Inadequate Serum Vitamin Research Articles

Effect of Interaction Between Vitamin D and Serum Uric Acid on Hypertension in Adults

Abstract OBJECTIVE To investigate whether the interaction between serum vitamin D and serum uric acid has an effect on blood pressure. METHODS A cross-sectional study was conducted with 7,951 subjects selected from the health management center of the Second Hospital of Dalian Medical University during 1 January 2020 and 30 September 2022. The dose–response relationship between serum vitamin D, blood uric acid, and blood pressure was analyzed using restricted cubic spline. The relationship between each variable and elevated blood pressure was analyzed using multifactorial analysis in a generalized additive model and combined with a multiplicative–additive hierarchical interaction model to explore the effects of the interaction of serum vitamin D and blood uric acid on elevated blood pressure. RESULTS The mean age of the study population was (42.61 ± 11.17) years and the detection rate of hypertension was 12.14% (965/7,951). The risk of elevated blood pressure (high-normal blood pressure + hypertension) decreased with increasing serum vitamin D concentration, but the risk of elevated blood pressure increased with increasing serum uric acid levels. Compared with those with adequate serum vitamin D and normal blood uric acid, the odds ratio (OR) for the risk of high-normal blood pressure was 1.54 [95% confidence interval, CI (1.22, 1.94), P < 0.001] and the OR for the risk of hypertension was 3.17 [95% CI (2.13, 4.72), P < 0.001] for those with inadequate serum vitamin D and high blood uric acid. The risk of elevated blood pressure was highest when serum 25-hydroxyvitamin D was less than 25 nmol/l and blood uric acid was higher than 600 µmol/l. CONCLUSIONS The interaction between serum vitamin D and blood uric acid has an effect on elevated blood pressure. The risk of hypertension was maximized when serum vitamin D was insufficient and blood uric acid was high.

Vitamin D Concentrations in Pediatric Patients With COVID-19

This study was conducted on 98 children with confirmed COVID-19 and 2112 patients in a healthy control group. Serum vitamin D levels were significantly lower in the patients with confirmed COVID-19 than in the control group (10.9 ng/dL vs 16.1 ng/dL; P < .001). Almost 65% of patients with inadequate serum vitamin D levels had symptomatic COVID-19, and 30% of patients with adequate vitamin D levels had symptomatic COVID-19 (P = .043). In the logistic model, inadequate vitamin D status was associated with symptomatic COVID-19 compared with asymptomatic COVID-19 (odds ratio = 4032; 95% confidence interval, 1.036-17.776; P = .045).

Prevalence of vitamin D deficiency in seniors – A retrospective study

Vitamin D deficiency is a condition with different causes. It is associated with numerous comorbidities such as autoimmune diseases, bone diseases, cancer, cardiovascular diseases, neurodegenerative diseases, psychiatric diseases, and respiratory infections like COVID-19. Due to its high prevalence all over the world, it is a major task for health care systems worldwide. Through a combination of low sunlight exposure, insufficient nutrition, and age-related changes in skin, liver, and kidney function, especially seniors and nursing home residents, in particular, have a significantly increased risk of developing a vitamin D deficiency. This retrospective study analyzed the prevalence of vitamin D deficiency (serum 25-hydroxyvitamin D [25(OH)D]<12ng/ml) amongst selected Austrian nursing home seniors. It also examined whether demographic data and other laboratory values like calcium correlate with vitamin D levels by using the Pearson correlation coefficient. This correlation was graphically illustrated with a scatter plot and regression line. A total of 478 patients admitted to a nursing home in Vienna between January 3, 2017, and August 31, 2020, were included. A total of 106 seniors (22,2%) suffered from a manifest vitamin D deficiency. The vitamin D level of the men was significantly lower than the level of the women (22.9±12.6ng/ml vs. 26.2±14.8ng/ml, p=0.027). The vitamin D serum levels significantly correlated with the serum calcium levels of the participants (r=0.19, p<0.001). 39.5% (189 out of 478) of the nursing home residents had inadequate serum vitamin D levels. In summary, it can be said that the prevalence of vitamin D deficiency among nursing home residents is considerably high. Inadequate vitamin D levels were often associated with reduced calcium levels. Given the high prevalence, the numerous negative health consequences of inadequate levels, and the large therapeutic index, this risk group should get a general supplementation with a dose of 25μg (1000 IU) vitamin D3 per day. In addition, a blood examination should be performed as early as three months after the start of the supplementation therapy. If some residents do not achieve an adequate vitamin D concentration, the substitution has to be adapted to the individual needs to treat them as precisely as possible.

IMPACT OF THE COVID-19 PANDEMIC ON FRAGILITY HIP FRACTURE MANAGEMENT AND MORTALITY RATE

Background: The COVID-19 pandemic has greatly affected patients without COVID, including osteoporotic hip fractures. Treatment protocols and time for surgery have been disrupted and delayed resulting in unsatisfactory outcomes. This study compared the mortality rate among patients with osteoporotic hip fractures during the COVID-19 pandemic and during the prepandemic periods.&#x0D; Methods: The patients’ information recorded in the Fracture Liaison Service (FLS) registry was retrospectively reviewed. We defined the prepandemic group as the admissions between May 2019 and March 2020 and the pandemic group as admissions from April 2020 to February 2021. The demographic data were collected, including serum calcium and 25(OH)D levels. Time to surgery, postoperative complications, length of stay and death were obtained and compared between the two periods.&#x0D; Results: We included 813 patients, with 444 and 369 patients in the prepandemic and the pandemic groups, respectively. Mean age, sex and comorbidities were comparable in both groups. The proportion of patients with insufficient and deficient vitamin D was significantly higher in the pandemic group (46.41 vs. 62.85%, p&lt;0.01). Time to surgery and length of hospital stay was significantly longer in the pandemic period (p &lt;0.05). The mortality was higher but did not significantly differ in the pandemic period with an adjusted hazard ratio of 1.08 (95% CI = 0.76-1.54).&#x0D; Conclusion: Properly managing hip fractures during the pandemic is crucial to prevent and reduce morbidity and mortality. Inadequate serum vitamin D level has been noted in the pandemic group but was not associated with mortality rate.

Association of Vitamin D with Obesity in Premenstrual Syndrome: A Study of Female Population of Hyderabad, Sindh

Introduction/Objectives: The affiliation between decreased vitamin D and obesity is well built up. Females with Premenstrual Syndrome (PMS) are more prone to gain weight. Obese women's low calcifediol levels are impacted by diets and inactive lifestyles.The studyfocused to discover out the relationship between vitamin D and obesity in premenstrual syndrome females. Materials &amp; Methods: Two hundred fifty (250) females between15-45 yearswith a history of PMS were selected from OPD-Gynecology, Liaquat University of Medical&amp;Health Sciences (LUMHS), Jamshoro and Hyderabad in collaboration with Physiology Department LUMHS Jamshoro and samples were analyzed in Diagnostic and Research lab Hyderabad. Information was collected on marital status, vitamin D3 levels, PMS intensity, and BMI. The Chi-square test compared the vitamin D levels with BMI and PMS scores. Results: Mean age of the patients was 29.89±5.206 years. 64.8% of patients were married. 42.8% had normal weight and 40.8%were obese. 35.2% of patients had mild PMS scores and 36.4% had extreme PMS. 61.2% of patients had vitamin D lack with only 4.8% having adequate serum vitamin D levels. 22.8% of normal-weight patients had inadequate serum vitamin D levels. 35.6% of obese patients had vitamin insufficiency in their blood. The relationship between obesity and vitamin D levels was significant (P-value: 0.001). 18.8% of patients who had mild PMS scores had deficient serum vitamin D levels. The relationship between PMS scores and vitamin D levels was remarkable (P-value: 0.001). Conclusion: We found a significant, inverse relationship between vitamin D levels and BMI, showing that losing weight through vitamin D and calcium-enriched diets may result in typical vitamin D levels, and so PMS may be treated. Keywords: Vitamin D (Vit D),Premenstrual Syndrome, body-mass index(BMI)

Association of Vitamin D with Obesity in Premenstrual Syndrome: A Study of Female Population of Hyderabad, Sindh

Introduction/Objectives: The affiliation between decreased vitamin D and obesity is well built up. Females with Premenstrual Syndrome (PMS) are more prone to gain weight. Obese women's low calcifediol levels are impacted by diets and inactive lifestyles. The study focused to discover out the relationship between vitamin D and obesity in premenstrual syndrome females. Study design: Cross-sectional study Place and Duration: OPD-Gynecology, Liaquat University of Medical &amp;Health Sciences (LUMHS), Jamshoro and Hyderabad in collaboration with Physiology Department LUMHS Jamshoro and Diagnostic and Research lab Hyderabad. Materials &amp; Methods: Two hundred fifty (250) females between15-45 years with a history of PMS were selected for this study. Information was collected on marital status, vitamin D3 levels, PMS intensity, and BMI. The Chi-square test compared the vitamin D levels with BMI and PMS scores. Results: Mean age of the patients was 29.89±5.206 years. 64.8% of patients were married. 42.8% had normal weight and 40.8%were obese. 35.2% of patients had mild PMS scores and 36.4% had extreme PMS. 61.2% of patients had vitamin D lack with only 4.8% having adequate serum vitamin D levels. 22.8% of normal-weight patients had inadequate serum vitamin D levels. 35.6% of obese patients had vitamin insufficiency in their blood. The relationship between obesity and vitamin D levels was significant (P-value: 0.001). 18.8% of patients who had mild PMS scores had deficient serum vitamin D levels. The relationship between PMS scores and vitamin D levels was remarkable (P-value: 0.001). Practical implication The advantages of 25(OH) D supplementation/repletion on bone health are well known. Although there is a biological plausibility linking the status of vitamin D and obesity supported by basic and clinical research findings, basic research is necessary to know the molecular pathways involved in this association. Also this study will help the community to decrease the PMS symptoms by taking vitamin D supplements. Those females who take the vit D prior their PMS stage will be prevented from severe symptoms. Conclusion: We found a significant, inverse relationship between vitamin D levels and BMI, showing that losing weight through vitamin D and calcium-enriched diets may result in typical vitamin D levels, and so PMS may be treated. Keywords: Vitamin D (Vit D), Premenstrual Syndrome, body-mass index (BMI), obesity, women

Vitamin D levels among adults in a tertiary care hospital in Wayanad

Background: Vitamin D insufficiency affects nearly 50% of the population worldwide. Inadequate serum Vitamin D levels are associated with multiple conditions such as secondary hyperparathyroidism and increased fracture risk. Multiple studies carried out also showed a correlation between Vitamin D deficiency and occurrence of diabetes and hypertension (HTN) in these deficient individuals. This study aimed to determine the serum levels of Vitamin D among patients frequenting a tertiary care hospital in Wayanad and the associations with sunlight exposure, gender, dietary factors, and diabetes and HTN. Settings and Design: Cross-sectional study. Materials and Methods: Hundred patients were randomly selected from the outpatient department over 6 months and asked to fill up a questionnaire. Vitamin D analysis was done by Elecsys Vitamin D total assay. Statistical analysis used was IBM SPSS statistics for Windows, version 20.0: Association between continuous data was determined using t-test/Mann–Whitney test depending on normality of data and association between categorical variables was determined using Pearson's Chi-square test. Results: Fifty-seven percentage of patients had Vitamin D deficiency. Significantly lower values of Vitamin D were seen among women. Conclusions: The median Vitamin D levels in men were 22.785 ng/ml and 17.81 ng/ml in women. No association was established between &gt;1 h of daily sunlight exposure, the prevalence of diabetes and HTN, and daily consumption of dairy products and Vitamin D deficiency.

Serum Vitamin D and Cardiometabolic Markers: A Comparative Study in Adult Men Based on Body Mass Index

INTRODUCTION: Deficiency of vitamin D has been implicated in several disorders, including skeletal, immune, neural, metabolic, and cardiovascular diseases (CVDs). The impact of vitamin D deficiency on CVDs is potentially through derangement of cardiometabolic profile. The present work assessed the relationship between serum vitamin D levels and cardiometabolic markers in adult men. MATERIALS AND METHODS: A cross-sectional analytical study (n=160) was conducted on adult men between the ages 35-50 years without a history of CVDs and/or diabetes, liver, or kidney disorders. Serum vitamin D, lipid profile (cholesterol, triacylglycerol; TAG, low[1]density lipoprotein; LDL, high-density lipoprotein; HDL), and renal function tests (urea, creatinine) were measured using enzyme‑linked immunosorbent assays (ELISA). Pearson’s correlation was used for assessing correlations between the studied parameters. Participants were further grouped as underweight, normal weight, overweight, and obese based on their BMI values, and one-way ANOVA and post-hoc Tukey’s tests were done to observe group mean differences. RESULTS: Vitamin D and HDL were positively correlated (r=0.395, p=0.000) while negative correlation of serum vitamin D levels was seen with TAG (r=-0.539, p=0.000), cholesterol (r=-0.325, p=0.000), LDL (r=-0.541, p=0.000) and urea (r=-0.514, p=0.000). Levels of serum vitamin D (p=0.000) and HDL (p=0.000) were lower while levels of TAG (p=0.000), cholesterol (p=0.000), LDL (p=0.000) and urea (p=0.000) were higher in the overweight and obese groups. CONCLUSION: Inadequate serum vitamin D status is associated with dyslipidaemia in adult men. Moreover, obese and overweight men have lower serum vitamin D levels with pronounced dyslipidaemia, thus highlighting vitamin D as a potential cardiometabolic risk factor.

Vitamin D and Osteoarthritis: An Updated Clinical Summary and Review

BACKGROUND: Osteoarthritis remains the most widespread disabling musculoskeletal condition affecting the wellbeing of many older adults. AIM: This work aimed to update and document findings published in the English language concerning what is known about vitamin D and osteoarthritis disease manifestations and progression, an area of research that has produced confusing results. QUESTIONS: Specifically examined were: (1) Whether the presence of inadequate serum vitamin D levels predisposes an older adult to more profound osteoarthritis disability than adequate levels; and (2) Whether applying vitamin D as a supplement to older adults with osteoarthritis and coexisting vitamin D deficiencies is likely to ameliorate osteoarthritis disability in some way. METHODS: To achieve the current aims, all relevant English language research reports published in the last 40 years, with an emphasis on data from January 1, 2018 up until January 16 2021, and located in the major data bases of PUBMED, Scopus, and Web of Science, were sought. A narrative depiction and synthesis of the key points that emerged from this diverse body of literature was then undertaken. RESULTS: Findings showed that regardless of study type, a vitamin D deficit that may prevail in a fair proportion of older osteoarthritis cases may produce less than favorable results if the deficiency is not compensated for. However, very few studies are sufficiently well-designed and a number show no uniform consensus in this regard. CONCLUSION: More well-designed research may help to more firmly establish the possible protective, reparative or aversive role of vitamin D in mediating osteoarthritis and whether supplementation is desirable in vitamin D deficient cases.

Conducting Vitamin D3 Supplementation To Observe Serum 25(OH)D Levels, Body Composition, And Depression In Athletes

Vitamin D insufficiency is linked with muscle weakness and adequate levels can improve muscle performance. Secondarily, Vitamin D is stored in fat via fat sequestration and has ties to depression. Athletes in preseason use copious amounts of muscle potentially altering body composition. Indoor athletes in particular, would benefit from supplementation due to their specific population risk of limited access to sunlight and living in a seasonally changing climate; both of which are indicators for inadequate Serum Vitamin D (25(OH)D) and depression. PURPOSE: To first examine 25(OH)D levels in an indoor athletic population with daily supplementation of Vitamin D3 (D3) to observe any potential relationships between supplementation, 25(OH)D, body composition, and depression levels. METHODS: Men’s Basketball players at a Division II school were recruited during preseason. Subjects with 25(OH)D levels <40ng/mL were admitted and started on 4000IU/day D3 supplementation for 8 weeks, Visit 1 (V1). Visit 2 (V2) and Visit 3 (V3), were 4 and 8 weeks after V1, respectively. Visit 4 (V4) was 4 weeks after V3 and D3 completion. 25(OH)D via blood draws, body composition (BodPod), anthropometrics such as height, weight, and waist circumference were measured at all visits. Depression (CES-D Scale) was measured at screen and V4. RESULTS: Five (19.4±1.3yo, 25.6±1.1kg/m2 BMI, 23.0±9.2ng/dL 25(OH)D) subjects completed. 25(OHD) increased from V2-V3 (27.7±5.9-38.7±3.6, p=0.02) but not from V1-V2 nor V1-V3. A trend was noted with falling 25(OH)D from V3-V4 (38.7±3.6-32.3±7.7, p=0.06), 4 weeks post supplementation. No changes were seen in any body composition measures over time nor in comparison with paralleled 25(OH)D levels. Screen 25 (OH)D was not different than depression at pre study (4.4±2.3, p=0.67.) but trended towards a difference compared to post study (2.3±1.7, p=0.06). CONCLUSION: 25(OH)D eventually increased in Division II basketball players with continual supplementation, possibly improving rates of depression. Further research is warranted with a larger active athletic population over a longer period of supplementation to perhaps see any definitive relationships in 25(OH)D and depression or in comparison to body composition, and to continue detecting levels after stopped supplementation.

P547 Inadequate vitamin C status and association with inflammatory biomarkers in adults with active Crohn’s disease

Abstract Background Micronutrient deficiencies are common in inflammatory bowel disease (IBD) due to the inflammatory burden and changes in dietary intake. Vitamin C, an essential water-soluble antioxidant required for tissue repair and immune function, is found primarily in fresh fruit and vegetables however, this food group is more often avoided by people with IBD compared with the general population. This research aimed to determine serum vitamin C status in subjects with active Crohn’s disease, measure urinary vitamin C excretion in healthy controls (HC) and Crohn’s disease patients before and after exclusive enteral nutrition (EEN) and assess associations between inflammatory markers and vitamin C. Methods Stored serum and random urine samples prospectively collected from adults with mild to moderately active Crohn’s disease and adult HC were analysed. Both HC and Crohn’s disease groups received EEN with a known vitamin C content for two weeks. Serum and urinary vitamin C were measured using high-performance liquid chromatography with electrochemical detection. Urinary vitamin C was standardised to urinary creatinine. Non-parametric t-tests and correlations were performed. Results EEN was initiated in 38 patients (aged 16 to 39 years old). Inadequate serum vitamin C (&amp;lt;50 µmol/l) was present in 36/38 patients with active Crohn’s disease and 45% had hypovitaminosis C. Baseline C-reactive protein (CRP) was 12 mg/l (range, 3 to 158 mg/l) and faecal calprotectin was 1065 µg/g (range, 60 to 3838 µg/g). Serum vitamin C correlated weakly with CRP (r = −0.30 95% CI: −0.58 to 0.03, p = 0.06) but not with faecal calprotectin. Two weeks of EEN was completed by 30 (79%) patients and 17 (81%) HC. The average vitamin C intake was 168mg/day (range, 108–252 mg/day). Baseline urinary excretion of vitamin C was low in both Crohn’s disease and HC. Following EEN urinary vitamin C excretion increased significantly in both groups (Figure 1). Conclusion Patients with active Crohn’s disease had inadequate vitamin C status. EEN increased urinary vitamin C excretion in both Crohn’s disease and HC, suggesting low baseline dietary vitamin C intake and potentially enhanced utilisation. Further research with a larger patient cohort would provide a greater understanding of vitamin C metabolism in active Crohn’s disease.

Trajectory of vitamin D, micronutrient status and childhood growth in exclusively breastfed children

This study aimed to compare the trajectory of serum 25(OH)D, micronutrient levels, and anthropometric measurements between exclusively breastfed and mixed-fed children. This is a prospective cohort study. Anthropometric measurements of the children were obtained during scheduled clinical visits. Tests for 25(OHD), ferritin, zinc and complete blood count were performed yearly until 3 years of age. Clinical records and questionnaires on dietary habits were obtained. The results showed that despite official recommendations on vitamin D/iron supplements for breastfed children, less than 10% of our exclusively breastfed children received regular supplements. Thus, after 1 year, the odds for having iron deficiency anemia and vitamin D insufficiency were 9 [95% CI, 4–19] and 6 [95% CI, 2–16], respectively. Longitudinal follow-up showed the prevalence of iron deficiency to decrease from 34% at 1 year to 2% at age 3 years. However, the prevalence of vitamin D insufficiency remained persistently high throughout the first three years of life (60% at 1 to 44% at 3 years). Very few children had zinc deficiency. Anthropometric measurements showed exclusively breastfed children to have lower mean z-scores for body weight and height when compared to mixed-fed children after 12 months. In conclusion, children who were exclusively breastfed for longer than 4 months without proper supplement were more likely to have transient iron deficiency anemia and persistent vitamin D insufficiency. Their growth became relatively slower after infancy. Whether this was associated with underlying inadequate serum vitamin D and iron level remains an important issue to be explored.

The effect of prolonged breast-feeding on the development of postmenopausal osteoporosis in population with insufficient calcium intake and vitamin D level.

Breast-feeding affects bone metabolism and calcium homeostasis, and prolonged breast-feeding may influence the development of postmenopausal osteoporosis, particularly in highly susceptible populations. The study determined that breast-feeding may be a risk factor for postmenopausal osteoporosis, especially in people with low calcium intakes and vitamin D deficiencies. The purpose of this study was to determine whether breast-feeding is a risk factor in the development of postmenopausal osteoporosis, especially in highly susceptible population. The study was performed using data from the 2010 to 2011 Korea National Health and Nutrition Examination Survey, and it included 1231 postmenopausal women who were aged between 45 and 70years. Osteoporosis was defined using the World Health Organization's T-score criteria, namely, a T-score of ≤-2.5 at the femoral neck or the lumbar spine. The patients' ages, body mass indexes, daily calcium intakes, serum vitamin D levels, exercise levels, smoking histories, and reproductive factors relating to menarche, menopause, delivery, breast-feeding, hormone treatment, and oral contraceptive use were evaluated. Comparisons between the osteoporosis and non-osteoporosis groups were undertaken using Student's t test and the chi-square test, and logistic regression models were built. A significant increase in the risk of osteoporosis was apparent in postmenopausal women with prolonged breast-feeding histories (≥24months) (model 1: odds ratio [OR] = 2.489; 95% confidence interval [CI] = 1.111 to 5.578, p = 0.027; model 2: OR = 2.503; 95% CI = 1.118 to 5.602, p = 0.026; model 3: OR = 2.825; 95% CI = 1.056 to 7.56, p = 0.039), particularly in those with inadequate serum vitamin D levels and calcium intakes (<800mg/day). Breast-feeding seems to increase the risk of postmenopausal osteoporosis; however, its impact may not be definitive in women with sufficient vitamin D levels and calcium intakes. Therefore, sufficient calcium intakes and adequate vitamin D levels may be important to prevent osteoporosis in postmenopausal women that is derived from breast-feeding.

Which factors are associated with health related quality of life one year after an acute hospitalisation in an elderly patient population?

to assess the prevalence of inadequate serum vitamin D levels in European women aged over 80years. Material and methods.– Assessment of 25-hydroxyvitamin D [25(OH)D] was performed in 8532 European women with osteoporosis or osteopenia, of which 1984 were aged over 80years. European countries included France, Belgium, Denmark, Italy, Poland, Hungary, United Kingdom, Spain and Germany. Two cut-offs of 25(OH)D inadequacy were fixed: <75nmol/L and<50nmol/L. Results.– Mean (SD) age of the patients was 83.4 (2.9) years, body mass index was 25.0 (4.0) kg/m2. Level of 25(OH)D was 53.3 (26.7) nmol/L. There was a highly significant difference of 25(OH)D level across European countries (P<0.0001)with the lowest level of 25(OH)D found in France [47.7 (26.4) nmol/L]. In thesewomenaged over80years, theprevalenceof 25(OH)D inadequacywas88.6%and 53.4% when considering cut-offs of 75 and 50nmol/L, respectively. In the 397 (20.0%) patients taking supplemental vitamin D with or without supplemental calcium, themean serum25(OH)D levelwas significantly higher than in the other patients (65.2 (29.2) nmol/L vs 50.3 (25.2) nmol/L; P<0.001). Conclusion.– This study indicates a high prevalence of vitamin D [25(OH)D] inadequacy in old European women. The prevalence could be even higher in some particular countries.

The Vitamin D Connection to Pediatric Infections and Immune Function

Over the past 20 y, a resurgence in vitamin D deficiency and nutritional rickets has been reported throughout the world, including the United States. Inadequate serum vitamin D concentrations have also been associated with complications from other health problems, including tuberculosis, cancer (prostate, breast, and colon), multiple sclerosis, and diabetes. These findings support the concept of vitamin D possessing important pleiotropic actions outside of calcium homeostasis and bone metabolism. In children, an association of nutritional rickets with respiratory compromise has long been recognized. Recent epidemiologic studies clearly demonstrate the link between vitamin D deficiency and the increased incidence of respiratory infections. Further research has also elucidated the contribution of vitamin D in the host defense response to infection. However, the mechanism(s) by which vitamin D levels contribute to pediatric infections and immune function has yet to be determined. This knowledge is particularly relevant and timely, because infants and children seem more susceptible to viral rather than bacterial infections in the face of vitamin D deficiency. The connection among vitamin D, infections, and immune function in the pediatric population indicates a possible role for vitamin D supplementation in potential interventions and adjuvant therapies.

Highest Prevalence of Vitamin D Inadequacy in Institutionalized Women Compared with Noninstitutionalized Women: A Case–Control Study

The reduced capacity of older skin to synthesize vitamin D(3) under the influence of ultraviolet light makes older persons at risk of vitamin D deficiency. The risk could even be increased in institutionalized persons owing to their lower sunshine exposure. It has been reported that an inadequate vitamin D level is associated with secondary hyperparathyroidism, increased bone turnover, and bone loss, which increase fracture risk. The objective of this study was to assess the prevalence of inadequate serum vitamin D levels in institutionalized, postmenopausal, osteoporotic women. Assessment of 25-hydroxyvitamin D [25(OH)D] was performed in 445 institutionalized, osteoporotic women from nine countries (Australia, Belgium, France, Germany, Hungary, Italy, Poland, Spain and UK). For each institutionalized woman, three age-matched, noninstitutionalized, osteoporotic controls were also included. Four cutoffs of 25(OH)D inadequacy were fixed: less than 80, less than 75, less than 50 and less than 30 nmol/l. Mean age was 79.7 years (standard deviation [SD] = 5.8) for the institutionalized women and 79.5 years (SD = 5.5) for the noninstitutionalized women (p = 0.45). Significantly fewer institutionalized women received vitamin D supplements (13.2 vs 24.0%; p < 0.0001). In women without vitamin D supplements, the level of 25(OH)D was significantly lower in institutionalized women (56.9 [SD = 23.9] nmol/l) compared with noninstitutionalized women (63.2 [SD = 22.0] nmol/l; p < 0.0001). In institutionalized women (without vitamin D supplements), the prevalence of 25(OH)D inadequacy was 10.4, 41.2, 80.3 and 84.2% when considering cutoffs of 80, 75, 50 and 30 nmol/l, respectively. In the control group, the prevalence was 2.7, 22.9, 74.4 and 81.7%, respectively. The prevalence of vitamin D inadequacy was significantly higher in institutionalized women when considering the 75, 50 and 30 nmol/l cutoffs but not when considering the 80 nmol/l cutoff. This study highlights a high prevalence of vitamin D inadequacy in institutionalized, osteoporotic women. Compared with age-matched osteoporotic controls, the prevalence of severe vitamin D inadequacy was substantially more important in institutionalized women. We believe that a greater awareness of the importance of vitamin D inadequacy is needed in order to address this public health problem.

Prevalence of vitamin D inadequacy in European postmenopausal women

ABSTRACTObjective: Inadequate vitamin D level is associated with secondary hyperparathyroidism and increased bone turnover and bone loss, which in turn increases fracture risk. The objective of this study is to assess the prevalence of inadequate serum vitamin D levels in postmenopausal European women. There are no clear international agreements on what constitutes a level of vitamin D inadequacy, but recent publications suggest that the circulating level of vitamin D should be over 80 nmol/L or at least between 50 and 80 nmol/L.Material and methods: Assessment of 25-hydroxyvitamin D [25(OH)D] was performed in 8532 European postmenopausal women with osteoporosis or osteopenia. European countries included France, Belgium, Denmark, Italy, Poland, Hungary, United Kingdom, Spain and Germany. Two cut-offs of 25(OH)D inadequacy were fixed : < 80 nmol/L and < 50 nmol/L.Results: Mean (SD) age of the patients was 74.2 (7.1) years, body mass index was 25.7 (4.1) kg/m². Level of 25(OH)D was 61.0 (27.2) nmol/L. There was a highly significant difference of 25(OH)D level across European countries ( p < 0.0001). The lowest level of 25(OH)D was found in France [51.5 (26.1) nmol/L] and the highest in Spain [85.2 (33.3) nmol/L]. In the whole study population, the prevalence of 25(OH)D inadequacy was 79.6% and 32.1% when considering cut-offs of 80 and 50 nmol/L, respectively and when considering patients aged less than 65 years, the prevalence reached 86% (cut-off of 80 nmol/L) and 45% (cut-off of 50 nmol/L).Conclusion: This study indicates a high prevalence of vitamin D [25(OH)D] inadequacy in European postmeno­pausal women. The prevalence could be even higher in some particular countries. A greater awareness of the importance of vitamin D inadequacy is needed to address this public health problem.