Mean Serum 25OHD Concentration Research Articles

Vitamin D Status in Diabetic Moroccan Children And Adolescents: a Case-control Study

Background: Type 1 diabetes mellitus (T1DM) incidence is currently increasing worldwide, and different environmental players along with genetic predisposition, could be involved as powerful triggers of this disease onset. In this study, we aim to shed the light on the relationship between 25OHD deficiency and T1DM. Patients and methods: A case-control study was laid out to compare serum 25OHD level between T1DM patients and controls. A total of 147 T1DM patients aged under 19 years old were recruited from our Endocrinology-Diabetology and Nutrition department between October 2014 and December 2019. A total of 147 controls were randomly enlisted from clinical biochemistry laboratory of our center, and were carefully matched. The levels of 25OHD in the serum were determined in T1DM patients and nondiabetic controls. Results: Average serum 25OHD concentration was established in both groups; reaching 19,29 ±6,13 ng/ml in the control arm and 15,02 ± 6,48 ng/ml in the selected group with T1DM independently of the disease duration. However, the mean serum 25OHD concentration was not significantly different between the two T1DM subgroups according to diabetes duration below or above 5 years, and 25OHD concentration remained lower either in winter or summer months. A negative correlation was noticed between HbA1c and serum 25 OHD concentration in T1DM patients and was statistically significant (p<0,05). Conclusion: Key messages on the importance of vitamin D status, particularly in diabetic children and adolescents, should be spread widely in order to start a suitable vitamin supplementation, and establish guidelines regarding its timing at adequate recommended doses..

Maternal Vitamin D and Newborn Telomere Length.

Nutrition is important during pregnancy for offspring health. Gestational vitamin D intake may prevent several adverse outcomes and might have an influence on offspring telomere length (TL). In this study, we want to assess the association between maternal vitamin D intake during pregnancy and newborn TL, as reflected by cord blood TL. We studied mother–child pairs enrolled in the Maternal Nutrition and Offspring’s Epigenome (MANOE) cohort, Leuven, Belgium. To calculate the dietary vitamin D intake, 108 women were asked to keep track of their diet using the seven-day estimated diet record (EDR) method. TL was assessed in 108 cord blood using a quantitative real-time PCR method. In each trimester of pregnancy, maternal serum 25-hydroxyvitamin D (25-OHD) concentration was measured. We observed a positive association (β = 0.009, p-value = 0.036) between newborn average relative TL and maternal vitamin D intake (diet + supplement) during the first trimester. In contrast, we found no association between average relative TL of the newborn and mean maternal serum 25-OHD concentrations during pregnancy. To conclude, vitamin D intake (diet + supplements), specifically during the first trimester of pregnancy, is an important factor associated with TL at birth.

Serum 25-hydroxyvitamin D concentration among users of a referral outpatient unit for vascular diseases and associated factors.

Assess serum 25-hydroxyvitamin D (25OHD) concentration and associated factors among users of a referral outpatient unit for vascular diseases in Southern Brazil. Cross-sectional study conducted for almost one year, from March 2016 to January 2017. The serum vitamin D level was determined biochemically and classified as: sufficient (>50nmol/L), insufficient (30-50nmol/L) and deficient (<30nmol/L). Associations were tested through multiple linear regression. At a reference outpatient clinic specialized in vascular diseases located in a southern Brazilian medium-sized city (latitude 29°S). Consecutive sample of 133 individuals of both sexes, aged at least 40 years. The mean serum 25OHD concentration was 54.9±25.9nmol/L (57.7±27.9nmol/L for men; 52.2±24.2nmol/L for women, p=0.267). A total of 12.8% of the participants had vitamin D deficiency and 32.3% had insufficiency. Regarding the total sample, variables associated to the serum 25OHD concentration were: age (β=-0.55; CI95%-0.95;-0.17), sun exposure (β=1.22; CI95% 0.32; 2.10) and vitamin D intake (β=7.29; CI95% 2.10; 12.48). Among men, a significant association was observed for age (β=-0.82; CI95%-1.47;-0.17, p=0.015) and borderline for sun exposure (β=1.22; CI95% 0.32; 2.10, p=0.053). Among women, only vitamin D intake was significantly associated with serum concentration of this vitamin (β=8.74; CI95% 1.32; 16.17, p=0.022). Although the mean 25OHD concentration was greater than 50nmol/L, about 45% of this consecutive sample presented poor vitamin D nutritional status. Unadjusted for seasonality, factors associated with serum 25OHD concentration were age and sun exposure among men and vitamin D intake among women.

Serum 25-hydroxyvitamin D concentration in childhood and risk of islet autoimmunity and type 1 diabetes: the TRIGR nested case\u2013control ancillary study

Aims/hypothesisOur aim was to study the association between serum 25-hydroxyvitamin D (25OHD) concentration and islet autoimmunity and type 1 diabetes in children with an increased genetic risk of type 1 diabetes.MethodsSerum samples for 25OHD measurements were obtained in the Trial to Reduce IDDM in the Genetically at Risk (TRIGR) ancillary study (Divia) from children in 15 countries. Case children (n = 244) were defined as having positivity for at least two out of four diabetes-associated autoantibodies measured at any one sample. For each case child, two control children were selected matched for country and date of birth (±1 year) (n = 488). Of the case children, 144 developed type 1 diabetes. Serum 25OHD was measured repeatedly in infancy and childhood and was compared according to age at the first seroconversion (at 6, 12 and 18 months prior to and at seroconversion) and calendar age (0, 6, 12 and 18 months).ResultsIn children with islet autoimmunity, mean serum 25OHD concentration was lower 18 months prior to the age of first seroconversion of the case children compared with the control children (57.7 vs 64.8 nmol/l, p = 0.007). In children with type 1 diabetes (n = 144), mean serum 25OHD concentration was lower 18 months prior to the age of the first seroconversion (58.0 vs 65.0 nmol/l, p = 0.018) and at the calendar age of 12 months (70.1 vs 75.9 nmol/l, p = 0.031) than in their control counterparts. Analyses were adjusted for month of sample collection, human leucocyte antigen genotype, maternal type 1 diabetes and sex.Conclusions/interpretationThe results suggest that early postnatal vitamin D may confer protection against the development of type 1 diabetes.Trial registrationClinicalTrials.gov NCT00179777

Comparative effectiveness of vitamin D supplementation via buccal spray versus oral supplements on 25(OH)D concentrations: a systematic review

AbstractVitamin D (vitD) deficiency is the most common nutritional deficiency worldwide. Most patients are treated with oral vitD capsules (either vitD2 or vitD3). A few studies have reported equal efficacy of buccal spray vitD. This is a new formulation that is absorbed via the oral mucosa into the systemic circulation, bypassing the gastrointestinal route. The main objective of this systematic review was to identify RCT evidence for the comparative effectiveness of buccal spray versus oral vitD on serum 25-hydroxyvitaminD [25-OHD] concentrations and any adverse effects of buccal spray vitD. We have published an a priori protocol using Joanna Briggs Institute (JBI) methodology (PROSPERO CRD42018118580). A three-step search strategy to identify RCTs was conducted, which reported serum 25-OHD concentrations from five databases from 2008–2018. Retrieved abstracts were screened; included papers imported into JBI SUMARI and assessed for study quality (GRADE) by two authors. Meta-analysis was planned. Three RCTs met our inclusion criteria. Due to heterogeneity of studies, meta-analysis was not possible. In a RCT crossover study, mean serum 25-OHD concentrations were significantly higher in patients with malabsorption syndrome (n = 20) on 1000IU buccal spray + 117.8%(10.46, 95%CI6.89,14.03ng/ml) vs.1000IU oral vitD3 + 36.02%(3.96, 95%CI2.37, 5.56ng/ml) at 30days (p &lt; 0.0001). Mean serum 25-OHD were also significantly higher in healthy adults (n = 20) on buccal spray + 42.99%(7.995, 95%CI6.86,9.13ng/ml)vs.oral vitD3 + 21.72%(4.06, 95%CI3.41,4.71ng/ml) at 30days (p &lt; 0.0001). In another RCT crossover study, ANCOVA revealed no significant difference in the mean and SD change from baseline total 25-OHD concentrations in adults (n = 22) on 3000IU buccal spray vs. 3000IU oral vitD3 + 44%,26.15 (SD17.85) vs. + 51%,30.38 (SD17.91)nmol/l, respectively;F = 1.044, adjusted r20.493,p = 0.313 at 4 weeks. In a RCT, 800IU buccal spray was equally effective as 750IU oral vitD3 in children with neurodisabilities(n = 24) at 3 months. Both groups had a significant increase in 25-OHD; 11.5 ng/ml(median8–19) to 26.5(13.6–39)ng/ml and 15.5ng/ml(8–20) to 34.5(22–49)ng/ml, respectively (z = 150;p &lt; 0.0001). The overall certainty of evidence was very low to moderate. No adverse effects were reported. The evidence from these studies suggests that 800IU-3000IU doses of buccal spray vitD3 given daily may be an effective alternative as oral vitD3 in obtaining short-term haematological responses in serum 25-OHD concentrations. Buccal spray vitD3 may be a useful alternative for patients with intestinal malabsorption or dysphagia. Future research should compare buccal spray VD3 to intramuscular injections and confirm these findings in well-designed trials.

Vitamin D deficiency in school-age Iranian children with attention-deficit/hyperactivity disorder (ADHD) symptoms: A critical comparison with healthy controls

ABSTRACTThe associations between serum vitamin D levels and the severity of attention-deficit/hyperactivity disorder (ADHD) symptoms were assessed among Iranian hospitalized children (50 ADHD cases and 50 healthy (non-ADHD) controls) during 2014–2015. Levels of ADHD severity and serum 25-hydroxyvitamin D (25OHD) were determined by the Conners’ Parent Rating Scale (CPRS) test and an ELISA kit, respectively. The serum 25OHD concentrations of <10, 10–29, and >30 ng/mL were respectively considered as deficient (severe deficiency), insufficient (mild deficiency), and sufficient levels of vitamin D. The association of nutrient bioavailability with ADHD was evaluated by statistical and regression analyses.There was no significant difference in the mean of socio-demographic variables (e.g., gender, age, weight, BMI, daily intake of dairy products, and daily sunlight exposure) between ADHD and non-ADHD subjects. The mean serum 25OHD concentration (16.57 ± 9.09 ng/mL) was found to be significantly lower in ADHD children with more parathyroid hormone (PTH) levels as compared to controls (22.01 ± 12.67ng/mL). The sufficient 25OHD concentration was more predominant in the controls than the cases (p = 0.002). A severe deficiency of vitamin D was more found in children with ADHD (3.36 times). There was a negative and significant association between the participants’ age and their serum 25OHD levels. Although 25OHD levels in boys were significantly more than those in girls, the reduction of serum 25OHD concentration among boys with ADHD was more severe compared to the patient girls(p = 0.014). The results support the importance of vitamins D role in ADHD patients through the regular monitoring of serum 25OHD levels.

Hypovitaminosis D in HIV-infected Patients

Introduction Vitamin D (VD) deficiency is highly prevalent among HIV-infected patients and has been associated with a worse disease prognosis. Aim To determine the prevalence of hypovitaminosis D in a cohort of HIV-positive Romanian patients compared to healthy controls Methods Plasma samples for the determination of serum 25OHD concentration were collected from HIV-infected patients and healthy controls. 25OHD status was defined as: deficiency 30 ng/mL. Clinical and laboratory parameters were retrospectively extracted from patients'files (CD4+ cell count, CD4+ nadir, HBV/HCV co-infection, ART). Results We evaluated 118 HIV-positive patients, (72 males, 46 females, aged 36.9±12.2 years). 106 patients (98.14 %) were on complex ART regimens. 9.3% had B/C hepatitis coinfection. We also 119 healthy controls matched by age, sex and menopausal status. The mean serum 25OHD concentration in the HIV-positive patients was significantly lower (19.36 ±11.34 ng/ml) compared to controls (23.74±8.32 ng/ml; p=0.001). Normal VD status was determined in only 15.96% of patients and 12.71% of controls. Severe VD deficiency was found in a higher percentage of HIV positive patients (23.52%) compared to controls (4.2%, p=0.001). The serum 25OHD level in patients was not significantly correlated with gender, age, menopausal status in women, number of years of previous ART treatment or nadir CD 4 positive cell-count. Conclusions Low levels of 25OHD are present in a significantly higher percentage in HIV-positive patients compared to healthy controls. The serum 25OHD concentration was not correlated with any particularities of the treatment regimen or disease characteristics in our sample. Clinical guidelines related to the VD status in HIV-positive patients are needed.

Vitamin D Status in Premature Infants at Risk of Metabolic Bone Disease of Prematurity

Objectives: The purpose of this study is to report the vitamin D status in a group of premature infants with increased risk of MBD and to describe the relationship between their vitamin D status and intake. Methods: Retrospective descriptive study in in a level IV neonatal intensive care unit. Results: One hundred and fifty-two subjects were included in the study. Mean gestational age was 26.8 ± 3.3 weeks and mean age was 157 ± 93 days. Mean serum 25OHD concentration was 57.8 ± 2.0 mg/mL. The prevalence of 25OHD 100 ng/mL was 5.9% (n=9) and 8.6% (n=13), respectively. No association between 25OHD level and vitamin D intake with respect to total daily dose (p=0.43) or total daily dose based on body weight (p=0.812) was found. Younger gestational age and younger chronological age were associated with wider range of 25OHD levels. Conclusions: Both suboptimal and elevated 25OHD concentrations are found with our current protocol for supplementation. Vitamin D status in premature infants does not correlate with their vitamin D intake, but younger gestational age and chronological age are both associated with more diverse range of 25OHD.

Serum vitamin D status is associated with the presence but not the severity of primary open angle glaucoma

ObjectivesVitamin D is involved in visual health and function. Our objective was to determine whether age-related vitamin D insufficiency was associated with the presence and the severity of primary open angle glaucoma (POAG) in a case-control study of older adults. Study designCase-control study.Main outcome measures. One hundred fifty cases diagnosed with moderate-to-severe POAG (mean, 75.1±8.5 years; 42.0% female) and 164 healthy controls (mean, 73.0±7.9 years; 59.8% female) were included. POAG diagnosis was based on classical diagnostic criteria of optic nerve cupping and/or RNFL thinning, measured with optical coherence tomography. Severe POAG was defined as Humphrey visual field mean deviation (MD) worse than −12dB. Vitamin D insufficiency was defined as serum 25OHD≤75nmol/L. Age, gender, mean arterial pressure, vitamin D supplementation, visual acuity, and intraocular pressure were used as potential confounders. ResultsPOAG cases had lower mean serum 25OHD concentration than controls (42.9±25.7nmol/L versus 49.4±29.5nmol/L, P=0.039) and a greater prevalence of vitamin D insufficiency (90.7% versus 82.3%, P=0.032). Increased mean serum 25OHD concentrations were associated with lower POAG frequency, even after adjustment for potential confounders (OR=0.89 per 10nmol/L of 25OHD, P=0.045). Similarly, vitamin D insufficiency was associated with POAG (OR=2.09, P=0.034). Among POAG cases, no 25OHD difference was observed between moderate and severe POAG cases (respectively, 39.2±23.3nmol/L versus 45.1±26.7nmol/L, P=0.188); and no between-group difference regarding the prevalence of vitamin D insufficiency (88.9% versus 94.0%, P=0.313). ConclusionsDecreased serum 25OHD concentration was associated with POAG. There was no 25OHD difference between moderate and severe POAG.

Vitamin D Status Is Associated with Intestinal Inflammation as Measured by Fecal Calprotectin in Crohn's Disease in Clinical Remission.

Vitamin D, as potential immune modulator, has been implicated as an environmental risk factor for Crohn's disease (CD). Vitamin D status may be associated with disease risk, severity, activity, and progression. While associations between circulating 25OHD and markers of disease activity and inflammation in CD have been reported, the results are inconsistent. To determine the association between vitamin D status and markers of disease activity and inflammation in CD. One hundred and nineteen CD patients' active and inactive diseases were enrolled in the cross-sectional study. Subject demographics and clinical data were collected. A serum sample was collected for 25OHD and CRP analysis, and a stool sample was collected for fecal calprotectin (FC) measurement. The mean serum 25OHD concentration of the group was 59.8 (24.9)nmol/L. After controlling for confounding variables, serum 25OHD inversely correlated with FC (r=-0.207, P=0.030), particularly among those in clinical remission (r=-0.242, P=0.022). The association between FC and 25OHD was further confirmed by linear regression (r=31.3%, P<0.001). FC was lower in patients with 25OHD levels ≥75nmol/L compared with levels <25nmol/L [FC: 32.2 (16.3-98.2) vs 100.0 (34.4-213.5)μg/g, P=0.004]. In the current study, however, 25OHD was not significantly associated with either CRP or CDAI. Circulating 25OHD was significantly inversely associated with intestinal inflammation as determined by FC in CD. Subgroup analysis confirmed the association among those in clinical remission, but not in those with active disease. 25OHD was not associated with disease activity score (CDAI) or systemic inflammation (CRP). Vitamin D intervention studies are warranted to determine whether raising serum 25OHD levels in patients with CD may reduce intestinal inflammation as measured by FC.

Can vitamin D status be assessed by serum 25OHD in children?

To examine the relationship of serum 25-hydroxyvitamin D (25OHD) concentrations with serum parathyroid hormone (PTH) levels, body mass index (BMI), and environmental factors in a population of Caucasian children living at latitude 43°N. Cross-sectional study on 288 children aged 1 month to 13 years who presented to a pediatric emergency unit during a 21-month period. Mean (SD) serum 25OHD concentrations were 40.6 (17.6), 30.9 (12.0), and 26.4 (9.9) ng/ml (1 ng/ml = 2.5 nmol/l), in children aged 0-1, 2-5, and ≥ 6 years, respectively. Serum PTH levels were 26.6 (13.6), 24.3 (11.9), and 32.7 (12.1) pg/ml in the same groups. Infants had 25OHD concentrations significantly higher. PTH levels were significantly higher in children aged ≥ 6 years. There was no significant correlation between serum 25OHD and PTH concentrations. Totals of 15.6 % and 2.1 % of children had 25OHD values less than 20 and 10 ng/ml, respectively, but none had elevated serum PTH or clinical manifestations related with vitamin D deficiency. Age (inverse correlation) and season (higher values in summer), but not BMI, sex, and time spent outdoors, influenced serum 25OHD concentrations. Our results raise doubt on the assumption of only a serum 25OHD threshold as indicative of vitamin D deficiency in children.

Associations between serum vitamin D levels and precocious puberty in girls.

PurposeVitamin D deficiency has been linked to chronic diseases, such as diabetes mellitus, obesity and autoimmune disease. However, data on the vitamin D status and its association with precocious puberty in girls are limited. We aimed to investigate the association between serum 25-hydroxyvitamin D (25OHD) and precocious puberty in girls.MethodsA total of 60 girls with central precocious puberty (CPP) and 30 control girls were enrolled. Anthropometric measurement and serum level of 25OHD were estimated for all subjects.ResultsThere was a significant difference in the mean serum 25OHD concentration between the precocious puberty group and the control group (17.1±4.5 ng/mL vs. 21.2±5.0 ng/mL, P<0.05). Forty-two of the 60 girls with CPP (70%) had vitamin D deficiency (defined as serum 25OHD<20 ng/mL) and 18 (30%) had vitamin D insufficiency. Of the 30 girls in the control group, vitamin D deficiency was seen in 13 subjects (43.3%), 15 subjects (50%) had vitamin D insufficiency, and 2 subjects (6.7%) had sufficient serum vitamin D (defined as serum 25OHD>30 ng/mL). Vitamin D deficient girls had a significantly higher odds ratio (OR, 3.05; 95% CI, 1.22-7.57, P=0.021).ConclusionThese results showed that vitamin D levels may be associated with precocious puberty. Further studies are required to establish the potential effect of vitamin D status on puberty.

Bone loss during hematopoietic cell transplantation (HCT) in children

HCT may be deleterious to bone health and vitamin D status in children, but longitudinal studies are few. We conducted a multicenter, prospective cohort study to define time related changes in bone health markers during the first 100 days following allogeneic HCT in 26 children. Bone mineral density (BMD), bone mineral content (BMC), bone‐specific alkaline phosphatase (BSAP) and serum 25‐hydroxyvitamin D (25‐OHD) concentrations were measured at baseline, 30 days, and 100 days after HCT. Mean BMD and BMC Z‐scores (mean ± SD, −0.48 ± 1.09 and −0.59 ± 1.36, respectively) were normal at baseline. Repeated‐measures analysis revealed a 0.5 decline in BMD Z‐score (p&lt;.0001) over the 100 day study period, when adjusted for age, sex, Tanner stage, lean mass, fat mass, resting energy expenditure, total energy intake, insulin sensitivity, and serum phosphorus. BMC and BSAP concentrations also declined significantly. Adjusted mean (SE) serum 25‐OHD concentrations declined from 30.1 ± 2.9 ng/ml at baseline, to 18.9 ± 2.0 ng/ml at 100 days after HCT. At 100 days after HSCT, 50% of patients were vitamin D deficient (serum 25‐ OHD &lt;20 ng/ml). Significant bone loss and vitamin D deficiency occur in children in the first 100 days following allogeneic HCT. Strategies to attenuate acute bone loss in this setting are needed.Grant Funding Source: This project was supported by the Massachusetts Vitamin Litigation Grant and NIH grants M01‐ RR02172, UL1 RR025758–01, M01‐RR00865, M01‐RR00188, and K24 HD 058795.

Vitamin D status and bone density in steroid-treated children with glomerulopathies: effect of cholecalciferol and calcium supplementation

The aim of this study was to assess vitamin D status and bone density in steroid-treated children with glomerulopathies and to evaluate the effect of prophylactic vitamin D and calcium supplementation. Retrospective analysis was performed on 55 children aged 4-18 yrs with glomerulopathies. The following data were analyzed: antropometrical parameters, bone densitometries, parathormone, 25-hydroxyvitamin D (25-OHD), urinary calcium excretion and medications received for prevention of low bone mass. A significant number of children (38%) had decreased spinal bone mineral density (BMD z-score < -2.0) and the majority of them (89%) had hypovitaminosis D (25-OHD < 30 ng/ml), 75% were vitamin D insufficient (25-OHD < 20 ng/ml) and 16% were vitamin D deficient (25-OHD < 10 ng/ml). The mean serum 25-OHD concentration was comparable to that of controls (19.32 ± 12.87 vs. 15.05 ± 8.52 ng/ml). Nearly all patients (82%) were receiving preparations of calcium and/or vitamin D to improve bone health. Patients on cholecalciferol had higher mean concentration of 25-OHD compared to those who were not receiving it (p=0.027) and to the controls (p=0.047). In 23 children on vitamin D and calcium supplementation for an average 6-month time, we observed an increase in the mean BMD values (p=0.004), however, mean BMD z-score and 25-OHD concentrations did not significantly change over time. Vitamin D and bone density deficits are remarkably common in steroid-treated children with glomerulopathies, despite vitamin D and calcium repletion. In order to enhance the effectiveness of vitamin D supplementation for improvement of bone density, we suggest regular assessment of serum concentration of 25-OHD that can guide subsequent dose adjustment of vitamin D.

Vitamin D insufficiency and mild cognitive impairment: cross‐sectional association

Low serum 25-hydroxyvitamin D (25OHD) concentrations have been associated with dementia. The association with mild cognitive impairment (MCI) has not yet been explored. Our aim was to examine the association between vitamin D status and MCI status amongst older community-dwellers with subjective memory complaint. Ninety-five non-demented Caucasian community-dwellers with subjective memory complaint (mean, 71.1 ± 6.4 years; 54.7% women) included in the Gait and Alzheimer Interaction Tracking (GAIT) study were categorized into two groups according to Winblad et al. consensus criteria [i.e., subjects with MCI or cognitively healthy individuals (CHI)]. Serum 25OHD concentration was divided into quartiles, the fourth quartile corresponding to the highest 25OHD concentration. The cross-sectional associations between 25OHD concentrations and MCI were modeled using logistic regressions. Age, gender, body mass index, number of comorbidities, education level, Mini-Mental State Examination score, Frontal Assessment Battery score, Geriatric Depression Scale score, creatinine clearance, and season tested were considered as potential confounders. Compared to CHI, patients with MCI (n = 43; mean, 71.4 ± 5.6 years; 34.9% women) had lower mean serum 25OHD concentrations (P = 0.006) and belonged more often to the lower quartiles compared to the highest quartile (P = 0.03). Increased serum 25OHD concentration was associated with a lower risk of MCI [adjusted odds ratio (OR) = 0.96, P = 0.002]. Accordingly, lower quartiles of 25OHD were positively associated with MCI whilst using the highest quartile as reference (adjusted OR = 25.46, P = 0.002 for the first quartile; adjusted OR = 6.89, P = 0.03 for the second quartile; and adjusted OR = 10.29, P = 0.02 for the third quartile). Low 25OHD concentrations were associated with MCI status in older non-demented community-dwellers with subjective memory complaint.

Relationship between Vitamin D Levels and Outcome of Pneumonia in Children

Pneumonia, a common childhood infection in Nigerian children with a number of debilitating complications such as empyema thoracis, has been linked to vitamin D deficiency due to its ability to modulate the T lymphocyte of the immune system . To determine the relationship between vitamin D and outcome of pneumonia in children. This was a case-control study involving 24 children, admitted for pneumonia as subjects and 10 children without pneumonia as controls. Pre-formatted questionnaire was utilized to obtain background information, anthropometric measurements were made to determine nutritional status and estimation of 25- hydroxy cholecalciferol (25OHD) done for all those studied. The mean (SD) serum 25OHD concentration was 104 (59) nmol/L and 130 (107) nmol/L for subjects and controls respectively. Amongst the subjects 15 (54%) had serum 25OHD less than 70 nmol/L and 11 (46%) serum 25OHD greater than 70 nmol/L. Hypocalcaemia was present in 15 (54%) of the subjects. Further analysis of hypocalcaemia with regards to the concentration of serum 25OHD showed that 2 (13%) had levels below 40 nmol/L, 10 (67%) had levels below 70 nmol/L and 3 (20%) above 70 nmol/L. Hypocalcaemia was more frequent among subjects with 25OHD below 70nmol/L compared with those above 70nmol/L, (p =0.01). Empyema thoracis and death occurred amongst the two subjects with 25OHD between 27.5 and 40 nmol/L. Anaemia was more frequent among subjects with 25OHD below 70 nmol/L compared with those above 70 nmol/L (p = 0.03). The study showed that Vitamin D insufficiency, and not solely its deficiency, may have an important role to play in the immune and haemopoetic system. It may therefore affect the response of a child to infections especially pneumonia.

Hypovitaminosis D in geriatric inpatients: a marker of severity of chronic diseases.

Hypovitaminosis D is associated with adverse health outcomes including several bone and non-bone chronic diseases. It remains unclear whether hypovitaminosis D leads to more numerous or more severe chronic diseases. Our aim was to determine whether there was an association between serum 25-hydroxyvitamin D deficiency (i.e., 25OHD ≤25 nmol/L) and, respectively, the number and severity of chronic diseases assessed with the Kaplan- Feinstein index (KFI) among geriatric inpatients. Two hundred and forty older Caucasian adults admitted between December 2008 and September 2009 to the geriatric acute care unit of Angers University Hospital, France (mean 84.6±0.4 years; 68.8% women) were included in this cross-sectional study. Serum 25OHD, KFI score and number of chronic diseases (i.e., diseases lasting at least 3 months or running a course with minimal change, whatever their nature or site) were assessed. Subjects were divided into 2 groups according to 25OHD concentration (either deficient for 25OHD ≤25 nmol/L, or non-deficient for 25OHD >25 nmol/L). Age, gender, use of vitamin D supplements, number of chronic diseases, serum parathyroid hormone and season tested were used as potential confounders. Mean serum 25OHD concentration was 35.2 ± 1.7 nmol/L. The 102 (42.5%) subjects with 25OHD deficiency had higher KFI compared with their counterparts (p=0.008). Vitamin D deficiency was not significantly associated with the number of chronic diseases (adjusted β=-0.37 with p=0.216), but with KFI (unadjusted β=1.33 with p=0.008; adjusted β=1.37 with p=0.010). Irrespective of the number of chronic diseases, 25OHD deficiency was associated with the severity of chronic diseases.

Vitamin D Deficiency is Correlated with Poor Outcomes in Patients with Luminal-type Breast Cancer

PurposeVitamin D deficiency may be an indicator of poor prognosis in patients with breast cancer before surgery. We investigated the association between serum vitamin D concentration and breast cancer prognosis according to intrinsic cancer subtypes.MethodsFrom June to December 2006, serum 25-OHD was measured in 310 Korean women with breast cancer who were treated at the Asan Medical Center, Korea. Clinicopathologic data were examined to determine the prognostic effects of serum 25-OHD. Expression of estrogen receptor (ER), progesterone receptor (PR), and epidermal growth factor receptor 2 (Her2) were measured using tissue microarrays. Patients were classified with luminal A, luminal B, Her2-enriched, or basal-like subtypes of breast cancer.ResultsMean patient age was 48.7 years, and mean serum 25-OHD concentration was 31.4 ± 16.1 ng/ml. The 25-OHD levels were deficient (< 20 ng/ml) in 75 patients (24.2%), insufficient (20–29 ng/ml) in 95 (30.6%), and sufficient (30–150 ng/ml) in 140 (45.2%). Women with deficient 25-OHD levels were at increased risk of recurrence compared with those with sufficient vitamin D levels (P = 0.002). The 25-OHD concentration was inversely associated with prognosis of patients with cancer of the luminal A (P = 0.012) and luminal B subtypes (P = 0.023), but not with the prognosis of patients with Her2/neu-enriched (P = 0.245) or triple-negative (P = 0.879) cancer subtypes. This association remained valid after adjustment for age, tumor size, nodal status, and estrogen receptor status (hazards ratio = 3.97; 95% confidence interval = 1.77–9.61).ConclusionsVitamin D deficiency may be associated with poor outcomes in patients with luminal-type breast cancer.

Improvement of Vitamin D Status in Japanese Institutionalized Elderly by Supplementation with 800 IU of Vitamin D3

To study the adequate intake (AI) for vitamin D in the elderly, we have performed an intervention study with 800 IU/d of vitamin D(3) in the institutionalized elderly. Sixty-two institutionalized elderly were randomly assigned to two groups; receiving either supplements of 200 mg calcium plus 800 IU vitamin D(3)/d (Ca+VD group), or supplements of 200 mg calcium/d (Ca group) for 30 d in October. Serum concentrations of 25-hydroxyvitamin D (25OH-D), parathyroid hormone (PTH), and bone turnover markers were measured before and after intervention. Average dietary vitamin D intake during the intervention period was approximately 300 IU/d in both groups, exceeding the AI in Dietary Reference Intakes for Japanese 2005 of 200 IU/d. In both groups, mean serum 25OH-D level at baseline fell into the hypovitaminosis D range (9.7 ng/mL), despite apparently adequate vitamin D intake. Serum PTH level at baseline was within the reference range. Mean serum 25OH-D concentration significantly increased to 19.3 ng/mL in the Ca+VD group and to 11.1 ng/mL in the Ca group. Post intervention serum 25OH-D level was significantly higher in the Ca+VD group than in the Ca group (p<0.001). In 53 subjects (85.5%) who took more than 80% of their supplements for 30 d, serum PTH level in the Ca+VD group was significantly lower than in the Ca groups (p=0.05). Bone turnover markers were not significantly changed after intervention in either group. Daily supplementation of 800 IU vitamin D(3) was considered effective in the institutionalized elderly with minimal chance of sun exposure, but further studies with longer duration are necessary.

Avaliação da densidade mineral óssea em doentes com fibrose quística

Patients with cystic fibrosis (CF) have an increasing life span and osteoporosis has become a more recognised problem in these patients. The pathogenesis of low bone mineral density (BMD) in CF seems to be multifactorial and the aim of this study was to assess the prevalence of low BMD in a group of CF outpatients and to relate the findings with the variables studied.The study included 22 patients aged between 14 and 45 years (mean age 26.3). Two of the subjects were lung transplant patients. BMD was assessed by dualenergy X-ray absorptiometry (DEXA) at the lumbar spine (LS) and femoral neck (FN). This data was correlated with serum 25-hydroxy vitamin D (25-OHD) levels, BMI and the forced expiratory volume in one second (FEV1).BMD (Z-score and T-score) ranged from 0.6 to -6 and from 0.5 to -6.7 at LS; at FN the scores ranged from 0.6 to -3.9 and from 0.6 to -4.1. The mean serum 25-OHD concentration (12,57ng/ml) was at the low end of the normal range (10-60ng/ml). On average patients did not present with malnutrition, however BMI ranged from 15.2 to 33.7kg/m2. Lung function status was assessed by FEV1; 64% of patients had FEV1 below 80% and within this group four patients had a FEV1 under 40%.There was a positive correlation between low BMD and 25-OHD concentrations and also between BMD and FEV1. There was no linear correlation between BMD and BMI.Rev Port Pneumol 2008; XIV (5): 625-634