Median Serum Vitamin Research Articles

Serum Vitamin D and B12 Levels in Alcoholic Male Patients: A Cross-sectional Study

INTRODUCTION
 Alcohol dependence is a global problem and is rapidly increasing in developing countries. We aimed to analyze the serum levels of vitamin B12 and vitamin D in chronic alcoholic patients and their association with parameters of liver function.
 MATERIAL AND METHODS
 A cross-sectional study was carried out in Universal College of Medical Sciences, Bhairahawa, Nepal from March 2020 to September 2020 on patients visiting the Psychiatric Out Patient Department (OPD) for the treatment of alcohol dependence. The patients were categorized as excessive and moderate drinkers. Serum vitamin B12, vitamin D, and hepatic function parameters were measured.
 RESULTS
 The median serum vitamin B12 and vitamin D levels were 467.8 pg/ml and 24.9 ng/ml respectively. Excessive drinkers had significantly higher B12 levels than moderate drinkers. Vitamin B12 levels correlated positively with liver function parameters, as well as alcohol amount and duration of consumption. Vitamin D levels were insufficient in 57 (71.25%) of the overall participants.
 CONCLUSION
 Serum levels of vitamin B12 are not affected in patients with alcohol dependence. Alcohol consumption, however, reduces serum concentrations of vitamin D. Vitamin B12 concentration is positively associated with liver enzymes and other parameters of liver function.

MO578OSTEOCALCIN AND VASCULAR CALCIFICATION IN HEMODIALYSIS PATIENTS: AN OBSERVATIONAL COHORT STUDY

Abstract Background and Aims Vascular calcification contributes to morbidity and mortality in patients with ESRD on maintenance hemodialysis. to study the relationship between osteocalcin and vascular calcification. Method 160 patients with ESRD on maintenance hemodialysis and 60 age-and sex-matched healthy controls were recruited. Serum vitamin K2 and osteocalcin both intact and undercarboxylated were measured. Transthoracic echocardiography was done for valvular calcification and thickening, and carotid duplex was done for carotid intimal medial calcification and thickening. Results Hemodialysis patients have higher median serum vitamin K2 (p<0.001), higher undercarboxylated osteocalcin (p<0.001). Only older age, duration of hypertension, and duration of established cardiovascular disease are associated with carotid media-intimal calcification. Old age is a strong predictor of carotid media intimal thickening. Female sex is associated with valvular thickening. Conclusion Functional vitamin K deficiency is present in maintenance hemodialysis patients and serum osteocalcin is not associated with cardiovascular calcification.

Relationship between Serum 25(OH)D Levels and Blood Pressure in Children with Nephrotic Syndrome

BACKGROUND: Vitamin D plays an eminent role in the renin-angiotensin system that may interfere with blood pressure regulation. Children with nephrotic syndrome (NS) are often observed with low serum vitamin D levels that may lead to Vitamin D deficiency status. AIM: This study aimed to investigate the correlation between serum vitamin D [25(OH)D] levels and blood pressure in children with NS. METHODS: A cross-sectional, observational analytic study was conducted in 35 children NS with minimal change diseases from February to August 2019 in Haji Adam Malik General Hospital, Medan. Blood pressure was examined and serum Vitamin D levels along with serum creatinine, albumin, and calcium were measured. RESULTS: Of 35 children, 21 children (60%) had proteinuria. Regarding the category of Vitamin D status, there were 40% and 34.3% with deficiency and severe deficiency of Vitamin D, respectively. The median serum Vitamin D levels were not significantly different among the age group. Children with proteinuria showed lower serum Vitamin D levels (P < 0.001). There was an elevation of systolic and diastolic blood pressure in children with proteinuria (P = 0.039 and P = 0.036, respectively). Our study showed a weak negative correlation between serum Vitamin D levels and either systolic or diastolic blood pressure (r-0.114 and r-0.174, respectively). CONCLUSION: Both Vitamin D deficiency and severe deficiency are common in children with NS. In this study, serum Vitamin D levels have been shown to have a weak negative correlation with blood pressure in children with NS.

Osteocalcin and vascular calcification in hemodialysis patients: an observational cohort study.

Vascular calcification contributes to morbidity and mortality in patients with ESRD on maintenance hemodialysis. To study the relationship between osteocalcin and vascular calcification. 160 patients with ESRD on maintenance hemodialysis and 60 age-and sex-matched healthy controls were recruited. Serum vitamin K2 and osteocalcin both intact and undercarboxylated were measured. Transthoracic echocardiography was done for valvular calcification and thickening, and carotid duplex was done for carotid intimal medial calcification and thickening. Hemodialysis patients have higher median serum vitamin K2 (p < 0.001), higher undercarboxylated osteocalcin (p < 0.001). Only older age, duration of hypertension, and duration of established cardiovascular disease are associated with carotid media-intimal calcification. Old age is a strong predictor of carotid media intimal thickening. Female sex is associated with a valvular thickening. Functional vitamin K deficiency is present in maintenance hemodialysis patients and serum osteocalcin is not associated with cardiovascular calcification.

Evaluation of vitamin D status in children with cerebral palsy

Objective The current study was conducted to evaluate vitamin D status in children with cerebral palsy (CP) and its relations with associated risk factors. Patients and methods The present research included 50 children with CP of both sexes compared with a control group of 20 healthy children with matched age and sex. Serum 25-hydroxyvitamin D, serum calcium, and phosphorus were measured and compared in cases and controls. The Gross Motor Function Classification System (GMFCS) was recorded, and children with GMFCS level I–III were considered ambulatory, whereas children with level IV–V were considered nonambulatory. Results Median (interquartile range) serum vitamin D levels exhibited a significant decrease in the CP group (22.2 (14.48) ng/dl) as compared with the controls (33.1 (7.8) ng/dl). Twenty-two (44%) children with CP were vitamin D deficient versus two (10%) control groups. A significant difference was found in serum vitamin D level in those who were nonambulatory, had feeding problems in comparison with those who were ambulatory, and had no feeding problems. At the same time, there was no significant difference regarding antiepileptic drugs (AEDs) use. Serum vitamin D level was inversely correlated with nonambulation and feeding problems, whereas the correlation was not significant regarding AEDs use. Conclusion Children with CP are susceptible to vitamin D deficiency, especially those who are nonambulatory, having feeding problems, whereas those who used AEDs are not.

Bone Mineral Density and Content Among Patients With Coronary Artery Disease: A Comparative Study

Some studies indicate an association between coronary artery disease (CAD) and osteoporosis. This case-control study examined the association between body composition and bone mineral content (BMC) and density (BMD) among patients with CAD. A group of men (n=73) with established CAD and age and sex matched controls (n=65) were included in the study. Data collected included socio-demographic information, disease related data (from cases), anthropometric measurements, serum vitamin D, calcium and phosphorous and body composition analysis using DEXA. Two groups were compared using independent sample t-test, Mann Whitney U-test or Chi square test. Pearson correlation and regression models were used to test the associations between body compartments. Among cases, the mean disease duration was 29 (range 5-192) months and 15% had triple vessel disease. Patients had higher mean total body fat mass (TBFM) (18869.7 vs 16733.0)g, p=0.018), truncal fat mass (TRFM) (9259.1 vs 7992.5g, p=0.009) and fat percentage (28.6 vs 25.9%, p=0.001) compared to controls. Median serum vitamin D level was significantly lower among patients (20.0 ng/mL) compared to controls (27.1ng/mL) (p=0.003). In both groups, TBFM and total body lean mass (TBLM) both showed significant positive correlations with total body BMD/BMC and regional BMDs. Of the two, TBLM emerged the best predictor of TBBMC/TBBMD. These associations were greater among patients than controls. TBLM appears to be the strongest predictor of TBBMD and TBBMC in patients and controls. The strength of associations was greater among patients compared to controls even after adjusting for possible confounders .

Vitamin C deficiency and impact of vitamin C administration among pediatric patients with advanced chronic kidney disease.

Vitamin C deficiency is common in chronic kidney disease (CKD) due to losses through dialysis and dietary intake below requirement. We investigated prevalence of vitamin C deficiency and impact of vitamin C treatment in deficient/insufficient patients. A prospective cohort study in patients aged 1-18years with CKD stages 4 and 5D collected demographic data including underlying disease, treatment, and anthropometric assessment. Vitamin C intake was assessed using 24-h dietary recall. Hemoglobin, iron status, serum vitamin C, and serum oxalate were measured at baseline and after treatment. Vitamin C (250mg/day) was given orally for 3months to deficient/insufficient patients. Nineteen patients (mean age 12.00 ± 4.1years) showed prevalence of 10.6% vitamin C insufficiency and 78.9% deficiency. There were no associations between vitamin C level and daily vitamin C intake (p = 0.64) or nutritional status (p = 0.87). Median serum vitamin C was 1.51 (0.30-1.90) mg/L. In 16 patients receiving treatment, median serum vitamin C increased from 1.30 (0.23-1.78) to 3.22 (1.77-5.96) mg/L (p = 0.008) without increasing serum oxalate (79.92 (56.6-106.84) vs. 80.47 (56.88-102.95) μmol/L, p = 0.82). However, 62.5% failed to achieve normal vitamin C levels. Ordinal regression analysis revealed patients with non-oligoanuric CKD were less likely to achieve normal vitamin C levels (β = - 3.41, p = 0.03). We describe high prevalence of vitamin C insufficiency/deficiency among pediatric CKD patients. Vitamin C levels could not be solely predicted by nutritional status or daily intake. The treatment regimen raised serum vitamin C without increasing serum oxalate; however, it was largely insufficient to normalize levels, particularly in non-oligoanuric CKD. Graphical abstract .

Abstract C088: Assessing vitamin D and mammographic breast density in a population of Alaskan Native women

Abstract Background: Several studies have suggested that vitamin D may have antiproliferative and anticarcinogenic properties and a protective effect against breast cancer. Alaskan Natives have demonstrated high rates of vitamin D deficiency, particularly in young individuals. Hence, high breast density has been associated with increased breast cancer risk. Therefore, we examined the association between serum vitamin D levels and mammographic breast density in a population of Alaskan Native women. Methods: Patients seen in the Mayo Clinic-Alaska Native Medical Center telemedicine program from December 2014 to December 2017 were offered to enroll in the study. Consent was obtained by a study coordinator in Minnesota using a telemedicine platform. Participants were asked to complete the Breast Cancer Risk Questionnaire, which includes questions on hormonal, lifestyle factors and family history. Serum vitamin D levels (25-hydroxyvitamin D2 and D3) were obtained and later correlated with mammographic breast density (percent density). Data were summarized with frequencies and percentages or medians and interquartile ranges (IQR), as appropriate. Pearson correlation was used to estimate the association between breast density and vitamin D levels. Results: 33 women were included; median age was 53 years (IQR 45-58), 70% self-identified as American Indian/Alaskan Native, 12% as White, 6% as Native Hawaiian/Pacific islander and 12% as other. Median BMI was 31 kg/m² (IQR 26.4-34.3), menarche was at age 12 or older for 23 (70%) of the participants and 20 women were postmenopausal at the time enrollment. 10 participants had a hysterectomy, of whom 60% also had oophorectomy. 76% reported history of hormonal birth control use and 23% postmenopausal hormonal supplementation. Median number of pregnancies was 3 (IQR 2-5), and 20 women reported breastfeeding. Fifteen women were current or former smokers (&amp;gt;100 cigarettes) and 19 reported none or low alcohol consumption. Median serum vitamin D level was 39 ng/mL (IQR 30-52) and 9 (27%) women had low vitamin D levels. In regard to breast density, median percentage (average of images) was 15% (IQR 7.5-24.9) with a median dense area of 21.8 cm² (IQR 16.4-34.2). Median time from blood draw to mammogram was 110 days (IQR 41-172) and 19 (58%) participants were taking vitamin D supplementation at the time of study enrollment; doses ranged from 400 to 50,000 units. No correlation was identified between breast density and serum vitamin D levels (correlation=0.02). Conclusion: In this cohort, no association between serum vitamin D levels and breast density was observed. More than half of the participants were on vitamin D supplementation and this could have obscured our observations. Larger studies controlling for vitamin supplementation are needed, as this association could potentially impact breast cancer rates in populations at risk for vitamin D deficiency. Citation Format: Narjust Duma, Ivana Croghan, Sarah Jenkins, Loni Neal, Karthik Ghosh, Sandhya Pruthi. Assessing vitamin D and mammographic breast density in a population of Alaskan Native women [abstract]. In: Proceedings of the Eleventh AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2018 Nov 2-5; New Orleans, LA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(6 Suppl):Abstract nr C088.

Is COVID-19 Lockdown Associated with Vitamin D Deficiency?

This work was aimed at assessing whether the ongoing coronavirus disease 2019 (COVID-19) outbreak, along with associated social restrictions, may have impacted the vitamin status of the general population. To this end, we reviewed all vitamin D test results carried out for outpatients aged 18 years or older during the last three years at an Italian University Hospital. The median serum vitamin D concentrations measured from the first day of Italian lockdown to present time did not significantly differ from those of the same period in the previous two years (78 vs. 77 nmol/L; p=0.277), whilst the prevalence of vitamin D deficiency was found to be marginally lower in 2020 than in the previous two years (16.0% vs. 17.9%; p=0.003). These results suggest that vitamin D deficiency in our province has not increased during the Italian COVID-19 outbreak or in correspondence with the nationwide lockdown.

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 and its association with allergic status and serum IgE

Vitamin D exerts multiple immune-regulatory functions on the innate and adaptive immune systems. However, there is conflicting evidence concerning the contribution of vitamin D to the progression of allergies. The goal of this study was to investigate the connection between vitamin D and the prevalence of allergic disorders and serum IgE levels among young adults. The study samples included 272 students (120 males and 152 females) from Birjand University of Medical Sciences in Birjand, Iran. The allergic disorders studied, comprising allergic rhinitis (AR), asthma and atopic dermatitis (AD), were confirmed by an expert allergist. Commercial Elisa kits were used to measure serum levels of vitamin D and total IgE for all participants. The median (IQR) serum vitamin D value was 10.0 (6.0–17.0) ng/mL and the prevalence of vitamin D deficiency among the target population was 81.5%. Vitamin D levels were notably higher in males than in females [12.0 (8.0–18.0) vs. 8.0 (4.0–15.0); P<0.001]. The prevalence of AR, asthma and AD were 35.7%, 3.7% and 5.1%, respectively. There was no notable difference in serum vitamin D status between allergic and non-allergic students. The results of this study did not support any correlation between vitamin D status and allergy status among students.

Patterns of Vitamin D Levels and Exposures in Active and Inactive Noninfectious Uveitis Patients

To compare serum vitamin D levels and patterns of ultraviolet light and dietary exposure among patients with active and inactive noninfectious uveitis and population controls. Prospective case-control study. All participants (n= 151) underwent serum 25-hydroxy vitamin D measurement and completed a questionnaire on vitamin D intake and ultraviolet light exposure. Serum 25-hydroxy vitamin D levels were compared between active and inactive uveitis groups and with local population estimates. Adult patients with active and inactive noninfectious uveitis were recruited from 2 Victorian tertiary hospitals and 1 private ophthalmic practice. Serum 25-hydroxy vitamin D levels were compared between patients with active and inactive uveitis and population-based estimates of serum 25-hydroxy vitamin D levels, stratified by geographic region and season. Vitamin D intakes and exposures based on questionnaire results, including vitamin D supplementation and sunlight exposures on weekdays and weekends, were compared between active and inactive uveitis groups. Serum vitamin D levels, intake of vitamin D, and exposure to sources of vitamin D. The median level of serum vitamin D in those with active uveitis (n= 74) was 46 nmol/l (interquartile range [IQR], 29-70 nmol/l), significantly lower than in the inactive control group (n= 77) at 64 nmol/l (IQR, 52-79 nmol/l; P < 0.001). The active uveitis group also showed lower median serum vitamin D levels than the local population median of 62 nmol/l (IQR, 46-77 nmol/l). Vitamin D supplementation also was associated significantly with uveitis inactivity (P= 0.026, Kendall's τ test). In a subanalysis of vitamin D-deficient participants, sun exposure was associated significantly with uveitis inactivity (P= 0.014 for weekday and weekend analyses). Participants with active uveitis showed significantly lower serum 25-hydroxy vitamin D levels than inactive uveitis patients and local population-based estimates. Vitamin D supplementation was found to be associated with decreased uveitis activity, as was sun exposure in those with vitamin D deficiency. These results suggest that vitamin D supplementation should be studied as an option for the prevention of uveitis relapse in at-risk patients.

Vitamin D Deficiency Predicts for Poor Overall Survival in Caucasian but Not African American Patients with Multiple Myeloma

Background: A number of studies have reported elevated incidence of 25-OH-vitamin D deficiency among patients with multiple myeloma (MM). Several studies have found association between vitamin D levels and factors associated with survival, including ISS stage at diagnosis. However, the impact of vitamin D deficiency on MM prognosis is not entirely clear. Also, in general, both the incidence and the impact of vitamin D deficiency differ substantially by race. Here, we investigate the impact of vitamin D deficiency on prognosis in a large and racially heterogenous patient population with MM in the Veterans Affairs (VA) system.Methods: We used the VA's nationwide Corporate Data Warehouse to identify patients diagnosed with symptomatic MM from 1999 to 2017. Various demographic and laboratory data was collected including age, race, 25-OH-vitamin D levels, and ISS stage at diagnosis as well as survival outcome data. Details of therapies received was also available which indicted similar access to all newer agents approved for myeloma for both African American (AA) and Caucasian patients.Results: We identified 15,717 patients diagnosed with MM (3353 AA and 9070 Caucasian), of whom 6675 had vitamin D measurements within 2 months of diagnosis (1959 AA and 4398 Caucasian). Median serum vitamin D levels were significantly lower among AA patients (21.8 ng/mL) than Caucasians (28.6 ng/mL; p<0.0001). No difference in median vitamin D levels was observed across ISS stage at diagnosis (p=0.7575), but a significant positive correlation (ρ=0.166; p<0.0001) was found between vitamin D levels and age at diagnosis.We evaluated the ability of serum vitamin D level to predict overall survival (OS) in patients with MM using a cut-off of 20ng/mL. Patients with vitamin D deficiency (<20ng/mL) had a significantly worse prognosis than patients with normal levels (≥20ng/mL) (Fig 1A). Specifically, median OS was 3.10 years (95% CI 2.73-3.52) for patients with vitamin D deficiency, compared to 3.91 years (95% CI 3.59-4.38) for patients with normal serum vitamin D. Univariate Cox proportional hazard analysis also showed that vitamin D deficiency is a significant predictor of OS after MM diagnosis (HR 1.24; P=0.0021), and vitamin D deficiency remained an independent predictor of OS under multivariate analysis in which adjustments were made for race, age, and stage at diagnosis (HR 1.28; P=0.0385).The analyses were repeated for AA and Caucasian patients separately. Among AA patients, serum vitamin D was not a significant predictor of OS in univariate (P=0.5096) or multivariate analysis (P=0.6923), while it was still a strong predictor among Caucasian patients in both univariate (HR 1.38; P=0.0006) and multivariate analysis (HR 1.45; P=0.0048). Median OS is 3.54 years (95% CI 2.99-5.52; n=255) for AA patients with vitamin D deficiency and 3.95 years (3.25-5.35; n=296) with normal levels. Among Caucasians, median OS is 2.71 years (2.18-3.47; n=273) for deficient and 3.87 years (3.59-4.42; n=885) for normal. Kaplan-Meier plots (Fig. 1B and 1C) illustrate the observed OS curves for the two subgroups. Since levels of vitamin D were lower in AA patients, a lower cut-off of 10 ng/mL was also tested. Even using this lower cutoff, vitamin D deficiency was not a statistically significant predictor of OS in univariate (HR 1.33; P=0.0781) or multivariate analysis (HR 1.09; P=0.7039), though the number of AA patients with vitamin D <10 ng/ML is small (n=73).Conclusions: Vitamin D deficiency is a significant predictor of survival among patients diagnosed with MM, even after accounting for race, age, and ISS stage. However, this relationship is onlyobserved in Caucasian patients and not observed among AA patients. Studies are ongoing to evaluate impact of Vitamin D deficiency of disease presentation including bone disease as well as genetic characteristics. This investigation highlights the need to assess the underlying biological mechanism responsible for the observed impact of vitamin D deficiency across race in MM. [Display omitted] DisclosuresYellapragada:Novartis: Employment; Celgene: Research Funding; Takeda: Research Funding. Munshi:OncoPep: Other: Board of director.

Serum vitamin A, zinc and visual function in children with moderate to severe persistent asthma

Background: Asthma is a common childhood disorder with complex pathobiologic components that may include aspects of nutritional deficit. The contribution of vitamin deficiency, specifically vitamin A, as part of the disease complex has not been well studied, particularly among at risk children. In this study, we examined the prevalence of vitamin A as well as zinc deficiency in conjunction with visual function among an urban pediatric population sample with moderate–severe persistent asthma. Methods: A cross-sectional case–control assessment of serum vitamin A, zinc and visual function among urban children with and without asthma was undertaken. Inclusion criteria involved (1) well-controlled pediatric asthmatic patients between the ages of 8–18 with corrected vision of at least 20/25 in each eye and (2) chronic use of a combination beta agonist-steroid inhaler. Visual function was assessed by Snellen visual acuity and Peli Robson contrast sensitivity assessment. Results: Overall, 24 patients were enrolled for study with body mass index and age matched between asthmatic and control groups. Median serum vitamin A and zinc levels among control subjects was statistically higher compared to asthmatics (p = 0.0303 and p = 0.0111, respectively). Based on age-based reference levels there was no evidence of vitamin A or zinc deficiency among asthmatics or controls. Serum vitamin A and zinc were found to directly correlate with body mass index (p = 0.0074 and p = 0.0474, respectively), but not age or measures of visual function. Contrast sensitivity was however significantly reduced among asthmatic subjects (p = 0.0003). Conclusions: Children with chronic asthma demonstrate reduced levels of vitamin A and zinc that may be related to disease pathobiology however, evidence of frank zinc or vitamin A deficiency was not demonstrated. Reduced contrast sensitivity found in the asthmatic group appears unrelated to serum vitamin A and/or zinc levels.

No improvement in vitamin D status in German infants and adolescents between 2009 and 2014 despite public recommendations to increase vitamin D intake in 2012

PurposeVitamin D is a key component for the growth and development of children and adolescents, influencing a multitude of functions. Worldwide epidemiological studies have shown that minimum vitamin D blood levels of ≥ 20.0 ng/ml, often defined as vitamin D sufficiency by international and national nutrition and pediatric organizations, are often not met in practice. In 2012 the D–A–CH (Germany, Austria, Switzerland) nutrition societies increased their vitamin D intake recommendations fourfold from 200 IU (5 µg) to 800 IU (20 µg) per day. The outcome of this study will contribute to answering the question as to whether the new recommendations for increased vitamin D intake improve the highly prevalent vitamin D deficiency status in German children and adolescents.MethodsFor this 6-year study (January 2009–December 2014) carried out in Mülheim an der Ruhr, Germany, healthy children and adolescents (n = 1929, age range 1–17 years, median age 11.0 years, 46.9% female) consulting a pediatric group practice (KIDS4.0) were recruited. Serum 25(OH)D determinations were performed using a competitive chemoluminescence immunoassay (CLIA, DiaSorin).ResultsThe median serum vitamin D values for each year from 2009 to 2014 were 18.4, 13.0, 20.8, 16.4, 19.4 and 14.9 ng/ml. The summarized median 25(OH)D serum concentrations between the two time periods 2009–2012 and 2013–2014 after increasing recommendations for vitamin D intake did not show a significant difference (17.0 versus 16.8 ng/ml).ConclusionsThe increased D–A–CH recommendations for vitamin D intake had no influence on vitamin D levels in children and adolescents. The prevalence of vitamin D deficiency has not changed compared to previous studies.

Vitamin/mineral and micronutrient status in patients with classical phenylketonuria

Strict low-phenylalanine diet is associated with an increased risk of developing micronutrient deficiencies in patients with phenylketonuria (PKU). The primary objective of this single-center, case-control study was to assess the nutritional parameters of patients with PKU on strict low-phenylalanine diet without vitamin and mineral supplementation compared to a healthy control group. Secondary objective was to identify the adequacy of vitamin/mineral supplementation in phenylalanine-free (Phe-free) amino acid formulas. A total of 112 age- and sex-matched patients with PKU and 36 controls who did not take vitamin or mineral supplementation at least for the last 6 months were enrolled in the study. Biochemical and hematological markers including hemoglobin, serum vitamin B12, folic acid, iron, ferritin, transferrin saturation, copper, prealbumin, albumin, total protein, phosphorus, calcium, 25-hydroxy vitamin D, zinc, vitamin A and vitamin E levels were screened from fasting morning blood samples. One hundred and twelve patients with classical PKU (53 females, 47.3%) and 36 healthy controls (18 females, 50.0%) were enrolled in the study. The mean age of patients with PKU was 136.8±82.1 months (18-377). Median serum vitamin B12 level of patients with PKU was found to be higher than the control group (p=0.002). Vitamin B12 deficiency was 15.2% and 30.6% in patients with PKU and healthy controls, respectively (p=0.040). Mean serum folic acid level was higher in patients with PKU than the control group (p<0.0001). In 55.4% of patients with PKU, and 2.8% of the control group, serum folic acid level was above the reference range (p<0.0001). The frequency of ferritin and prealbumin values above the reference range was found to be higher in patients with PKU compared to the control group (44.4% vs 16.9%, p=0.001; 38.8% vs 22.1%, p=0.020, respectively). 25-Hydroxy vitamin D deficiency was detected in 53.6% and 47.2% of patients with PKU and the control group, respectively. Mean serum copper level was higher in the well-controlled (114.3±26.7μg/dL) group than the poorly controlled group (101.0±29.1μg/dL) (p=0.022). Phe-free amino acid formulas provide adequate vitamin A and zinc levels in patients with PKU, and result in excess folic acid, vitamin B12, copper and vitamin E values that are higher than required levels. Our results demonstrate a high percentage of vitamin D deficiency in patients with classical PKU and also in healthy controls in Turkey.

Vitamin D status in tuberculosis patients with diabetes, prediabetes and normal blood glucose in China: a cross-sectional study

ObjectiveThe association between tuberculosis (TB), diabetes mellitus (DM) and vitamin D status is poorly characterised. We therefore: (1) determined vitamin D status in patients with TB in relation to whether...

Bone Mineral Density is Lower in Patients with Severe Knee Osteoarthritis and Attrition.

Bone quality is probably important for the survival of knee arthroplasty (KA), but little is known about systemic bone mineral density and bone turnover in patients prior to KA surgery. The aim of this study was to explore the prevalence of osteoporosis and bone turnover in relation to knee osteoarthritis (OA) grade in patients scheduled for KA surgery. Prospective preoperative evaluation of 450 patients (259 females) prior to KA between 2014 and 2016 with standing knee radiography, Dual-energy X-ray absorptiometry (DXA), biomarkers for bone turnover (CTX, P1NP), and vitamin D. Grading of knee OA was done with the Altman Atlas and Kellgren Lawrence (KL). Adjustments for age and BMI were made. The mean age was 67.9years (range 39-94), and mean BMI was 28.8 (SD 4.8). The prevalence of osteoporosis was 9.6% (CI 95% 7.2; 12.7), while the proportion of patients with osteopenia was 36.0%. T score was similar between KL OA grade 3 and 4 (p=0.06); however, T score was lower (p=0.02) with the worst knee OA grade (attrition). The median serum Vitamin D level was 78.5nmol/L (range 10-196), and there was no association between serum vitamin D and the grade of OA (p>0.88). P1NP was significantly higher in KL grade 4 compared to KL grade 3 (p=0.03), but there was no association between KL grade and CTX (p=0.21). 10% had osteoporosis, which is similar to the age-matched background population. Bone mineral density was lower with severe knee osteoarthritis (attrition), and P1NP was higher with worse osteoarthritis grading.

Association of Serum Vitamin D Levels with Level of Control of Childhood Asthma.

To study the association between serum vitamin D levels and levels of asthma control in children aged 5-15 years. Children with physician-diagnosed asthma who were under follow-up for at least 6 months were enrolled. Participants were categorized into three asthma control groups as per standard guidelines, and their serum 25-hydroxy vitamin D levels and pulmonary function tests were compared. Out of 105 children with asthma enrolled in the study, 50 (47.6%) were controlled, 32 (30.5%) were partly controlled and 23 (21.9%) were uncontrolled. Median (IQR) serum vitamin D levels in these three groups were 9.0 (6.75, 15) ng/mL, 10 (6.25, 14.75) ng/mL and 8 (5, 10) ng/mL (P=0.24), respectively. We did not observe any association of serum 25-hydroxy vitamin D levels with the level of control of childhood asthma.

Low serum glutathione-S-transferase activity and vitamin e levels do not correlate with disease severity in steady state adults with sickle cell anemia

Introduction: Adequate levels of antioxidants are essential in subjects with sickle cell anaemia (SCA) to counter the effects reactive oxygen species generated during normal red cell metabolism. Objective: This study evaluated serum glutathione transferase activity and vitamin E levels in comparison with disease severity in steady state adult SCA subjects. Subjects And Methods: Five milliliters of venous blood was collected from each of 30 homozygous haemoglobin SS, 30 heterozygous haemoglobin AS and 30 haemoglobin AA subjects for glutathione transferase activity, vitamin E levels, haemoglobin phenotype and full blood count determination. The objective score of disease severity was calculated using white cell count, haemoglobin concentration and number of life time disease related complications and correlated with serum glutathione transferase activity and vitamin E levels, using the Spearman's correlation; P Results: The median serum Glutathione transferase activity and vitamin E levels in all study participants were 22 U/L (Q1 –Q3; 15:00 U/L – 28:50 U/L) and 32:00 ug/ml (Q1 – Q3; 17.00 ug/ml – 54.00 ug/ml, respectively). Glutathione transferase enzyme activity was significantly lower in HbSS compared with HbAA (P = 0.001) and HbSS compared with HbAS study subjects (P = 0.01). Enzyme activity and vitamin E levels did not show significant correlations with disease severity in subjects with HbSS (r = 0.07; P = 0.94 and r = -0.04; P = 0.12, respectively. Conclusion: Serum glutathione transferase activity and vitamin E levels may not be predictors of disease severity in SCA patients.