High Prevalence Of Deficiency Research Articles

High prevalence of deficiencies in fat-soluble vitamins, minerals and trace elements but no relation with malnutrition in patients with gastroenteropancreatic neuroendocrine tumours using somatostatin analogue's

High prevalence of deficiencies in fat-soluble vitamins, minerals and trace elements but no relation with malnutrition in patients with gastroenteropancreatic neuroendocrine tumours using somatostatin analogue's

Impact of the COVID-19 lockdown on the vitamin D status of people in the West of Ireland.

Identify the impact of COVID-19 lockdown restrictions on the vitamin D status of individuals in the west of Ireland. Cross-sectional study. Adults who had wintertime serum 25(OH)D analysis completed in Galway University Hospital. A total of 16,725 participants (2015-2020 (n = 13,449) and 2020-2021 (n = 3276)). Baseline demographics; sex, age, origin of the sample and the date of sample collection. Median serum vitamin D and serum vitamin D3 concentrations were higher in the 5-month period from October-February 2020-2021 (61nmol/L (± 36-85nmol/L) and 60nmol/L (± 34-85nmol/L)) respectively, than for the corresponding 5-month period (October-February) in 2015-2020 (53nmol/L (± 32-78nmol/L) and 51nmol/L (± 30-77nmol/L)) respectively. These changes coincided with a decline in the prevalence of deficiency. In the 5-month period October-February 2020-2021, 19.2% of the population were vitamin D deficient (< 30nmol/L) compared to 22.5% in the corresponding 5-month period in 2015-2020, and 38.1% were vitamin D deficient (< 50nmol/L) in the 5-month period October-February 2020-2021 compared to 46.6% in the corresponding 5-month period in 2015-2020. Males were more likely to be deficient at both thresholds (p < 0.001). For the total cohort, at the < 30nmol/L threshold, inpatients (25.5%) and nursing home residents (34.1%) had higher prevalence of deficiency. Vitamin D levels were higher in the 5-month period of October-February 2020-2021, and this precipitated a decline in deficiency at both thresholds, indicating that lockdown coincided with enhanced vitamin D status. We postulate that it may be attributable to changes in diet and/or supplementation, or increased sun exposure, but further confirmatory studies are required.

Vitamin D deficiency and malignancies

The analysis of domestic and foreign literature shows that oncological diseases are most often accompanied by a low level of 25(OH)D in the blood serum of patients and a high prevalence of deficiency and severe deficiency of vitamin D. It can be confidently stated that the level of 25(OH)D in serum blood of oncological patients, on average, is lower than in healthy people of the corresponding sex and age. In this regard, statistical studies were carried out, which demonstrated the prevalence of vitamin D deficiency in the countries of Europe and North America, which is directly proportional to the level of annual mortality from cancer and the probability of death from cancer, any type of cardiovascular disease, diabetes and chronic respiratory diseases, and this relationship is statistically significant (p &lt; 0.001). Oncological morbidity and mortality from cancer in the Russian Federation naturally increases especially in higher latitudes, which, along with other reasons, is associated with a limitation in the duration of the effective production of vitamin D3 in human skin under the influence of ultraviolet radiation. Some clinical studies of vitamin D supplementation as a therapeutic agent are showing measurable positive results in cancer, with far more positive than in placebo groups. However, negative results that are harmful to patients participating in clinical experiments have not been established in the study of many hundreds of studied articles on this issue. The most commonly seen beneficial effects of vitamin D supplementation have been in the treatment of breast and colorectal cancer, which are particularly noticeable in patients with low baseline serum levels of 25(OH)D and high daily doses of 25(OH)D3 supplementation well above standard recommendations of 400–800 IU daily. Due to the high prevalence of vitamin D deficiency among cancer patients, taking into account international positive experience, it seems very useful and necessary to create domestic scientific foundations and expand the clinical practice of using vitamin D supplements as a therapeutic agent for cancer.

Заключение совета экспертов «Роль витамина D в профилактике острых респираторных инфекций»

Acute respiratory viral infections (ARVIs) are the most common respiratory tract diseases that can reduce the quality of life of patients and aggravate bronchopulmonary and cardiovascular diseases. All ARVIs annually lead to a total economic damage of approximately 758 billion rubles, which corresponds to 80% of the damage from all infectious diseases. Due to a relatively limited number of non-specific causal therapy options, specific and non-specific prevention of ARVIs becomes extremely important. However, no specific vaccines against ARVIs, except influenza, have been developed so far. The majority of drugs for ARVI prevention have suboptimal efficacy and weak evidence (grade C). Given the pronounced economic damage from ARVIs (reaching 40 billion rubles annually), as well as the need for effective non-specific preventive agents, it is important to analyze the evidence base of new drugs for non-specific ARVI prevention, assess their cost-effectiveness, and availability for most patients. This can contribute to reducing ARVI incidence and both direct and indirect healthcare costs. Objective. Present the main provisions of the Council of Experts "The role of vitamin D in the prevention of acute respiratory infections" (February 18, 2023, Moscow, Russia) and assess the prospects for using in routine practice for improving the quality of patients life and optimize the costs of health care system. Main points. Preventive doses of colecalciferol (vitamin D3) is associated with a low risk of ARVI with daily or weekly intake lasting from 6 months. Vitamin D3 supplementation of 6 to 12 months should be recommended for people without obesity (BMI&lt;30 kg / m2) in a dose of 2000 IU / day or 10,000 IU / week, and with obesity (BMI&gt;30 kg / m2) in doses from 3000 IU / day to 6,000 IU / day for a long time. Long-term using of preventive doses of vitamin D3 is associated with a necessary maintain its target level throughout the year. Conclusions. In Russian Federation there is a high prevalence of deficiency and insufficiency of colecalciferol (vitamin D3) among the population, regardless of region and age group. According to the results of randomized clinical studies and metaanalyses, daily or weekly intake of vitamin D3 is associated with a low risk of ARVI. At the same time, vitamin D3 has a high therapeutic range, which makes its using more safe. Experts consider it it important to include colecalciferol (vitamin D3) in Russian clinical guidelines "Acute respiratory viral infections (ARVI) in adults" as part of their next revision as a means of non-specific prevention of ARVI. Level of evidence A (higher quality of evidence- 1). Key words: acute respiratory viral infections, influenza, COVID-19, nonspecific prevention, vitamin D3, colecalciferol

An observational study to determine prevalence of vitamin D3 deficiency and insufficiency in pregnant mothers of rural and urban health centres in Panvel block of Maharashtra

Background: Severe deficiency of vitamin D3 leads to increased risk of pre-eclampsia, gestational diabetes, preterm labour, and reduced bone mineral density in mother as well as child. Objectives were to know prevalence of vitamin D3 deficiency and insufficiency in pregnant mothers and to understand rural urban difference in vitamin D3 levels.Methods: An observational cross-sectional study was done on data of 1100 pregnant mothers coming to ANC clinics at Rural and urban health centres, of Panvel block, Maharashtra, for Serum 25-hydroxyvitamin D using venous blood samples. The duration of study was from June 2019 to December 2021.Two study groups were made rural and urban. Statistical software’s like Excel, SPSS were used.Results: Fifty five per cent pregnant mothers were from rural and 45% from urban settings. Study revealed that in rural study group 16% were grossly deficient, and 69% had insufficient levels. In urban group15% had deficient and 70% had insufficient levels of Vitamin D3. An overall inadequacy of 85% was found at the end of study. Out of the total study population 26% of pregnant mothers were in first and third trimester and 48%in second trimester. No relationship was established in vitamin D3 levels and demographic settings or gestational age.Conclusions: In India vitamin D3 supplementation is not part of antenatal care, but seeing the high prevalence of deficiency and insufficiency, which indicate an on-going hidden epidemic, prophylactic vitamin D3 supplementation can be thought of in national health programs like RMNCH+A.

Factors Associated with Low Vitamin D Status among Older Adults in Kuwait.

Low vitamin D levels among older people represent a significant health problem worldwide. This study aimed to examine the factors associated with vitamin D deficiency in older people (aged ≥ 65) in the Kuwaiti population. A cross-sectional study was conducted in seven primary healthcare centers across Kuwait (November 2020 to June 2021). The participants (n = 237) had their serum vitamin D (25(OH)D) concentrations (analyzed using LC-MS) classified as sufficiency 75 nmol/L (30 ng/mL) or deficiency < 75 nmol/L (below 30 ng/mL). The data were collected using self-administered questionnaires and face-to-face interviews with participants in geriatric clinics. Binomial logistic regression analysis was applied to assess factors associated with vitamin D deficiency. Vitamin D deficiency was found to be present in two thirds of the participants (n = 150, 63%), with a higher prevalence of deficiency in participants who did not receive vitamin D supplements, compared to those who did (84% vs. 16%, p = 0.001). The results from the binary logistic regression showed that a low duration of sun exposure (OR = 0.24, 95% C.I. [0.08–0.7], p = 0.011), dark skin pigmentation (OR = 4.46, 95% [1.35–20.49], p = 0.026), and lower caloric intake (OR = 0.9, 95% C.I. [0.85–0.96], p = 0.001) were risk factors for vitamin D deficiency. Furthermore, a significant inverse relationship was found between vitamin D levels and parathyroid hormone (PTH) levels (OR = 1.16, 95% C.I. [1.04–1.31], p = 0.016). These findings support the recommendation that vitamin D supplementation and adequate sunlight exposure are necessary for raising low vitamin D levels in older people in Kuwait.

Low socioeconomic status predicts vitamin D status in a cross-section of Irish children.

Vitamin D is essential for bone and muscle health with adequate status in childhood crucial for normal skeletal development. We aimed to investigate vitamin D status in a convenience sample (n = 1226) of Irish children (aged 1-17 years) who had serum 25-hydroxyvitamin D (25(OH)D) tested by request of their GP at a Dublin Hospital between 2014 and 2020. We examined predictors including age, sex, season and socioeconomic status (SES). Vitamin D deficiency (<30 nmol/l) was prevalent affecting 23 % and was more common in disadvantaged areas (34 %) and in those aged >12 v. ≤12 years (24 % v. 16 %, P = 0⋅033). The greatest predictor was SES (disadvantaged v. affluent, OR 2⋅18, CI 1⋅34, 3⋅53, P = 0⋅002), followed by female sex (OR 1⋅57, CI 1⋅15, 2⋅14, P = 0⋅005) and winter season (October to February, OR 1⋅40, CI 1⋅07, 1⋅84, P = 0⋅015). A quarter of our sample of children were deficient, rising to one-third in those in disadvantaged areas. Females and those aged over 12 years had a higher prevalence of deficiency. Public health strategies to improve vitamin D status in Irish children, including systematic food fortification may need to be considered to address this issue.

Vitamin D and acute and severe illness - a mechanistic and pharmacokinetic perspective.

The coronavirus disease 2019 (COVID-19) pandemic has generated high interest in factors modulating risk of infection, disease severity and recovery. Vitamin D has garnered interest since it is known to modulate immune function and vitamin D deficiency is associated with increased risk of respiratory infections and adverse health outcomes in severely ill patients. There are no population representative data on the direct relationship between vitamin D status and severe acute respiratory syndrome coronavirus 2 infection risk and severity of COVID-19. Data from intervention studies are limited to four studies. Here we summarise findings regarding vitamin D status and metabolism and their alterations during severe illness, relevant to COVID-19 patients. Further, we summarise vitamin D intervention studies with respiratory disease outcomes and in critically ill patients and provide an overview of relevant patient and population guidelines. Vitamin D deficiency is highly prevalent in hospitalised patients, particularly when critically ill, including those with COVID-19. Acute and critical illness leads to pronounced changes in vitamin D metabolism and status, suggestive of increased requirements. This needs to be considered in the interpretation of potential links between vitamin D status and disease risk and severity and for patient management. There is some evidence that vitamin D supplementation decreases the risk of respiratory tract infections, while supplementation of intensive care unit patients has shown little effect on disease severity or length of treatment. Considering the high prevalence of deficiency and low risks associated with supplementation, pro-actively applying current population and patient management guidelines to prevent, monitor and correct vitamin D deficiency is appropriate.

Vitamin D Status in Hospitalized Patients with SARS-CoV-2 Infection.

BackgroundThe role of vitamin D status in COVID-19 patients is a matter of debate.ObjectivesTo assess serum 25-hydroxyvitamin D (25OHD) levels in hospitalized patients with COVID-19 and to analyze the possible influence of vitamin D status on disease severity.MethodsRetrospective case–control study of 216 COVID-19 patients and 197 population-based controls. Serum 25OHD levels were measured in both groups. The association of serum 25OHD levels with COVID-19 severity (admission to the intensive care unit, requirements for mechanical ventilation, or mortality) was also evaluated.ResultsOf the 216 patients, 19 were on vitamin D supplements and were analyzed separately. In COVID-19 patients, mean ± standard deviation 25OHD levels were 13.8 ± 7.2 ng/mL, compared with 20.9 ± 7.4 ng/mL in controls (P < .0001). 25OHD values were lower in men than in women. Vitamin D deficiency was found in 82.2% of COVID-19 cases and 47.2% of population-based controls (P < .0001). 25OHD inversely correlates with serum ferritin (P = .013) and D-dimer levels (P = .027). Vitamin D-deficient COVID-19 patients had a greater prevalence of hypertension and cardiovascular diseases, raised serum ferritin and troponin levels, as well as a longer length of hospital stay than those with serum 25OHD levels ≥20 ng/mL. No causal relationship was found between vitamin D deficiency and COVID-19 severity as a combined endpoint or as its separate components.Conclusions25OHD levels are lower in hospitalized COVID-19 patients than in population-based controls and these patients had a higher prevalence of deficiency. We did not find any relationship between vitamin D concentrations or vitamin deficiency and the severity of the disease.

Factors Affecting Vitamin C Status and Prevalence of Deficiency: A Global Health Perspective.

A recent review of global vitamin C status has indicated a high prevalence of deficiency, particularly in low- and middle-income countries, as well as in specific subgroups within high-income countries. Here, we provide a narrative review of potential factors influencing vitamin C status globally. The in vivo status of vitamin C is primarily affected by dietary intake and supplement use, with those who supplement having a higher mean status and a lower prevalence of deficiency. Dietary intake can be influenced by cultural aspects such as traditional cooking practices and staple foods, with many staple foods, such as grains, contributing negligible vitamin C to the diet. Environmental factors can also affect vitamin C intake and status; these include geographic region, season, and climate, as well as pollution, the latter partly due to enhanced oxidative stress. Demographic factors such as sex, age, and race are known to affect vitamin C status, as do socioeconomic factors such as deprivation, education and social class, and institutionalization. Various health aspects can affect vitamin C status; these include body weight, pregnancy and lactation, genetic variants, smoking, and disease states, including severe infections as well as various noncommunicable diseases such as cardiovascular disease and cancer. Some of these factors have changed over time; therefore, we also explore if vitamin C status has shown temporal changes. Overall, there are numerous factors that can affect vitamin C status to different extents in various regions of the world. Many of these factors are not taken into consideration during the setting of global dietary intake recommendations for vitamin C.

Vegans, Vegetarians, and Omnivores: How Does Dietary Choice Influence Iodine Intake? A Systematic Review.

Vegan and vegetarian diets are becoming increasingly popular. Dietary restrictions may increase the risk of iodine deficiency. This systematic review aims to assess iodine intake and status in adults following a vegan or vegetarian diet in industrialised countries. A systematic review and quality assessment were conducted in the period May 2019–April 2020 according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Studies were identified in Ovid MEDLINE, Embase, Web of Science, PubMed, Scopus, and secondary sources. Fifteen articles met inclusion criteria. Participants included 127,094 adults (aged ≥ 18 years). Vegan groups presented the lowest median urinary iodine concentrations, followed by vegetarians, and did not achieve optimal status. The highest iodine intakes were recorded in female vegans (1448.0 ± 3879.0 µg day−1) and the lowest in vegetarians (15.6 ± 21.0 µg day−1). Omnivores recorded the greatest intake in 83% of studies. Seaweed contributed largely to diets of vegans with excessive iodine intake. Vegans appear to have increased risk of low iodine status, deficiency and inadequate intake compared with adults following less restrictive diets. Adults following vegan and vegetarian diets living in countries with a high prevalence of deficiency may be more vulnerable. Therefore, further monitoring of iodine status in industrialised countries and research into improving the iodine intake and status of adults following vegan and vegetarian diets is required.

The vitamin D paradox: high prevalence of deficiency in sunny Athens (Greece)

There is a universal hype regarding vitamin D (vitD) and a belief that we are over-screening and over-treating population for vitD deficiency, especially in Athens, one of the sunniest cities in Europe. We studied 271 postmenopausal women (mean age: 67.3 years old) who had been referred for vitD level assessment to the microbiology lab of Peristeri’s Health Center during a period of three months (January–March 2017). The mean serum 25-hydroxy vitD [25-(OH)D] was 16.53±6.41 (ng/mL), which was unexpectedly low for a population living in a Mediterranean region, while a significant proportion of postmenopausal women in Athens appeared to suffer from hypovitaminosis D, varying from 39.5% to 92.2%, depending on the cut-off values we utilise to define the vitD deficiency. These data justify screening of perimenopausal women for vitD deficiency, as they indefinitely consist a high-risk group.

Prevalence and predictors of vitamin D deficiency in a nationally representative sample of adults participating in the 2011-2013 Australian Health Survey.

Vitamin D deficiency is recognised as a public health problem globally, and a high prevalence of deficiency has previously been reported in Australia. This study details the prevalence of vitamin D deficiency in a nationally representative sample of Australian adults aged ≥25 years, using an internationally standardised method to measure serum 25-hydroxyvitamin D (25(OH)D) concentrations and identifies demographic and lifestyle factors associated with vitamin D deficiency. We used data from the 2011-2013 Australian Health Survey (n 5034 with complete information on potential predictors and serum 25(OH)D concentrations). Serum 25(OH)D concentrations were measured by a liquid chromatography-tandem MS that is certified to the reference measurement procedures developed by the National Institute of Standards and Technology, Ghent University and the US Centers for Disease Control and Prevention. Vitamin D deficiency and insufficiency were defined as serum 25(OH)D concentrations &lt;50 nmol/l and 50 to &lt;75 nmol/l, respectively. Overall, 20 % of participants (19 % men; 21 % women) were classified as vitamin D deficient, with a further 43 % classified as insufficient (45 % men; 42 % women). Independent predictors of vitamin D deficiency included being born in a country other than Australia or the main English-speaking countries, residing in southern (higher latitude) states of Australia, being assessed during winter or spring, being obese, smoking (women only), having low physical activity levels and not taking vitamin D or Ca supplements. Given our increasingly indoor lifestyles, there is a need to develop and promote strategies to maintain adequate vitamin D status through safe sun exposure and dietary approaches.

Vitamin B12 deficiency is endemic in Indian population: A perspective from North India

Background:Vitamin B12 deficiency is believed to be widespread in Indian population. However, more data is needed to fuel a meaningful debate on preventive and therapeutic strategies.Aims and Objectives:Objective of the current study is to evaluate status of vitamin B12 levels in people from a tier 3 city and among people living in an urban area with or without diabetes.Settings and Design:Retrospective, cross-sectional study.Methodology:Data captured in electronic medical records (EMR) of an endocrine practice and from a diagnostic laboratory was analysed.Statistical Analysis Used:Statistical analysis was done using open source software “Jamovi”.Results:Prevalence of vitamin B12 deficiency (Vitamin B12 levels <200 pg/ml) in tier 3 city was 47.19% (n = 267). From an urban endocrine practice, database of 11913 patients was searched for reports of vitamin B12 levels. Prevalence of vitamin B12 deficiency was 37.76% in people with pre-diabetes (n = 92), 31.23% in people with endocrine problems other than diabetes and pre-diabetes (n = 285) and 18.25% in people with diabetes (n = 378). Tier 3 city population had significantly lower vitamin B12 levels than people living in an urban area and attending an endocrine clinic. Vitamin B12 levels were significantly higher in people with diabetes as compared to people with other endocrine problems.Conclusion:Prevalence of vitamin B12 deficiency is 47% in north Indian population. People with diabetes have higher vitamin B12 levels than general population though still have high prevalence of deficiency. This data shows that Vitamin B12 deficiency is widespread in Indian population.

To determine the prevalence of glucose-6-phosphate dehydrogenase deficiency using a novel water-soluble tetrazolium-8 formazan method' for neonatal screening in region of Himachal Pradesh, India

Background: Glucose-6-phosphate dehydrogenase (G6PD) deficiency is the most significant enzyme defect in India with an incidence ranging from 2% to 27.9% in different communities. Prolonged neonatal jaundice and haemolytic crisis are known to occur in children with G6PD deficiency. Hence, screening of a population for G6PD deficiency is paramount. A Novel water soluble tetrazolium-8 (WST-8) Formazan Method has been used in this study for in-field mass-screening of G6PD in the region of Himachal Pradesh, India. Materials and Methods: In this prospective study, 5652 neonates were screened to assay G6PD activity using WST8/1-methoxy phenazine methosulphate method within the first 48 h of life. Orange colour at the end of the procedure indicated normal G6PD activity while pink or colourless appearance indicated G6PD deficiency. Results: After the screening of 5652 neonates, the prevalence of G6PD deficiency was 12.4%. 45 newborns (6%) had a severe G6PD deficiency. Males were more affected than females (70:30). Furthermore, males had higher prevalence of deficiency than females (64% [n = 29] and 16% [n = 16]). Conclusions: G6PD deficiency assessment by the method used for population screening in the study was easy to do and quite simple. Following this, the high prevalence of this deficiency was noted in Himachal Pradesh. This study highlights the need to do neonatal screening of G6PD deficiency in population so that untowards complications like haemolytic crisis, complications due to neonatal jaundice can be avoided.

Vitamin D nutritional status and its relationship with metabolic changes in adolescents and adults with severe obesity.

increased vitamin D deficiency occurs together with obesity and the association between these conditions has been observed. to assess the nutritional status of vitamin D and metabolic profile in adolescents and adults with obesity, and the relationship between complications arising from severe class of obesity with vitamin D nutritional status, and to compare the differences between these groups. observational comparative study. Population comprises adolescents and adults with severe obesity. Waist circumference (WC) and body mass index (BMI) were measured. Analysis of vitamin D (25(OH)D), lipid profile, C-reactive protein (CRP), blood glucose, fasting insulinemia, insulin sensitivity, blood pressure and diagnoses of nonalcoholic fatty liver disease (NAFLD) and metabolic syndrome (MS) were performed. a total of 60 adolescents (G1) and 68 adults (G2) were evaluated. The percentage of vitamin D inadequacy was observed in 90% in G1 and 79.4% in G2. There was a negative and significant correlation of BMI with the values of 25(OH)D in the group of adults (r = -0.244; p = 0.045). Individuals with inadequacy of vitamin D showed higher values of CRP in both groups (p = 0.000). HOMA-IR showed a negative correlation with 25(OH)D in G1 (r = -0.832; p = 0.000) and G2 (r = -0.589; p = 0.000). The inadequacy of this vitamin showed association with high total cholesterol in G1 (p = 0.029) and higher values of LDL-c in G2 (p = 0.003). high prevalence of deficiency and insufficiency of vitamin D were observed, associated with metabolic changes both in obese adults and adolescents. It is necessary to develop strategies for the prevention and control of obesity and vitamin D deficiency.

Роль дефіциту вітаміну D у виникненні акушерських та перинатальних ускладнень (Огляд літератури)

The article gives an overview of the literature that shows the high prevalence of deficiency and insufficiency of vitamin D in pregnant women in countries irrespective of their geographical location, leading to adverse health outcomes, such as miscarriage, premature birth defects, preeclampsia, gestational diabetes, risk Caesarean section, low birth weight and an increase in the number of autoimmune diseases associated with low levels of vitamin D during pregnancy. Key words: vitamin D deficiency, pregnancy, obstetric complications, perinatal complications.

Associations between serum 25(OH)D concentrations and prevalent asthma among children living in communities with differing levels of urbanization: a cross-sectional study

BackgroundPrior evidence suggests that vitamin D deficiency may increase the risk of asthma and atopy and impair pulmonary function in children.MethodsIn this cross-sectional analysis nested in a case-control study, we analyzed serum 25(OH)D concentrations in 413 children with asthma and 471 children without asthma living in two geographically adjacent study communities (Pampas and Villa El Salvador). We measured total and antigen-specific IgE levels, pulmonary function, asthma control, and exhaled nitric oxide.ResultsMean 25(OH)D concentrations were 25.2 ng/mL (SD 10.1) in children with asthma and 26.1 ng/mL (SD 13.7) in children without asthma (p = 0.28). Vitamin D deficiency (25(OH)D < 20 ng/ml) was more common in Pampas than in Villa El Salvador (52.7% vs. 10.5%; p < 0.001). In the overall study population, a 10 ng/ml decrease in serum 25(OH)D concentrations was not significantly associated with odds of asthma (OR 1.09, 95% CI: 0.94 to 1.25). However, vitamin D deficiency was associated with a 1.6-fold increase in odds of asthma in the overall cohort (95% CI: 1.14 to 2.25). After stratifying by site, a 10 ng/mL decrease in serum 25(OH)D concentrations was associated with 18% higher odds of having asthma in Pampas (OR = 1.18, 95% CI 1.02 to 1.38), whereas there was no significant association between 25(OH)D concentrations and asthma in Villa El Salvador (OR = 0.95, 95% CI 0.87 to 1.05). Combined data from these geographically adjacent populations suggests a possible threshold for the relationship between 25(OH)D levels and asthma at approximately 27.5 ng/ml. Serum 25(OH)D concentrations were not clearly associated with asthma control, total serum IgE, atopy, or airway inflammation.ConclusionSerum 25(OH)D concentrations were inversely associated with asthma in one study community with a high prevalence of deficiency. Studies are needed to investigate a possible threshold 25(OH)D concentration after which higher vitamin D levels show no further benefit for asthma.

Thiamine Levels During Intensive Insulin Therapy in Critically Ill Patients.

Thiamine is an essential cofactor in carbohydrate metabolism, and deficiency can therefore cause various organ dysfunctions. Little is known about the prevalence and possible worsening of thiamine deficiency in critically ill patients. In this study, we investigated the prevalence of thiamine deficiency at admission to the intensive care unit (ICU) and hypothesized that intensive insulin therapy, aimed at regulating glucose levels, increases thiamine utilization and therefore might cause or worsen deficiency in patients with limited thiamine stores. An observational prospective cohort study was carried out in a medical-surgical ICU in a general teaching hospital in Apeldoorn, the Netherlands. All adults who were treated during that time with intensive insulin therapy were included. Deficiency was defined as a thiamine level <100 nmol/L. No thiamine supplementation was administered except for normal amounts present in standard enteral feeding. A total of 58 patients were available for analysis. Median thiamine level at admission was 111 nmol/L. Deficiency was present in 39.7% of patients and was significantly associated with the presence of gastrointestinal pathology and with recent surgery. Thiamine levels increased a median of 14 nmol/L in 48 hours. Only 3.4% of patients showed a predefined relevant decline in thiamine levels. Intensive insulin therapy does not appear to cause or worsen thiamine deficiency. However, based on the high prevalence of deficiency at admission, it might be warranted to supplement thiamine in all patients admitted to the ICU, especially when there is an underlying gastrointestinal disease or recent surgery.

Vitamin D deficiency and TB disease phenotype

BackgroundExtrapulmonary TB is increasingly common, yet the determinants of the wide clinical spectrum of TB are poorly understood.MethodsWe examined surveillance data (Birmingham, UK: 1980–2009 and USA Centers for Disease Control:...