Insufficient Group Research Articles

Serum Vitamin D status is associated with increased blastocyst development rate in women undergoing IVF

Research questionTo determine the relationship between vitamin D (VitD) status and embryological, clinical pregnancy and live birth outcomes in women undergoing IVF. DesignCross-sectional, observational study conducted at a university-affiliated private IVF clinic. A total of 287 women underwent 287 IVF cycles and received a fresh embryo transfer. Patients had their serum 25-hydroxyvitamin D2/D3 (VitD) determined on the day of oocyte retrieval, which was analysed in relation to blastocyst development rate, clinical pregnancy and live birth outcomes. ResultsIn stepwise, multivariable logistic regression models, increases in blastocyst development rate, number and quality, along with embryo cryopreservation and utilization rates were associated with women with a sufficient VitD status (≥20 ng/ml). For a single increase in the number of blastocysts generated per cycle or embryos cryopreserved per cycle, the likelihood for the patient to be VitD sufficient was increased by 32% (odds ratio [OR] 1.32, 95% confidence interval [CI] 1.10–1.58, P = 0.002 and OR 1.33, 95% CI 1.10–1.60, P = 0.004, respectively). Clinical pregnancy (40.7% versus 30.8%, P = 0.086) and live birth rates (32.9% versus 25.8%, P = 0.195) in the sufficient VitD group versus the insufficient group were not significantly different and VitD sufficiency was not significantly associated with these outcomes. ConclusionA strong relationship was observed between blastocyst development and VitD sufficiency. However, there was no association between VitD and clinical pregnancy or live birth outcomes. Further larger studies are needed to investigate whether the observed effect on blastocyst development may have downstream implications on subsequent clinical pregnancy or live birth rates, and on a potential mechanism where sufficient VitD concentrations are linked to improved IVF outcomes.

Increased E. coli bio-adsorption resistance of microfiltration membranes, using a bio-inspired approach

Cells have inherent anti-fouling properties. The mechanisms underpinning these natural properties inform the design of an anti-biosorption coating for a polyethersulfone microfiltration membrane, which includes polydopamine and chitosan layers. This tri-layered membrane is created using quick and easy synthesis method. Its ability to resist bio-adsorption and membrane extracellular polymeric substances (EPS) formation is investigated using the bacterium E. coli (ATCC 11775, 1.5 × 107 CFU/mL). In addition, the proliferative bio-adsorption process is explored on the microfiltration membrane surface, using natural water under static and shaken conditions, while monitoring the bio-adsorption kinetics and EPS dynamic changes. The characterization results show that the modification by polydopamine and chitosan change the membrane surface morphology and increase its hydrophilicity. After 10 min dipping in 5 g/L chitosan solution, the pure water flux of the modified membrane is 5469 ± 30 L/(m2·h) (0.2 bar) and the contact angle decreases to 36.7 ± 1.0°, compared with 9889 ± 23 L/(m2·h) (0.2 bar) and 60.3 ± 1.5° for the unmodified polyethersulfone membrane, respectively. In proliferative bio-adsorption tests, the modified membrane is shown to decrease bio-adsorption by 0.4–2.3 orders of magnitude. However, no antimicrobial function is observed, probably due to the alkaline environment and insufficient functional amino groups. A series of linear and non-linear kinetic models is applied to fit the proliferative bio-adsorption process. The pseudo-second-order model is found to describe the proliferative bio-adsorption process best. Neither total organic carbon (TOC) nor protein is detected on the modified membrane surface. In contrast, on the unmodified PES membrane the ratios of protein/TOC (%), TOC/abundance ((μg/cm2)/CFU (log)) and protein/abundance ((μg/cm2)/CFU(log)) are 10%–16%, 0.17–0.28 and 0.02–0.04, respectively. No significant difference (p > 0.05) is found between static and shaken conditions. All these results point to improved anti-biosorption properties for water treatment applications, encouraging further studies on this membrane.

Continuous Vitamin D3 Supplementation Effectively Improves the Low Vitamin D Status in Children with Autism Spectrum Disorder

Background: We previously showed that vitamin D supplementation might ameliorate typical clinical symptoms in children with autism spectrum disorder (ASD). In this study we examined the effects on serum vitamin D status in ASD children of discontinuation of vitamin D3 supplementation after 9 months. Methods: We enrolled 5 male and 1 female Japanese children with ASD and 5 male typically developing children, all aged 3 years. Serum 25-hydroxy vitamin D, calcitroic acid and vitamin D binding protein were measured at 4months after the end of supplementation with oral vitamin D3 oil (2μg/day of vitamin D3, corresponding to twice the daily requirement) for 9 months. Results: The 25-hydroxy vitamin D levels were ≥30 ng/mL (sufficient) in 1 child, >20 ng/mL and <30ng/ mL (insufficient) in 4 children and ≤20 ng/mL (deficient) in 1 child after 9 months of vitamin D3 supplementation. No significant differences were seen in the results for the typically developing children. At 4 months after the end of supplementation, the number of children in the insufficient group decreased from 4 to 1 (3 became deficient), while the number in the sufficient group decreased from 1 to 0 (1 became insufficient). This distribution was the same as that prior to vitamin D3 supplementation. Most vitamin D in the body is known to be activated finally metabolized to calcitroic acid. The serum calcitroic acid level was the same as the 25-hydroxy vitamin D level after 9 months of supplementation. At 4 months after the end of supplementation, the serum calcitroic acid level was lower than the 25-hydroxy vitamin D level. These results suggest that supplemented vitamin D is quickly converted to calcitroic acid. No difference was seen in the value of serum vitamin D binding protein. Conclusion: These findings show that continuous vitamin D3 supplementation is effective for ameliorating clinical symptom in children with ASD.

The Monitoring and Application of Transcranial Doppler Ultrasound in Patients with Severe Neurovascular Diseases

To investigate the monitoring effect and application of transcranial Doppler ultrasound (TCD) in patients with severe neurovascular cerebrovascular diseases. From December 2016 to October 2018, 96 patients with cerebrovascular disease in Department of Neurology and ICU, West China Hospital, Sichuan University were monitored by bedside TCD, including the detection of bilateral middle cerebral arteries (MCAs) through temporal window, and the detection of the basilar artery (BA) through occipital window, characterized by the peak systolic blood flow velocity, peak diastolic blood flow velocity, average peak blood flow velocity, vascular pulsatility index, vascular pulsatility index, vascular resistance index and blood flow spectrum morphology in local hemodynamic changes. According to the monitoring results, it was divided into vasospasm group, increased blood flow group and insufficient blood supply group. Relevant data of monitoring results were analysed. Bedside TCD monitoring was successfully used to all cerebrovascular diseases patients. Among 96 patients, 37 patients (38.54%) had increased cerebral blood flow, 15 patients (15.62%) had cerebral vasospasm, and 93 patients had insufficient cerebral blood supply (90.62%, including insufficient blood supply to the MCA and BA). Patients mainly with cerebral aneurysm and hypertensive intracerebral hemorrhage types contributed the highest proportion of insufficient blood supply, followed by the increase of blood flow, and the incidence of vasospasm was relatively low. In cerebral aneurysm group and hypertensive intracerebral hemorrhage group, and differences in the incidence of insufficient blood supply, increased blood flow, and vasospasm were statistically significant ( P<0.05). The bedside TCD monitoring can assess the patient's craniocerebral hemodynamic information and provide a clinical guidance.

Effect of serum 25-hydroxyvitamin D levels on sperm quality and assisted reproductive technology outcomes for men of infertile Chinese couples.

Vitamin D insufficiency/deficiency is highly prevalent in China, but its effect on sperm quality and outcomes of assisted reproductive technology (ART) in men from infertile couples is not clear. This study aimed to explore the association of serum 25-hydroxyvitamin D (25OHD) levels and semen parameters, as well as ART outcomes for men from infertile couples. This study recruited 1308 men from infertile couples who attended the Reproductive Medicine Center of Peking University Third Hospital for first time from February to August 2019 (NCT03804294). Reproductive hormones levels, semen parameters, and clinical outcomes of ART were compared between vitamin D-deficient group (serum 25OHD≤10ng/mL), insufficient group (serum 25OHD 10-20ng/mL), and sufficient group (serum 25OHD≥20ng/mL). We found 27.7% of participants were vitamin D sufficient, suggesting high prevalence of vitamin D insufficiency/deficiency in China. Reproductive hormone levels were similar between the three groups. The total number of morphologically normal spermatozoa was significantly different between the three groups in all participants, impaired semen quality subgroup, and normozoospermia subgroup (P<.05) with the adjustment of confounders (age, BMI, alcohol consumption, cigarette smoking, and physical exercise). The percentage of normal sperm morphology significantly increased with elevated serum 25OHD levels in all participants and the participants with impaired semen quality (P<.05), and the total sperm count showed significant difference in participants with impaired semen quality (P=.026). For routine in vitro fertilization and intracytoplasmic sperm injection cycles, there were no differences in fertilization rate, top-quality embryo rate, biochemical pregnancy rate, and clinical pregnancy rate between serum 25OHD<20ng/mL and serum 25OHD≥20ng/mL groups. Males of infertile couples with higher serum 25OHD levels exhibit better results in sperm morphology, and serum 25OHD levels may contribute to total sperm number in participants with impaired semen quality, but show no effects on the ART outcomes.

Vitamin D Status at Admission and Its Association With Mortality in Children Admitted to the Pediatric Intensive Care Unit.

IntroductionThis study aims to evaluate the prevalence of vitamin D deficiency and the correlation between serum 25-hydroxyvitamin D (25(OH)D) and mortality.Materials and methodsA prospective observational study was conducted among 522 children admitted to the Pediatric Intensive Care Unit in the Pediatrics Department of the Jawaharlal Institute of Postgraduate Medical Education and Research, Pondicherry, India. After measuring vitamin D levels, children were assigned into three groups based on their serum 25(OH)D levels: a sufficient group (25(OH)D level ≥ 30 ng/mL), an insufficient group (25(OH)D level = 20-29.9 ng/mL), and a deficient group (25(OH)D level < 20 ng/mL). Each group was again divided into two sub-groups (survivors and non-survivors if death was the outcome), and then each sub-group was again divided into two groups (sepsis and all non-septic causes). Results were evaluated for an association with mortality.ResultsA majority (66.6%) of patients who died had low levels of 25(OH)D (deficient = 37.9%; insufficient = 28.7%). Mortality was higher in children with 25(OH)D deficiency (P = 0.03). In univariate analysis, 25(OH)D deficiency was strongly associated with sepsis in children according to our observation, with 51% from the deficient group, 38% from the insufficient group, and 27.5% from the sufficient group (P ≤ 0.01). Mortality is not associated with 25(OH)D deficiency or insufficiency in multilogistic regression analysis. A serum vitamin D level of 20 ng/mL can predict higher mortality, with a specificity of 62.1%.ConclusionsVitamin D supplementation may be recommended for PICU-admitted cases to decrease the risk of sepsis. This association can be explored more in the future among the community population for further recommendations.

2166-PUB: Surprisingly High Prevalence of Vitamin D Deficiency in Japanese Diabetic Patients

Vitamin D is known to regulate many cellular functions such as insulin secretion, cardiac function, immune system, skeletal muscle in addition to bone mineral metabolism. With respect to diabetes, diabetes prevention trials by vitamin D supplementation and reports showing an association between low levels of blood vitamin D and cardiovascular events, bone fractures, falls and most recently the life prognosis have been published. However, reports on Japanese diabetic patients and vitamin D is scarce. We measured serum 25 (OH) D concentration (ECLIA) in 133 patients (M/F: 85/48) with type 1 (n=15) and type 2 diabetes patients (118). Age, sex, BMI and biochemical indicators (serum Ca, P, Alb, HbA1c, LDL-C, TG, CPR and atherosclerosis indices (urinary albumin, NT-proBNP, baPWV and max IMT) were investigated. The subjects mean age was 59.1±14.0 years (mean±SD) and HbA1c9.1 ±2.6%, and BMI25.0±4.3. Serum 25 (OH) D concentration state was only 3% in sufficient group(&amp;gt;30ng/ml), 11% insufficient group and 86% was in deficiency (&amp;lt;20ng/ml). This was the same regardless of type 1 or type 2. Correlations with the aforementioned indicators including HbA1c was not observed. However, serum 25 (OH) D concentration and max IMT in HbA1c above 8% group had a weak but significant reverse correlation, which was consistent with the previous metaanalysis. The limitation of this study is a single center based, and it does not include data on dieting status, or exposure to sunlight. However, subjects have a history of medical nutritional education and they are residents of urban areas with adequate ADL, it is unlikely that they are particularly biased diabetes populations. In an aging society, it is important to prevent sarcopenia, and fractures in diabetes. The present results shed a new insight in Japanese medical nutritional therapy. For vitamin D deficiency cohort, interventions and bone salt quantification are going to be carried out and osteoporosis, fractures, and cardiovascular risk are evaluated in a prospective manner. Disclosure N. Kashima: None. K. Hamano: None.

The association between serum vitamin D level and sperm parameters; A pilot study in a subset of Iranian infertile males

Introduction: Male-factor infertility affects about 7% of males in the general population. Vitamin D deficiency has been reported as an important public health issue all around the world and plays an important role in male fertility. Objectives: The aim of the present study was to investigate the association between serum levels of vitamin D and sperm parameters. Patient and Methods: We conducted this pilot cross-sectional study among infertile males who referred to Khanevadeh Specialty Hospital, Isfahan, Iran. A researcher-made checklist was used to collect data on basic characteristics of patients. Serum vitamin D level as well as sperm parameters (comprising sperm concentration, volume, vitality, total motility, progressive motility and abnormal morphology), DNA fragmentation and chromatin maturity were assessed according to standard protocols. Subjects with a serum vitamin D level of ≥30 ng/mL and 20-29 ng/mL were categorized as vitamin D sufficient and insufficient groups respectively. Results: According to our results, sperm parameters except for sperm volume were significantly different between two groups (P&lt;0.05). There was a positive significant correlation between sperm concentration, vitality, progressive motility and total motility with serum levels of vitamin D (P&lt;0.05). A negative significant correlation was observed between sperm abnormal morphology, DNA fragmentation and chromatin immaturity with serum levels of vitamin D (P&lt;0.05). We did not find any significant correlation between sperm volume and serum levels of vitamin D among infertile males (P&gt;0.05). Conclusion: The results of the current study showed that low vitamin D levels can be considered as a potential risk factor for male infertility among the Iranian population. Further large-scale studies are warranted to determine the association between male infertility with serum vitamin D level and underlying mechanisms.

0992 Prevalence Of Insufficient Sleep Duration And Consequences On Daytime Sleepiness, Mood And Academic Performance In Thai Adolescents

Abstract Introduction Insufficient sleep duration in adolescents is key public health concerns in many societies. This study aims to assess the prevalence of insufficient sleep duration and the association between short sleep with daytime sleepiness, depressive symptoms, and anxiety among Thai adolescents. Methods Thai adolescents aged 11 -18 years completed a self-administered questionnaire including Phramongkutklao Hospital Sleep disorders center Questionnaire, Pittsburg Sleep Quality Index (PSQI), Epworth Sleepiness Scale (ESS), The Children depress Inventory (CDI) scale and Child Anxiety Related Emotional Disorder (SCARED). Results 232 adolescents with the mean age of 14.58 (range 11-18) years participated in this survey. The average total sleep time was 7.44 hours. The overall prevalence of insufficient sleep duration (sleep duration &amp;lt;8 hours) was 37.5% and the small difference was found between males (42.0%) and females (32.7%). Compared with those who had a sleep length of 8 hours and more, insufficient sleep duration group exhibited higher in BMI and less in Grade Point Average (GPA). Subjective sleep insufficiency among Thai adolescent also had higher percentage of subjects with ESS ≥10 (43.2% vs 21.3%, P &amp;lt;0.001), depressive symptoms (56.3% vs 39.3%, P 0.012) and anxiety (54.0% vs 38.6%, P 0.022) compare to those with adequate sleep duration. Conclusion High amount of Thai adolescents with poor sleep duration were observed in the study, consistency with prior surveys. Insufficiency sleep duration group had significantly increased daytime sleepiness, mood and anxiety problems among Thai adolescents. These findings emphasized the development of interventions to improve sleep duration in Thai adolescents and more sample size should be achieved in the future. Support None

1034 Should We Recommend More Sleep To Prevent Obesity?

Abstract Introduction According to the 2015-2016 National Health and Nutrition Examination Survey (NHANES), the national adult obesity rate was 40% with the incidence of adult obesity having increased by 70% over the last 30 years. Paralleling the obesity epidemic have been worsening sleep deprivation and eroding sleep quality. We analyzed data from a Cardiovascular Health Registry to explore a link between total sleep time and obesity. Methods Registry participants underwent anthropometrics and completed validated questionnaires assessing health behaviors and symptoms including total sleep time (TST), Epworth Sleepiness Scale (ESS), Fatigue Severity Scale (FSS), Pittsburgh Sleep Quality Index (PSQI), Perceived Stress Scale (PSS), and exercise time. Differences between subjects with sufficient (≥7 hours) and insufficient (&amp;lt;7 hours) sleep were analyzed using T-tests. Results Registry participants (n=630) had mean age 55.3±9.9 years (45% men, 391W, 182B, 26H, 12A, 19O). The subgroup with sufficient sleep (n=261, 48% men), had mean BMI 29.3±5.6 while the subgroup with insufficient sleep (n=369, 44% men) had mean BMI of 30.5±5.3, p=0.008. The insufficient sleep group was noted to be sleepier (ESS 9.7±4.9 vs 7.4±4.6, p&amp;lt;0.001), more fatigued (FSS 4.9±2.3 vs 3.5±2.4, p&amp;lt;0.001) and have worse sleep quality (PSQI 8.6±3.7 vs 4.7±2.8, p&amp;lt;0.001). Insufficient sleepers also perceived greater stress levels (PSS 22.2±8.4 vs 18.9±6.2, p&amp;lt;0.001), and showed a trend toward less exercise per week (143±134 vs 163±106 minutes, p=0.13). Conclusion Participants with insufficient sleep were significantly more overweight on average and were more symptomatic for insufficient sleep. While current approaches to weight management focus largely on diet and physical activity, the data from this study suggest that insufficient sleep should also be considered as a risk factor for obesity and should be incorporated into management plans for obesity. Support

The association between serum 25-hydroxyvitamin D levels and dental caries in US adults.

We investigated whether 25-hydroxyvitamin D concentration is independently associated with dental caries among adults in the United States. This investigation was a cross-sectional study. A total of 4,244 participants (aged 20-80years) were enrolled through the 2007-2008 National Health and Nutrition Examination Survey (NHANES). Serum 25-hydroxyvitamin D was categorized into four groups based on previous studies: normal (≥75nmol/ml), insufficient (50-74.9nmol/ml), deficient (25-49.9nmol/ml), and severely deficient (<25nmol/ml). The dependent and independent variables included dental caries and serum 25-hydroxyvitamin D, respectively. The data were analyzed using univariate analyses, multivariable-adjusted analyses, and subgroup analyses. The fully adjusted model showed that 25-hydroxyvitamin D levels were negatively associated with dental caries after adjusting for the confounders (OR=0.93, 95% CI 0.89 to 0.98). Compared with the normal group, the likelihood of dental caries was 2.48, 1.29, and 1.43 times higher in the severely deficient, deficient, and insufficient groups, respectively. Our findings suggest that serum 25-hydroxyvitamin D levels are significantly associated with the occurrence of dental caries among US adults.

MON-387 Association Between Vitamin D Level and Bone Mineral Density in Korean Adolescents

IntroductionFractures are common in pediatric population, and lower bone density increases the risk of fracture. Most bone acquisition happens during youth, so juvenile bone mineral density (BMD) assessment is important. There are many factors associated with low BMD, including vitamin D status, calcium intake, low body weight, and physical activity. Among these, our investigation focused on the association of BMD with vitamin D in adolescents.MethodsThis study investigated data of 1,063 adolescents aged 12-18 years from the fifth and sixth Korea National Health and Nutritional Examination Survey (2009-2011). The association of various factors (vitamin D level, calcium intake, body mass index (BMI), lean mass, fat mass, and physical activity) with BMD Z-scores in whole body, lumbar spine, total femur, and femur neck were analyzed. We defined vitamin D deficiency (≤ 12 ng/mL), vitamin D insufficiency (12-20 ng/mL), and sufficiency (> 20ng/mL) according to the 25-hydroxyvitamin D (25-OHD) level. We analyzed association between BMD and vitamin D levels after adjusting for other factors.ResultsThe mean 25-OHD level of subjects was low (16.28 ng/ml). Of all subjects, 21.9% were vitamin D deficient, and 58.5% were vitamin D insufficient. Among the vitamin D groups, the vitamin D sufficient group had significantly higher BMD Z-scores than the vitamin D deficient group in whole body, lumbar spine, and femur neck. The sufficient vitamin D group had higher BMD Z-score than the vitamin D insufficient group in femur neck, and the vitamin D insufficient group had higher BMD Z-score than the vitamin D deficient group in whole body. Among various factors, vitamin D status, calcium intake, BMI, lean mass, fat mass, and physical activity were positively associated with BMD Z-scores. In particular, lean mass was the strongest independent factor. Vitamin D levels were positively associated with the BMD Z-scores even after adjusting for other factors.ConclusionsVitamin D deficiency and insufficiency were common among adolescents. This study suggested that vitamin D level was positively associated with BMD, and that sufficient vitamin D level was needed to prevent low BMD. Vitamin D status is an important factor of BMD in adolescents.

Vitamin D deficiency and suicidal ideation: A cross-sectional study of 157,211 healthy adults

ObjectivesVitamin D deficiency has been reported to be associated with various neuropsychiatric disorders. However, there are few studies addressing deficient vitamin D levels and suicidal ideation. MethodsSerum vitamin D of 157,211 Korean adult participants were measured using electrochemiluminescence immunoassay. A self-reported questionnaire was used to assess whether participants experienced suicidal ideation. Logistic regression model was used to estimate the odds ratio (OR) of suicidal ideation according to vitamin D levels. The regression was adjusted for a range of covariates. ResultsCompared with sufficient vitamin D levels (≥20 ng/mL), deficient vitamin D levels (<10 ng/mL) were significantly associated with the risk of suicidal ideation (OR = 1.138, 95% Cl = 1.027–1.262). However, the OR of suicidal ideation was not significantly different between the vitamin D insufficient group (10–19.99 ng/mL) and sufficient group (≥20 ng/mL) (OR = 0.988, 95% Cl = 0.932–1.047). ConclusionDeficient vitamin D levels were significantly associated with the risk of suicidal ideation. However, the risk of suicidal ideation was not significantly different between the vitamin D insufficient group and sufficient group.

Effective factors on inadequate results in endometrial biopsy with Pipelle

Objective: In this study, it was aimed to investigate the factors that may affect the pathological diagnosis in pipelle endometrial biopsies.&#x0D; Material and Methods: Four hundred and twenty endometrial biopsies performed by the same specialist using pipelle were analyzed retrospectively in our outpatient clinic for eleven months. Endometrial samples which were made for diagnosis of ectopic pregnancy and patients who have history of cancer or needed anesthesia for the procedure were excluded from the study. Group 1 was created from 65 patients whose endometrial biopsy were resulted as insufficient endometrial biopsy and Group 2 was created with 173 patients who had sufficient material as a result of biopsy. The effect of demographic information, ultrasound data (presence and localization of leiomyoma, endometrial thickness) and biopsy indications were investigated.&#x0D; Results: The average age of patients in Group 1 was found to be statistically significantly higher than Group 2, of 238 patients who were investigated retrospectively (p&lt;0,001). Endometrial thickness in Group 1 was statistically lower than Group 2 (p&lt;0,001). Endometrial biopsy indications were frequently observed as postmenopausal bleeding for Group 1 and abnormal uterine bleeding for Group 2.&#x0D; Conclusion: According to our opinion that it will be more appropriate to perform dilatation / curettage biopsy, instead of biopsy with pipelle if a need for endometrial sampling is required in older ages especially for the postmenopausal patient group.

The Study of Correlation Between Serum Vitamin D3 Concentrations and HBV DNA Levels and Immune Response in Chronic Hepatitis Patients.

Chronic hepatitis B (CHB) is a common chronic disease. Previous studies have shown a link between 25-hydroxyvitamin D3 (vitamin D3) concentration and liver disease. Hepatitis B virus (HBV) infection has been attributed to the inappropriate functioning of cell-mediated immunity. However, the effects of vitamin D3, immune cell, and HBeAg status on HBV viral load in CHB patients are still unclear. We investigated the relationship between the serum concentration of vitamin D3, percentage of immune cells in peripheral blood, and the HBV viral load of CHB patients. Sixty CHB patients were recruited, and their blood samples were collected and analyzed. Vitamin D level was measured using a chemiluminescence assay. A level of 30 ng/mL or above was defined as a vitamin D3 sufficiency. We assigned vitamin D3 status as either normal (≥30 ng/mL), insufficient (20–30 ng/mL), or deficient (<20 ng/mL). T-lymphocyte and B-lymphocyte surface markers in peripheral blood were detected using flow cytometry. The factors associated with HBV viral load were analyzed using univariate and multivariate-adjusted models. The mean serum vitamin D3 concentration in the subjects was 20.9 ± 5.6 ng/mL. Up to 88.3% of the patients were either deficient in or had insufficient vitamin D3. The gender, BMI, hepatitis B surface antigen levels, and ALT levels were significantly related to serum vitamin D3 levels. Serum vitamin D3 concentration, HBe status, HBs levels, ALT, and AST levels showed a statistically significant correlation with the HBV DNA levels. Serum vitamin D3 concentrations and hepatitis B surface antigen levels were strongly correlated with HBV DNA levels. Vitamin D3 levels were significantly associated with CD19 numbers (β:−6.2, 95% CI: −10.5). In multivariate analysis, vitamin D3 levels in the deficient and insufficient groups, and the CD8, HBeAg, and WBC counts were significantly associated with HBV DNA levels. In the immune tolerance phase of HBeAg-negative chronic HBV infection, vitamin D3 may be a modulator of immune function via CD8, CD19, and HBV DNA.

Vitamin D Sufficiency Has a Limited Effect on Placental Structure and Pathology: Placental Phenotypes in the VDAART Trial.

Vitamin D insufficiency during pregnancy is widespread. The effects of active vitamin D on the human placenta in vivo are unknown. We test the hypotheses that 25(OH)D sufficiency (arbitrarily defined as 25(OH)D ≥32 ng/mL) modulates placental structure and function in vivo in a population of women whose offspring are at risk for childhood asthma, and that placental pathology is more common in offspring that evolve asthma at age 3. Pregnant volunteers in the St. Louis, MO, cohort of the Vitamin D Antenatal Asthma Reduction Trial (VDAART, NIH grant #HL091528) participated in a nested case-control study and consented for the study of placentas after delivery. Maternal concentrations of 25(OH)D were measured at trial entry and in the third trimester. The histopathology of the placentas from women with sufficient 25(OH)D, versus insufficient, showed no clinically significant differences, but morphometry revealed villi of women with sufficient third-trimester 25(OH)D had a higher villous surface density. Notably, analyses of transcripts, extracted from formalin-fixed paraffin-embedded specimens, revealed higher expression of INTS9, vWF, MACC1, and ARMS2, and diminished expression of the CNTN5 genes in the insufficient group. A larger proportion of placentas showed chronic chorioamnionitis in offspring with versus without asthma at age 3. These findings suggest that maternal 25(OH)D insufficiency has a limited effect on human placental villous histopathology and morphometry, but attenuates a small number of placental gene expression profiles in this selected population. The association of placental chronic chorioamnionitis and offspring asthma is worthy of further study.

Associations between self-reported physical activity and oral health: a cross-sectional analysis in 17,777 Spanish adults.

Background The aim of this study was to assess the association between levels of physical activity and oral health in adults residing in Spain.Methods Cross-sectional data from the Spanish National Health Survey 2017 were analysed (n = 17,777 adults aged ≥15 years; 52.0% females). The International Physical Activity Questionnaire (IPAQ) short form was used to measure physical activity. Oral health was self-reported through eight variables. Covariates included were sex, age, marital status, education, obesity, smoking and alcohol consumption.Results Dental caries (19.8% vs 27.8%), dental extraction (72.7% vs 75.4%), gingival bleeding (15.5% vs 19.1%), tooth movement (4.3% vs 5.9%) and missing tooth (57.9% vs 62.5%) were statistically significantly less frequent in the sufficient than insufficient physical activity group, whereas dental filling (74.2% vs 70.9%), dental material (36.6% vs 34.8%) and no missing tooth and no material (28.2% vs 25.1%) were statistically significantly more common. After adjustment, there was a negative relationship between physical activity and dental caries (OR = 0.72; 95%CI = 0.66-0.78), gingival bleeding (OR = 0.79; 95%CI = 0.72-0.86), tooth movement (OR = 0.83; 95%CI = 0.71-0.96) and missing tooth (OR = 0.91; 95%CI = 0.85-0.98). In contrast, physical activity was positively associated with dental material (OR = 1.16; 95%CI = 1.07-1.25).Conclusions Participation in physical activity is favourably associated with some but not all self-reported oral health correlates.

Association between vitamin D deficiency and cognitive function in the elderly Korean population: A Korean frailty and aging cohort study.

It is well known that vitamin D (VitD) plays an important role in bone and calcium metabolism in the human body. VitD has additional roles in the body including modulation of cell growth, neurogenesis, neuroprotection, detoxification, immune function, and reduction of inflammation. Recent studies reveal insufficiency of VitD as a risk factor for cognitive decline or dementia. VitD has a role in normal brain function; insufficiency of VitD may lead to decreased memory and cognitive function.Using 2 years of baseline data from Korean frailty and aging cohort study, 2990 subjects (1415 men and 1575 women) were recruited. A short form of Korean version of the consortium to establish a registry for Alzheimer disease (CERAD-K), an assessment of cognitive status in patients with dementia was used. Among CERAD-K tests, we included word list memory/recall/recognition, digit span (forward, backward), trail making test (TMT) A, and mini-mental state examination in the Korean version of the CERAD assessment packet (MMSE-KC). Serum samples were collected and 25-hydroxyvitamin D (25(OH)D) was measured. Serum 25(OH)D concentrations were classified into clinically relevant categories as: deficient (<10 nmol/L), insufficient (10–30 nmol/L), and sufficient (≥30 nmol/L).The mean age of participants was 76.5 ± 3.9 years, and 52.7% were women. Among 2990 participants, 119 (4.0%) were classified as 25(OH)D deficient and 2253 (75.3%) as insufficient. Only 618 (20.7%) participants were sufficient for 25(OH)D. Among them performance in MMSE-KC, TMT A, and digit span tests was better in sufficient, insufficient, and deficient groups, which was statistically significant (P < .05). However, in multivariable regression analysis after adjusting for age, sex, body mass index, education, center, seasonality, physical activity, and alcohol use, association between 25(OH)D and cognitive function was not statistically significant.Although, when comparing VitD levels, there were differences in cognitive tests among the groups, fully adjusted analysis did not show any association. This result suggests that cognition was not affected by VitD levels alone but also population and sociological variables. In a fully adjusted model, there was no statistically significant association between VitD and cognitive function in the elderly Koreans in logistic regression analysis.

Impact of Mental Health Background and Nutrition Intake on Medium-Term Weight Loss in Japanese Patients Undergoing Laparoscopic Sleeve Gastrectomy

Objectives: Bariatric surgery is the most effective weight loss therapy, and recently laparoscopic sleeve gastrectomy (LSG) is gaining popularity worldwide. On the other hand, patients undergoing bariatric surgery have a high prevalence of mental disorders. A Japanese nationwide survey reported high prevalence of mental disorders in patients with low percent total weight loss (%TWL) and also in those with high %TWL. The aim of this study was to investigate the relationship of 1-year %TWL with background mental health status, 3-year outcomes, and nutrition intake in Japanese patients after LSG. Methods: This study was a single-center retrospective database analysis. A total of 89 Japanese patients who underwent LSG and were followed for 3 years were enrolled (mean age 41.9 years, baseline body mass index 44.9, baseline glycosylated hemoglobin, HbA_1c, 7.0%). The patients were divided into 3 groups according to 1-year %TWL as follows: ≤19.9% (insufficient group), 20.0–34.9% (average group) and ≥35.0% (excessive group). Psychosocial and nutritional status as well as physical data were collected from all patients. Results: The prevalence of mental disorders was 51.7%, and 1-year %TWL was 28.1% in all patients. No significant differences were observed in the changes in body weight and HbA_1c between patients with and those without mental disorders. The prevalence of mental disorders was particularly high in the insufficient and excessive groups. In the insufficient group, mood disorders and mental retardation/developmental disorders were frequent, and snacking and eating out habits were often observed. In the excessive group, the frequencies of mood disorders and binge eating were high, and a decrease in skeletal muscle mass due to low protein intake was observed. Furthermore, weight regain was shown 12 months after LSG in both groups. In the average group, there were fewer problems in weight loss outcomes, mental health, nutrition intake and body composition. Conclusions: Psychosocial and nutritional problems were often found not only in patients with insufficient weight loss, but also in those with seemingly “excellent” weight reduction. To improve long-term weight loss outcome and future health, a multidisciplinary approach focusing on mental health and nutrition is essential for patients undergoing bariatric surgery.

Correlation of serum vitamin D with lipid profiles in middle-aged and elderly Chinese individuals.

Deficiency of vitamin D has been associated with various health conditions. The purpose of this study was to evaluate the associations between the serum 25OHD concentration and lipid profiles in Chinese individuals. Serum 25OHD and lipid profiles were obtained for a cross sectional sample of 10100 individuals aged 40-75 years from Lanzhou city, which is located in western China. Linear-by-linear association, partial correlation analysis and multiple logistic regression analysis were used to evaluate associations between serum 25OHD concentration and lipid profiles. 10038 subjects aged 40- 75 years were included in the study. The 25OHD deficient and insufficient groups had higher TC, LDL-C and TG when compared to the optimal group. The dyslipidemia rates of vitamin D deficiency, insufficiency, and sufficiency groups were 45.4%, 41.6%, 38.8%, respectively. The prevalence rates of dyslipidemia, high cholesterol, high LDL-C, hypertriglyceridemia and mixed type hyperlipidemia exhibited decline trend in vitamin D deficiency, insufficiency and sufficiency groups. The correlation coefficients in between TC and 25OHD, LDL-C and 25OHD, TG and 25OHD were -0.033, -0.022, -0.044, respectively. Low 25OHD levels were associated with the risk of onset of dyslipidemia [OR 1.225 (95% CI 1.075-1.397), p=0.002] in the logistical regression analyses. Deficient serum 25OHD is associated with higher TC, LDL-C, and TG in middle-aged and elderly Chinese individuals. These findings suggest that low 25OHD levels observationally is simply a marker for elevated atherogenic lipoproteins and question a role for vitamin D supplementation in the prevention of cardiovascular disease.