Deficient Levels Of Vitamin Research Articles

Vitamin D Status among Patients Visiting an Urban Tertiary Care Hospital, Dhaka

Background: Majority of the Bangladeshi population lives in an areas receiving ample sunshine throughout the year. Despite this fact multiple studies have shown wide prevalence of vitamin D deficiency in our country in all ages and both sexes. Adequate vitamin D status has an important clinical advantage for maintaining various activities as well as preventing diseases. In this lab based retrospective study, it was determined the prevailing condition of vitamin D deficiency among adult patients visiting MH Samorita Hospital and Medical College outdoor. The present study aimed to focus on assessing Vitamin D status of adult patients visited a tertiary care hospital of Dhaka city. Materials and methods: This was a retrospective study. A total of 72 cases were chosen by random sampling with records of vitamin D status, age and sex from July to December, 2022.The results were statistically analyzed with Statistical Packages for Social Science (SPSS-24). Results: Out of total subject (n=72) none of them showed toxic serum concentration of vitamin, 12.5 % had sufficient, 23.6% had insufficient and 63.9% had deficient levels of vitamin D. Gender wise comparison of vitamin D status showed male patients, 28.3% were deficient in vitamin D, 47.1% were insufficient, and a substantial 77.8% had sufficient levels. In contrast, a much higher proportion of female patients were deficient (71.7%) or insufficient (52.9%) in vitamin D, with only 22.2% having sufficient levels. According to age wise distribution, the highest percentage of vitamin D deficiency (58.7%) was observed in the youngest age group (18-30 years), while the proportion decreased in older age groups (30.4% for 31-50 years and 10.9% for 51-65 years). Conclusion: Vitamin D is an important vitamin which impacts many systems of the body .This study indicates that 63.9 % of subjects are vitamin D deficient which is very much alarming. So, it becomes paramount to further scrutinize the associated factors apart from age and gender. To this end, further studies are needed. IAHS Medical Journal Volume 6(2) December 2023; 68-72

The Relationship between Vitamin D, Inflammatory Markers, and Insulin Resistance in Children.

In this study, we investigated 25-hydroxyvitamin D (25(OH)D, vitamin D), inflammatory hematologic ratios such as neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), systemic immune-inflammation index (SII), monocyte/HDL-C ratio (MHR) and plasma atherogenic index (PAI) and possible relationships with insulin resistance (IR) in children. A total of 210 individuals, including 96 children with IR and 114 children without IR, aged 6-18 years, who were admitted to the Pediatric Endocrinology Outpatient Clinic at Medicine Hospital, Istanbul Atlas University were included in our study. Compared to patients without IR, NLR, PLR, SII, and MHR were significantly higher in patients with IR. Fasting insulin, PAI, homeostasis model assessment of insulin resistance (HOMA-IR), and HOMA-β were significantly higher and quantitative insulin sensitivity check index (QUICKI) was considerably lower in patients with IR compared to those without IR. NLR, SII, and MHR were lower in normal vitamin D groups than the others (p < 0.001). PLR was lower in the group with normal vitamin D levels than the groups with insufficient or deficient levels of vitamin D (D < 21). We found that vitamin D deficiency in childhood is related to increased levels of circulating inflammatory markers (NLR, PLR, MHR, PAI), IR, and decreased insulin sensitivity. According to our results, supplementation of vitamin D may be beneficial in averting IR and enhanced systemic inflammation.

The Analysis Study of The Effect Vitamin D to Risk for Type 2 Diabetes Mellitus in People with Pre-Diabetes : A Comprehensive Systematic Review

Background: Individuals with prediabetes are at a 50% increased risk of advancing to Type 2 Diabetes Mellitus (T2DM). Deficient levels of vitamin D are associated with higher risks of insulin resistance and diabetes. Methods: This systematic review adhered to PRISMA 2020 guidelines, focusing exclusively on full-text articles published in English between 2012 and 2024. Result: The review process involved analyzing over 300 publications from the selected databases. After an initial screening, eight studies met the criteria for detailed examination. These studies underwent an in-depth review to ensure a rigorous and comprehensive evaluation of their findings. Conclusion: Vitamin D supplementation may offer potential benefits in reducing the risk of T2DM in individuals with prediabetes by enhancing insulin synthesis and sensitivity. However, the overall effectiveness of diabetes prevention is still debated, with recent large-scale trials reporting nonsignificant results. The fat-soluble nature of vitamin D may limit its effectiveness in obese individuals. The American Diabetes Association advocates for further research to explore the potential advantages of combining vitamin D supplementation with lifestyle interventions.

Albumin and multiple sclerosis: a prospective study from UK Biobank.

Multiple sclerosis (MS) is a chronic inflammatory disease affecting the central nervous system. While previous studies have indicated that albumin, the primary protein in human plasma, may exert influence on the inflammatory process and confer beneficial effects in neurodegenerative disorders, its role in the context of MS has been underexplored. Here, we aimed to explore the link between albumin and the risk of MS. Employing data from the UK Biobank, we investigated the association between baseline levels of serum and urine albumin and the risk of MS using Cox proportional hazards regression analysis. A higher baseline level of serum albumin was associated with a lower risk of incident MS (HR=0.94, 95% CI: 0.91-0.98, P=7.66E-04). Subgroup analysis revealed a more pronounced effect in females, as well as participants with younger ages, less smoking and deficient levels of vitamin D. Conversely, no association was identified between baseline microalbuminuria level and risk of incident MS. Higher serum albumin level at baseline is linked to a reduced risk of MS. These results contribute to an enhanced understanding of albumin's role in MS, propose the potential use of albumin as a biomarker for MS, and have implications for the design of therapeutic interventions targeting albumin in clinical trials.

Vitamin D Among Type 2 Diabetic Patients Attending Aden Diabetic Center During May-July 2023: A Descriptive Study

Introduction: Vitamin D plays a crucial role in the pathogenesis and management of type 2 diabetes mellitus (T2DM). However, limited data are available regarding the status of vitamin D among T2DM patients attending healthcare centers, particularly in the Aden Diabetic Center, Yemen. The study aimed to assess the prevalence of vitamin D deficiency among T2DM patients and explore its association with potential factors such as demographics, diabetes characteristics body mass index (BMI). Methods: A descriptive cross-sectional study was conducted on 138 T2DM patients attending Aden Diabetic Center (ADC) between May and July 2023. Data on age, sex, diabetes characteristics (diabetes duration, family history of diabetes, and medication use), RBS, BMI, and serum vitamin D level were measured. Vitamin D status was categorized as deficient, insufficient, or sufficient based on established cutoffs. Descriptive statistics and chi-square tests were used for data analysis. Results: Majority of patients had vitamin D deficiencyy (73.2%) and the remaining had insufficient (17.4%), and sufficient (9.4%) status. Males comprised 53.6% and females 46.4%. Mean age was 53.70±12.93 years, with the highest proportion (60.9%) were in the age group 40-60 years. Majority of the patients (62.3%) had T2DM duration ≥ 5 years, and 89.1% were receiving diabetes medications, and 68.8% had a family history of DM. The mean RBS level was 220.13±86.90 mg/dl, with more than half (55.6%) having RBS levels ≥ 140 mg/dl. Also, the mean BMI was 27.00±5.90 kg/m², and more than half of the patients had overweight and obesity. The study found no significant association between serum vitamin D levels with age, diabetes characteristics, or BMI categories, while a significant association to sex was observed (P = 0.006). Conclusion: The study highlights the high prevalence of vitamin D deficiency among T2DM patients attending the ADC in Aden. The majority of patients were found to have deficient levels of vitamin D, with limited differences based on age, diabetes characteristics, and BMI. The significant association between vitamin D levels and sex, indicating that sex may contribute to the risk of deficiency in T2DM patients. These findings emphasize the importance of assessing and addressing vitamin D status in T2DM patients to optimize their overall health and diabetes management.

Abstract 2565: Vitamin D deficiency and outcomes in prostate cancer patients: A real-world database

Abstract Introduction: Vitamin D is essential for many bodily functions, including bone health and the prevention of osteoporosis and rickets. In recent years, the importance of vitamin D metabolism in immune system regulation and cancer prevention has been studied with increased focus. With the advent of cancer immunotherapies this has become more important. Multiple recent publications document that vitamin D deficiency is prevalent in cancer patients. This has also been observed specifically in prostate cancer patients, with a high percentage of these deficient patients being of African- American ancestry. It has been theorized that high levels of vitamin D deficiency among African American prostate cancer patients could contribute to worse cancer outcomes and increased health disparities. However, routine vitamin D testing has not been commonly performed in the oncologic community. We hypothesized that deficient levels of vitamin D could lead to inferior prostate cancer outcomes in men with a wide range of ethnic and socio-economic backgrounds. In this project we recorded vitamin D levels in prostate cancer patients at a large community oncology group and evaluated them by stage, pathologic data, survival, race/ethnicity, and other clinical features. Methods: This study is a retrospective, observational study of the data from the electronic medical records of patients with prostate cancer who received vitamin D level testing at Florida Cancer Specialists &amp; Research Institute from 2008- 2023, throughout the state of Florida. All data used in this study will constitute secondary data, it will have been collected originally for clinical use in the general oncology practice setting. No date parameters or patient limits will be applied to this study, and all eligible patients are included. Results: 451 patients with prostate cancer had determination of vitamin D levels, out of a total of 27,772 prostate cancer patients in the database. 38% of the prostate cancer patients analyzed had low 25-OH vitamin D levels (&amp;lt;32 ng/ml). Patients with low vitamin D levels had an average Gleason score of 7.46. Patients with low vitamin D levels who died had an average survival of 144 months. Patients with low vitamin D levels who presented with localized disease had a 35% chance of eventually developing castrate-resistant disease. 45% of the low vitamin D group developed metastatic disease during their course of treatment. Further comparisons of vitamin D levels with pathologic data, survival/longevity, race/ethnicity, and clinical course will be evaluated and presented. Citation Format: Lowell L. Hart, James Reeves, Stacey Garofalo, William Amick. Vitamin D deficiency and outcomes in prostate cancer patients: A real-world database [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2024; Part 1 (Regular Abstracts); 2024 Apr 5-10; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2024;84(6_Suppl):Abstract nr 2565.

The vitamin D status and the levels of β1- and β2-defensins in children and adolescents with different forms of pulmonary TB

Introduction. The basic research demonstrated an important role of vitamin D in strengthening the immune response to Mycobacterium tuberculosis and proved its effect on the production of antimicrobial peptides. However, the correlation between the levels of vitamin D and defensins (β1 and β2) in children and adolescents with different forms of pulmonary TB was not studied.Aim. To study the correlation between the levels of vitamin D and β1- and β2-defensins in children and adolescents with different forms of pulmonary TB.Materials and methods. We carried out a prospective study of 75 patients with pulmonary TB aged 2–17 years (52 new cases and 23 retreatment cases) in 2021–2023. The levels of 25(OH)D and β1- and β2-defensins were determined at admission to hospital.Results. Out of 75 patients 2.7% had adequate levels of vitamin D (more than 30 ng/mL), 13.3% had insufficient levels of vitamin D (20 to 30 ng/mL), 34.7% had deficient levels of vitamin D (10 to 20 ng/mL), and 49.3% had severe deficiency of vitamin D (less than 10 ng/mL). We established a direct correlation between 25(OH)D and β1-defensin levels (p = 0.004766) and lack of correlation between 25(OH)D and β2-defensin levels. We discovered significant differences in the levels of 25(ОН)D and β1-defensin between new and retreatment cases: 13.10 ± 1.04 ng/mL and 8.74 ± 1.07 ng/mL (p = 0.004644) and 6.66 ± 0.79 ng/mL and 4.0 ± 0.85 ng/mL (p = 0.024816), respectively.Conclusion. The differences in the levels of calcidiol and β1-defensin between new and retreatment cases witness an impaired function of one of the innate non-specific immunity components during long-lasting advanced pulmonary TB in children and adolescents.

Association between deficient levels of vitamin D and the occurrence of selected retinal diseases

Introduction and Purpose:&#x0D; Vision originates in the eye's retina, a complex structure essential for processing visual information. The connection between nutritional inadequacy, particularly vitamin deficiencies, and overall health, including ocular health, has long been acknowledged. Recent studies highlight the potential impact of vitamin D, a crucial nutrient, on retinal health. The aim is to investigate the association between low levels of vitamin D and retinal diseases like age-related macular degeneration (AMD) and diabetic retinopathy (DR), and to evaluate the potential benefits of vitamin D supplementation or lifestyle changes for at-risk patients.&#x0D; Description of the State of Knowledge:&#x0D; AMD, a significant cause of blindness in the elderly, involves factors like oxidative stress and inflammation. Various stages of AMD require different treatments, with limited options for advanced stages. DR, a complication of diabetes, leads to conditions such as retinal ischemia and neovascularization. Both conditions are potentially influenced by vitamin D levels. Studies show mixed results regarding the impact of vitamin D on these diseases. Some suggest lower levels may increase risk, while others report no significant effect or even contradictory findings.&#x0D; Conclusions:&#x0D; While some studies indicate a potential association between low vitamin D levels and the occurrence of retinal diseases, discrepancies exist in the findings. Lower vitamin D concentrations may be linked to a higher frequency of AMD and DR, but the evidence is not consistent across all studies. Therefore, a more in-depth exploration of this subject is warranted to draw conclusive insights. It is crucial to consider supplementation or dietary changes in cases of vitamin D deficiency, given its potential impact on systemic health.

Incidence of Vitamin D deficiency and insufficiency in those with hip fractures: A prospective cohort study

Introduction As the rise in the population over the age of 65 years continues, there is a concern that there will be an increase in fragility hip fractures. Inadequate vitamin D levels could affect the health of the bone, and subsequently increase of sustaining a hip fracture. The purpose of our study was to determine if there was in fact an association between insufficient or deficient vitamin D levels and sustaining a hip fracture in our patients 90 years of age or older. Methods 25-hydroxy vitamin D levels in all patients who presented to the Emergency Department of a high-volume teaching institution who also had a diagnosis of hip fracture from 2017 to 2019 were prospectively and randomly assessed. Vitamin D levels were randomly ordered and assessed by the on-call orthopedic resident on all patients over 90 years of age. Overall, 47 patients that were 90 years of age or older were treated in our institution of which the study cohort consisted of 47 patients. This included 7 men and 40 women with a mean age of 94 years (range, 90 to 102 years). The guidelines of the Endocrine Society definitions of Vitamin D deficiency, insufficiency, and normal levels were used. The incidence of vitamin D deficiency and insufficiency was compared to those with normal levels for statistical significance. Outcomes were further sub-stratified by gender. Results The cohort had mean Vitamin D levels of 27.2 ng/ml (range, 4.3 to 69.4 ng/mL). Sixty-four percent of patients had lower than normal Vitamin D levels (p = 0.007) with 43% (n = 20) who were deficient and 21% (n = 10) who were considered insufficient. When outcomes were stratified by gender, men and women had similar mean vitamin D levels (p= 0.67). Women with hip fractures had higher incidences of vitamin D levels of &lt; 30 ng/mL (p =0.002) while men had similar incidences (p = 0.6) of vitamin D levels above and below 30 ng/mL. Discussion We found an association between the incidence of hip fractures and increased incidence of insufficient or deficient levels of vitamin D those over 90 years of age. Future studies should examine how improvements in vitamin D levels can reduce potential risk of fragility hip fractures.

ISCHEMIC STROKE(CVA) AND VITAMIN-D LEVEL

Vitamin D(25-hydroxyvitaminD), a neuroprotective prohormone, is associated with neurological disorders in particular ischemic stroke. In ischemic stroke patients lower than normal vitamin D level is more prevalent and number of male patients had low vitamin D as compared to number of female patients. Statistically significant, vitamin D in low level range was found in ischemic stroke with diabetes mellitus than patients with normal blood glucose level. Elevated CRP level was also found in those patients who had low vitamin D level. Compared to normotensive stroke patients, decreased value than normal vitamin D range were found in patients having hypertension. Ischemic stroke with associated dyslipidemia patients had low levels of vitamin D as compared to patients with normal lipid. Deficient levels of vitamin D were found mostly in age group more than 60 years.

Correlation of Serum Vitamin D with Crestal Bone Level in Dental Implant Patients Using CBCT: A Clinical Retrospective Study.

The purpose of this study is to correlate the role of serum vitamin D levels associated with crestal bone in dental implant patients using cone-beam computed tomography (CBCT). This retrospective study enrolled patients among whom implants were placed after a detailed planning using CBCT and the delayed loading protocol was followed. After 3 months and 6 months of loading, CBCT evaluations were carried out, serum vitamin D levels were also tested at the end of 6 months of loading. A total of 30 patients were recruited with 15 patients in each group based on normal and deficient levels of vitamin D to correlate with crestal bone levels using CBCT. Clinically acceptable crestal bone loss (CBL) was visible with all the implants at different time intervals. Statistical analysis was done for intergroup and intragroup comparisons which showed significant p-value (< 0.05) for CBL at the time of loading, at 3 months, and at 6 months follow-up for both normal and deficient serum values. In the deficient group, the mean value at baseline was 9.69 mm ± 1.10 and the CBL at 6 months follow-up was 8.80 mm ± 1.10 whereas for the normal group at baseline, the mean was 9.08 mm ± 1.21 and at 6 months follow-up was 8.12 mm ± 1.25 which showed meaningful difference. There is a positive correlation seen between CBL on CBCT and vitamin D serum levels. The success of the implant is significantly affected by vitamin D as it regulates the bone physiology and has systemic effects on accelerating bone formation around titanium implants. Vitamin D is essential in maintaining the balance of bone minerals and assists to preserve the crestal bone level making the implant treatment more predictable and successful.

Vitamin D levels and anxiety symptomatology in pregnancy and the postpartum.

Anxiety and vitamin D deficiency are both common in pregnancy, but research into the relationship between vitamin D levels and perinatal anxiety is sparse. We sought to examine whether an association exists and compare the distribution of vitamin D levels in women with and without anxiety symptoms. We analyzed 25-hydroxyvitamin D using ab213966 25(OH) vitamin D enzyme-linked immunosorbent assay in 54 women with and 47 women without anxiety symptoms at the first, second, and third trimesters and at 6 weeks postpartum. We conducted univariate and chi-square analyses to compare the frequencies of non-optimal and optimal vitamin D levels between the anxiety and non-anxiety groups at each timepoint. Overall, vitamin D levels were lower in the first and second trimesters than in the third trimester. In the first trimester only, the non-anxiety group had a marginally higher proportion of women with optimal vitamin D levels when compared to the anxiety group. Many pregnant women have insufficient or deficient levels of vitamin D, and our exploratory findings point to the need for further research into whether this differs between women with anxiety compared to healthy women.

Vitamin D and hypertension: Is there any significant relation?

Vitamin D and hypertension: Is there any significant relation?

Effect of Smoking on Serum Vitamin D Levels and the Influence on COPD Symptoms Using NHANES 2007 – 2014 Datasets Among Women of Different Ethnic Backgrounds

Smoking is one of the major causes of chronic obstructive pulmonary disease (COPD). The number of women who smoke is increasing and they are at enhanced risk of developing fatal COPD. Symptoms of COPD include frequent coughing, wheezing, whistling, excess phlegm and shortness of breath. According to National Health Interview Survey (NHIS) data during 1999 to 2011, the prevalence of COPD among non-Hispanic whites was generally higher contrasted with non-Hispanic blacks and Hispanics. Among women the annual age-adjusted prevalence was higher than in men, especially among young women. It is likely that nutritional status of COPD patients may impact the outcome of the disease. Deficient levels of vitamin D is common among COPD patients. The goal of this study is to further investigate a potential correlation between smoking and serum vitamin D levels as it influences COPD. The National Health and Nutrition Examination Survey (NHANES) 2007-2014 datasets were utilized for this study. A 10 ng/mL decrease in vitamin D₃ level was associated with an increased number of wheezing and whistling attacks (relative risk (RR) 1.33 (95% CI (1.03, 1.07), <I>P</I>=0.02). There was no evidence of an association between vitamin D₂ with the number of wheezing and whistling attacks. Although there was no evidence of an association between vitamin D₃ (either lower or higher levels) with bringing up phlegm and coughing, there was marginal evidence <I>P</I><0.1 of an association between vitamin D₂ with bringing up phlegm and coughing. Conclusion: This data confirmed the previous conclusion from an NHANES 2001-2006 investigation that smoking may still influence vitamin D₃ levels among women. Further research is necessary to better understand whether vitamin D₃ has a positive impact on respiratory health in women because they are more likely to be burdened by the symptoms of COPD.

A preliminary investigation of the clinical and cognitive correlates of circulating vitamin D in bipolar disorder

The role that vitamin D plays in the cognitive and clinical characteristics of bipolar disorder (BD) is unclear. We examined differences in the levels and deficiency status of vitamin D in an Australian sample of BD patients compared to healthy controls; and determined the extent to which vitamin D is associated with clinical variables and cognitive function in the sample. 22 healthy controls and 55 stable outpatients with a diagnosis of BD and low-grade mood symptomatology provided a sample of blood and completed cognitive tests and clinical measures. Plasma concentrations of 25-hydroxyvitamin D (vitamin D) were assayed and used to segregate participants into subgroups with sufficient or deficient levels of vitamin D. Subgroups were then compared in terms of global cognition and a range of sociodemographic and clinical factors (number of past mood episodes, illness duration, seasonal mood pattern, mood symptom severity), while mean levels of vitamin D were compared between patients and controls. Although almost 27% of the current sample were vitamin D deficient, no significant differences in mean vitamin D levels or the prevalence of vitamin D deficiency were evident between BD patients and controls. Vitamin D was not associated with global cognition in either patients or controls, nor any of the clinical measures assessed in the study.In conclusion, we observed no difference in the vitamin D levels and deficiency status of an Australian sample of healthy individuals and BD patients with low grade mood symptomatology compared to controls. Clinical symptoms and global cognition also appear to be independent of vitamin D levels in BD.

Orthopaedic Diagnoses in the Black Pediatric Population.

The Black pediatric population is one that has been historically underserved and continues to have unmet needs. Factors including lack of diversity in orthopaedic studies and in historical standards, such as bone age, may inadvertently lead to inferior care. There are certain conditions in this population for which the practicing orthopaedic surgeon should have a higher degree of suspicion, including slipped capital femoral epiphysis, Blount disease, and postaxial polydactyly. Systemic diseases with higher rates in this population have orthopaedic manifestations, including sickle cell disease, vitamin D deficiency, and obesity. Racial discrepancies in access to prenatal care can have orthopaedic consequences for babies, especially cerebral palsy and myelodysplasia. Racial discrepancy exists in evaluation for nonaccidental trauma. Increased awareness of these issues better prepares practitioners to provide equitable care.

Frequency of Vitamin D Deficiency and its Association with CP Class in Cases of Liver Cirrhosis

Objective: To find out the frequency of vitamin D deficiency and its association with CP class in cases of liver cirrhosis. Study Design: Cross sectional study. Place and Duration: Bahawal Victoria Hospital, Bahawalpur (From September 2021 to March 2022). Methodology: Total 195 cirrhotic patients of any etiology, 20-40 years of age both male and female were selected. Vitamin D deficiency and its association with CP class was assessed. Results: Mean age of cirrhotic patients was 38.46 ± 11.383 years. Out of 195 patients, vitamin D was deficient in 83 (43%) patients. Vitamin D deficiency was found in CP class A, B and C 7 (7.78%) patients, 13 (44.83%) patients and 63 (82.89%) patients respectively. CP class had significant (P = 0.000) association with vitamin D deficiency. Conclusion: In this study, higher proportion of cirrhotic patients had deficient levels of vitamin D. Most of the patients were between 20-40 years. A higher number of male patients had deficient levels of vitamin D. It is also concluded that vitamin D deficiency is significantly associated with CP class. Keywords: liver cirrhosis, CP class, vitamin D, hepatic osteodystrophy

Prenatal and child vitamin D levels and allergy and asthma in childhood.

Early-life vitamin D deficiency may impair immune system development contributing to allergy and asthma onset. Findings from prospective studies are inconsistent. To examine whether maternal and child vitamin D levels are associated with allergic and asthma-related symptoms throughout childhood in a Spanish birth cohort. 25-Hydroxyvitamin D3 (25(OH)D3) levels were measured in the serum of pregnant women (N = 2525) and children (N = 803). Information on allergic and asthma-related symptoms was obtained from repeated questionnaires from 1 to 9 years. A total of 19% of mothers and 24% of children had deficient 25(OH)D3 levels (<20 ng/ml). Higher child 25(OH)D3 levels at 4 years were associated with lower odds of atopic eczema from 4 to 9 years (adjusted odds ratio = 0.90; 95% CI = 0.84-0.97 per 5 ng/ml). Higher maternal and child 25(OH)D3 levels were associated with a lower prevalence of late-onset wheezing at the limit of statistical significance (adjusted relative risk ratio (RRRadj) = 0.86; 95% CI = 0.74-1.00 and RRRadj = 0.76; 95% CI = 0.58-1.02 per 5 ng/ml, respectively). All the remaining associations were null. Child 25(OH)D3 levels at pre-school age are associated with a reduced odds of atopic eczema in later childhood and both maternal and child levels may reduce the prevalence of late-onset wheezing. In this Spanish birth cohort, with a total of 19% of mothers and 24% of children with deficient levels of vitamin D, higher child vitamin D at 4 years of age was associated with reduced odds of atopic eczema up to 9 years. There was also some evidence that higher maternal and child vitamin D levels reduced the prevalence of late-onset wheezing. Although these findings need replication, they may imply optimal vitamin D levels at pre-school age to prevent atopic eczema.

Cardiovascular Risk after Kidney Transplantation: Causes and Current Approaches to a Relevant Burden.

Background. Cardiovascular disease is a frequent complication after kidney transplantation and represents the leading cause of mortality in this population. Material and Methods. We searched for the relevant articles in the National Institutes of Health library of medicine, transplant, cardiologic and nephrological journals. Results. The pathogenesis of cardiovascular disease in kidney transplant is multifactorial. Apart from non-modifiable risk factors, such as age, gender, genetic predisposition and ethnicity, several traditional and non-traditional modifiable risk factors contribute to its development. Traditional factors, such as diabetes, hypertension and dyslipidemia, may be present before and may worsen after transplantation. Immunosuppressants and impaired graft function may strongly influence the exacerbation of these comorbidities. However, in the last years, several studies showed that many other cardiovascular risk factors may be involved in kidney transplantation, including hyperuricemia, inflammation, low klotho and elevated Fibroblast Growth Factor 23 levels, deficient levels of vitamin D, vascular calcifications, anemia and poor physical activity and quality of life. Conclusions. The timely and effective treatment of time-honored and recently discovered modifiable risk factors represent the basis of the prevention of cardiovascular complications in kidney transplantation. Reduction of cardiovascular risk can improve the life expectancy, the quality of life and the allograft function and survival.

Prevalence of vitamin D insufficiency and deficiency among children with epilepsy

Background and aim The relation between vitamin D, the use of antiepileptic drugs (AEDs), and bone integrity has been found in patients with epilepsy. The aim of the work was to study the prevalence of vitamin D insufficiency and deficiency among children with epilepsy, and to identify some possible risk factors. Patients and methods A comparative cross-sectional study was done on randomly chosen 60 children with epilepsy aged 3–15 years attending the neurology out-patient clinic and 20 healthy age-matched and sex-matched children, attending the pediatric outpatient clinic at Alexandria University Children’s Hospital from September 2014 to March 2015. They were divided into three groups: group I included 40 children receiving AED monotherapy for more than 1 year; group II included newly diagnosed epileptic children before receiving medications; group III included 20 healthy children as controls. History taking included patients’ age, sex, seizure history, nutritional history, sunlight exposure, associated illness or drug intake and history of vitamin D or calcium supplementation. Clinical examinations were done (systematic and neurological examination, weight and BMI). Laboratory investigations [liver and kidney function tests, serum calcium, phosphorus, alkaline phosphatase, and serum 25-hydroxyvitamin D (25(OH)D) levels] were done. Electroencephalogram was done for groups I and II. Results There was no significant difference between all groups regarding age and sex. The BMI was significantly different between groups II and III. Laboratory tests (alanine aminotransferase, aspartate aminotransferase, urea, creatinine, serum calcium, phosphorus, and alkaline phosphatase levels) showed no significant differences between the three studied groups. The mean of 25(OH)D among children in group I was significantly lower compared with children in group III. Females were associated with insufficient and deficient levels of vitamin D. There were statistically significant relations between 25(OH)D levels and BMI and the duration of AED treatment in group I. Conclusion The present study provides evidence of the increased prevalence of vitamin D insufficiency and deficiency among newly diagnosed children with epilepsy and in those on treatment with AEDs. In addition, the study has indicated that female sex, high BMI, AED use (carbamazepine, Na valproate) and prolonged duration of treatment are risk factors for vitamin D insufficiency and deficiency.