Determination Of Serum Vitamin Research Articles

The Analysis of Serum Vitamin D (25[OH]D) Level in Psoriasis Patients Comparing with Control Subjects

Background: Vitamin D has been shown to have an immunomodulatory effect, and previous studies have proven that vitamin D deficiency contributed to several autoimmune diseases, including psoriasis. Purpose: The purpose of this study was to determine serum vitamin D levels in psoriasis vulgaris patients and compare them with control subjects. Methods: The research samples were sixteen adults with psoriasis vulgaris and 16 control subjects. Blood samples were taken, and the serum 25 (OH) D levels were measured using the Chemiluminescent Microparticle Immunoassay method. Result: The mean serum vitamin D in psoriasis vulgaris patients and controls were 14.36 ± 6.36 and 19.92 ± 7.59 ng/mL, respectively. No psoriasis vulgaris were observed in patients with normal 25(OH)D levels, and only 3 control subjects with normal serum 25(OH)D levels. These results were not statistically significant (p = 0.09). Conclusion: Most patients with psoriasis vulgaris were observed having vitamin D deficiency. However, the prevalence of vitamin D deficiency in the control subjects was high as well. Therefore, there were no differences in serum 25(OH)D levels between psoriasis vulgaris and control patients.

P547 Inadequate vitamin C status and association with inflammatory biomarkers in adults with active Crohn’s disease

Abstract Background Micronutrient deficiencies are common in inflammatory bowel disease (IBD) due to the inflammatory burden and changes in dietary intake. Vitamin C, an essential water-soluble antioxidant required for tissue repair and immune function, is found primarily in fresh fruit and vegetables however, this food group is more often avoided by people with IBD compared with the general population. This research aimed to determine serum vitamin C status in subjects with active Crohn’s disease, measure urinary vitamin C excretion in healthy controls (HC) and Crohn’s disease patients before and after exclusive enteral nutrition (EEN) and assess associations between inflammatory markers and vitamin C. Methods Stored serum and random urine samples prospectively collected from adults with mild to moderately active Crohn’s disease and adult HC were analysed. Both HC and Crohn’s disease groups received EEN with a known vitamin C content for two weeks. Serum and urinary vitamin C were measured using high-performance liquid chromatography with electrochemical detection. Urinary vitamin C was standardised to urinary creatinine. Non-parametric t-tests and correlations were performed. Results EEN was initiated in 38 patients (aged 16 to 39 years old). Inadequate serum vitamin C (<50 µmol/l) was present in 36/38 patients with active Crohn’s disease and 45% had hypovitaminosis C. Baseline C-reactive protein (CRP) was 12 mg/l (range, 3 to 158 mg/l) and faecal calprotectin was 1065 µg/g (range, 60 to 3838 µg/g). Serum vitamin C correlated weakly with CRP (r = −0.30 95% CI: −0.58 to 0.03, p = 0.06) but not with faecal calprotectin. Two weeks of EEN was completed by 30 (79%) patients and 17 (81%) HC. The average vitamin C intake was 168mg/day (range, 108–252 mg/day). Baseline urinary excretion of vitamin C was low in both Crohn’s disease and HC. Following EEN urinary vitamin C excretion increased significantly in both groups (Figure 1). Conclusion Patients with active Crohn’s disease had inadequate vitamin C status. EEN increased urinary vitamin C excretion in both Crohn’s disease and HC, suggesting low baseline dietary vitamin C intake and potentially enhanced utilisation. Further research with a larger patient cohort would provide a greater understanding of vitamin C metabolism in active Crohn’s disease.

Determination of serum vitamin D status of mothers and newborns and related outcomes

AbstractVitamin D deficiency (VDD) has been associated with severe adverse health outcomes during pregnancy is increasingly recognised as a public health concern and maternal and infant VDD is closely associated. The aim of this study was to evaluate the magnitude of VDD and associated factors in pregnant women and newborns in the postpartum period. A cross-sectional study was carried out in a total of 66 pregnant women at > 37 weeks of gestation and newborns at the Gaziantep University Faculty of Medicine, Department of Obstetrics and Gynecology in Gaziantep, Turkey. Demographic characteristics, 24-h dietary recalls, intake of food supplements were determined in pregnant women, maternal and newborn anthropometric measurements and serum (25-OHD) levels were assessed. Mean age (± SD) of pregnant women was 28.8 ± 6.9 years. Although Turkey has “National Vitamin D Supplementation Programme for Pregnant Women” only 33.3% of women had VD supplementation during pregnancy, not all in the recommended levels (1200 IU/day). Mean (± SD) serum 25(OH)D levels in pregnant women and cord blood of newborns were 17.3 ± 9.0 ng/mL [non-supplemented women (NSW): 16.5 ± 7.9 ng/mL; supplemented women (SW): 18.8 ± 11.0 ng/mL] and 16.6 ± 9.9 ng/mL [newborns of non-supplemented women (NNSW): 13.9 ± 8.7 ng/mL and newborns of supplemented women (NSW): 22.1 ± 10.1 ng/mL], respectively. Vitamin D severe deficiency (< 10 ng/dL) was noted in 22.7%, deficiency (11–19 ng/mL) 51.5%, insufficiency (20–29 ng/mL) 15.2% and sufficiency (≥ 30 ng/mL) 10.6% of the women whereas severe deficiency, deficiency, insufficiency and sufficiency respectively, were determined in 33.3%, 39.5%, 13.6% and 13.6% of newborns (NNSW vs NSW, p = 006, p < 0.05). Median serum VD levels of NSW were statistically higher than NNSW (p = 0.000, p < 0.05). Out of total, 86.4% of women were dressing traditionally covered, and had lower serum VD level (p = 0.049, p > 0.05). SW had higher median body weight (p = 0.026) and body mass index (BMI) (p = 0.036) levels than NSW (p < 0.05). No statistically significant differences were found between anthropometric measurements of NNSW and NSW groups, although birth weights of NNSW and NSW groups were determined as 3005.1 ± 456.1 g and 3153 ± 422.5 g (p > 0.05), respectively. Maternal serum vitamin D levels strongly were correlated with newborn levels. Maternal vitamin D deficiency is a great problem and “National Vitamin D Supplementation Programme for Pregnant Women and Infants” should be effectively implemented and monitored. Also fortification programme should be a national policy.

Vitamin B12 Deficiency among Boarding School Children from Seven Districts of Bhutan

Introduction: Bhutanese school children are vulnerable to vitamin B12 deficiency as outbreaks of micronutrient deficiency diseases have been a common occurrence. The study presents the status of vitamin B12 deficiency among boarding school children from those seven districts. Methods: A cross-sectional study was conducted to determine serum vitamin B12 level. Data and blood samples were collected from 448 boarding school children from the seven districts of Bhutan. Serum cobalamin levels were assessed and relationship between factors analyzed. Results: The study found that 64 % of the school children were found to have vitamin B12 deficiency. Adjusted Odds Ratio for the vitamin deficiency among boarding school children from lower secondary and higher secondary schools were 4.05 and 3.3 respectively, when compared to those from the primary school. Starches were the most commonly served foods in boarding schools, while the animal source foods were served twice or less in a month. Conclusion: The study found a high prevalence of Vitamin B12 deficiency among boarding school children from seven districts. Boarding school meals had very less frequency of animal source foods.

The Association between Cardiovascular Disease Risk Factors and 25-Hydroxivitamin D and Related Analytes among Hispanic/Latino Adults: A Pilot Study.

Although the association of vitamin D levels with cardiovascular risk profiles among Hispanics/Latinos has been studied, little is known about this association among Hispanics/Latinos with chronic conditions. This pilot study determined serum vitamin D and parathyroid hormone (PTH) levels in a sample of participants from the University of Illinois at the Chicago Cohort of Patients, Family and Friends (UIC Cohort) and examined their association with traditional cardiovascular disease risk factors. From July 2012 to June 2016, the UIC Cohort study enrolled and conducted clinical examinations on men and women ages 18 years and older, who had one or more diagnosed chronic diseases/conditions (excluding cancer). This pilot study sample included 40 participants from the six main Hispanic/Latino background groups in the United States, namely Dominican, Cuban, Puerto Rican, Mexican, Central American, and South American, and were grouped by Caribbean or mainland origin. No substantial differences were noted in the vitamin D-related measures by Hispanic/Latino background, but the PTH levels were somewhat higher in the Caribbean vs. mainland group (43.0 ± 4.6 vs. 38.6 ± 2.7 pg/mL). The associations between selected CVD risk factors (systolic and diastolic blood pressure (SBP, DBP), total cholesterol, glucose) and PTH and vitamin D-related analytes were investigated using interval-censored multivariate regression models adjusted for age, sex, percent body fat, serum albumin/calcium, and Hispanic/Latino background. A negative association between total 25[OH]D and blood pressure was corroborated (SBP: β = −1.2, 95%CI = −2.0, −0.3; DBP: β = −0.7, 95% CI = −1.2, −0.1), whereas a positive association with total cholesterol was observed (β = 1.9, 95% CI = 0.02, 3.7). Levels of 1, 25[OH]2D were not associated with CVD risk factors, whereas 24, 25[OH]2D3 was associated with blood pressure (SBP: β = −13.0, 95% CI = −20.7, −5.2; DBP: β = −6.3, 95% CI = −11.6, −1.0). Estimated free 25[OH]D was inversely associated with both SBP (β = −3.5, 95% CI = −6.1, −0.9) and DBP (β = −2.1, 95% CI = −3.8, −0.3). Similarly, calculated bioavailable 25[OH]D was inversely associated with both SBP (β = −9.2, 95% CI = −15.9, −2.4) and DBP(β = −5.3, 95% CI = −9.8, −0.8). In conclusion, a negative association between 25[OH]D with BP was observed and a positive association with lipids is suggested. Due to the small sample size, most associations did not reach statistical significance.

Case Report: Vitamin A Deficiency and Nyctalopia in a Patient with Chronic Pancreatitis

Vitamin A deficiency is a known concern in developing countries, but it is often overlooked in developed regions. A history of conditions causing alimentary malabsorption should be considered when patients present with complaints of nyctalopia. A case of vitamin A deficiency with nyctalopia in a patient with chronic pancreatitis including pertinent diagnostic testing, treatment, and management is presented. The intent is to draw attention to the condition as a differential diagnosis for nyctalopia due to increased prevalence of conditions causing malabsorption. A patient with a history of chronic pancreatitis and pancreatic tumor presented with symptoms of nyctalopia and xerophthalmia. Given his systemic history, testing was ordered to determine serum vitamin A levels and retinal function. After results had confirmed depleted vitamin A levels and diminished retinal function, treatment with both oral and intramuscular vitamin A supplementation was initiated to normalize vitamin A levels and improve retinal photoreceptor function. Subjective improvement in symptoms was reported shortly after beginning supplementation, and ultimately, vitamin A levels and retinal function showed improvement after intramuscular treatment. Detailed case history and a careful review of systems along with serum vitamin A testing and, if available, electroretinography to assess retinal function can help to make a definitive diagnosis. With appropriate comanagement with the patient's primary care physician, it is possible for those with nyctalopia to begin vitamin A supplementation and regain retinal function.

A variant in CYP2R1 predicts circulating vitamin D levels after supplementation with high-dose of vitamin D in healthy adolescent girls.

The determinants of serum vitamin D seems to be the environmental factors (dietary and supplementary intake and exposure to ultraviolet light) and genetic factors. We aimed to study the relationship between a vitamin D-associated genetic polymorphism and serum 25(OH)D concentrations in healthy adolescent girls in Iran, and its effects on a high-dose supplement of vitamin D. A total of 616 healthy adolescent girls with mean age 15 received 50,000 IU of vitamin D3 weekly over 9 weeks. Serum vitamin D levels and other metabolic factors were measured at baseline and after the intervention. The genotyping of the CYP2R1 variant (rs10741657) was performed by TaqMan genotyping assays. Regardless of the genetic background, at baseline, 87% of adolescent girls were vitamin D deficient (serum 25(OH)D level < 50 nmol/l). High-dose supplementation with VitD reduced the proportion of girls who were deficient substantially to about 24%. The genetic analysis revealed that although at baseline there was not a gene-vitamin D association ( p trend = 0.1), the response to supplementation appeared to be modulated by this variant ( p trend < 0.001). However, other anthropometric and biochemical measures were not affected by this intervention, over this short period. Serum 25(OH)D was increased in all participants although the carriers of the minor A allele seemed to be better responders so that the percentages of the change serum vitamin D in the holder of AA and AG genotypes were 539.4 ± 443.1 and 443.7 ± 384.6, respectively, compared with those with common GG genotype (363.3 ± 354.0). Our regression analysis revealed that the probability of an increase in serum 25(OH)D in a participant with AA genotype was 2.5-fold greater than those with a GG genotype (OR = 2.5 (1.4-4.4); p value = 0.002). Based on our findings, it appears that the rs10741657 variant of the CYP2R1 gene modulates the response to high-dose of vitamin D supplementation.

The comparison of serum biomarker sin patients with osteoarthritis and rheumatoidarth ritis

Introduction: This study aims to assess the status of serum vitamin D, parathyroid hormone, type II collagen, calcium, phosphate, albumin, and alkaline phosphatase in osteoarthritis and rheumatoid arthritis patients and to study their association with rheumatoid arthritis disease activity. Materials and Methods: This prospective cross-sectional study was conducted at the clinical analysis department, College of Pharmacy, Hawler Medical University in 2017. They study samples were collected at Rizgary Teaching Hospitalduring the period September 2015 to January 2016. A total of (N=156) participants were included: (N=53) patients with rheumatoid arthritis (RA), (N=53) with osteoarthritis (OA), and (N=50) healthy controls. Enzyme Linked Immuno Sorbent Assay kits determined serum vitamin D, parathyroid hormone, and type II collagen; and serum albumin, calcium, phosphate and alkaline phosphatase, were determined by standard colorimetric methods. Results: and Discussion: Statistically significant higher levels of parathyroid hormone and type II collagen, with lower levels of Vitamin D, were found in the osteoarthritis group than the rheumatoid arthritis group and the healthy controls (P=0.007, P&lt;0.001, P= 0.005) respectively. Multiple linear regression showed a statistically significant difference in serum type II collagen as a dependent variable, inpatients suffering from RA or OA compared to the healthy control group; after adjusting for the effect of other independent study variables, there was a mean increase of (45.90 nmol/L, P&lt;0.001) in RA patients, and OA patients showed greater levels of type II collagen (73.950 nmol/L) than the health control group (P&lt;0.001).Conclusions: Elevated type II collagen levels, in conjunction with a low vitamin D status, may be strong discriminator between osteoarthritis and rheumatoid arthritis patients.

Serum levels of vitamin A and 25-hydroxyvitamin D3 (25OHD3) as reflectors of pulmonary function and quality of life (QOL) in children with stable asthma: A case-control study.

Background:This study aims to explore the relationship between serum vitamin A and 25-hydroxyvitamin D3 (25OHD3) levels with pulmonary function and quality of life (QOL) in children with stable asthma.Methods:A total of 117 cases of children with stable asthma were assigned into the case group and 129 healthy children underwent physical examination during the same period into the control group. Electrochemiluminescence was employed to determine serum vitamin A and 25OHD3 levels. The children with stable asthma were further divided into the mild, moderate, and severe groups according to their degree of asthma. A pulmonary function meter was used to assess the pulmonary function indexes: percentage of forced expiratory volume in 1 sec/predictive value (FEV1%pred), forced vital capacity (FVC), forced expiratory volume in 1 sec/forced vital capacity (FEV1/FVC), peak expiratory flow (PEF), and maximal voluntary ventilation (MVV). The children's quality (QOL) of life with asthma was evaluated by their activities of daily living (ADLs) and Medical Research Council (MRC) scores. Pearson correlation analysis was applied to analyze the correlations of serum vitamin A and 25OHD3 levels with FEV1%pred, FVC, FEV1/FVC, PEF, MVV, ADL, and MRC.Results:Serum vitamin A and 25OHD3 levels were lower in children with stable asthma than those who were in the control group (P < .05). The severe group showed the lowest FEV1%pred, FVC, FEV1/FVC, PEF, MVV, and ADL scores, and the highest MRC score compared to the mild and moderate groups (all P < .05). Serum vitamin A and 25OHD3 levels were positively correlated with pulmonary function and ADL score in children with stable asthma, while serum vitamin A and 25OHD3 levels were negatively correlated with MRC score (all P < .05). In the case group, serum vitamin A and 25OHD3 levels were positively correlated with serum calcium and phosphorus levels (all P < .05).Conclusion:These findings indicate that increased serum vitamin A and 25OHD3 levels reflect good pulmonary function and good QOL in children with stable asthma.

Albumin and Serum Vitamin A Status of Malnourished Children

Malnutrition remains a major health problem in the third world countries, and is a key factor to the high death rate among children below five years old. This study aimed to determine serum vitamin A, mid-upper arm circumference (MUAC), and albumin levels of malnourished children and their well-fed counterparts. A total of one hundred (100) children comprising of fifty (50) malnourished children under the age of five years and fifty (50) well-fed age-matched children were recruited into this study. Mid upper arm circumference (MUAC) measurement was used to categorize the children into malnourished and the well-fed groups. The malnourished were further classified into kwashiorkor and marasmic cohorts. Serum vitamin A and albumin levels were determined by colorimetric methods. Data were analyzed using SPSS version 20.0 statistical package, differences between and variations among groups were determined by Student’s t-test and ANOVA respectively while the association between variables by Pearson’s correlation. Differences were considered statistically significant at p≤0.05. Serum vitamin A, MUAC and albumin levels of the well-fed group were significantly higher (p<0.05) than those of the malnourished. Comparing the well-fed, the kwashiorkor and the marasmic groups, the mean serum vitamin A, MUAC and albumin of the well-fed were significantly higher (p=0.001) than those of the kwashiorkor and marasmic groups. Mean albumin level of the kwashiorkor was significantly lower (p<0.05) than that of marasmic group. Mean MUAC of the kwashiorkor subjects was significantly higher (p<0.05) than that of the marasmic subjects. Serum vitamin A was not significantly different (p=0.724) between the kwashiorkor and the marasmic groups. In the marasmic subjects mean serum vitamin A correlates negatively with albumin (r= -0.517, p=0.011). In the kwashiorkor subjects, serum vitamin A correlates negatively with albumin (r=-0.080, p=0.690). In the well-fed children, serum vitamin A correlates positively with albumin (r=0.340, p=0.016). Conclusion: malnourished children with kwashiorkor and marasmus have lower albumin, serum vitamin A and MUAC compared with the well-fed children.

Prognostic evaluation of vitamin D deficiency in breast cancer patients: a pilot study in India

Background : Vitamin D deficiency has been associated with poor prognosis in breast cancer. A new molecular classification of breast cancer is being increasingly used that is based on expression of estrogen receptors, progesterone receptors and Her2/neu amplification and is found to correlate well with prognosis and outcome of disease. The present study was designed to determine serum vitamin D deficiency in these molecular subtypes of breast cancer. Methods: Estimation of serum vitamin D levels by chemiluminiscence was done in a cohort of 99 breast cancer patients and 25 age matched healthy controls. Breast cancer patients were further grouped into luminal A, luminal B, Her2/neu enriched and triple negative subtypes based on immunohistochemistry results. Non-parametric tests were performed to compare vitamin D levels in different groups. Results: 54.6%, 60%, 66.6% and 84.2% of patients with luminal A, luminal B, Her2/neu enriched and triple negative subtypes respectively were found to be vitamin D deficient (<20ng/mL) as compared to only 20% in healthy controls. More aggressive Her2/neu enriched and triple negative subtype patients had significantly lower serum vitamin D levels than the luminal subtypes of breast cancer. Conclusion: Vitamin D deficiency is more prevalent and significantly lower levels are found in more aggressive subtypes of breast cancer. Vitamin D supplementation must be considered in these forms of breast cancer to improve outcome.

Serum vitamin A levels among malnourished children aged 6 - 59 months in Zaria

Background : Vitamin A deficiency (VAD) affects an estimated 6 million pre-school children in Nigeria and 20 million in Africa. When associated with severe malnutrition, it significantly increases morbidity and mortality. Objectives : To determine serum vitamin A levels in children with Protein Energy Malnutrition and age and sex prevalence of vitamin A deficiency among children with Protein Energy Malnutrition and controls at the institute of Child Health ABUTH Zaria. Method : This was a case-control hospital-based descriptive study carried out at the Institute of Child Health (ICH) Banzazzau, Zaria. Systematic sampling method was adopted to select undernourished children aged 6-59 months for the study. Serum vitamin A level was analysed by High Performance Liquid Chromatography. The frequency of values below a cut off, usually taken as 0.70 μmol/L (20 μg/ dl ) for low and 0.35 μmol/L (10 μg/dl) for deficiency. Data was analysed using the Statistical Programme for Social Sciences version 15.4. Results : In this study, 132 children (66 cases and 66 controls) aged 6-59 months were studied. Among the cases, all were wasted, out of which 13 (19.7%), 9 (13.6%) and 44 (66.7%) had mild, moderate and severe wasting. Similarly, all the cases were stunted with the severity ranging from mild, 11 (16.7%), moderate, 19 (28.8%) and severe, 36 (54.5%). All the controls were nutritionally normal. Twenty six (39.4%) and 30 (45.5%) were males while 40 (60.6%), 36(54.2%) were females (M:F= 1:1.5 and 1:1.2) among cases and controls respectively. Low serum vitamin A levels among the cases was 16.7%. VAD was seen only in those with severe wasting (5%). Malnourished females aged 13-24 months and males aged 49-59 months for the controls were more at risk of low vitamin A levels. Children who had measles, persistent diarrhoea, low maternal educational levels and low social class were at a higher risk of having low serum vitamin A levels Conclusion : This study has been able to establish low vitamin A levels among both undernourished and controls in Zaria. This is of public health significance.

Abstract B09: Serum vitamin D levels in breast cancer patients to assess its risk prediction to improve health

Abstract Introduction: In the field of cancer, vitamin D has emerged as the most creative research connecting it with risk reduction in various epithelial cancers. Aside from calcium homeostasis, vitamin D exerts a wide range of immunogenic and antiproliferative activities in the human body. Vitamin D exerts its antiproliferative outcome by binding to vitamin D receptor (VDR) found in various tissues and cells of the body. Several human genes contain vitamin D response elements (specific DNA sequences) that encode for proteins important in regulation of cell proliferation, differentiation, apoptosis, and angiogenesis. When the serum vitamin D levels are suboptimal these activities are impaired and as a result enhanced cellular growth, neo-angiogenesis, and cancer development takes place. The breast cells have VDRs in their nuclei and it is postulated that polymorphism of genes for these VDRs results in increased risk for breast cancer. Serum concentration of 25(OH) 2 D are more sensitive to exogenous sources like: dietary and supplemental intake and endogenous production through synthesis in the skin of vitamin D which is the best indicator of vitamin D status of the body. There are data showing that locally advanced breast cancer patients had more severe vitamin D deficiency than those with early stage disease. The aim of the study was to determine serum vitamin D levels in breast cancer patients related with grade and stage of the tumor and to assess its risk prediction to improve health. Materials and Methods: Study samples: The study was conducted on indoor and outdoor patients for a period of one year (January to December), and an equal number of age and sex matched controls were taken which included total of 500 adults. Clinical Aassessment: Body mass index (BMI) was categorized as normal weight (&amp;lt;24 kg/m2), overweight (24-28 kg/m2) and obese (&amp;gt;28 kg/m2), fasting blood glucose (60 to 100 mg/dl) and Glycosylated Hemoglobin (controlled&amp;lt;7% and &amp;gt;7% uncontrolled). Vitamin D nutritional status was based on 25(OH) D levels, which were assessed as mild/sufficient (30-50 nmol/L), moderate/insufficient (12.5-29.9 nmol/L), and severe/deficient (&amp;lt;12.5 nmol/L). Results: The mean age was 42±1.5 years. Age, marital status, menopausal, residential area and BMI were similar in distribution among cases and controls. The mean serum vitamin D level in the breast cancer patients was &amp;lt;12.5 nmol/L and in the control group was 36.9 nmol/L (P value &amp;lt;0.001). Vitamin D deficiency was seen in 97.6% breast cancer patients and in 69.3% of the control group (P value &amp;lt;0.001). Among the breast cancer patients the tumor characteristics (histology, grade, stage, and receptor status) did not show any significant associations with serum levels of vitamin D. Premenopausal breast cancer females had a mean serum vitamin D level of 11.1 nmol/L and postmenopausal females had a mean value of 15.65 nmol/L (P value 0.015). Low BMI did not correlate significantly with vitamin D deficiency (P value 0.787). Conclusion: Invariably almost all patients with breast cancer were vitamin D deficient. Tumor characteristics and BMI did not show any significant associations with serum levels of vitamin D. Note: This abstract was not presented at the conference. Citation Format: Vinit Mehrotra, Ashutosh Sharma. Serum vitamin D levels in breast cancer patients to assess its risk prediction to improve health. [abstract]. In: Proceedings of the AACR Special Conference: Improving Cancer Risk Prediction for Prevention and Early Detection; Nov 16-19, 2016; Orlando, FL. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2017;26(5 Suppl):Abstract nr B09.

High Prevalence of Vitamin D Deficiency in Patients With Bone Marrow Edema Syndrome of the Foot and Ankle.

Bone marrow edema syndrome (BMOS) is a phenomenon primarily affecting the lower extremity. It is characterized by a sudden onset of pain and an ill-defined osseous hyperintense signal in magnetic resonance imaging. The main cause of BMOS is still largely unknown. Its pathophysiology is presumably multifactorial and it has recently been demonstrated that it usually involves an increase in bone turnover and alterations within the bone microenvironment. Vitamin D plays a pivotal role in maintaining a healthy and well-balanced bone microenvironment. However, to date only limited information has been reported on vitamin D status in patients with BMOS. Moreover, it is still uncertain whether hypovitaminosis D is associated with the etiology and course of the disease. For this reason, the aim of this study was to determine serum vitamin D levels (25(OH)D) of patients diagnosed with BMOS of the foot and ankle. Patients were identified and laboratory results collected by retrospective review of the medical records between year 2011 and 2015. Diagnosis was based on clinical examination, the existence of prolonged foot pain, the presence of abnormal bone marrow signal intensity in T1- and T2-weighted magnetic resonance imaging, and the patient's medical history. All patients who demonstrated other concomitant diagnoses were excluded from the study. Overall, 31 patients were affected by BMOS with a mean age of 44.4 (range, 18-76) years. Notably, 84% of patients (26/31) had low vitamin D levels with a mean 25(OH)D level of 19.03 ng/mL. Specifically, 61% of patients (19/31) were vitamin D deficient, 23% (7/31) vitamin D insufficient, and only 5 patients (16%) had sufficient vitamin D levels. Statistical analysis showed no significant difference comparing vitamin D levels with patient age, sex, and time of diagnosis. Moreover, there was no correlation between vitamin D status and the number of bony foci or location of BMOS. We found a widespread rate of vitamin D deficiency in patients presenting with BMOS of the foot and ankle. Comparing these data to the vitamin D status of the general population in Germany and to patients living in comparable latitudes, this raises the possibility that BMOS might be associated with low vitamin D status. Level IV, retrospective case series.

Serum Vitamin D and Prostate Cancer Prognosis: The Story Continues.

data that hypovitaminosis D is a reliable prognostic parameter or that the outcome of patients with PC might be improved by vitamin D supplementation. Several drawbacks hamper the clinical interpretation of serum vitamin D levels in cancer: the hormonal activity of vitamin D is mediated by its binding to vitamin D receptor (VDR) within the cell nuclei, and both VDR expression and VDR polymorphisms reflect the individual susceptibility to vitamin D action 3 ; and hypovitaminosis D is associated with secondary hyperparathyroidism, which could have contributed tothe negative prognostic features observed. Parathyroid hormone (PTH), in fact, is similar to PT-related peptide, which is a potent growth factor, and both PTH and PT-related peptide interact with the same receptor that is expressed by PC cells. 4 In the study by Nyame et al, 1 neither tissue VDR and its relevant polymorphisms nor serum PTH were measured; therefore, information on the interaction between vitamin D status and these important biologic parameters is lacking. Moreover, the assays to determine serum vitamin D levels are not standardized, and a significant variability among methods and laboratories was reported. 5 This further complicates the application of the results of the Nyame et al 1 study to clinical practice. In their discussion, Nyame et al 1 stated that patients with PC with intermediate risk may benefit, in terms of disease outcome, from the normalization of vitamin D levels. In principle, we agree with the authors that future studies are warranted to assess the efficacyofvitaminD supplementationin terms ofPC aggressiveness. However, caution should be taken in administering vitamin D to patients with PC outside a clinical trial. In fact, the results of a prospective phase III clinical trial testing the efficacy of high-dose calcitriol plus docetaxel versus single-agent docetaxel in men with castrate-resistant metastatic PC showed a shorter survival in the vitamin D arm compared with the control arm. 6

Associations of Serum Vitamin D Level with Dental Caries in Korean Adults

Background: A few studies have revealed the associations between serum vitamin D level and dental caries in the general population. The present study was conducted to elucidate the association between serum vitamin D level and dental caries using the 6th Korean National Health and Nutrition Examination Survey (KNHANES). Methods: This study included Korean adults aged 19 years and older who participated in the KNHANES (VI-1) and underwent dental check-ups for determination of serum vitamin D levels. The associations between the serum vitamin D levels and the number of men with a serum vitamin D level 20 ng/mL. Results: The serum vitamin D level was significantly lower in women than in men (P 20 ng/mL of serum vitamin D (β=0.224, P=0.041; β=0.676, P=0.046, respectively). The number women with a serum vitamin D level 30 ng/mL. Conclusion: The results of the present study suggest that in Korean adults, serum vitamin D deficiency in men and insufficiency in women are significantly associated with dental caries. Further prospective studies are warranted to determine the causal relationship between serum vitamin D levels and dental caries.

Low Serum Vitamin C Status Among Pregnant Women Attending Antenatal Care at General Hospital Dawakin Kudu, Northwest Nigeria.

Background:Vitamin C levels are low in pregnancy. The purpose of this study was to determine serum Vitamins C levels among pregnant women attending antenatal care at a General Hospital in Dawakin Kudu, Kano, and this can help further research to determine the place of Vitamin C supplementation in pregnancy.Methods:This was a prospective study of 400 pregnant women who presented for antenatal care in General Hospital Dawakin Kudu, Kano, Nigeria. Research structured questionnaire was administered to 400 respondents. Determination of serum Vitamin C was done using appropriate biochemical methods.Results:Vitamin C deficiency was found in 79.5% of the participants. The values for Vitamin C were 0.20 ± 0.18 mg/dl during the first trimester, 0.50 ± 0.99 mg/dl in the second trimester, and 0.35 ± 0.36 mg/dl in the third trimester and P = 0.001.Conclusions:There is a significant reduction in the serum Vitamins C concentration throughout the period of pregnancy with the highest levels in the second trimester. Therefore, Vitamin C supplementation is suggested during pregnancy, especially for those whose fruit and vegetable consumption is inadequate.

Serum vitamin D and colonic vitamin D receptor in inflammatory bowel disease.

To determine serum vitamin D levels and colonic vitamin D receptor (VDR) expression in inflammatory bowel disease (IBD) and non-IBD patients and correlate these with histopathology. Puerto Rican IBD (n = 10) and non-IBD (n = 10) patients ≥ 21 years old scheduled for colonoscopy were recruited. Each patient completed a questionnaire and provided a serum sample and a colonic biopsy of normal-appearing mucosa. For IBD patients, an additional biopsy was collected from visually diseased mucosa. Serum vitamin D levels were measured by ultra-performance liquid chromatography and mass spectrometry. Hematoxylin and eosin stained tissue sections from colonic biopsies were classified histologically as normal or colitis (active/inactive), and scored for the degree of inflammation present (0-3, inactive/absent to severe). Tissue sections from colonic biopsies were also stained by immunohistochemistry for VDR, for which representative diagnostic areas were photographed and scored for staining intensity using a 4-point scale. The IBD cohort was significantly younger (40.40 ± 5.27, P < 0.05) than the non-IBD cohort (56.70 ± 1.64) with a higher prevalence of vitamin D deficiency (40% vs 20%, respectively) and insufficiency (70% vs 50%, respectively). Histologic inflammation was significantly higher in visually diseased mucosa from IBD patients (1.95 ± 0.25) than in normal-appearing mucosa from control patients (0.25 ± 0.08, P < 0.01) and from IBD patients (0.65 ± 0.36, P < 0.05) and correlated inversely with VDR expression in visually diseased colonic tissue from IBD patients (r = -0.44, P < 0.05) and from IBD patients with Crohn's disease (r = -0.69, P < 0.05), but not in normal-appearing colonic tissue from control patients or IBD patients. Control and IBD patient serum vitamin D levels correlated positively with VDR expression in normal colon from control and IBD patients (r = 0.38, P < 0.05) and with patient age (r = 0.54, P < 0.01). Levels of serum vitamin D correlate positively with colonic VDR expression in visually normal mucosa whereas inflammation correlates negatively with colonic VDR expression in visually diseased mucosa in Puerto Rican patients.

Vitamin D status in pediatric osteoarticular tuberculosis.

Tubercular patients, in general, have been demonstrated with lower serum levels of vitamin D, but the levels in osteoarticular tuberculosis (TB) in children are largely unknown. We aimed to determine serum vitamin D status in pediatric cases with osteoarticular TB. The values of serum vitamin D were estimated in 100 children with osteoarticular TB. The patients were divided into three groups based on gender, age, and site to assess variations of vitamin D levels in pediatric osteoarticular TB. Hypovitaminosis D was associated with active osteoarticular TB in children. The mean vitamin D levels were 42.165nmol/L. There were no statistical difference between mean vitamin D levels in boys and girls (p value=0.6143); age groups <5 and 5-12 years (p value=0.3857); or spinal and non-spinal osteoarticular groups (p value=0.8350). Active osteoarticular TB in children was also associated with hypovitaminosis D. The correlation between hypovitaminosis D and osteoarticular TB appears to be more disease specific rather than host specific.

Detection of Vitamin (D) deficiency in children and adolescents suffering from bronchial asthma in Suez Canal University Hospital, Ismailia

Background: Recent data suggest that there is a worldwide epidemic of vitamin D deficiency and lack of vitamin D has been linked to increased incidence of asthma and increased severity of asthma in children. Therefore, the examination of relationship between vitamin D and bronchial asthma was important. Objective: To determine serum vitamin D level in children and adolescents suffering from bronchial asthma and to detect the relationship between vitamin D level and asthma severity symptoms. Methods: This case–control study was conducted on 40 asthmatic children and adolescents, their ages ranged from 2-18 years who were attending to pediatric department at Suez Canal University Hospital, and were previously diagnosed as bronchial asthma according to the National Asthma Education and Prevention Program (NAEPP) 2007. In addition, 40 age and sex matched healthy children served as a control group. All children were subjected to history taking, clinical examination, including; anthropometric measurements, and chest examination. Serum levels of 25-hydroxyvitamin D (25OHD)[25(OH) D], total IgE level, and peripheral blood eosinophil count were evaluated. Results: The mean age of studied asthmatic children was 5.14±2.87 years. Asthma was more reported in girls than boys (55% and 45% respectively). Asthma prevalence was higher in urban than rural areas. In our study, asthmatic patients had significantly lower vitamin D levels than controls. We found that vitamin D insufficiency in 35% of studied asthmatic children. There was a statistically significant negative correlation between vitamin D level and the severity of asthma (p <0.001). Conclusion: Vitamin D deficiency is relatively frequent in asthmatic patients who were attending the pediatric department at Suez Canal University Hospital. There was a significant inverse relationship between vitamin D levels and the severity of asthma symptoms. Keywords: Children, adolescences, bronchial asthma, vitamin D