Prevalence Of Subclinical Vitamin Research Articles

Prevalence of subclinical Vitamin K deficiency in early infancy in exclusively breast-fed term infants

Prevalence of subclinical Vitamin K deficiency in early infancy in exclusively breast-fed term infants

Vitamin C Deficiency Reduces Neurogenesis and Proliferation in the SVZ and Lateral Ventricle Extensions of the Young Guinea Pig Brain.

Although scurvy, the severe form of vitamin C deficiency, has been almost eradicated, the prevalence of subclinical vitamin C deficiency is much higher than previously estimated and its impact on human health might not be fully understood. Vitamin C is an essential molecule, especially in the central nervous system where it performs numerous, varied and critical functions, including modulation of neurogenesis and neuronal differentiation. Although it was originally considered to occur only in the embryonic brain, it is now widely accepted that neurogenesis also takes place in the adult brain. The subventricular zone (SVZ) is the neurogenic niche where the largest number of new neurons are born; however, the effect of vitamin C deficiency on neurogenesis in this key region of the adult brain is unknown. Therefore, through BrdU labeling, immunohistochemistry, confocal microscopy and transmission electron microscopy, we analyzed the proliferation and cellular composition of the SVZ and the lateral ventricle (LVE) of adult guinea pigs exposed to a vitamin-C-deficient diet for 14 and 21 days. We found that neuroblasts in the SVZ and LVE were progressively and significantly decreased as the days under vitamin C deficiency elapsed. The neuroblasts in the SVZ and LVE decreased by about 50% in animals with 21 days of deficiency; this was correlated with a reduction in BrdU positive cells in the SVZ and LVE. In addition, the reduction in neuroblasts was not restricted to a particular rostro–caudal area, but was observed throughout the LVE. We also found that vitamin C deficiency altered cellular morphology at the ultrastructural level, especially the cellular and nuclear morphology of ependymal cells of the LVE. Therefore, vitamin C is essential for the maintenance of the SVZ cell populations required for normal activity of the SVZ neurogenic niche in the adult guinea pig brain. Based on our results from the guinea pig brain, we postulate that vitamin C deficiency could also affect neurogenesis in the human brain.

Prevalence of vitamin D insufficiency in Kashmiri teenagers with appendicular fractures

Objective: This study has been done to assess the significance and prevalence of subclinical vitamin D deficiency in the development of fractures in children and adolescents of Kashmiri Origin. Materials and Methods: Three groups of children were recruited into a cross-sectional study for assessment of serum 25 hydroxyvitamin D [25(OH)D]. Theseincluded100 upper limb fractures (group 1), 100 lower limb fractures (group 2)] and 100 healthy controls (group 3). The level of serum 25 hydroxyvitamin D [25(OH)D] was assessed by electrochemiluminescence immunoassays. Results: 14 % of the injured teenagers in the study were vitamin D deficient (

Prevalence of Vitamin A Deficiency among Preschool Children in Ethiopia: A Systematic Review and Meta-Analysis.

Background Vitamin A deficiency is a major nutritional concern in lower-income countries. The aim of this systematic review and meta-analysis was to show the magnitude of vitamin A deficiency among preschoolers in Ethiopia. Objective The present study was aimed at synthesizing qualitatively and quantitatively the existing literature on the prevalence of VAD in preschool children in Ethiopia. Methods Studies were searched through the search engine of Google Scholar, Hinari, MEDLINE/PubMed, Cochrane Library, and Africa-Wide Information. Searching was made using the keywords/MeSH of vitamin A deficiency, xerophthalmia, night blindness, Bitot's spot, retinol, children, and Ethiopia. Data were analyzed and compared with the WHO threshold criteria to declare a public health problem. Heterogeneity among studies was assessed using a Cochran Q test and I2 statistics. A random-effects model with 95% confidence interval was used for prevalence estimations. Results Of the 13 studies included in clinical analysis, 12 of them reported the prevalence of night blindness and/or Bitot's spot among preschool children in Ethiopia which was above WHO cutoff point for the public health problem 1% and 0.5%, respectively. The prevalence of night blindness significantly decreased from moderate public health problem 4.2% (95% CI: 2.8%-5.7%) in a period from 1990 to 2004 to mild public health problem 0.8% (95% CI: 0.6%-1.0%) in a period from 2005 to 2019. Furthermore, statistically insignificant reduction was observed in the prevalence of Bitot's spot in a period from 1990 to 2004, 2.2% (95% CI: 1.3%-3.2%) to 1.8% (95% CI: 1.2%-2.3%) in a period from 2005 to 2019. Among 8 studies on subclinical vitamin A deficiency, 7 of them indicated a severe public health problem (>20%). The prevalence of subclinical vitamin A deficiency decreased from 55.7% (95% CI: 39.8%-71.6%) in a period from 1990 to 2004 to 28.3% (95% CI: 9.8%-46.7%) in a period from 2005 to 2019, but not statistically significant. Conclusions Despite the reduced proportion of night blindness and Bitot's spot, still both clinical and subclinical vitamin A deficiencies remain a public health problem in Ethiopia requiring strengthen intervention through the newly initiated health extension program.

AB005. Vitamin D in children—role beyond bones

: Vitamin D is a fat-soluble steroid hormone that contributes to the maintenance of normal calcium homeostasis and skeletal mineralization. The prevalence of subclinical vitamin D deficiency is not only restricted to rural population, but it is highly prevalent across the whole globe. It affects the individuals irrespective of their gender, race and geography. It’s deficiency is common in all age groups including the neonates. Although, it is commonly known as vitamin, but is actually not an essential dietary vitamin in the strict sense, as it can be easily synthesized by all mammals from sunlight in adequate amount. Vitamin D not only plays an essential role in calcium homeostasis and bone mineral metabolism, but it also helps in performing a wide range of fundamental biological functions such as cell differentiation, inhibition of cell growth and immunomodulation. By inhibiting uncontrolled proliferation and stimulation of cell differentiation, Vitamin D helps to prevent development of autoimmune disorders and even common cancers. Prolonged usage of certain drugs (Glucocorticoids, cytochrome P450 enzyme inducers, anticonvulsants, antiretro viral agents etc.) and other health problems including chronic kidney disease, asthma, pneumonia, coeliac disease, liver disease, tuberculosis, cancers (prostate, breast and colon), diabetes etc. are associated with Vitamin D deficiency. The concept of vitamin D possessing important pleiotropic actions and owing to its multiple implications on health, the epidemic of vitamin D deficiency significantly contributes to the burden on the healthcare system and society. Thus, it is desirable to update our knowledge about current research related to role of vitamin D beyond bone metabolism.

Prevalence of vitamin K deficiency in older people with hip fracture

ABSTRACTIntroduction: Vitamin K plays an important role in blood coagulation. Diet is the main source of vitamin K and body stores are depleted in days, hence deficiency is common in malnourished older people. A high proportion of people who sustain a hip fracture are already malnourished, compounded by fasting for surgery which might further increase deficiency. We wanted to explore the prevalence of vitamin K deficiency in hip fracture patients and the impact of a short period of fasting.Methods: In consecutive patients hospitalised with a hip fracture, we measured vitamin K and PIVKA-II (undercarboxylated factor II – a marker of subclinical vitamin K status) on admission and on first post-operative day. We excluded those on anticoagulants.Results: N = 62 participated; 4 had missing pre-op vitamin K samples and n = 3 had no surgery leaving n = 55 with paired samples. Mean age was 80.0 ± 9.6 years, 33% males. Prevalence of subclinical vitamin K deficiency on admission was 36% (20/55) based on reference range of > 0.15µg/L. The proportion with subclinical K deficiency after surgery rose to 64% (35/55), p < 0.05. 13% had detectable PIVKA-II concentrations pre-operatively, 15% did post-operatively. None had abnormal prothrombin time. Vitamin K status was not associated with post-operative haemoglobin drop or transfusion requirements.Conclusion: Prevalence of vitamin K deficiency in hip fracture patients is high and increases further following a short period of fasting. Though no significant impact was noted on peri-operative blood loss, larger studies are warranted to explore this, and the potential role of vitamin K supplements peri-operatively.

Prevalence and predictors of subclinical micronutrient deficiency in German older adults: Results from the population-based KORA-Age study

Introduction Subclinical micronutrient deficiency in older adults is associated with chronic age-related diseases and adverse functional outcomes. In Germany, the older population is at-risk of insufficient micronutrient intake, but representative studies on micronutrient status in old and very old adults are scarce. This study's objectives were to estimate the prevalence of subclinical vitamin D, folate, vitamin B12 and iron deficiencies among older adults, aged 65 to 93, from the KORA-Age study in Augsburg, Germany (n = 1079), and to examine associated predictors. Methods Serum concentrations of 25-hydroxyvitamin D (25OHD), folate, vitamin B12, and iron were analyzed and compared to selected cut-offs for subclinical micronutrient deficiency. Associated predictors were investigated using multiple logistic regression analysis. Results The prevalence of subclinical vitamin D and vitamin B12 deficiencies were high, with 52.0% and 27.3% of individuals having low 25OHD ( Conclusion Subclinical micronutrient deficiency is a public health concern among KORA-Age participants, especially for vitamins D and B12. The predictors identified provide further rationale for screening high-risk subgroups and developing targeted public health interventions to tackle prevailing micronutrient inadequacies among older adults.

Prevalence of sub-clinical vitamin-D deficiency and hypothyroidism in children aged 18- 36 months with open anterior fontanelle: a cross-sectional study

Background: The range of normal closure time of the anterior fontanelle (AF) is generally regarded to be 4 to 26 months. The objectives of this study was to find out the prevalence of subclinical vitamin D deficiency and hypothyroidism in children aged 18-36 months with open AF.Methods: This is a hospital based, cross-sectional study done over a period of 24 months, in which thyroid function tests and 25-hydroxy-vitamin D levels were done for healthy children aged 18-36 months with open AF; the latter was also done for equal numbers (n=30) of age and sex matched children with closed AF for control values. The mean vitamin D levels and proportion of children of various categories based on vitamin D levels among both the groups were compared.Results: Open AF was seen in 37 children. Seven of them had obvious causes of delayed AF closure and were excluded. In the remaining 30 children, none of the children had abnormal thyroid function tests. 23.3% of the study group had low vitamin D levels; but, the levels were low even in 37% of control group. The mean vitamin D level of the study group (39.05±17.11 ng/ml) was similar to the control group (37.3±14.74 ng/ml).Conclusions: Neither subclinical vitamin D deficiency nor subclinical hypothyroidism accounted for delayed AF closure in this study.

Prevalence of subclinical vitamin K deficiency in Thai newborns: relationship to maternal phylloquinone intakes and delivery risk

BackgroundVitamin K deficiency bleeding (VKDB) in infants is a rare but serious worldwide problem, particularly in Southeast Asia. Apart from exclusive breast feeding, little is known of the maternofetal risk...

Nutrition status in Argentinean children 6 to 72 months old: results from the National Nutrition and Health Survey (ENNyS)

Data availability on nutrition status from vulnerable population groups is essential for the design and evaluation of interventions. The Ministry of Health from Argentina developed in 2004-2005 the National Survey of Nutrition and Health. Our objective is to describe the nutrition status of infants and preschool children (6-72 months), globally and by region and socioeconomic level. A probabilistic, multistage sample was selected, representative at the national, regional and provincial levels. Anthropometric indices weight/age, height/age and weight/height, were estimated, according to WHO reference. Nutrient intake was estimated by a 24-hours recall, and hemoglobin, serum ferritin, retinol and vitamin D concentration were measured. Prevalence of stunting, wasting and obesity were 8.0%, 1.3%, and 10.4%, respectively. Prevalence of anemia was 16.5% in children <6 years and 35.3% in children aged 6-23 months. Prevalence of subclinical vitamin A deficiency in children of 2-5 years was 14.3%, and prevalence of vitamin D deficiency in Patagonia was 2.8% in children aged 6-23 months. Different nutrient intake inadequacies were observed. Infants and children at the lower socioeconomic level showed higher prevalence of nutrition inadequacies. The coexistence of different nutrition deficiencies and overweight and obesity constitute the main characteristic of Argentinean infants and preschool children. Relevant differences exist according to socio-economic and geographic conditions.

Prevalence of Subclinical Vitamin K Deficiency in Cholestatic Liver Disease

Prothrombin time (PT), a surrogate marker of vitamin K deficiency, may underestimate the prevalence of vitamin K deficiency in cholestatic liver disease. This study investigated the frequency of vitamin K deficiency in children and adults with cholestatic liver disease by determining plasma protein induced in vitamin K absence II (PIVKA-II), and assessed the relation between plasma PIVKA-II levels and markers of cholestasis, measured PT, international normalized ratio (INR), serum undercarboxylated osteocalcin (ucOC), serum vitamins A and E, and serum 25-hydroxyvitamin D levels. Blood was collected from patients with cholestatic liver disease for liver biochemistries, PT, INR, bile acids, 25-hydroxyvitamin D, vitamin A, vitamin E, ucOC, and PIVKA-II. Thirty-one patients were enrolled (age range 0.5-54 years, median age 5.7 years, 17 females). Nine patients (29%) had increased INRs, whereas 21 (68%) had elevated plasma PIVKA-II levels. All patients with increased INRs had increased plasma PIVKA-II. Fifteen of 21 patients with increased plasma PIVKA-II were receiving supplemental vitamin K therapy (range 7.8-700 mug/kg/day). Plasma PIVKA-II levels were positively correlated with serum conjugated bilirubin, bile acids, aspartate aminotransferase, alanine aminotransferase, PT, INR, and serum ucOC (P <or= 0.02) and negatively correlated with serum 25-hydroxyvitamin D levels (P = 0.01). Twenty-two patients (71%) had vitamin D deficiency, 9 patients (29%) had vitamin A deficiency, and 2 patients (6%) had vitamin E deficiency. Despite vitamin K supplementation, elevation of plasma PIVKA-II suggesting ongoing vitamin K deficiency is common in cholestatic liver disease. Better strategies for vitamin K supplementation and dosing guidelines are needed.

Management of vitamin D depletion in postmenopausal women

In the United States, the impact regarding the routine fortification of milk and other dairy products has been less than satisfactory in preventing vitamin D depletion in adults. As more individuals are being evaluated and treated for osteoporosis, it has become necessary to exclude vitamin D depletion as a cause, because of the likelihood that differences in vitamin D and calcium nutrition may modify the individual response to therapy. Increased prevalence of subclinical vitamin D depletion among vertebral and hip fracture patients and the beneficial effect of vitamin D therapy and calcium supplementation in preventing such fractures lend credence to this assumption. The prevalence of vitamin D depletion is increasing again, especially among older adults, precisely the group at greatest risk for osteoporotic fractures.

Use of biomarkers of sub-clinical infection, nutrition and neonatal maturity to interpret plasma retinol in Nigerian neonates.

Using the World Health Organization criterion, the prevalence of sub-clinical vitamin A deficiency can be assessed using plasma retinol concentrations <0.7 micromol/l. However, plasma retinol can be depressed by infection; thus, the use of this criterion alone may overestimate deficiency. In the present study, we investigated the usefulness of the acute-phase proteins (APP) alpha1-antichymotrypsin (ACT) and alpha1-acid glycoprotein (AGP), plasma carotenoids and anthropometric and gestational indices to interpret plasma retinol in the blood of 192 apparently healthy Nigerian neonates collected randomly during days 1-20 postpartum. The mean weight (2.64 kg) and length (0.458 m) of the neonates and plasma concentrations (geometric mean, micromol/l) of retinol (0.54), alpha-carotene (0.072), ss-carotene (0.076) and lutein (0.080) were low. The prevalence of vitamin A deficiency was 72 %, indicating a severe public health problem. Babies who were of low birth weight (P<0.003) or premature and low birth weight (P<0.023) had significantly lower retinol concentrations than full-term normal weight babies. Thirty-two neonates had abnormal ACT and forty-four abnormal AGP concentrations. Positive correlations between retinol and ACT (r 0.186, P=0.05) and AGP (r 0.31, P=0.0001) during days 1-5 may be due to the increasing plasma retinol from maternal milk and a coincidental increasing capacity to synthesise APP. Subsequently, negative correlations between retinol and ACT (r -0.28, P=0.02) and AGP (r -0.29, P=0.018) from day 6 onwards reflected the continuing increase in plasma retinol, but no further increase in the APP. Overall, weight, ACT, lutein and age explained 30 % of the variance in retinol, but lutein was the most significant (r(2) 0.18, P<0.0001). Hence, the distribution of plasma retinol concentrations in this group of neonates was more strongly linked with nutrition (via the surrogate marker lutein) than infection.

Bias and Random Error in Retinol Measurements of Laboratories in Countries with Populations with Mild to Severe Vitamin A Deficiency

Vitamin A deficiency is common in many developing countries. Population-based surveys suggest that as many as 175 million children of preschool age are vitamin A-deficient (1). Especially in sub-Saharan Africa, severe subclinical deficiency (retinol values ≤0.70 μmol/L) often exceeds 30%. In these countries, laboratories should be able to measure the biochemical indicators of nutritional status to acceptable standards. The aim of the present study was to determine the proficiency of selected laboratories, particularly in Africa, in measuring retinol in serum. The study was performed between September 1999 and February 2000. Laboratories in Africa with the capability to measure vitamin A in serum were located with help from WHO headquarters and country offices, UNICEF headquarters, and through our contacts. Sixteen of the 35 invited laboratories were able to participate in the study: 12 within Africa [in Ethiopia, South Africa (4 laboratories), Tanzania, Zambia, Gabon, Ghana, Nigeria, Egypt, and Morocco], and 4 outside Africa [in Guatemala, Indonesia (2 laboratories), and Vietnam]. Participants were offered a total honorarium of US $200. All laboratories claimed that they could measure retinol in serum. The prevalence of subclinical vitamin A deficiency among preschool children in these countries is 30–40% (2). Two concentrations of serum were used: a high-concentration serum (undiluted serum with a target of 1.75 μmol/L retinol) and a low-concentration serum (0.60 μmol/L retinol), which was prepared by diluting one volume of the high-concentration serum with two volumes of an aqueous solution containing 0.15 mol/L sodium chloride and 0.45 mmol/L bovine serum albumin. Each participating laboratory was provided with four samples …

Vitamin D deficiency and associated factors in adolescent girls in Beijing

Several locally published reports indicate a high prevalence of vitamin D deficiency among adolescents in China, but no systematic population-based survey has been conducted. The objective was to determine the prevalence of vitamin D deficiency and to study associated factors in adolescent girls in Beijing. A cross-sectional study was conducted in a random sample of 1248 Beijing girls aged 12-14 y. Nutrient intakes, ultraviolet light exposure, anthropometric characteristics, physical activity, signs and symptoms of rickets, and plasma concentrations of 25-hydroxyvitamin D, 1,25-dihydroxyvitamin D, and calcium were measured and X-rays of the hand and wrist were taken. The prevalence of clinical vitamin D and calcium deficiency (plasma 25-hydroxyvitamin D <12.5 nmol/L, plasma calcium <2.25 mmol/L, and muscle spasm at least once per week) was 9.4% in winter. The prevalence of subclinical vitamin D deficiency (25-hydroxyvitamin D <12.5 nmol/L) was 45.2% in winter and 6.7% in summer (P < 0.0005). Logistic regression analysis showed that subclinical and clinical vitamin D deficiency in winter were associated with low plasma 25-hydroxyvitamin D concentrations (<12.5 nmol/L) in summer, low calcium intake ( x +/- SD: 280 +/- 48 compared with 440 +/- 61 mg/d), and low plasma calcium concentrations (<2.25 mmol/L) in winter. The odds ratios for these associations were 3.1, 1.5, and 1.5, respectively. Subclinical vitamin D deficiency was widespread among Beijing adolescent girls in winter. Low plasma 25-hydroxyvitamin D concentrations in summer, low calcium intake, and low plasma calcium concentrations in winter were the main risk factors for vitamin D deficiency in winter.

National Vitamin A Prophylaxis Programme: need for change in current age strategy.

Child survival and Safe Motherhood Programme emphasises on giving vitamin A prophylaxis upto three years of age only, contrary to earlier practice of its administration upto six years of age, based on the assumption of reduction of serious manifestations of vitamin A deficiency three years of age onwards. A cross-sectional study enrolling 1094 children was done to investigate vitamin A deficiency in under six children in urban slums of Nagpur city in Central India in post CSSM scenario. Clinical as well as subclinical (detected by abnormal conjunctival impression cytology) assessment of vitamin A status was performed according to standard procedures, as per WHO recommendations. The overall prevalence of xerophthalmia was 8.7%. Only milder manifestations of xerophthalmia were observed. Significantly higher prevalence of xerophthalmia was observed in more than three years of age. Although nonsignificant, higher prevalence of subclinical vitamin A deficiency was observed in above three years of age group. In view of current age strategy for vitamin A supplementation (< or = 3 years) and observed higher prevalence of clinical and subclinical vitamin A deficiency above three years of age in this study (also endorsed by earlier studies) a call for review of current age strategy for vitamin A supplementation is warranted.

Prevalence of subclinical vitamin D deficiency in different European countries.

Long-lasting and severe vitamin D deficiency leads to osteomalacia, a metabolic bone disease characterized by typical biochemical abnormalities (low serum concentrations of calcium and phosphate, increased activity of alkaline phosphatase). Bone histology shows decreased mineralization of bone matrix, increased osteoid volume and decreased bone formation. Vitamin D deficiency can be confirmed by measuring the serum concentration of 25-hydroxyvitamin D (25(OH)D), which is the major circulating metabolite bound with high affinity to a binding protein (DBP) and representing the storage form of vitamin D. In patients with osteomalacia, serum 25(OH)D levels are usually below 5 ng/ml and often undetectable. In contrast, patients with primary osteoporosis usually have serum concentrations of calcium and phosphate within the normal range, and alkaline phosphatase is rarely elevated. Therefore, in the opinion of many authors vitamin D deficiency is not an important pathogenetic factor for the development of osteoporosis. However, growing evidence demonstrates that moderately low levels of vitamin D can already have unfavorable effects on calcium homeostasis leading to bone loss, even if osteomalacia is not present. BargerLux and coworkers [1] showed that 25(OH)D contributes to the stimulation of enteral calcium absorption explaining the secondary increase in parathyroid hormone resulting from vitamin D deficiency, although 1,25-dihydroxyvitamin D (1,25-(OH)2D) levels may still be normal. A vitamin D status insufficient to maintain physiologic calcium homeostasis, but not resulting in overt osteomalacia, is called vitamin D insufficiency or subclinical vitamin D deficiency. Vitamin D insufficiency is a common problem especially in Europe (for reasons explained below), and therefore this paper will review the vitamin D status in different European countries. Definition of ‘Subclinical’ Vitamin D Deficiency

Relationship between unsupplemented vitamin A serum concentrations and measles vaccine response in Jamaican children.

Relationship between unsupplemented vitamin A serum concentrations and measles vaccine response in Jamaican children.

Vitamin A deficiency among children in a periurban South African settlement

Preschool children (aged 3-6 y) who were living in an informal settlement within metropolitan Durban, South Africa, were assessed for vitamin A status. The serum retinol concentration of 169 children tested was 0.73 +/- 0.26 mumol/L (mean +/- SD). Nine children (5%) had vitamin A deficiency (< 0.35 mumol/L) and 75 children (44%) had low vitamin A concentrations (< 0.70 mumol/L). Conjunctival impression cytology (CIC) in 185 children revealed that 18% had poor vitamin A status as defined by two abnormal conjunctival specimens. The CIC test was a feasible and reproducible method; however, it correlated poorly with the traditionally accepted serum retinol threshold of deficiency in this population where overt vitamin A deficiency is not prevalent. This survey demonstrated that regardless of the measurement tool, there is a prevalence of subclinical vitamin A deficiency in this typical periurban informal settlement and accordingly we suggest that these children should be targeted for vitamin A-intervention strategies.