High Rates Of Vitamin Research Articles

Investigating Vitamin D Status: A Key Factor in Gestational Diabetes among Pregnant Women

Background: Vitamin D deficiency within the general population suggests the emergence of glucose intolerance. The relationship between insufficient vitamin D levels and gestational diabetes mellitus remains a subject of ongoing discussion. Objectives: The investigation looked into the connection between vitamin D levels and the chances of developing gestational diabetes mellitus. Methodology: This cross-sectional analytic study includes 262 pregnant women who attended the Gestational Diabetes Center and Antenatal Counseling Center at the Maternity Teaching Hospital in Sulaimani City. The study used convenience sampling, and the data was collected from November 1st, 2021, to October 1st, 2022. The study used a specific questionnaire divided into four sections: demographics, medical, and obstetric. Simultaneously, the Roche Elecsys vitamin D3 assay determined serum vitamin D status. Results: Women with gestational diabetes mellitus had a significantly higher prevalence of vitamin D inadequate levels (p =0.000), Significant variance in residency (p =0.000), education (p =0.000), body mass index (p =0.038), age at marriage (p =0.023), history of using the contraceptive pill (p-value =0.000), parity (p =0.001), and gravidity (p =0.014) were additionally identified between the two groups of gestational diabetes mellitus and non-gestational diabetes mellitus. Conclusion: Women with gestational diabetes mellitus had higher rates of vitamin D deficiency than those without, but the differences were not statistically significant.

High rates of vitamin D insufficiency among patients presenting for total knee arthroplasty.

Widely varying prevalence of vitamin D deficiency has been reported in patients presenting for total knee arthroplasty (TKA). The primary aim of this study was to determine vitamin D levels in TKA patients and to compare to patients already routinely evaluated for vitamin D levels, patients with fragility fractures of the distal radius (DRF). There is significant overlap between patients presenting for TKA and with DRF, both in terms of medical comorbidities and overall health status, making these populations suitable comparative cohorts. Wefound that all patients presenting for TKA consultation had vitamin D insufficiency and 33% had vitamin D deficiency, compared to only 37% and 14% in the DRF cohort, a patient population routinely evaluated for vitamin D due to the high risk of deficiency. Furthermore, patients with DRF had higher levels of vitamin D before (38 ± 16 vs. 23 ± 5) and after vitamin D supplementation (39 ± 17 vs. 33 ± 10), suggesting that patients presenting for TKA are at even higher risk of vitamin D insufficiency than patients presenting with DRF. Reassuringly, supplementation successfully corrected 39.0% and 55.8% of patients in the DRF and TKA cohorts, respectively.

Vitamin D Deficiency Is Frequent in Patients with Rapidly Destructive Osteoarthritis-Data from a Single-Center Analysis.

Rapidly destructive osteoarthritis (RDO) of the hip joint is characterised by the rapid destruction of the femoral head with or without acetabular involvement. There has been increasing interest in this disease over the past years; however, the entity is still poorly understood, and its pathophysiology remains unknown. Yet, there is ample evidence today that increased bone metabolism might play a role in the onset and progression of the disease. Vitamin D is of utmost importance to maintain a balanced bone metabolism. However, whether vitamin D deficiency is involved in disease development remains to be elucidated. Further, the vitamin D status of patients with RDO has not yet been analysed. For this reason, the objective of this study was to assess the vitamin D status of patients with RDO. Moreover, the aim was to clarify whether there is a difference in the vitamin D status of patients with RDO compared with patients with primary osteoarthritis (OA). In this single-centre analysis, the 25(OH)D, PTH, and calcium levels of 29 patients who presented with RDO between 2020 and 2022 were assessed. Altogether, 97% of patients (28/29) were vitamin D deficient, a further 3% (1/29) were vitamin D insufficient, and not a single patient presented with a sufficient vitamin D status. Notably, the vitamin D levels of RDO patients (mean = 11.04 ng/mL) were significantly lower than the vitamin D levels of patients with OA (mean = 22.16 ng/mL, p = 0.001). In conclusion, we found a widespread and high rate of vitamin D deficiency in patients with RDO. Hence, we believe that 25(OH)D status should routinely be analysed in these patients.

Significant Association between a Diagnosis of Hypovitaminosis D and Rotator Cuff Tear, Independent of Age and Sex: A Retrospective Database Study.

As high rates of vitamin D deficiency have been demonstrated in orthopedic patient cohorts, this study aimed to characterize the association between a diagnosis of hypovitaminosis D and primary rotator cuff tear (RCT), primary rotator cuff repair (RCR), and postoperative complications in different sex and age cohorts. In this retrospective cohort study using PearlDiver, a nationwide administrative claims database, records for all patients aged 30 to 89 yr who received a diagnosis of hypovitaminosis D between January 1, 2011, and October 31, 2018, were queried. Rates of primary RCT, primary RCR, and postoperative complications including subsequent surgery were calculated within sex- and age-specific cohorts and compared with matched control cohorts using multivariable logistic regression. Among the 336,320 patients included in the hypovitaminosis D cohort, these patients were significantly more likely to experience an RCT (odds ratio (OR), 2.70; 95% confidence interval (CI), 2.55-2.85) as well as a full-thickness RCT (OR, 2.36; 95% CI, 2.17-2.56) specifically within 2 yr of their diagnosis. Women with hypovitaminosis D were more likely to undergo surgery to address their full-thickness tears (OR, 1.37; 95% CI, 1.09-1.74). There was no difference in the rates of revision RCR or irrigation and debridement. However, women with hypovitaminosis D were significantly more likely to undergo manipulation under anesthesia (OR, 1.16; 95% CI, 1.03-1.31). Patients diagnosed with hypovitaminosis D were significantly more likely to suffer from a primary RCT and to undergo manipulation under anesthesia within a year of their RCR. Although many risk factors for RCT are unmodifiable, vitamin D deficiency is a readily modifiable risk factor with several treatment regimens demonstrating positive effects on musculoskeletal health.

Prevalence and risk factors of vitamin D deficiency among living with HIV adults receiving antiretroviral treatment in tropical area: Cross-sectional study

BackgroundThere was found HIV infection have a higher rate of vitamin D deficiency (VDD) than the general population, even a slight deficiency, can increase the risk of osteoporosis in adults. This study aimed to determine the prevalence and risk factors of VDD in HIV-infected adults receiving antiretroviral therapy (ART) in a tropical area. MethodsA cross-sectional study of an HIV-clinical population-based cohort was conducted at Police General Hospital (PGH), from 1st August 2020 to 31st July 2021, in Bangkok, Thailand. Serum 25(OH)D level was measured using ECLIA. All other laboratory investigations were conducted at the PGH's central lab center. The descriptive analysis utilized frequency (percentages) and mean (SD) as appropriate variable types. Chi-square tests (χ2) and independent samples t-tests were used to differentiate between VDD and non-VDD groups. To determine the association between VDD and non-VDD, gender, age (years), BMI discrepancy, ART regimens, ART-duration (years), HIV viral load, and CD4 count (cells/mm3). Univariate and multivariable logistics regression was conducted, respectively. ResultsOf 602 patients, 66.4% were females with mean age of 45.22 ± 10.23 years. The average serum 25(OH)D level was 18.69 ± 7.23 ng/ml. The prevalence of VDD (<20 ng/ml) and insufficiency (VDI) (20–29.9 ng/ml) was 58.5% and 35.2%, respectively. Risk factors associated with vitamin D inadequacy were increasing age (AOR = 1.05, 95%CI = 1.03–1.07, P < .001), efavirenz (EFV-based) use (AOR = 6.07, 95%CI = 3.57–10.31, P < .001), while male (AOR = 0.44, 95%CI = 0.29–0.66, P < .001), body mass index (BMI) lower than 18.5 (AOR = 0.26; 95% CI, 0.11–0.62, P = .002), protease Inhibitors (PIs-based) use (AOR = 0.18, 95%CI = 0.11–0.30, P < .001),and CD4 count <200 cells/mm3 (AOR = 0.41; 95% CI, 0.20–0.85, P = .017) were associated with less VDD. ConclusionThe implementation of focused strategies for vitamin D supplementation, specifically targeting older patients and patients undergoing EFV-based ART regimen, can serve as a valuable addition to comprehensive HIV management. By optimizing vitamin D levels, there is a potential to improve health outcomes and enhance overall well-being for individuals living with HIV.

Bone health practices in metastatic prostate cancer (mPCA).

e17119 Background: Patients (pts) with mPCA and bone metastases (BM) are at risk for skeletal-related events (SREs), which include pathologic fracture, bone irradiation or surgery, spinal cord compression, and hypercalcemia. This study examined the evaluation, prevention, and treatment of osteopenia/-porosis (OP/P) and BM in pts with mPCA at the UCCC and affiliated sites. Methods: Pts diagnosed with mPCA and BM between 2011-2021 and treated with ADT were included. Demographic, clinical, treatment, and outcomes data were retrospectively collected. The primary endpoint was time from mPCA diagnosis to first SRE. Secondary endpoints included rates of DEXA scans, rates of vitamin D and calcium supplementation, and bone agent toxicity. The log-rank test was conducted to compare the primary endpoint by use of a bone strengthening agent. The Kruskal Wallis non-parametric test was used for continuous variables and Fisher’s exact test for categorical variables. Results: Of the 369 pts with mPCA, 247 (66.9%) were treated with a bone agent. Median age at metastatic diagnosis (mDx) was 69.6 years. Pts were predominately white (315, 85.4%) with hormone-sensitive mPCA (mHSPC) (327, 88.6%) at mDx. There were no significant differences in race, ethnicity, PSA, Gleason score, or time on ADT between patients who did and did not receive a bone agent. 222 pts (60.2%) were former or current smokers, 5 (1.4%) had pre-existing low testosterone ( &lt; 150 ng/dL), 8 (2.2%) had prolonged glucocorticoid use (equivalent &gt; 10 mg prednisone for 30 days), and 17 (4.6%) had known OP/P prior to mDx. 130 pts (35.3%) had a DEXA scan (27 pre-ADT, 103 post-ADT). 325 pts (88.1%) and 286 pts (77.5%) were recommended vitamin D and calcium supplementation, respectively. Bone agent use and toxicity are presented in table 1. 110 of 247 pts (44.5%) treated with a bone agent were started in the mHSPC setting without OP/P. Time from mPCA diagnosis to first SRE was a median of 32.8 months (IQR 13.5 to 66.8) for pts who received a bone agent vs. 28.2 months (IQR 8.7 to 59.1) who did not (Chi-squared = 7.089, p = 0.008). Among SREs, 102 pts (27.6%) had a pathologic fracture, 1 (0.3%) severe hypercalcemia &gt; 14 mg/dL, 23 (6.2%) bone surgery, 142 (38.5%) bone irradiation, and 4 (1.1%) spinal cord compression. Conclusions: Bone agent use was associated with an expected improvement in time to first SRE. Pts with mPCA had high rates of vitamin D and calcium supplementation for OP/P prevention. Denosumab was the most used bone agent in concordance with guidelines for mPCA. DEXA scan rates were low, and nearly half of patients received a bone agent prior to castrate resistance. [Table: see text]

Vitamin D levels in relation to bariatric surgery: a single center experience

Background: Bariatric surgery has become a major component of the treatment of obesity and obesity related illnesses such as diabetes mellitus, hypertension and dyslipidemia. However, bariatric surgeries have been linked to some disturbances in the overall micronutrient profile in the post-operative period. In obese patients, visceral fat, is most closely related to the development of metabolic syndrome (MS). In this respect, vitamin D is of major importance, since numerous studies have shown that it can impact the prevention of MS, immune diseases and some cancers. Furthermore, given its inverse association with adiposity, high rates of vitamin D deficiency (VDD) have been found in obese patients, including those with morbid obesity who are candidates for bariatric surgery. Methods: A cross sectional study design was carried out after obtaining the required ethical approval. The surgery register was scanned for all bariatric procedures done from January 2018 till December 2018. Data were retrieved about each case through ISEHA labs, progress notes, medications summary, radiological images. Files were retrieved from the filing department for cases who were admitted to the surgical HDU or ICU (as they still use paper documentation). All data were compiled into a detailed excel sheet. Results: The total number of included patients was 232, with a mean age of 41.3. The majority of patients underwent laparoscopic Roux-En-Y bypass (67.2%), while laparoscopic sleeve gastrectomy was done in 32.8% of patients. As expected, mean body mass index (BMI) dropped down from (46.3 to 35.1). The striking result noted was the percentage of patients who had vitamin D deficiency pre bariatric surgery (44 patients, 19%). This percentage has increased up to (73 patients, 31.4%) post bariatric surgery at 12 months follow up. Conclusions: Bariatric surgery is linked to increased incidence of vitamin D deficiency post operatively. Vitamin D level close monitoring in peri-operative management of bariatric patients is recommended to avoid potential complications.

Clinical and lifestyle patterns in Asian children with inflammatory bowel disease in the U.S.

While there are many epidemiologic studies of Asian immigrants to the West and risk of inflammatory bowel disease (IBD), the phenotype and lifestyle of Asian patients, particularly children, with IBD are not well described. In this study, we describe lifestyle practices, such as dietary pattern, as well as disease phenotype in Asian American children with IBD. We reviewed the records of children with IBD, ages 0 to 21 years old, and race identified as Asian, Indian, or Pacific Islander. Patients who received outpatient IBD care at our center between January 2013 and January 2020 were included. We excluded patients who were international second opinions, who did not have a definitive diagnosis of IBD, and in whom a diagnosis of IBD was made after 18 years of age. A survey, including a food frequency questionnaire adapted from NHANES DSQ with modifications to include culturally appropriate food elements, was designed and conducted within this cohort to assess for dietary patterns. Asian patients in our cohort have similar phenotypes as non-Asians with few distinctive differences. There was a Crohn's disease and male predominance similar with non-Asians. However, there was a high rate of proctitis in ulcerative colitis in Asian patients. Asian patients reported a typical dietary pattern that reflects a Westernized pattern rather than a traditional pattern. Despite a similar dietary pattern, there was a high rate of 25-OH Vitamin D deficiency (44%) and insufficiency (40%). This single center study showed that the phenotype of Asian children with IBD in the U.S. is similar with that of non-Asian with a few distinct differences. The Asian children in our cohort reported following a Westernized dietary pattern and lifestyle. However, there was a high rate of Vitamin D deficiency surrounding diagnosis, suggesting a need for vigilant monitoring.

A case of hyponatraemia secondary to vitamin D deficiency

Hyponatraemia and Vitamin D deficiency are common conditions in older adults. Both conditions cause bone fragility and gait abnormalities, which are risk factors for falls and poor health outcomes in older adults. Vitamin D deficiency is a risk factor for osteoporosis and increases the risk for fragility fractures. Hyponatraemia, the commonest electrolyte abnormality, causes bone resorption and contributes to falls by impairing cognition and by causing gait abnormalities. Sodium homeostasis is complex and the syndrome of inappropriate antidiuretic hormone secretion (SIADH), a diagnosis of exclusion, is one of the most common causes of hyponatraemia. Instability is a feared geriatric syndrome, as falls can have devastating consequences for the older adult, leading to significant morbidity and mortality. Previous studies have shown that patients with hyponatraemia had a higher rate of vitamin D deficiency and, conversely, those with vitamin D deficiency had a higher rate of hyponatraemia. The exact pathophysiological mechanism behind this correlation is unclear but may involve bone derived hormone fibroblast growth factor 23 and the renin–angiotensin–aldosterone system. A case of an 83-year-old Asian female, who presented with an osteoporotic intertrochanteric femoral fracture following a fall, is presented. She was found to have chronic hyponatraemia and was subsequently diagnosed with SIADH due to vitamin D deficiency.

Association Between Vitamin D Levels and the Atherogenic Index of Plasma Among Chinese with Type 2 Diabetes Mellitus.

The relationship between atherogenic index of plasma (AIP) values and 25-hydroxyvitamin D (25[OH] D) was examined in type 2 diabetes mellitus (T2DM). Six hundred and ninety-eight T2DM patients were included. Patients were allocated to two groups, namely, the vitamin D-deficient and non-deficient groups (threshold of 20 ng/mL). The AIP was determined as log (TG [mmol/L] / HDL-C [mmol/L]). The patients were then allocated to two further groups according to the median AIP value. AIP level in the vitamin D-deficient group was significantly higher than that in non-deficient group (P<0.05). Patients with high AIP values had markedly reduced levels of vitamin D levels compared with those in the low-AIP group [15.89 (11.97, 20.29) VS 18.22 (13.89, 23.08), P<0.001]. Patients in the high AIP group had a higher rate of vitamin D deficiency (73.3% VS 60.6%). It was found that AIP values were adversely and independently correlated with vitamin D levels. The AIP value was shown to independently predict vitamin D deficiency risk in T2DM patients. Patients with T2DMwere shown to have an increased risk of vitamin D insufficiency when their AIP levels were low. This suggests that AIP is associated with vitamin D insufficiency in Chinese patients with type 2 diabetes.

Abstract A079: Genetic ancestry and vitamin D may predict degree of prostatic apoptosis in prostate tumor and benign epithelium among men undergoing radical prostatectomy

Abstract There is evidence that vitamin D metabolites such as 25 hydroxyvitamin D [25(OH)D], may be protective against prostate cancer (PCa). Vitamin D and its analogs are hypothesized to have pro-apoptotic effects in multiple cell lines. Blacks have higher rates of vitamin D deficiency, higher tumor progression rates 1,2, and higher apoptosis rates3 compared to Whites. West African ancestry (WAA) may confound this relationship if it is associated with both vitamin D status and apoptosis rates. Our objective is to assess for independent associations between in vivo vitamin D status, genetic ancestry, and degree of apoptosis using prostatic epithelial Terminal deoxynucleotide transferase dUTP Nick End Labeling (TUNEL) staining. Radical prostatectomy specimens of men with clinically localized PCa were stained for TUNEL. Prostatic and serum levels of 25(OH)D and serum levels of 1,25 hydroxyvitamin D were assessed at the time of surgery. Ancestry informative markers were used to estimate the percentage of genetic West African, Native American, and European ancestry. Continuous variables were compared using medians tests across three groups of vitamin D status. Categorical variables were compared using the Chi-Squared test. Correlations between the degree of TUNEL staining and vitamin D metabolites were assessed using Spearman correlations. Linear regressions were used to access the bivariant associations between tumor and benign epithelial TUNEL staining with quartiles of ancestry, and serum and prostatic vitamin D metabolite levels. Multivariate linear regressions for the percentage of benign and tumor TUNEL staining were used to test the independent associations of vitamin D metabolites and genetic ancestry. Overall, 121 men, age 40-79, who underwent radical prostatectomy were enrolled between 2013-2018. Serum 25(OH)D correlated positively with both tumor (ρ = 0.17, p = 0.03), and benign (ρ = 0.16, p = 0.04) prostatic epithelial TUNEL staining. Similarly, prostatic 25(OH)D correlated positively with both tumor (ρ = 0.31, p &amp;lt; 0.001) and benign (ρ = 0.20, p = 0.03) prostatic tissue TUNEL staining. Relative to West African ancestry, Native American ancestry was more strongly positively correlated with tumor (ρ = 0.22, p = 0.05) and benign (ρ = 0.27, p= 0.02) TUNEL staining. In multivariate regression models, increasing quartiles of prostatic 25(OH)D (β = 0.25, p = 0.04) and Native American ancestry (β = 0.327, p = 0.004) were significant predictors of tumor TUNEL staining. Physiologic levels of serum and prostatic 25(OH)D and percentage of Native American ancestry are positively associated with the degree of apoptosis in tumor and benign prostatic epithelium from men with clinically localized PCa. Vitamin D may have secondary chemoprevention benefits in preventing PCa progression in localized disease. Citation Format: Cordero L. McCall, James Stinson, Ryan W. Dobbs, Neil Mistry, Adrian Rosenberg, Oluwarotimi Nettey, Pooja Sharma, Michael Dixon, Jamila Sweis, Virgilia Macias, Roohollah Sharifi, Rick A. Kittles, Andre Kajdacsy Balla, Adam B. Murphy. Genetic ancestry and vitamin D may predict degree of prostatic apoptosis in prostate tumor and benign epithelium among men undergoing radical prostatectomy [abstract]. In: Proceedings of the 15th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2022 Sep 16-19; Philadelphia, PA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2022;31(1 Suppl):Abstract nr A079.

Vitamin D3 Supplementation in Overweight/Obese Pregnant Women: No Effects on the Maternal or Fetal Lipid Profile and Body Fat Distribution-A Secondary Analysis of the Multicentric, Randomized, Controlled Vitamin D and Lifestyle for Gestational Diabetes Prevention Trial (DALI).

Vitamin D deficiency is a common finding in overweight/obese pregnant women and is associated with increased risk for adverse pregnancy outcome. Both maternal vitamin D deficiency and maternal obesity contribute to metabolic derangements in pregnancy. We aimed to assess the effects of vitamin D3 supplementation in pregnancy versus placebo on maternal and fetal lipids. Main inclusion criteria were: women <20 weeks’ gestation, BMI ≥ 29 kg/m2. Eligible women (n = 154) were randomized to receive vitamin D3 (1600 IU/day) or placebo. Assessments were performed <20, 24–28 and 35–37 weeks and at birth. Linear regression models were used to assess effects of vitamin D on maternal and cord blood lipids. In the vitamin D group significantly higher total 25-OHD and 25-OHD3 levels were found in maternal and cord blood compared with placebo. Adjusted regression models did not reveal any differences in triglycerides, LDL-C, HDL-C, free fatty acids, ketone bodies or leptin between groups. Neonatal sum of skinfolds was comparable between the two groups, but correlated positively with cord blood 25-OH-D3 (r = 0.34, p = 0.012). Vitamin D supplementation in pregnancy increases maternal and cord blood vitamin D significantly resulting in high rates of vitamin D sufficiency. Maternal and cord blood lipid parameters were unaffected by Vitamin D3 supplementation.

Prevalence and factors associated with vitamin C deficiency in inflammatory bowel disease.

BACKGROUNDPatients with inflammatory bowel disease (IBD) are prone to several nutritional deficiencies. However, data are lacking on vitamin C deficiency in Crohn’s disease (CD) and ulcerative colitis (UC) patients, as well as the impact of clinical, biomarker and endoscopic disease severity on the development of vitamin C deficiency.AIMTo determine proportions and factors associated with vitamin C deficiency in CD and UC patients.METHODSIn this retrospective study, we obtained clinical, laboratory and endoscopic data from CD and UC patients presenting to the IBD clinic at a single tertiary care center from 2014 to 2019. All patients had an available plasma vitamin C level. Of 353 subjects who met initial search criteria using a cohort discovery tool, 301 ultimately met criteria for inclusion in the study. The primary aim described vitamin C deficiency (≤ 11.4 μmol/L) rates in IBD. Secondary analyses compared proportions with deficiency between active and inactive IBD. Multivariate logistic regression analysis evaluated factors associated with deficiency.RESULTSOf 301 IBD patients, 21.6% had deficiency, including 24.4% of CD patients and 16.0% of UC patients. Patients with elevated C-reactive protein (CRP) (39.1% vs 16.9%, P < 0.001) and fecal calprotectin (50.0% vs 20.0%, P = 0.009) had significantly higher proportions of deficiency compared to those without. Penetrating disease (P = 0.03), obesity (P = 0.02) and current biologic use (P = 0.006) were also associated with deficiency on univariate analysis. On multivariate analysis, the objective inflammatory marker utilized for analysis (elevated CRP) was the only factor associated with deficiency (odds ratio = 3.1, 95% confidence interval: 1.5-6.6, P = 0.003). There was no difference in the presence of clinical symptoms of scurvy in those with vitamin C deficiency and those without.CONCLUSIONVitamin C deficiency was common in IBD. Patients with elevated inflammatory markers and penetrating disease had higher rates of vitamin C deficiency.

Metabolic bone disease and fracture risk after gastric bypass and sleeve gastrectomy: comparative analysis of a multi-institutional research network.

Roux-en-Y gastric bypass (RYGB) and sleeve gastrectomy (SG) are the two most performed bariatric procedures. Multiple studies have investigated the metabolic bone complications after bariatric surgery, but there is a paucity of data comparing bone health after RYGB and SG. To compare the rates of major fractures and osteoporosis after Roux-en-Y gastric bypass and sleeve gastrectomy. Data from TriNetX multi-institutional research network that includes data from multiple health care organizations in the USA was analyzed at West Virginia University. We conducted a retrospective cohort study using TriNetX, a federated multi-institutional research network. We identified patients who underwent RYGB or SG. Primary outcome was the rate of major fractures at 3 years after the procedure. Other outcomes includedthe rate of spine fracture, femur fracture, osteoporosis, and vitamin D deficiency at follow-up. In unmatched analysis, patients with SG were less likely to have major fractures or an osteoporosis diagnosis than RYGB patients at 3 years after the procedure (P < .05). After propensity-score matching, similar results were noted; patients with SG were less likely to have major fractures than RYGB patients at 3 years after procedure (2.85% versus 3.66%, risk ratio [RR]: .78, 95% confidence interval [CI]: .71-.85), and a lower rate of osteoporosis diagnosis was noted in the SG group. High rates of vitamin D deficiency were noted in both cohorts. The incidence of spine fractures was significantly lower in the SG group than in the RYGB group (.76% versus 1.18%, RR: .65, 95% CI: .54-.77). Similarly, the incidence of femur fracture was significantly lower after SG (RR: .62, 95% CI: .44-.88). Female sex, higher age, smoking history, and diabetes were independently associated with osteoporosis diagnosis during follow-up (all P values <.05). Our analyses showed that RYGB is associated with a higher risk of osteoporosis, vitamin D deficiency, and osteoporotic fractures. Thus, in patients with a higher baseline osteoporotic risk, SG may be preferred option; however, further studies are needed.

The Effect of Cord Blood Vitamin D Level on Bronchopulmonary Dysplasia and Other Neonatal Morbidities in Preterm Infants

OBJECTIVES: We aimed to investigate the relationship between cord 25-hydroxyvitamin D level and bronchopulmonary dysplasia and other neonatal morbidities (sepsis, necrotizing enterocolitis, intraventricular hemorrhage, patent ductus arteriosus, respiratory distress syndrome, retinopathy of prematurity) in preterm neonates. STUDY DESIGN: Infants aged &lt;32 gestational weeks who were admitted to the neonatal intensive care unit between March 2014 and November 2014 were enrolled in this prospective study. Cord blood samples were obtained during delivery. 25-hydroxyvitamin D level was measured using an automatic biochemical analyzer. Patients were divided into two groups according to their 25-hydroxyvitamin D levels: 25-hydroxyvitamin D &lt;20 ng/mL and 25-hydroxyvitamin D ≥20 ng/mL. We used descriptive statistics and multiple regression models to identify risk factors associated with bronchopulmonary dysplasia. RESULTS: Sixty premature infants were analyzed in this study. The mean cord 25-hydroxyvitamin D level was 13,8±6,8 ng/mL (range 3,5-30,7 ng/mL). Eighty percent of the patients (48/60) had 25-hydroxyvitamin D levels &lt;20 ng/mL. Among the infants, 21 (35%) developed bronchopulmonary dysplasia. Infants with bronchopulmonary dysplasia had higher frequencies of 25-hydroxyvitamin D deficiency than the non-bronchopulmonary dysplasia group (p=0.028). Duration of hospitalization was also longer in infants with low levels of cord 25-hydroxyvitamin D. On the other hand, there was no significant difference between infants with and without vitamin D deficiency with respect to respiratory distress syndrome, patent ductus arteriosus, retinopathy of prematurity, necrotizing enterocolitis, sepsis, and intraventricular hemorrhage. CONCLUSION: This study shows the high rate of vitamin D deficiency in pregnant women in the central Anatolian region (Sivas) of Turkey. Low cord 25-hydroxyvitamin D levels were associated with an increased risk of bronchopulmonary dysplasia and prolonged hospitalization in very preterm infants. These data strengthen the necessity for vitamin D supplementation during pregnancy.

The frequency of vitamin D deficiency in Ordu and its relationship with chronic diseases

Aim: The aim of this study was to evaluate the frequency of vitamin D deficiency in adult patients admitted to our hospital in Ordu and the relationship between this deficiency and chronic diseases.&#x0D; Material and Method: In our study, the vitamin D levels of 1432 patients aged 18 yeras and over who applied to the Internal Medicine outpatient clinic between 01.01.2019-31.12.2019 were retrospectively evaluated. Age, gender, chronic diseases were evaluated and vitamin D levels of the patients were measured. Patients with serum vitamin D level of 30 ng/ml were included in the normal vitamin D group. &#x0D; Results: The study consisted of 1092 females (76.4%) and 340 males (23.6%). We found vitamin D deficiency and insufficiency in approximately 88.3% of the patients. In addition, serum vitamin D levels of female patients included in the study were found to be significantly lower than male patients (p=0.007). There were statistically significant differences between the groups in the number of patients included in the study who had a chronic disease and in the evaluation of their vitamin D levels (insufficient, deficient, normal)(p=0.021, p=0.012, p=0.047, p=0.043, p=0.032, respectively). &#x0D; Conclusion: With this study, a very high rate of vitamin D deficiency and insufficiency, such as 88.3%, was found in Ordu. In addition, there was a significant relationship between vitamin D deficiency and chronic diseases in our study.

Vitamin A intake forms resistance to hypervitaminosis A and affects the functional activity of the liver

Vitamin A intake forms resistance to hypervitaminosis A and affects the functional activity of the liver

Association Between Migraine Complicated With Restless Legs Syndrome and Vitamin D.

Background: This study aimed to evaluate the prevalence of restless legs syndrome (RLS) in patients with migraine and explore its association with vitamin D deficiency, aiming to provide biological support for the comorbidity of migraine with RLS, and shed new lights into clinical diagnosis and treatment.Methods: A case-control study was performed on 175 migraine patients and 151 non-headache controls. The information of all subjects concerning headache severity [visual analog scale (VAS) score], RLS, RLS severity [International Restless Legs Scale (IRLS) score], sleep quality [Pittsburgh sleep quality index (PSQI)], anxiety and depression symptoms [hospital anxiety and depression scale (HADS)], and demographic data were collected. At the same time, serum 25-(OH) D levels were also measured (concentration <20 ng/ml was defined deficiency). Afterward, the logistic regression model was adopted to explore the risk factors for RLS in patients with migraines.Results: Compared with control group, migraine group had lower vitamin D levels [(21.10 ± 6.58) vs. (16.42 ± 5.6) ng/ml, P < 0.001], a higher rate of vitamin D deficiency (45.03 vs. 72%, P <0001), higher prevalence of RLS (6.62 vs. 22.29%, P < 0.001). Compared with the pure RLS group, RLS with the migraine group had lower vitamin D levels and higher IRLS score (P < 0.05). Compared with pure migraine group, migraine with RLS group had lower vitamin D levels [(17.36 ± 5.56) vs. (13.15 ± 4.42) ng/ml, P < 0.001], higher incidence of vitamin D deficiency (66.18 vs. 92.31%, P = 0.001), higher frequency of headache attacks (P = 0.004). Thereafter, the multivariate logistic regression model was employed to adjust confounding factors such as age, gender, season, frequency of headache attacks, PSQI score, and HADS scores. According to the results vitamin D deficiency in patients with migraines was an independent risk factor for RLS (OR = 5.03, 95%CI: 1.2–21.16, P = 0.027).Conclusions: The prevalence of RLS in migraine patients was significantly higher than that in the non-headache population. Besides, vitamin D levels decreased, while the incidence of vitamin D deficiency increased in the migraine patients complicated with RLS. Finally, the occurrence of RLS in migraine patients was significantly related to vitamin D deficiency.

Evaluation of 25-hydroxy vitamin D levels in COVID-19 positive patients

Aim: With this study, the aim was to evaluate the serum 25-hydroxy vitamin D levels in COVID-19 positive patients. &#x0D; Material and Method: The study retrospectively screened the archive records for patient data from 732 patients, attending the pandemic clinic in our hospital from March 2020 to February 2021 aged over 18 years with COVID-19 positivity and serum 25-hydroxy vitamin D levels examined, with data from 360 control patients between the same dates in similar age group and without COVID-19 positivity. COVID-19 positive patients and control group patients were divided into three groups according to serum 25-hydroxy vitamin D levels (deficiency, insufficiency, and normal level). &#x0D; Results: Of the 732 COVID-19 positive patients included in the study, 66.4% were female (n=486) and 33.6% were male (n=246). The mean serum 25(OH)D level in the COVID-19 positive patient group was calculated as 14.2± 11.7 ng/ml. For the 360 patients included in the COVID-19 negative control group, 70% were female (n=252) and 30% were male (n=108). Mean serum 25(OH)D level in the COVID-19 negative control group was 27.6±12.1 ng/l. There was a significant difference between the groups (p=0.012). &#x0D; Conclusion: High rates of vitamin D deficiency and insufficiency are seen in COVID-19 positive patients. Sufficient levels of replacement for patients with low vitamin D levels will provide significant reductions in musculoskeletal system symptoms and complaints of patients. We think vitamin D is a protective vitamin for COVID-19.

Vitamin D levels in persons with traumatic spinal cord injury: a multicentre observational study

Background: According to the published literature, Vitamin D deficiency is prevalent in spinal cord injury (SCI). Many studies were done earlier to find out different factors which predispose the SCI population to the risk of vitamin deficiency, but correlation with any such factor is still uncertain. Studies from India are scarce. The present study was conducted in view of this lacuna in existing knowledge in India and in the developing countries, to observe the levels of Vitamin D in traumatic SCI patients admitted for rehabilitation.Methods: In this prospective, observational, multicentre study, all patients admitted consecutively in the three study centres, satisfying the selection criteria were included. The level of 25-OH Vitamin D was assessed by Chemiluminescence procedure. Vitamin D level &lt;20 ng/ml was taken as deficient, 20-29ng/ml as insufficient, ≥30 ng/ml was the optimum and ≥150 ng/ml was taken as toxic level.Results: Among 56 patients of traumatic spinal cord injury who were included in the study, having mean age of 32.32±11.82 years, only 14 (25%) were having optimum Vitamin D level. 25 (45%) subjects were deficient in Vitamin D, whereas 16 (28%) were having insufficient levels. One subject was found to have toxic level of Vitamin D (156 ng/ml). No differences of Vitamin D levels were observed between demographic and clinical groups.Conclusions: Although a high rate of Vitamin D deficiency was encountered in SCI individuals, the role of different factors causing Vitamin D deficiency remains unproven. Also the amount of Vitamin D required to forestall insufficiency is still unknown, indicating a necessity for more studies with well-defined outcome measures.