Improvement In Vitamin Research Articles

Link Between Daily Sunlight Exposure and Dyslipidemia Patients – A Cross-Sectional Study

Background: Earlier studies have suggested that Sunlight and vitamin D are related to cardiovascular disease (CVD), but the link between sunlight exposure and risk factors for CVD has not been adequately investigated. Dyslipidaemia is a major risk factor for CVD we aim to investigate whether sunlight exposure has an effect on dyslipidemia patients’ serum lipid profile and vitamin D. Methods: This study was carried out in apparently healthy Indian adults of both sexes, aged above 18 years and dyslipidemia patients’ from Swamy Vivekananda Medical College Hospital (SVMCH). Normal control group (healthy subjects) (n30), Dull sunlight exposure group dyslipidemia patients N30, and bright sunlight exposure group dyslipidemia patients n30, Oral supplement of Vitamin D group (n30), Obese dyslipidemia patients group (n30) before and after sunlight exposure, after overnight fasting peripheral venous blood samples were collected, and the serum was stored in -80 oC fridge. Serum levels of 25(OH) D (25- hydroxy vitamin D3) and lipid levels were analyzed by routine lab method using an Autoanalyzer. Results: We compare the bright and dull sunlight exposure dyslipidemia patients and obese groups; a significant elevation was seen in 25-(OH) D concentrations in the bright sunlight exposure group (P < 0.01), and the lipid profiles TGs, TCs, LDL-C, and VLDL-C were significantly decreased (P < 0.05). The HDL-C level significantly increased when compared to the dull sunlight exposure group. There was no significant change in serum Vitamin D and lipid profile level of the oral supplement vitamin D group compared with the bright sunlight exposure group. Conclusion: Our study reveals that bright sunlight exposure is beneficial and linked with the improvement of Vitamin D and lipid profile of dyslipidemia. In comparison orally supplemented Vitamin D had an adverse effect on lipid profile.

Projecting the Contribution of Provitamin A Maize Biofortification and Other Nutrition Interventions to the Nutritional Adequacy and Cost of Diets in Rural Zimbabwe

BackgroundEvidence of the effectiveness of biofortified maize with higher provitamin A (PVA) to address vitamin A deficiency in rural Africa remains scant. ObjectivesThis study projects the impact of adopting PVA maize for a diversity of households in an area typical of rural Zimbabwe and models the cost and composition of diets adequate in vitamin A. MethodsHousehold-level weighed food records were generated from 30 rural households during a week in April and November 2021. Weekly household intakes were calculated, as well as indicative costs of diets using data from market surveys. The impact of PVA maize adoption was modeled assuming all maize products contained observed vitamin A concentrations. The composition and cost of the least expensive indicative diets adequate in vitamin A were calculated using linear programming. ResultsVery few households would reach adequate intake of vitamin A with the consumption of PVA maize. However, from a current situation of 33%, 50%–70% of households were projected to reach ≥50% of their requirements (the target of PVA), even with the modest vitamin A concentrations achieved on-farm (mean of 28.3 μg RAE per 100 g). This proportion would increase if higher concentrations recorded on-station were achieved. The estimated daily costs of current diets (mean ± standard deviation) were USD 1.43 ± 0.59 in the wet season and USD 0.96 ± 0.40 in the dry season. By comparison, optimization models suggest that diets adequate in vitamin A could be achieved at daily costs of USD 0.97 and USD 0.79 in the wet and dry seasons, respectively. ConclusionsThe adoption of PVA maize would bring a substantial improvement in vitamin A intake in rural Zimbabwe but should be combined with other interventions (e.g., diet diversification) to fully address vitamin A deficiency.

Supply of vitamins (A, E, D, C, B6, B12) and mineral substances (ZN, FE, MG, CA, P) for children with recurrent respiratory infections and deficiency correction of their deficiency as a possibility to prevent frequent respiratory infections

Introduction. Recurrent respiratory infections in children are a pressing problem in pediatrics. To maintain and function the immune system in children, their provision of vitamins and minerals is important.Purpose. To assess the provision of children with recurrent respiratory infections with vitamins (A, E, D, C, B6, B12, folic acid) and minerals (Zn, Fe, Mg, Ca, P) and to correct their deficiency with a vitamin-mineral complex.Materials and methods. The study was conducted on 65 children aged 3 to 8 years in 2 groups of children: group 1, children with RID, n = 50; group 2 – control, n = 15). An outpatient examination, a parent survey and a blood test for vitamins (A, E, D, C, B6, B12, folic acid) and minerals (Zn, Fe, Mg, total Ca, Ca++, P) were carried out. 30 children with RID were prescribed the vitamin and mineral complex, 1 tablet 2 times a day, with an assessment of vitamin and mineral sufficiency and the frequency of respiratory infections after the end of the dose.Results. In all examined children, both in the main and control groups, the most common were deficiencies of fat-soluble vitamins D (69%), A (40%), E (35%) and the minerals Zn (70%) and Fe (44%). In children with RID, deficiency of vitamins D, A and Zn was more common than in the control group (p < 0.05), in 96% of cases it was combined, more often in the form of a combined deficiency of fat-soluble vitamins D, A, E and minerals Zn, Fe (66% of cases). Taking vitamin-mineral complex in the 2nd prophylactic dose for 1 month contributed to an improvement in vitamin and mineral sufficiency and a decrease in respiratory morbidity in the next 2 months after stopping the drug.Conclusion. Vitamin-mineral complex can be successfully used to maintain vitamin and mineral levels and reduce respiratory morbidity in children with recurrent respiratory infections.

Incidence of Vitamin D deficiency and insufficiency in those with hip fractures: A prospective cohort study

Introduction As the rise in the population over the age of 65 years continues, there is a concern that there will be an increase in fragility hip fractures. Inadequate vitamin D levels could affect the health of the bone, and subsequently increase of sustaining a hip fracture. The purpose of our study was to determine if there was in fact an association between insufficient or deficient vitamin D levels and sustaining a hip fracture in our patients 90 years of age or older. Methods 25-hydroxy vitamin D levels in all patients who presented to the Emergency Department of a high-volume teaching institution who also had a diagnosis of hip fracture from 2017 to 2019 were prospectively and randomly assessed. Vitamin D levels were randomly ordered and assessed by the on-call orthopedic resident on all patients over 90 years of age. Overall, 47 patients that were 90 years of age or older were treated in our institution of which the study cohort consisted of 47 patients. This included 7 men and 40 women with a mean age of 94 years (range, 90 to 102 years). The guidelines of the Endocrine Society definitions of Vitamin D deficiency, insufficiency, and normal levels were used. The incidence of vitamin D deficiency and insufficiency was compared to those with normal levels for statistical significance. Outcomes were further sub-stratified by gender. Results The cohort had mean Vitamin D levels of 27.2 ng/ml (range, 4.3 to 69.4 ng/mL). Sixty-four percent of patients had lower than normal Vitamin D levels (p = 0.007) with 43% (n = 20) who were deficient and 21% (n = 10) who were considered insufficient. When outcomes were stratified by gender, men and women had similar mean vitamin D levels (p= 0.67). Women with hip fractures had higher incidences of vitamin D levels of < 30 ng/mL (p =0.002) while men had similar incidences (p = 0.6) of vitamin D levels above and below 30 ng/mL. Discussion We found an association between the incidence of hip fractures and increased incidence of insufficient or deficient levels of vitamin D those over 90 years of age. Future studies should examine how improvements in vitamin D levels can reduce potential risk of fragility hip fractures.

Prevalence of Vitamin A Deficiency in Children Aged 6 to 17 Years - Western and Central Rural Areas, China, 2012-2021.

Vitamin A deficiency (VAD) is a leading global nutritional concern, ranking among the top four major nutritional deficiencies worldwide. The prevalence of VAD is unevenly distributed across various regions, both within China and globally. The report adds valuable insights into the vitamin A nutritional status of rural students aged 6-17 years who participated in the Nutrition Improvement Programme for Rural Compulsory Education Students (NIPRCES). Over the decade from 2012 to 2021, there was a modest improvement in vitamin A status. The prevalence of VAD and sub-clinical VAD (SVAD) declined as the students aged. Throughout the majority of the survey years, the incidence of VAD was higher among males and western regions compared to females and central regions, respectively. A comprehensive approach, incorporating dietary diversification, nutrition education, and food fortification, should be implemented to prevent VAD and SVAD especially in males, younger children and children in western areas.

Intense Testing and Use of Vitamin D Supplements Leads to Slow Improvement in Vitamin D Adequacy Rates: A Cross-Sectional Analysis of Real-World Data.

Vitamin D testing (VDT) and supplement use (VDS) are on the rise, but most patients remain deficient (<30 ng/mL-VDD). We designed the present real-world study to assess this paradox. We reviewed data from all patients visiting our clinics between 2014 and 2022. We estimated the rate of patients with vitamin D adequacy (≥30 ng/mL) (VDA) by year and month of testing, the dose of VDS (low (≤1200 IU/day), medium (1201-3000 I/day) and high dose (>3000 IU/day)), intake duration (short-term (<12 months) and long-term use (≥12 months)), and timing of use (current use, former use, no use). We enrolled n = 6912 subjects with vitamin D measurements: n = 5195 females (75.2%), age 44.0 ± 16.8 years, BMI 27.9 ± 6.5 kg/m2; never users: n = 5553 (80.3%), former users: n = 533 (7.7%), current users: n = 826 (12.0%). Current use of VDS was higher in females. VDT rose from 42.1% in 2014 to 92.7% in 2022, and VDA rose from 14.8% to 25.5% for the same time. VDA was found overall in n = 1511 (21.9%); Never users: n = 864 (15.6%), Former users: n = 123 (23.2%); and Current users: n = 370 (44.8%). The maximal VDA (67.9%) was found in subjects using high-dose VDS in the long term. Despite the significant rise in VDT and VDS use, VDA was found in a minority of patients. Prolonged use of high-dose supplements produces modest improvements in VDA.

Screening and characterization of indigenous non-Saccharomyces cerevisiae with high enzyme activity for kiwifruit wine production

To explore the diversity and fermentation potential of non-Saccharomyces cerevisiae associated with kiwifruit, indigenous yeasts isolated from kiwifruit and natural fermentation were comprehensively analyzed. A total of 166 indigenous yeasts were isolated, of which 54 representative strains were used for subsequent enzyme activity characterization. Different colorimetric methods were used to verify the ability of these strains to secrete hydrolytic enzymes, and then six strains were selected for sequential fermentation by specific activity assay. The performance of indigenous yeasts in improving organic acids, polyphenols, volatile compounds and sensory characteristics of wines was evaluated holistically. Results indicated that most sequential fermentations exhibited significant improvements in vitamin C and polyphenols. Remarkably, the involvement of Zygosaccharomyces rouxii, Meyerozyma guilliermondii, and Pichia kudriavzevii increased the concentrations of ethyl esters, acetates and alcohols, enhancing floral and tropical fruit odors and ultimately achieving the highest overall sensory acceptability, thereby highlighting their potential in kiwifruit wine fermentation.

Impact of medically supervised fasting on the vitamin D, glycemic control, quality of life and need for medication among type 2 diabetes mellitus: Protocol for a randomized control trial (FAVIT Trial)

Abstract Objective The objective of this study is to investigate the effect of prolonged medically supervised fasting (PMSF) for 6 months on vitamin D levels and diabetes-related clinical outcomes in type 2 diabetes mellitus (T2DM) patients. Methods This is an open-label, parallel arm, randomized control trial; 170 T2DM patients from a complementary medicine setting, aged between 20 and 70 years, with a body mass index &gt;25 kg/m2 and glycated hemoglobin (HbA1C) levels &gt;6% and &lt;12%, treated with lifestyle advice and/or oral hypoglycemic drugs, will be randomized to receive PMSF or a diabetic diet (DD), along with their usual care. The patients will be initially trained in PMSF and DD for a duration of 10 days in the study setting, followed by 5 months of practice at their respective residences. The PMSF will fast for five days a month for three consecutive months after the initial exposure, whereas the DD group will follow the same diet for 6 months. Other than fasting days, the PMSF group will follow the same DD as the control group. The primary outcome is an improvement in vitamin D levels, and the secondary outcomes include serum calcium, insulin levels, insulin resistance, blood cell counts, anthropometrics, quality of life, medication score, compliance rate, and disease perception. Discussion In this study, we hypothesize that PMSF would gradually increase vitamin D levels, which would increase calcium levels, which would promote insulin secretion and upregulate its function. This may help reduce the need for diabetic medication and result in diabetic remission.

Prevalence and predictors of vitamin D deficiency in Lebanon: 2016-2022, before and during the COVID-19 outbreak.

Vitamin D deficiency is very common worldwide, particularly in Middle-Eastern countries. Recent Lebanese studies demonstrated an improvement in vitamin D status over time. However, the comparison between the years before and during the COVID-19 outbreak has never been analyzed in the Middle-East area. This study aimed to determine the prevalence and the predictors of 25-hydroxyvitamin D (25(OH)D) levels during the last 7 years. Serum 25(OH)D levels from a large laboratory database were retrospectively collected from Hôtel-Dieu de France Hospital between January 2016 and June 2022 (N = 66,127). Data related to age, gender, season and year of sampling were also retrieved. Mean age of the population was 50.6 ± 19 years, 62.7% were women, 5.3% were children and adolescents, 67.6% adults and 27% elderly. Mean serum 25(OH)D level was 25.7 ± 11.9 ng/mL. The overall population with vitamin D sufficiency (>30 ng/mL) was 31.9%. The increase in mean serum 25(OH)D observed between 2016 and 2022 was 6.36 ng/mL (p < 0.0001). The prevalence of 25(OH)D deficiency (<30 ng/mL) decreased from 76.2% in 2016 to 56.5% in 2022 (p < 0.0001) with a significant difference between the period before and during the COVID-19 outbreak (72.3% vs.42.5%, p < 0.0001). In a multivariate logistic regression, older age, female sex, summer season, years of the COVID-19 outbreak and outpatient samples were protective factors against the risk of hypovitaminosis D (p < 0.0001 for all variables). Our study showed a continuous positive change in vitamin D status time, most notably after the COVID-19 outbreak. Further studies are needed to assess the clinical impact of the pandemic on vitamin D status in our population.

The effect of maternal vitamin D deficiency during pregnancy on glycolipid metabolism of offspring rats and the improvement of vitamin D intervention after weaning.

Vitamin D deficiency during pregnancy is common, but whether maternal vitamin D status affects glycolipid metabolism of offspring remains unclear. To evaluate the effect of maternal vitamin D deficiency during pregnancy on the glycolipid metabolism of offspring at different life-cycles (from birth to adulthood) and to explore the improvement of different dosages of vitamin D supplementation. Sprague-Dawley rats were fed vitamin D-deprived (VDD group) or standard vitamin D diets (SC group) during pregnancy, and their diets were changed to standard vitamin D diets during lactation (the offspring were sorted into VDDoffspring and SCoffspring groups). After weaning, rats in the VDDoffspring group were randomly assigned to the VDDoffspring, VDDoffspring-S3300 and VDDoffspring-S10000 groups with diets containing standard, medium and high dosages of vitamin D for 12 wk. Serum was collected for biochemical analyses at postnatal Day 21, postnatal Day 56 and postnatal Day 84. Oral glucose tolerance test (OGTT) was performed at postnatal Day 70. Compared to SCoffspring, rats in the VDDoffspring group had significantly lower birth weight with faster weight gain and higher levels of lipid metabolism in early life. After near adulthood, the differences in weight and lipid metabolism between the two groups disappeared. OGTT showed significantly higher blood glucose levels in the VDDoffspring group at 30 min, 60 min, and 90 min. The continuation of vitamin D supplementation at medium and high dosages after weaning did not cause any obvious changes in weight or glycolipid metabolism (except for postprandial hyperglycemia). OGTT demonstrated that the glucose levels in the VDDoffspring-S3300 group were lowest at all the time points and that those in the VDDoffspring-S10000 group were the highest at 30 min, 60 min, and 90 min among the three groups. The adverse effects of vitamin D deficiency during pregnancy on glycolipid metabolism in offspring vary in different stages. Over a long time period, adequate vitamin D supplementation is beneficial to glycolipid metabolism for the offspring of subjects with vitamin D deficiency during pregnancy; however, further improvement is required.

Medical management and rehabilitation in a patient with avascular necrosis of the femoral head in the context of vitamin D deficiency and secondary hyperparathyroidism – case report

Vitamin D is essential in determining bone and muscle health. Vitamin D deficiency (VDD) produces secondary hyperparathyroidism, loss of bone quality and mass, mineral-ization effects and fractures, myopathy, and falls. The avascular necrosis (AVN) of the femoral head pathophysiology is still unclear and can be considered a vascular bone dis-ease. Our paper aimed to evaluate the etiology of AVN in a young male with bilateral fem-oral neck damage who required bilateral arthroplasty. Method: We present the case of a 46-year-old male patient with VDD and bilateral total hip arthroplasty for osteoarthritis secondary to AVN of the femoral head. After complete hormonal, biological, and imaging evaluations, the diagnosis of primary hyperparathyroidism was not supported; the im-provement of vitamin D deficiency after eight months of treatment clarified the diagnosis: hyperparathyroidism secondary to vitamin D deficiency. Results: Supplementation with 4000 IU of vitamin D improved the patient’s response to specific rehabilitation methods. Conclusions: Severe vitamin D deficiency can secondarily affect the structure of the femoral head through secondary hyperparathyroidism, producing AVN, but only osteopenia was obtained on DXA evaluation. VDD can be an important etiological factor in the occur-rence of AVN, and its correction can improve the evolution of the disease, improving the reabilitation of these patients. Keywords: avascular necrosis, secondary hyperparathyroidism, vitamin D deficiency, rehabilitation

Medical management and rehabilitation in a patient with avas-cular necrosis of the femoral head in the context of vitamin D deficiency and secondary hyperparathyroidism – case report

Vitamin D is essential in determining bone and muscle health. Vitamin D deficiency (VDD) produces secondary hyperparathyroidism, loss of bone quality and mass, mineral-ization effects and fractures, myopathy, and falls. The avascular necrosis (AVN) of the femoral head pathophysiology is still unclear and can be considered a vascular bone dis-ease. Our paper aimed to evaluate the etiology of AVN in a young male with bilateral fem-oral neck damage who required bilateral arthroplasty. Method: We present the case of a 46-year-old male patient with VDD and bilateral total hip arthroplasty for osteoarthritis secondary to AVN of the femoral head. After complete hormonal, biological, and imaging evaluations, the diagnosis of primary hyperparathyroidism was not supported; the im-provement of vitamin D deficiency after eight months of treatment clarified the diagnosis: hyperparathyroidism secondary to vitamin D deficiency. Results: Supplementation with 4000 IU of vitamin D improved the patient’s response to specific rehabilitation methods. Conclusions: Severe vitamin D deficiency can secondarily affect the structure of the femo-ral head through secondary hyperparathyroidism, producing AVN, but only osteopenia was obtained on DXA evaluation. VDD can be an important etiological factor in the occur-rence of AVN, and its correction can improve the evolution of the disease, improving the reabilitation of these patients.

EFFICACY OF VITAMIN D SUPPLEMENTATION IN PATIENTS WITH CHRONIC LOW BACKACHE – A PROSPECTIVE STUDY

Background: Chronic low back ache (LBA) is one of the commonest and expensive ailments of youngsters with ambiguous pathophysiology leading to a signicant loss of productivity. Studies established that the vitamin D is a proven anabolic hormone for the entire musculoskeletal system. This study was designed to evaluate the differences in outcomes with various oral formulations of vitamin D available in the market. This Methodology: study is a randomised, prospective, open label analytical study of a cohort of patients with LBA and hypovitaminosis D from June 2022 to August 2022. Patients were sequentially randomized to one of the three treatment subgroups (Granule group, Nano Syrup group, Soft gel capsule group) named after the vit.D formulation they received after establishment of clinical, radiological and biochemical eligibility. Total number of 145 subjects were screened, among them 119 subjects were eligible and 87 have completed the study. Vitamin D supplementation of 60,000 IUs per dose for ten consecutive days (pulse-D therapy) was given in form of granule (1 g sachet) or nano syrup using aqueous nanotechnology (5 mL bottle) or soft gel capsule. Adverse drug reaction recording chart was provided to all patients and was reviewed regularly. The patient's weight was measured on day 0, week 3, week 6, week 9 and week 12. Hypovitaminosis D is a potential Results: causative factor for LBA in addition to the other known factors. The results obtained with nano syrup formulation were signicantly better compared to other formulations. Vitamin D can play an important role in pathogenesis and treatment of LBA. Nano Conclusion: formulations developed with aqueous technology have shown enhanced stability, water solubility, bioavailability, signicantly better improvement in vitamin D level and functional outcome in low back pain

Vitamin D Status and SLE Disease Activity among Dubai Hospital Lupus Patients

Background: Vitamin D deficiency is common worldwide, but is particularly prevalent in the Middle Eastern region, where cultural and religious factors influence its incidence further. As patients with Systemic Lupus Erythematosus (SLE) avoid sun exposure and use medications that could potentially result in vitamin D deficiency, this problem becomes more apparent. Unfortunately, there are no data available on the prevalence of vitamin D deficiency among patients with SLE in our local area. Objective: To assess the prevalence of vitamin D deficiency among patients with a new onset of systemic lupus erythematosus in Dubai, and to determine whether low vitamin D levels are correlated with disease activity. Methodology and Data Collection: a retrospective cohort study of patients with new onset of Systemic Lupus Erythematosus, being diagnosed in less than 1 year and were followed up at Dubai Hospital (UAE) from January 2009 till December 2012. Demographic and clinical data were collected as well as 25(OH) D3 levels. The incidence of vitamin D insufficiency was calculated as a ratio between the numbers of patients with 25(OH) D levels below the specified cut-off values (30ng/ml and 10ng/ml, respectively). SLE was diagnosed according to the American college of rheumatology (ACR SLE) classification criteria of 1997. Patients with drug-induced SLE and vitamin D deficiency were excluded. Results: a total number of 150 patients were included. 87% (n=131) were females and 13% (n=19) were males. The mean vitamin D level at the baseline was 21.6+/- 47 (mean +/- SD), increased to 27.8+/- 16 at 1 year, while the SLEDAI has improved from 8.3+/-5 (mean +/- SD) to 2.4 +/- 2.9 at 1 year respectively. The changes in vitamin D level as well as the SLEDAI were statistically significant with a P value &lt;0.001. Spearman correlation test showed a statistically significant inverse correlation between vitamin D level versus SLEDAI % from baseline to 1-year later. Conclusion: This study showed a direct inverse relationship between lupus activity and a low level of vitamin D. Furthermore, the SLE disease activity score got better with the improvement in vitamin D level, measured at baseline, and after 12 months period.

Pain in COVID-19: Quis est culpa?

&lt;b&gt;Background&lt;/b&gt;: At present, during the coronavirus disease (COVID-19) pandemic, chronic pain is becoming more prominent, and it is also associated with the post-COVID-19 syndrome. Thanks to quick decisions on the therapy and as part of COVID-19 prevention, we have succeeded in stabilising the situation all over the world. On the other hand, ‘quick decisions’ have contributed to other significant issues which we are beginning to deal with now: in the effort to defeat the virus, many experts regarded the adverse effects of the medications used to be of secondary importance.&lt;br /&gt; &lt;b&gt;Purpose:&lt;/b&gt; The article aims to demonstrate the side effects of treatment with various drugs (and their combinations) that are used to treat COVID-19 disease.&lt;br /&gt; &lt;b&gt;Method: &lt;/b&gt;From the beginning of January until mid-May, the COVID-19 department of the 2nd Surgical Clinic of the Faculty of Medicine of the Comenius University in Bratislava (University Hospital Bratislava, Hospital of Saints Cyril and Methodius) treated 221 patients with moderate and severe course of COVID-19 (2nd wave of the pandemic). We saw some adverse effects and lack of effect of certain drugs for COVID-19.&lt;br /&gt; &lt;b&gt;Results: &lt;/b&gt;The benefits of preventive measures compared to treatment are enormous. For example, corticoids can impair metabolism, cause diabetes, or suppress immunity. Antibiotics may cause colitis and blood pressure medications may negatively impact blood circulation.&lt;br /&gt; &lt;b&gt;Conclusion: &lt;/b&gt;Preventive measures such as vaccination and activation of intrinsic antiviral immune systems are based on an incomparable benefit. Important in the process of the activation of antiviral immunity (linked to interferon synthesis) in the prevention of COVID-19 is the improvement of vitamin D deficit and the use of other micronutrients.&lt;br /&gt; &lt;b&gt;Practical value:&lt;/b&gt; The results of the study will be valuable in the field of medicine, for virologists, pharmacologists, pharmacists, and medical professionals.

Are There Any Pleiotropic Benefits of Vitamin D in Patients With Diabetic Kidney Disease? A Systematic Review of Randomized Controlled Trials.

Type 2 diabetes (T2D) and kidney disease are risk factors for vitamin D deficiency. Native forms of vitamin D have a lower risk of hypercalcemia than calcitriol, the active hormone. The enzyme responsible for activating native vitamin D is now known to be expressed throughout the body; therefore, native vitamin D may have clinically relevant effects in many body systems. The objective of this systematic review was to examine the effect of native vitamin D supplementation on clinical outcomes and surrogate laboratory measures in patients with T2D and diabetic kidney disease (DKD). Systematic review. Randomized controlled trials (RCTs) conducted in any country. Adults with T2D and DKD receiving supplementation with any form of native vitamin D (eg, ergocalciferol, cholecalciferol, calcifediol). Clinical outcomes and surrogate clinical and laboratory measures reported in each of the trials were included in this review. The following databases were searched from inception to January 31, 2023: Embase, MEDLINE, Cochrane CENTRAL, Web of Science, ProQuest Dissertations and Theses, and medRxiv. Only RCTs examining supplementation with a native vitamin D form with a control or placebo comparison group were included. We excluded studies reporting only vitamin D status or mineral metabolism parameters, without any other outcomes of clinical relevance or surrogate laboratory measures. Study quality was evaluated using the Cochrane risk-of-bias tool (RoB2). Results were synthesized in summary tables for each type of outcome with the P values from the original studies displayed. Nine publications were included, corresponding to 5 separate RCTs (377 participants total). Mean age ranged from 40 to 63. All trials administered vitamin D3. Intervention groups experienced improvements in vitamin D status and a reduction in proteinuria in 4 of the 5 included RCTs. There was a decrease in low-density lipoprotein and total cholesterol in the 2 trials in which they were measured. Improvements in bone mass, flow-mediated dilation, and inflammation were also reported, but each was only measured in 1 RCT. Effects on glucose metabolism, high-density lipoprotein, triglycerides, blood pressure, oxidative stress, and kidney function were mixed. No serious adverse effects were reported. Limitations include the small number of RCTs and lack of information on the use of drugs that affect measured outcomes (eg, proteinuria-lowering renin-angiotensin-aldosterone system inhibitors and lipid-lowering medication) in most studies. Our study is also limited by the absence of a prestudy protocol and registration. Native vitamin D is a safe treatment that improves vitamin D status in patients with DKD. Vitamin D may modify proteinuria and lipid metabolism in DKD, but further well-designed trials that include well-established treatments are necessary. Overall, there is limited evidence for beneficial pleiotropic effects of vitamin D in patients with DKD.

Serum Vitamin D, Renal Biomarkers, Protein Profile and Some Electrolytes in Chronic Kidney Disease Patients With a Clinical Trial of Vitamin D Therapy

Background: Vitamin D deficiency is involved in a broad spectrum of diseases including chronic kidney disease (CKD). Objectives: This study was designed to assess serum vitamin D, renal biomarkers, protein profile, and electrolytes in CKD patients with a clinical trial of vitamin D therapy. Methods: This case-control follow-up interventional study comprised 42 CKD patients and 42 apparently healthy controls. Patients and controls were matched for age and gender. Patients were assigned to receive, a weekly oral dose of vitamin D3 (50000 IU) for 3 successive months. The follow-up therapy was conducted under direct and full physician supervision. Results: Vitamin D was significantly lower in CKD patients compared to controls (29.6±12.4 versus 35.2±9.9 ng/dL, P=0.033). Significant increases were shown in the urea, creatinine, and uric acid in patients compared to controls whereas glomerular filtration rate (GFR), total protein, albumin, and calcium were significantly lower in patients. A significant improvement was noted for vitamin D and calcium where they registered mean values of 43.8±9.1 ng/dL and 9.65±0.70 mg/dL at the end of the therapeutic period compared to 29.6±12.4 ng/dL and 8.61±0.77 mg/dL in patients before vitamin D therapy (P=0.028 and P=0.033, respectively). Conclusion: General amelioration of the metabolic profile of CKD patients in response to vitamin D therapy has been shown. Besides a significant improvement in vitamin D and calcium. Consequently, vitamin D is a useful candidate in clinical settings for the improvement of renal function and controlling of CKD, and more importantly its complications.

The Efficacy of Vitamin D Supplementation in Patients With Alzheimer's Disease in Preventing Cognitive Decline: A Systematic Review.

To evaluate the role of vitamin D supplementation in preventing cognitive decline in patients with Alzheimer's disease (AD), five databases such as PubMed, PubMed Central (PMC), Medical Literature Analysis and Retrieval System Online (MEDLINE), ScienceDirect, and Google Scholar were searched for articles relevant to the research question with filters such as English and human studies from 2011 to 2022. Two investigators extracted the data and assessed the quality of the study using the predefined criteria. We identified 24 relevant articles after the critical screening. There were five randomized controlled trials (RCTs), two observational studies, two systematic reviews and meta-analyses, one pilot study, and 14 review articles. Most RCTs showed no significant improvement in vitamin D supplementation except for one study, which reported significant improvement in cognition on taking vitamin D in Alzheimer's disease but was not taken much into consideration as it had a small sample size (n=210) and was for a shorter duration. Another study evidenced significant improvement in Mini-Mental State Examination (MMSE) score when memantine and vitamin D were taken together compared to when memantine and vitamin D were taken independently.Studies have shown that vitamin D deficiency is associated with an increased risk of developing cognitive impairment. But there is no sufficient evidence indicating vitamin D supplementation can improve cognitive function in Alzheimer's disease.

PSUN273 Endocrine Management of Renal Transplant Patients: A Role in Successful Graft Survival? Updated Data

Abstract Introduction Graft survival after renal transplantation is dependent upon multiple factors. Many patients undergoing renal transplantation have endocrine disorders, such as pre-existing diabetes and metabolic bone disease, and can develop post-transplant diabetes (PTDM) and hyperlipidemia. Diabetes, lipid abnormalities, and hypovitaminosis D have been associated negatively with patient and graft survival1, 2. Our kidney transplant program ranks among the top 3 programs in the country for its kidney transplant outcomes according to the data by the Scientific Registry of Transplant Recipients. We hypothesized that our multidisciplinary team management of these patients was one factor in this success. We reported our findings in 2017. Here we present follow up data through 2021 on this same cohort. Methods Over 20 years ago members of the Endocrine division began attending the transplant clinic in the Department of Surgery to facilitate patient care. In 2016 we identified all patients followed over the previous 3 years. Charts were reviewed after IRB approval and data collected retrospectively. Data for this cohort has been updated through 2021. Results A total of 241 patients were seen (of 626 total transplant recipients). There were 154 males, 87 females, and the average age at transplant was 47 years. Diabetes was present prior to transplant in 118 (46.6%) and an additional 51 (21%) developed PTDM. For patients with diabetes, the pre transplant A1c fell from 7.5 ± 1.6% to 7 ± 1.2% at 6 months (p = 0.13). At 6 months, the A1c was 6.45% for those who had developed PTDM. Pre-transplant, 79 (31%) were on some form of lipid lowering therapy. Post-transplant, 216 (90%) had hyperlipidemia: 186 (77%) were on a statin, in addition to 51(21%) on fish oil, 28 (12%) on gemfibrozil, and 4 (1.5%) on niacin. The average Vitamin D level within 1 year post-transplant was 19.9 ± 8, but increased to 33± 14 at most recent visits (P &amp;lt; .01). Of 217 patients over the age of 40, 93 (43%) have had a DEXA: Osteoporosis was diagnosed in 43 patients and osteopenia in an additional 31. Of these patients, 34 are or have been on treatment (bisphosphonate). Conclusions We believe that multidisciplinary team management of post renal transplant patients can improve graft survival. While our improvement in A1c values at 6 months post-transplant was not statistically significant, the trend was clearly there even considering potential artefactual lowering of the A1c in renal failure patients. We did demonstrate improvement in Vitamin D levels and frequency of statin use. We also found that there remain some barriers for care (evidence, for example, by many patients not having Vitamin D levels or DEXA). Presentation: Sunday, June 12, 2022 12:30 p.m. - 2:30 p.m.

Case control study on the association between vitamin d deficiency and diabetes mellitus type 2 at tertiary care hospital, Jaipur

Introduction: Diabetes mellitus refers to a group of common metabolic disorders. Recently, emerging evidence has suggested a role for suboptimal vitamin D status in the etiology of T2DM. This study aimed to determine the association between Vitamin -D deficiency and type 2 Diabetes Mellitus in patients of tertiary care centre, Jaipur. Method and material: This was a hospital based descriptive type of observational study done in Department of Medicine, of a tertiary care hospital in Jaipur, Rajasthan. This study included 100 cases and 100 control. Result: There were 55% males and 45% female among study participants. Out of 200 participants, 160 (80%) subjects are vit D deficient in which 84 (42%) are cases and 76 (38%) are controls, means cases are more deficient for vit D in comparision to controls. Conclusion: Though vitamin D deficiency is prevalent in T2DM and non-diabetic control subjects, its relationship in glycation control or insulin resistance in T2DM subjects could not be confirmed in our study population. This is potentially an important finding for public health, demonstrating that improvement in vitamin D status is one of the factors responsible for better health of the individuals.