Low Vitamin D3 Levels Research Articles

Assessment of Vitamin D3 Level Among a Sample of Type 2 Diabetic Patients Attending Diabetes and Endocrinology Center in Al-Hilla City

Vitamin D is found in foods in two primary forms: cholecalciferol (vitamin D3) and ergocalciferol (vitamin D2), with vitamin D3 being a fat-soluble vitamin. that is necessary for calcium homeostasis and the maintenance of proper function in a variety of tissues. Humans get vitamin D from their diets or from being exposed to ultraviolet B radiation from the sun. Aside from its well-known effects on bone health, vitamin D has been hypothesized to play a role in various disease states and health situations, such as cardiovascular disease and type 2 diabetes. To assess vitamin D3 concentration in patients with type 2 diabetes, using the Vitamin D Total III kit on the Cobas E 411 device. A total of 300 people were recruited, with 150 people suffering from type 2 diabetes serving as cases and 150 healthy volunteers of the same gender and age being used as the control group. Both genders were represented, with an age group between 30 – 79 years. The collection of data lasts for five months, beginning Started in November 2022 to April 2023. The data was analyzed with the readily available statistical package SPSS-28, and Chi-square tests were used to evaluate the relationship among vitamin D, T2DM, and control. Data were provided in simple frequency, percentage, mean, standard deviation, and range measures. Type 2 diabetes patients' mean ± SD ages were 55.4 ± 10.1, while controls had a mean ± SD of age of 55.3 ± 10.0. the sociodemographic features of T2DM and participant control. Shows A statistically significant association was found in the variables of age groups, school level (P = 0.0001), and marital status (P = 0.008). The BMI: mean ± SD (29.69 ± 5.14) of T2DM was higher than the BMI: mean ± SD (24.41 ± 1.95) of controls, as well as the waist-to-height ratio, which showed that the mean ± SD (0.527 ± 0.046) of T2DM was greater than the control mean ± SD (0.483 ± 0.019) at level (P = 0.0001); T2DM patients had deficient and insufficient vitamin D3 levels (38.7% and 33.3%, respectively), whereas controls had deficient and insufficient vitamin D3 levels (28.7% and 30.0%, respectively). It was found that there is a significant difference between low vitamin D3 levels and individuals with type 2 diabetes, and A lack of vitamin D3 is related to an increased risk of developing T2DM.

A Study of Hepcidin Levels and Other Biochemical Parameters in Women with Osteoarthritis: As a Pharmaceutical Control

Background: Hepcidin, one of the peptide hormones generated from the liver, can be defined as an important regulator regarding systemic iron homeostasis, while its lopsided production plays a role in the pathogenesis of a variety of iron diseases. Osteoarthritis (OA) frequently coexists with a number of diseases, including hemochromatosis, ß-thalassemia, cell disease, sickle cell disease, and hemosiderosis caused by iron overload. Evidence suggests that iron deficiency and iron overload negatively impact the bone, which acts immediately on the bone’s cells. The present work aims to determine whether a direct correlation exists between female patient’s OA and levels of hepcidin, DHVD3, and other indicators. Methods: A total of 60 participants were split into two groups for this work: 30 healthy controls and 30 female OA patients. This work was carried out from Nov. 2021 to the end of June. 2021. The ages ranged from (40 to 55). In Al-Mahmudiya Hospital and in Al-Yarmok Teaching Hospital, an endocrinologist assessed each one of the patients. We measured Hb, BMI, ferritin, hepcidin, DHVD3, iron, Ca, and PO4. Results: Hepcidin levels significantly increased, whereas ferritin, BMI, iron, vitamin D, calcium, and PO4 levels significantly decreased compared with the control group. However, alterations in lipid profile and glycemic profile were not statistically significant. Conclusion: By connecting low levels of iron, ferritin, calcium, vitamin D3, and PO4 with high levels of hepcidin in women with OA, it may be concluded that vitamin D3 insufficiency is associated with hepcidin malfunction as a factor affecting women with OA.

VITAMIN D SCREENING BEFORE FERTILITY TREATMENT PLANS: PILOT STUDY IN PCOS AND NON-PCOS INFERTILE WOMEN

Background: Polycystic ovarian syndrome (PCOS) and hypovitaminosis D are two most common endocrine disorders in young women leading to many adverse metabolic consequences. Objective of this study was to compare Vitamin D (VD) levels, Body Mass Index (BMI), lipid profile, hormonal parameters, and oocytes in PCOS and non-PCOS infertile females and to explore any association of VD levels with these parameters. Methods: This cross-sectional study was conducted from July 2019 to June 2020 after ethical approval at Aga Khan University in collaboration with Australian Concept of Infertility Medical Centre (ACIMC). It was conducted on 88 infertile females with age range 25–45 years recruited for Intracytoplasmic Sperm Injection (ICSI). Subjects were divided into two groups; PCOS (n=37) and non-PCOS (n=51) based on diagnostic criteria of PCOS. Serum VD was analyzed using ELISA. Statistical analysis was performed on SPSS-20. Mann-Whitney U-test and Spearman’s rank correlation were applied. Results: The mean BMI was significantly higher among PCOS as compared to non-PCOS women (p<0.001). There were statistically significant differences in total cholesterol, triglycerides, Low Density Lipoprotein (LDL-C), High Density Lipoprotein (HDL-C), and Very Low Density Lipoprotein (VLDL) among groups (p<0.05). There was significant correlation of vitamin D with maturity of oocytes (r=0.836, p<0.0001). Conclusion: The findings indicated that PCOs women were obese, had abnormal lipid profile with low VD levels. Low levels of VD were associated with poor maturity of oocytes which is required for successful conception. Pak J Pysiol 2023;19(2):15–9

Low Serum Levels of Zinc, Selenium, and Vitamin D3 Are Biomarkers of Airway Inflammation and Poor Asthma Control: A Two-Centre Study.

Background Asthma is a chronic inflammatory disease with its control beingaffected by underlying oxidative stress. Trace elements, along with vitamin D3, play an important role in immune alterations leading to an imbalance of Th1/Th2 helper cells. However, their role in asthma pathogenesis and control is inconsistent and inconclusive. The objective of our study was to assess levels of serum trace elementslike zinc, copper, selenium, iron, magnesium,vitamin D3 levels, IgE, and HsCRP in asthmatic children, compare with healthy controls, and assess their association with the level of asthma control. Methods A cross-sectional study was conducted from 2019 to 2021 enrolling 100 asthmatic children and 75 healthy controls. The level of asthma control was assessed as uncontrolled, partly controlled, and controlled asthma as per GINA Guidelines. Mean and standard deviation were calculated for each element and mean differences between groups were analyzed by student t-test. A p-value of <0.05 was considered significant. Results The mean age was 8.75±2.89 yrs in cases and 9.04±2.79 in controls. A total of 57.6% of cases had atopic comorbidities. The mean serum zinc levels were 51±12.8 mg/dl, which was very low in asthmatic children as compared to 60±18.2mg/dl (p-value 0.0002) in healthy controls. Serum selenium was 13±3 µg/dl in asthmatics vs. 15±4 µg/dl (p-value 0.0002) in healthy controls. Serum copper was 115.2±21.92µg/dl vs. 125.3±31.99µg/dl (p-value 0.015), Serum vitamin D3 levels were 13.07±7.82ng/ml vs. 17.82±14.62 ng/ml(p-value 0.006) in both groups, respectively. SIgE and HsCRP were high in asthmatic children suggestive of eosinophilic inflammation. Serum zinc was 49±5.45 mg/dl in the uncontrolled group, 53±6.1 in the partly controlled, and 58±8.0 in the well-controlled group (p<0.0001). Serum selenium was 10± 3.0 µg/dlin the uncontrolled group vs. 13± 2.0 and 14± 2.0 µg/dl in the partly controlled and well-controlled groups, respectively (p-value <0.0001). Vitamin D3 wassignificantly low (9.32±5.95ng/dl) in the uncontrolled group vs. 12.99±4.97 and 13.40±5.92 ng/dl(p<0.005) in the partly controlled and well-controlled groups respectively. Vitamin D3 showed a strong positive correlation with zinc (r=0.4,p< 0.0001) and a negative correlation with inflammatory markers like SIgE and HsCRP. Conclusion Children with asthma had low zinc, selenium, and vitamin D3 levels, and were associated with airway inflammation and poor asthma control.

Sarcopenia in Perimenopausal and Postmenopausal Women in a Tropical Country [ID: 1377057

INTRODUCTION: Improving health services worldwide has led to a gradually aging population. Sarcopenia has been identified as an important contributor to health costs in elderly women in developed countries. The lifestyle and access to medical services is vastly different in the developing countries like India. The present research was conducted to study the status of sarcopenia among perimenopausal and postmenopausal women of India. METHODS: Institutional review board approval for the study was obtained from institutional ethical committee. Women aged 40 years or more, having no complaints, and coming to hospital as companions were enrolled after taking consent. A detailed history was taken and activity levels were classified according to the ICATUS 2016 (International Classification for Time-Use Statistics). Muscle strength was evaluated by handgrip strength, gait speed, and appendicular skeletal mass measurement. Serum estradiol, vitamin D3, fasting plasma glucose, and fasting insulin levels were also assessed. RESULTS: A total of 50 women were enrolled. 80% (n=40) of women had a sedentary lifestyle while the remaining reported light activity. Sarcopenia was noted in 16% (n=8) and showed a significant association with increasing age (P&lt;.001). None of the women less than 62 years of age had sarcopenia. All women with sarcopenia had a sedentary lifestyle. Women with low body mass index were more likely to have sarcopenia. Low serum estradiol and serum vitamin D3 levels were significantly correlated to sarcopenia (P&lt;.001). CONCLUSION: Sarcopenia is an emerging problem. Counseling of women for good nutrition and an active lifestyle can help prevent or delay the onset of sarcopenia. Poor nutrition status of women in developing countries needs to be addressed to combat the problem.

Association of Vitamin-D Status with Ischemic Stroke and It’s Risk Factors In Bangladeshi Patients: A Case-Control Study

Background: Vitamin D (VD) shortage and inadequacy are serious global health issues affecting people of all ages. Several studies have shown a link between VD insufficiency and ischemic stroke. Unfortunately, VD is rarely measured, diagnosed, or treated, especially in patients with severe neurological disorders like stroke in our context. The study aimed to explore the association between VD and the risk of acute ischemic stroke along with its risk factors in Bangladeshi patients. Methods: Forty-four patients with ischemic stroke and 44 age and sex-matched healthy subjects were included in this study from Chittagong Medical College Hospital. Demographic and clinical data were collected with a structured interview questionnaire. Fasting 25(OH) VD, calcium, lipid profile, and blood sugar were measured. VD levels classified the individuals in sufficient (VDSe”30.0 ng/mL), insufficient (VDI: 20.0–29.9 ng/mL), and deficient (VDD&lt;20.0 ng/mL) status. Results: Out of 44 stroke patients, 27 (61.4%) were men, and the mean age was 54.6±11.0 years (age range: 18-70 years). The frequency of hypertension, diabetes mellitus, obesity, and dyslipidemia were 68.2%, 31.8%, 52.3%, and 81%, respectively, among stroke cases. VDD and VDI was observed in 29 (65.9%), 9 (20.5%) stroke patients and 5 (11.4%), 12 (27.3%) controls respectively. Multiple logistic regression analysis showed an independent association of 25(OH)D deficiency or insufficiency with ischemic stroke (odds ratio: 10.71, 95% confidence interval: 2.21-51.88, p=0.003). Conclusions: This study shows that low VD levels may be associated with an increased risk of ischemic stroke. Bangladesh J Medicine 2023; 34(2): 105-111

Effect of Serum Vitamin D Content on the Clinical Course of Psoriasis

Objectives: To evaluate the incidence of serum vitamin D insufficiency in patients with psoriasis and study the relationship between dietary intake of vitamin D and clinical characteristics. Materials and Methods: Totally eighty individuals were enrolled and were equally divided into two groups (40 patients in each group): Group A consisted of psoriasis patients, whereas Group B consisted of controls. By using the PASI scale, psoriasis plaques were identified and assessed. The predesign questionnaire was developed and was given to each participant to complete it. Age, gender, the length of the psoriasis, concurrent illnesses, and medications were among the collected data. A dermatologist examined all of the patients and gathered information about their demographics, health, and any other pertinent information. Blood samples were taken to measure the level of serum vitamin D using the immuno-enzyme method. All measurements were conducted during winter months to avoid the influence of sun exposure on synthesis of vitamin D3 and its derivative 25-hydroxycholecalciferol. SPSS (v 25.0) was used for analysis and the results were shown in the form of graph and table. Results: Statistically significant difference was found in 25(OH) D3 levels between psoriasis affected individuals and healthy individuals. Both groups have low level of 25-hydroxycholecalciferol. In our results there is negative correlation between 25(OH) D3 and PASI. There is also a negative correlation between 25(OH) D3 and duration of psoriasis. Practical implication: This study will help the clinical practitioner to advise the patients with psoriasis to use enough amounts of vitamin D3 that will help to normalize the vitamin D level in patients. It is believed that psoriasis can cause a progressive decrease in the level of vitamin D3 derivatives in the whole human body, including the skin. So vitamin D rich food must be eaten in high amount. Conclusion: It is found in this study that both the groups have low serum vitamin D3 level. Both the general public and persons with psoriasis should eat enough amounts of vitamin D3. Keywords: PASI, vitamin D3, Psoriasis, serum, antiproliferative,

Serum Vitamin D Levels and Dry Eye Disease in Postmenopausal Women: A Case-Control Study at a Tertiary Care Center in Rural Haryana.

Despite the high prevalence of Vitamin-D insufficiency and high susceptibility to dry eye disease (DED) in postmenopausal women (PMW), correlation between DED and Vitamin D has not been explored in PMW in any Indian study. To explore the correlation between serum Vitamin D levels in PMW with and without DED, in a hospital-based population in rural Haryana. Subjective (ocular surface disease index [OSDI] questionnaire) and objective clinical tests were undertaken for DED diagnosis. 25(OH) Vitamin D was measured in serum using enzyme-linked immunosorbent assay; insufficient (10-30 ng/ml) and deficient (<10 ng/ml). Descriptive statistics were analyzed by mean ± standard deviation for continuous and frequencies for the categorical variables; Student's t-test used to find out mean difference in Vitamin D levels; P < 0.05 was considered statistically significant. One hundred and forty PMW (60.1 ± 5.32 years) were included; Group-A (Controls; no DED; n: 70); Group-B (Cases; DED diagnosed by OSDI scores; n: 70); Subgroup-B1 (clinical tests negative; n: 30) and B2 (clinical tests positive; n: 40). There was no statistically significant difference in OSDI scores between B1 and B2. Significantly lower mean Vitamin D levels were found in cases (14.36 ± 4.08 ng/ml) as compared to controls (19.19 ± 6.4 ng/ml) (P = 0.001) and in B2 (13.15 ± 3.51 ng/ml) as compared to B1 (15.57 ± 4.66 ng/ml) (P = 0.01). There were significantly low levels of Vitamin-D in clinically established DED. Evaluating Vitamin D levels as a part of the dry eye workup in PMW is recommended. OSDI scores were not aligned with the clinical test scores; questionnaire-based tests alone may not be sufficient for diagnosing DED.

Vitamin D and Chronic Kidney Disease Association with Mineral and Bone Disorder: An Appraisal of Tangled Guidelines.

Chronic kidney disease (CKD) is a highly prevalent condition worldwide in which the kidneys lose many abilities, such as the regulation of vitamin D (VD) metabolism. Moreover, people with CKD are at a higher risk of multifactorial VD deficiency, which has been extensively associated with poor outcomes, including bone disease, cardiovascular disease, and higher mortality. Evidence is abundant in terms of the association of negative outcomes with low levels of VD, but recent studies have lowered previous high expectations regarding the beneficial effects of VD supplementation in the general population. Although controversies still exist, the diagnosis and treatment of VD have not been excluded from nephrology guidelines, and much data still supports VD supplementation in CKD patients. In this narrative review, we briefly summarize evolving controversies and useful clinical approaches, underscoring that the adverse effects of VD derivatives must be balanced against the need for effective prevention of progressive and severe secondary hyperparathyroidism. Guidelines vary, but there seems to be general agreement that VD deficiency should be avoided in CKD patients, and it is likely that one should not wait until severe SHPT is present before cautiously starting VD derivatives. Furthermore, it is emphasized that the goal should not be the complete normalization of parathyroid hormone (PTH) levels. New developments may help us to better define optimal VD and PTH at different CKD stages, but large trials are still needed to confirm that VD and precise control of these and other CKD-MBD biomarkers are unequivocally related to improved hard outcomes in this population.

Vitamin D3 and COVID-19 Outcomes: An Umbrella Review of Systematic Reviews and Meta-Analyses.

The immune system (innate and adaptive) is influenced by vitamin D3, which affects gene expression and inflammatory pathways. An umbrella review was conducted to evaluate the power and accuracy of data connecting vitamin D3 to the outcomes of COVID-19 infection and to appraise the proof provided by published meta-analyses. MEDLINE, Embase, and the Cochrane Library were searched from database inception to 31 May 2022. Meta-analyses of prospective or retrospective observational studies and randomized trials were included. Evidence of association was graded according to the established criteria: strong, highly suggestive, suggestive, weak, or not significant. From 74 publications, 27 meta-analyses described five associations between vitamin D3 levels and supplementation and COVID-19 outcomes. Low levels of vitamin D3 were significantly associated with severity (highly suggestive evidence; OR = 1.97 [95% CI, 1.55-2.51], p < 0.01; I2 = 77%, p < 0.01) and mortality risk due to COVID-19 disease (OR = 1.83 [95% CI, 1.55-2.16], p < 0.01; I2 = 50%, p < 0.01). Vitamin D3 supplementation, after a diagnosis of COVID-19 infection, was associated with significantly reduced infection severity (e.g., ICU admission) and mortality. This umbrella review of the available evidence suggests that insufficient vitamin D3 may increase COVID-19 infection risk, severity, and mortality, in addition to showing a highly suggestive association between vitamin D3 supplementation and reduced severity and mortality among infected patients.

Vitamin-D Levels of Patients with ST-elevation Myocardial Infarction and Association with In-hospital Prognosis: An Exploratory Observational Study in Southern India

Introduction: The role of vitamin-D in various diseases, including heart disease, has been a subject of interest in recent years. Many studies revealed low vitamin-D status in patients with Acute Coronary Syndrome (ACS). Studies have shown statistically significant low Vitamin-D levels in patients with Myocardial Infarction (MI) in recent years with some studies showing association of vitamin-D deficiency with worse outcome in patients with severe deficiency. Aim: To determine serum vitamin-D levels in patients with acute ST-Elevation Myocardial Infarction (STEMI), and its association with in-hospital prognosis. Materials and Methods: An exploratory observational study was conducted in 100 patients with STEMI consulting a General Medicine Department, JSS Hospital (Tertiary Healthcare Centre), Mysuru, Karnataka, India, from May 2015 to June 2016. The patients were followed-up for in-hospital prognosis. Serum vitamin-D was estimated by ECLIA (Enhanced Chemiluminiscence Immunoassay) method. Electrocardiogram (ECG), Echocardiogram (ECHO) and Coronary Angiogram (CAG) were done in all patients using standard procedures. In-hospital prognosis of the subjects with vitamin-D deficiency and those with normal vitamin-D levels were compared. Data was analysed using Statistical Package for the Social Sciences (SPSS) software version 21.0. Results: Of total 100 patients, majority (n=59, 15.36%) were in the age group of 50-69 years and there were 81 males and 19 females. The results showed 72% of the subjects were deficient and 19% had insufficient vitamin-D levels, therefore, a total of 91% of the STEMI patients had abnormally low vitamin-D levels. Those with Diabetes Mellitus (DM) (n=52) and past Ischaemic Heart Disease (IHD) (n=9) had significantly low vitamin-D levels, suggesting that the association of vitamin-D deficiency with these risk factors may also contribute to the role of vitamin-D deficiency in STEMI. Among those with cardiac failure (44%), 86.3% had deficient and 11.6% had insufficient vitamin-D levels. Conclusion: Vitamin-D deficiency was seen in majority of the STEMI patients. Significantly deficient level of vitamin-D was observed in STEMI patients who progressed to cardiac failure (44%) as a complication.

Assessment of serum levels of vitamin D and tissue levels of vitamin D receptors in acanthosis nigricans

Background Acanthosis nigricans (AN) is a skin disorder characterized by symmetrical, thickened, dark plaques comprising hyperkeratosis and acanthosis. Vitamin D (VD) plays an important role in the regulation of skin proliferation and differentiation, and mediates its action by binding to specific vitamin D receptors (VDR) in the nuclei of target cells. Objective To measure the serum levels of VD and tissue levels of VDR in a group of Egyptian patients with AN in comparison to healthy controls, in order to shed more light on the possible relation between VD, VDR, and AN. Patients and methods This study included 25 AN patients and 25 age-matched and sex-matched healthy controls. Blood samples and skin biopsies were taken from all participants for the evaluation of serum VD, glucose, insulin, and tissue VDR levels. Results Serum VD and tissue VDR were significantly lower (P<0.001 for both), while serum insulin and homeostatic model for insulin resistance were significantly higher (P<0.001 and P=0.002, respectively) in patients than controls. Patients had a more deficient pattern of VD status than controls (P<0.001). There was a statistically significant positive correlation between serum VD and tissue VDR in patients (r=0.632, P=0.001). Conclusion The present study suggests a possible role for low serum VD and tissue VDR levels in causing AN, in genetically predisposed individuals.

The correlation between vitamin D and levels of IFN-γ, NF-κB, thyroid antibodies in down syndrome: study in Indonesian children.

Vitamin D (VD) reduces interferon-gamma (IFN-γ) production and prevents nuclear factor kappa-light-chain-enhancer of activated B cells (NF-κB) activation, impacting the inhibition of the autoimmunity process such as autoimmune thyroiditis (AITD). Children with Down syndrome (DS) are reported to have a higher risk of autoimmunity and lower VD levels than non-DS. Therefore, this study aimed to evaluate VD levels in Indonesian DS children and their relationship with marker of AITD. This study was conducted on DS children at Dr Soetomo Hospital between February 2021-June 2022. Socio-demographic status, amount of milk, fish and meat consumption, and duration of sun exposure were obtained using a self-report questionnaire. Thyroid hormone (TSH and FT4), thyroid antibody (TPO-Ab and Tg-Ab), 25 (OH)D, IFN-γ, and NF-κB levels were measured using ELISA. Of the 80 participants, 53.75% had sufficient (50.829±17.713 ng/ml) and 46.25% had non-sufficient (20.606±5.974 ng/ml) VD levels. Daily milk consumption, meat and fish consumption were risk factors contributing to VD levels in multivariate analysis [p=0.003, OR=1.007(1.003-1.012); p=0.004, OR=1.816(1.209- 2.728), respectively]. Participants with sufficient VD had significantly higher TPO-Ab (p=0.007) and Tg-Ab (p=0.016). Mean of VD levels were significantly negatively correlated with IFN-γ levels (r =-0.262, p=0.037) and positively correlated with TPO-Ab (r= 0.432, p=1x10-5,) and Tg-Ab (r= 0.375, p=0.001). Majority of subjects had sufficient VD levels. VD suppresses IFN-g, but is unable to affect NF-κB levels, presumably causing high levels of TPO-Ab and Tg-Ab in sufficient VD patient.

Pre-transplantation vitamin D deficiency increases acute graft-versus-host disease after hematopoietic stem cell transplantation in thalassemia major patients.

Although there are many studies on the role of vitamin D deficiency (VDD) in hematopoetic stem cell transplantation (HSCT), outcomes have often reported conflicting results because of the heterogeneity of the patients in the studies. We investigated the association between VDD prior to HSCT and outcomes after HSCT in a relatively homogenous group of patients with thalassemia major (TM) who received identical treatment for TM before transplantation, and the same conditioning regimen and GVHD prophylaxis during and after transplantation. All patients, including the patients with normal vitamin D3 levels received 400 to 800 IU per day of vitamin D for the first 6 months after HSCT. Pre-HSCT VDD increased the frequency of aGVHD after transplantation, particularly in HSCTs performed with PBSC for the stem cell source. Pre-transplant low vitamin D3 levels had no association with transplant outcomes such as engraftment, viral infections, alloimmunization, chronic GvHD, total days of hospitalization, and success in terms of transfusion independence. Low vitamin D3 levels before HSCT carry a significant risk for aGVHD. All patients with TM should be screened for VDD before HSCT, and every effort should be made to supplement vitamin D before the transplant in VDD patients.

VITAMIN D AND OPHTHALMOPATHIAS. A REVIEW.

The importance of vitamin D3 (hydroxycholecalciferol) as one of the liposoluble vitamins is known in the prevention and treatment of metabolic bone diseases (rickets, osteomalacia, osteoporosis). In recent years, however, information has increased on the importance of vitamin D3 in numerous organ systems and in the pathogenesis of various diseases, e. g. ophthalmopathies. The immunological functions of vitamin D3 are the subject of studies dealing with autoimmune optic nerve disorders and their results appear to have a positive effect on demyelinating diseases. It also plays an important role in maintaining the thickness of the retinal nerve fiber layer, but its additional administration has not been successful. Optical neuritis may be the first sign of multiple sclerosis. It appears that sufficient serum vitamin D3 levels may protect patients from deterioration in the form of a further attack of demyelination. The course of diabetic retinopathy is probably also influenced by vitamin D3, inter alia, by correlating the fact that its receptor and the enzymes of its metabolism are expressed on the retina. Low serum levels of vitamin D3 may even trigger age-related macular degeneration. Conversely, higher dietary intake of vitamin D3 may positively affect neovascularization. The optimal level of hydroxycholecalciferol is between 60 and 200 nmol /l, the severe deficit represents a decrease below 25 nmol/l. The body can normally produce up to 10,000 IU of this vitamin after exposure to sunlight. However, the demonstration of its protective character in connection with the mentioned diseases of the retina and optic nerve will require a sufficient number of studies to confirm the facts found so far about this rediscovered vitamin.

Vitamin D: A Factor affecting the Success of Type 1 Tympanoplasty.

Vitamin D (VD) plays role in wound healing and protection against infections. The relationship between plasma VD level and the outcomes of Type 1 tympanoplasty (T1T) has not been studied before. A total of 101 patients with chronic otitis media scheduled for T1T were divided into four groups in relation with their VD levels as severe insufficiency, insufficiency, mild-to-modest deficiency and optimal VD level groups. Graft success, hearing improvement and postoperative infection rates were compared among the groups in 12-month follow-up period. The graft success rate (P = 0.014) and air-bone gap gain (P = 0.004) were significantly higher, and postoperative infection rate was significantly lower (P < 0.001) in optimal VD level group. 25-OH VD deficiency should be considered as a factor for failure in T1T. VD replacement may increase success of tympanoplasty in patients with low preoperative serum VD levels.

ODP594 Vitamin D Levels At Hospital Admission Predict Severity Of Covid-19: A Controlled Prospective Study

Abstract Low Vitamin D (VD) levels in COVID-19 patients have been related to increased disease severity and worse outcomes. However, most of these trials designs were not-controlled and retrospective, including patients with demographic differences and biases potentially influencing the reported associations between lower VD levels and severe COVID-19. Aim of this study was to prospectively evaluate VD levels influence on disease severity in a COVID-19 patients cohort matched for age, sex and comorbidities with control subjects. Patients admitted to San Raffaele University Hospital for COVID-19 from March to June 2021 were consecutively enrolled in this study, which was approved by the local IRB, after giving their informed consent. Severe (i. e. those needing high flow oxygen therapy) and non-severe COVID-19 patients matched for age, sex and comorbidities were recruited at admission in Emergency Department (ED). Control subjects from the outpatient Endocrinology Unit of the same Hospital were enrolled in the same period. We excluded patients with comorbidities and therapies influencing VD metabolism. 25OH-VD levels were evaluated at admission in ED and VD deficiency was defined by serum 25OH-VD below 20 ng/mL. A total of 73 COVID-19 patients and 30 control subjects were included in the study. No differences regarding age, sex and comorbidities were found between patients and control groups, but 25OH-VD levels were statistically lower in COVID-19 patients (13.3 vs 23.6 ng/mL, p&amp;lt;0. 001) with a higher prevalence of VD deficiency (75% vs 43%, p=0. 002). After the ED admission, during the hospitalization, a severe disease occurred in a total of 46 COVID-19 patients, and 27 were affected by a non-severe one. No differences regarding age, sex and comorbidities were found between severe vs non-severe groups, but 25OH-VD was significantly lower in the severe one (11.7 vs 16.7 ng/mL, p=0. 007) with a higher prevalence of VD deficiency (85% vs 59%, p=0. 015). We observed lower 25OH-VD levels at admission in patients with non-invasive mechanical ventilation requirement (n.18) and in those admitted in intensive care unit (n.8) during hospitalization, compared to the other patients (p=0. 003 and p=0. 01), although no differences regarding age and comorbidities were found. Moreover, in patients with VD deficiency we found higher levels of inflammatory markers C-reactive protein and ferritin (69 vs 42 mg/L, p=0. 036; 723 vs 414 ng/mL, p=0. 028), and lower SaO2/FiO2 and PaO2/FiO2 ratios (433 vs 447, p=0. 005; 261 vs 311; p&amp;lt;0. 001) at hospital admission. In conclusion, our prospective data confirm that low VD levels are widely found in hospitalized COVID-19 patients compared to control subjects and predict increased disease severity independently from age, sex and comorbidities of patients affected. We suggest that tackling VD deficiency may be an effective preventive measure to prevent severe COVID-19. Presentation: Saturday, June 11, 2022 1:00 p.m. - 3:00 p.m.

Relationship between Maternal Vitamin D Levels and Adverse Outcomes.

Vitamin D (VD), a fat-soluble vitamin, has a variety of functions that are important for growth and development, including regulation of cell differentiation and apoptosis, immune system development, and brain development. As such, VD status during pregnancy is critical for maternal health, fetal skeletal growth, and optimal pregnancy outcomes. Studies have confirmed that adverse pregnancy outcomes, such as preeclampsia, low birth weight, neonatal hypocalcemia, poor postnatal growth, skeletal fragility, and increased incidence of autoimmune diseases, can be associated with low VD levels during pregnancy and infancy. Thus, there is growing interest in the role of VD during pregnancy. This review summarizes the potential adverse health outcomes of maternal VD status during pregnancy for both mother and offspring (gestational diabetes mellitus, hypertensive gestational hypertension, intrauterine growth restriction, miscarriage, stillbirth, and preterm birth) and discusses the underlying mechanisms (regulation of cytokine pathways, immune system processing, internal secretion, placental function, etc.) of VD in regulating each of the outcomes. This review aims to provide a basis for public health intervention strategies to reduce the incidence of adverse pregnancies.

Vitamin D status in children with a psychiatric diagnosis, autism spectrum disorders, or internalizing disorders.

Background and objectiveMultiple studies suggest that children with Autism Spectrum Disorders (ASD) have significantly lower vitamin D3 levels than typically developing children. However, whether vitamin D3 deficiency is more common in children with ASD than in children with other psychiatric disorders remains unclear. This study was conducted to explore the prevalence of vitamin D3 in children with a psychiatric diagnosis including children with ASD or with internalizing disorders (mood and anxiety disorders). In addition, this study investigated the potential associations between vitamin D3 and Body Mass Index (BMI).Materials and methodsClinical data, including BMI and vitamin D3 levels, of 93 children (6–18 years; n = 47; 51% female) with ASD (n = 58) and internalizing disorders (n = 37) were retrospectively analyzed.ResultsIn the overall sample, the prevalence of vitamin D3 deficiency (<50 nmol/L) was 77.4%. Additionally, 75.9% of the children with ASD and 79.5% with internalizing disorders had vitamin D3 deficiency. BMI was inversely related to vitamin D3 in the total group (p = 0.016). The multiple regression model for the total group significantly predicted vitamin D3 (p = 0.022). Age contributed significantly to the prediction. Stratified for sex and primary diagnosis, multiple regression models showed that for boys with ASD, higher BMI levels were associated with lower vitamin D3 levels (p = 0.031); in boys with internalizing disorders and in girls, no relation was found between BMI and vitamin D3 levels.ConclusionIn this this cross-sectional, explorative study high rates of vitamin D3 deficiency in children with different psychiatric disorders were found. The results showed an inverse relation between BMI and vitamin D3 levels in the total group. Vitamin D3 deficiency was particularly common in boys with ASD and obesity. Lifestyle factors may contribute to the association between high BMI and low vitamin D3 levels in boys with ASD. Vitamin D3 deficiency is common in patients with psychiatric disorders and it is highly recommended to increase clinicians’ awareness of this common and remediable risk factor.

Relevance of Vitamin D and Its Deficiency for the Ovarian Follicle and the Oocyte: An Update.

For many years, vitamin D (VD) has been known to be an essential micronutrient with important relevance not only for the skeletal system, but also for numerous other mammalian organ systems. Low levels of VD result in a VD deficiency, which is a global health problem. Moreover, VD deficiencies are linked to several pathologies, for instance, diseases of the cardiovascular system, diabetes mellitus, or sub- and infertility. In the past two decades, an increasing body of evidence has shown that adequate physiological levels of VD are crucial for the female gamete and its microenvironment, and VD deficiency has been associated with decreased live birth rates among women undergoing in vitro fertilization (IVF). With regard to the female reproductive tract, VD receptors (VDRs) have been detected in the ovary, endometrium, and the placenta. Although it has been reported that VD seems to be relevant for both calcium-dependent and independent pathways, its relevance for the oocyte’s developmental competence and life span remains elusive. Therefore, herein, we aim to provide an update on the importance of VD and VD deficiency for the oocyte and the follicular microenvironment.