Low Levels Of 25-hydroxyvitamin Research Articles

Impact of vitamin D binding protein (GC) and vitamin D receptor (VDR) gene polymorphism on the risk of developing preeclampsia

ObjectivePreeclampsia is a multifactorial disease characterized by high blood pressure and protein in the urine. In this study, we investigated the association of vitamin D binding protein (GC) and vitamin D receptor (VDR) gene polymorphism with the risk of developing preeclampsia. Methods25-hydroxyvitamin D was measured using High-performance Liquid Chromatography. Vitamin D binding protein and vitamin D receptor gene polymorphisms were determined by polymerase chain reaction-restriction fragment length polymorphism. ResultsThe control subjects have significant higher level of 25-hydroxyvitamin D (33.5 ± 1.194 ng/mL) relative to patients (23.97 ± 1.604 ng/mL) (p < 0.05). Vitamin D receptor rs1544410 and rs2228570 dominant model (GA + AA; TC + CC) showed significant higher risk of developing Preeclampsia (OR = 4.11, 95% CI = 0.62–27.09, p < 0.01; OR = 3.58, 95%CI = 0.78–16.38, p < 0.001 respectively). Similarly, vitamin D binding protein rs7041 and rs4588, dominant model (TG + GG; CA + AA) showed higher risk of preeclampsia development compared to control people (OR = 1.69, 95%CI = 0.35–8.19, p < 0.05; OR = 1.06, 95%CI = 0.25–4.44, p < 0.05 respectively). AA genotype of rs4588 of GC gene was significantly associated with 25-hydroxyvitamin D level in serum relative to CC and CA (p < 0.05). ConclusionFrom our study, we can conclude that a low level of 25-hydroxyvitamin D, GC (rs1544410 and rs2228570), and VDR (rs4588 and rs7041) gene polymorphism is linked with an increased risk of developing preeclampsia.

The effect of vitamin D supplementation on the brain mapping and behavioral performance of children with ADHD: a double-blinded randomized controlled trials

ABSTRACT Background Attention deficit hyperactivity disorder (ADHD) is one of the common neurodevelopmental diseases that are accompanied with EEG pattern changes and Low levels of 25-hydroxyvitamin D [25(OH)D]. Neurofeedback provides a feedback signal to alleviate brain wave abnormalities and offers an alternative therapy for ADHD. This study aimed to investigate the concomitant effects of Vitamin D3 supplementation and Neurofeedback on children with ADHD. Method This study was implemented on children with an established diagnosis of ADHD who received multisession Neurofeedback therapy. The intervention and control groups received 50000 IU vitamin D3 capsules and placebo respectively once a week for 2 months. The background rhythm was measured using quantitative EEG both before and at the end duration of the therapy. Results All of the vitamin D3 treated children showed a significant increase in the 25(OH)D (46 ± 18, 28 ± 10 (ng/ml), p = 0.001) and serum calcium level (9.5 ± 0.5, 9.8 ± 0.3 (mg/dl), p = 0.003) compared to the baseline. There were a statistically significant decrease in the treatment group about theta relative power, theta/beta, and theta/alpha power ratios within two eyes conditions (p = 0.004). All the changes were significant within eye open state in the treatment group (2.4 ± 1.2, 1.7 ± 0.5, p = 0.01). There is a significant relationship between Connors scores and some brain waves improvement (in relative theta (r = 0.998) and theta-to-beta power difference score (r = 0.56) (p < 0.001). Conclusion Concomitant use of vitamin D3 supplementation and neurofeedback, increases the serum level of this vitamin and reveal favorable electrophysiological results in children with ADHD. Trial registration: Iranian Registry of Clinical Trials identifier: IRCT20200922048802N1..

PREDICTIVE FACTORS OF MACROANGIOPATHY IN HYPERTENSIVE DIABETIC PATIENTS WITH VITAMIN D DEFICIENCY

Objective: Several studies have shown an association between low levels of 25-hydroxyvitamin D and an increased risk of cardiovascular disease. Cardiovascular complications are the most prevalent cause of mortality in patients with type 2 diabetes mellitus and hypertension. The aim of our study was to determine the risk factors related to macroangiopathy among hypertensive diabetic patients with vitamin D deficiency. Design and method: Retrospective study, conducted on 1756 type 2 diabetics with hypertension in whom a vitamin D assay was done in the internal medicine department in the area of Blida during the period from April 2020 to November 2022. Results: 63.1% of patients had high blood pressure at the first examination. In addition, hyperuricemia was present in 39.8% patients, NASH (non-alcoholic fatty liver disease) was also present in 34.6% patients, hypertriglyceridemia in 48.3% patients, hypercholesterolemia in 60.2% patients and mixed dyslipidemia in 46.7% patients. Microalbuminuria, as a cardiovascular risk factor was positive in 39.2% patients. 61 % patients had at least one macrovascular complication. The univariate analysis showed a significant association between macroangiopathy and male gender (p = 0.029), HbA1c &gt; 9.5% (p = 0.008), the cumulative number of cardiovascular risk factors &gt; 5 (p 24 pg / mL (p = 0.007). Multivariate regression analysis showed that cumulative cardiovascular risk factors &gt; 5 (OR = 13.9 [95% CI: 1.4 -137.6], p = 0.024), presence of microangiopathy (OR = 22 [95% CI: 2.2 - 215.4], p = 0.008) and HbA1c &gt; 9.5% (OR = 36.6 [95% CI: 2.6 - 505]; p = 0.007) were predictor factors of macroangiopathy among patients with type 2 diabetes mellitus and Vitamine D deficiency. Conclusions: In hypertensive diabetic patients, cardiovascular diseases were the consequence of the additive effects of traditional risk factors with the participation of vitamin D deficiency.

The role of single nucleotide variant rs3819817 of the Histidine Ammonia-Lyase gene and 25-Hydroxyvitamin D on bone mineral density, adiposity markers, and skin pigmentation, in Mexican population.

Vitamin D (VD) deficiency and osteoporosis have become a global public health problem. A variant in the Histidine Ammonia-Lyase (HAL) gene has been associated with VD levels and bone mineral density (BMD). However, whether this variant has an influence on VD levels and BMD in Mexican adults remain unclear. This cross-sectional analysis included 1,905 adults participating in the Health Worker Cohort Study and 164 indigenous postmenopausal women from the Metabolic Analysis in an Indigenous Sample (MAIS) cohort. The rs3819817 variant was genotyped by TaqMan probe assay. Total 25 hydroxyvitamin D levels were measured by DiaSorin Liaison. BMD at the different sites was assessed through dual-energy X-ray absorptiometry. Linear and logistic regression models were performed to evaluate the associations of interest. The prevalence of VD deficiency was 41%, showing differences between sexes. Obesity and skin pigmentation were associated with lower levels of VD in males and females. rs3819817-T allele was associated with low levels of 25-hydroxyvitamin D, VD deficiency, and hip and femoral neck BMD values (g/cm2). We found two interactions with VD levels, one between adiposity and rs3819817-T allele (P = 0.017) and another between skin pigmentation and rs3819817-T allele (P = 0.019). In indigenous postmenopausal women, we observed higher VD levels in the southern region compared to the northern region (P < 0.001); however, we did not observe differences by genotype. Our findings confirm that the genetic variant rs3819817 has an essential function in VD levels and BMD and suggests a role in skin pigmentation in the Mexican population.

Characterization of serum vitamin D levels in pediatric patients with chronic lymphocytic thyroiditis.

Chronic lymphocytic thyroiditis or Hashimoto's thyroiditis is the most frequent cause of acquired hypothyroidism in children. An association between low levels of 25-hydroxyvitamin D (25OH vitamin D) and the development of the disease have been detected. The aim of this study was to describe 25OH vitamin D levels in patients aged 5 to 18 years with a diagnosis of Hashimoto's thyroiditis in three pediatric endocrinology outpatient centers in Medellín, Colombia. We conducted a cross-sectional observational study with retrospective data collection. We evaluated the sociodemographic characteristics, diagnoses, presence of comorbidities, and frequency of vitamin D deficiency. Sixty patients were included. The 25OH vitamin D levels were sufficient in 65% of the cases according to the Institute of Medicine (IOM) criteria and in 10% of the cases according to the Endocrine Society criteria. Serum calcium and phosphorus values were normal in 53% and 45% of the patients, respectively. All patients had normal magnesium and parathyroid hormone levels. No differences were found in the exploratory analysis when comparing 25OH vitamin D levels, thyroid antibody levels, and thyroid volume. In this chronic lymphocytic thyroiditis population, we did not find an increased prevalence of vitamin D deficiency according to IOM or the Endocrine Society criteria compared with previous data from the general population. No statistically significant differences were found in the exploratory analysis.

Immobilisation hypercalcaemia.

Hypercalcaemia is a common metabolic abnormality and its differential diagnosis is vast. Immobility is an uncommon cause of hypercalcaemia. Immobilisation hypercalcaemia is independent of parathyroid hormone and is associated with low levels of 25-hydroxyvitamin D and 1,25-dihydroxyvitamin D. In addition, it is characterised by elevated levels of markers of bone resorption and low levels of bone-specific alkaline phosphatase, highlighting an imbalance of bone remodelling favouring osteoclastic bone resorption. Although immobilisation hypercalcaemia is a diagnosis of exclusion, physicians need to be aware of this condition to avoid excessive and invasive investigations when all other causes of parathyroid hormone-independent hypercalcaemia have been excluded. Management of immobilisation hypercalcaemia revolves around early mobilisation and rehabilitation together with pharmacotherapeutic agents such as intravenous isotonic saline, calcitonin and bisphosphonates. Denosumab may be a potential alternative yet off-label treatment for immobility hypercalcaemia in patients with renal insufficiency.

25(OH)D AS A RISK FACTOR OF ESSENTIAL ARTERIAL HYPERTENSION CONSIDERING THE GENES POLYMORPHISM AGTR1 (RS5186) AND VDR (RS2228570)

Objective: Essential arterial hypertension (EAH) remains the most common global non-communicable disease. More than 50% of patients with hypertension have additional cardiovascular risk factors. The aim of this study is to establish the role of 25-hydroxyvitamin D as an additional risk factor of EAH depending on 1166A&gt;C polymorphism of AGTR1 gene (rs5186) and A/G polymorphism of VDR gene (rs2228570). Design and method: 100 subjects with EAH and target-organ damaging (2nd stage), moderate, high, very high cardiovascular risk were involved in the case-control study. Among them, 70.84% females, 29.16% males, mean age 57.86 ± 7.81 yo. The control group consisted of 60 healthy individuals of relevant gender and age. All recruited subjects were tested for serum levels 25-hydroxyvitamin D (immune luminescent test “MAGLUMI’’, “SNIB’’, China). To detect gene polymorphism the qualitative real-time polymerase chain reaction was done. AGTR1 gene genotyping was performed for 72 patients and 48 healthy individuals and VDR gene – for 100 patients and 60 healthy subjects. Results: EAH associates with the decreased 25-hydroxyvitamin D (&lt;30 ng/ml) regardless the genotypes AGTR1 (rs5186) and VDR (rs2228570) genes. Reduced serum level of 25-hydroxyvitamin D escalate the risk of EAH almost threefold (OR – 2.90; 95%CI OR:1.0–8.59; p = 0.048). Conclusions: Low level of 25-hydroxyvitamin D increases the EAH risk regardless the AGTR1 (rs5186) and VDR (rs2228570) genes’ alleles in the examined population.

Long-term cholecalciferol supplementation in hemodialysis patients: Effects on mineral metabolism, inflammation, and cardiac parameters.

Low levels of 25-hydroxyvitamin D [25(OH)D] are frequent in chronic kidney disease and are associated with adverse outcomes. The aim of this 5-year prospective study was to evaluate the effects of cholecalciferol supplementation on mineral metabolism, inflammation and cardiac parameters in hemodialysis (HD) patients. The study included 97 patients. Cholecalciferol was given after HD according to 25(OH)D baseline levels measured twice (end of winter and of summer). The 25(OH)D levels, circulating bone metabolism, inflammation parameters, brain natriuretic peptide (BNP), pulse pressure (PP), and left ventricular mass index (LVMI) were evaluated before and after supplementation. There was a significant increase in 25(OH)D levels after supplementation (p < 0.001); however, serum calcium (p = 0.02), phosphorus (p = 0.018), and iPTH (p = 0.03) were decreased. Magnesium levels increased during the study (p = 0.03). A reduction in the number of patients under active vitamin D (p < 0.001) and in the dose and number of patients treated with darbepoetin (p = 0.02) was observed. Serum albumin increased (p < 0.001), and C-reactive protein decreased (p = 0.01). BNP (p < 0.001), PP (p = 0.007), and LVMI (p = 0.02) were significantly reduced after supplementation. Long-term cholecalciferol supplementation allowed correction of 25(OH)D deficiency, improved mineral metabolism with less use of active vitamin D, attenuated inflammation, reduced the dose of the erythropoiesis-stimulating agent, and improved cardiac dysfunction.

Vitamin D and Its Metabolites Deficiency in Acute Coronary Syndrome Patients Undergoing Coronary Angiography: A Case-Control Study.

BackgroundVitamin D deficiency is considered an emerging health problem that affects at least one billion patients worldwide. Calcitriol 1,25(OH)2D3 has several systemic effects, including anti-inflammatory, anti-thrombotic and anti-atherosclerotic impacts that explain its cardioprotective effects. The precise association between vitamin D and its metabolites and the value of supplements in acute coronary syndrome (ACS) is still controversial. This study aims to search the association between vitamin D2, D3, and metabolites and ACS in patients undergoing coronary angiography.Materials and MethodsThis was a case–control study on 73 consecutive adult patients with ACS undergoing coronary angiography compared to 50 controls without coronary artery disease and matched for age and sex from June 2019 till July 2019. Echocardiography and coronary angiography were done for all cases. Plasma vitamin D and its metabolites were measured at admission for all participants along with chemistry profiles.ResultsVitamin D and its metabolites were statistically significantly lower in ACS patients than the controls. Multivariate regression analysis revealed that low levels of 25-hydroxyvitamin D (25(OH)D) and 1,25-dihydroxyvitamin D (1,25(OH)2D) significantly predicted ACS occurrence; the other significant predictors were high systolic blood pressure (BP), high total cholesterol, and low high-density lipoprotein-cholesterol. Interestingly, vitamin D2 and D3 did not significantly predict ACS (p>0.05). We did not find a statistically significant association between the number of affected coronary vessels and vitamin D metabolites. Moreover, there was no statistically significant correlation between vitamin D and its metabolites and left ventricular ejection fraction measured by echocardiography.ConclusionThere was a strong association between vitamin D and all its metabolites with ACS. Significantly, low 25(OH)D and 1,25(OH)2D predicted ACS, but vitamin D2 and D3 did not. Large randomized controlled trials are needed to verify the beneficial values of vitamin D supplementation in ACS patients.

Correlation between vitamin D levels and hard-to-heal wounds: a systematic review.

Hard-to-heal wounds are a major biological, psychological, social and financial burden on both individual patients and the broader health system. They are associated with a variety of comorbidities and have a complex aetiology, but are typically associated with nutritional deficiencies, such as low vitamin D levels. This systematic literature review evaluates the current research regarding the connection between inadequate vitamin D status and wound healing. PubMed and EBSCO databases were searched following PRISMA guidelines for primary research studies relating to pressure ulcers, diabetic ulcers or venous ulcers and vitamin D status. A total of 10 studies, involving 2359 participants, met the inclusion criteria. There was a strong correlation between low levels of 25-hydroxyvitamin D and the presence of all three types of hard-to-heal wounds. Research suggests a correlation between low vitamin D levels and hard-to-heal wounds. However, it is not clear if the relationship is causal or only correlational. There is also emerging evidence on the use of vitamin D supplementation for the treatment of hard-to-heal wounds. More research is needed to understand the correlation between vitamin D and hard-to-heal wounds.

Patients hospitalized with COVID-19 have low levels of 25-hydroxyvitamin D.

Patients hospitalized with COVID-19 have low levels of 25-hydroxyvitamin D.

Serum 25-hydroxyvitamin D concentration and its association with glucose intolerance in an indigenous population

Type 2 diabetes is a multifactorial disease resulting from diverse genetic and environmental factors as well as the interaction between them. Low levels of 25-hydroxyvitamin D [25(OH)D], an indicator of vitamin D status, have been associated with an increased risk of type 2 diabetes, but not consistently. Also, it remains to be determined if this association differs among ethnic groups. Therefore, we aimed to evaluate vitamin D status and its association with glucose intolerance in a Brazilian indigenous population, the Xavante Indians. The study population consisted of 819 full Xavante Indians (410 women), aged ≥18 years and living in two indigenous reserves located in Mato Grosso State, central region of Brazil. Clinical examination and anthropometrical measurements were made, blood samples were obtained for total cholesterol, HDL-cholesterol, triglycerides and 25(OH)D measurement. Fasting and 2-h post 75g oral glucose load capillary glucose was measured. Vitamin D status was defined by serum 25(OH)D levels: vitamin D sufficiency (25(OH)D: 30-100ng/mL), vitamin D insufficiency (25(OH)D: 20- <30ng/mL) and vitamin D deficiency (25(OH)D: < 20ng/mL). Multiple logistic regression was performed to identify independent associations between 25(OH)D levels and impaired glucose tolerance or diabetes mellitus. Analyses stratified by 25(OH)D levels shows that 65.5% of the population had vitamin D deficiency/insufficiency (25(OH)D<30ng/mL). 25(OH)D concentrations were lower in individuals with impaired glucose tolerance or diabetes mellitus than in normal glucose tolerant individuals. Multiple logistic regression analysis showed an inverse association between increments of 25(OH)D and presence of diabetes mellitus (OR per 1ng/mL increase in 25(OH)D: 0.97; 95% confidence interval: 0.95-0.99), or impaired glucose tolerance (OR per 1ng/mL increase in 25(OH)D: 0.87; 95% confidence interval: 0.85-0.89), in an age, sex, BMI and season of sampling-adjusted model. The present population-based study found a high prevalence of hypovitaminosis D among Xavante Indians. In this at-risk population of type 2 diabetes, a significant association of higher serum 25(OH)D with a decreased prevalence of diabetes mellitus and impaired glucose tolerance was observed.

Balancing Altered Calcium Metabolism with Bone Health in Sarcoidosis.

Abnormal calcium metabolism in sarcoidosis patients can lead to hypercalcemia, hypercalciuria, and kidney stones. Hypercalcemia in sarcoidosis is usually due to increased activity of 1α-hydroxylase in macrophages of pulmonary granulomata, resulting in low levels of 25-hydroxyvitamin D and high levels of calcitriol. Vitamin D supplementation may be dangerous for some sarcoidosis patients and is recommended only for those with decreased 25-hydroxyvitamin D and reduced or normal calcitriol level. Diagnosis, treatment of osteoporosis, and maintenance of bone health are complex issues for sarcoidosis patients. An approach to diagnosis and treatment of bone fragility is presented.

Effect of Long-term Vitamin D3 Supplementation vs Placebo on Risk of Depression or Clinically Relevant Depressive Symptoms and on Change in Mood Scores

Low levels of 25-hydroxyvitamin D have been associated with higher risk for depression later in life, but there have been few long-term, high-dose large-scale trials. To test the effects of vitamin D3 supplementation on late-life depression risk and mood scores. There were 18 353 men and women aged 50 years or older in the VITAL-DEP (Vitamin D and Omega-3 Trial-Depression Endpoint Prevention) ancillary study to VITAL, a randomized clinical trial of cardiovascular disease and cancer prevention among 25 871 adults in the US. There were 16 657 at risk for incident depression (ie, no depression history) and 1696 at risk for recurrent depression (ie, depression history but no treatment for depression within the past 2 years). Randomization occurred from November 2011 through March 2014; randomized treatment ended on December 31, 2017, and this was the final date of follow-up. Randomized assignment in a 2 × 2 factorial design to vitamin D3 (2000 IU/d of cholecalciferol) and fish oil or placebo; 9181 were randomized to vitamin D3 and 9172 were randomized to matching placebo. The primary outcomes were the risk of depression or clinically relevant depressive symptoms (total of incident and recurrent cases) and the mean difference in mood scores (8-item Patient Health Questionnaire depression scale [PHQ-8]; score range, 0 points [least symptoms] to 24 points [most symptoms]; the minimal clinically important difference for change in scores was 0.5 points). Among the 18 353 randomized participants (mean age, 67.5 [SD, 7.1] years; 49.2% women), the median treatment duration was 5.3 years and 90.5% completed the trial (93.5% among those alive at the end of the trial). Risk of depression or clinically relevant depressive symptoms was not significantly different between the vitamin D3 group (609 depression or clinically relevant depressive symptom events; 12.9/1000 person-years) and the placebo group (625 depression or clinically relevant depressive symptom events; 13.3/1000 person-years) (hazard ratio, 0.97 [95% CI, 0.87 to 1.09]; P = .62); there were no significant differences between groups in depression incidence or recurrence. No significant differences were observed between treatment groups for change in mood scores over time; mean change in PHQ-8 score was not significantly different from zero (mean difference for change in mood scores, 0.01 points [95% CI, -0.04 to 0.05 points]). Among adults aged 50 years or older without clinically relevant depressive symptoms at baseline, treatment with vitamin D3 compared with placebo did not result in a statistically significant difference in the incidence and recurrence of depression or clinically relevant depressive symptoms or for change in mood scores over a median follow-up of 5.3 years. These findings do not support the use of vitamin D3 in adults to prevent depression. ClinicalTrials.gov Identifiers: NCT01169259 and NCT01696435.

Correlation Between Serum Levels of 25-Hydroxyvitamin D and Severity of Community-Acquired Pneumonia in Hospitalized Patients Assessed by Pneumonia Severity Index: An Observational Descriptive Study.

IntroductionPneumonia severity index (PSI) is a prognostic index used for estimating the possibility of death due to community-acquired pneumonia. Vitamin D is a fat-soluble vitamin, essential for calcium and phosphate homeostasis. Vitamin D also has antimicrobial properties and according to recent studies, its deficiency may be correlated to an increased frequency of respiratory infections. The serum concentration of 25-hydroxyvitamin D (25(OH)D) is the best vitamin D status index reflecting vitamin D produced in the skin and offered from food and dietary supplements.MethodsThe study involved patients, who fulfilled the criteria of community-acquired pneumonia. The exclusion criteria were: patients <18 years old, severely immunocompromised patients, patients with tuberculosis, patients with malabsorption disorders, nursing home residents, patients with a history of malignancy, chronic renal or liver disease, patients with congestive health failure or cerebrovascular disease, and patients receiving vitamin D as a supplement. The following parameters, recorded on admission, were evaluated: age, sex, co-morbidity, residence in a nursing home, duration of symptoms, clinical symptoms, confusion, blood gas analysis, chest radiograph (pleural effusion), and laboratory parameters. The patients were classified in risk classes according to the PSI. Blood samples were collected within the first 48 hours of hospitalization. The serum levels of 25-hydroxyvitamin D were determined by electrochemiluminescence binding assay in Roche Cobas 601 immunoassay analyzer and mean serum levels of 25-hydroxyvitamin D in each risk class were calculated. For statistical analysis, the statistical program SPSS for Windows version 17.0 (Statistical Package for the Social Sciences, SPSS Inc., Chicago, IL) was used.ResultsA total of 46 patients, 28 males and 18 females, with a mean age of 71.5±17.57 years, hospitalized with community-acquired pneumonia, were included. Sixteen patients (35%) had a severe deficiency, with 25(OH)D levels <10 ng/ml, 17 patients (37%) had moderate deficiency with 25(OH)D levels between 10-20 ng/ml, and 13 patients (28%) had insufficiency with 25(OH)D levels between 20-29 ng/ml. According to the PSI, four (8.7%) patients with a mean age of 53.75±15.43 years were classified as risk class I, 10 (21.7%) patients with a mean age of 54.7±14.82 years as class II, 10 (21.7%) patients with a mean age of 68.41±3.96 years as class III, 17 (37%) patients with a mean age of 84.82±9.73 years as class IV, and five (10.9%) patients with a mean age of 80.2±9.41 years as class V. The mean levels of 25(OH)D were 19.11±11.24 ng/ml in class I, 16.81±8.94 ng/ml in class II, 16.65±9.18 ng/ml in class III, 14.76±10.22 ng/ml in class IV, and 7.49±4.41 ng/ml in class V. There was a positive correlation between low levels of 25(OH)D and the pneumonia severity and statistically significant difference between the mean levels of 25(OH)D in class V (7.49±4.41 ng/ml) compared to overall mean levels in classes I, II, III and IV (16.15±9.49 ng/ml), with p<0.05.ConclusionsAccording to our results, there was a positive association between low levels of 25-hydroxyvitamin D and community-acquired pneumonia severity assessed by PSI. The determination of 25-hydroxyvitamin-D status, mostly in patients >60 years old, may prevent severe community-acquired pneumonia.

Correlation between vitamin D levels and hard-to-heal wounds: a systematic review.

Hard-to-heal wounds are a major biological, psychological, social and financial burden on both individual patients and the broader health system. They are associated with a variety of comorbidities and have a complex aetiology, but are typically associated with nutritional deficiencies, such as low vitamin D levels. This systematic literature review evaluates the current research regarding the connection between inadequate vitamin D status and wound healing. PubMed and EBSCO databases were searched following PRISMA guidelines for primary research studies relating to pressure ulcers, diabetic ulcers or venous ulcers and vitamin D status. A total of 10 studies, involving 2359 participants, met the inclusion criteria. There was a strong correlation between low levels of 25-hydroxyvitamin D and the presence of all three types of hard-to-heal wounds. Research suggests a correlation between low vitamin D levels and hard-to-heal wounds. However, it is not clear if the relationship is causal or only correlational. There is also emerging evidence on the use of vitamin D supplementation for the treatment of hard-to-heal wounds. More research is needed to understand the correlation between vitamin D and hard-to-heal wounds.

Influence of vitamin d on the formation of the menstrual function in teenage girls

The data of Russian and foreign literature on the role of vitamin D in the regulation of health and the participation of vitamin D in the reproductive health of teenage girls are analyzed. Evidence has been provided that vitamin D can affect steroidogenesis of sex hormones (estradiol and progesterone), which contributes to follicular development and endometrial growth. Low levels of 25-hydroxyvitamin D (25 (OH) D) affect hormonal and metabolic disorders, and the inclusion of vitamin D in complex therapy can help regulate the menstrual cycle and metabolic disorders.

25-Hydroxyvitamin D at time of breast cancer diagnosis and breast cancer survival.

Previous studies have shown that low levels of 25-hydroxyvitamin D (25(OH)D) are associated with a poorer breast cancer survival. The relationship between vitamin D status and breast cancer outcomes is however still debated. The aim of the present study was to investigate the association between 25(OH)D blood levels measured at time of diagnosis and event-free survival (EFS) and overall survival (OS) in a large cohort of patients with early-stage primary invasive breast cancer. From April 2008 to April 2013, 25(OH)D status was measured at time of diagnosis in all women operated for early stage primary invasive breast cancer at Rigshospitalet, Copenhagen, Denmark. Associations between 25(OH)D and EFS and OS were investigated using a Cox Proportional hazards model, adjusting for age, disease characteristics, time period, and BMI. Differences in survival were evaluated by hazard ratios (HR). In the present study, 2510 women with primary invasive breast cancer were included. Women with the lowest 25(OH)D levels (≤ 52nmol/L) had an inferior EFS with a HR of 1.63 (95% CI 1.21-2.19) compared to women in the third quartile (76-99nmol/L). Women with the highest 25(OH)D levels (≥ 99nmol/L) also had an inferior EFS with a HR of 1.37 (95% CI 1.02-1.83). Plotting 25(OH)D status against EFS, the association was inversely J-shaped. For OS, a similar association with 25(OH)D status was observed. We confirmed previous findings suggesting that a low 25(OH)D status is associated with an inferior breast cancer survival, but unlike previous findings, we found an indication of poorer breast cancer survival also among women with high 25(OH)D levels.

Comparing the effectiveness of vitamin D plus iron vs vitamin D on depression scores in anemic females: Randomized triple-masked trial.

Background: Low levels of 25-hydroxyvitamin D (25(OH)D) have been related to depression and anxiety. It seems that anemia is associated with vitamin D deficiency. We aimed to evaluate the effects of iron-vitamin D co-supplementation versus vitamin D alone on depression scores in anemic females with low levels of serum 25-hydroxyvitamin D. Methods: This randomized controlled trial was conducted on eighty premenopausal females who were recruited between May 2015 and October 2015 from primary health care centers. Women with anemia and low concentrations of 25(OH)D were randomized to either 1000 IU/d vitamin D plus 27 mg/d iron (D-Fe) or vitamin D plus placebo supplements (D-P) for 12 weeks. Depressive and anxious symptoms were evaluated with the Beck Depression Inventory (BDI) with subscales 1–13 and 14–21 and Beck Anxiety Inventory (BAI). To compare the groups, Mann–Whitney or chi-squared tests were used and within groups comparison was performed using Wilcoxon signed ranks test. The study was registered on www.clinicaltrial.org as NC 01876563. Results: The serum concentrations of 25(OH)D were increased significantly in both groups at the end of the study. In both groups, there was a significant improvement in total BDI, the BDI subscale, and the BAI scores (p<0.001). No differences were found between groups (p>0.05). Conclusion: Although the potential positive effect of vitamin D on mental health was evident, iron plus vitamin D co-supplementation did not demonstrate any significant benefits over vitamin D alone, neither in depression score reduction nor anxiety symptoms.

Link between Vitamin D and Cardiovascular Diseases

Over the last decades, cardiovascular diseases (CVD) effect is increasing very fast. This review article discuss the association between low level of 25-hydroxy vitamin and cardiovascular diseases. This review also tells us the direct effect of vitamin D on heart or on cardiovascular system may also be involved. Apart from regulating blood pressure, vitamin D also regulate endothelial and smooth muscle cell muscles, most studies support 25 (OH) vitamin D having protective effects on cardiovascular system. However this association of vitamin D and cardiovascular diseases is based on observation & ecological studies and thus is a matter of controversy. Adequate clinical data are not available to confirm these association. Unopposed activation of RAAS & generation of angiotensin promote arterial stiffing & endothelial dysfunction that proceed & contribute to the development of hypertension & also predictors of CVD risk.