Low Levels Of Vitamin Research Articles

Assessment of the influence of vitamin D level on the course of chronic hepatitis C in comorbidity with chronic pancreatitis

Background. Chronic hepatitis C (СHC) is often complicated by the presence of concomitant gastrointestinal diseases, one of which is chronic pancreatitis (CP). This has a negative impact on the clinical course of both diseases, contributes to nutrient deficiencies, in particular vitamin D, and worsens the quality of life of patients. The aim of the research was to study the features of the clinical course of CHC in comorbidity with CP and to evaluate the quality of life in patients with different levels of vitamin D in blood serum. Materials and methods. The study included 120 patients who were divided into 2 groups: group 1 — 72 patients with CHC and CP and group 2 — 48 patients with CHC. In turn, patients of group 1, depending on the enzymatic activity of the pancreas, were divided into group 1a (n = 52), which included patients with CHC and CP with exocrine insufficiency (EI), and group 1b (n = 20) — patients with CHC and CP with preserved exocrine function of the pancreas. In all patients, fecal coproscopy was performed, the level of fecal elastase (FE-1), vitamin D, viral load was determined, and the degree of fibrosis and necroinflammatory activity was evaluated using FibroTest and ActiTest. Situational anxiety was assessed according to the Spielberger-Hanin method, and quality of life using the SF-12 questionnaire. The analysis and processing of the results of the examination of patients was carried out using the computer program Jamovi 2.3.2.1, Microsoft Office Excel for Windows 2016 using the Kruskal-Wallis method, the Mann-Whitney-Wilcoxon criterion and the Pearson correlation coefficient. The difference was considered to be statistically significant at p < 0.05. Results. A significantly lower level of vitamin D was found in patients of group 1a than in patients of groups 1b and 2. Patients of group 1 with higher stages of fibrosis (F2–3 and F3–4), a higher degree of necroinflammatory activity in the liver (> A2) and a high viral load have lower levels of vitamin D than those with initial stages of fibrosis and less severe necroinflammatory process in the liver. Patients with CHC, CP and exocrine insufficiency complained of mood changes, increased anxiety, rapid fatigue, and muscle weakness significantly more often than those with preserved exocrine function and patients with CHC. The level of vitamin D in people with CHC, CP and exocrine insufficiency positively correlates with the level of FE-1. In all patients with CHC in comorbidity with CP, a negative effect of low levels of vitamin D on indicators of quality of life and anxiety was found. Conclusions. A reduced level of vitamin D in the blood of patients with CHC and CP worsens the course of the disease and is associated with a decrease in quality of life.

Measurement of Serum Vitamin D Level and its association with Rheumatoid Arthritis, A prospective study at eastern region of Nepal.

Introduction: Rheumatoid arthritis (RA) is a chronic inflammatory autoimmune disease characterized by synovitis. The etiology and pathogenesis of RA remain obscure and many factors may be associated with its pathogenesis. Recent findings support that low levels of serum Vitamin D is associated with an increased risk for the development of RA. Recently, the role of vitamin D deficiency in the pathogenesis of RA, as well as the relationship between vitamin D deficiency and the activity of RA has also been an area of interest for many researchers.
 Objectives: The objectives of this study is to analyse the vitamin D levels in RA patients and investigate the association between the serum levels of vitamin D and disease activity of RA patients from Eastern region of Nepal.
 Methodology: A prospective study was conducted at Birat Medical college teaching hospital, Tankisinwari from September 2022 to August 2023. A total of 150 patients, after fulfilling exclusion and inclusion criteria were enrolled with convenience sampling technique. A control group (n=97) of patients were also enrolled for comparison. After collection of all data, ANOVA test was used to compare continuous variables between control and vitamin D groups.
 Results: Vitamin D deficiency was found in 35 patients (23.3%), Vitamin D insufficiency found in 94 patients (62.6%), and is normal in only 21 patients (14%). Also patients with RA had significantly lower vitamin D levels in comparison to patients with control activity. The difference between these two groups was statistically significant (P<0.05).
 Conclusion: Our study finds a significant inverse relationship between blood vitamin D levels and RA activity. However, due to the small number of patients included in the current study, further research with a larger sample size is needed to gain a better understanding of the relationship between RA activity and vitamin D.

Is vitamin D deficiency associated with retinopathy in type 2 diabetes mellitus? A case-control study

Background and aimsThis study aimed to determine the associations between vitamin D deficiency and diabetic retinopathy (DR) progression risk in type 2 diabetes mellitus (T2DM) patients. MethodsThis is a case-control study that enrolled 201 diabetic retinopathy (DR) patients as case and 201 T2DM without DR as a control. Demographic variables were obtained during an interview using a questionnaire, furthermore, anthropometric measures were evaluated based on the standard protocol. In addition, biochemical indices including 25-hydroxyvitamin D, fasting blood glucose (FBG), insulin, Glycosylated hemoglobin (HbA1c), total cholesterol (TC), LDL-C, HDL-C, and triglyceride (TG) were assessed for all of the participants. Multivariate logistic regression was performed to estimate the relationship between vitamin D and retinopathy. ResultsBased on the statistical analysis of age, sex, and BMI there was no significant difference between the two groups, while the mean concentration of 25-hydroxyvitamin D substantially was lower in case group in comparison with the control group (14.46 VS. 19.88). Furthermore, low levels of vitamin D are associated with DR and consequently proliferative diabetic retinopathy (PDR) in patients with T2DM. ConclusionTotally based on the results of the present study vitamin D deficiency increased the risk of RD in patients with T2DM, also in case of deficiency of this nutrient, retinopathy may develop into PDR type.

The Association Between Rheumatoid Arthritis and Serum Levels of Vitamin D

Objective: To find out the status of vitamin D in patients with Rheumatoid Arthritis. Material and Methods: This comparative study was conducted in Govt Kot Khawaja Saeed Teaching Hospital. Duration of study was from June 2017 to June 2018. A case control study was carried out on 60 patients with Rheumatoid arthritis (age range 25 to 60 years fulfils the criteria of 2010 Rheumatoid arthritis classification. Duration of study was from June 2017 to June 2018. Patients/controls were comprised as group A (30 patients with mild arthritis), group B (30 patients with moderate form of arthritis) and group C (20 age, sex matched healthy controls). Results: Mean age of patients was 36.50 years. Majority of women were house wives with average health status with normal pulse rate and blood pressure. Clinical variables of patients showed the small joint involvement, swelling, tenderness with moderate to severity of disease. It is observed that the level of vitamin D was significantly low in group of patients presented with severe form of arthritis as compared to group of patient who has mild to moderate arthritis. Study also observed that both group of patient has significantly low levels of vitamin D as compared to controls. Conclusions: Vitamin D deficiency is observed in patients with rheumatoid arthritis, and may be linked to severity in RA. It is therefore a need of supplementation of Vitamin D for the pain relief in RApatients.

Vitamin and microelement status and somato­sexual development of adolescents with type 1 diabetes

Objective — to study peculiarities of the state of vitamin and microelement provision in children and adolescents with type 1 diabetes with the physiological and pathological course of puberty.
 Materials and methods. The study involved 143 patients (75 boys and 68 girls) with type 1 diabetes aged 10 to 17 years. The level of retinol, tocopherol, 25(OH)D3 and Zn concentration were determined in blood serum.Results and discussion. The gender characteristics of vitamin and microelement imbalance in adolescents with type type 1 diabetes were determined, the nature of which depended on the course of puberty. Among boys with type 1 diabetes under the conditions of harmonious physical development (PD), an increase in the percentage of low levels of vitamin E was recorded more often than in girls (39.1 vs. 12.2 %, рφ < 0.02). In girls with a disharmonious type of PD with increased body weight and high height, there was an increase in the frequency of high levels of vitamin E (48.1 %) under conditions of a normal level of retinol (37.0 %). In boys with high height and body weight disorders, an increased level of Zn (64.3 %) and an increase in the frequency of pronounced vitamin D deficiency (47.6 %) were recorded more often. Only 9.5 % of patients had vitamin D levels that corresponded to the optimal level of provision. In girls with disharmonious PD, the level of 25(OH)D3 was higher than in boys and was (19.06 ± 1.51) and (13.10 ± 1.53) ng/ml, respectively; (рu < 0.002). Under the conditions of disharmonious PD boys had lower values of vitamin A (52.2 vs. 29.6 %, рφ < 0.05) and vitamin E (39.1 vs. 3.7 %, рφ < 0.05) compared to girls. In boys with the physiological course of sexual development (SD), in comparison with girls, a decrease in the level of zinc, retinol and tocopherol was more often registered. Under the conditions of SD disorders, a reduced level of vitamin A was more often registered in girls (66.7 vs. 35.7 %, рφ < 0.03) with a simultaneous decrease in the frequency of its elevated values (8.3 vs. 37.5 %, рφ < 0.01) relative to patients with a physiological course of SD. At the same time, normal levels of vitamin E were recorded more often. Under conditions of sexual development delay in boys, the frequency of normal values of vitamin E was decreased compared to girls. Аt the same time, pronounced deficiency of vitamin D was more often registered in boys with a simultaneous decrease in the frequency of its suboptimal level.
 Conclusions. Based on the results of the study, a relationship between indicators of vitamin and microelement status and somatic and sexual development in adolescents with type I diabetes was established. The tension of reserves of vitamins A, E, D and the imbalance of zinc concentration were found in boys with disharmonious physical development. Sexual development delay in boys was accompanied by a deterioration in the nature of providing the body with vitamins D and E.

Thyroid nodule malignancy is associated with increased non-invasive hepatic fibrosis scores in metabolic subjects.

Thyroid cancer incidence is increasing, and adiposity-related conditions are gaining space in its pathogenesis. In this study, we aimed to detect any anthropometric, biohumoral, and clinical features that might be associated with thyroid nodule malignancy, potentially representing novel non-invasive markers of thyroid cancer. The study was conducted in a group of 142 consecutive outpatients (47 men and 95 women) who underwent fine-needle aspiration biopsy/cytology (FNAB/C) due to suspicion of malignancy from January 2018 to September 2022. We compared lipid and glycemic blood profiles as well as non-invasive liver fibrosis indexes such as aspartate aminotransferase (AST) to alanine aminotransferase (ALT) ratio (AAR), AST to platelet ratio index (APRI), and fibrosis index based on four factors (FIB-4) between patients with benign and malignant newly diagnosed nodules. Then, we performed receiver operating characteristic (ROC) analysis to assess their best cutoff values for discrimination of malignant nodules and chi-squared test to evaluate the association of specific dysmetabolic conditions with malignancy. To understand whether and to what degree dysmetabolic conditions increased the risk of thyroid nodule malignancy, we also calculated the odds ratio (OR) of the main biomarkers. After FNAB/C, 121 (85%) patients were diagnosed with benign thyroid nodules, while 21 (15%) individuals were diagnosed with thyroid cancer. Comparing patients with benign and malignant nodules, we found that individuals with thyroid cancer exhibited increased body mass index (BMI) (p = 0.048) and fasting plasma glucose (p = 0.046). Intriguingly, considering non-invasive scores for liver fibrosis, subjects with thyroid cancer presented increased AAR (p < 0.001) and APRI (p = 0.007), and these scores were associated with malignancy (p < 0.005) with OR = 7.1 and OR = 5, respectively. Moreover, we showed that only in the cancer group, low levels of vitamin D correlated with stigmata of impaired metabolism. In our study, AAR and APRI scores were associated with thyroid nodule malignancy and could be used to predict it and to speed up the diagnostic process. From a pathogenic point of view, we speculated that metabolic-associated fatty liver disease (MAFLD) along with hyperglycemia and vitamin D deficiency may represent putative drivers of thyroid carcinogenesis.

Association between VDR genetic polymorphisms and risk of gestational diabetes mellitus in the Chinese population.

Abnormal metabolism of vitamin D was the primary mechanism in many pregnancy diseases. Our study was the first to examine the hypothesis that VDR gene polymorphisms contribute to the risk of gestational diabetes mellitus (GDM) in the Chinese population at high altitudes. One hundred and eighteen women with GDM and 104 women with normal glucose tolerance (NGT) were included in this study using a case-control design. Four single nucleotide polymorphisms (g.47879112G>A, g.47846052C>T, g.47844974A>G, and g.47845054C>A) of mother and fetus were genotyped. Maternal and fetal frequency of the A allele of g.47879112G>A was significantly increased in women with GDM than in those with NGT (p<.05). A correlation between the AA homozygous genotype of g.47879112G>A and GDM was noted. Compared with non-carriers, A allele carriers showed higher fasting plasma insulin and two-hour post-challenge plasma glucose (2h-PPG), and lower levels of vitamin D. Furthermore, both maternal and fetal 4-marker haplotype ACCG were found to be significantly associated with GDM (p<.05). Association and haplotype analysis indicated that the A allele of g.47879112G>A could be a risk factor for GDM development in the Chinese population at high altitudes. Additionally, the VDR gene polymorphism of the fetus and mother may have a synergistic effect. The VDR polymorphism is associated with an increased risk of GDM and may be useful for predicting the development of the disease.

Vitamin E and Supplements Offer Eye Neuroprotection – Myth or Reality?

Background: Several studies suggested that nutrition might have an effect on eye health. Although exposure to nutrients is ubiquitous, on the other hand without it, we generally cannot survive and an exposure too high or too low causes health problems. Vitamins are a good example and the ubiquitous exposure to vitamins has led to many epidemiological studies for many diseases, including glaucoma.&#x0D; Abstract: Leading causes of vision loss include several eye conditions such as cataract and glaucoma. The role of nutritional supplementation to prevent the progression of ocular disease is of great interest to health care professionals. It is recognized that the crystalline lens and retina suffer oxidative damage and the most protective agents are anti-oxidant vitamins A, C and E. The Age-Related Eye Disease Study (AREDS), found that supplementation with vitamins C and E, reduced the risk of developing various ocular diseases. The RDA for vitamin E is 15 mg/day α-tocopherol for both women and men. Vitamin E exists naturally in nuts and seeds, in addition to dark leafy vegetables. In a recent study reported lower plasma levels of vitamin E in POAG subjects.&#x0D; Conclusion: In conclusion, exposure to nutrients although is ubiquitous, without it, in general we cannot survive. Conflicting evidence is presented for vitamins A and E in prevention of ocular disease. A number of epidemiological studies showed an increased risk of nuclear or cortical cataract in people with low blood levels of vitamin E. Furthermore, a number of studies suggested that nutrition might have an effect on the intraocular pressure (IOP) or glaucoma, arbitrated by oxidative stress.

Hypovitaminosis D in persons with Down syndrome and autism spectrum disorder

BackgroundPlasma levels of vitamin D have been reported to be low in persons with Down syndrome (DS) and existing data is limited to small and homogenous cohorts. This is of particular importance in persons with DS given the high rates of autoimmune disease in this population and the known relationship between vitamin D and immune function. This study sought to investigate vitamin D status in a multi-center cohort of individuals with DS and compare them to individuals with autism spectrum disorder (ASD) and neurotypical (NT) controls.MethodsA retrospective, multi-center review was performed. The three sites were located at latitudes of 42.361145, 37.44466, and 34.05349. Patients were identified by the International Classification of Diseases (ICD)-9 or ICD-10 codes for DS, ASD, or well-child check visits for NT individuals. The first vitamin D 25-OH level recorded in the electronic medical record (EMR) was used in this study as it was felt to be the most reflective of a natural and non-supplemented state. Vitamin D 25-OH levels below 30 ng/mL were considered deficient.ResultsIn total, 1624 individuals with DS, 5208 with ASD, and 30,775 NT controls were identified. Individuals with DS had the lowest mean level of vitamin D 25-OH at 20.67 ng/mL, compared to those with ASD (23.48 ng/mL) and NT controls (29.20 ng/mL) (p < 0.001, 95% CI: −8.97 to −6.44). A total of 399 (24.6%) individuals with DS were considered vitamin D deficient compared to 1472 (28.3%) with ASD and 12,397 (40.3%) NT controls (p < 0.001, 95% CI: −5.43 to −2.36). Individuals with DS with higher body mass index (BMI) were found to be more likely to have lower levels of vitamin D (p < 0.001, 95% CI: −0.3849 to −0.1509). Additionally, having both DS and a neurologic diagnosis increased the likelihood of having lower vitamin D levels (p < 0.001, 95% CI: −5.02 to −1.28). Individuals with DS and autoimmune disease were much more likely to have lower vitamin D levels (p < 0.001, 95% CI: −6.22 to −1.55). Similarly, a history of autoimmunity in a first-degree relative also increased the likelihood of having lower levels of vitamin D in persons with DS (p = 0.01, 95% CI: −2.45 to −0.63).ConclusionsIndividuals with DS were noted to have hypovitaminosis D in comparison to individuals with ASD and NT controls. Associations between vitamin D deficiency and high BMI, personal autoimmunity, and familial autoimmunity were present in individuals with DS.

The Role of Vitamin D and Its Molecular Bases in Insulin Resistance, Diabetes, Metabolic Syndrome, and Cardiovascular Disease: State of the Art.

In the last decade, an increasing awareness was directed to the role of Vitamin D in non-skeletal and preventive roles for chronic diseases. Vitamin D is an essential hormone in regulating calcium/phosphorous balance and in the pathogenesis of inflammation, insulin resistance, and obesity. The main forms of vitamin D, Cholecalciferol (Vitamin D3) and Ergocalciferol (Vitamin D2) are converted into the active form (1,25-dihydroxyvitamin D) thanks to two hydroxylations in the liver, kidney, pancreas, and immune cells. Some anti-inflammatory cytokines are produced at higher levels by vitamin D, while some pro-inflammatory cytokines are released at lower levels. Toll-Like Receptor (TLR) expression is increased, and a pro-inflammatory state is also linked to low levels of vitamin D. Regardless of how it affects inflammation, various pathways suggest that vitamin D directly improves insulin sensitivity and secretion. The level of vitamin D in the body may change the ratio of pro- to anti-inflammatory cytokines, which would impact insulin action, lipid metabolism, and the development and function of adipose tissue. Many studies have demonstrated an inverse relationship between vitamin D concentrations and pro-inflammatory markers, insulin resistance, glucose intolerance, metabolic syndrome, obesity, and cardiovascular disease. It is interesting to note that several long-term studies also revealed an inverse correlation between vitamin D levels and the occurrence of diabetes mellitus. Vitamin D supplementation in people has controversial effects. While some studies demonstrated improvements in insulin sensitivity, glucose, and lipid metabolism, others revealed no significant effect on glycemic homeostasis and inflammation. This review aims to provide insight into the molecular basis of the relationship between vitamin D, insulin resistance, metabolic syndrome, type 1 and 2 diabetes, gestational diabetes, and cardiovascular diseases.

“Impact Of Metformin Therpy on Serum Cobalamin and Homocysteine Among the Type II Diabetes Mellitus Patients”

Objective: The aim of the study is to observe the long-term treatment of metformin and its associated effect on Vitamin B12 among Type II Diabetes mellitus south Indian patients. Methods: An observational study conducted over a period of 54 months on Type II Diabetes mellitus patients who are in chronic therapy with metformin. The study described the Vitamin B12 levels among the Type II DM patients, which could alert the patients who are in the low and borderline range of serum Vitamin B12, which may prevent the risk of peripheral neuropathic complications and anaemic conditions, etc. Findings: Totally, 387 patients were enrolled as per the inclusion and exclusion criteria, including 232 males (59.94%) and 155 females (40.05%). A total of 39 patients had been observed to have low levels of Vitamin B12, among them 23 females (Mean 184.17 ± S.D. 10.69) and 16 males (Mean 185.31± S.D 7.56), followed by 16 patients found to be above the normal range of Vitamin B12, among them 02 females (Mean 991 ± S.D. 15.55) and 14 males (Mean 1578.14 ± S.D. 406.93), followed by 76 patients had been found to be borderline of Vitamin B12, among them 43 females (Mean 220.76 ± S.D 6.50). Conclusion: High doses of chronic Metformin therapy may alter Vitamin B12 levels. Some of the patients had an abnormally high level of serum Vitamin B12, whose medical condition should be ruled out, and such Patients’ diet histories were also cross-examined, which was a mixed normal diet, and they had various medical conditions. However, the high chances of metformin-associated effects on Vitamin B12 with higher doses and long-term therapy of metformin, whose duration was 10 to 20 years, Moreover, age is also an important factor, and the study reveals that, among genders, female populations had a higher rate of low-level Vitamin B12 than male populations. Patients in the age group between 50 and 65 years had a higher rate of low-level Vitamin B12 than other age groups, total 20 patients, among them 12 females (Mean 183.08 ± S.D. 13.17) and 8 males (Mean 185.5 ± S.D. 4.3). Patients with other comorbid conditions also had low levels and borderline levels of Vitamin B12 and had been on long-term metformin therapy. Further, homocysteine investigations had been done on low and borderline vitamin B12 patients. Investigation of homocysteine had been done on low range (39) and border line (76) of vitamin B12 patients. Among Low vitamin B12, 13 patients have elevated level of Homocysteine (6 males &amp; 7 females). Among border line of vitamin B12, 4 patients (2 males and 3 females) have elevated level of Homocysteine. Therefore, our study concluded that chronic therapy and higher doses of metformin may lead to a deficit in serum Vitamin B12, which requires regular checks on Vitamin B12 among Type 2 DM patients to avoid the risk of Peripheral neuropathy and other complications.

THU443 Acute Iridocyclitis Associated With Intravenous Zoledronic Acid

Abstract Disclosure: A.R. Ankireddypalli: None. S.D. Sibley: None. Introduction: Bisphosphonates are widely used for osteoporosis. Intravenous (IV) zoledronic acid (ZA) is frequently prescribed in cases of oral bisphosphonate intolerance or noncompliance. Well known immediate ZA side effects include flu-like symptoms such as nausea, myalgias and fever. Here we report a case of a rare side effect of acute anterior uveitis following initial ZA dosing. CASE: A 71-year-old female was diagnosed with osteoporosis; DEXA scan had lowest T score of -2.6 at the lumbar spine. Vitamin D level was 10 ng/mL. She received calcium and vitamin D supplementation. Two months later vitamin D level was 31 ng/mL. ZA was recommended due to difficulty with adherence to oral bisphosphonate. Five days after infusion she presented to our emergency department (ED) with progressive symptoms of bilateral eye itching, redness, excessive tearing, blurry vision, photosensitivity, floaters, pain and headaches that had begun 1 day post infusion. She’d had 2 prior outside ED visits for these symptoms and received polymyxin B and later ofloxacin eye drops which did not relieve them. She denied fever, chills, arthralgias and myalgia. She denied any prior known autoimmune disorder or prior history of eye symptoms. On examination she was afebrile and had bilateral conjunctival injection, excess tearing and watery discharge. She was discharged with olopatadine eye drops and cetirizine, diagnosed with allergic conjunctivitis, and referred to ophthalmology. On ophthalmic exam 7 days after her infusion, visual acuity was 20/60 in the right eye, and 20/60 in the left eye. Intraocular pressure was 12 mmHg in the right eye and 16 mmHg in the left eye. Slit lamp eye exam showed diffuse conjunctival injection of the right eye, mild corneal endothelial folds, and flare with cells in anterior chamber and synechiae posterior to the iris. Right acute iridocyclitis was diagnosed, she received prednisolone eye drops and cyclopentolate eye drops. Symptoms improved in 1 week with almost complete resolution after 3 weeks of therapy. She has not had a recurrence of these symptoms; she has declined future treatment with ZA. Conclusion: ZA-associated ocular inflammation is a rare but serious side effect. This adverse effect has been hypothesized to be associated with increased levels of pro-inflammatory cytokines including Interleukin (IL)-1, IL-6, and tumor necrosis factor (TNF)-alpha. As with other acute phase reactions to ZA, it does not appear that ocular inflammation tends to recur with subsequent ZA. Optimizing vitamin D levels prior to treatment may help to prevent this condition. There is some evidence for higher rates of acute phase reaction in patients with lower levels of vitamin D but this patient’s vitamin D status was adequate at the time of treatment. Clinicians should be aware of the rare occurrence of post-ZA ocular inflammation. Early recognition and prompt treatment are essential. Presentation: Thursday, June 15, 2023

Vitamin D3 Inhibits the Viability of Breast Cancer Cells In Vitro and Ehrlich Ascites Carcinomas in Mice by Promoting Apoptosis and Cell Cycle Arrest and by Impeding Tumor Angiogenesis.

The incidence of aggressive and resistant breast cancers is growing at alarming rates, indicating a necessity to develop better treatment strategies. Recent epidemiological and preclinical studies detected low serum levels of vitamin D in cancer patients, suggesting that vitamin D may be effective in mitigating the cancer burden. However, the molecular mechanisms of vitamin D3 (cholecalciferol, vit-D3)-induced cancer cell death are not fully elucidated. The vit-D3 efficacy of cell death activation was assessed using breast carcinoma cell lines in vitro and a widely used Ehrlich ascites carcinoma (EAC) breast cancer model in vivo in Swiss albino mice. Both estrogen receptor-positive (ER+, MCF-7) and -negative (ER-, MDA-MB-231, and MDA-MB-468) cell lines absorbed about 50% of vit-D3 in vitro over 48 h of incubation. The absorbed vit-D3 retarded the breast cancer cell proliferation in a dose-dependent manner with IC50 values ranging from 0.10 to 0.35 mM. Prolonged treatment (up to 72 h) did not enhance vit-D3 anti-proliferative efficacy. Vit-D3-induced cell growth arrest was mediated by the upregulation of p53 and the downregulation of cyclin-D1 and Bcl2 expression levels. Vit-D3 retarded cell migration and inhibited blood vessel growth in vitro as well as in a chorioallantoic membrane (CAM) assay. The intraperitoneal administration of vit-D3 inhibited solid tumor growth and reduced body weight gain, as assessed in mice using a liquid tumor model. In summary, vit-D3 cytotoxic effects in breast cancer cell lines in vitro and an EAC model in vivo were associated with growth inhibition, the induction of apoptosis, cell cycle arrest, and the impediment of angiogenic processes. The generated data warrant further studies on vit-D3 anti-cancer therapeutic applications.

Nutritional Rickets Among Children: A Retrospective Study from Saudi Arabia.

Nutritional rickets remains a significant concern in certain countries, with increasing prevalence attributed to factors such as limited sunlight exposure and undernourishment. This study aimed to identify the factors associated with rickets due to nutritional deficiency in children from Jazan Province, southwestern Saudi Arabia. A retrospective cross-sectional study was conducted using descriptive data from medical records at a tertiary hospital in Jazan Province. Records of patients diagnosed with rickets between January 2010 and December 2020 were analyzed. Symptomatic rickets cases from pediatric clinics were included, and diagnoses were based on biochemical and clinical tests. Risk factors were assessed using patient medical records. Data were analyzed using percentages, mean, and standard deviation. The study included 84 patients with rickets (53 females and 31 males), primarily between 11-18 years old. The mean body mass index (BMI) of the participants was 21.21. The most common risk factor was nutritional deficiencies, including vitamin D deficiency or calcium deficiency, with 75 patients reporting a family history of vitamin D deficiency. The children had limited sunlight exposure and low levels of calcium and vitamin D. Malnutrition was identified as the highest risk factor for rickets in the study population. Nutritional rickets appears to be prevalent in the Jazan Province, emphasizing the need for government organizations to address this preventable disease. Adequate sun exposure and recommended dietary vitamin D intake are crucial to prevent rickets, as this study detected inadequate levels of calcium and vitamin D in children. National studies are required to further identify risk factors and develop appropriate strategies.

DETERMINATION OF CHANGES IN VITAMIN D, FOLIC ACID AND VITAMIN B12 LEVELS IN PATIENTS PRESENTING TO THE EMERGENCY DEPARTMENT AFTER SUICIDAL INTERVENTIONS

ABSTRACT&#x0D; &#x0D; Introduction: Depression is a psychological and physiological destruction process. In recent years, it has been one of the leading causes of public health problems in our country and in the world. Patients with depressive mood are at a higher risk compared to the normal population in terms of realizing suicidal ideation. Since the first place of application after a suicide attempt is usually the emergency services, the studies carried out in the ED are extremely important in this sense.&#x0D; Methods: Data in the study were analyzed using SPSS Data:23.0 (SPSS Inc., Chicago, Illinois, USA). Continuous variables were expressed as mean ± standard deviation (SD). In the evaluation of the data, the significance test of the difference between the two means (Independent t test) was used when the parametric test assumptions were fulfilled, and the Man Whitney U test was used when the parametric test assumptions were not fulfilled.&#x0D; Results: In our study, we compared the levels of vitamin D, folic acid and vitamin B12 in patients who applied to the emergency department after a suicide attempt with the normal population. Vitamin D and vitamin B12 levels were found to be significantly lower in the patient group compared to the control group.&#x0D; Conclusions: Our current clinical study supports many studies in the literature, with the detection of low levels of vitamin D and vitamin B12 after the examinations of the patient group who came to the emergency room with a depressive episode and the control group.

PCOS and vitamin D: a clinical appraisal.

Polycystic ovary syndrome (PCOS) is the most common endocrine-reproductive disease linked not just to infertility but also to serious comorbidities. There is a reported association between low vitamin D levels and multiple health conditions including PCOS. This narrative review aims to analyze the role of vitamin D in PCOS development, use of the vitamin D in the treatment of PCOS, and the molecular basis of these observations. A Medline and PubMed research was performed, during the years 1990-2023, using a combination of keywords on such topic. According to the author's evaluation and target, papers were identified and included for a narrative review. There are associations between lower levels of vitamin D and PCOS, as well as with insulin resistance, metabolic syndrome, hyperandrogenemia, metabolic and endocrine disorders as well as the onset of oxidative stress and pro-inflammatory milieu, in PCOS women. Vitamin D has a role in pathologic changes linked to PCOS. Molecular and clinical investigations which give new information about the role of vitamin D in the development of PCOS and related endocrine and metabolic disturbance are further needed.

The Impact of B12 Vitamin and Folate Deficiency on Depression Levels in Breast Cancer Patients

Objective: This study aims to investigate the impact of B12 vitamin and folate deficiency on depression levels in breast cancer patients. Material and Methods: A total of 99 breast cancer patients were included in the study, and sociodemographic data, treatment information, and lifestyle factors were recorded. Depression levels were evaluated using the Beck Depression Inventory, and B12 and folate levels were measured through laboratory tests. Statistical analyses were performed using the SPSS software, and the Mann-Whitney U test was used. Results: Patients who smoked and used alcohol had significantly higher depression scores (p=0.009 and p=0.028, respectively). Additionally, patients with low B12 vitamin levels had significantly higher depression scores (p=0.036). Similarly, patients with folate deficiency also had higher depression scores (p=0.015). Conclusion: This study demonstrates that B12 and folate deficiency can increase depression levels in breast cancer patients. Correcting B12 and folate levels in the management of depression may help improve the quality of life and positively influence the treatment process. Regular monitoring of B12 and folate levels and providing necessary treatment and support are essential in clinical practice.

The association between umbilical cord blood fat-soluble vitamin concentrations and infant birth weight.

Fat-soluble vitamins, including vitamins A, D and E, play an important role in the regulation of glucose and lipid metabolism, and may affect infant birth weight. Evidence on the association of birthweight with fat-soluble vitamins is controversial. Therefore, this study aims is to determine the associations of birthweight with vitamin A, D, and E concentrations in cord blood. A total of 199 mother-infant pairs were enrolled in the study. According to gestational age and birth weight, the mother-infant pairs were divided into small for gestational age (SGA), appropriate for gestational age (AGA), and large for gestational age (LGA). The Vitamin A, D, and E concentrations in serum were measured by high-performance liquid chromatography tandem-mass spectrometry. The concentrations of vitamin A in the SGA group were significantly lower than those in the AGA and LGA groups. The concentrations of vitamin E in the SGA group were significantly higher than those in the AGA and LGA groups. However, no significant differences were observed in vitamin D among the three groups. Being male (β = 0.317, p < 0.001) and birth weight (β = 0.229, p = 0.014) were positively correlated with the levels of vitamin A. Birth weight (β = -0.213, p= 0.026) was correlated with lower levels of vitamin E. No correlation was found between influencing Factors and the levels of vitamin D (p> 0.05). After adjusting for gestational age, sex, mother's age, delivery mode, pre-pregnancy BMI, and weight gain during pregnancy, the levels of cord blood vitamin A were positively correlated with birth weight (p=0.012). The infant's birth weight is associated with the levels of cord blood vitamins A and E. The dysregulation of vitamins A and E in infants may be a risk factor for fetal growth and future metabolic diseases.

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

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

The Association between Vitamin D, Interleukin-4, and Interleukin-10 Levels and CD23+ Expression with Bronchial Asthma in Stunted Children.

Children with stunted growth have an increased risk of wheezing, and studies have shown that low levels of vitamin D and interleukin (IL)-10, along with increased IL-4 levels and CD23+ expression, are present in stunted and asthmatic children. To date, it is not known whether these factors are related to the incidence of asthma in stunted children. This case-control study investigated the association between vitamin D, IL-4, and IL-10 levels and CD23+ expression with bronchial asthma in stunted children. The study included 99 children aged 24-59 months, i.e., 37 stunted-sthmatic children (cases), 38 stunted children without asthma, and 24 non-stunted children with asthma. All children were tested for their 25(OH)D levels using chemiluminescent immunoassay (CLIA), IL-4 and IL-10 levels were measured through enzyme-linked immunosorbent assay (ELISA) testing, and CD23+ expression was measured through flow cytometry bead testing. The data were analyzed using chi-squared, Kruskal-Wallis, and Mann-Whitney tests. The results showed that stunted asthmatic children had a higher incidence of atopic family members than those without asthma. Additionally, stunted asthmatic children had a higher prevalence of vitamin D deficiency (48.6%) than the control group (44.7% and 20.8%). Furthermore, stunted asthmatic children had significantly lower levels of 25(OH)D [20.55 (16.18-25.55), p = 0.042] and higher levels of IL-4 [1.41 (0.95-2.40), p = 0.038], although there were no significant differences in IL-10 levels and CD23+ expression. The study concluded that low vitamin D and high IL-4 levels are associated with bronchial asthma in stunted children, while IL-10 and CD23+ do not show a significant association.