Mean Serum 25-OHD Levels Research Articles

Accelerated bone loss in late reproductive-aged and perimenopausal women with vitamin D insufficiency.

The association between serum vitamin D levels and bone mineral density (BMD) varies by race and gender. This study aimed to evaluate this relationship between serum vitamin D levels and BMD, and changes of BMD over time in Korean women. We analyzed data from 586 generally healthy Korean women aged 29-79 who underwent health check-ups at Seoul National University Gangnam Center between 2010 and 2011 (baseline measurement) and 2015-2016 (follow-up). Dual energy X-ray absorptiometry (DEXA) and serum 25-hydroxyvitamin D (25OH-D) level measurements were conducted. We assessed the association between serum 25OH-D levels and BMD, as well as changes in BMD over time. The mean age of participants was 51.3 ± 7.9years, with a mean follow-up interval of 4.6 ± 0.7years, and mean serum 25OH-D level of 20.6 ± 8.5ng/ml. Baseline serum 25OH-D levels did not correlate with BMD values at the lumbar spine, femoral neck, or total femur, nor with changes in BMD over time. A significant negative association was found between perimenopausal status and BMD changes at all sites, and between premenopausal status and lumbar bone mass, compared to postmenopausal status in the 25OH-D < 20ng/ml group. This association was not observed in women with higher serum 25OH-D levels. Serum 25OH-D levels did not correlate with BMD levels or changes in BMD overall. However, in late reproductive-aged and perimenopausal women with serum 25OH-D insufficiency, there was a significant association with accelerated bone loss.

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

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

Histomorphometric analysis of patients with femoral neck fracture and 25-hydroxyvitamin D deficiency: a cross-sectional study.

Vitamin D deficiency causes osteoporosis, bone mineralization disorders, and osteomalacia. Osteomalacia is diagnosed using blood biochemical tests, clinical symptoms, and imaging; however, accurate detection of mineralization disorders requires tissue observation. We investigated the prevalence of bone mineralization disorders and their relationship with serum 25-hydroxyvitamin D (25OHD) levels in patients with untreated osteoporosis with femoral neck fractures. A non-demineralized specimen was prepared from the femoral head removed during surgery in 65 patients. Bone histomorphometry of cancerous bone in the femoral head center was conducted. Osteoid volume per bone volume (OV/BV) and osteoid thickness (O.Th) were measured as indicators of mineralization disorder. The mean serum 25OHD level (11.9 ± 5.7ng/mL) was in the deficiency range (< 12ng/mL). There were no clinically diagnosed cases of osteomalacia (OV/BV > 10% and O.Th > 12.5µm); however, one case of mineralization disorder, considered histologically pre-osteomalacia (OV/BV > 5% and O.Th < 12.5µm), was observed (OB/BV, 17.6%; O.Th, 12.3µm). Excluding this case, those with severe (25OHD < 12ng/mL, at risk of osteomalacia; n = 39) and non-severe deficiency (25OHD ≥ 12ng/mL; n = 25) did not significantly differ in OV/BV (%; 0.77 ± 0.54 vs. 0.69 ± 0.38, p = 0.484) or O.Th (µm; 5.32 ± 1.04 vs. 5.13 ± 0.78, p = 0.410). Further, 25OHD and OV/BV were not significantly correlated (R = -0.124, p = 0.327). This is the first study in the twenty-first century to examine serum 25OHD concentrations and bone mineralization disorders in Japanese patients with osteoporosis. The results indicate that vitamin D deficiency does not necessarily cause bone mineralization disorders and rarely leads to osteomalacia.

Vitamin D levels in children with cerebral palsy.

The aim of this study was to assess serum vitamin D levels and related factors in children with cerebral palsy (CP). One hundred and nineteen children with CP between the ages of 1 year to 10 years 9 months who were admitted to the children's inpatient rehabilitation unit of a tertiary rehabilitation hospital between January 1, 2017, and December 31, 2018, were included in this study. Demographic and clinical characteristics were obtained from the patient files. CP types and serum 25 hydroxyvitamin D (25OHD) levels were recorded. Gross Motor Function Classification System (GMFCS) was used to assess the functional level. Mean age was 5.1±2.9 years. Forty-two (35.3%) were girls, 105 (88.3%) were spastic, and 14 (11.7%) were ataxic and mixed type CP. Mean GMFCS level was 4 (IQR:2). Thirty-one (26.1%) were getting extra liquid feed while the rest were eating a normal diet. Mean serum 25OHD level was 27.4±15.7 (3-79) ng/mL. Vitamin D levels were normal in 68 children (57.1%), whereas 36 (30.3%) had vitamin D insufficiency and 15 (12.6%) showed vitamin D deficiency. Those whose serum vitamin D levels were within a normal range had a median age of 3.8 (IQR:4.2) years. On the other hand, mean age was 6.4 (4.3) years for those with low vitamin D level (p < 0.0001). Vitamin D level was 19.8 (21.4) ng/mL in those (n = 88) who had regular diets, whereas it was 31.0 [16] ng/mL in those (n = 31) who were getting extra liquid feed (p = 0.015). There was no statistically significant correlation between vitamin D level and gender, GMFCS, CP type, season or antiepileptic drug treatment. A binary logistic regression model showed that older age and having only regular meals were significant risk factors for low vitamin D. In this study, 42.9% of the children with CP had low vitamin D. Older children with CP or those who had regular diets were higher risk groups in terms of low vitamin D.

Extended-Release Calcifediol Effectively Raises Serum Total 25-Hydroxyvitamin D Even in Overweight Nondialysis Chronic Kidney Disease Patients with Secondary Hyperparathyroidism

Introduction: Obesity increases the risk of vitamin D insufficiency, which exacerbates secondary hyperparathyroidism in chronic kidney disease. Recent studies suggest that serum total 25-hydroxyvitamin D (25OHD) levels of ≥50 ng/mL are necessary to produce significant reductions in elevated parathyroid hormone levels in nondialysis patients. Data from real-world and randomized controlled trials (RCTs) involving these patients were examined for (1) relationships between vitamin D treatments and the achieved levels of serum 25OHD and between serum 25OHD and body weight (BW)/body mass index (BMI); and (2) the impact of BW/BMI on achieving serum 25OHD levels ≥50 ng/mL with extended-release calcifediol (ERC) treatment or vitamin D supplementation (cholecalciferol or ergocalciferol). Methods: Data obtained from nondialysis patients participating in two real-world studies, one conducted in Europe (Study 1) and the other (Study 2) in the USA, and in two US RCTs (Studies 3 and 4) were analyzed for serum 25OHD outcomes after treatment with ERC, vitamin D supplements, or placebo. Results: More than 50% of subjects treated with vitamin D supplements in both real-world studies (Studies 1 and 2) failed to achieve serum 25OHD levels ≥30 ng/mL, a level widely viewed by nephrologists as the threshold of adequacy; only 7.3–7.5% of subjects achieved levels ≥50 ng/mL. Data from the European study (Study 1) showed that serum 25OHD levels had significant and nearly identical inverse relationships with BW and BMI, indicating that high BW or BMI thwarts the ability of vitamin D supplements to raise serum 25OHD. One RCT (Study 3) showed that 8 weeks of ERC treatment (60 μg/day) raised serum 25OHD levels to ≥30 and 50 ng/mL in all subjects, regardless of BW, while cholecalciferol (300,000 IU/month) raised serum 25OHD to these thresholds in 56% and 0% of subjects, respectively. The other RCT (Study 4) showed that ERC treatment (30 or 60 μg/day) successfully raised mean serum 25OHD levels to at least 50 ng/mL for subjects in all BW categories, whereas no increases were observed with placebo treatment. Conclusion: Real-world studies conducted in Europe and USA in nondialysis patients (Studies 1 and 2) showed that vitamin D supplements (cholecalciferol or ergocalciferol) were unreliable in raising serum total 25OHD to targets of 30 or 50 ng/mL. In contrast, ERC was demonstrated to be effective in one real-world study (Study 2) and two RCTs (Studies 3 and 4) conducted in US nondialysis patients in raising serum 25OHD to these targeted levels irrespective of BW.

AACE2021-A-1099: Does Diet Pattern (Vegetarian Vs. Non-Vegetarian) Influence Serum 25-Hydroxyvitamin (25OHD) Levels Among Women with Polycystic Ovary Syndrome (PCOS): Lessons from a Cross Sectional Study from North India?

Polycystic ovary syndrome (PCOS), the commonest endocrinopathy of reproductive age women has multiple metabolic aberrations. Vitamin D deficiency (VDD) is reported in epidemic proportions (70-100%) among Indians, and PCOS is not an exception. VDD is linked to negative consequences on non-skeletal health including worsening of metabolic derangements among women with PCOS. Data is lacking on the subject of vegetarians are at greater risk of VDD than non-vegetarians since animal sources are believed to be rich in vitamin D.To evaluate differential impact of dietary composition (veg vs. non-veg) on serum 25 OHD levels among women with PCOS.T. In this cross-sectional study, consecutive women aged 14–40 years and diagnosed PCOS by Rotterdam 2003 criteria were enrolled from endocrinology outpatient clinics of AIIMS New Delhi and SKIMS Srinagar between March 2014 and April 2016. Among 177 women enrolled, 74 vegetarians (from AIIMS) and 104 non-vegetarians (from SKIMS) underwent a uniform evaluation using a common predesigned proforma at both the centers. Clinical assessment (medical history including menstrual cyclicity, anthropometry, hirsutism scoring, acne and alopecia grading), food frequency questionnaire (FFQ) and laboratory evaluation (CBC, KFT, LFT, Ca, P, lipid profile, T4, TSH, LH, FSH, total testosterone, prolactin, 17-OHP, 8am Cortisol, 25OHD) were carried out. The mean age of subjects (26.43 ± 4.44 vs.26.77 ± 5.51 years) was comparable as was mean BMI (23.51 ± 2.97 vs.23.81 ± 4.22 Kg/m2). Total calorie intake was 1838.33±298.54 vs. 1478.44±404.87 kcal among non-vegetarians and vegetarians respectively. Number of menstrual cycles/year (8.13±3.40 vs. 8.02 ± 2.38), FG score (11.82±4.52 vs. 11.32±4.23), biochemical (LFT, KFT, calcium, phosphorus) and hormonal (serum LH, FSH,) parameters were also similar except for serum alkaline phosphatase (105.46 ± 32.27 vs. 162.70 ± 42.58 IU/L), total cholesterol (98.92 ± 24.33 vs. 81.15 ± 25.32 md/dl), and triglycerides (135.01 ± 50.25 vs.107.06 ± 42.10 md/dl). The mean serum 25OHD levels did not differ significantly among non-vegetarians and vegetarians (15.64 ± 5.41 vs. 12.50 ± 8.39 ng/ml). VDD is very common among women with PCOS and the deficiency is marginally severe among vegetarian women with PCOS than those consuming non-vegetarian diet.

Comparative Efficacy of Metformin vs. Pioglitazone alone and in Combination with High Dose Oral Cholecalciferol among Women with Polycystic Ovary Syndrome (PCOS): A Six-month Randomized, Open Label Study

Purpose: We aimed to evaluate the comparative efficacy of metformin and pioglitazone coadministered with high dose VD on clinical, biochemical, hormonal and insulin sensitivity parameters in women with PCOS. Material and Methods: In this open label randomised study, a total of 136 women, aged 18-40 years, diagnosed with PCOS as per the AE PCOS 2009 criteria, were randomly assigned into four groups (n=34 per group). The four groups received Metformin-1gm/day alone, metformin-1gm/day+cholecalciferol4000IU/ d,pioglitazone-30mg/day alone and pioglitazone- 30mg/day+cholecalciferol-4000IU/d.The clinical, biochemical, hormonal and insulin sensitivity parameters were evaluated at 0, 3 months and 6 months after the intervention. Results: The mean age of subjects was 21.89±4.99 years with mean BMI of 22.19±3.24kg/m2. The mean serum 25OHD level at the baseline in the metformin+VD and pioglitazone+VD group was 13.28±8.44ng/ml and 11.17±7.46ng/ml and it improved to 63.33±19.76ng/ml and 57.69±14.43ng/ ml respectively after six months of intervention. The mean no. of cycles/year and Ferriman-Gallwey (FG) score improved in all four arms. Significant decrease in the total serum testosterone level was observed in the groups that received VD in addition to metformin and pioglitazone, the effect being more significant in the metformin+VD group (64.60±23.59ng/dl at 0 months to 41.24±12.83ng/dl after 6 months). Plasma glucose and insulin levels from a two-hour OGTT showed a significant improvement in subjects receiving VD in addition to pioglitazone. Conclusion: Metformin and pioglitazone are equally efficacious for treatment of women with PCOS. High dose oral cholecalciferol co-administration significantly improved the metabolic outcomes among these women. Key words: Metformin; Pioglitazone; PCOS; Insulin resistance; Vitamin D deficiency.

Vitamin D levels in children and adolescents with autism.

ObjectiveThis study aimed to investigate the relationship between autism spectrum disorder (ASD) and vitamin D levels in children and adolescents.MethodsWe measured serum 25-hydroxyvitamin D (25-OHD) levels in 1529 patients with ASD aged 3 to 18 years, without any additional chronic diseases. Levels of 25-OHD were compared according to sex, age (<11 or ≥11 years), and birth season. Additionally, laboratory parameters (calcium, phosphorus, alkaline phosphatase, and 25-OHD) of 100 selected patients with ASD were compared with those of the healthy control group.ResultsVitamin D deficiency or insufficiency was found in approximately 95% of all patients. Levels of 25-OHD in adolescent patients with ASD aged 11 to 18 years were significantly lower than those in patients aged younger than 11 years. In the 100 selected patients with ASD, mean serum 25-OHD levels were significantly lower and alkaline phosphatase levels were higher compared with those in healthy children.ConclusionOur study suggests a relationship between vitamin D and ASD in children. Monitoring vitamin D levels is crucial in autistic children, especially adolescents, to take protective measures and treat this condition early.

SUN-LB18 Serum 25-Hydroxyvitamin D Is Not Associated With the Type of Central Precocious Puberty in Girls

[Objective] To evaluate the clinical value of serum 25-hydroxyvitamin D (25OHD) in girls with different types of central precocious puberty (CPP), in order to provide basis for the clinical diagnosis and treatment. [Methods] 340 CPP girls diagnosed in our hospital from January 2016 to January 2018 were enrolled and retrospectively studied. According to the progression of Tanner stage ≥1 during 6 months, bone age(BA) levels were higher than chronological age of more than 1 year. 226 patients were included in the rapidly progressive CPP group (RP-CPP), while 114 patients were included in the slowly progressive CPP group (SP-CPP) as a control. We analyzed the correlation between serum 25OHD levels and the different puberty characteristics (BA, disease course, body mass index (BMI), bone mineral density (BMD), serum LH peak to FSH peak ratio (LHP/FSHP), insulin-like growth factor 1(IGF1)) of two groups. According to sunshine duration, the sampling season was divided into two groups (December to May, June to November), then we compare the correlation between different serum 25OHD levels and season of sampling as well as the different puberty characteristics respectively. [Results] (1) The mean serum 25OHD levels of CPP girls were 15.89±6.87ng/ml. The 25OHD levels of 68 (20.0%), 95 (27.9%) and 167 (49.1%) patients were <10, 10-15 and 16-29 ng/mL, respectively. Only 10 (2.9%) patients had normal 25OHD (>30 ng/mL). (2) No significant difference in serum 25OHD levels between RP-CPP group and SP-CPP group (F =0.809, p=0.369) was found. There is no correlation of BMD and disease course between the two groups (p>0.1). Bone age, BMI, LHP/FSHP and IGF1 levels in RP-CPP group were higher than SP-CPP group (P<0.05). Logistic regression analysis showed that BMI, LHP/FSHP and IGF1 were the independent risk factors for CPP (OR 2.690, 1.005, 3.288, respectively). (3) There were significant differences among different serum 25OHD levels as for season, disease course and IGF1 (p<0.05). The correlation with the season was the highest (r=0.402, p<0.001). [Conclusions] (1) Vitamin D levels are generally insufficient in CPP girls and are not related to different types of CPP. (2) The higher BMI, IGF1, LHP/FSHP levels are, the easier CPP girls will transfer to RP-CPP, but not associated with vitamin D levels. (3) CPP girls suffer from vitamin D deficiency in seasons of winter and spring easilier.

Association of Vitamin D Level and Forced Expiratory Volume in First Second in COPD Patients

Background: Chronic Obstructive Pulmonary Disease (COPD) is a major cause of morbidity and mortality throughout the world which is preventable as well as treatable disease. In recent years, multiple roles of vitamin D have been highlighted in various diseases. Data on vitamin D status in COPD in Bangladeshi population are still limited. Aim of our study is to see any association between vitamin D level and FEVI (Forced Expiratory Volume in First Second) in COPD patients.&#x0D; Materials and methods: Fifty cases of COPD patients were diagnosed by GOLD (Global Initiative for Chronic Obstructive Lung Disease) criteria included in this study conducted at Medicine Department of Chittagong Medical College Hospital for six months period from April 2018 to September 2018. Serum vitamin D 25-OH level were assessed by enhance chemiluminance method and post-bronchodilator FEV1 was measured in all patients by spirometry.&#x0D; Results: The mean age of patients was 64.50 ± 7.60 years. The mean serum 25-OHD level was 21.69 ± 7.39 ng/ml and mean FEV1 (%) was 20.62 ± 18.80. There was very strong positive correlation present between, serum 25-OHD and FEV1% of predicted. Only 16% of the COPD patients had sufficient vitamin D level, 42% had insufficient and other 42% had deficient vitamin D status.&#x0D; Conclusion: COPD patients with more severe disease tend to have lower serum Vitamin D level.&#x0D; JCMCTA 2019 ; 30 (2) : 22-25

Seasonal Variation in Serum 25-hydroxy Vitamin D and its Association with Clinical Morbidity in Healthy Infants from Northern India

To evaluate the seasonal change in serum 25-hydroxyvitamin D (25-OHD) level in healthy infants and to relate it to common childhood morbidities. 72 healthy breastfed infants residing in Delhi were enrolled at the end of summer and followed till the end of winter [mean (SD) duration 200 (10) d]. Serum 25-OHD was estimated at baseline and follow-up. Infants were monitored for common childhood diseases. Mean (SD) serum 25-OHD level was lower at the end of winter (20.7 (8.02) ng/mL) than summer (22.9 (8.70) ng/mL) [mean difference (95% CI) -2.14 ng/mL (-3.36, -1.06), P<0.001). The seasonal distribution of children according to vitamin D status in summer and winter - Deficient (15.3%, 12.5%), Insufficient (19.4%, 30.6%) and Sufficient (65.3%, 56.9%), respectively was comparable P=0.17). The morbidity profile remained unaffected by change in vitamin D status from summer to winter. Seasonal changes in vitamin D levels do not have significant clinical effect or effect on overall vitamin D status in apparently healthy infants from North India. This may have implications for results of population surveys for vitamin D status, irrespective of the season when they are conducted.

Vitamin d deficiency in psoriatic patients -A case control study

Abstract Introduction: Many studies have shown that vitamin D deficiency have been associated with multiple autoimmune conditions like psoriasis, rheumatoid arthritis, diabetes mellitus. Objective: The main purpose of this study was to analyze vitamin D status of psoriasis patients in comparison to healthy controls. Materials and Methods: The study comprised of 50 (30 male & 20 female) clinically confirmed cases of chronic plaque psoriasis of age group (20-60 years) attending outpatient department of Dermatology, venereology, leprosy, Vinayaka Mission’s Medical College & Hospital, Karaikal from 2012 to 2014.At the same time 50 healthy individuals without psoriasis were also investigated (age & sex matched). Results: The mean serum 25-OHD levels in psoriatic patients and controls were 22.308+_2.974 and 33.726 +_2.688 ng/ml respectively. The difference was statistically significant (P= Limitations: Additional studies with bigger numbers of patients are essential to evaluate the pathogenic mechanisms associated with psoriasis and vitamin D. Keywords: Psoriasis, Autoimmunity, Psoriasis Area and severity index, 25-hydroxy vitamin D. Introduction Psoriasis is a chronic, non-contagious skin disease characterized by red, inflamed cutaneous lesions covered with silvery-white scale. It involves the innate immunologic system (keratinocytes, dendritic cells, histiocytes, mastocytes and endothelial cells) and acquired immunologic system (T lymphocytes).[1]Psoriatic plaques are defined histologically by epidermal hyperplasia, epidermal and dermal infiltration by leukocytes and changes in dermal microvasculature.[2] Psoriasis affects both genders equally and can occur at any age, although it most commonly appears for the first time between the ages of 15 and 25. The disease affects the skin and potentially the joints. The prevalence of psoriatic arthritis in psoriasis patients is estimated to be between 25-31%. Vitami

Effect of High-dose Vitamin D Supplementation on Beta Cell Function in Obese Asian-Indian Children and Adolescents: A Randomized, Double Blind, Active Controlled Study.

Objective:Vitamin D deficiency has been found to be associated with insulin resistance. In an attempt to explore this association, we planned a study to investigate the effects of high-dose vitamin D supplementation on beta cell function in obese children and adolescents.Methods:A randomized, double blind, active-controlled study was carried out to investigate the effects of high dose (120,000 IU once a month) vitamin D supplementation in comparison to recommended daily allowance (12,000 IU/month) for 12 months. Beta cell function was assessed by disposition index. Inflammatory cytokines and cardiovascular risk factors were also assessed before and after supplementation.Results:A total of 189 obese children and adolescents were recruited. The mean serum 25OHD level of the study population was 8.36 ± 5.45 ng/ml. At baseline, 94.7% subjects were vitamin D deficient (<20 ng/mL). After 12 months of supplementation, serum 25OHD level in intervention group was 26.89 ± 12.23 ng/mL, while in control group, it was 13.14 ± 4.67 ng/mL (P < 0.001). No significant difference in disposition index as well as other parameters of insulin resistance, sensitivity, inflammatory cytokines, and pulse wave velocity was seen after supplementation.Conclusion:Vitamin D supplementation in doses of 120,000 IU per month for 12 months in obese Asian-Indian children and adolescents did not affect beta cell function as well as cardiovascular risk factors.

Serum vitamin D deficiency in children and adolescents is associated with type 1 diabetes mellitus.

BackgroundTo investigate the relationship 25-hydroxy vitamin D (25OHD) level among children and in children with type 1 diabetes mellitus (T1DM).MethodsA case–control study was conducted to compare the serum 25OHD levels between cases and controls. This study recruited 296 T1DM children (106 newly diagnosed T1DM patients and 190 established T1DM patients), and 295 age- and gender-matched healthy subjects as controls.ResultsThe mean serum 25OHD in T1DM children was 48.69 ± 15.26 nmol/L and in the controls was 57.93 ± 19.03 nmol/L. The mean serum 25OHD in T1DM children was lower than that of controls (P < 0.01). The mean serum 25OHD level (50.42 ± 14.74 nmol/L) in the newly diagnosed T1DM children was higher than that (47.70 ± 15.50 nmol/L) in the established T1DM children but the difference was not statistically significant (P = 0.16). HbA1c values were associated with 25OHD levels in established T1DM children (r = 0.264, P < 0.01), and there was no association between 25OHD and HbA1c in newly diagnosed T1DM children (r = 0.164; P > 0.05).ConclusionVitamin D deficiency is common in T1DM children, and it should be worthy of attention on the lack of vitamin D in established T1DM children.

Serum 25-hydroxyvitamin D levels throughout pregnancy: a longitudinal study in healthy and preeclamptic pregnant women

BackgroundWorldwide there is a high prevalence of 25-hydroxyvitamin D (25OHD) deficiency and has been associated with adverse outcomes during pregnancy.ObjectiveThis is a nested, case–control study in a longitudinal cohort to compare the serum 25OHD levels and other biomarkers throughout pregnancy in a group of 20 preeclamptic women and 61 healthy pregnant women. An additional group of 29 healthy non-pregnant women were also studied during the two phases of the menstrual cycle.ResultsMean 25OHD levels in non-pregnant women were 31.9 ng/mL and 34.9 ng/mL during follicular and luteal phase, respectively (P < 0.01). Mean serum 25OHD levels in healthy pregnant women were 26.5, 30.1 and 31.9 ng/mL, at first, second and third trimester, respectively (P < 0.001). The first trimester levels of 25OHD were lower than those of healthy non-pregnant women (P < 0.001), showing a significant recovery at third trimester. In the group of healthy pregnant women, the 25OHD levels were 25.7 ng/mL and 27.2 ng/mL at 3 and 6 months postpartum, respectively; both values were lower than those observed in the non-pregnant women (P < 0.001). In preeclamptic women, 25OHD serum levels were similar to those of healthy pregnant women; nevertheless, they remained almost unchanged throughout pregnancy.ConclusionThere were no significant differences between healthy and preeclamptic pregnant women in terms of 25OHD levels throughout the pregnancy. Serum 25OHD levels in non-pregnant women were higher during luteal phase compared with follicular phase. The 25OHD levels of non-pregnant women tended to be higher than those of pregnant women.

Influence of serum 25-hydroxyvitamin D on the rate of pain episodes in Nigerian children with sickle cell anaemia

Background: In sickle cell disease (SCD), symptoms of vitamin D deficiency (VDD) and chronic pain can overlap.Aim: To examine the relationship between serum vitamin D levels and the frequency of acute pain episodes.Methods: In this cross-sectional study, serum 25-hydroxyvitamin D (25-OHD) was assayed by high-performance liquid chromatography, and its influence on the number of significant pain episodes was examined by bivariate and logistic regression analyses.Results: The mean (SD) serum 25-OHD level in 123 children with SCD (HbSS) was 105.8 (24.1) nmol/L (range 37.5–155.8). Fourteen patients (11.4%) either had a deficient (1.6%) or insufficient (9.8%) level. None had severe VDD. All the children with sub-optimal vitamin D experienced pain, as did 69.7% of those with normal vitamin D [14 (100%) vs 76 (69.7%), 95% CI 0.7–0.9, p = 0.04]. The mean serum vitamin D level in the 90 patients with at least one pain episode [103.1 (25.2) nmol/L] was significantly lower than the 113.1 (19.3) nmol/L in the 33 without a pain episode (95% CI 1.3–7.8, p = 0.04). The frequency of pain correlated inversely with the serum 25-OHD level. Serum levels of vitamin D (OR 1.2, 95% CI 1.3–1.7, p = 0.04) and fetal haemoglobin concentration (OR 1.6, 95% CI 1.1–1.4, p = 0.02) predicted significant pain episodes.Conclusion: In children with SCD, there is a possible association between depressed serum vitamin D levels and increased frequency of acute pain episodes. Vitamin D supplements should be considered in patients with low levels and frequent episodes of pain.

High Prevalence of Osteoporosis and Morphometric Vertebral Fractures in Indian Males Aged 60 Years and Above: Should Age for Screening Be Lowered?

Current guidelines recommend bone mineral density (BMD) measurement in asymptomatic men above age 70 years and vertebral fracture (VF) assessment above 80 years with T-score <−1.0 with risk factors. We studied the prevalence of osteoporosis and morphometric VF in asymptomatic males aged 60 years and above in North India. Free-living community-dwelling men (n = 241, age: mean ± standard deviation 68.0 ± 6.2 years) underwent a detailed history, physical examination, biochemical evaluation, and BMD measurements at 3 sites: lumbar spine, total hip (TH), and femoral neck (FN). Morphometric VF were assessed by instant vertebral assessment using Genant et al's semiquantitative method. We observed osteoporosis, osteopenia, and normal BMD in 19%, 56%, and 25% of subjects, respectively. The decade wise prevalence of osteoporosis in the age groups 60–70 years, 71–80 years, and >80 years was 16.9%, 17%, and 50%, respectively. Mean serum 25OHD levels were 17.2 ± 10.3 ng/mL. Vitamin D deficiency (<20 ng/mL) and secondary hyperparathyroidism (plasma intact parathyroid hormone >65 ng/mL) were present in 68.8% and 45.4%, respectively. VF were present in 29.6% subjects (grade I: 58%, grade II: 32.4%, and grade III: 8.8%). Age and iPTH had significant negative correlation with BMD at FN and TH. Serum 25OHD had no correlation with BMD at any site. The prevalence of VF was positively associated with age (p = 0.018) and negatively associated with BMD at FN (p = 0.002) and TH (p = 0.013). Osteoporosis and VF are common in asymptomatic Indian males aged 60 years and above. Screening for osteoporosis and instant vertebral assessment may be recommended earlier than currently existing guidelines.

Assessment of Adequacy of Supplementation of Vitamin D in Very Low Birth Weight Preterm Neonates: A Randomized Controlled Trial.

To compare the effect of 400 IU and 1000 IU vitamin D for 6 weeks in very low birth weight preterm neonates. Randomized, double-blinded controlled trial in a teaching hospital. Fifty very low birth weight preterm neonates. Vitamin D 400 IU/day (Group 1) or 1000 IU/day (Group 2). Change in serum calcium, phosphate, alkaline phosphatase (ALP), 25-hydroxy vitamin D (25-OHD), parathormone, incidence of skeletal hypomineralization and growth. After 6 weeks of supplementation, the mean serum calcium and 25-OHD levels were significantly higher (p < 0.001 each), while ALP and parathormone levels significantly lower (p < 0.001 each) in group 2. Skeletal hypomineralization was lesser and growth better in group 2. Vitamin D supplementation in a dose of 1000 IU/day is more effective in maintaining serum calcium, phosphate, ALP, 25-OHD and parathormone levels with lower incidence of skeletal hypomineralization and better growth.

Impact of hypovitaminosis D on clinical, hormonal and insulin sensitivity parameters in normal body mass index polycystic ovary syndrome women

Earlier data on the relationship of 25 hydroxyvitamins (25OHD) levels with various components of polycystic ovary syndrome (PCOS) has been conflicting. We studied 122 normal body mass index (BMI) women with PCOS (cases) and 46 age and BMI-matched healthy women (controls) and assessed the impact of serum 25OHD levels on clinical, biochemical and insulin sensitivity parameters in these lean Indian women with PCOS. The mean age and BMI of the cases and controls were comparable. Mean serum 25OHD levels respectively were 10.1 ± 9.9 and 7.9 ± 6.8 ng/ml with 87.7% and 91.1% vitamin D (VD) deficient. No significant correlation was noted between 25OHD levels and clinical, biochemical and insulin sensitivity parameters except with the total testosterone levels (p = 0.007). Also, no significant difference in these parameters was observed once the PCOS women were stratified into various subgroups based on the serum 25OHD levels. We conclude that VD deficiency being common in normal BMI Indian women with or without PCOS does not seem to alter the metabolic phenotype in these women.

Impact of a cholesterol membrane transporter's inhibition on vitamin D absorption: A double-blind randomized placebo-controlled study

Oral supplements are important to prevent and treat vitamin D deficiency. Despite the growing number of prescriptions, vitamin D's absorptive mechanisms are not clearly elucidated. By evaluating the effect of ezetimibe on vitamin D absorption, we aim to determine if the cholesterol transporter Niemann–Pick C1-Like 1 transporter contributes to it. This randomized, double-blind, placebo-controlled trial (ClinicalTrials.govNCT02234544) was developed in a South Brazilian University Hospital. Fifty-one medical students were randomized to ezetimibe 10mg/day or placebo for 5days. On the fifth and 19th days, blood samples for 25-hydroxycholecalciferol (25OHD), parathyroid hormone (PTH), calcium, and albumin were collected. After the first blood sample collection, all participants received a single oral 50,000IU cholecalciferol dose during a 15g-fat meal. Serum 25OHD levels were measured by the immunoassay Diasorin Liaison®. Measurements were compared in a general linear model adjusted for multiple comparisons by the Bonferroni test. Before cholecalciferol administration, 25OHD was <30ng/mL and <20ng/mL, respectively, in all and in 82.3% of the participants. Fourteen days after a single 50,000IU oral dose of cholecalciferol, mean (SD) changes in serum 25OHD were similar in both groups, after adjustment to BMI and 25OHD levels before cholecalciferol administration (p=0.26): 8.7 (3.7) ng/mL in the ezetimibe group, versus 10.0 (3.8) ng/mL in the placebo group. Mean serum 25OHD, PTH, calcium and albumin levels remained similar in both groups. We conclude that ezetimibe had no effect on the mean change in serum 25OHD after a single oral dose of cholecalciferol, in these healthy and young adults.