Regular Vitamin Research Articles

Effect of 25-hydroxycholecalciferol and high phytase doses on performance, vitamin D status, bone mineralization, and mechanistic target of rapamycin kinase gene expression of broilers

The use of exogenous phytase and vitamin D3 metabolites such as 25-hydroxycholecalciferol (25-OH-D3) for poultry is well consolidated, but the potential for additive effects when supplementing both requires further investigation. This study investigated possible interactions between supplementation of 25-OH-D3 and high doses of phytase for broilers fed Ca− and P-deficient diets. A total of 1 200 one-d-old male broiler chicks were randomly allocated from one of four dietary treatments in a 2 × 2 factorial arrangement: 600 or 2 000 phytase units (FYT)/kg and with or without the inclusion of 25-OH-D3 at 69 µg/kg, with 12 replicates of 25 broilers each. Two feeding phases were stablished (1-to-21 and 22-to-42 d) and all diets contained commercial levels of vitamin D3 (100 µg/kg) with total Ca and available P respectively set to 0.6 and 0.3%. Supplementation with 25-OH-D3 increased body weight gain (BWG) and reduced feed conversion ratio (FCR) from 1 to 21 d (P < 0.05), as well as increased BWG from 1 to 42 d (P < 0.05). Serum 25-OH-D3 levels at 21 and 42 d were increased with 25-OH-D3 (P < 0.001). Phytase did not affect growth performance from 1 to 21 d, but a higher dose (2 000 FYT/kg) reduced feed intake and FCR from 22 to 42 d compared to 600 FYT/kg, also reducing FCR in the total period (P < 0.05). Expression of the mechanistic target of rapamycin mRNA in breast muscle assessed at 42 d was enhanced with 2 000 FYT/kg (P < 0.001). Bone weight, bone contents of ash, Ca, and P, and bone breaking strength of tibia bone measured at 42 d were not affected by any dietary treatment. Although both additives are known to improve dietary Ca and P utilization, there were no detected additive or synergic effects. The results suggested that the inclusion of 25-OH-D3 and phytase combined with regular vitamin D3 levels can help minimize losses of performance and bone mineralization of broilers fed Ca- and P-deficient diets. Furthermore, vitamin D status is refined with dietary 25-OH-D3 and potential improvements on breast meat yield can be obtained with a high phytase dose of 2 000 FYT/kg.

Prevalence and Risk Factors of Vitamin D Deficiency in Patients Scheduled to Undergo Revision Arthroplasty of the Hip, Knee and Shoulder-Data from a Single-Centre Analysis.

Vitamin D is crucial for ideal bone health and good muscle function, both essential requirements for successful joint arthroplasty. Hence, vitamin D deficiency has recently been identified as a predictor of poorer outcomes in patients scheduled to undergo total joint arthroplasty (TJA). Moreover, there is ample evidence today that vitamin D deficiency is associated with periprosthetic joint infection. Yet, vitamin D deficiency seems to be frequent in patients who are scheduled to undergo TJA. However, the prevalence of hypovitaminosis D in patients who require revision arthroplasty (rTJA) is largely unknown. Further, risk factors of vitamin D deficiency in these patients remain to be elucidated. For this reason, the primary objective of this study was to assess the vitamin D status of patients scheduled to undergo rTJA of the hip, knee and shoulder. The secondary objective was to identify potential risk factors for hypovitaminosis D in these patients. Serum vitamin D [25(OH)D] levels of 249 patients who were scheduled for rTJA were assessed over a period of twelve months at a high-volume TJA centre. Collectively, 23% of patients reported a routine intake of vitamin D supplements (58/249). Notably, 81% of patients (155/191) who did not report a routine vitamin D intake presented with insufficient vitamin D levels (below 30 ng/mL), while only 19% of patients (36/191) had sufficient vitamin D levels. Of those who reported a routine vitamin D intake, 75% (43/58) had sufficient vitamin D levels, while 25% (15/58) showed insufficient vitamin D status. Patients who did not routinely take any vitamin D supplements had significantly lower vitamin D levels compared to patients who reported regular vitamin D intake (19.91 ng/mL vs. 40.66 ng/mL). Further, BMI and nicotine abuse were identified as potential risk factors for hypovitaminosis D in patients without vitamin D supplementation. Moreover, the season of spring seems to be a risk factor in patients with vitamin D supplementation, while age itself did not appear to be a significant risk factor for low vitamin D levels. In conclusion, we found an alarmingly high rate of vitamin D deficiency in patients scheduled to undergo rTJA. Notably, reported routine vitamin D supplementation showed significantly increased serum vitamin D levels compared to patients with no reported supplementation. Due to the high prevalence of vitamin D deficiency, we believe that vitamin D status should routinely be assessed in patients who are scheduled to undergo rTJA.

Micronutrient intake and telomere length: findings from the UK Biobank.

To investigate whether micronutrient intake from food as well as the regular uptake of specific vitamins and/or minerals are associated with leucocyte telomere length (LTL). This is a cross-sectional study using data from 422,693 UK Biobank participants aged from 40 to 69 years old, during 2006-2010. LTL was measured as the ratio of telomere repeat number to a single-copy gene and was loge-transformed and z-standardized (z-LTL). Information concerning supplement use was collected at baseline through the touchscreen assessment, while micronutrient intake from food were self-reported through multiple web-based 24h recall diaries. The association between micronutrient intake or supplement use and z-LTL was assessed using multivariable linear regression models adjusting for demographic, lifestyle and clinical characteristics. About 50% (n = 131,810) of the participants, with complete data on all covariates, self-reported regular supplement intake. Whilst overall supplement intake was not associated with z-LTL, trends toward shorter z-LTL with regular vitamin B (-0.019 (95% CI: -0.041; 0.002)) and vitamin B9 (-0.027 (-0.054; 0.000)) supplement intake were observed. z-LTL was associated with food intake of pantothenic acid (-0.020 (-0.033; -0.007)), vitamin B6 (-0.015 (-0.027; -0.003)), biotin (0.010 (0.002; 0.018)) and folate (0.016 (0.003; 0.030)). Associations of z-LTL with these micronutrients were differentiated according to supplement intake. Negative associations equivalent to a year or less of age-related change in LTL between micronutrient intake and LTL were observed. Due to this small effect, the clinical importance of the associations and any relevance to the effects of vitamin and micronutrient intake toward chronic disease prevention remains uncertain.

Alkaptonuria and Ochronotic Arthropathy: The Path to Pain-Free Mobility

This article discusses a case of ochronotic arthropathy, a manifestation of alkaptonuria. Alkaptonuria is characterized by the accumulation of homogentisic acid [HGA] in tissues, leading to a distinctive blue-black pigmentation and early joint degeneration. A 68-year-old female patient, with a history of alkaptonuria, presented with progressive hip pain and was eventually treated with an elective total hip replacement. Due to vertebral calcifications, the operation was performed under general anesthesia. Pre- and post-operative care was guided by the patient’s comorbidities and potential complications related to alkaptonuria, including potential cardiac and respiratory issues. Following surgery, the patient exhibited significant improvements in hip joint functionality. The paper also discusses the challenges in diagnosing alkaptonuria, the absence of definitive treatment, and the potential of dietary restrictions and symptomatic treatments. Moreover, it addresses surgical considerations for ochronotic arthropathy and emphasizes the role of regular calcium and vitamin D intake in maintaining bone quality. The success of the hip replacement surgery in this case suggests a potential intervention for managing ochronotic arthropathy in alkaptonuria patients.

Evaluating the Impact of Airborne Fine Particulate Matter and Heavy Metals on Oxidative Stress via Vitamin Supplementation.

This cross-sectional study aimed to assess the interrelationships between PM2.5 exposure, heavy metal concentrations, and oxidative stress indicators, while evaluating the impact of antioxidant intake, such as vitamins, on these associations. PM2.5 exposure assessments were conducted using portable sensor-based monitors; biomarker analyses for heavy metals and oxidative stress were performed in 114 non-smoking adults. We observed that personal or ambient PM2.5 exposure levels were not associated with increased levels of heavy metals in blood and urine, nor with oxidative stress levels in urine. However, the concentrations of cadmium and lead in blood, and those of chromium and nickel in urine, were significantly associated with the urinary malondialdehyde (MDA) concentration. Additionally, increases in blood cadmium, urinary chromium, and nickel levels were significantly associated with higher urinary MDA concentrations in the non-vitamin-supplement group, but this trend was not observed in the regular vitamin supplement group. Our findings suggest that a regular intake of vitamin supplements might modulate the relationship between heavy metal exposure and oxidative stress, indicating potential protective effects against oxidative damage induced by PM2.5 and heavy metals. This study highlights the complexity of environmental pollutant exposure and its impact on human health, emphasizing the need for further research to elucidate the underlying mechanisms and explore potential protective strategies.

Study protocol for a non-inferiority, multicenter, randomized study to evaluate a smartphone app-based follow-up program after bariatric surgery (BELLA plus trial)

IntroductionAdherence to follow-up (FU) care after bariatric surgery is poor despite strong recommendations. In our pilot Bella trial, we demonstrated that a completely remote follow-up program via smartphone is feasible and safe for patients after bariatric surgery. Building on this, we aim to verify our results in a multicenter, randomized controlled setting. MethodsThis trial plans to enroll 410 participants undergoing primary bariatric surgery in seven German bariatric centers. Participants are randomized into two groups: a control group receiving in-person FU according to the standard in the bariatric centers, and an interventional group monitored using a smartphone application (app). The app sends standardized questionnaires and reminders regarding regular vitamin intake and exercises. The built-in messaging function enables patients to communicate remotely with medical care professionals. After one year, all participants are evaluated at their primary bariatric centers. The primary outcome is weight loss 12 months after surgery. The secondary outcomes include obesity-related comorbidities, quality of life, serum values of vitamins and minerals, body impedance analysis, visits to the emergency department or readmission, patient compliance, and medical staff workload. DiscussionThe current study is the first prospective, individually randomized-controlled, multicenter trial where a mobile application completely replaces traditional in-person visits for post-bariatric surgery follow-ups in bariatric centers.

Vitamin D prophylaxis in persons with epilepsy?

Limited guidelines exist regarding osteoporosis prevention in the general population. Despite being a subject of controversy, the majority of research suggests that decreased vitamin D levels correlate with increased bone turnover, that is, an important risk factor for osteoporosis development. In most guidelines, daily vitamin D supplementation is recommended. In persons with epilepsy (PWE), the situation is more complex, as other factors can increase the chance of being vitamin D deficient. Currently, there are no internationally accepted guidelines regarding monitoring bone health in PWE. Our aim was to review the existing evidence in PWE on: (1) risk factors for vitamin D deficiency, (2) the identification of higher risk groups, and (3) the optimal ways to monitor bone health. Our narrative review shows that: (1) anti-seizure medication (ASM) use, especially enzyme-inducing ASM (EIASM) and valproic acid, is identified as an important risk factor for impaired bone health (e.g., increased risk for osteoporosis/fractures and/or vitamin D deficiency); (2) higher risk groups within the PWE population are present: intellectual or physical disability, institutionalized patients, puberty, early onset epilepsy and developmental epileptic encephalopathies, postmenopausal women, and use of multiple ASM/concomitant drugs (e.g. corticosteroids); and (3) a monitoring scheme can be suggested including laboratory tests, bone density measurements, managing of risk factors, and/or vitamin D supplementation. Overall, regular vitamin D measurement in PWE is a cost-effective and practical method for monitoring vitamin D deficiency, whereas in high-risk patients the combination of vitamin D measurement and bone densitometry is recommended. There is not enough evidence to advocate continuous vitamin D supplementation in all PWE. Children with epilepsy should receive the recommended daily intake of vitamin D for age and additional monitoring and supplementation if at higher risk of deficiency. There is a need for prospective trials exploring the potential benefit of vitamin D supplementation in PWE.

The associations of serum vitamin D status and vitamin D supplements use with all-cause dementia, Alzheimer’s disease, and vascular dementia: a UK Biobank based prospective cohort study

BackgroundPrior studies on vitamin D and dementia outcomes yielded mixed results and had several important limitations. ObjectivesWe aimed to assess the associations of both serum vitamin D status and supplementation with all-cause dementia, Alzheimer’s disease (AD), and vascular dementia (VD) incidence. MethodsWith a prospective cohort study design, we comprehensively assessed the associations of vitamin D and multivitamin supplementation, as well as vitamin D deficiency {25-hydroxyvitamin D [25(OH)D] <30 nmol/L}, and insufficiency [25(OH)D 30 to <50 nmol/L], with the 14-year incidence of all-cause dementia, AD, and VD in 269,229 participants, aged 55 to 69, from the UK Biobank. ResultsAlthough 5.0% reported regular vitamin D use and 19.8% reported multivitamin use, the majority of participants exhibited either vitamin D deficiency (18.3%) or insufficiency (34.0%). However, vitamin D deficiency was less prevalent among users of vitamin D (6.9%) or multivitamin preparations (9.5%) than among nonusers (21.5%). Adjusted Cox regression models demonstrated 19% to 25% increased risk of all 3 dementia outcomes for those with vitamin D deficiency [hazard ratio (HR) 95% confidence interval (CI)]: 1.25 (1.16, 1.34) for all-cause dementia; 1.19 (1.07–1.31) for AD; 1.24 (1.08–1.43) for VD] and 10% to 15% increased risk of those with vitamin D insufficiency [HR (95% CI): 1.11 (1.05, 1.18) for all-cause dementia; 1.10 (1.02–1.19) for AD; 1.15 (1.03–1.29) for VD]. Regular users of vitamin D and multivitamins had 17% and 14% lower risk of AD [HR (95% CI): 0.83 (0.71, 0.98)] and VD [HR (95% CI): 0.86 (0.75, 0.98)] incidence, respectively. ConclusionsAlthough our findings indicate the potential benefits of vitamin D supplementation for dementia prevention, randomized controlled trials are essential for definitive evidence.

Impact of vitamin D supplementation as COVID-19 vaccine adjuvant on sperm parameters and sex hormones in men with idiopathic infertility: Two separate pre-post studies.

Vitamin D deficiency is a major problem for human health worldwide. The mechanisms of vitamin D in the male reproductive system are unknown. After coronavirus disease 2019 (COVID-19) vaccines were developed, doubts were raised about their possible effects on male fertility. Based on vitamin D's function in the immune system, its potential role as an adjuvant for COVID-19 vaccines is intriguing. The aims of this study were to assess the effects of vitamin D first on sperm parameters and sex hormones, and then as an immune adjuvant on sperm parameters and sex hormones after study participants had received their second doses of COVID-19 vaccines. Phase 1 (before the COVID-19 pandemic) included 72 men with idiopathic infertility, and phase 2 had 64 participants who received two doses of COVID-19 vaccines. Both groups were instructed to take 50,000 IU of vitamin D twice monthly for 3 months. Sperm parameters and sex hormones were assessed pre- and post-supplementation. Regular vitamin D intake for 3 months significantly increased the participants' vitamin D levels (p=0.0001). Both phases showed a positive correlation between vitamin D intake and sperm parameters. Vaccination had no negative effects on sperm parameters and sex hormones. Vitamin D was associated with follicle-stimulating hormone (p=0.02) and testosterone (p=0.0001) in phase 2 after treatment. Our results support vitamin D supplementation as an immune adjunct to COVID-19 vaccination for improving sperm parameters and hormone levels. COVID-19 vaccination is not harmful for male fertility potential, and vitamin D is an effective factor for male fertility.

Effect of Vitamin D on Retinoblastoma Protein in Prediabetic Individuals.

About 50.8 million people were diagnosed with diabetes in 2011; the count has increased by 10 million in the last five years. Type-1 diabetes could occur at any age, but predominantly in children and young adults. The risk of developing type II diabetes mellitus in the offspring of parents with DM II is 40% if one parent has DM II and approaches 70% if both parents have DM II. The process of developing diabetes from normal glucose tolerance is continuous, with insulin resistance being the first stage. As prediabetes progresses slowly to DM II, it may take approximately 15-20 years for an individual to become diabetic. This progression can be prevented or delayed by taking some precautions and making some lifestyle amendments, e.g., reducing weight by 5-7% of total body weight if obese, etc. Retinoblastoma protein is one of the pocket proteins that act as crucial gatekeepers during the G1/S transition in the cell cycle. A loss or defect in single- cell cycle activators (especially CDK4 and CDK6) leads to cell failure. In diabetic or stress conditions, p53 becomes a transcription factor, resulting in the transactivation of CKIs, which leads to cell cycle arrest, cell senescence, or cell apoptosis. Vitamin D affects insulin sensitivity by increasing insulin receptors or the sensitivity of insulin receptors to insulin. It also affects peroxisome proliferator-activated receptors (PPAR) and extracellular calcium. These influence both insulin resistance and secretion mechanisms, undertaking the pathogenesis of type II diabetes. The study confines a marked decrement in the levels of random and fasting blood glucose levels upon regular vitamin D intake, along with a significant elevation of retinoblastoma protein levels in the circulatory system. The most critical risk factor for the occurrence of the condition came out to be family history, showing that patients with first-degree relatives with diabetes are more susceptible. Factors such as physical inactivity or comorbid conditions further aggravate the risk of developing the disease. The increase in pRB levels caused by vitamin D therapy in prediabetic patients directly influences blood glucose levels. pRB is supposed to play a role in maintaining blood sugar levels. The results of this study could be used for further studies to evaluate the role of vitamin D and pRB in regeneration therapy for beta cells in prediabetics.

Assessment of Serum Vitamin D Levels and Evaluation of Knowledge, Attitude, and Practices of Vitamin D Deficiency among Emergency Health-care Workers at a Tertiary Care Center in North India: A Prospective Cross-sectional Study

Background: The importance of vitamin D in maintaining overall health cannot be overstated, as its deficiency is a significant contributor to mortality and morbidity. There is a paucity of literature on vitamin D deficiency among healthcare workers (HCWs) in India, especially those working in emergency settings and day-night shifts. Aims and Objectives: This prospective cross-sectional study aimed to assess the levels of vitamin D among emergency healthcare workers (HCWs) and evaluate their knowledge, attitudes, and practices (KAP) regarding vitamin D deficiency. The study sought to address the limited literature on vitamin D deficiency among HCWs in emergency settings in India. Materials and Methods: A total of 105 randomly selected healthy HCWs from the emergency department of a tertiary care hospital in north India participated in the study. A structured questionnaire was administered to collect demographic information and assess the participants' knowledge, attitudes, and practices related to vitamin D. Serum vitamin D levels were measured using a 2 ml venous blood sample. Results: The mean serum vitamin D level was 15.08 ± 8.52 ng/ml, indicating a high prevalence of vitamin D deficiency (94.3%) among the participants. While most participants were aware of the active form of vitamin D, its sources and critical functions, knowledge about non-skeletal manifestations and measurable forms of vitamin D deficiency was limited. A majority of the participants (85.3%) recognized the importance of vitamin D as a micronutrient, and 69.3% expressed the need for education on its role. However, only 48.5% emphasized regular vitamin D intake. Conclusion: This study highlights the high prevalence of vitamin D deficiency among HCWs in the emergency department and identifies knowledge gaps regarding its critical functions. There is a need for an effective system to identify and address vitamin D-related health issues among HCWs, which could potentially enhance their overall efficiency.

Formulation of Lichen Based Pill a Natural Source of Vitamin D3 with a High Absorption Rate by Ambrosiya Neo-Medicine Pvt. Ltd

The physiological functioning of the human body depends on vitamin D as a source of minerals. Numerous ailments like bone health, cancer, heart issues, infectious diseases, and CNS are brought on by its shortage. The body's vitamin D insufficiency can be caused by a variety of things, including a person's diet, lifestyle, and geographic location. Blood levels of vitamin D can be maintained through a variety of means, including vitamin D supplements, vitamin D medications, and lifestyle changes. A pharmaceutical company with its main office in India called Ambrosiya Neo-Medicine Pvt. Ltd. has introduced a food-grade vitamin D pill based on lichen to address the global problem of vitamin D deficiency's consequences. In Dr. JAIN's Precision Diagnostic Centre, a comparison study of conventional vitamin D and lichen-based pills was done on ten patients who were vitamin D deficient. The results of the vitamin D level after 48-hours have shown that the lichen-based vitamin D is absorbed at a higher rate than regular vitamin D. We anticipate Ambrosiya’s supply of vitamin D supplements made from lichen, and it can make a big difference to the government's attempts to address the problem of vitamin D insufficiency in people everywhere.

H - 26 Cognitive Functioning Following Bariatric Surgery in a Bilingual, Spanish, and English - Speaking, Patient: a Case Study.

Overall, 256,000 bariatric surgeries were completed in the United States in 2019 (ASMBS, 2023). Bariatric surgeries are effective in reducing morbidity, prolonging life, and improving cognition, particularly among patients with BMI >40 and those with BMI >35 and obesity-related complications (Handley et al., 2016; Cornejo-Pareja et al., 2021). Nevertheless, up to 16% of patients undergoing bariatric procedures experience neurological sequelae (Thaisetthawatku et al., 2004) that is likely secondary to surgery-related nutritional deficiencies (Gasmi et al., 2022). Although neuropsychological assessments may help to identify postsurgical cognitive changes, cultural and linguistic differences may preclude reliable and valid assessment of non-native English-speaking persons. A Spanish-dominant 38-year-old, right-handed, female reported diminished attention, reduced thinking speed, and memory difficulties that were interfering with her daily functioning. She completed a thorough Clinical Interview (both individually and with collaterals), Record Review, and a comprehensive neuropsychological workup. She demonstrated multi-domain impairment (>1.5S.D. below the normative mean), suggesting a possible dementia or encephalopathy. When her cognitive profile was interpreted in the context of her medical history, further testing was recommended to rule out reversible etiologies. Interdisciplinary collaborations with primary care and gastroenterology revealed nutritional deficiencies that had persisted for over 18months after bariatric surgery and that were not fully resolved with regular oral vitamin consumption. Cultural and linguistic differences were relevant when assessing cognitive changes in non-native English-speaking persons, and in helping to determine whether pharmacological and behavioral interventions are ameliorating these complications. Practical considerations of these high-stakes assessments will be discussed from neuropsychological, psychosocial, and ethical perspectives.

The Effects of Low-Input (Wild and Organic Farming) Conditions on the Nutritional Profile of Ziziphus jujuba Mill. Fruits from the Valencian Mediterranean

Jujube fruit (Ziziphus jujuba Mill.) has been a food source since ancient times. In Spain, it is considered a marginal crop, and jujube fruits are of low economic importance. Its consumption is bound to local marketplaces. However, jujube is a good alternative crop due to its climatic adaptation and low-input conditions. We aimed to evaluate the morphological, physicochemical, and bioactive compounds of jujube fruits grown under low-input conditions (wild and organic farming) in the Mediterranean basin, specifically in Marjal de los Moros, Valencia, Spain. The organic system produces higher protein, fiber, ash, and carbohydrate concentrations from small-caliber fruit cultivars. Potassium and phosphorus are the major mineral elements in jujube. The fruits’ total polyphenols range from 480.83 to 630.81 mg EGA·100 g−1 fw in organic conditions and 520.71 mg EGA·100 g−1 fw in wild conditions. Low-input conditions influence the production of glucose (sweet fruits) and bioactive compounds, as well as mineral concentrations. A strong relationship exists between vitamin C levels and the potassium concentration. Jujube fruits are classified as “vitamin C-rich”. A 20 g serving of fruit can provide the regular vitamin C requirements of an adult person. The environmental and nutritional opportunities offered by jujubes are in line with different SDGs.

Advanced Messaging Intervention for Medication Adherence and Clinical Outcomes Among Patients With Cancer: Randomized Controlled Trial.

Medication adherence is crucial for improving clinical outcomes in the treatment of patients with cancer. The lack of adherence and adverse drug reactions can reduce the effectiveness of cancer therapy including the quality of life. The commonly used intervention methods for medication adherence continue to evolve, and the age of fifth-generation (5G) messaging has arrived. In this study, we conducted a prospective, pilot randomized controlled trial to evaluate the effect of 5G messaging on medication adherence and clinical outcomes among patients with cancer in China. The research population was patients with nonsmall cell lung cancer undergoing pemetrexed chemotherapy who require regular folic acid (FA) and vitamin B12 supplements. The intervention and control groups were assigned to 5G messaging and second-generation (2G) messaging, respectively. The patients' medication adherence and quality of life were assessed at baseline and 1-month and 3-month time points. Moreover, the chemotherapy-related hematologic or nonhematologic toxicities, as well as the serum levels of FA and vitamin B12, were measured. Of the 567 patients assessed for eligibility between January and May 2021, a total of 154 (27.2%) patients were included. Overall, 80 were randomized to the control group and 74 to the intervention group. The odds of adherence in the 5G messaging intervention group were significantly higher than the control group at the 1-month (62/69, 90% vs 56/74, 76%; adjusted odds ratio 2.67, 95% CI 1.02-7.71) and 3-month (50/60, 83% vs 48/64, 75%; adjusted odds ratio 2.36, 95% CI 1.00-5.23) time points. Correspondingly, the FA and vitamin B12 serum levels of patients in the 5G messaging group were higher than those of the control group. Regarding hematologic toxicities, only the incidence of leukopenia in the intervention group was lower than that in the control group (25/80, 31% in the control group vs 12/74, 16% in the intervention group; P=.04). There were no differences in nonhematologic toxicities and quality of life between the 2 groups. In summary, we conclude that compared with conventional 2G text-based messaging, a 5G messaging intervention can better improve medication adherence and clinical outcome among patients with cancer. Chinese Clinical Trial Registry ChiCTR2200058188; https://www.chictr.org.cn/showproj.html?proj=164489.

Evaluation of vitamin D levels and affecting factors of vitamin D deficiency in healthy children 0-18years old.

This study showed that vitamin D deficiency still remains a major problem for healthy children and daily supplementation of vitamin D is mandatory. Prophylactic vitamin D supplementation and adequate sunlight exposure should be provided for all children, in particular healthy adolescents. In addition, future studies may focus on screening for vitamin D status in children who did not receive vitamin D supplementation. • Vitamin D is an essential component in bone metabolism. Seasonality, age, sex, dark skin pigmentation, and limited exposure to sunlight are causes of vitamin D deficiency. • The World Health Organization has drawn attention to this increased frequency, recommending lifelong, regular vitamin D prophylaxis. • The frequency of vitamin D deficiency and insufficiency was found to be 42.9% in healthy children and the frequency significantly increased with age. • There were almost no cases of prophylactic vitamin D usage in adolescent group which are at the highest risk.

Vitamin D and hypertension: Is there any significant relation?

Vitamin D and hypertension: Is there any significant relation?

Multiple Bone Metastatic Invasion with Clinical Implications due to Ductal Mammary Carcinoma – Case report and Short Literature Review

Multidisciplinary approach of clinical cases in rehabilitations units can be very complex and divers. Method: We present a case of a woman 30 years old, whose oncological histo-ry begins 9 years ago, when the diagnosis of invasive ductal mammary infiltrating ca-nelular carcinoma grade I was made and treated by tumorectomy (lumpectomy). The pa-tient refused oncological treatment at that time and resorted to alternative medicine dur-ing a period of 7 years: diet without sugar and animal products; regular vitamin B17 treatments; almond kernel cure; high-dose intravenous vitamin C treatment for; intrave-nous ozone therapy; apitherapy with bee venom; oral administration of cannabis oil dur-ing the past four years until now; physical therapy. Results: The evolution is marked by the appearance of multiple bone metastatic lesions. The most worst clinical consequence was a hyperalgesic cervicobrachial neuralgia, due to multiple C6-T3 lytic lesions diag-nosed 2 years ago and C7 compression (close to spinal cord injury), situation which had as medical approach two surgeries interventions, radiotherapy and chemotherapy. Con-clusions: The rehabilitation program was adapted to every stage of clinical evolution and was marked by many complications. All the steps were made for functional improvement and for increase the quality of life.

Association between Serum 25-Hydroxyvitamin D and Abdominal Aortic Calcification: A Large Cross-Sectional Study.

In the American population, the relationship between the standardized serum 25-hydroxyvitamin D (25(OH)D) concentration and the risk of abdominal aortic calcification (AAC) is unclear. The purpose of our study was to investigate the relationship between serum 25(OH)D concentration and AAC risk. Participants from the National Health and Nutrition Examination Survey (NHANES) between 2013 and 2014 were analyzed cross sectionally. An analysis of the relationship between serum 25(OH)D concentration and incident AAC and severe AAC (SAAC) was based on the restricted cubic spline (RCS) and multivariable logistic regression model. In addition, generalized additive models with smooth functions were used to evaluate the relationship between serum 25(OH)D concentration and the degree of AAC. Finally, a subgroup analysis was conducted. There were a total of 3,040 individuals in our study. The serum 25(OH)D concentration was divided into quartiles (Q1: 9.37-50.5 nmol/L; Q2: 50.6-67.2 nmol/L; Q3: 67.3-85.8 nmol/L; and Q4: 85.9-318.0 nmol/L); the lowest quartile served as the reference group (Q1). After adjusting for known confounding variables, compared with the lowest quartile (Q1) of serum 25(OH)D concentration, the odds ratios with 95% confidence intervals for AAC and SAAC across the quartiles (Q2, Q3, and Q4) were (1.042 (0.812, 1.338), 0.863 (0.668, 1.115), and 1.022 (0.787, 1.327)) and (1.48 (0.87, 2.52), 1.70 (1.01, 2.92), and 2.13 (1.19, 3.86)), respectively. As shown by the RCS plot, the serum 25(OH)D concentration was associated with the risk of AAC/SAAC in a U-shaped pattern (P for nonlinearity <0.05). In addition, the degree of AAC decreased at first and then increased as the serum 25(OH)D concentration increased. In conclusion, a U-shaped relationship existed between serum 25(OH)D concentration and the risk of AAC and SAAC. Consequently, the risk of AAC and SAAC may be mitigated with regular monitoring and vitamin D supplementation.

P133 Risk Factors for the Occurrence and Severity of Vertebral Fractures in Inflammatory Bowel Disease Patients: A Nationwide Population-Based Cohort Study

Abstract Background The risk of vertebral fractures is increased in inflammatory bowel disease (IBD) patients. However, whether the severity of vertebral fractures differs between IBD patients and the general population, or between patients with Crohn’s disease and ulcerative colitis, is unknown. Methods We investigated risk factors associated with the occurrence and severity of vertebral fractures in IBD patients using The National Healthcare Insurance Service (NHIS) database. Results From 2008 to 2018, there were 33,778 patients with IBD (24,370 UC patients and 9408 CD patients) and 101,265 patients in the reference population. The incidence rate ratio of vertebral fractures in IBD patients was 1.27 per 1000 person-years (95% CI 1.26–1.27). The risk of vertebral fracture was higher in CD and UC patients than in the matched reference group (HR 1.593; 95% CI 1.317–1.927; p &amp;lt; 0.001 and HR 1.269; 95% CI 1.141–1.412; p &amp;lt; 0.01 respectively). The occurrence of vertebral fracture was associated with Crohn’s disease, older age, female sex, high Charlson Comorbidity Index (CCI) score, and long-term steroid use. The severity of vertebral fractures was associated with IBD and older age. Conclusion Vertebral fractures occur frequently and more severely in IBD patients, particularly those with CD. Therefore, we suggest monitoring of bone density, regular vitamin D supply, and reducing the use of corticosteroids to prevent vertebral fractures in IBD patients who are older, female, or have comorbidities.