Insufficient Levels Of Vitamin Research Articles

Early Symptoms in Children with Inflammatory Bowel Disease: Implications for Subsequent Bone Mineral Deficiency.

Inflammatory bowel disease (IBD) is associated with multiple factors that influence bone metabolism. This study aimed to compare the clinical manifestations and diagnostic parameters of patients with Crohn's disease (CD) and ulcerative colitis (UC) at the time of diagnosis, as well as to assess their relationship with subsequent bone disorders. Blood tests (including calcium-phosphate metabolism) and fecal tests (including calprotectin) were performed in eighty children recently diagnosed with IBD. Additionally, the bone densitometry results were evaluated in 25 of them. Diarrhea (p = 0.02) and bloody stools (p < 0.001) were more frequent in patients with UC, whereas fever was more common in patients with CD (p = 0.003). Laboratory tests revealed anemia in 62.5% (50/80) and thrombocytosis in 36.3% (29/80). Higher calprotectin levels in the feces were found in girls at the time of diagnosis (p = 0.02). Osteopenia was detected in almost half of the examined patients (12/25), and 20% (5/25) met the criteria for osteoporosis. Low calcium levels at diagnosis were correlated with subsequent bone disorders (p = 0.005). Insufficient levels of vitamin D were detected in 77.8% (56/80). Early disease detection and the appropriate monitoring of children with IBD may decrease the risk of serious consequences, including osteoporosis.

Vitamin D Insufficiency In Type 2 Diabetics: AHospitalBased Evaluation Of Incidence And Severity

Objective: The objective of the study was to determine the frequency and intensity of vitamin D insufficiency in individuals with type 2 diabetes mellitus (DM). Methods: This retrospective investigation was carried out in the Department of Medicine over a one-year period. After receiving the consent of the patients and approval from the Ethical committee, a total of 200 participants were recruited for the study. Out of them, 100 healthy individuals were included as the case group (Group-A) and 100 patients with type-2 diabetes mellitus were enrolled as the control group (Group-B). Results: A total of 120 individuals (60% males and 40% females) were included in the study. Our study revealed that 38% of the participants fell within the age range of 40-50, while 32% were between 50-60 years old. Additionally, 16% were below the age of 40, and 14% were above the age of 60. Out of the total sample, 35 individuals (35%) had been diagnosed with diabetes for a duration of 1-5 years, 45 individuals (45%) for 6-10years, and 20 individuals (20%) for more than 10 years. Out of the total sample, 6 individuals (6%) werediagnosed with ischemic heart disease, whereas 18 individuals (18%) had hypertension as a result of vitamin D insufficiency. Diabetes patients with well-managed HbA1C levels had 10 instances of adequate, inadequate, and insufficient levels of Vitamin D, while uncontrolled diabetes patients had 8 instances, 34 instances, and 18 instances respectively. Conclusion: Diabetic patients have a higher prevalence of vitamin D insufficiency compared to the general healthy population. The majority of afflicted patients were male, and the deficit was most commonly identified in the uncontrolled group

Clinical Characteristics, Nutritional Status, and Disease Severity in Pediatric Patients with COVID-19

Background: Limited clinical data are available regarding the impact of coronavirus disease 2019 (COVID-19) on children. Objective: This study assessed the clinical characteristics, nutritional status, and disease severity in pediatric patients with COVID-19. Methods: A retrospective study examined medical records of children with COVID-19 admitted to Abuzar Hospital (Ahvaz, Iran) for six months. Data related to their clinical, nutritional status and demographic characteristics were documented. Results: This study included medical records of 500 patients. More than half of them were boys. Different levels of COVID-19 severity were observed in 202, 172, and 126 children as mild, moderate, and severe cases, respectively. Children with severe or moderate COVID-19 had substantially elevated levels of various inflammatory markers, blood urea nitrogen (BUN), gamma-glutamyl transferase (GGT), neutrophils, alanine transaminase (ALT), creatinine, bilirubin, and aspartate aminotransferase (AST) compared to those with mild COVID-19 (p &lt; 0.001). They had lower levels of lymphocytes and vitamin D, as well as longer hospital stays than children with mild COVID-19 (p &lt; 0.001). In addition, 52% and 40.2% of patients had malnutrition and anemia, respectively. The majority of underweight and stunted children had moderate or severe COVID-19. Conclusion: This study revealed a high prevalence of malnutrition, anemia, insufficient levels of vitamin D, elevated levels of inflammatory markers, and abnormal liver and kidney function tests in children with severe or moderate cases of COVID-19 compared to those with mild COVID-19.

Association of vitamin B12 and vitamin D in T2DM patients in north Indian population

IntroductionDiabetes mellitus, highly prevalent endocrine disorder and metformin is the most frequently recommended oral hypoglycemic agent (OHA). MethodsWe recruited 100 individuals who were taking OHA including metformin more than one year as cases and 40 healthy individuals as control. The patients were divided into three groups. The first group, Group I (n = 58) patients taking metformin, group II (n = 42) patients taking OHA other than metformin and group III (n = 40), taken as control group. ResultsIn groups I, II, and III, a considerable number of patients experienced low levels of vitamin B12 i.e. 42 (72.41 %), 8 (19.05 %), and 14 (35 %) respectively. When comparing all groups, p-value was highly significant (p = 0.000). 35 (60.36 %), 13(30.95 %), and 15(37.5 %) patients had insufficient levels of vitamin D in groups I, II, III respectively. On comparing, p-value was highly significant (p = 0.007). ConclusionThe study concluded that long-term metformin treatment causes insufficiency and deficiency of vitamin D and vitamin B12, respectively.

Association of serum 25-hydroxyvitamin D3 levels with carotid artery intima-media thickness and carotid atherosclerotic plaques in smokers

ObjectiveThis study explores the association of serum 25-hydroxyvitamin D3 (25(OH)D3) levels with carotid artery intima-media thickness (CIMT), and the presence of carotid atherosclerotic plaques in individuals with a history of smoking. MethodsA total of 469 patients suspected of having carotid atherosclerosis, aged 52 to 73 years with an average age of 65.26 ± 4.37 years, were recruited from the author's hospital from January 2023 to October 2023. All patients had a smoking history of nearly 5 years. Based on their serum 25(OH)D3 levels, they were divided into two groups: the normal group (serum level 30–50 ng/mL, n = 300) and the deficiency group (<30 ng/mL, n = 169). General details of the two patient groups were collected. Carotid artery ultrasound was employed to assess pulse wave velocity (PWV), carotid artery compliance coefficient (CC), and CIMT. Blood chemistry analysis measured serum lipid metabolism indicators including total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), and high-density lipoprotein cholesterol (HD-LC). The relationship between CIMT and each variable was analyzed through Pearson correlation, and logistic regression was used to identify risk factors influencing carotid artery plaque development. ResultsGeneral patient information between the two groups showed no significant differences (P > 0.05). Patients in the 25(OH)D3 deficiency group exhibited elevated left and right PWV and CC compared to the 25(OH)D3 normal group (P < 0.05). The deficiency group exhibited larger CIMT and plaque area compared to the normal group (P < 0.05). Additionally, the deficiency group demonstrated higher levels of TC, LDL-C, and HD-LC compared to the normal group (P < 0.05). A moderate positive correlation was found between TC, LDL-C, and CIMT (P < 0.05), while a strong positive correlation existed between 25(OH)D3 and CIMT (P < 0.05). In smokers, the formation of carotid artery plaque was associated with factors such as patient age, CIMT, serum LDL-C, and 25(OH)D3 levels (P < 0.05). As age, CIMT, LDL-C levels increased, and 25(OH)D3 levels decreased, the risk of carotid plaques in smokers increased (P < 0.05). ConclusionsSmokers with lower 25(OH)D3 levels exhibit higher CIMT and more prominent carotid atherosclerotic plaques, indicating increased arterial stiffness and elevated cardiovascular risk. These findings demonstrate crucial implications that insufficient levels of vitamin D may potentially contribute to a higher risk of atherosclerosis among smokers.

Characteristics of Vitamin D Concentration in Elite Israeli Olympic Athletes.

The prevalence of vitamin D deficiency has been a growing concern in recent years. Vitamin D is important in many of the body's physiological systems, such as the musculoskeletal, cardiovascular and immune functions. A deficiency of vitamin D in athletes may negatively impact both muscle functions and recovery and, thus, affect performance and increase the risk of injury. Many studies assessed the prevalence of vitamin D deficiency in athletes; however, as of today, there are no official recommendations/protocols for screening vitamin D levels in athletes, and only a few studies were performed in male and female elite athletes (i.e., Olympic level), in different sport disciplines. We investigated the prevalence of vitamin D deficiency among athletes entering the Israeli Olympic team. A total of 761 samples of Vitamin D(OH)25 from 334 athletes were analyzed. For this analysis, we used the first test the athlete had performed when joining the Olympic team. The prevalence of vitamin D deficiency (<50 nmol/L, as defined by the Endocrine Society Committee) was investigated according to gender, types of sports and outdoor vs. indoor sports through the different seasons of the Israeli Olympic team athletes. Twenty-five athletes (7.5%) were diagnosed with vitamin D deficiency. One hundred and thirty-one athletes (39.2%) had insufficient levels of vitamin D (50-75 nmol/L). The highest incidence of vitamin D deficiency was found amongst gymnastics and combat sport athletes. A significant difference was also found in vitamin D concentration between seasons. Vitamin D average concentration in the winter was 74.1 nmol/L compared to 86.4 nmol/L in the Summer (p < 0.0005). Due to the importance of vitamin D to athletic performance and the high prevalence of deficiency and insufficiency, we suggest careful and frequent monitoring of groups at risk, including elite athletes, especially in susceptible sports and during the winter. Future studies are necessary to investigate the effectiveness of Vitamin D supplementation in athletes with low baseline vitamin D levels.

Prevalence of Osteoporosis in Patients with Chronic Skin Diseases

Abstract Osteoporosis is a skeletal disorder resulting from decreased bone mass that results in increased liability to fractures. Several chronic diseases including dermatological diseases were reported to affect bone mineral density with resulting osteopenia and osteoporosis. Aim of the Study to evaluate the prevalence of osteopenia and osteoporosis in chronic skin diseases. Patients and Methods One hundred patients diagnosed with chronic primary dermatological diseases divided into 4 groups according to dermatological disease were included in the current study. Assessment of BMD by DEXA scan and estimation of serum level of vitamin D were performed. Results In all studied patients, there was no significant association between osteopenia/osteoporosis and studied dermatological diseases or vitamin D levels as T score analysis either lumbar, femoral or forearm in relation to vitamin D status and disease severity. There was significant association of insufficient vitamin D levels with all skin diseases but there was no significant association between T score results and vitamin D status in studied patients. Conclusion The current study revealed that dermatological diseases were associated with insufficient levels of vitamin D.

Relationship between Vitamin D Concentration and Lipid Concentration in Patients with NAFLD in the Hulunbuir Region of China.

We aimed to characterize the relationship between the serum 25-hydroxyvitamin D concentration and the circulating lipid concentrations of patients with NAFLD in the Hulunbuir region of China. One hundred fifty-six patients, who were diagnosed with NAFLD in the Physical Examination Department of the Second Clinical College of Inner Mongolia University for the Nationalities between January 2021 and March 2023, were recruited as NAFLD group, and 160 healthy people were recruited as a control group during the same period. The serum 25(OH)VitD, TBIL, TG, TC, LDL-C, HDL-C, AST, ALT, GGT, and FPG activities of the participants were measured, and hepatic ultrasonography was performed. The BMI of the NAFLD group was higher than of the control group (p < 0.05). The serum 25(OH)VitD3 (p < 0.05) and the HDL-C concentrations of the NAFLD group were lower than those of the normal control group. However, the AST (p < 0.05), ALT (p < 0.05), and GGT (p < 0.05) activities, and the serum TG (p < 0.05), TC (p < 0.05), LDL-C (p < 0.05), and the fasting glucose (p < 0.05) concentrations of the NAFLD group were higher than those of the normal control group. The serum 25(OH)VitD3 concentrations of the NAFLD group significantly cor-related negatively with BMI (r = -0.302, p < 0.01), TG (r = -0.221, p < 0.05), and fasting glucose (r = -0.236, p < 0.05). The BMI, TG, and fasting glucose of vitamin D-deficient participants were higher than of the participants with adequate or insufficient levels of vitamin D (p < 0.05). Finally, the BMI of vitamin D-deficient participants was higher than of those with an adequate vitamin D status (p < 0.05). A deficiency of 25(OH)VitD is more common in people from the Hulunbuir region of China than elsewhere. In addition, the vitamin D status is significantly associated with NAFLD; as the serum vitamin D concentration decreases, patients with NAFLD show greater dyslipidemia and hyperglycemia and a higher BMI.

The Association of Serum Vitamin D With Anthropometric Indices, Lipid Profile, ICAM-1, and IL-17 in Patients Undergoing Coronary Artery Bypass Graft Surgery.

This study aimed to assess the relationship between serum levels of vitamin D with anthropometric indices, lipid profile and vascular inflammatory factors, in patients who candidate for coronary artery bypass grafting (CABG). This analytical cross-sectional study was conducted in patients who were candidate for CABG. Demographic information, medical records, anthropometric indicators, blood samples, and physical activity of 150 patients were collected. 146 participants with mean ± standard deviation of age: 61.8 ± 10.0 years and body mass index: 26.9 ± 3.7 kg/m2 completed the study. Based on serum levels of vitamin D, patients were divided into 2 groups; groups with sufficient (≥ 30 ng/mL) and insufficient amount of vitamin D (< 30 ng/mL). The 30.14% of the patients had serum vitamin D deficiency. Ejection fraction (EF) % between the 2 groups had significant difference. Unexpectedly the EF% increased 7% in patients with insufficient level of vitamin D (odds ratio [OR], 1.07; 95% confidence interval [CI], 1.03-1.11; p = 0.001). Vitamin D status had a significant inverse association with body weight. The odds of vitamin D deficiency significantly increased by 4% with increasing one kg in weight (OR, 1.04; 95% CI, 1-1.08; p = 0.044). There were no significant association between serum vitamin D level and intra cellular adhesion molecule-1, interleukin-17, fasting blood glucose, and lipid profile (p > 0.05). Considering the inverse association observed between serum vitamin D with EF% and body weight, vitamin D may play a role in modulating of these indices.

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.

Research trends in the relationship between vitamin D and type 2 diabetes mellitus: a 20-year bibliometric and visualization analysis.

Vitamin D has a significant correlation with type 2 diabetes. Insufficient levels of vitamin D can cause insulin resistance, which impairs the ability of cells to respond to insulin and worsens the progression of diseases. Furthermore, vitamin D has the potential to enhance the release of insulin, enhance the regulation of blood sugar levels, and reduce the glycemic index. Research has indicated that insufficient levels of vitamin D may elevate the likelihood of experiencing complications related to type 2 diabetes, including cardiovascular disease and neuropathy. This study employed bibliometric analysis to investigate recent advancements in research about the relationship between vitamin D and type 2 diabetes. We searched for articles on the topic of vitamin D and type 2 diabetes published between January 1, 2004, and December 31, 2023. The search was performed on February 20, 2024, using the Web of Science Core Collection (WoSCC). Utilizing VOSviewer and CiteSpace, we conducted bibliometric analysis and visualization. A comprehensive study was conducted on a total of 1362 papers pertaining to the relationship between vitamin D and type 2 diabetes. The United States had the biggest number of publications and the highest effect among these articles. Within the top 10 most published journals, the journal "DIABETES CARE" has the highest H-index, indicating its significant influence in this field of study. Currently, there is an extensive body of research on the supplementation of vitamin D for the improvement of type 2 diabetes and prevention of complications in type 2 diabetes, as well as its related mechanisms. Research related to bone turnover and peripheral neuropathy represents a promising area for future studies. Overall, bibliometrics may assist researchers in comprehending the trajectory, significant themes, and scholarly influence of the field concerning vitamin D and type 2 diabetes. This, in turn, offers substantial backing for future studies that delve further into the subject matter.

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.&#x0D; 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&lt;0.05.&#x0D; 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.&#x0D; 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.