Median Serum 25-hydroxyvitamin Research Articles

How effective is public health policy in Scotland on vitamin D deficiency during pregnancy?

To evaluate the uptake of universal vitamin D supplementation during pregnancy, its effectiveness in preventing vitamin D deficiency and the factors associated with these. The regional public health organisation in Ayrshire, Scotland has a policy of universal provision of vitamin D supplements (10 µg/d) to all pregnant women for the duration of their pregnancy. Pregnant women in this area were recruited at their 12-week antenatal appointment. Blood samples were collected at the 12-week and 34-week appointments. To account for the seasonal variation, women were recruited in two cohorts: summer and winter. Telephone interviews were conducted at 34 weeks to assess the uptake of vitamin D supplements during pregnancy. Other variables were obtained from medical records. The study was conducted in the NHS Ayrshire and Arran Health Board in Scotland. 612 pregnant women (aged 15-44 years) living in Ayrshire (latitude 55°), Scotland. Sixty-six percentage took supplementation as recommended. Consumption of supplementation was significantly associated with a higher median serum 25-hydroxyvitamin D concentrations at 34 weeks. Despite this at 34 weeks, 33 % of the summer cohort had insufficient or deficient vitamin D status, while 15 % of the winter cohort had insufficient or deficient status. In multivariable analysis, only adherence and season were independent predictors of vitamin D status. While supplementation improved and maintained vitamin D status during pregnancy, it was not adequate to ensure all those insufficient at 12 weeks achieved sufficient status at the end of pregnancy.

Is Serum 25-Hydroxyvitamin D Level Associated with Severity of COVID-19? A Retrospective Study.

(1) Background: SARS-COV2 infection has a clinical spectrum ranging from asymptomatic infection to COVID-19 with acute respiratory distress syndrome (ARDS). Although vitamin D deficiency is often found in patients with ARDS, its role in COVID-19 is not clear. The aim of this study was to explore a possible association between serum 25-hydroxyvitamin D levels and the severity of COVID-19 in hospitalised patients. (2) Methods: In this retrospective observational study, we analysed data from 763 patients hospitalised for COVID-19 in 2020 and 2021. Patients were included in the study if serum 25-hydroxyvitamin D was assessed 30 days before or after hospital admission. Vitamin D deficiency was defined as <50 nmol/L (<20 ng/mL). The primary outcome was COVID-19 severity. (3) Results: The overall median serum 25-hydroxyvitamin D level was 54 nmol/L (IQR 35-76); 47% of the patients were vitamin D deficient. Most patients had mild to moderate COVID-19 and no differences were observed between vitamin D deficient and non-deficient patients (81% vs. 84% of patients, respectively p = 0.829). (4) Conclusion: No association was found between serum 25-hydroxyvitamin D levels and COVID-19 severity in this large observational study conducted over 2 years of the pandemic.

Admission eGFR predicts in-hospital mortality independently of admission glycemia and C-peptide in patients with type 2 diabetes mellitus and COVID-19

Objective Type 2 diabetes mellitus (T2DM) and impaired kidney function are associated with a higher risk of poor outcomes of coronavirus disease 2019 (COVID-19). We conducted a retrospective study in hospitalized T2DM patients with COVID-19 to assess the association between in-hospital mortality and admission values of different hematological/biochemical parameters, including estimated glomerular filtration rate (eGFR), plasma glucose and C-peptide (the latter serving as a marker of beta-cell function). Methods The study included T2DM patients with confirmed severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection who were consecutively admitted to our Institution between 1 October 2020 and 1 April 2021. Results Patients (n = 74) were categorized into survivors (n = 55) and non-survivors (n = 19). Non-survivors exhibited significantly higher median white blood cell (WBC) count, D-dimer, neutrophil-to-lymphocyte ratio, high-sensitivity C-reactive protein (hsCRP), and procalcitonin levels, as well as significantly lower median serum 25-hydroxyvitamin D [25(OH)D] levels compared to survivors. Non-survivors exhibited significantly higher median admission plasma glucose (APG) values compared to survivors (210 vs. 166 mg/dL; p = .026). There was no statistically significant difference in median values of (random) plasma C-peptide between non-survivors and survivors (3.55 vs. 3.24 ng/mL; p = .906). A significantly higher percentage of patients with an eGFR < 60 mL/min/1.73 m2 was observed in the non-survivor group as compared to the survivor group (57.9% vs. 23.6%; p = .006). A multivariate analysis performed by a logistic regression model after adjusting for major confounders (age, sex, body mass index, major comorbidities) showed a significant inverse association between admission eGFR values and risk of in-hospital mortality (OR, 0.956; 95% CI, 0.931-0.983; p = .001). We also found a significant positive association between admission WBC count and risk of in-hospital mortality (OR, 1.210; 95% CI, 1.043–1.404; p = .011). Conclusions Admission eGFR and WBC count predict in-hospital COVID-19 mortality among T2DM patients, independently of traditional risk factors, APG and random plasma C-peptide. Hospitalized patients with COVID-19 and comorbid T2DM associated with impaired kidney function at admission should be considered at high risk for adverse outcomes and death.

Vitamin D status in pregnancy and childhood associates with intelligence quotient at age 7 years: An Odense child cohort study.

Animal studies indicate a key role for vitamin D in brain development and function, but observational studies in humans only suggests a borderline positive association between prenatal vitamin D exposure and cognitive development in the offspring. Knowledge gaps include insights in exposure time window and differences by sex for the association. We aimed to investigate the association between blood concentrations of serum 25-hydroxyvitamin D measured at four different time points and intelligence quotient score at the age of 7 years, including analyses spilt by child sex. In Odense child cohort, we included 1404 mother-child pairs with serum 25-hydroxyvitamin D data from early pregnancy to age 7 years. Full-scale intelligence quotient was assessed with Wechsler Intelligence Scale for Children - fifth edition. Associations were adjusted for maternal education, pre-pregnancy body mass index, gestational age, sex and head circumference. Subanalyses stratified by sex were performed. The median (interquartile range) serum 25-hydroxyvitamin D in cord was 45.88 (31.15-61.08) nmol/L; early pregnancy, 66.45 (51.29-78.74); late pregnancy, 79.13 (59.69-97.31); 7 years, 66.29 (53.45-80.23) nmol/L. The mean (standard deviation) full-scale intelligence quotient was 99.44 (11.98). In adjusted analyses, cord serum 25-hydroxyvitamin D < 50 nmol/L was associated with 2.2 points lower full-scale intelligence quotient compared to the reference (50-75 nmol/L) in boys, β = -2.2; 95% confidence interval = [-4.3, -0.1], p = 0.039. The same association with full-scale intelligence quotient was found for early pregnancy serum 25-hydroxyvitamin D, β = -2.5 [-4.6, -0.3], p = 0.025, primarily driven by an association in boys, β = -4.0 [-7.2, -0.8], p = 0.015; and for serum 25-hydroxyvitamin D at 7 years in girls, β = -3.0 [-6.0, -0.1], p = 0.042. In this cohort, serum 25-hydroxyvitamin D < 50 nmol/L in both early gestation and cord blood in boys and current serum 25-hydroxyvitamin D < 50 nmol/L in girls were independent risk factors for two to four points lower full-scale intelligence quotient at the age of 7 years. Vulnerability to hypovitaminosis D, especially in pregnancy, may relate to child sex.

Association of vitamin D deficiency with COVID-19 severity and mortality in Iranian people: a prospective observational study.

BackgroundAs the coronavirus disease 2019 (COVID-19) pandemic continues to escalate, it is important to identify the prognostic factors related to increased mortality and disease severity. To assess the possible associations of vitamin D level with disease severity and survival, we studied 248 hospitalized COVID-19 patients in a single center in a prospective observational study from October 2020 to May 2021 in Tehran, Iran. MethodsPatients who had a record of their 25-hydroxyvitamin D level measured in the previous year before testing positive with COVID-19 were included. Serum 25-hydroxyvitamin D level was measured upon admission in COVID-19 patients. The associations between clinical outcomes of patients and 25-hydroxyvitamin D level were assessed by adjusting for potential confounders and estimating a multivariate logistic regression model.ResultsThe median (interquartile range) age of patients was 60 years (44–74 years), and 53% were male. The median serum 25-hydroxyvitamin D level prior to admission decreased with increasing COVID-19 severity (P=0.009). Similar findings were obtained when comparing median serum 25-hydroxyvitamin D on admission between moderate and severe patients (P=0.014). A univariate logistic regression model showed that vitamin D deficiency prior to COVID-19 was associated with a significant increase in the odds of mortality (odds ratio, 2.01; P=0.041). The multivariate Cox model showed that vitamin D deficiency on admission was associated with a significant increase in risk for mortality (hazard ratio, 2.35; P=0.019).Conclusions: Based on our results, it is likely that deficient vitamin D status is associated with increased mortality in COVID-19 patients. Thus, evaluating vitamin D level in COVID-19 patients is warranted.

Welfare receipt and the risk of vitamin D deficiency in Japanese patients on maintenance hemodialysis: a cross-sectional, retrospective study

BackgroundVitamin D deficiency is often observed in patients undergoing maintenance hemodialysis and is associated with significantly increased risk of overall mortality. Despite reports of poor nutrition/intake, vitamin D status among patients on maintenance hemodialysis receiving welfare remains unknown. This study investigated the vitamin D status in welfare recipients undergoing maintenance hemodialysis.MethodsThis cross-sectional study investigated vitamin D status among 106 outpatients undergoing maintenance hemodialysis at two medical facilities in Japan. Patients were divided into welfare and non-welfare groups based on their status as of September 2018. Patients were divided into two categories: serum vitamin D deficiency, defined as serum 25(OH)D concentrations < 12 ng/mL, or non-deficiency. Vitamin D deficiency was used as a dependent variable, while welfare receipt was used as the main predictor variable.ResultsMean [± standard deviation] patient age, median [interquartile range] body mass index, and hemodialysis duration were 66.9 [± 10.8] years, 21.5 [19.6, 24.3] kg/m2, and 7.9 [2.9, 12.3] years, respectively. Among 106 patients, 45 were women (42.5%) and 16 (15.1%) were receiving welfare. The welfare group had a higher diabetes prevalence (P = 0.003) and significantly lower median serum 25-hydroxyvitamin D concentrations (11.5 [8.7, 14.0] vs. 14.8 [11.2, 19.9] ng/mL, P = 0.005). Multiple logistic regression analysis revealed that welfare receipt was a significant risk factor for vitamin D deficiency (odds ratio [95% confidence interval], 4.41 [1.08, 18.07]).ConclusionsWelfare recipients undergoing maintenance hemodialysis are at significantly increased risks of vitamin D deficiency compared with patients not receiving welfare.

Vitamin D Supplementation and Disease-Free Survival in Stage II Melanoma: A Randomized Placebo Controlled Trial.

Patients with newly resected stage II melanoma (n = 104) were randomized to receive adjuvant vitamin D3 (100,000 IU every 50 days) or placebo for 3 years to investigate vitamin D3 protective effects on developing a recurrent disease. Median age at diagnosis was 50 years, and 43% of the patients were female. Median serum 25-hydroxy vitamin D (25OHD) level at baseline was 18 ng/mL, interquartile range (IQ) was 13–24 ng/mL, and 80% of the patients had insufficient vitamin D levels. We observed pronounced increases in 25OHD levels after 4 months in the active arm (median 32.9 ng/mL; IQ range 25.9–38.4) against placebo (median 19.05 ng/mL; IQ range 13.0–25.9), constantly rising during treatment. Remarkably, patients with low Breslow score (<3 mm) had a double increase in 25OHD levels from baseline, whereas patients with Breslow score ≥3 mm had a significantly lower increase over time. After 12 months, subjects with low 25OHD levels and Breslow score ≥3 mm had shorter disease-free survival (p = 0.02) compared to those with Breslow score <3 mm and/or high levels of 25OHD. Adjusting for age and treatment arm, the hazard ratio for relapse was 4.81 (95% CI: 1.44–16.09, p = 0.011). Despite the evidence of a role of 25OHD in melanoma prognosis, larger trials with vitamin D supplementation involving subjects with melanoma are needed.

A longitudinal histologic evaluation of vitamin D receptor expression in the skeletal muscles of patients with a distal radius fracture.

Vitamin D supplementation is known to enhance muscle mass and function, but whether the VDR is essential in this process remains unknown. We evaluated the change in VDR expression and CSA in the forearm muscles following vitamin D supplementation in patients with a DRF. We prospectively recruited 18 women with a median age of 63.5 years who have a DRF. We obtained two biopsies of the forearm muscle, first at the time of fracture repair and then during hardware removal. We supplemented 1000 IU of vitamin D per day during a median interval of 8 months. We examined the changes in VDR expression and CSA by immunohistochemistry. The median serum 25-hydroxyvitamin D [25(OH)D] increased from 14.3 to 32.1 ng/mL (P = 0.001). The median VDR expression increased from 0.72 to 0.78 (P = 0.002), and the median CSA increased from 1290.0 to 1685.8 μm2 (P = 0.022). Significant increases in VDR expression and CSA were observed in vitamin D-deficient patients [25(OH)D] < 20 ng/mL, but not in vitamin D-non-deficient patients. The changes in VDR expression and CSA were in the same direction in 13 patients, but in the opposite direction in 5 patients. Vitamin D supplementation may increase muscle VDR expression and CSA in patients with a DRF, especially in vitamin D-deficient patients. The increase in CSA without an increase in VDR expression in some patients indicates that the effect of vitamin D supplementation on muscle mass could be mediated by indirect effect of serum vitamin D restoration and by VDR.

Seasonal variation of idiopathic benign paroxysmal positional vertigo correlates with serum 25-hydroxyvitamin D levels: a six-year registry study in Shanghai, China

Seasonal variation of benign paroxysmal positional vertigo (BPPV) occurrence has been reported in recent years. Whether the seasonality of BPPV also exists in Chinese patients and whether it correlates with serum vitamin D levels is unexplored. We retrospectively analyzed the data of 1269 new-onset idiopathic BPPV patients registered in our vertigo outpatient clinic over a six-year period. Additionally, serum 25-hydroxyvitamin D levels during this period were measured in 877 patients by chemiluminescence immunoassay. We delineated the changing trend of the monthly BPPV patient numbers and serum 25-hydroxyvitamin D levels, and the correlation between them was explored. December to next March is the top 4 months with higher BPPV patient numbers. The median BPPV patient numbers in winter group were higher than those in summer group (20 vs. 16 patients, p < 0.05). Median 25-hydroxyvitamin D levels in winter group were much lower than those in summer group (16.3 vs. 20.8 ng/ml, p < 0.001) and autumn group (16.3 vs. 19.3 ng/ml, p < 0.05). A moderate negative correlation was observed between median serum 25-hydroxyvitamin D levels and BPPV patient numbers each month. The onset of BPPV also shows a seasonal fluctuation in Chinese patients. This phenomenon may be related to serum vitamin D levels.

The Impact of Serum 25-Hydroxyvitamin D3 Levels on Allergic Rhinitis

We aimed to clarify the relation between allergic rhinitis and the serum levels of 25-hydroxivitamin D in the adult population. The study group consisted of 86 patients with allergic rhinitis who were diagnosed with the help of history of allergy, positive signs for allergy, blood samples, and positive skin prick tests; while the control group included 43 age- and sex-matched healthy volunteers with negative skin prick tests. The demographic data, medical history, findings in the physical examinations, serum levels of total immunoglobulin E (IgE) and 25-hydroxyvitamin D, and skin prick test results of the groups were noted. A total of 129 patients fulfilling the necessary criteria were enrolled. The median serum 25-hydroxyvitamin D levels in the study group were significantly lower compared to the control group (P = .014). In the study group, median serum vitamin D levels were significantly higher in men, compared to women (P = .03). There was a significant negative correlation between IgE and vitamin D levels in the allergic rhinitis group (P = .028, r = -0.246). This study showed that patients with allergic rhinitis might be more vulnerable to have lower serum levels of vitamin D. Thus, vitamin D supplementation as an adjunctive therapy may be considered in those patients.

Vitamin D status among preterm infants with cholestasis and metabolic bone disease.

Metabolic bone disease of prematurity (MBD) is a common problem among preterm infants. Our previous study identified cholestasis as an important risk factor for the development of MBD. We conducted this study to determine the vitamin D status in preterm infants with MBD and cholestasis. We retrospectively reviewed medical record of preterm infants evaluated in NICU at Holtz Children's/Jackson Memorial Hospital between June 2014 and May 2016. Demographic, biochemical data, and vitamin D intake were collected and analyzed. We identified 58 preterm infants (median gestational age 25 weeks) with MBD during this period. Twenty five infants also developed cholestasis. Median serum 25-hydroxyvitamin D level at the time of diagnosis of MBD was similar in cholestasis (C), (29.1 ng/ml, IQR 24.4-33.5), and non-cholestasis (NC), (28.7 ng/ml, IQR 22.7-34.6), group (p = 0.41). At the second measurement, average 6 weeks after the first measurement; median serum 25-hydroxyvitamin D level was lower (p = 0.02) in the C group (31.2 ng/ml, IQR 23.0-38.8) than in the NC group (36.5 ng/ml, IQR 28-45). However, the actual percentage of infants with vitamin D deficiency was similar in both the groups. Most preterm infants with cholestasis and MBD had normal vitamin D status.

The Relationship Between 25-Hydroxyvitamin D3 and Hepatitis B Surface Antigen Levels in Patients with Chronic Hepatitis B in Japan

Background: Although there are many reports on the relationship between serum 25-hydroxyvitamin D3 levels and chronic liver diseases, the relevance of the former to the latter is still unclear. Objectives: This study aimed at clarifying the relationship between serum 25-hydroxyvitamin D3 levels and HBV-related markers, such as HBV-DNA, hepatitis B surface antigen (HBsAg), and hepatitis B virus core-related antigen (HBcrAg) in patients with chronic hepatitis B. Methods: This was a multicenter retrospective study. The subjects consisted of 236 consecutive untreated patients with chronic hepatitis B. Serum 25-hydroxyvitamin D3 levels were measured by double-antibody radioimmunoassay. The 25-hydroxyvitamin D3 levels were divided to three groups: ≤ 20 ng/mL for deficiency, 21 to 29 ng/mL for insufficiency, and ≥ 30 ng/mL for sufficiency. Results: The subjects consisted of 127 males and 109 females, with a median age of 57 years (range, 15 to 84 years). The patients with positive HBeAg and genotype C accounted for 14.4% and 63.1%, respectively. The median HBV-DNA level and HBsAg level were 684 IU/mL and 750 IU/mL, respectively. The median serum 25-hydroxyvitamin D3 level was significantly lower in patients (21.0 ng/mL) than in healthy volunteers (25.0 ng/mL, P = 0.013). The median serum 25-hydroxyvitamin D3 level in patients with a serum HBsAg level ≥ 1000 IU/mL was significantly lower than that in patients with a serum HBsAg level of < 1000 U/mL (P = 8.06 × 10-3). The incidence of the HBsAg level ≥ 1000 IU/mL was 55.8% in patients with vitamin D deficiency and 38.2% in patients with vitamin D insufficiency/sufficiency (P = 8.92 × 10-3). On multivariate analysis, female gender, the cold season, and a serum HBsAg level of ≥ 1000 IU/mL were independently associated with vitamin D deficiency. From the opposite viewpoint, vitamin D deficiency and high serum HBcrAg level were independent factors associated with an HBsAg level of ≥ 1000 IU/mL. Conclusions: This study suggests that serum vitamin D level is closely and negatively correlated with the HBsAg level in chronic hepatitis B patients.

Nutritional rickets in Taiwanese children: Experiences at a single center.

The number of children with nutritional rickets in Taiwan has increased over the last decade. The aim of this study was to present our experiences in the management of patients with this condition. From 2011 to 2016, 10 children (3 boys and 7 girls) with nutritional rickets were enrolled in this study. Their clinical and biochemical data were analyzed. The median age of the 10 patients was 21 months (range, 12-25 months). The predisposing factors included exclusive breastfeeding, dietary restriction, and limited outdoor activities. The most common presentations were unsteady gait and bowlegs, and two patients had hypocalcemic seizures. All patients had elevated alkaline phosphatase levels (median, 1008U/L; range, 484-2051U/L), elevated serum intact parathyroid hormone levels (median, 333.8pg/mL; range, 130-817pg/mL), and hypophosphatemia (median, 3.0mg/dL; range, 2.4-3.9mg/dL). The median serum 25-hydroxyvitamin D level was 7.44ng/mL (range, 1.44-9.82ng/mL). After vitamin D supplementation was initiated, serum phosphorus levels normalized within 1 month, and serum intact parathyroid hormone levels returned to the normal range within 2 months. Six of the 10 patients had serum alkaline phosphatase levels close to the normal range within 3 months. All 10 patients exhibited complete bone healing within 6 months of vitamin D treatment. Nutritional rickets is not as rare in Taiwan as previously thought. When physicians encounter infants or toddlers with typical bone deformities or hypocalcemic seizures, a high index of suspicion and a detailed nutritional history are important for early diagnosis and treatment.

Vitamin D Levels are Associated with Liver Disease Severity in Patients with Cirrhosis

Vitamin D deficiency is common in advanced liver disease but its clinical significance remains controversial. The aim of this study was to examine the correlation of 25-hydryoxyvitamin D levels with liver disease severity and calcium levels in adults with cirrhosis. This cross-sectional study included 180 adults with cirrhosis enrolled in a clinical cohort study at a single university hospital. The mean age was 58.8 (±9.2) years, and cirrhosis was attributed to alcohol use in 27.2%, hepatitis C in 35.0%, non-alcoholic steatohepatitis in 27.2%, and both alcohol and hepatitis C in 10.6%. The median model for end-stage liver disease-sodium (MELD-Na) score was 12.0 (interquartile range 9.0–16.0), and mean serum albumin levels were 3.4 (±0.7) gm/dl. Median serum 25-hydroxyvitamin D levels were 28.0 (interquartile range 20–38) ng/mL, with 16 patients (8.9%) having levels &lt;12 ng/ml and 43 (23.9%) with 25(OH)D levels &lt;20 ng/ml. No correlation was noted between levels of 25-hydroxyvitamin D and albumin-corrected calcium in the total group and in groups stratified by vitamin D supplementation. In contrast, both serum albumin (r = 0.32; P &lt; 0.001) and MELD-Na scores were significantly correlated with 25-hydroxyvitamin D levels (r = –0.29; P &lt; 0.001). Correlations between 25-hydroxyvitamin D levels and serum albumin (r = ?0.39; P &lt; 0.001) and MELD-Na scores did not change substantially after excluding 67 patients receiving vitamin D supplementation (r = ?0.33; P = 0.009). In conclusion, total 25-hydroxyvitamin D levels correlate inversely with liver disease severity in adults with cirrhosis.

Vitamin D status among the elderly Chinese population: a cross-sectional analysis of the 2010\u20132013 China national nutrition and health survey (CNNHS)

BackgroundVitamin D inadequacy is common among the elderly, especially within the Asian population. The vitamin D status among healthy adults in the elderly Chinese population was evaluated.MethodsA total of 6014 healthy adults aged 60 years or older (2948 men, 3066 women) participated in this descriptive cross-sectional analysis. Possible predictors of vitamin D inadequacy were evaluated via multiple logistic regression analyses.ResultsThe median serum 25-hydroxyvitamin D (25(OH)D) levels were 61.0 nmol/l (interquartile range (IQR) 44.3–80.6, range 5.1–154.5) for men and 53.7 nmol/l (IQR 38.8–71.0, range 6.0–190.0) for women, with 34.1% (95% confidence interval (CI) 32.4–35.8) of men and 44.0% (95% CI 42.2–45.8) of women presenting vitamin D inadequacy (25(OH)D <50 nmol/l). According to the multivariate logistic regression analyses, vitamin D inadequacy was positively correlated with female gender (P <0.0001), underweight (P = 0.0259), the spring season (P <0.0001), low ambient UVB levels (P <0.0001) and living in large cities (P = 0.0026). For men, vitamin D inadequacy was positively correlated with the spring season (P = 0.0015), low ambient UVB levels (P <0.0001) and living in large cities (P = 0.0022); for women, vitamin D inadequacy was positively correlated with the spring season (P = 0.0005) and low ambient UVB levels (P <.0001).ConclusionsVitamin D inadequacy is prevalent among the elderly population in China. Because residing in regions with low ambient UVB levels increases the risk of vitamin D inadequacy both for men and women, vitamin D supplementation and sensible sun exposure should be encouraged, especially during the cooler seasons. Further studies are required to determine the optimal vitamin D intake and sun exposure levels to maintain sufficient vitamin D levels in the elderly Chinese population.

Effect of vitamin D supplementation on health status in non-vitamin D deficient people with type 2 diabetes mellitus.

ObjectiveIncreased levels of depressive symptoms, fatigue or pain (all dimensions of reduced health-related quality of life (HRQOL)) are common in people with type 2 diabetes mellitus (DM). Earlier studies have reported associations between low vitamin D status and fatigue and depressive symptoms. The aim of the present study was to examine the effects of vitamin D supplementation on dimensions of HRQOL in people with type 2 DM.DesignRandomised, double-blind, placebo-controlled trial.MethodsThe effect of monthly cholecalciferol 50,000 IU vs placebo on HRQOL was assessed in 275 adults with type 2 DM derived from general practices. HRQOL at baseline and after six months using the Short Form 36 Health Survey (SF-36) was collected. Linear regression analyses were used to compare the change in HRQOL over time between the vitamin D and placebo group.Results187/275 (68%) completed baseline and follow-up SF-36 and were included in the analysis. Median serum 25-hydroxyvitamin D almost doubled in the intervention group compared to that in the placebo group (58.5–106.0 nmol/L vs 60.0–61.5 nmol/L, respectively). A small significant difference (adjusted B: −8.90; 95% CI: −17.16 to −0.65) between both groups was seen concerning the SF-36 domain role limitations due to physical problems in disadvantage of the vitamin D group.ConclusionsSix months of vitamin D supplementation did not improve HRQOL in non-vitamin D-deficient people with type 2 DM managed on oral antidiabetic therapy.

The association between serum 25-hydroxyvitamin D level and recurrent falls in the elderly population: a cohort study.

IntroductionSerum vitamin D concentration is a major contributing factor for increasing the risk of fall and fall-related injuries in older adults. However, when prescribed and supplemented for these populations, the outcomes are controversial, and in several cases no improvement has been reported in reducing the risk of recurrent falls. This study aimed to examine the association between serum vitamin D concentration and recurrent falls in Iranian older adults.MethodsThis cohort study was conducted in the emergency departments of two university hospitals. A cohort of 82 elderly participants aged over 60 and suffered from an unintentional episode of falling was evaluated six months after their first ED visit. A structured, self-administered checklist was developed to obtain the participants’ demographic and clinical information. Participants also were asked about any recurrent fall experience during follow-up.ResultsThe mean (SD) age of the study population was 75 (8). Over half of the participants were male (57.3%). The mean (median) serum 25-hydroxyvitamin D (25 (OH)D) concentration was 38 (34) ng/ml. Mean serum 25(OH)D levels varied slightly between gender groups (p=0.450). An inverse but insignificant association was found between the age of participants and their serum 25(OH)D levels (r=−0.03, p=0.7). A small but insignificant association also was found between the mean serum 25(OH)D level and the number of recurrent falls in elderly patients irrespective of their age, gender, or physical activity groups (OR=1.008, p=0.992).ConclusionIn contrast to previous studies, no significant association of serum 25(OH)D concentration was found with recurrent falls in Iranian older adults.

Children with lower respiratory tract infections and serum 25-hydroxyvitamin D3 levels: A case-control study.

Pneumonia is the leading cause of death in children under age of 5 years worldwide. The role of vitamin D in respiratory infections including pneumonia is unclear; therefore, we aimed to determine if children with lower respiratory tract infections had low serum 25-hydroxyvitamin D3 . We performed a case-control study of children ages 3-60 months from the Guatemala City metropolitan area, hospitalized with community-acquired pneumonia between September and December 2012. Controls were selected from the well-baby/care immunization clinics serving the population from which cases emerged. We analyzed serum 25-hydroxyvitamin D3 levels and conducted parental interviews to assess subject age, sex, race, feeding type, vitamin D supplementation, frequency of sun exposure, and maternal education. Height and weight were ascertained from medical records. Complete information was available for 70 (83%) of 84 eligible cases and 68 (60%) of 113 eligible controls. The median (IQR) serum 25-hydroxyvitamin D3 concentration for cases was 23.2 ng/ml (14.4-29.9) compared to 27.5 ng/ml (21.4-32.3) in controls (P = 0.006). Multiple regression analysis using an a priori cut-point for vitamin D of <20 ng/ml showed that children with lower respiratory tract infections were more likely to have low 25-hydroxyvitamin D3 levels than controls (adjusted odds ratio 2.4, 95% confidence interval 1.1-5.2, P = 0.02). Children with lower respiratory tract infections in Guatemala had low 25-hydroxyvitamin D3 levels. Pediatr Pulmonol. 2016;51:1080-1087. © 2016 Wiley Periodicals, Inc.

Vitamin D Deficiency in Patients with Acute Myocardial Infarction: An Italian Single-Center Study.

Hypovitaminosis D is a vitamin deficiency that has been increasing in developed countries; it was also suggested as an emerging risk factor for developing of atherosclerosis and acute myocardial infarction. The primary source of vitamin D is its cutaneous synthesis under exposure to sunlight. It has been suggested that 30 min of sun exposure twice weekly leads to sufficient vitamin D synthesis. The residents of Trieste (Italy) are well-known for their high exposure to sunlight in all seasons. We aimed to investigate the vitamin D status in subjects with acute myocardial infarction living in this area. Vitamin D status was identified in 478 subjects diagnosed with acute myocardial infarction. The median serum 25-hydroxyvitamin D concentration was 14.5 [7.8 - 22.7] ng/mL. Vitamin D deficiency and insufficiency were present in 324 (68 %) and 107 (22 %) subjects, respectively. Vitamin D deficiency was less frequent among subjects enrolled in the period from July to the end of September (p < 0.001). In a multivariate analysis vitamin D deficiency was predicted by older age (p = 0.02), female gender (p = 0.002), higher body mass index (p = 0.05), autumn/winter sampling (p < 0.001), increased parathyroid hormone (p = 0.03) and alkaline phosphatase (p = 0.003). We observed very high prevalence of vitamin D deficiency among subjects with myocardial infarction in all seasons of enrollment. However, it was lower in the summer when sun exposure is higher. The exposure to sunlight may be a cost-saving therapeutic strategy for the management of vitamin D deficiency.

Vitamin D deficiency prevalence and risk factors among pregnant Chinese women.

To evaluate vitamin D deficiency prevalence and risk factors among pregnant Chinese women. A descriptive cross-sectional analysis. China National Nutrition and Health Survey (CNNHS) 2010-2013. A total of 1985 healthy pregnant women participated. Possible predictors of vitamin D deficiency were evaluated via multiple logistic regression analyses. The median serum 25-hydroxyvitamin D level was 15·5 (interquartile range 11·9-20·0, range 3·0-51·5) ng/ml, with 74·9 (95 % CI 73·0, 76·7) % of participants being vitamin D deficient (25-hydroxyvitamin D <20 ng/ml). According to the multivariate logistic regression analyses, vitamin D deficiency was positively correlated with Hui ethnicity (P=0·016), lack of vitamin D supplement use (P=0·021) and low ambient UVB level (P<0·001). In the autumn months, vitamin D deficiency was related to Hui ethnicity (P=0·012) and low ambient UVB level (P<0·001). In the winter months, vitamin D deficiency was correlated with younger age (P=0·050), later gestational age (P=0·035), higher pre-pregnancy BMI (P=0·019), low ambient UVB level (P<0·001) and lack of vitamin D supplement use (P=0·007). Vitamin D deficiency is prevalent among pregnant Chinese women. Residing in areas with low ambient UVB levels increases the risk of vitamin D deficiency, especially for women experiencing advanced stages of gestation, for younger pregnant women and for women of Hui ethnicity; therefore, vitamin D supplementation and sensible sun exposure should be encouraged, especially in the winter months. Further studies must determine optimal vitamin D intake and sun exposure levels for maintaining sufficient vitamin D levels in pregnant Chinese women.