Insufficient Levels Of Vitamin Research Articles

Vitamin-D induced neurological disorders: A review

Vitamin D inadequacy represents a pervasive global health concern, impacting an estimated 1 billion individuals. Beyond its well-established role in calcium regulation and skeletal health, contemporary investigations reveal that vitamin D serves as a crucial neuro-steroid hormone, exhibiting diverse protective and regulatory functions within the brain. Neurons and glial cells express vitamin D receptors, with particularly elevated levels found in key regions such as the hippocampus, hypothalamus, thalamus, subcortical grey nuclei, and substantia nigra. Insufficient levels of vitamin D have been associated with compromised functionality in various cerebral processes. The deficiency in serum 25-hydroxyvitamin D concentrations may be reversible, providing a potential avenue for intervention. Given the limited availability of efficacious therapeutic alternatives, beyond disease-modifying strategies, comprehensive exploration of various risk factors is imperative. Addressing these factors in the realm of neurology may contribute to ameliorating brain disorders. Associations between genetic and environmental factors and prolonged vitamin D insufficiency as a predisposing element for diverse neurological conditions necessitate thorough examination. This underscores the importance of scrutinizing the role and justification of vitamin D-based therapeutic interventions. The straightforward and cost-effective nature of such interventions may offer potential benefits in both primary and secondary prevention of a spectrum of neuropsychiatric illnesses.

Vitamin D and childhood disability: diseases of the nervous system

Child disability associated with diseases of the nervous system, the main cause of which is cerebral palsy (CP), is often accompanied by an insufficient level and high prevalence of vitamin D deficiency, but in our opinion, practicing physicians and health officials at all levels pay insufficient attention to this problem, therefore, this paper is devoted to the study of the influence of vitamin D on the disability of children resulting from diseases of the nervous system. We statistically investigated the association between the prevalence of vitamin D deficiency in municipalities of Khanty-Mansiysk Autonomous Okrug — Yugra and the number of cases of resulting childhood disability due to nervous system disease in 2021, using the anonymized results of 31,596 measurements of vitamin D levels in residents of the autonomous okrug, gratuitously provided to us by INVITRO-Ural LLC, whose staff the authors express their deep gratitude to. The calculations demonstrated the presence of a directly proportional relationship between the incidence of disability as a result of nervous system disease and the prevalence of severe vitamin D deficiency in the territory of Khanty-Mansi Autonomous Okrug — Yugra. The incidence of cerebral palsy is largely due to pregnancy abnormalities. Many researchers have associated the occurrence of cerebral palsy with preterm labor and low birth weight of the newborn with normal gestational age. The analysis indicates the great influence of vitamin D on the course and results of pregnancy, since pregnant women often have insufficient levels of vitamin D, which does not ensure full development of the fetus, which is accompanied by an increased incidence of various pathologies in the mother and child. Taking vitamin D supplements as prescribed by a doctor can be useful for pregnant women and children with cerebral palsy. The former need it to ensure the normal course and favorable outcome of pregnancy, and the latter — to increase bone mineral density and improve the body’s immune defense against a variety of diseases. To make recommendations on the amount of daily dosage and duration of vitamin D preparations, accurate knowledge of its initial level in the patient’s blood serum is required, which predetermines the need for mandatory monitoring of 25(OH)D levels in pregnant women and patients with cerebral palsy.

Vitamin D Status in Patients with Primary Antiphospholipid Syndrome (PAPS): A Systematic Review and Meta-Analysis.

Primary antiphospholipid syndrome (PAPS) is a systemic autoimmune disorder, characterised by consistently high levels of antiphospholipid antibodies, thrombosis, and/or pregnancy morbidity. Due to various suspected causes, deficient or insufficient levels of vitamin D in the serum have been reported in patients with PAPS; however, the reports have been sporadic and inconclusive. This systematic review and meta-analysis aimed to comprehensively evaluate the serum vitamin D levels in patients with PAPS compared to controls. A protocol was registered in PROSPERO (Registration No. CRD42019132128) and a systematic literature search was conducted through Google Scholar, PubMed, Web of Science, Scopus, and ScienceDirect databases without restricting language and year. Pooled prevalence, mean difference (MD), and odds ratio (OR) along with 95% confidence intervals (CI) were determined by using a random effects model. Study quality was assessed by the Joana Brigg's Institute (JBI) protocol and publication bias was evaluated by a trim and fill funnel plot, Begg's, and Egger's tests. The pooled prevalence of vitamin D deficiency and insufficiency was found to be 32.2% [95% CI: 16.3-48.2] and 61.5% [95% CI: 40.2-82.8], respectively. Serum levels of vitamin D were considerably lower in the PAPS patients compared to controls (MD: -5.75, 95% CI: -9.73 to -1.77; p = 0.005). Multiple sensitivity analyses showed that the results remained statistically significant, demonstrating the robustness of this meta-analysis. No significant publication bias was detected in determining the MD of serum vitamin D levels in PAPS and controls. In conclusion, PAPS patients had greater rates of vitamin D deficiency or insufficiency, higher frequency of thrombosis, and lower serum vitamin D levels than healthy individuals.

The vitamin D status and the levels of β1- and β2-defensins in children and adolescents with different forms of pulmonary TB

Introduction. The basic research demonstrated an important role of vitamin D in strengthening the immune response to Mycobacterium tuberculosis and proved its effect on the production of antimicrobial peptides. However, the correlation between the levels of vitamin D and defensins (β1 and β2) in children and adolescents with different forms of pulmonary TB was not studied.Aim. To study the correlation between the levels of vitamin D and β1- and β2-defensins in children and adolescents with different forms of pulmonary TB.Materials and methods. We carried out a prospective study of 75 patients with pulmonary TB aged 2–17 years (52 new cases and 23 retreatment cases) in 2021–2023. The levels of 25(OH)D and β1- and β2-defensins were determined at admission to hospital.Results. Out of 75 patients 2.7% had adequate levels of vitamin D (more than 30 ng/mL), 13.3% had insufficient levels of vitamin D (20 to 30 ng/mL), 34.7% had deficient levels of vitamin D (10 to 20 ng/mL), and 49.3% had severe deficiency of vitamin D (less than 10 ng/mL). We established a direct correlation between 25(OH)D and β1-defensin levels (p = 0.004766) and lack of correlation between 25(OH)D and β2-defensin levels. We discovered significant differences in the levels of 25(ОН)D and β1-defensin between new and retreatment cases: 13.10 ± 1.04 ng/mL and 8.74 ± 1.07 ng/mL (p = 0.004644) and 6.66 ± 0.79 ng/mL and 4.0 ± 0.85 ng/mL (p = 0.024816), respectively.Conclusion. The differences in the levels of calcidiol and β1-defensin between new and retreatment cases witness an impaired function of one of the innate non-specific immunity components during long-lasting advanced pulmonary TB in children and adolescents.

DYNAMICS IN MAIN CLINICAL AND IMMUNOLOGICAL INDICATORS IN PATIENTS WITH COMORBIDITY OF CHRONIC HEPATITIS C AND CHRONIC PANCREATITIS FOLLOWING INTEGRATED THERAPY INCLUDING VITAMIN D

The aim of this study is to evaluate the impact of integrated therapy including vitamin D on the clinical and immunological parameters of patients with chronic hepatitis C combined with chronic pancreatitis.
 Materials and methods. 52 patients with chronic hepatitis C and chronic pancreatitis with exocrine pancreatic insufficiency who had an insufficient level of vitamin D were under observation. They were divided into 2 groups depending on the treatment prescribed. All patients received antiviral therapy and sofosbuvir 400 mg + daclatasvir 60 mg once a day for 12 weeks and rabeprazole 20 mg once a day for a month. Depending on the scheme of taking enzyme preparations and vitamin D, all patients were divided into 2 groups. Group 1 (n=24) received Creon 25,000 according to the scheme and vitamin D 4,000 IU/day for 12 weeks of antiviral therapy and 12 weeks after the completion of antiviral therapy. Group 2 (n=28) took only Creon 10,000 according to the scheme. Analysis of findings obtained and their processing were carried out in Jamovi 2.3.2.1, Microsoft Office Excel for Windows 2016 programs using the Mann-Whitney, Wilcoxon U-test. The difference was considered statistically significant at p<0.05.
 Results: The administration of complex therapy, supplemented with vitamin D, resulted in a 100% achievement of sustained virological response (SVR) in patients belonging to group 1, while group 2 exhibited an SVR rate of 82.1%. It has been found out the treatment in group 1 demonstrated a significantly more pronounced reduction in ALT, AST, and total bilirubin levels compared to group 2. Furthermore, patients in group 1 exhibited more substantial changes in the cytokine profile, including a decrease in the levels of IL-6, TNF-б, neopterin, IL-4, IL-10, and TGF-в. Three months after the completion of antiviral therapy, the average FE-1 level in group 1 normalized, whereas in group 2, it only displayed a tendency toward normalization.
 Conclusion: The integration of a polyenzyme drug with minimal lipase activity (25,000 units) and vitamin D (4,000 IU/day) into the therapy for patients with comorbidity of chronic hepatitis C and chronic pancreatitis enhances the efficacy of antiviral therapy. This combination facilitates the rapid normalization of ALT, AST, and total bilirubin, mitigates cytokine imbalances, and improves exocrine pancreas function.

Association of Vitamin D with Suicide Behaviors: A Systematic Review and Meta-Analysis.

Objective: Research findings on the relationship between vitamin D and suicide are not consistent; therefore, the objective of the present paper is to assess the relationship between vitamin D and suicide behaviors using a systematic review and meta-analysis. Method : A search strategy was developed using keywords including "Vitamin D", "Vitamin D deficiency", "suicide" "attempted suicide", "completed suicide", "Suicide, Attempted", "Suicidal Ideation." We searched databases including Scopus, Medline, Web of Science, and Google Scholar by July 7, 2022. We examined the titles, abstracts, and full texts of the articles to select eligible ones. To pool the results of the selected studies, we used the random-effect method and mean difference as the effect size. The quality of the articles was evaluated by the Newcastle-Ottawa Scale (NOS). Moreover, heterogeneity and bias of reporting were evaluated by the I2 statistic and Egger's and Begg's tests, respectively. Results: Out of 149 studies retrieved in the databases, 11 studies were included in the final phase. Among these, the pooled findings of seven studies included in the meta-analysis phase showed that low levels of vitamin D are related to increased probability for suicide behaviors (P < 0.05). Moreover, subgroup analysis showed a significant relationship between vitamin D and suicide ideation and suicide attempt (P < 0.05). In addition, the I2 statistic indicated moderate heterogeneity (58%) and Egger's and Begg's tests did not show any evidence of publication bias (P > 0.05). Conclusion: This study provides evidence in favor of the relationship between vitamin D and suicide behaviors. It suggests that insufficient levels of vitamin D play a role in suicidal behaviors. However, it should be noted that further and stronger evidence is needed to establish this role. Finally, incorporating vitamin D-rich foods into the diet or taking vitamin D supplements is recommended to reduce the risk of suicide.

Analysis of Vitamin D Level among COVID-19 Patients: A Cross-sectional Study

Introduction: Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) is the virus responsible for causing coronavirus disease (COVID-19). Vitamin D has been proposed as a potentially modifiable risk factor that could influence the severity of COVID-19 infection. In the case of respiratory tract infections, the failure of cellular damage mechanisms and impaired oxygen diffusion can lead to acute respiratory failure. This study aimed to describe the effects of vitamin D levels in COVID-19 patients. Methods: A cross-sectional study was taken on 360 COVID-19 older than 18 years old unrepeated patients in Dr. Wahidin Sudirohusodo Hospital and its network, Makassar, South Sulawesi, Indonesia. Vitamin D level was analyzed from blood. Age, gender, body mass index (BMI), comorbidity, severity degree of COVID-19, and vitamin D level are also analyzed. Results: According to the findings of the study, several factors were identified to have notable correlation with the severity of COVID-19 symptoms. However, the study did not establish any connection between vitamin D levels and the severity of COVID-19 symptoms. Conclusion: Individuals affected by COVID-19 often have insufficient levels of vitamin D, although the severity of symptoms experienced by patients is not associated with their serum vitamin D levels. Keywords: Vitamin D, COVID-19, severity

Association of vitamin D levels with severity and outcome of COVID-19 infection among inward patients at a tertiary care unit in Sri Lanka

Introduction: A link between vitamin D and COVID-19 infection has been expressed by many experts. In this study, we aim to investigate the association of the prevalence of vitamin D deficiency with the severity and outcome of COVID-19 infection in patients who are admitted to Teaching Hospital Batticaloa, Sri Lanka. Methods: A retrospective cross-sectional study was conducted among COVID-19 patients over a period of one month in May 2021. All patients who tested positive for COVID-19 were included. Patients with chronic kidney disease, known vitamin D deficiency, and patients on vitamin D supplements were excluded from the study. The vitamin D deficiency was defined according to the Oxford Academic Endocrine Society guidelines. The severity of the COVID-19 was defined according to the Provisional Clinical Practice Guidelines on COVID-19 suspected and confirmed patients. Primary endpoints of this study were 'recovered from COVID-19' or 'death'. Data was analysed to report the proportion of patients with different vitamin D levels and disease severity. Chi-squared and Fisher's exact tests were used to analyse the results. A p-value of &lt;0.05 was considered as statistically significant. Results: Out of 141, 58% were males. Mild, moderate, and severe COVID-19 were observed in 29.8%, 48.2%, and 22.0% of patients respectively. Only 30.5% of the population had normal vitamin D levels while the rest had some degree of vitamin D insufficiency. None of the patient population had severe vitamin D deficiency status. A 52.9% in the moderate category of COVID-19 severity had insufficient levels of vitamin D levels. Those that recovered from COVID-19 were 93.6%. No significant association was observed between the severity of COVID-19 and vitamin D deficiency (p=.1041 ). Interestingly hypoxia was significantly prevalent among those with normal vitamin D levels (p=.0005). vitamin D deficiency does not impact the mortality rate among COVID-19 patients (p=.6559). Conclusions: The association of vitamin D levels with COVID-19 severity and mortality was not statistically significant.

The correlation of vitamin D level with body mass index in women with PCOS.

The aim of this study is to analyze correlation between vitamin D level and BMI in polycystic ovary syndrome (PCOS) women. The study group consisted of 311 patients with PCOS. Patients were categorized according to four phenotypes. All of the women participating in the study had their blood tested in the appropriate phase of the menstrual cycle and after proper preparation for the tests. The ultrasound examination and anthropometric measurements were performed. Vitamin D concentration was assessed in all study subgroups. The majority of patients had vitamin D deficiency or insufficient level. Variables included in the study, such as level of vitamin D, low density lipoprotein (LDL), sex hormone binding globulin (SHBG), testosterone, androstenedione, Anti-Müllerian Hormone (AMH) and BMI were correlated. A negative correlation was observed with the the level of SHBG, vitamin D and AMH. Subsequently, positive correlations were shown with testosterone, LDL and free testosterone level. An analysis of the correlation between BMI and vitamin D concentration showed that in phenotype I of PCOS this correlation was statistically significant and in the remaining PCOS phenotypes the correlation was close to statistical significance. Most PCOS patients have a deficiency or insufficient level of vitamin D. Women with PCOS have shown a significant negative correlation between BMI and SHBG serum level and between BMI and AMH level. A positive correlation exists between BMI and total and free testosterone and LDL. There is a negative correlation between BMI and vitamin D level in PCOS patients and in phenotype I this correlation was statistically significant.

P081 Is it necessary to test vitamin D prior to zoledronate or denosumab treatment?

Abstract Background/Aims Prior to each treatment of zoledronate (ZA) or denosumab, it is routine clinical practice to test for vitamin D. If vitamin D levels are low, patients must be started on replacement therapy prior to treatment. Other studies suggest that osteoporosis patients not taking vitamin D supplementation are likely to have subtherapeutic vitamin D levels. Awaiting vitamin D levels can delay timely treatment and organising these tests is labour intensive. In this service evaluation, we examined whether patients could have been treated empirically with vitamin D without testing. Methods We included all 542 patients from the New Cross Hospital osteoporosis treatment clinic lists between November 2021 to June 2022. The only patients excluded were those not taking ZA or denosumab. Data collected included demographics, medication history, and vitamin D levels. Vitamin D levels were measured as follows: &amp;lt;15 nmol/L: severe deficiency, 15-30 nmol/L: deficiency, &amp;gt;30-50 nmol/L: insufficiency, &amp;gt;50-250 nmol/L: adequate, &amp;gt;250 nmol/L: potential toxicity. Results 484 patients were included of which 88.6% were female. The mean age was 76.8. 90.0% were either on vitamin D and calcium supplementation, or on vitamin D supplementation alone. Of these patients on supplementation, vitamin D levels were adequate in 79.8%, insufficient in 7.8%, deficient in 0.4%, severely deficient in 0.2% and not available for the remaining patients. Of those not on supplementation, vitamin D levels were adequate in 45.9%, insufficient in 16.2%, deficient in 10.8% and severely deficient in 4%, and not available for the remaining patients. None of the patients had toxic levels of vitamin D. On contacting the 3 patients prescribed vitamin D supplementation but with deficient or severely deficient vitamin D levels, 2 were not taking the supplements and 1 was taking alfacalcidol (which is not measured in the standard trust vitamin D test). Therefore, of those patients taking vitamin D supplementation as prescribed, their vitamin D levels were all above 30 nmol/L. Conclusion This service evaluation therefore supports an approach of not testing vitamin D levels in patients who are due to receive either ZA or denosumab and are taking vitamin D supplementation. A small number of patients taking vitamin D supplementation still had insufficient levels of vitamin D; therefore, it could be recommended to treat all patients on vitamin D supplementation with a short course of high does vitamin D prior to ZA or denosumab treatment. In addition, any patients not taking vitamin D supplementation could also be treated with a course of high dose vitamin D prior to treatment without testing vitamin D levels. This will ensure safe levels of vitamin D and timely treatment of osteoporosis. This will save time and money and reduce waste. Disclosure J. Keasley: None. C. Stevens: None. A. Kumar: None. H. Sapkota: None.

Associations of urinary organophosphate esters metabolites with asthma and lung function in adolescents.

Organophosphate esters (OPEs) are ubiquitously detected in environments and their exposure may affect respiratory health. However, epidemiological evidence, particularly among adolescents, is very limited. We aimed to investigate the associations of urinary OPEs metabolites with asthma and lung function among adolescents and to identify potential effect modifiers. Included were 715 adolescents aged 12-19 years old participating in the National Health and Nutrition Examination Survey (NHANES) 2011-2014. Multivariable binary logistic regression and linear regression were used to assess associations with asthma and lung function, respectively. Stratified analyses were conducted to assess the effect modifications of serum sex hormones, vitamin D levels, and body mass index (BMI). After multivariable adjustment, we found that bis(2-chloroethyl) phosphate (BCEP) (3rd tertile [T3] vs 1st tertile [T1], OR = 1.87, 95% CI: 1.08, 3.25; P-trend=0.029) and diphenyl phosphate (DPHP) (T3 vs T1, OR = 2.52, 95%CI: 1.25, 5.04; P-trend=0.013) were associated with elevated odds of asthma in all adolescents. Sex-stratified analyses revealed that associations of these two OPEs metabolites tended to be stronger in males. Meanwhile, BCEP and the molecular sum of OPEs metabolites (∑OPEs) were significantly associated with declined lung function, either in all adolescents or by sex. Furthermore, stratified analyses revealed that positive associations of OPEs metabolites with asthma tended to be stronger among adolescents with insufficient levels of Vitamin D (VD < 50 nmol/L), relatively high levels of total testosterone (≥356 ng/dL and ≥22.5 ng/dL for males and females, respectively), or low levels of estradiol (<19.1 pg/mL and <47.3 pg/mL for males and females, respectively). Certain urinary OPEs metabolites, especially DPHP and BCEP, were associated with elevated odds of asthma and declined lung function in adolescents. Such associations might be partly modified by levels of VD and sex steroid hormones. The observed associations of urinary OPEs metabolites with increased risk of asthma and declined lung function highlight the potential hazard of OPEs exposure to respiratory health among adolescents.

Impact of Vitamin D Deficiency on Oral Health

Normally, the body can produce vitamin D at sun exposure. Vitamin D plays a key role in bone and tooth mineralization, and when levels are unregulated it can lead to the “rachitic tooth”, which is a defective and hypomineralized organ highly susceptible to fracture and decay. The conditions like recurrent aphthous stomatitis, atrophic glossitis or a painful, burning tongue which is characterized by inflammation and defoliation of the tongue, are possibly caused by nutritional deficiencies such as vitamin B and iron deficiencies. The deficiency has been linked to a variety of diseases, including in the oral cavity. Inadequate sun exposure may accelerate the onset of these diseases since the synthesis of vitamin D is interrupted. Vitamin D not only benefits the overall health of oral cavity but is also associated with tooth mineralization. It can help to fight against inflammation and stimulate the production of antimicrobial peptides for immune response. Thus, in this paper, we will briefly discuss the origin of various oral diseases caused by insufficient level of vitamin D in the body and shed light on the potential benefits of safe sun exposure to maintain both oral and body health. Lack of vitamin D can lead to dental caries, and weak or brittle teeth that easily break, chip, and crack. Their inadequacy leads to absorption impairment, increased bleeding tendency, bone resorption, looseness, and premature tooth loss. Inadequacy of those essential minerals is associated with delayed tooth eruption and with enamel or dentin hypoplasia.

Vitamin D Insufficiency is Associated with Higher Incidence of Dementia, a Large Community-Based Retrospective Cohort Study.

Active metabolite of vitamin D has neuro-immunomodulatory and neuroprotective properties. However, there is still a debate about the potential association between low serum levels of hydroxy-vitamin D and increased risk for dementia. To determine an association between hypovitaminosis D and dementia for different 25-hydroxyvitamin-D (25(OH)D) serum level cutoffs. Patients were identified utilizing the database of Clalit Health Services (CHS), the largest healthcare provider in Israel. For each subject, all available values of 25(OH)D during the study period, which lasted from 2002 to 2019, were obtained. Rates of dementia were compared across different cutoffs of 25(OH)D levels. Cohort included 4278 patients, of whom 2454 (57%) were women. The mean age at the beginning of follow-up was 53 (±17). During the 17-year study period, a total of 133 patients (3%) were diagnosed with dementia. In a fully adjusted multivariate analysis, the risk for dementia was almost 2-fold higher in patients with an average of vitamin D insufficiency (<75nmol/l) measurements (OR = 1.8, 95% C.I. = 1.0-3.2) compared to reference values (≥75nmol/l). Patients with vitamin D deficiency (<50nmol/l) demonstrated higher rates of dementia (OR = 2.6, 95% C.I. = 1.4-4.8). In our cohort, patients were diagnosed with dementia at a younger age in the deficiency (77 vs. 81 P-value = 0.05) and the insufficiency groups (77 vs. 81 P-value = 0.05) compared to the reference values (≥75nmol/l). Insufficient levels of vitamin D are associated with dementia. Dementia is diagnosed at a younger age in patients with insufficient and deficient vitamin D levels.

Vitamin D deficiency in persons over 50 years of age with and without carotid artery atherosclerosis: a cross-sectional outpatient study

Highlights. The association between vitamin D levels and estimated glomerular filtration rate and triglyceride levels was revealed in people with cardiovascular risk factors aged older than 50 years. Vitamin D deficiency was more frequently noted in patients with acute coronary syndrome. They also were more likely to have abdominal obesity and type 2 diabetes mellitus, indicating the association between vitamin D deficiency and metabolic syndrome. The high prevalence of both vitamin D deficiency and metabolic syndrome in the population necessitates further larger-scale studies to identify the relationship between vitamin D levels and cardiovascular risk factors.Aim. To assess the level of vitamin D in people older than 50 years with the presence/ absence of carotid artery atherosclerosis.Methods. The single-stage observational study was conducted, the study included 70 outpatients over 50 years of age, of which 17 (24%) were men and 53 (76%) were women. The mean age of the patients was 66 (60; 72) years. All examined patients underwent history taking, anthropometry, biochemical examination of blood plasma with the determination of lipid spectrum, glucose, creatinine and estimated glomerular filtration rate, echocardiographic examination. The presence of carotid atherosclerosis was determined by ultrasound examination of the carotid arteries. The study of the level of 25-OH vitamin D in blood serum was carried out by enzyme immunoassay (25-OH vitamin D ELISA).Results. It was found that about half (46%) of the examined persons have insufficient levels of vitamin D in the blood plasma, while its deficiency (less than 20 ng/mL) was determined in 9% of patients. Individuals with carotid atherosclerosis had slightly lower levels of vitamin D than those without it, but the differences did not reach statistical significance. In acute coronary syndrome survivors, there was a statistically significant decrease in vitamin D levels, the vast majority of these patients had diabetes mellitus and abdominal obesity. Statistically significant moderate relationships were found between vitamin D levels and triglyceride levels (r = –0.33; p&lt;0.05) and estimated glomerular filtration rate (r = 0.26; p&lt;0.05), which confirms the association of vitamin D deficiency with metabolic syndrome. No statistical regularity was found between the level of vitamin D and other laboratory biochemical parameters, as well as morphological changes in the heart and blood vessels.Conclusion. Insufficient content of vitamin D in blood plasma is more common in individuals with a history of acute coronary syndrome, among them diabetes mellitus and abdominal obesity are more often detected, which confirms the relationship of vitamin D deficiency with metabolic syndrome.

Vitamin D Status in Patients with Renal Disorders at a Tertiary Care Hospital in Coimbatore, Tamil Nadu, India: A Cross-sectional Study

Introduction: Patients with renal disorders often have insufficient levels of vitamin D. One of the key enzymes involved in activating vitamin D, 1-α hydroxylase, is present in the kidneys. As a result, patients with kidney diseases are more susceptible to developing vitamin D deficiency, which can increase mortality and morbidity in these patients. Additionally, variations in lifestyle and culture can contribute to geographical differences in baseline serum vitamin D levels. Aim: To evaluate and compare serum vitamin D levels in patients with various renal disorders. Materials and Methods: This retrospective cross-sectional study was conducted in the Department of Biochemistry at the KMCH Institute of Health Sciences and Research Centre in Coimbatore, Tamil Nadu, India from August 2018 to August 2019. Data from 269 patients were collected from the Medical Records Department (MRD) using a predefined data collection tool. All patients with renal disease, regardless of disease severity, who had serum vitamin D levels measured during the study period were included. The collected data included age, gender, height, weight, Body Mass Index (BMI), dietary history, diagnosis, serum vitamin D3 levels, and serum creatinine levels. The data were statistically analysed using Analysis of Variance (ANOVA) and Pearson’s correlation coefficient. Results: Among the study participants, 148 were males and 121 were females, with a mean age of 54.12±17.43 years. The mean vitamin D3 level in the study population was 20.8 ng/mL. The mean serum creatinine and urea levels were 2.2±1.1 mg/ dL and 63.2±42.1 mg/dL, respectively. The mean estimated Glomerular Filtration Rate (eGFR) was 41.4±25.34 ml/min/1.73 m2. The mean serum calcium, phosphate, and uric acid levels were 5.8±2.65 mg/dL, 2.16±0.87 mg/dL, and 3.6±2.3 mg/dL, respectively. One-way ANOVA showed no significant difference in serum vitamin D3 levels among patients with different renal diseases (F=0.473, p=0.854). Pearson’s correlation analysis revealed no significant correlation between serum vitamin D3 levels and any other parameters. Conclusion: In present study, only 23% of patients had vitamin D levels within the normal reference range, 22% had insufficient vitamin D levels, and 55% had vitamin D deficiency. No significant difference in vitamin D levels was observed among patients with different renal diseases.

Determination of vitamin D, iron and n-3 fatty acids in adolescents with different eating habits.

Proper eating habits ensure human health, so it is important to eat a balanced diet and learn the basics of proper eating from an early age. Adolescence is considered very important period for maintaining good health in terms of nutrition. In the study, we monitored the eating habits of 182 adolescents aged 14-19 years with different eating habits (73 vegetarians and 109 nonvegetarians) using a questionnaire on nutrition and determination of selected blood parameters - vitamin D, iron and n-3fatty acids. Insufficient levels of vitamin D were determined in the whole group of adolescents, regardless of eating habits. Low iron concentrations negatively affect the biosynthesis of long-chain n-3 fatty acids, which was also reflected in our adolescents with alternative diets. Based on the obtained results, it is necessary to place emphasis on the composition of the diet in adolescent age.

Association of serum vitamin D levels and TaqIrs731236 among patients with hypertensive coronary heart disease

The development of cardiovascular diseases (CVD) is influenced through multiple risk factor and hypertension. It may increase the risk of cardiac events, and has a significant impact when combined with other risk factors including low levels of vitamin D and genetic variations like single nucleotide variations (SNV) (TaqIrs731236) in vitamin D receptor (VDR) gene. Blood samples from 500 study participants gathered including 250 hypertensive coronary heart disease patients, 250 age and gender matched healthy controls. To isolate genomic DNA, conventional salting out procedure used followed by amplification of targeted variations through Amplification Refractory Mutation System- Polymerase Chain Reaction (ARMS-PCR) Assay. The amplicon consists of 148 base pairs which was visualized on 2 % agarose gel electrophoresis and confirmed by DNA sequencing. The compared clinical parameters including systolic blood pressure (SBP), diastolic blood pressure (DBP), body mass index (BMI), high density lipoproteins (HDL), low density lipoproteins (LDL), cholesterol, triglycerides found significantly different among patients when compared with controls (P < 0.001). The Vitamin D exhibited insufficient levels at different stages of hypertension which were statistically, found significantly associated among patients with hypertensive coronary heart disease showing compared to controls (P < 0.001). The genotype association SNV (TaqIrs731236) T > C showed significant association with hypertensive coronary heart disease compared to healthy controls (Chi-Square χ2 = 60.75 and P < 0.00001). Further, the odds ratio of allelic association for risk allele (C) showed the strength of association with risk of disease, which increases by 2.02 times(P = 0.01). The results suggest that (TaqIrs731236) T > C as genetic predisposition factor, may contribute to develop the risk of hypertensive coronary heart disease. Hypertension as a risk factor along with insufficient levels of vitamin D and SNV (TaqIrs731236) as genetic variations may have been an important contributor to disease risk of hypertensive coronary heart disease.

A cross sectional study of vitamin D status of 5-18 years children in a tertiary care of hospital

High prevalence of Vitamin D deficiency has been reported in pediatric population from different parts of the country. However, this study investigated the prevalence and risk factors associated with vitamin D deficiency in children. To assess the serum Vitamin D level and also to find out the prevalence of Vitamin D deficiency among children and adolescents in Gwalior, a major northern city of Madhya Pradesh. Cross sectional descriptive study The serum 25(OH)D levels of 258 children from age five to below 18 years, attending the out-patient clinics of the hospital were analyzed from June 2021 to Dec 2021. Data being non-parametric was presented as median and interquartile range. The group differences were computed by Mann Whitney U test. A p value &amp;#60; 0.05 was considered as statistically significant. 60% of the study population had insufficient levels of Vitamin D, with girls having significantly lower levels of serum vitamin D. Only 27% of adolescents had optimum level of serum Vitamin D. A high prevalence of vitamin D insufficiency and Vitamin D deficiency was found among the children living in the urban and sub urban areas of Gwalior city in northern Madhya Pradesh India.

Micronutrients Deficiencies in Candidates of Bariatric Surgery: Results from a Single Institution over a 1-Year Period

BackgroundMicronutrient deficiencies represent a common condition after bariatric surgery (BS). The prevalence of these nutritional disorders before BS is still debated. The aim of our study was to retrospectively evaluate the prevalence of micronutrient deficiencies in candidates for BS.MethodsA prospectively maintained database of our institution was searched to find all patients who underwent surgery between January and December 2021. The following data were collected: age, gender, body mass index (BMI), obesity-associated diseases, and preoperative serum levels of vitamin B12, folate, and vitamin D.ResultsA total of 174 patients were included in our study. Mean age and BMI were 39.2 ± 11.4 years and 44.3 ± 7.1 kg/m2, respectively. One hundred and thirty-nine patients (79.9%) had at least one preoperative micronutrient disorder, with vitamin D deficiency being the most common (116, 66.7%), followed by a deficit of folate (76, 43.7%) and vitamin B12 (10, 5.7%). Forty-seven (27%) individuals had insufficient levels of vitamin D. Comparison of deficiencies between sexes showed that vitamin B12 < 20 ng/ml was significantly more frequent in women (p = 0.03). DLP showed a mild significant effect on folate levels (p = 0.01), while the association of HNT and T2DM had a mild significant effect on vitamin B12 (p = 0.02).ConclusionsPreoperative micronutrient deficiencies were frequently found in candidates for BS. Approximately 90% of patients had deficient or insufficient serum levels of vitamin D preoperatively. Almost half of the patients had a preoperative deficit of folate, and vitamin B12 deficiency was significantly more frequent in the female population. It is mandatory to screen all patients undergoing BS for vitamin deficiencies before surgery.

Relationship of vitamin D levels with clinical presentation and recurrence of BPPV in a Southeastern United States institution

To examine the relationship of 25hydroxyvitamin D serum levels with BPPV incidence and recurrence rates. A retrospective cross-sectional, case-controlled study with follow-up phone survey was performed on patients diagnosed with BPPV between 05/2017-05/2020, who had available 25hydroxyvitamin D serology. Patients were seen at a multidisciplinary, vestibular-focused, neurotology clinic at a tertiary referral center. Controls consisted of subjects from the National Health and Nutrition Examination Survey (NHANES), and a locoregional age, sex, and race-matched group of patients from our institution. Our BPPV cohort consisted of 173 patients (mean age 66.2 ± 11.8 years), who were predominately female (75.7%) and Caucasian (76.3%). Almost all age subgroups (BPPV, NHANES, and locoregional groups) ≤60 years old had insufficient levels of vitamin D. However, the overall BPPV cohort had a significantly higher vitamin D level than the NHANES control (31.4 ± 16.5 v. 26.0 ± 11.2 ng/mL, d=0.474 [0.323, 0.626]). There was no significant difference when compared to the overall locoregional control (31.4 ± 20.5 ng/mL). Migraines were significantly correlated to increased BPPV recurrence rates on univariate (beta=0.927, p=0.037, 95% CI: [0.057, 1.798]) and multiple regression analyses (beta=0.231, 95% CI: [0.024, 2.029], p=0.045). Furthermore, patients with BPPV recurrences had significantly lower levels of vitamin D at initial presentation when compared to patients with no recurrences (29.0 ± 12.0 v. 37.6 ± 18.3 ng/mL, d=0.571[0.139,1.001]). Many BPPV patients in our cohort had insufficient vitamin D levels, and patients with BPPV recurrences had insufficient and significantly lower vitamin D levels than those without. As a readily available and affordable supplement, vitamin D may be used as an adjunct treatment but prospective studies should be done to confirm if it can prevent or reduce recurrence.