High Prevalence Of Vitamin D Deficiency Research Articles

Association between serum vitamin D levels and skeletal muscle indices in an older Japanese population: The SONIC study.

Vitamin D (VD) affects skeletal muscles. The high prevalence of VD deficiency in Japan may lead to decreased skeletal muscle mass and strength, increasing the prevalence of sarcopenia. Therefore, we aimed to investigate the association between serum VD levels and skeletal muscle indices in a Japanese community-dwelling older population. We extracted data from the Septuagenarians, Octogenarians, Nonagenarians Investigation with Centenarians (SONIC) study. We analyzed the data for participants in the 70s and 90s age groups. Skeletal mass index (SMI) using bioimpedance analysis, grip strength, walking speed, and serum VD levels using 25-hydroxyvitamin D [25(OH)D] were measured. We analyzed the data of 310 participants in their 70s and 48 in their 90s. Mean serum 25(OH)D levels were 21.6 ± 5.0 ng/mL in the 70s group and 23.4 ± 9.1 ng/mL in the 90s group. In the 70s group, serum 25(OH)D levels correlated with SMI (r = 0.21, P < 0.0001) and grip strength (r = 0.30, P < 0.0001). Serum 25(OH)D levels were independently associated with SMI after adjusting for sex, body mass index, and serum albumin levels. In the 90s group, serum 25(OH)D levels were correlated with SMI (r = 0.29, P = 0.049) and grip strength (r = 0.34, P = 0.018). However, the multivariate analysis showed no independent association between SMI, grip strength, and serum 25(OH)D levels. In a cross-sectional analysis of an older population, serum VD levels were associated with SMI and grip strength, and this association was more pronounced in the 70s group than in the 90s group. Our results suggest that serum VD levels maintain skeletal muscle mass and grip strength. Geriatr Gerontol Int 2024; ••: ••-••.

Factors associated with vitamin D deficiency in health care workers exposed to SARS-CoV-2: a cross-sectional study.

Globally, up to 76.6% of the population may be affected by vitamin D (VD) deficiency, which has been linked to increased morbidity and mortality from COVID-19. This underscores the importance of further research into VD supplementation, particularly for health care workers, who are at higher risk due to indoor work environments and dietary challenges associated with shift schedules. This study aimed to identify factors associated with VD deficiency in Mexican health care workers exposed to SARS-CoV-2. We conducted a cross-sectional study from June 2020 to January 2021 among frontline health care workers treating hospitalized COVID-19 patients. Blood samples were collected to measure 25-hydroxy VD levels via radioimmunoassay. We also assessed previous COVID-19 infection and comorbidities that could influence VD levels. The study included 468 health care workers. The median serum VD concentration was 16.6 ng/mL. VD deficiency was found in 69.4% (n = 325) of participants, while only 5.1% (n = 24) had normal levels. Those with type 2 diabetes (13.3 ng/mL vs. 17.1 ng/mL) or obesity (15.7 ng/mL vs. 17.1 ng/mL) had significantly lower VD levels than their counterparts (p < 0.001 and p = 0.049, respectively). No significant differences were found among participants with high blood pressure. Multivariate analysis revealed that type 2 diabetes was independently associated with VD deficiency. There is a high prevalence of VD deficiency among health care workers, which is potentially linked to both personal health factors and occupational conditions.

Vitamin D Status among Patients Admitted to a Geriatric Ward-Are Recommendations for Preventing Its Deficiency Effective Enough?

Despite a decade of available recommendations aimed at preventing vitamin D (VD) deficiency in Poland, the efficacy of these measures among community-dwelling older individuals remains inconsistent. The PolSenior2 study provided valuable insights into VD status among community-dwelling older individuals in Poland. However, it is important to note that this research did not include the elderly living in care institutions. Therefore, our study concentrates on evaluating VD status in older patients admitted to a geriatrics ward to indirectly assess their adherence to existing recommendations and preventive actions in this particular setting (whether they translate into health-promoting behaviors (i.e., taking vitamin D supplements) and whether the recommended, optimal 25(OH)D concentration values are achieved). This approach offers a comprehensive understanding of VD status in a previously understudied population. We aimed to evaluate VD status in patients aged 70 and above within the geriatrics ward, exploring its association with age, sex, BMI, and the use of VD supplements. The study involved the measurement of serum VD concentration in 240 individuals. Of these participants, 177 (73.8%) were women, and 193 (80.4%) were over 75 years old. The median 25(OH)D concentration was found to be 22.95 (IQR, 13.7-33.0) ng/mL. Notably, profound deficiency (<10 ng/mL) was noted in 15% of the participants, while 67.5% exhibited VD inadequacy (<30 ng/mL). It is worth mentioning that only 18.3% of individuals took VD supplements preadmission. Insufficiency was more prevalent in nonsupplemented individuals (70.9% vs. 52.3%, p = 0.02) and those with a BMI ≥30 kg/m2 (76.2% vs. 59.2%, p = 0.007). The logistic regression model demonstrated that obese patients had over two times higher odds of VD inadequacy (OR = 2.21, p = 0.0074), as did nonsupplemented individuals (OR = 2.23, p = 0.0187). The high prevalence of VD deficiency and inadequacy in geriatric ward admissions emphasizes the urgent need for targeted interventions and enhanced education for older adults, caregivers, and physicians to improve adherence to preventive supplementation practices.

Vitamin D levels in postmenopausal women and their relationship with diabetes mellitus

Background: Vitamin D (VD) plays a crucial role in regulating calcium and phosphorus metabolism and bone growth and has emerging roles beyond the skeleton. Deficiency is linked to various health issues, especially in postmenopausal women. The burden of T2DM in India, particularly among women, emphasizes the need for exploring the VD-diabetes connection. Aim and Objective: To investigate VD levels in postmenopausal women with T2DM compared to premenopausal women, assessing the association between VD deficiency and glycemic control. Materials and Methods: A case–control study was conducted in Chennai, India, involving pre-menopausal and post-menopausal women with T2DM. Ethical clearance was obtained, and participants were recruited with informed consent. Fifty pre-menopausal and post-menopausal women, each with T2DM, were included. Exclusions involved individuals taking calcium and vitamin D supplements, anticonvulsants, and those afflicted with osteoporosis, renal disease, asthma, and hypertension. Blood samples were collected for glucose and VD level assessments, employing standard methodologies. Results: Pre-menopausal women exhibited significantly higher VD levels compared to their post-menopausal counterparts. Blood sugar levels did not significantly differ based on menopausal status. Conclusion: This study contributes valuable insights into the complex interplay between VD, menopausal status, and glycemic control in women with T2DM. The high prevalence of VD deficiency and its association with suboptimal glycemic control emphasize the need for further research. Understanding these relationships is crucial for developing targeted interventions for postmenopausal women with diabetes.

Evaluation of bone mineral density and bone turnover in children on anticoagulation.

Childhood and adolescence are critical periods of bone mineral acquisition. Children on anticoagulation (AC) might have an increased risk for reduced bone mineral density (BMD). Risk factors for impaired bone accumulation include chronic diseases, immobility, and medication. Vitamin K (VK) deficiency reflected by undercarboxylated osteocalcin levels (ucOC) has been identified as a predictor of osteoporosis and fractures. Data on bone health in children under AC are sparse. To evaluate BMD in children on AC and characterize the risk factors of low BMD, including VK and Vitamin D (VD) status. Single-center cross-sectional study of clinical, biochemical, and densitometric parameters. Assessment of VK surrogate parameters included ucOC and matrix gla protein (MGP). A total of 39 children (4-18 years; 12 females) receiving AC were included, 31 (79%) on VK antagonists and 8 (21%) on direct oral anticoagulants. Overall, BMD was decreased for both the lumbar spine (LS; -0.7SDS) and total body less head (TBLH; -1.32SDS) compared with pediatric reference data. Significant associations were found between early pubertal development and TBLH-BMD, and between BMI and LS-BMD. VK surrogate parameters were highly related to patients' age and pubertal development. Neither serum parameters nor AC-related factors predicted BMD. VD was detected in 10/39 patients with lower values during puberty. Our data indicate BMD reduction in pediatric patients on AC. Although AC-related factors did not predict reduced BMD, low BMI and pubertal stages represented important risk factors. Awareness of risk factors for low BMD and high prevalence of VD deficiency during puberty could contribute to the improvement of bone health in this vulnerable patient group.

Effect of Maternal Supplementation With Two Different Doses of Vitamin D During Lactation on Vitamin D Status, Anthropometry and Bone Mass of Infants: A Randomized Controlled Trial

There is a high prevalence of vitamin D deficiency (VDD) in exclusively breast-fed infants in the absence of appropriate vitamin D supplementation. To evaluate the efficacy of two doses of maternal vitamin D supplementation on vitamin D levels of mother-infant pairs and to assess its effect on growth parameters (weight, length and head circumference) and bone mass of infants. Randomized controlled trial. Lactating mother-infant pairs (n=220). Maternal oral vitamin D supplementation in two doses (group 1: 1,20,000 IU/month and group 2: 12,000 IU/month) for 12 months. Main outcomes: Maternal and infant serum 25OHD levels, and infants' growth and bone mass. There was high prevalence of VDD at baseline in mothers (94%) as well as infants (98.5%), which was reduced to 43.1% in (mothers) and 46.5% in infants after 12 months. Significantly higher median (IQR) serum 25OHD levels (ng/mL) were observed among mothers in group 1 compared to group 2 [46 (17-159) vs 18 (6-64); P<0.01] and in infants [36.5 (15-160) vs 17 (7-32); P<0.01]. No significant association was observed between growth parameters or bone mass and serum 25OHD levels of mother or infant between the two groups. Four mothers (3.6%) and two infants (1.8%) in group I had serum 25OHD>100 ng/mL, but without hypercalciuria or hypercalcemia. Bolus vitamin D supplementation in the dose of 1,20,000 IU/month was more efficacious in improving maternal and infant vitamin D status at 12 months, as compared to 12,000 IU/month.

Effects of vitamin D in thyroid autoimmune pathologies: literature review and own data

Background. Vitamin D (VD) is a versatile steroid hormone that regulates the activity of several thousand genes. Over the past decades, numerous diseases associated with VD deficiency have been reported, including cancer and autoimmune thyroid disorders. Researches revealed that VD can influence the development and course of these diseases. The VD participation in modulation of the hypothalamus-pituitary-thyroid gland axis, both at the level of the pituitary gland and at that of the thyroid, has been shown. The effect of VD on autoimmune diseases, including thyroid autoimmune diseases, is widely studied. Most of the existing data support the relationship between VD deficiency and a greater tendency to develop and higher antibody titers associated with Hashimoto’s thyroiditis, Graves’ disease (GD) and postpartum thyroiditis. An important fact is that epidemiological studies have demonstrated a high prevalence of VD deficiency or insufficiency throughout the world. VD insufficiency is a potent dietary trigger that results in severe, chronic diseases. The question arises how reliable is the relationship between VD and autoimmune thyroid diseases (AITD). Although the results of the studies performed are somewhat contradictory, the vast majority of data indicates a link between VD deficiency and an increased risk of developing the disease, high antibody titers, and difficulties in treatment. Genetic polymorphisms associated with VD function and metabolism also have some influence on the risk of ATD. With regard to the precise nature of the relationship between VD and AITD, it is believed that VD plays a small but significant role in the AITD pathogenesis. After the AITD development, its consequence may be an increase in VD deficiency. It is the need to determine the effect of VD supplementation in the prevention and treatment of AITD and its optimal level directly for clinical practice. It is necessary for clinical practice to determine the effect of VD supplements in the prevention and treatment of AITD and its optimal level. A study, the purpose of which was to study the content of VD, namely 25(OH)D in 176 patients with GD complicated by autoimmune ophthalmopathy (AO) and to identify a correlation relationship with antithyroid antibodies (TPO, TSHR-Ab) was carried out at the State Institution “V.P. Komissarenko Institute of Endocrinology and Metabolism of the National Academy of Medical Sciences of Ukraine”. Materials and methods. The levels of 25(OH)D, TSH, TSHR-Ab, TPO were determined by enzyme immunoassay using standard kits from Siemens firm. During the study, 176 patients were divided into two groups, depending on the presence of AO: the first group consisted of patients with GD without AO (62 people), the second group included patients with GD and AO (114 people). Results. In GD, 91.78 % of patients (161 people) have an insufficient level of 25(OH)D content: a suboptimal level was recorded in 42 patients (23.86 %), and a deficit — in 119 patients (67.61 %). A significant negative correlation relationship was revealed between TSHR-Ab and 25(OH)D in the group of patients with GD and AO — with a lower level of 25(OH)D, the higher values of TSHR-Ab correlate. Compensation of the 25(OH)D deficiency leads to a significant (P&lt; 0.05) decrease in the levels of TSHR-Ab and TPO in patients with GD. Besides, there is a large body of literature available lin-king vitamin D to thyroid autoimmunity as a result of cross-sectional studies and observations. Conclusions. Thus, there is still an urgent need for large multicenter studies to evaluate the effect of vitamin D supplementation on meaningful long-term clinical endpoints in AITD.

High early pregnancy serum 25-hydroxy vitamin D level, within a sub-optimal range, is associated with gestational diabetes mellitus: a prospective cohort study.

BACKGROUND/OBJECTIVESLow early pregnancy serum 25-hydroxy vitamin D (25[OH]D) levels can increase gestational diabetes mellitus (GDM) risk, although inconsistent findings related to that association have been reported. This study examined the association of serum vitamin D with GDM and the possible influencers on this association.SUBJECTS/METHODSThis study included 259 pregnant women within the Seremban Cohort Study (SECOST). Blood samples at < 14 weeks of gestation were drawn to determine serum 25(OH)D levels. GDM diagnosis was made at 24 to 32 weeks of gestation using a standard procedure. Association between serum vitamin D and GDM was tested using binary logistic regression.RESULTSNearly all women (90%) had mild (68.3%) or severe (32.2%) vitamin D deficiency (VDD). Non-GDM women with mild VDD had a significantly higher mean vitamin D intake than GDM women with mild VDD (t = 2.04, p < 0.05). Women with higher early pregnancy serum vitamin D levels had a greater risk of GDM. However, this significant association was only identified among those with a family history of type 2 diabetes mellitus (T2DM) and in women with a body mass index indicating overweight or obese status.CONCLUSIONSThe high prevalence of VDD in this sample of pregnant women underscores the need for effective preventive public health strategies. Further investigation of this unexpected association between serum vitamin D level and GDM risk in predominantly VDD pregnant women and the potential effects of adiposity and family history of T2DM on that association is warranted.

Clinical Implications of Vitamin D in Oral Diseases- A Review

Oral health is a reflection of systemic health. The various nutritional deficiencies not only affect the systemic health but also have an impact on oral health. The prevalence of Vitamin D deficiency (VDD) is rampant globally. Vitamin D (VD) is not only essential for skeletal growth during childhood and adulthood but has a great impact on oral tissues and odontogenesis. VDD has several implications on oral health from childhood to adulthood. VD can negatively influence the oral health of the mother and child and VD supplementation brings positive outcomes during and after pregnancy. In children, severe VDD can impair tooth mineralization, resulting in defects of enamel and dentin and predispose patients to caries. A remarkably high prevalence of periodontitis is seen in VDD and has implications on systemic health as well. A high prevalence of VDD is seen in oropharyngeal cancers. This review aims to provide the biological role of VD and its receptor, its implication on oral health and future strategies for targeted therapies in oral pathologies.

Association between vitamin D deficiency and sepsis in pediatric ICU

ObjectiveTo evaluate association between 25-hydroxyvitamin D [25(OH)D] and sepsis in pediatric ICU (PICU).BackgroundVitamin D is a fat-soluble steroid hormone that helps maintain proper calcium homeostasis and has a role in the function of the immune system. Data on the prevalence of vitamin D deficiency (VDD) in PICU in children with sepsis and its association with poor outcome were obtained.Patients and methodsThis study was carried out on 45 patients with sepsis admitted to the PICU, Pediatric Department, Menoufia University Hospital, and 45 controls, who attended the patient clinic and were found to be healthy. Demographic data, history, and general and local clinical examination were done. Investigations such as complete blood count and C-reactive protein were done. For measurement of vitamin D, fresh blood samples were taken within 24 h of admission, and level of vitamin D was measured by ELISA. VDD was defined as less than 10 ng/ml.ResultsPrevalence of VDD [25(OH)D level < 10 ng/ml] was higher among critically ill children with sepsis compared with health controls (33.3 vs. 11.1%; P = 0.02). 25(OH)D was strongly associated with pediatric index of mortality (P = 0.02), duration of mechanical ventilation (P = 0.003), length of PICU stay (P < 0.001), and mortality (P < 0.001). VDD was not associated with age, sex, residence, or admission season.ConclusionLower 25(OH)D levels are associated with sepsis. There was a high prevalence of VDD in critically ill children with sepsis, and it was association with poor outcome.

Vitamin D status and its associations with clinical and laboratory parameters in patients with Addison's disease.

There is increasing evidence that several autoimmune diseases, as well as their activity, are associated with vitamin D (VD) deficiency. Our study aimed to evaluate the prevalence of VD insufficiency in patients with Addison's disease (AD), as well as to evaluate associations between VD concentrations and various clinical and laboratory parameters of the disease. We retrospectively analyzed medical records of 31 adult patients diagnosed with autoimmune Addison's disease, in whom serum VD was measured. We assessed correlations between serum VD and various clinical and laboratory parameters. R e s u l t s: 90.3% of AD patients had inadequate VD concentrations (<30 ng/mL), and 19.3% of them were found to be severely VD deficient (<10 ng/mL). Among assessed laboratory variables, only serum calcium concentrations significantly correlated with VD status (r = 0.53, p = 0.006). The mean serum VD concentration was significantly lower in patients with severe fatigue (15.17 ± 8.41 vs 26.83 ± 12.29 ng/mL, p = 0.011) and limited exercise capacity (12.38 ± 6.9 vs 21.63 ± 10.87 ng/mL, p = 0.016). C o n c l u s i o n s: This study demonstrates a high prevalence of VD deficiency in AD patients, as well as the association between low VD concentrations with symptoms such as severe fatigue or limited exercise capacity. Further studies are needed to clarify if impaired VD status is a risk factor in the pathogenesis of AD and to assess if VD supplementation improves the quality of life of AD patients.

Prevalencia de hipovitaminosis D en pacientes con osteocondritis disecante juvenil

BackgroundJuvenile osteochondritis dissecans (JOCD) is an acquired joint disease of unknown etiology that affects skeletally immature patients and has the potential to progress to osteoarthritis. Recent studies have reported a high prevalence of vitaminD deficiency in patients with osteochondral lesions. The aim of our study was to determine serum vitaminD levels in patients diagnosed with JOCD. MethodsSerum 25(OH)D levels of 31 patients (22 males) presenting 40 lesions (29 JOCD of the knee, and 11 of the ankle) were evaluated. The average age was 11.9±2.9years. HypovitaminosisD was defined as a value less than 30ng/mL and was divided into vitaminD insufficiency (20 to 30ng/mL) and vitaminD deficiency (<20ng/mL). ResultsHypovitaminosisD was present in 45.2% of the evaluated patients (32.2% insufficiency and 13% deficiency). No significant differences were found in the mean values and incidence of hypovitaminosis between those patients in which the sample was taken in warm or cold season (P=.267 and P=.875, respectively). Patients who required surgery had a higher incidence of hypovitaminosis than those treated conservatively (60% versus 31%, P=.054). There was no correlation in the incidence of hypovitaminosis with sex, location, stability of the lesion, or if the lesion was uni- or bilateral. ConclusionIn our series, almost half of the patients diagnosed with JOCD presented abnormal serum levels of vitaminD. A two-fold incidence of hypovitaminosis was observed in patients requiring surgical treatment compared to patients managed conservatively. The association found in this study does not imply causation, but it should be considered within the set of actions for the treatment of these injuries.

Vitamin D status and its associations with clinical and laboratory parameters in patients with Addison’s disease

INTRODUCTION There is increasing evidence that several autoimmune diseases, as well as their activity, are associated with vitamin D (VD) deficiency. Our study aimed to evaluate the prevalence of VD insufficiency in patients with Addison's disease (AD), as well as to evaluate associations between VD concentrations and various clinical and laboratory parameters of the disease. MATERIALS AND METHODS We retrospectively analyzed medical records of 31 adult patients diagnosed with autoimmune Addison's disease, in whom serum VD was measured. We assessed correlations between serum VD and various clinical and laboratory parameters. R e s u l t s: 90.3% of AD patients had inadequate VD concentrations (<30 ng/mL), and 19.3% of them were found to be severely VD deficient (<10 ng/mL). Among assessed laboratory variables, only serum calcium concentrations significantly correlated with VD status (r = 0.53, p = 0.006). The mean serum VD concentration was significantly lower in patients with severe fatigue (15.17 ± 8.41 vs 26.83 ± 12.29 ng/mL, p = 0.011) and limited exercise capacity (12.38 ± 6.9 vs 21.63 ± 10.87 ng/mL, p = 0.016). C o n c l u s i o n s: This study demonstrates a high prevalence of VD deficiency in AD patients, as well as the association between low VD concentrations with symptoms such as severe fatigue or limited exercise capacity. Further studies are needed to clarify if impaired VD status is a risk factor in the pathogenesis of AD and to assess if VD supplementation improves the quality of life of AD patients.

Vitamin D status is associated with high BMI, working status and gravidity among pregnant Malaysian women

Introduction: Vitamin D deficiency (VDD) is associated with adverse health outcomes in pregnancy and newborns. This study aims to determine the Vitamin D status among pregnant Malaysian women and its associations with specific maternal & pregnancy characteristics. Methods: This study utilised cross-sectional data from a prospective cohort study of pregnant women in Seremban district in which 259 pregnant women had available vitamin D data. Blood samples were taken 75nmol/L). Early pregnancy body mass index (AOR=2.95, 95% CI=1.03-8.47), working status (AOR=3.17, 95% CI=1.06-9.50) and gravidity (AOR=0.68, 95% CI=0.48-0.98) were significantly associated with VDD. Conclusion: The present study showed a high prevalence of VDD among pregnant women in Malaysia, especially among those who were overweight or obese, working in indoor environment and primigravida.

Association between vitamin D deficiency and common variants of Vitamin D binding protein gene among Mexican Mestizo and indigenous postmenopausal women.

Vitamin D deficiency (VDD) and polymorphisms in the group-specific component (GC) gene are known to be associated in different populations. However, the effects of such genetic variants may vary across different populations. Thus, the objective of this study was to estimate the association between Vitamin D-Binding Protein (VDBP) haplotypes and VDD in mestizo postmenopausal women and Mexican Amerindian ethnic groups. This was a cross-sectional study of 726 postmenopausal Mexican women from the Health Workers Cohort Study (HWCS) and 166 postmenopausal women from the Metabolic Analysis in an Indigenous Sample (MAIS) cohort in Mexico. GC polymorphisms (rs7045 and rs4588) were analyzed by TaqMan probes. Serum 25-hydroxyvitamin D [25(OH)D] levels were measured by Chemiluminescent Microparticle Immuno Assay. The prevalence of VDD serum 25(OH)D < 20ng/mL was 43.7% in mestizo women and 44.6% in indigenous women. In HWCS, the single nucleotide polymorphisms (SNPs) rs7041 and rs4588 were associated with VDD. In addition, women from the HWCS, carrying the haplotypes GC2/2 and GC1f/2 had higher odds of VDD (OR = 2.83, 95% CI 1.14, 7.02; and OR = 2.30, 95% CI 1.40, 3.78, respectively) compared to women with haplotype 1f/1s. These associations were not statistically significant in the MAIS cohort. Our results show genetic association of the analyzed SNPs and related haplotypes, on the GC gene, with VDD in mestizo Mexican postmenopausal women. Moreover, a high prevalence of VDD with high genetic variability within the country was observed. Our results support the need for national policies for preventing VDD.

Vitamin D Improves Nitric Oxide-Dependent Vasodilation in Adipose Tissue Arterioles from Bariatric Surgery Patients.

There is a high prevalence of vitamin-D deficiency in obese individuals that could be attributed to vitamin-D sequestration in the adipose tissue. Associations between vitamin-D deficiency and unfavorable cardiometabolic outcomes were reported. However, the pathophysiological mechanisms behind these associations are yet to be established. In our previous studies, we demonstrated microvascular dysfunction in obese adults that was associated with reduced nitric oxide (NO) production. Herein, we examined the role of vitamin D in mitigating microvascular function in morbidly obese adults before and after weight loss surgery. We obtained subcutaneous (SAT) and visceral adipose tissue (VAT) biopsies from bariatric patients at the time of surgery (n = 15) and gluteal SAT samples three months post-surgery (n = 8). Flow-induced dilation (FID) and acetylcholine-induced dilation (AChID) and NO production were measured in the AT-isolated arterioles ± NO synthase inhibitor N(ω)-nitro-L-arginine methyl ester (L-NAME), hydrogen peroxide (H2O2) inhibitor, polyethylene glycol-modified catalase (PEG-CAT), or 1,25-dihydroxyvitamin D. Vitamin D improved FID, AChID, and NO production in AT-isolated arterioles at time of surgery; these effects were abolished by L-NAME but not by PEG-CAT. Vitamin-D-mediated improvements were of a higher magnitude in VAT compared to SAT arterioles. After surgery, significant improvements in FID, AChID, NO production, and NO sensitivity were observed. Vitamin-D-induced changes were of a lower magnitude compared to those from the time of surgery. In conclusion, vitamin D improved NO-dependent arteriolar vasodilation in obese adults; this effect was more significant before surgery-induced weight loss.

The prevalence of hypovitaminosis D and its risk factors in pregnant women and their newborns in the Middle East: A systematic review.

BackgroundPregnant women and newborns are at risk for vitamin D deficiency (VDD). Also, poor health outcomes for pregnant women with VDD are reported in the published literature.ObjectiveThe aim of this systematic review was to estimate the prevalence of hypovitaminosis D and the associated risk factors for hypovitaminosis D in Middle Eastern pregnant women and their newborns.ResultsThe prevalence of circulating 25-hydroxyvitamin D (25(OH)D) 50 nmol/L as a marker of vitamin D status in pregnant women and their newborns was between 24.5-98% and 22-100%, respectively. The prevalence of 25(OH) D 25 nmol/L in pregnant women and their newborns was over a wide range between 16.7-80% and 22-82%, respectively. Predictors for low maternal and neonatal 25(OH)D concentrations included decreased vitamin D synthesis due to reduced exposure to sunlight and decreased nutritional intake of vitamin D. A predictor of low neonatal 25(OH)D concentrations included maternal vitamin D status and the correlation between vitamin D concentrations in maternal and cord blood.ConclusionThe high prevalence of VDD in the pregnant women of the Middle East underscores the necessity of implementing national prevention and intervention strategies. A clear policy for clinicians and healthcare workers is needed for screening and maintaining sufficient vitamin D status during pregnancy.

Association of vitamin D deficiency with clinical outcomes in critically ill Korean children.

BACKGROUND/OBJECTIVESVitamin D is a pleiotropic hormone that affects various body organ systems. We evaluated the prevalence of a vitamin D deficiency (VDD) and its potential role in the clinical condition of critically ill Korean children.SUBJECTS/METHODSPatients under 18 years old with a 25(OH) vitamin D measurement on the first day of PICU admission were included from among the children admitted to the pediatric intensive care unit (PICU) of our tertiary children's hospital between October 2017 and January 2019.RESULTSA total of 172 pediatric patients were enrolled. The mean 25(OH) vitamin D level was 17.5 ± 12.8 ng/mL. There was a 65.1% prevalence of VDD (25(OH) vitamin D level < 20 ng/mL). VDD was associated with age at PICU admission, gastrointestinal/hepatobiliary disorders, International Society of Thrombosis and Hemostasis disseminated intravascular coagulation (ISTH DIC) score, pediatric multiple organ dysfunction syndrome (pMODS) score and with several laboratory test findings including hemoglobin, platelet, C-reactive protein, serum albumin, total bilirubin, prothrombin time, and anti-thrombin III levels. Most of these parameters also showed significant linear correlations with the 25(OH) vitamin D level (P < 0.05). However, no statistically meaningful association was found between VDD and other clinical conditions such as the need for a mechanical ventilator, requirement for vasoactive drugs, duration of the PICU and hospital stays, or PICU mortality.CONCLUSIONThere is a high prevalence of VDD in critically ill Korean children. There were significant associations between the 25(OH) vitamin D level and gastrointestinal/hepatobiliary disorders, the pMODS score and with coagulation related factors. Further large-scale studies with more specific subgroup analyses are required to more precisely assess the clinical implications of VDD in critically ill pediatric patients.

Intervention for Increasing Vitamin D Supplementation in a Deficient Rehabilitation Population: Outcomes of a Quality Improvement Initiative.

Vitamin D deficiency (VDD) is highly prevalent and increases the risk of osteoporosis, falls, and fractures. Patients in acute inpatient rehabilitation have several risk factors for VDD, the adverse effects of which may hinder long-term functional gain. To evaluate the prevalence of and risk factors for VDD in patients admitted to acute inpatient rehabilitation and to evaluate the efficacy of a standardized vitamin D screening and supplementation protocol. Prospective cohort study as part of a quality improvement initiative. An academic, freestanding acute inpatient rehabilitation hospital. Patients consecutively admitted over a 4-month period between November 2014 and February 2015 (n=128 pre-intervention and n=129 post-intervention). Universal screening of vitamin D level on admission followed by utilization of a standard supplementation protocol. Vitamin D insufficiency (VDI) and VDD prevalence along with screening, and supplementation rates. Preintervention, 10.2% of patients were screened for VDD, with 23.1% VDI and 46.2% VDD. Postintervention, 89.9% were screened, with 31.9% VDI and 47.4% VDD. 6.3% of all patients were supplemented on vitamin D preintervention compared to 53.5% postintervention. In multivariate analyses, the odds of VDD was significantly associated with African American race (OR 7.30, 95% CI, 1.56-34.20, P = .12) and age younger than 65 (OR 13.62 95% CI, 2.51-73.83, P = .002). Diagnoses in the "other neurologic" category were associated with decreased odds of VDD (OR 0.01, 95% CI, 0.001-0.193, P = .002). Given the high prevalence of VDD in an acute inpatient rehabilitation hospital, a routine screening and standardized supplementation protocol may improve quality of care. III.

Association of vitamin D status with liver and kidney disease: A systematic review of clinical trials, and cross-sectional and cohort studies.

Background: Vitamin D deficiency (VDD) is a major public health problem. There are few comprehensive systematic reviews about the relationship between Vitamin D status and liver and renal disease in Iran. Methods: We systemically searched the following databases: Web of Science; PubMed; Cochrane Library; Scopus; Science Direct; Google Scholar and two Iranian databases (Scientific Information Database (SID) and IranMedex) up until November 2017 to identify all randomized control trials(RCTs), case control, cross-sectional and cohort studies investigating the association between vitamin D and any form of liver or kidney disease. Results: Vitamin D insufficiency, or deficiency (VDD), is highly prevalent in Iran, reports varying between 44.4% in Isfahan to 98% in Gorgan. There is also a high prevalence of VDD among patients with liver or kidney disease, and the administration of vitamin D supplements may have beneficial effects on lipid profile, blood glucose, liver function and fatty liver disease, and bone health. Low serum vitamin D levels are related with abnormalities in these laboratory and clinical parameters. Conclusion: VDD is prevalent in patients with chronic liver or renal disease in Iran. There appear to be several beneficial effects of vitamin D supplementation in vitamin D deficient patients with liver or kidney disease.