Low Levels Of Vitamin Research Articles

Effect of Vitamin D and Skeletal Muscle Mass on Prognosis of Patients with Diffuse Large B-Cell Lymphoma.

This study investigated the prognostic impact of vitamin D deficiency and reduced skeletal muscle mass in diffuse large B-cell lymphoma (DLBCL) patients. A retrospective analysis of 186 newly diagnosed DLBCL patients from 2012 to 2022 was conducted, measuring serum 25-hydroxyvitamin D [25(OH)D] levels and the skeletal muscle index (SMI). Decreased vitamin D levels were linked to more severe DLBCL disease, with a median 25(OH)D concentration of 13 (4.0-27) ng/mL. Males in the group with a low SMI had a considerably lower 25(OH)D concentration. The optimal threshold of 25(OH)D levels for overall survival (OS) was 9.6 ng/mL, with lower values associated with a higher likelihood of recurrence and mortality. Multivariable analysis showed hazard ratios for OS of 1.4 [95% CI 0.77-2.5] for a low SMI and 3.2 [95% CI 1.8-5.8] for low 25(OH)D concentration. The combination of a low SMI and low vitamin D concentration resulted in the worst prognosis. Thus, low levels of vitamin D associated with disease progression significantly impact DLBCL prognosis, which can be further stratified by the SMI, providing valuable insights for patient management and potential therapeutic interventions.

2199 The prevalence of pre-admission vitamin D levels in the management and outcomes of proximal femur fractures

Abstract Introduction The aim of this study was to examine the prevalence of vitamin D deficiency in elderly patients with fragility fractures of the hip by estimating 25-hydroxyvitamin D levels, whether low levels of Vitamin D at the time of admission affects the functional outcomes and mortality at 28 day and one year. Methods A retrospective study of all the patients admitted with a fracture neck of femur from Jan 2018 to March 2021 was carried out. The data was obtained from NHFD (National Hip Fracture Database) and Medway software. A total of 1221 patients were admitted during this period. Patient demographics including age, sex, fracture pattern, Vitamin D levels at the time of admission, function at 120 days, mortality at one month and one year were calculated. Results Of the 1221 patients, 106 patients did not have the Vit D levels checked at the time of admission. The average age was 81.91 (range-60 to 108). There were 845 (70%) females and 376 (30%) males. The serum Vit D levels were low in 611 (55.3%) patients. The mobility in patients with Vit D deficiency 261 (40.9%) has dropped significantly in the 3 months after surgery for fractures of proximal femurs. The 28 day and one year mortality was 6.74% and 30.3% compared to 4.7% and 27.3% for those with low and normal levels of vitamin D respectively. Patients with low Vit D levels at the time of admission with proximal femur fractures has got higher 28 day and one year mortality rates compared to those with normal levels. Conclusion Our study showed that low levels of Vitamin D at the time of admission with proximal femur fractures are associated with poor functional mobility, higher perioperative and one year mortality.

On-admission serum 25(OH)D level and mortality within one year in older patients

BackgroundMounting evidence suggests that vitamin D deficiency is associated with a higher risk of many chronic non-skeletal, age-associated diseases as well as mortality.AimTo determine, in older patients aged ≥ 80, the prevalence of vitamin D deficiency and its association with comorbidity, laboratory tests, length of stay and mortality within one year from blood withdrawal on admission to acute geriatrics ward.MethodsWe retrospectively surveyed electronic hospital health records of 830 older patients. The recorded data included patient demographics (e.g., age, sex, stay duration, readmissions number, death within one year from blood withdrawal on admission), medical diagnoses, laboratory results, including 25-hydroxyvitamin D [25(OH)D], and medications. We compared the characteristics of the patients who survived to those who died within one year.ResultsOn admission, in 53.6% patients, vitamin D levels were lower than 50 nmol/L, and in 32%, the levels were ≤ 35 nmol/L. Persons who died were likely to be older, of male sex, were likely to be admitted for pneumonia or CHF, were likely to have lower level of albumin or hemoglobin, lower level of vitamin D or higher vitamin B12 and higher level of creatinine, were also likely to have had a lengthier hospitalization stay, a greater number of hospitalizations in the last year, a higher number of comorbidities, to have consumption of ≥5 drugs or likely to being treated with insulin, diuretics, antipsychotics, anticoagulants or benzodiazepines. Higher age, male sex, on-admission CHF, higher number of drugs, lower albumin, higher vitamin B12, vitamin D < 50 nmol/L, and consumption of antipsychotics and anticoagulants – were predictors of mortality.ConclusionHypovitaminosis D is predictive of mortality in older patients within one year from hospitalization in the acute geriatric ward, but a causal relationship cannot be deduced. Nevertheless, older patients in acute care settings, because of their health vulnerability, should be considered for vitamin D testing. In the acutely ill patients, early intervention with vitamin D might improve outcomes. Accurate evaluation of mortality predictors in this age group patients may be more challenging and require variables that were not included in our study.

A cross-sectional study on the association of level of Vitamin D with severity of fibromyalgia syndrome in a tertiary care hospital, Kolkata

Background: Fibromyalgia (FM) is a chronic disorder characterized by widespread pain associated with fatigue, stiffness, sleep disturbance, cognitive dysfunction, anxiety, and depression. The role of Vitamin D in the pathophysiology of FM is poorly known. Studies available to establish the association between Vitamin D and FM have inconsistent results. Some of the studies reported a positive association and others found no relation. It is not clear whether the pain is due to and/or associated with low levels of Vitamin D. Aims and Objectives: The objective of the current study is to estimate Vitamin D levels in FM patients and to find the association between Vitamin D levels and severity of FM. Materials and Methods: In this cross-sectional study, seventy patients who fulfilled the inclusion (American College of Rheumatology 2016 criteria) and exclusion criteria as has been considered for the study were enrolled and their serum 25 hydroxy-vitamin D level has been measured by enzyme-linked immunosorbent assay reader. Pre-designed questionnaires were prepared to measure FM severity. Pain intensity was measured by the Visual Analog Scale (VAS). Results: A total of 70 patients who were diagnosed with FM were included in our study. The majority of them (80%) were female and the rest (20%) were male. The mean age is 48.2±9.2 years. Their mean body mass index (BMI) is 23.7±3.82. The mean Vitamin D serum level was 22.4±9.2 ng/dL. Vitamin D deficiency (VDD) was defined as patients with a serum level of 20 ng/mL and below. In our study, 62.8% (44) of the study population had VDD. According to VAS (0–10) pain scale, 15 (21.4%) subjects suffered from moderate pain and 55 (78.6%) subjects suffered from severe pain. The severity of FM was measured by the Fibromyalgia Severity Scale (FSS). The mean score of FSS was 22.7. To find the association between VDD and severity of FM, several covariates were identified and a multivariable logistic regression was done. Conclusion: VDD increases with an increase in age, BMI, VAS, and FSS, all of which are predicators of FM syndrome.

Risk Factors for Decreased Bone Density in Adults with Celiac Disease

Background: Celiac disease (CD) is an autoimmune disease characterized by inflammation in the intestine, causing atrophy of the mucosal villi of the small intestine. Celiac disease can manifest with various signs and symptoms, including extra-intestinal symptoms such as osteopenia and osteoporosis. Objectives: Our study aimed to determine the frequency of osteopenia/osteoporosis in newly diagnosed CD cases and to evaluate the effect of different independent variables on the development of osteopenia/osteoporosis in these patients. Methods: Adult patients with CD who were referred to a celiac clinic were evaluated for osteopenia/osteoporosis using dual-energy X-ray absorptiometry. This cross-sectional analytical study took place from October 2017 to July 2022. Logistic regression analysis was used to assess the odds ratio (OR) of different independent variables for osteopenia/osteoporosis. Results: A total of 302 patients enrolled in this study, with 64.2% being female and 35.8% male. The mean ± SD age was 29.73 ± 12.39. Overall, 71.2% of patients had osteopenia or osteoporosis. The odds of developing osteopenia/osteoporosis were significantly higher in participants older than 30 years (OR: 2.19; 95% CI: 1.22 - 3.92; P = 0.008), underweight patients (OR: 2.38; 95% CI: 1.30 - 4.34; P = 0.005), and those with histologically severe atrophy (OR: 2.22; 95% CI: 1.14 - 4.32; P = 0.019). The mean ± SD serum levels of 25-hydroxy vitamin D in CD patients without and with osteopenia/osteoporosis were 34.0 ± 17.1 ng/mL and 25.8 ± 14.2 ng/mL, respectively. Participants with normal levels of 25-hydroxy vitamin D had a significantly lower OR of developing osteopenia/osteoporosis than patients with vitamin D deficiency (OR: 0.37; 95% CI: 0.21 - 0.62; P &lt; 0.001). Other variables, including gender, anti-tTG levels, and GI manifestations, did not significantly increase the OR of developing osteopenia/osteoporosis. Conclusions: The present study showed that increasing age, weight loss, severe villous atrophy, and low levels of vitamin D can significantly increase the OR of developing osteopenia/osteoporosis in CD patients. Until further studies are conducted, bone mineral density (BMD) evaluation is especially recommended in these high-risk subgroups of CD patients.

TET3 downregulation and low 5-hydroxymethylcytosine are epigenetic signatures of head and neck carcinoma.

Ten-eleven translocases (TETs) are enzymes responsible for demethylation processes, playing a crucial role in maintaining the body's methylation balance. Dysregulation of TET expression can lead to abnormal methylation levels. Isocitrate dehydrogenases (IDH) are upstream genes involved in Kreb cycle responsible for production of α-ketoglutarate (α-KG). α-KG and vitamin C are cofactors of TET3 enzyme. There is limited data on the relationship between TET3 and its cofactor Vitamin C in head and neck carcinoma (H&NC). In this study, we have investigated the expression of the TET3 gene along with IDH1/2 genes involved in the Krebs cycle in the peripheral blood of 32H&NC patients compared to 32 healthy controls. We estimated serum levels of TET3 protein and vitamin C and 5-hydroxymethylcytosine (5-hmC) percentage in DNA isolated from EDTA blood samples. Our findings revealed that TET3 and IDH1/2 were downregulated in H&NC patients compared to healthy controls. Serum levels of TET3 and Vitamin C were low in H&NC patients compared to healthy controls. Diminished levels of percentage 5-hmC were detected in EDTA blood samples of H&NC patients compared to controls. Spearman correlation analysis revealed a significant positive correlation between TET3 levels, vitamin C levels and 5-hmC percentage. The low levels of Vitamin C are believed to contribute to decreased activity of the TET3 gene and less conversion of 5-methylcytosine (5-mC) to 5-hmC. Dietary supplementation of Vitamin C may increase TET3 activity.

Effect of laparoscopic cholecystectomy on 25-hydroxyvitamin D levels and bone mineral density in post menopausal women

Background Laparoscopic cholecystectomy (LC) is the gold standard management for benign gallbladder diseases. It has been observed that there is alteration in vitamin D levels and bone mineral density after cholecystectomy due to altered enterohepatic circulation. With increase in average age expectancy of the population, low levels of vitamin D levels and osteoporosis after cholecystectomies might cause increased health care burden. Methods A prospective observational study was planned between 1 January 2022 and 30 June 2023 in the Department of General Surgery at PGIMER Chandigarh, a tertiary care hospital in north India. One hundred and three post-menopausal women who underwent LC and met the inclusion and exclusion criteria were included in the study. All participants underwent estimation of vitamin D and bone mineral density preoperatively and third-post operative month (POM). Results The mean age of the patients was 58.46 ± 7.44. Pain abdomen was present in 68(66%) patients, 18 had epigastric discomfort and 17 had dyspepsia. The mean levels of vitamin D decreased from 21.92 at the baseline to 20.12 at third POM (p < .001). There was a significant change in t score Femoral Neck (−1.12 vs −1.15, p < .001) and Lumbar spine L1–L4 − 1.98 vs −1.98 (p = .033). z-scores of the femoral neck were −0.34 vs −0.54 (p < .001) and of lumbar spine L1–L4 were −0.95 vs 1.02 (p < .001). The decrease in fracture risk for the femoral neck (p = .344) and the lumbar spine (p = .223) was not statistically significant. Conclusion There is a significant decrease in vitamin D and BMD levels after LC in post-menopausal females.

Serum zinc, selenium, and vitamin D levels in patients with acne vulgaris: A case-control study.

Acne vulgaris is a very common inflammatory skin disease that significantly impacts the quality of life of affected individuals. Previous studies have indicated that individuals with acne vulgaris often have low levels of zinc, selenium, and vitamin D. However, these three nutrients have rarely been collectively examined in a single study. The objective of this study was to compare serum levels of zinc, selenium, and vitamin D in patients with acne vulgaris in comparison to a control group. This case-control study included 100 adult patients with acne vulgaris attending a dermatology clinic, in 2020. A group of 100 patients without acne vulgaris attending the same clinics were evaluated as controls. Participants' sociodemographic characteristics, including age, sex, occupation, alcohol consumption, and tobacco smoking were recorded. In addition, anthropometric indices, such as weight and height, were measured and the body mass index (BMI) was calculated accordingly. Acne severity was determined using Tutakne and Chari's grading system. Serum zinc, selenium, and vitamin D levels were evaluated in peripheral blood samples of all the participants. Acne patients and controls were comparable regarding age, sex, weight, height, BMI, occupation, alcohol consumption, and tobacco smoking (p > 0.05). Serum zinc, selenium, and vitamin D levels were all significantly lower in acne patients than in controls (p < 0.001). Furthermore, the frequency of abnormal zinc and vitamin D levels was significantly higher in acne patients (p = 0.002 and p = 0.001, respectively), but there was no significant difference between the two groups regarding abnormal serum selenium levels (p = 0.228). Also, serum zinc, selenium, and vitamin D levels lower levels in patients with grade 4 acne compared to other disease severity grades (p < 0.001). Patients with acne vulgaris have lower levels of serum zinc, selenium, and vitamin D compared to the control group. Additionally, there is a correlation between the severity of the disease and lower levels of these nutrients.

Association between vitamin D deficiency and serum lipid levels in a group of Romanian patients.

Vitamin D deficiency is widespread across the globe. Numerous reports have linked vitamin D deficiency to certain non-skeletal diseases such as cardiovascular diseases. According to recent studies, there is evidence indicating a possible link between 25-hydroxyvitamin D deficiency and dyslipidemia. The main aim of this study is to investigate the relationship between vitamin D levels and lipid profile and to identify people who may benefit from vitamin D supplementation. In this observational study, a total of 154 patients were included, 98 women and 56 men, aged between 19 and 82 years, in which serum vitamin D levels, total cholesterol, high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C), triglycerides (TG) and blood sugar were analyzed. The serum levels of vitamin D showed some differences, being lower in patients with dyslipidemia, with a positive correlation between vitamin D levels and total cholesterol (F ratio = 7.3247, p=0.008), and also with LDL cholesterol (F ratio = 5.0023, p=0.027). The HDL-C fraction and triglycerides showed no significant correlation with the serum levels of vitamin D. Further on, we divided the patients according to the fraction that had pathological values and compared the levels of vitamin D between these categories. We observed that the lowest levels of vitamin D were present in patients with all lipid parameters modified (HIGH-TC/LOW-HDL/HIGH-LDL/HIGH-TG), and also the highest levels of low HDL-C and high LDL-C. Our research provides additional evidence to the unfavorable lipid profile found in people with vitamin D deficiency.

The metabolic role of vitamin D in children’s neurodevelopment: a network study

Neurodevelopmental disorders are rapidly increasing in prevalence and have been linked to various environmental risk factors. Mounting evidence suggests a potential role of vitamin D in child neurodevelopment, though the causal mechanisms remain largely unknown. Here, we investigate how vitamin D deficiency affects children’s communication development, particularly in relation to Autism Spectrum Disorder (ASD). We do so by developing an integrative network approach that combines metabolomic profiles, clinical traits, and neurodevelopmental data from a pediatric cohort. Our results show that low levels of vitamin D are associated with changes in the metabolic networks of tryptophan, linoleic, and fatty acid metabolism. These changes correlate with distinct ASD-related phenotypes, including delayed communication skills and respiratory dysfunctions. Additionally, our analysis suggests the kynurenine and serotonin sub-pathways may mediate the effect of vitamin D on early life communication development. Altogether, our findings provide metabolome-wide insights into the potential of vitamin D as a therapeutic option for ASD and other communication disorders.

The Role of Vitamin D and Vitamin D Receptor Gene Polymorphisms in the Course of Inflammatory Bowel Disease in Children.

Background: The etiopathogenesis of inflammatory bowel disease (IBD) is still unclear. Prior studies suggest genetic components that may influence the incidence and severity of the disease. Additionally, it was shown that low levels of serum vitamin D may have an impact on the clinical course of the disease due to its effect on the immunological system. Methods: We aimed to investigate the correlation between the incidence of vitamin D receptor (VDR) gene polymorphisms (rs11568820, rs10735810, rs1544410, rs7975232, and rs731236, commonly described as Cdx2, FokI, Bsm, ApaI, and TaqI, respectively) and vitamin D concentration with the clinical course of IBD (disease activity, extent of the intestinal lesions). Data were obtained from 62 patients with IBD (34 with Crohn's disease, 28 with ulcerative colitis), aged 3-18 years, and compared with controls (N = 47), aged 8-18 years. Results: Although there was no difference in the incidence of individual genotypes between the study groups (IBD, C) in all the polymorphisms examined, we described a significant increase in the chance of developing IBD for heterozygotes of Cdx2 (OR: 2.3, 95% CI 0.88-6.18, p = 0.04) and BsmI (OR: 2.07, 95% CI 0.89-4.82, p = 0.048) polymorphisms. The mean serum 25OHD level in patients with IBD was significantly higher compared with the controls (19.87 ng/mL vs. 16.07 ng/mL; p = 0.03); however, it was still below optimal (>30 ng/mL). Furthermore, a significant correlation was found between vitamin D level and TaqI in patients with IBD (p = 0.025) and patients with CD (p = 0.03), as well as with the BsmI polymorphism in patients with IBD (p = 0.04) and patients with CD (p = 0.04). A significant correlation was described between the degree of disease activity and genotypes for the FokI polymorphism in patients with UC (p = 0.027) and between the category of endoscopic lesions and genotypes for the Cdx2 polymorphism also in patients with UC (p = 0.046). Conclusions: The results suggest a potential correlation of VDR gene polymorphism with the chance of developing IBD, and the clinical course of the disease requires further studies in larger group of patients. Vitamin D supplementation should be recommended in both children with inflammatory bowel disease and in healthy peers.

Serum level of sclerostin and vitamin D in children with epilepsy

BackgroundEpileptic children can pose an additional risk of poor bone health; this study aimed to evaluate the influence of anti-seizure medications (ASMs) on vitamin D level and sclerostin as a bone turnover biomarker in children with epilepsy.Subject and methodsThis case–control comparative study was conducted on 180 children aged from 5–18 years diagnosed with epilepsy according to the definition of the International League Against Epilepsy on ASMs for more than 3 months and were classified into 90 epileptic children on ASM monotherapy and 90 epileptic children on ASM polytherapy, in addition to 90 healthy children age- and sex-matched who served as controls. After obtaining basic data, laboratory investigations were performed, including serum calcium, phosphorus, alkaline phosphatase, parathyroid hormone, vitamin D, and serum sclerostin.ResultsWhen we compared epileptic patients to the control group, there was a statistically significant low level of vitamin D, calcium, and phosphorus and a high level of sclerostin among both epileptic groups with mono or polytherapy. Sclerostin has a statistically significant negative correlation with vitamin D, alkaline phosphatase and parathyroid hormone. Additionally, it has a negative correlation with serum phosphorus, but without a significant correlation. On the other hand, sclerostin has a statistically positive correlation with age and serum calcium, but without a significant correlation. Multiple linear regression analyses were conducted to predict the contributing factors of sclerostin. Only duration of treatment and BMI were significant predictors of high levels of sclerostin. In contrast, the other factors failed to show any significant contribution.ConclusionThe present study showed that ASMs modulate the serum levels of sclerostin and vitamin D hence, might be involved in their adverse effects on bone.

Outcome of High Dose Vitamin D on Prognosis of Sepsis Requiring Mechanical Ventilation: A Randomized Controlled Trial

Abstract Background Critically ill patients have an increased requirement for vitamin D in sepsis and these patients have low levels of vitamin D. The researchers validated the efficiency and safety of high-dose oral vitamin D (50,000 IU) in patients with sepsis requiring mechanical ventilation. Methods Seventy five patients were randomly assigned to 2 groups (Group I = 37 patient and Group II = 38 patient) in accordance with the vitamin D treatment regimen: Group I (GI): patients received 50,000 IU vitamin D crushed and diluted in 50 ml of water and delivered to patients in the nasogastric tube (NGT) once daily for 5 consecutive days; Group II (GII): patients received daily requirements of vitamin D (5000 IU/ day) crushed in 50 ml of water and delivered to patients in the nasogastric tube (NGT) once daily for 5 consecutive days. Primary outcome of this study was the change in procalcitonin levels at day 7 and the changes in plasma vitamin D levels were secondary outcomes. Results Procalcitonin (PCT) decreased at day 4 and day 7 in study groups, procalcitonin (PCT) levels at days 4, 7 were significantly lower in high dose group (p &amp;lt; 0.032 and p &amp;lt; 0.013, respectively) and procalcitonin (PCT) levels reductions (day 7 – day 0) were significantly higher in high dose group (p &amp;lt; 0.010). Serum vitamin D (25(OH)D) levels increased at day 4 then decreased at day 7 in study groups, serum Vitamin D (25(OH)D) levels at days 4, 7 were significantly higher in high dose group (p &amp;lt; 0.001 and p &amp;lt; 0.001, respectively) and serum Vitamin D (25(OH)D) levels elevations (day 7 – day 0) were significantly higher in high dose group (p &amp;lt; 0.001). Conclusion The early use of high-dose oral vitamin D in patients with sepsis requiring mechanical ventilation in combination with the standard treatment for sepsis lowered the procalcitonin level, increased the antioxidant status, and improved the illness severity. Trial Registration This trial is registered with ClinicalTrials.gov Identifier (NCT05244018).

Serum Vitamin-D and Benign Paroxysmal Positional Vertigo (BPPV)

Abstract Background Vitamin D deficiency can occur when usual intake is lower than recommended levels over time, exposure to sunlight is limited, the kidneys cannot convert 25(OH)D to its active form, or absorption of vitamin D from the digestive tract is inadequate. Decreases vitamin D levels show complex relationships with diseases, which can affect the inner ear. The aim of study: To examine the level of serum 25-OH vitamin D concentrations on patients diagnosed with BPPV. Patients and Methods This study included 60 subjects; 40 subjects with BPPV (study group) and 20 healthy persons (control group). Both groups underwent full history taking, vitamin D level assay, otological examination and audio-vestibular evaluation. Results Subjects with BPPV (study group) have lower vitamin D levels than norms (control group). The recurrence of BPPV occurs in subjects have lowest vitamin D levels. Vitamin D deficiency more in elderly &amp; females. Hearing may be affected. Conclusion This study supports the relationship of lower vitamin D level with the occurrence of BPPV. Also, recurrent BPPV episodes are associated with a low level of vitamin D.

COVID-19 and the need for special care for women with polycystic ovary syndrome: A systematic review

Objective The study investigates the association between coronavirus disease 2019 (COVID-19) and polycystic ovary syndrome (PCOS) and assess whether women with PCOS are at a higher susceptibility and risk for COVID-19 complications. Methods This review analyzes articles indexed in PubMed, Scopus, Google Scholar, and the Cochrane Library, focusing on the onset of the COVID-19 pandemic in December 1, 2019, until November 1, 2022. The quality of the evidence was assessed using the NIH quality assessment tool. The study was registered on PROSPERO (CRD42023371956) on January 12, 2023. Results A total of 11 observational studies were identified, totaling 22,155 PCOS patients. Despite the heterogeneity of the included studies, the findings of most of the studies were similar in terms of increased susceptibility and severity of COVID-19 infection in PCOS patients. PCOS patients were reported to have a 51% higher risk of COVID-19 infection than non-PCOS women (HR =1.51). Many causes have been identified to play a role, most notably the overactivation of the renin-angiotensin system (RAS) and elevated levels of RAS-associated proteins, decreased serum levels of neuropilin-1 (sNRP1), elevated serum biomarkers such as platelet degranulation and coagulation cascade markers increased acute phase response, and lower levels of vitamin D could render PCOS patients susceptible to a chronic inflammatory state, which can also lead to difficulties and severe consequences, when impacted by COVID-19. Furthermore, the COVID-19 pandemic also influenced psychological well-being, with an increase in the incidence and severity of depression and anxiety among PCOS patients in the COVID-19 pandemic era compared to healthy individuals. Conclusions Patients with PCOS are more likely to get infected with COVID-19 and display a higher affinity to severe infections and complications due to overlapping and confounding factors. These findings suggest that PCOS patients may need more medical attention when infected with COVID-19.

Evaluation of Vitamin (A) Deficiency among Critically Ill Children with Sepsis

Abstract Background Vitamin A is an immunomodulatory, and its deficiency may cause impaired immune function, which are found in sepsis. There is a biological rationale that vitamin A deficiency (VAD) may be a contributing factor related to poor clinical outcomes in patients with sepsis. Aim of the Work to assess the prevalence of vitamin A deficiency in critically ill children with sepsis and its association with clinical outcomes. Patients and Methods This cross-sectional study included 40 critically ill children with sepsis who were admitted to the paediatric intensive care unit. The control group consisted of 40 age- and sex-matched approximate-health children from outpatient clinic. For the measurement of serum vitamin A status, blood samples were taken from all patients within the first 24 hours of admission. The vitamin A status of the sepsis and control groups were compared. Univariate and multivariate approaches were used to assess the link between vitamin A deficiency and sepsis. Results The study enrolled 40 children with sepsis and 40 matched healthy children so there was no statistically significant difference between controls and patients among age and sex, with median age 4 (2 – 12) months for both groups with male predominance (60.0%). Regarding body measures there was a high statistically significant lower values among patients group than controls group for z score of weight, height/length, body mass index (BMI) and mid arm circumference (MAC) of the studied subjects, that indicated increased malnutrition prevalence among septic children than control group. In the present study, by comparing VAD between patients and controls, there was high statistically significant difference as all septic patients (100%) had VAD and the VAD among healthy control was found in 30% of them. We also found that patients with septic shock, patients who were nothing per os (NPO), patients on ventilators and died patients were more deficient in vitamin A level than other patients compared with them (high statistically significant difference), illustrated that VAD may be had a role in sepsis related morbidity and mortality. There was a positive correlation between vitamin A and BMI z score and MAC while there was a negative correlation with prism 3 and prism 4.ROC curve for assessment of vitamin A as a predictor of sepsis, found that at cut off value ≤9 μg/dl, the Sensitivity, Specificity, positive predictive value (PPV) and negative predictive value (NPV) were 100% for each. Conclusion low level of vitamin A, lower than or equal to 9 μg/dl was associated with sepsis, septic shock, and higher PRISM score. Vitamin A deficiency may be a marker of morbidity and mortality in critically ill children with sepsis.

Dietary effects of vitamin C on antioxidant capacity, intestinal microbiota and the resistance of pathogenic bacteria in cultured Silver pomfret (Pampus argenteus).

As most teleosts are unable to synthesize vitamin C, supplemental diets containing vitamin C diets play a crucial role in fish health. The aim of this study was to investigate the effect of dietary vitamin C on the intestinal enzyme activity and intestinal microbiota of silver pomfre (Pampus argenteus). Four experimental diets were supplemented with basic diets containing 300 mg of vitamin C/kg (group tjl3), 600 mg of vitamin C/kg (group tjl6), and 1200 mg of vitamin C/kg (group tjl12), as well as vitamin C-free supplemental basic diet (group tjl0), respectively. The four diets were fed to juvenile P. argenteus (average initial weight: 4.68 ± 0.93 g) for 6 weeks. The results showed that the activity of SOD (superoxide dismutase) and CAT (catalase) increased significantly while that of MDA (malondialdehyde) decreased significantly in group tjl3 compared to vitamin group tjl0. At the genus level, groups tjl0, tjl6, and tjl12 contained the same dominant microbial community, Stenotrophomonas, Photobacterium, and Vibrio, whereas group tjl3 was dominated by Stenotrophomonas, Delftia, and Bacteroides. Among the fish fed with a basic diet containing 300 mg of vitamin C/kg, the intestines exhibited a notable abundance of probiotic bacteria, including lactic acid bacteria (Lactobacillus) and Bacillus. The abundance of Aeromonas in groups tjl3 and tjl6 was lower than that of the vitamin C-free supplemental basic diet group, whereas Aeromonas was not detected in group tjl12. In addition, a causative agent of the disease outbreak in cultured P. argenteus, Photobacterium damselae subsp. Damselae (PDD) was the dominant microbiota community in groups tjl0, tjl6 and tjl12, whereas the abundance of PDD in group tjl3 was the lowest among the diets. Taken together, the diets supplied with vitamin C could influence the composition microbial community of P. argenteus. The low level of vitamin C (300 mg of vitamin C/kg per basic diet) supplementation could not only improve the antioxidant capacity but also resist the invasion of pathogenic bacteria.

Vitamin D receptor polymorphisms and associated miRNAs in the development of breast cancer in African American women

Breast cancer (BCa) is a prevalent form of cancer in women, exhibiting varying rates and distribution across different ethnic groups. Among these groups, African American (AA) women have the highest incidence of BCa and the lowest levels of Vitamin D (VD). Numerous studies have explored the connection between variations in the VDR gene and BCa risk, particularly in different populations, but research on the AA population remains limited. Epigenetic modifications, including specific microRNAs (miRNAs), can influence gene expression without altering the genetic code and have been implicated in cancer initiation and progression. Our hypothesis suggests that VDR gene variations may increase BCa risk in AA women and that changes in miRNA expression profiles could contribute to BCa development. Using data from the 1000 Genome Project, we identified five VDR gene variants with significant frequency differences between AA and European-American (EA) populations. We genotyped 404 African American BCa cases and controls for five variants using TaqMan® assays. SNPstats assessed their association with BCa risk. The rs1544410 variant’s recessive model (A/A) showed a decreased BCa risk in AA (odds ratio 0.33, 95% CI: 0.15–0.73, p-value 0.0041). Conversely, the rs2853563 variant’s recessive model (A/A) was linked to an increased BCa risk (odds ratio 4.04, 95% CI: 1.49–10.95, p-value 0.0022). We investigated miRNA expression influenced by VD in HCC1806 Triple-Negative Breast Cancer (TNBC) cell lines with the A/A allele for rs2853563. nCounter® Nanostring technology assessed miRNA profiles after calcitriol treatment. Our results indicated that calcitriol treatment led to reduced expression of six miRNAs, four of which are associated with tumor suppression in the presence of the AA genotype in TNBC cell lines. These findings suggest that specific VDR genotypes could have a potential effect on the miRNAs expression which could potentially serve as markers for cell proliferation in TNBC.

Vitamin D Metabolites in Mother-Infant Dyads and Associated Clinical Outcomes in a Population of Nigerian Women.

Low levels of vitamin D in maternal and cord blood have been associated with neonatal sepsis. This study assessed the association of vitamin D metabolites (25(OH)D, 3-epi-25(OH)D3, and 24,25(OH)2D3) levels in maternal and cord blood with newborn sepsis evaluation in Nigerian mother-infant dyads. Maternal and cord blood from 534 mothers and 536 newborns were processed using liquid chromatography-tandem mass spectrometry. Spearman correlation was used to compare continuous variables, Mann-Whitney for dichotomous variables, and Kruskal-Wallis for two or more groups. High cord percent 3-epi-25(OH)D3 levels were positively associated with newborn evaluation for sepsis (p = 0.036), while maternal and cord 25(OH)D and 24,25(OH)2D3 levels were not. Being employed was positively associated with maternal and newborn 3-epi-25(OH)D3 concentrations (p = 0.007 and p = 0.005, respectively). The maternal 3-epi-25(OH)D3 and percent 3-epi-25(OH)D3 were positively associated with vaginal delivery (p = 0.013 and p = 0.012, respectively). Having a weight-for-age Z-score ≤ -2 was positively associated with newborn percent 3-epi-25(OH)D3 levels (p = 0.004), while a weight-for-length Z-score ≤ -3 was positively associated with maternal and newborn percent 3-epi-25(OH)D3 levels (p = 0.044 and p = 0.022, respectively). Our study highlights the need to further investigate the biological role of 3-epi-25(OH)D3 and its clinical significance in fetal growth and newborn outcome.

Hypovitaminosis D and Leukocytosis to Predict Cardiovascular Abnormalities in Children with Kawasaki Disease: Insights from a Single-Center Retrospective Observational Cohort Study.

Introduction: An aberrant immune response involving yet unidentified environmental and genetic factors plays a crucial role in triggering Kawasaki disease (KD). Aims: The aim of this study was to assess general and laboratory data at the onset of KD in a single-center cohort of children managed between 2003 and 2023 and retrospectively evaluate any potential relationship with the development of KD-related cardiovascular abnormalities (CVAs). Patients and methods: We took into account a total of 65 consecutive children with KD (42 males, median age: 22 months, age range: 2-88 months) followed at the Department of Life Sciences and Public Health in our University; demographic data, clinical signs, and laboratory variables at disease onset, before IVIG infusion, including C-reactive protein, hemoglobin, white blood cell (WBC) count, neutrophil count, platelet count, aminotransferases, natremia, albumin, total bilirubin, and 25-hydroxyvitamin D were evaluated. Results: Twenty-one children (32.3% of the whole cohort) were found to have echocardiographic evidence of CVAs. Univariate analysis showed that diagnosis of KD at <1 year or >5 years was associated with CVAs (p = 0.001 and p = 0.01, respectively); patients with CVAs had a longer fever duration and mostly presented atypical or incomplete presentations. Interestingly, all patients with CVAs had lower levels of vitamin D (less than 30 mg/dL, p = 0.0001) and both higher WBC and higher neutrophil counts than those without CVAs (p = 0.0001 and p = 0.01, respectively). Moreover, blood levels of albumin were significantly lower in KD patients with CVAs compared to those without (11/21, 52% versus 13/44, 30%, p = 0.02). Multiple logistic regression with correction for sex showed that serum vitamin D < 30 ng/mL, WBC count > 20.000/mm3, and age > 60 months at KD onset were the only independent factors statistically associated with CVAs. Conclusions: Hypovitaminosis D, WBC count over 20.000/mm3, and age above 5 years at KD onset emerged as independent factors statistically associated with the occurrence of CVAs.