Excess Vitamin Research Articles

The Role of Single Oral Dose of Excess Vitamin A and/or Vitamin E in Improving Ovarian Function Three Days Post-parturition in Primiparous Dairy Cows

The Role of Single Oral Dose of Excess Vitamin A and/or Vitamin E in Improving Ovarian Function Three Days Post-parturition in Primiparous Dairy Cows

Social Media as a Tool to Directly Address Misinformation in Health Care and Promote Patient Education

Social media plays an important role in the lives of many, including cancer patients. A majority of cancer patients rated the internet as their most important source of information, and many joined social media as a result of their diagnosis. Most online platforms health care information has not been vetted by healthcare professionals. Although readily available and easy to access, the questionable accuracy of this information poses risks for patients. We aim to assess the feasibility of an online platform led by health care professionals to engage cancer patients on social media to directly address misinformation through targeted patient education. We hypothesized that social media-based cancer information will be a well utilized tool that cancer patients could engage with for information and support regarding their diagnosis. A social media-based campaign called Cancer Real Talk was initiated on Instagram and TikTok, and a corresponding website for the campaign was launched. Topics were identified based on anecdotal experience with patient misconceptions of care and included the role of palliative care, relationship between cancer and sugar, clinical trials, patient radioactivity, cancer screenings, risks associated with excess vitamin intake, and surgery for lung cancer. Video reels were reviewed by two physicians and published with corresponding text on the two social media platforms with the goal of providing factual and relatable information. Metrics including views and "likes" were gathered based on available data on each platform at 1 day, 1 week, 1 month, and long-term (>3 months) data points. Between July 2022 and January 2023, a total of seven posts were disseminated through both platforms. Views and likes TikTok and Instagram, respectively, are located in Table 1 with Instagram data bolded. At the last check, the Instagram and TikTok accounts had 272 and 231 followers, respectively. Our posts confirmed engagement with social media users and this educational initiative. Variable engagement highlights the need for increased understanding of how and where to engage with patients on social media. Health care outreach and education has the potential to help patients address misinformation and better navigate their cancer care, which is often quite daunting and complex. Future directions include patient collaboration.

Analysis and correction of diets of overweight and obese women

The proposed study is important and relevant in view of the increasing level of obesity in the world. Preventive interventions are important to reduce long-term health care costs and improve overall population health as health care systems struggle with the financial burden of obesity-related diseases.
 Hypodynamia and obesity act as predictors of the development of atherosclerosis and metabolic syndrome. It is worth noting that the level of vitamin D in blood serum affects the development of the risk factors listed above. Research results demonstrate an inverse relationship between the level of 25-hydroxyvitamin D in blood serum and the development of obesity, metabolic syndrome, and insulin resistance.
 As part of a prospective randomized controlled trial, 106 women aged 19 to 68 years (mean age 43.66±5.02 years) who had a BMI of 25 kg/m2 or higher were examined. Measures (weight, body mass index, 25(OH)D) were assessed at the start of the study and every four weeks to monitor development and dietary compliance for 6 months. After six months of individual dietary adjustments, body weight and BMI were significantly reduced. Participants reduced their weight on average by 7.13±0.78 kg and 2.53±0.19 kg/m2 (p<0.001). Individualized dietary adjustments resulted in significant weight loss, highlighting the value of individualized dietary interventions for effective weight management. A link between excess body weight and vitamin D deficiency has been established.

Scientific opinion on the tolerable upper intake level for vitamin D, including the derivation of a conversion factor for calcidiol monohydrate.

Following two requests from the European Commission (EC), the EFSA Panel on Nutrition, Novel Foods and Food Allergens (NDA) was asked to deliver a scientific opinion on the revision of the tolerable upper intake level (UL) for vitamin D and to propose a conversion factor (CF) for calcidiol monohydrate into vitamin D3 for labelling purposes. Vitamin D refers to ergocalciferol (vitamin D2), cholecalciferol (vitamin D3), and calcidiol monohydrate. Systematic reviews of the literature were conducted to assess the relative bioavailability of calcidiol monohydrate versus vitamin D3 on serum 25(OH)D concentrations, and for priority adverse health effects of excess vitamin D intake, namely persistent hypercalcaemia/hypercalciuria and endpoints related to musculoskeletal health (i.e. falls, bone fractures, bone mass/density and indices thereof). Based on the available evidence, the Panel proposes a CF for calcidiol monohydrates of 2.5 for labelling purposes. Persistent hypercalciuria, which may be an earlier sign of excess vitamin D than persistent hypercalcaemia, is selected as the critical endpoint on which to base the UL for vitamin D. A lowest-observed-adverse-effect-level (LOAEL) of 250 μg/day is identified from two randomised controlled trials in humans, to which an uncertainty factor of 2.5 is applied to account for the absence of a no-observed-adverse-effect-level (NOAEL). A UL of 100 μg vitamin D equivalents (VDE)/day is established for adults (including pregnant and lactating women) and for adolescents aged 11-17 years, as there is no reason to believe that adolescents in the phase of rapid bone formation and growth have a lower tolerance for vitamin D compared to adults. For children aged 1-10 years, a UL of 50 μg VDE/day is established by considering their smaller body size. Based on available intake data, European populations are unlikely to exceed the UL, except for regular users of food supplements containing high doses of vitamin D.

Effects of Dietary Vitamin D3 Over-Supplementation on Broiler Chickens' Health; Clinicopathological and Immunohistochemical Characteristics

Introduction: Vitamin D3 is used as a supplement in the feeds of livestock, pets, and human infants. However, the presence of excessive Vitamin D3 has been shown to cause toxicity in humans and animals. This study investigated the clinicopathological aspects of Vitamin D3 toxicity in broiler chickens. Materials and methods: The median lethal dose (LD50) of Vitamin D3 was estimated by the up-and-down method. To determine long term (21 days) toxic effects of oral Vitamin D3 supplementation, 90 (14-day-old) IBL-80 unsexed chicks were randomly divided into three groups as group A (control, received basal diet), B (basal diet + Vitamin D3 at 16.67 mg/kg body weight daily), and C (basal diet + Vitamin D3 at 33.33 mg/kg body weight daily). Results: The findings indicated that broiler chickens tolerated a single oral dose of Vitamin D3 up to 550 mg/kg body weight (22,000,000 IU/kg) without mortality. The results of long-term (21 days) oral supplementation of divided doses of Vitamin D3 in broiler chickens (groups B and C) showed progressive emaciation, elevated hemoglobin, hypercalcemia, hypophosphatemia, and increased alkaline phosphatase activity. At necropsy, pale liver and kidneys, congestion and hardening of lungs, mild congestion in the brain, and soft bones were observed in Vitamin D3 treated chicks (groups B and C). Microscopically, degeneration and metastatic calcification in lung parenchyma and peribronchiolar epithelium, coagulative necrosis and calcification in kidneys, and calcification with fibroplasia in proventriculus was detected. Lungs and kidneys showed a significant difference in calcification score between groups B and C. Broiler chickens from Vitamin D3 treated groups (B and C) showed strong immunohistochemical expression of Calbindin D28K in the intestine and kidneys but weak expression in the lungs. Conclusion: This study demonstrates that broiler chicks can tolerate very high levels of a single oral dose of Vitamin D3. Toxic effects of prolonged exposure to Vitamin D3 are due to over-expression of Calbindin D28k in the intestine and kidneys, disturbing the calcium and phosphorous homeostasis and leading to metastatic calcification of vital organs. This study supports that prolonged over-supplementation of Vitamin D3 causes toxic effects; hence, appropriate dietary Vitamin D3 supplementation limits should be set.

Vitamin E Increases Leydig Cells and Testosterone in Rats with Excessive Exercise

Background. Excessive exercise increases oxidative stress, which affects cell damage, including Leydig cells. Damage to Leydig cells leads to a drop in testosterone levels. Vitamin E is known to protect spermatogenesis by inhibiting Leydig cell apoptosis and lipid peroxidation. This study investigates vitamin E efficacy in increasing Leydig cells count and testosterone levels in male Wistar rats exposed to excessive physical exercise. Methods. Thirty-six male Wistar rats were divided into the control and treatment groups in this posttest-only control group experimental study. The control group was a group that received excessive exercise and 1 ml/day of distilled water once daily. The treatment group was a group that received excessive exercise and vitamin E (20 mg/day) dissolved in distilled water up to 1 ml once daily. Excessive exercise in this study was swimming ≥ 60 minutes a day in an 80 cm x 50 cm pool with 60 cm deep. After 40 days; Leydig cells number and testosterone levels were examined and compared between groups. Results. Leydig cells' mean value in the treatment group was 2.6 times higher than the control (10.23±0.73 vs. 3.83±0.67; p<0.001). For testosterone levels, the mean value was 2.3 times higher in the treatment group compared to control (11.42±0.27 ng/mL vs. 4.94±0.21 ng/mL; p<0.001). Conclusions. Oral administration of vitamin E (20 mg/day) for 40 days increased Leydig cell number and testosterone levels in Wistar rats with excessive physical exercise compared to controls. Vitamin E might be considered a treatment for male Keywords: antioxidant; exercise; testosterone; vitamin E

Vitamin A: too good to be bad?

Vitamin A is a micronutrient important for vision, cell growth, reproduction and immunity. Both deficiency and excess consuming of vitamin A cause severe health consequences. Although discovered as the first lipophilic vitamin already more than a century ago and the definition of precise biological roles of vitamin A in the setting of health and disease, there are still many unresolved issues related to that vitamin. Prototypically, the liver that plays a key role in the storage, metabolism and homeostasis of vitamin A critically responds to the vitamin A status. Acute and chronic excess vitamin A is associated with liver damage and fibrosis, while also hypovitaminosis A is associated with alterations in liver morphology and function. Hepatic stellate cells are the main storage site of vitamin A. These cells have multiple physiological roles from balancing retinol content of the body to mediating inflammatory responses in the liver. Strikingly, different animal disease models also respond to vitamin A statuses differently or even opposing. In this review, we discuss some of these controversial issues in understanding vitamin A biology. More studies of the interactions of vitamin A with animal genomes and epigenetic settings are anticipated in the future.

Normal 24-hour urine calcium concentrations after long-term daily oral intake of vitamin D in doses ranging from 5000 to 50,000 international units in 14 adult hospitalized psychiatric patients

Many controversies exist regarding vitamin D3 supplementation. These include not only diseases that are responsive to vitamin D supplementation, but also the long-term safety of prolonged daily oral vitamin D3 intake above 4000–10,000 International Units (IU). In particular, supplementation levels that do not result in adverse events, and the upper limits of safe serum 25-hydroxyvitamin D (25OHD) concentrations. Adverse reactions reported to occur with excessive vitamin D intake include hypercalcemia, renal failure, calcium crystal formation, undetectable parathyroid hormone concentrations, and hypercalciuria, all of which are reported to be reversible. To address the long-term safety of vitamin D supplementation, we previously reported data from patients in our hospital who have been voluntarily supplemented with vitamin D3 ranging from 5,000 to 10,000 IU/day since July 2011 as a standard of care for the prevention and treatment of vitamin D deficiency. Historically 90% of patients have agreed to daily supplementation, with most taking 10,000 IU/day. These data indicate no evidence for hypercalcemia, renal failure, calcium crystal formation, nephrolithiasis. or undetectable parathyroid hormone concentrations in patients taking 5000 or 10,000 IU/day for extended periods of time. As another measure for potential vitamin D toxicity, we retrospectively assessed 24-hour urine calcium excretion in 14 individuals on long-term daily oral vitamin D intake ranging from 5000 to 50,000 IU/day to further assess the safety of supplementation using these doses. This included patients taking either 5000 (4), 10,000 (9), or 50,000 (1) IU/day. Time on supplementation ranged from 10 to 102 months. A patient taking 400 IU/day and getting frequent sun exposure was also included. All fifteen 24-hour urine calcium measurements were normal. The current findings complement our experience with over 7000 patients in the past 13 years, indicating that prolonged daily oral intake of vitamin D3 ranging from 5000 to 10,000 IU/day is safe.

Effect of the addition of different concentrations of Solanum glaucophyllum desf. extract on chondrocyte cultures from the growth cartilage of newborn rats

Solanum glaucophyllum Desf. is a calcinogenic plant responsible for enzootic calcinosis that affects ruminants and causes alterations in bone and cartilaginous tissues, among others. It is believed that changes in cartilage tissue, with reduced bone growth, are due to hypercalcitoninism, caused by excess vitamin D. However, we hypothesized that S. glaucophyllum Desf. can act directly on chondrocytes and therefore, chondrocyte cultures from the epiphysis of the long bones of newborn rats were used as a model to elucidate the direct effects of S. glaucophyllum Desf. on bone growth. Plant samples were collected from Cañuelas, Argentina. An aliquot of the plant extract was used to quantify vitamin D (1,25(OH)2D3). The effects of the three concentrations of the plant extract were tested in cultures of chondrocytes extracted from the epiphyses of the long bones of 32 three-day-old Wistar rats. A control group (without extract), and three groups treated with different concentrations of plant extract were formed: group 1 (100 μL/L); group 2 (1 mL/L), and group 3 (5 mL/L), containing respectively 1 × 10−9 M, 1 × 10−8 M, and 5 × 10−8 M of 1,25(OH)2D3. After 7, 14, and 21 days of culture, MTT assay for cell viability, alkaline phosphatase activity, and quantification of the percentage of areas with glycosaminoglycans (GAG) stained with periodic acid-Schiff (PAS) were performed. On day 7, all chondrocytes in group 3, that is, those with the highest concentration of plant extract, died. On days 14 and 21, groups 1 and 2 showed a significant reduction in chondrocyte viability compared to the control. At 7, 14, and 21 days, groups 1 and 2 showed significantly lower alkaline phosphatase activity than the control. On day 21, group 2 showed a significant reduction in areas with PAS + GAGs. There were no significant differences between the groups in the expression of gene transcripts for Sox9, Col2, ColX, and aggrecan. The S. glaucophyllum Desf. extract directly affected growing rat chondrocytes by reducing viability, alkaline phosphatase activity, and GAG synthesis without altering the expression of gene transcripts for Sox9, Col2, ColX, and aggrecan, which may be one of the mechanisms by which there is a reduction in bone growth in animals intoxicated by the plant.

Scientific opinion on the tolerable upper intake level for vitamin B6.

Following a request from the European Commission, the EFSA Panel on Nutrition, Novel Foods and Food Allergens (NDA) was asked to deliver a scientific opinion on the tolerable upper intake level (UL) for vitamin B6. Systematic reviews of the literature were conducted by a contractor. The relationship between excess vitamin B6 intakes and the development of peripheral neuropathy is well established and is the critical effect on which the UL is based. A lowest-observed-effect-level (LOAEL) could not be established based on human data. A reference point (RP) of 50 mg/day is identified by the Panel from a case-control study, supported by data from case reports and vigilance data. An uncertainty factor (UF) of 4 is applied to the RP to account for the inverse relationship between dose and time to onset of symptoms and the limited data available. The latter covers uncertainties as to the level of intake that would represent a LOAEL. This leads to a UL of 12.5 mg/day. From a subchronic study in Beagle dogs, a LOAEL of 50 mg/kg body weight (bw) per day can be identified. Using an UF of 300, and a default bw of 70 kg, a UL of 11.7 mg/day can be calculated. From the midpoint of the range of these two ULs and rounding down, a UL of 12 mg/day is established by the Panel for vitamin B6 for adults (including pregnant and lactating women). ULs for infants and children are derived from the UL foradults using allometric scaling: 2.2-2.5 mg/day (4-11 months), 3.2-4.5 mg/day (1-6 years), 6.1-10.7 mg/day (7-17 years). Based on available intake data, EU populations are unlikely to exceed ULs, except for regular users of food supplements containing high doses of vitamin B6.

Nanoengineered lanthanum niobate nanocaviar anchored carbon nanofibers for trace level detection of menadione in environmental samples

An innovative sensor is prepared by electrode modification through a nano-ranged electrode modifier composed of LaNbO4 nano caviars decorated on the enmeshed carbon nanofibers to identify excess vitamins in animal feed. Menadione (Vitamins K3) is a micronutrient fundamentally required in precise quantities for animal health upkeep. Still, its exploitation has recently resulted in water reservoir contamination through waste generated from animal husbandry. Sustainable prevention of water contamination makes menadione detection highly imperative and flickered the attention of researchers. Considering these aspects, a novel menadione sensing platform is designed by interdisciplinary incorporation of nanoscience and electrochemical engineering. The structural and crystallographic features and the electrode modifier's morphological insights were keenly investigated. The hierarchal arrangement of individual constituents in nanocomposite is benefited through hybrid heterojunction and quantum confinement that synchronously activate the menadione detection with a LOD of 68.5 nM and 67.49 nM for oxidation and reduction, respectively. The as-prepared sensor has a wide linear range (0.1–173.6 μM), high sensitivity, good selectivity, and stability. The application of this sensor is extended to a water sample to monitor the consistency of the proposed sensor.

Excess Dietary Vitamin B-6 Alters Startle Behavior of Rats

Excessive intakes of vitamin B-6 can produce peripheral nervous system abnormalities, but few reports of central nervous system effects exist. We measured startle response, a central nervous system reflex, in rats fed excess pyridoxine to determine if subtle effects on central nervous system function could be detected. Female Long-Evans rats (218 g; n = 12) were fed either 1, 10, 100, 200 or 300 times the requirement of pyridoxine HCl (7 mg/kg) for 7 wk. Startle behavior was assessed weekly in chambers that allowed quantification of movement in response to stimuli. Food intake and body weights did not differ among groups (P > 0.1), and urinary vitamin B-6 excretion reflected intake (P < 0.001). Overt toxicity was not observed. There was a marginally significant effect of pyridoxine intake over time (P = 0.053) on the amplitude of response to a startling acoustic stimulus (117 dB, 40 ms) administered alone; the response appeared attenuated at the three highest pyridoxine concentrations. When the same stimulus was preceded by either a 70- or 75-dB prepulse (40 ms), responses of groups fed the two highest pyridoxine concentrations were significantly reduced relative to those fed the two lowest concentrations (P < 0.05). No effect of diet was seen with a startling tactile stimulus. Changes in central nervous system function were detected in rats fed excess vitamin B-6 using techniques of startle behavior measurement.

Oxalate Nephropathy.

Oxalate Nephropathy.

A Curious Case of Hypervitaminosis D-related Hypercalcemia

Abstract Hypercalcemia can manifest with various symptoms and poses diagnostic challenges due to its multifactorial etiology. This case highlights a 74-year-old patient with hypercalcemia of complex origin. The patient had a history of chronic liver disease, chronic kidney disease, and a previous episode of hypercalcemia associated with excessive oral Vitamin D intake. On admission, the patient presented with disorientation and increased drowsiness. Further evaluation revealed persistently high serum calcium levels, low parathyroid hormone levels, and elevated levels of Vitamin D. Investigations identified a duodenal nodule with multiple lymph node enlargement, suggesting a malignancy as the underlying cause. Other potential factors contributing to hypercalcemia, such as a granulomatous disease, prolonged immobilization, and a deactivating mutation of the 24-hydroxylase gene (CYP24A1), were also considered. Despite interventions, including hemodialysis and denosumab administration, the patient’s condition deteriorated due to sepsis and hypotensive shock, ultimately resulting in death. This case emphasizes the importance of considering multiple etiologies in cases of hypercalcemia in the elderly and the challenges involved in managing severe symptomatic hypercalcemia. Medical professionals must employ sound clinical reasoning and comprehensive diagnostic approaches to accurately identify and address the underlying cause. Hemodialysis may be necessary in refractory cases to achieve serum calcium normalization.

Correlação entre níveis séricos de vitamina D e IMC de crianças e adolescentes atendidos em um ambulatório universitário

OBJECTIVE: To evaluate the correlation between BMI indices and serum vitamin D levels in children and adolescents. METHODS: Survey of BMI values and serum vitamin D levels of patients aged between one and 16 years, from April 2017 to November 2020, treated at a university hospital RESULTS: The statistical association between BMI classification and serum vitamin D level by Fishers exact test was p= 0,053, a value very close to the limit of significance. Thus, there was a borderline correlation between obesity and hypovitaminosis D CONCLUSIONS: The causal relationship between excess fat and low seeric vitamin D is still not well understood. It is questioned whether reduced serum vitamin D levels function as a direct or indirect cause or consequence of increased BMI. Routine screening of levels of this vitamin in patients with excess body fat is considered relevant, due to its multisystemic and multifunctional role, in addition to the important need for supplementation in patients with its deficiency.

Vitamin D deficiency in British South Asians, a persistent but avoidable problem associated with many health risks (including rickets, T2DM, CVD, COVID-19 and pregnancy complications): the case for correcting this deficiency.

High vitamin D deficiency rates, with rickets and osteomalacia, have been common in South Asians (SAs) arriving in Britain since the 1950s with preventable infant deaths from hypocalcaemic status-epilepticus and cardiomyopathy. Vitamin D deficiency increases common SA disorders (type 2 diabetes and cardiovascular disease), recent trials and non-linear Mendelian randomisation studies having shown deficiency to be causal for both disorders. Ethnic minority, obesity, diabetes and social deprivation are recognised COVID-19 risk factors, but vitamin D deficiency is not, despite convincing mechanistic evidence of it. Adjusting analyses for obesity/ethnicity abolishes vitamin D deficiency in COVID-19 risk prediction, but both factors lower serum 25(OH)D specifically. Social deprivation inadequately explains increased ethnic minority COVID-19 risks. SA vitamin D deficiency remains uncorrected after 70 years, official bodies using 'education', 'assimilation' and 'diet' as 'proxies' for ethnic differences and increasing pressures to assimilate. Meanwhile, English rickets was abolished from ~1940 by free 'welfare foods' (meat, milk, eggs, cod liver oil), for all pregnant/nursing mothers and young children (<5 years old). Cod liver oil was withdrawn from antenatal clinics in 1994 (for excessive vitamin A teratogenicity), without alternative provision. The take-up of the 2006 'Healthy-Start' scheme of food-vouchers for low-income families with young children (<3 years old) has been poor, being inaccessible and poorly publicised. COVID-19 pandemic advice for UK adults in 'lockdown' was '400 IU vitamin D/day', inadequate for correcting the deficiency seen winter/summer at 17.5%/5.9% in White, 38.5%/30% in Black and 57.2%/50.8% in SA people in representative UK Biobank subjects when recruited ~14 years ago and remaining similar in 2018. Vitamin D inadequacy worsens many non-skeletal health risks. Not providing vitamin D for preventing SA rickets and osteomalacia continues to be unacceptable, as deficiency-related health risks increase ethnic health disparities, while abolishing vitamin D deficiency would be easier and more cost-effective than correcting any other factor worsening ethnic minority health in Britain.

A Cross-Sectional Study on the Health Profile and Nutritional Status of Adults at Risk of Type 2 Diabetes Mellitus in Kuala Nerus, Terengganu

Surprisingly, 541 million people have impaired glucose tolerance (IGT) worldwide[1]. Prediabetes has been associated with an elevated risk of composite cardiovascular disease, coronary heart disease, stroke and all-cause mortality2 as well as an increased risk of type 2 diabetes mellitus (T2DM) than normal glycaemia[1]. In Malaysia, the undiagnosed diabetes prevalence has increased3. Health profile and nutritional status play a crucial role in prediabetes development. However, there is a scarcity of related health profile characteristics and nutritional status data in Kuala Nerus, Terengganu.&#x0D; &#x0D; This cross-sectional study aimed to identify the health profile and nutritional status of adults at risk of T2DM in Kuala Nerus, Terengganu. A total of 30 respondents at moderate and high risk of T2DM (Finnish Type 2 Diabetes Risk Assessment Tool (FINDRISC) score &gt; 4) aged 18 to 59 years old were recruited from Kuala Nerus using a convenience sampling method. Information on socio-demographic, anthropometric, fasting plasma glucose (FPG) level, clinical profile, FINDRISC score, dietary intake, and physical activity level were obtained. The data were analyzed using IBM SPSS system version 21.0 and Nutritionist ProTM software (Version 7.0.0, Axxya Systems). A descriptive statistic was used to present all outcomes. The continuous data were described as mean ± standard deviation (SD) whereas for categorical variables, the data were reported as the number of frequency and percentage.&#x0D; &#x0D; The respondents (mean age: 36.1 ± 8.7 years) were predominantly female (76.7%), Malay (96.7%), married (43.3%), with tertiary education (60.0%), and employed (83.3%) with a monthly income ranging below RM 1000. Half of the respondents were from the obese class I category. However, they had a normal FPG (5.6 ± 0.5 mmol/L) and were normotensive with a normal heart rate. Also, they had an average FINDRISC score of 6.3 ± 1.8. The respondents had excessive energy, fat, vitamin C, and selenium intake with insufficient dietary fibre, vitamin A, E, and K, calcium, and magnesium intake. Most of them (63.3%) were minimally active.&#x0D; The mean energy intake of this study was in accord with Malaysian Adult Nutrition Survey (MANS) 2003 (2097 kcal) and MANS 2014 (2123 kcal) after excluding under-reporters [3]. The National Health Morbidity Survey (NHMS) 2019 stated that 25.1% of Malaysian adults were physically inactive which was slightly higher than the current study finding. On the contrary, a higher percentage (80.0%) of the study respondents were physically active than 74.9% as reported by NHMS (2019) [4].&#x0D; &#x0D; It is vital to determine the health profile and nutritional status, which can provide important information for planning future cost-effective T2DM preventive strategies. This is because a strategic method of primary prevention for T2DM is by managing risk factors through lifestyle modification.

LBODP020 Treatment Of Hypercalcemia Due To Prolonged, Excessive Vitamin D Intake

Abstract Case A 66-year-old man with history of anxiety, depression, and complex regional pain syndrome presented to a psychiatric hospital with suicidal ideation. Admission laboratory studies demonstrated hypercalcemia (Ca 14.2 mg/dL) with kidney injury (Cr 3.26). He endorsed taking 5 to 16 (average 8-9) tablets of 1000 IU Vitamin D daily for 10 years. He had heard about the health benefits of Vitamin D and believed it gave him a euphoric effect. Work-up demonstrated elevated ionized calcium (1.63 mmol/L), normal serum phosphorus (3.8 mg/dL), low total protein (6.24 g/dL), normal total albumin (3.42 g/dL), and negative serum protein electrophoresis. Intravenous hydration with normal saline at 200 cc/hr was initiated along with intravenous furosemide. Additional work up demonstrated a suppressed parathyroid hormone level (10pg/ml). 25-hydroxyvitamin D3 (25-(OH)D3) levels were elevated beyond the measurable range (&amp;gt; 155.9 pg/mL). The plasma 1α,25-dihydroxyvitamin D3 (1α,25 (OH)2D3) was normal at 44 pg/mL (range 18-64 pg/mL). With intravenous fluid administration, the patient's ionized calcium level decreased and his creatinine improved. However, 48 hours after the fluids were discontinued on hospital day 3, the ionized calcium and serum creatinine rose once again. Due to the long half-life of Vitamin D and the up-trending calcium levels, he received 60mg of intravenous Pamidronate on hospital day 8. On discharge on hospital day 11, his renal function was stable (Cr 2.24) with normal ionized calcium (1.27 mmol/L). His psychiatric symptoms had resolved. Discussion The two most common causes of hypercalcemia are primary hyperparathyroidism and malignancy. Less commonly, vitamin D-mediated hypercalcemia may result from ectopic 1,25-dihydroxyvitamin D production or excessive Vitamin D ingestion. The known upper limit of daily Vitamin D intake in an adult that will cause no adverse risk is 4000 IU per day. Vitamin D is a fat-soluble vitamin with a half-life of approximately 2 months. The liver converts Vitamin D3 to the metabolite 25-(OH)D3, which has a half-life of 15 days, and the kidney further metabolizes this to 1α,25 (OH)2D3, which has a half-life of 15 hours. Therefore, this patient's 25-(OH)D3 was expected to remain at toxic levels for an unknown time period, placing him at risk of prolonged hypercalcemia with further deterioration of his renal function. There is no standard of care established for patients with vitamin D toxicity. Pamidronate, normally contraindicated for GFR &amp;lt;30 mL/min, was administered after nephrology consultation. Information about vitamin D toxicity is primarily gleaned from case reports and series. This case report serves as a model for study of Vitamin D toxicity in humans for understanding the long-term management in patients with chronic vitamin D toxicosis presenting with renal failure. Presentation: No date and time listed

260 The Effect of Different Bones and Analytical Methods on Assessment of Bone Mineralization Response to Dietary P, Phytase, and Vitamin D in Finishing Pigs

Abstract Pigs [n = 882; initial body weight (BW) of 33.2±0.31 kg] were used to evaluate the effects of different bones and analytical methods on assessment of bone mineralization response to dietary P, phytase, and vitamin D in growing-finishing pigs. Pens of pigs (20 pigs/pen) were completely randomized to 5 dietary treatments with 9 pens/treatment. After feeding diets for 112-d, nine pigs/treatment were harvested for bone analysis. Treatments were: 1) P at 80% of the NRC STTD P (deficient), 2) NRC STTD P using monocalcium phosphate, 3) NRC STTD P including phytase, 4) Industry P using monocalcium phosphate and phytase, 5) diet 4 with additional 2,000 IU/kg 25(OH)D3 (HyD). All diets contained vitamin D at 1,653 IU/kg. There were no significant differences for final BW, ADG, ADFI, G:F (P&amp;gt;0.10) or non-de-fat bone ash (bone ash×bone interaction, P&amp;gt;0.10). The response to treatment for bone density (Archimedes principle) and bone mineral content (DEXA) tended to depend on the bone (density×bone interaction, P=0.053; mineral density×bone interaction, P=0.157). There were no treatment differences (P&amp;gt;0.10) for bone density and bone mineral density between metacarpals, fibulas, and 2nd ribs. For 10th ribs, pigs fed industry levels of P had increased (P&amp;lt; 0.05) bone density compared with pigs fed NRC levels with phytase, with pigs fed deficient P, NRC P with no phytase, and excess vitamin D from HyD being intermediate. Pigs fed diets supplemented with HyD had increased bone mineral density in 10th ribs compared with pigs fed NRC levels of P with phytase, with pigs fed P deficient diets, industry P without HyD, and NRC P with monocalcium being intermediate. In summary, bone density and bone mineral content responses varied depending on the bone. Differences in bone density and mineral content in response to vitamin D and P were most apparent with the 10th ribs.

Vitamin B12 status and folic acid/vitamin B12 related to the risk of gestational diabetes mellitus in pregnancy: a systematic review and meta-analysis of observational studies

BackgroundThis review was conducted to investigate the association between serum vitamin B12 levels as well as folic acid/vitamin B12 during pregnancy and the risk of gestational diabetes mellitus (GDM).MethodsA comprehensive search of electronic databases (Embase, PubMed, and Web of Science) was performed. The odds ratios (ORs) with 95% confidence intervals (CIs) of GDM risk were summarized using a random effects model. We also performed subgroup analyses to explore the source of heterogeneity.ResultsA total of 10 studies, including 10,595 pregnant women were assessed. Women with vitamin B12 deficiency were at higher risk for developing GDM when compared with those who were vitamin B12 sufficient (OR, 1.46; 95% CI 1.21–1.79; I2: 59.0%). Subgroup analysis indicated that this association might differ based on sample size and geographical distribution. Elevated vitamin B12 levels may decrease the risk of GDM by 23%. The role of excess folic acid and low vitamin B12 levels in the occurrence of GDM is also controversial.ConclusionIn summary, vitamin B12 deficiency is associated with increased risk of GDM, it is necessary to pay more attention to the balance of vitamin B12 and folic acid. However, more in-depth studies across multiple populations are needed to verify these results.