintaining the homeostasis of bones. Low-energy fractures are defined as falling from the level of standing height or even less that usually should not result in fractures. Another study that was done in Jeddah on a sample of 510 children between the age of 4–15 taken in the pediatric clinic at Jeddah Clinic Hospital-Kandarah. 59% had relative deficiency, and 27% had a deficiency in 25-hydroxyvitamin D.&#x0D; AIM: Therefore, this research is conducted to collect more evidences to assess the association between vitamin D level and low-energy fractures in children.&#x0D; METHODS: The study group consisted of 14 children aged 3–15 years old with low-energy fractures and the control group consisted of 24 children in the same age without fractures. Vitamin D level was measured in each one of them and X-ray was obtained from the cases to prove the presence of low-energy fracture. The analysis plan that was used in this research is Fisher’s exact test to overcome the small sample size.&#x0D; RESULTS: Vitamin D levels were found deficient in four cases, and eight of them were insufficient. Whereas, the normal level of Vitamin D was found in only two of the cases. On the other hand, in the control group the level of Vitamin D was deficient in four participants, and 15 others were found to be insufficient. Also, five of the participants were found to have a normal Vitamin D level. According to the results, low levels of Vitamin D were observed in both groups. A total of 23 out of 38 children enrolled in the study were found to have an insufficient Vitamin D level. The result of p = 0.718 which is not significant to prove the correlation between Vitamin D insufficiency and low-energy fractures.&#x0D; CONCLUSION: In conclusion, this study did not show any relation between Vitamin D level and the presence of low energy fracture. Future studies are required to include more subjects and centers to their study or to compare the low energy fracture and high energy fracture in term of Vitamin D level.

25 Hydroxyvitamin D levels and gait, posture, and balance in Parkinson's Disease: A retrospective study

Background: Research studies have shown that deficiency of 25-Hydroxyvitamin D levels is associated with an increased risk of developing Parkinson's Disease (PD). The exact role that 25-Hydroxyvitamin D plays in the pathogenesis and clinical manifestations of Parkinson's Disease remains unclear. The present study was undertaken to explore potential associations between vitamin D levels and gait, posture, and balance in individuals with PD.

SERUM 25-HYDROXYVITAMIN D LEVELS IMPACT RISK OF EXTENSIVE ASSISTANCE NEEDED BY OLDER ADULTS TO WALK

Study objective is to determine the association between deficient 25-hydroxyvitamin D [25(OH)D] serum levels and the amount of assistance needed to walk in a room by older adults living in long-term care (LTC) communities. Participants (age ≥ 65) from five LTC communities in Central Texas were recruited for a multi-site, cross-sectional study (n=169). Double-blinded data abstraction protocols were used to collect a one-year medical history. Laboratory blood draws measured serum 25(OH)D levels. Level of assistance was measured by the activities of daily living score for walking in room from section G of the Minimum Data Set (MDS). To determine the association between deficient 25(OH)D serum levels (≤20 ng/ml) and assistance with walking, adjusted logistic regression was used. Total vitamin D per day (supplementation and meals), therapy and/or restorative programs, body mass index, race, gender, age, and years living in the community were used as confounders. Of the 169 participants (mean age=83) 27.17% had deficient serum 25(OH)D and 9.25% required extensive assistance to walk in a room. The mean serum level and supplementation rate of participants was 32.61 ng/ml and 1,160.64 IU per/d, respectively. Participants with deficient 25(OH)D serum levels had significantly elevated odds (OR=8.73; CL: 1.28, 8.54; p=0.027) of requiring extensive assistance to walk in a room compared to those with adequate serum levels (>20 ng/ml). Deficient 25(OH)D serum levels are associated with increased assistance to walk in a room indicating that adequate serum levels in LTC residents could potentially decrease burden on staff.

Serum 25-Hydroxyvitamin D Concentrations from Patient Groups at High Risk for Deficiency.

Deficiency of 25-hydroxyvitamin D in serum is endemic in the general population, and testing for this hormone is useful in accessing a patient's overall health and well-being. We obtained blood from 216 hospitalized patients and outpatients divided into 4 groups thought to be at high risk of 25-hydroxyvitamin D deficiency: homeless, recreational drug abusers, psychiatric patients with limited access to the outdoors, and those infected with HIV. The 25-hydroxyvitamin D concentrations from these patients were determined with 2 different methodologies (immunoassay and mass spectrometry) and compared against 25-hydroxyvitamin D concentrations in apparently healthy controls. We hypothesized that these groups may be at higher risk for vitamin D deficiency because of poor nutrition, inadequate housing, restricted access to outdoors, or the presence of chronic disease. For each of the patient groups including healthy controls, the median concentration of 25-hydroxyvitamin D was below 30 ng/mL, indicating deficiency. Comparisons between the healthy controls and the other groups were not statistically significant with either methodology, except for the homeless patients in whom a higher number of individuals had 25-hydroxyvitamin D concentrations below 20 ng/mL. Results between the 2 testing platforms demonstrated that only 52% of the specimens analyzed by immunoassay agreed within ±10% of the LC-MS/MS results, with an overall correlation coefficient to 0.920. The degree of concordance for deficiency with 2 published cutoffs of 20 and 30 ng/mL was 91% and 91%, respectively. Vitamin D deficiency is a common finding in all the populations studied. The Lumipulse® G vitamin D immunoassay is an alternative for detecting vitamin D deficiency.

The Association Between Vitamin D Status, Vitamin D Supplementation, Sunlight Exposure, and Parkinson's Disease: A Systematic Review and Meta-Analysis.

BackgroundThis literature review and meta-analysis aimed to determine the association between deficiency of vitamin D, or 25-hydroxyvitamin D, and Parkinson’s disease, and whether vitamin D from supplements and sunlight improves the symptoms of Parkinson’s disease.Material/MethodsA literature review and meta-analysis were performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. Systematic literature review was performed using databases that included the Web of Science, PubMed, the Cochrane Library, and Embase. The Jadad scale (the Oxford quality scoring system) and the Newcastle-Ottawa scale (NOS) were used to evaluate the quality of the studies.ResultsEight studies were included in the meta-analysis. Both 25-hydroxyvitamin D insufficiency (<30 ng/mL) (OR, 1.77; 95% CI, 1.29–2.43; P<0.001) and deficiency (<20 ng/mL) (OR, 2.55; 95% CI, 1.98–3.27; P<0.001) were significantly associated with an increased risk of Parkinson’s disease when compared with normal controls Sunlight exposure (≥15 min/week) was significantly associated with a reduced risk of Parkinson’s disease (OR, 0.02; 95% CI, 0.00–0.10; P<0.001). The use of vitamin D supplements was effective in increasing 25-hydroxyvitamin D levels (SMD, 1.79; 95% CI, 1.40–2.18; P<0.001), but had no significant effect on motor function (MD, −1.82; 95% CI, −5.10–1.45; P=0.275) in patients with Parkinson’s disease.ConclusionsInsufficiency and deficiency of 25-hydroxyvitamin D and reduced exposure to sunlight were significantly associated with an increased risk of Parkinson’s disease. However, vitamin D supplements resulted in no significant benefits in improving motor function for patients with Parkinson’s disease.

Bone Histomorphometric Findings in Ankylosing Spondylitis: A Case Report

There is minimal information on bone Histomorphometric characteristics in ankylosing spondylitis. We here report a case of a 36-year-old Japanese male that suffered from lumbago and could not gaze in the forward direction. Ultimately, a diagnosis of ankylosing spondylitis was made, and vertebroplasty was performed to correct the third lumbar spine. Histomorphometry of the iliac bone showed reduced bone volume parameters (bone volume, and trabecular thickness and width) than reference values. In addition, bone formation parameters (osteoid thickness and osteoblast surface per bone surface) and bone resorption parameters (eroded surface per bone surface and osteoclast number per bone surface) were also lower than reference values, indicating low bone turnover. By contrast, there was not a clear trend in bone resorption markers: bone- pecific alkaline phosphatase (17 U/l) was normal, TRACP-5b (136 mU/dl) was slightly lower, urinary N-terminal telopeptide (45.3 nmol BCE/mmol Cr) was normal, and deoxypyridinoline (9.1 nM/mM Cre) was higher than reference values. However, there was deficiency in 25-hydroxy vitamin D (25-OH-D; 14.4 ng/ml). This case highlights the rare possibility of performing bone histomorphometry, and indicates that a low bone volume and low bone turnover (in both bone formation and resorption) are characteristics of ankylosing spondylitis, although bone formation markers (bone-specific alkaline phosphatase) and bone mineral density are within the normal range. The possibility of a serum 25-OH-D deficient status in ankylosing spondylitis should be further considered.