Serum 25-hydroxyvitamin D3 Research Articles

Effects of Vitamin D Insufficiency on Hemoglobin Levels and Skin Infections Among Libyans of Various Ages

This study explores the effects of vitamin D deficiency on hemoglobin levels and skin infections in 138 Libyan men and women across various ages. A cross-sections study was done in Al-Ajilat city, during the period from June to September 2024. A total of 63 (45.35 %) males and 75 (54%) females were included in this study, with different skin infections from different ages. A hematological blood analyzer (Sysmex KX-21N) was used to evaluate the hemoglobin concentration (HGB) in venous blood samples obtained in EDTA tubes. A competitive ELISA-based immunoassay was also used to assess vitamin D (25-hydroxycholecalciferol) in the patients' serum. Vitamin D insufficiency was more prevalent in men (60.3%) than in women (49.3%), though the difference was not statistically significant (p = 0.263). Hemoglobin levels were higher in men (mean: 14.2 g/dL) than women (mean: 12.5 g/dL), reflecting potential gender-specific biological differences. Male participants also exhibited greater variability in vitamin D and inflammatory marker (CRP) levels. Infection patterns revealed gender-related trends, with fungal infections being more common in men and viral infections in women. However, the association between infection types and gender was not statistically significant (p = 0.137). Gender significantly influenced CRP and hemoglobin levels but had no apparent effect on vitamin D levels. No strong linear correlations were observed between vitamin D, CRP, hemoglobin, or age. The findings highlight gender differences in vitamin D status, immune responses, and infection types, although most differences lacked statistical significance. The study underscores the need for further research to elucidate vitamin D’s role in skin infections and its potential interplay with hemoglobin levels and immune markers

The effect of vitamin D3 supplementation on the incidence of type 2 diabetes in healthy older adults not at high risk for diabetes (FIND): a randomised controlled trial.

Vitamin D insufficiency is associated with an elevated risk of type 2 diabetes, but evidence from randomised trials on the benefits of vitamin D supplementation is limited, especially for average-risk populations. The Finnish Vitamin D Trial (FIND) investigated the effects of vitamin D3 supplementation at two different doses on the incidence of type 2 diabetes in a generally healthy older adult population. FIND was a 5 year randomised placebo-controlled, parallel-arm trial among 2271 male and female participants aged ≥60 years and ≥65 years, respectively, from a general Finnish population who were free of CVD or cancer and did not use diabetes medications. The study had three arms: placebo, 1600 IU/day of vitamin D3 or 3200 IU/day of vitamin D3. A non-study group statistician carried out sex-stratified simple randomisation in a 1:1:1 ratio, based on computerised random number generation. The participants, investigators and study staff were masked to group assignment. National health registries were used to collect event data. A representative subcohort of 505 participants had more detailed in-person investigations at months 0, 6, 12 and 24. During the mean follow-up of 4.2 years, there were 38 (5.0%), 31 (4.2%) and 36 (4.7%) type 2 diabetes events in the placebo (n=760), 1600 IU/day vitamin D3 (n=744; vs placebo: HR 0.81; 95% CI 0.50, 1.30) and 3200 IU/day vitamin D3 (n=767; vs placebo: HR 0.92, 95% CI 0.58, 1.45) arms, respectively (p-trend=0.73). When the two vitamin D3 arms were combined and compared with the placebo arm, the HR was 0.86 (95% CI 0.58, 1.29). In the analyses stratified by BMI (<25 kg/m2 [n=813, number of type 2 diabetes events=12], 25-30 kg/m2 [n=1032, number of events=38], ≥30 kg/m2 [n=422, number of events=54]), the HRs in the combined vitamin D3 arms vs the placebo were 0.43 (95% CI 0.14, 1.34), 0.97 (0.50, 1.91) and 1.00 (0.57, 1.75), respectively (p-interaction <0.001). In the subcohort, the mean (SD) baseline serum 25-hydroxyvitamin D3 (25(OH)D3) concentration was 74.5 (18.1) nmol/l. After 12 months, the concentrations were 72.6 (17.7), 99.3 (20.8) and 120.9 (22.1) nmol/l in the placebo, 1600 IU/day vitamin D3 and 3200 IU/day vitamin D3 arms, respectively. In the subcohort, no differences were observed in changes in plasma glucose or insulin concentrations, BMI or waist circumference during the 24 month follow-up (p values ≥0.19). Among generally healthy older adults who are not at high risk for diabetes and who have serum 25(OH)D3 levels that are sufficient for bone health, vitamin D3 supplementation did not significantly reduce the risk of developing diabetes. ClinicalTrials.gov NCT01463813.

Hemodialysis Patients May Benefit from Cholecalciferol Treatment Targeting High Level of 25(OH)D.

(1) Background and Objectives: Vitamin D is implicated in the pathogenesis of Chronic Kidney Disease-Mineral and Bone Disorder (CKD-MBD) in hemodialysis (HD) patients, including the development of secondary hyperparathyroidism (SHP). While cholecalciferol supplementation is recommended for vitamin D deficiency correction, its impact on CKD-MBD remains inconsistent. The aim of this observational prospective study was to assess the effect of cholecalciferol in achieving high-normal serum 25-hydroxycholecalciferol (25(OH)D > 75 ng/mL) levels and its impact on CKD-MBD biochemical markers, including 1,25-dihydroxycholecalciferol (1,25(OH)2D) and parathormone (PTH) in HD patients. The study also evaluated the maintenance dosage required to sustain 25(OH)D levels within the 50-75 ng/mL range. (2) Materials and Methods: A total of 22 HD patients with baseline 25(OH)D levels 30-50 ng/mL received cholecalciferol (70,000 IU/week) to achieve the target serum 25(OH)D > 75 ng/mL. Baseline data on calcium, phosphate, 1-84 PTH, 25(OH)D, and 1,25(OH)2D serum levels were compared with the data when 25(OH)D > 75 ng/mL was targeted or when the highest 25(OH)D levels were noted. (3) Results: Cholecalciferol significantly improved vitamin D status in HD patients, with 73% reaching the target 25(OH)D level >75 ng/mL in a median time of 7.5 weeks, with a median total dose of 525,000 IU. This was associated with a significant rise in 1,25(OH)2D, decrease in 1-84 PTH, and no significant effect on calcium and phosphate levels. The median maintenance dose of cholecalciferol was established at 30,000 IU/week. (4) Conclusions: The findings support the use of cholecalciferol targeting high normal 25(OH)D levels to improve biochemical markers of CKD-MBD in HD patients.

The association between vitamin D deficiency and childhood obesity and its impact on children’s serum calcium, alkaline phosphatase, and bone age

ObjectiveThe research aimed to investigate the Association between Vitamin D deficiency and childhood obesity and its Impact on children’s serum calcium, alkaline Phosphatase, and bone Age. MethodsThe study analyzed clinical data from 159 school-aged children who underwent medical examinations. The children were divided into a 25-(OH)D3 deficiency group and a non-25-(OH)D3 deficiency group based on their serum 25-hydroxy Vitamin D3 levels. The two groups were compared regarding BMI, TC, TG, FBG, HbA1c, Ca, ALP, and bone age differences. ResultsIndividuals with a deficiency in 25-(OH)D3 exhibited higher levels of BMI, TC, TG, and ALP, and lower levels of Ca and bone age than those without the deficiency. These differences were statistically significant (P<0.05). Further analysis revealed a negative association between 25-(OH)D3 levelsa positive correlation between Ca and bone age, and a positive correlation with, BMI, TC, TG, and ALP. ConclusionThe deficiency of 25-(OH)D3 in school-aged children is linked to obesity and impacts bone growth. Monitoring vitamin D levels is crucial for clinical practitioners.

Dose-Response Relationship Between Serum 25(OH)D and the Risk of Abnormal Glycemic Status in Chinese Older Adults.

The relationship between serum 25-hydroxyvitaminD (25(OH)D) concentration and the risk of abnormal glycemic status remains contradictory. Whether sufficient 25(OH)D plays a role in reducing the risk of diabetes and prediabetes is debatable. Its dose-response relationship and the optimal 25(OH)D threshold are not clear. This study investigated the relationship between serum 25(OH)D and the risk of abnormal glycemic status to explore the optimal cut-off value. This study included 5856 Chinese older adults aged 60 years and above from the China Adult Chronic Disease and Nutrition Survey (CACDNS 2015-2017). Serum 25(OH)D concentration was measured via an enzyme-linked immuosorbent assay. Abnormal glycemic status in the present study includes diabetes and prediabetes. Statistical methods such as a locally weighted regression and smoothing scatterplot (LOESS), restricted cubic spline regression (RCS) and binary and trend logistic regression were used to explore the dose-response relationship and the optimal 25(OH)D threshold. The concentration of 25(OH)D was nonlinearly related to the levels of FPG and HbA1C in the LOESS curves. The nonlinear relation between 25(OH)D and the risk of diabetes and prediabetes was illustrated in the RCS curves and the optimal 25(OH)D threshold beneficial for diabetes was preliminarily explored to be 29.06 ng/mL, but no threshold for prediabetes was found. The dose-response results showed that for each 1 ng/mL increase in 25(OH)D, the risk of the fasting glucose type of diabetes reduced by 2.1%, the risk of the abnormal HbA1C type of diabetes reduced by 2.2% and the risk of the mixed type of diabetes reduced by 1.7%, whereas a dose-response relationship was not found for prediabetes. Higher serum 25(OH)D concentrations in Chinese older adults were associated with a reduced risk of glycemic abnormalities. The optimal 25(OH)D cut-off value was sufficiently beneficial if the diseased diabetes risk was 29.06 ng/mL, but no threshold was found for prediabetes.

Quantitative analysis of the impact of seasonal cyclicality on serum 25-hydroxycholecalciferol concentration in Northwest Arctic

Background: 25-hydroxycholecalciferol also known as 25-hydroxyvitamin D plays a vital role in numerous physiological functions within the human body, and its deficiency is associated with conditions such as osteoporosis, cardiovascular diseases, autoimmune disorders, and certain cancers. In Alaska, sunlight exposure is a critical factor that influences vitamin D levels in the population. Methods: This study involved a review of serum 25-hydroxyvitamin D [25(OH)D] levels from January 2014 to June 2018 for Alaska residents, including individuals aged 18 years or older who were permanent residents of the area. The exclusion criteria comprised acute or chronic liver or kidney dysfunction, anemia, cancer history, absorption deficiency, and vitamin D supplementation exceeding 500 IU/day within 90 days before the blood draw. Results: A total of 304 participants, including 107 males (35.2%) and 197 females (64.8%), with a mean age of 50.88, were included. The overall mean serum level of 25(OH)D was 22.7 ± 9.89 ng/mL. Females exhibited a higher mean level (23.40 ± 10.24 ng/mL) than males (21.03 ± 9.05 ng/mL) (P &lt;0.05). Participants older than 60 years had a higher average level of 25(OH)D (26.52 ± 10.28 ng/mL) compared to those younger than 45 years (19.85 ± 9.27 ng/mL) (P &lt; 0.05). Seasonal variations were observed, with levels below 20.0 ng/mL from October to March, below 30.0 ng/mL from April to May (insufficient), and slightly above 30.0 ng/mL (desirable) from June to August (P &lt; 0.0001). No significant intercommunity differences were found. Only 24.3% of the participants had a desirable vitamin D level. The association between the 25(OH)D level and the solar zenith angle was linear and markedly negative (r = −0.924; P &lt; 0.0001). Conclusions: This study demonstrates seasonal variations in 25(OH)D serum levels among the Alaska population. Further exploration of factors such as skin pigmentation, daily vitamin D intake, and body mass index is necessary to comprehensively understand the variation in 25(OH)D serum levels in this region.

362 Nutrikinetic evaluation and modeling of 25-hydroxyvitamin D3 in beef cattle

Abstract The objective of this study was to evaluate serum 25-hydroxyvitamin D3 [25(OH)D3] status in beef cattle when 1) fed diets with supplemental 25(OH)D3 or calcidiol (HyD, dsm-firmenich, Plainsboro, NJ), and 2.) a single dose of calcidiol was administered to cannulated heifers on nutrikinetic evaluation and predictive modeling simulations. In experiment 1, crossbred heifer calves [n = 96, initial body weight (BW) = 222 ± 12.4 kg] were assembled from auction markets near Dickson, TN and transported ~1,069 km to Manhattan, KS. Heifers (n = 12 per pen) were stratified by BW and randomly allocated to a corn-based receiving diet with one of four dietary treatments: 1) No supplemental D3 or calcidiol (CON, n = 24), 2) 3,000 IU supplemental D3·heifer⁻¹·d⁻¹ (D3, n = 24), 3.) 0.5 mg calcidiol/h/d (Hy D Low, n = 24), or 4.) 1.0 mg calcidiol·heifer⁻¹·d⁻¹ (Hy D High, n = 24) for 60 d. Blood samples were collected from each heifer prior to transport (d -1), on arrival (d 0) and on d 14, 31, and 60 of dietary treatment period. Data were analyzed using the GLIMMIX procedure of SAS using animal as experimental unit and treatment as fixed effect. HyD High calves had greater (P &amp;lt; 0.001) serum 25(OH)D3 concentrations than HyD Low at d 14 and 31 (Figure 1 and 2). At d 14, 31 and 60, HyD High and HyD Low calves had greater (P &amp;lt; 0.001) serum 25(OH)D3 concentrations than CON or D3 treatments. In experiment 2, cannulated crossbred heifers (n = 8, initial BW = 289 ± 44.9 kg were randomly assigned to one of two treatments: 1.) 3 mg/272 kg BW calcidiol, or 2.) 5 mg/272 kg BW calcidiol in a single dose administered via rumen cannula at h 0. Serial blood samples were collected at baseline out to 70 d post-dose. Serum 25(OH)D3 concentrations were analyzed via HPLC coupled with tandem MS (dsm-firmenich, Belvidere, NJ). Predictive modeling simulations of serum 25(OH)D3 concentrations used non-parametric superposition (Certara Phoenix WinNonlin 64, St. Louis, MO) from applying non-compartmental analysis with the assumptions of linearity, independent calcidiol dose response, and the rate of absorption and the average systemic clearance were consistent for each calcidiol dosing interval. The elimination half-life (t1/2) of calcidiol was determined to be an average of 7.1 d and area under change in concentration-time curve time 0 to the last time point that measured above baseline concentration post dose (AUC0-last) averaged of 32.6 d (Table 1). Non-parametric dosing simulations using nutrikinetic parameters from experiment 2 suggest that administration of two 5 mg oral doses of calcidiol with daily feeding of 1 mg would result in a rapid and sustained increase in serum 25(OH)D3. However, simulations should be confirmed in vivo before implementation.

Relationship between serum vitamin D levels and the prevalence of knee osteoarthritis: A retrospective study on 3424 subjects.

The extent of the association between vitamin D deficiency and knee osteoarthritis remains inadequately understood. This study aimed to elucidate the relationship between vitamin D levels and knee osteoarthritis through a cross-sectional analysis. This retrospective study involved an analysis of knee radiographs and serum 25-hydroxyvitamin D3 (25-(OH) vitamin D3) levels in a cohort of 3424 individuals (2901 women and 523 men). Knee osteoarthritis severity was evaluated using the Kellgren-Lawrence radiological scoring system. Of the participants, 49.2% (n= 1,683) were diagnosed with knee osteoarthritis. Among these patients, the levels of adjusted 25-(OH) vitamin D3 were significantly lower (p< 0.001). Regression analysis revealed a significant association between vitamin D deficiency and knee osteoarthritis, with an adjusted odds ratio (OR) of 1.7 (95% CI: 1.5-2.0; p< 0.001). Notably, a stronger association was observed between vitamin D deficiency and knee osteoarthritis in women under 65 compared to those aged 65 and above. The findings of this study indicate a higher prevalence of vitamin D deficiency in patients with knee osteoarthritis. Maintaining adequate serum 25-(OH) vitamin D3 levels may prevent knee osteoarthritis, especially in women below 65.

Prevalence of Vitamin D Deficiency in Orthopedic Trauma Patients: A Cross-Sectional Survey From a Tertiary Care Trauma Center.

Background Vitamin D deficiency is prevalent globally, with potential consequences for bone health and trauma outcomes. This study aimed to assess the prevalence of vitamin D deficiency in orthopedic trauma patients and investigate its correlation with various demographic and injury-related factors. Methodology A cross-sectional investigation was undertaken at a tertiary care center. An evaluation of serum 25-hydroxyvitamin D3 levels was conducted on 124 individuals, aged 20 to 70 years, who were hospitalized with orthopedic injuries. Demographic information, the injury method, the bone involvement pattern, and socioeconomic status were documented. Statistical analysis was employed to evaluate the correlations between vitamin levels D and these variables. Results The overall prevalence of vitamin D deficiency was 54 (43.6%) cases, with nine (7.3%) cases exhibiting severe deficiency and 45 (36.3%) cases exhibiting moderate deficiency. Higher rates of deficiency were associated with lower socioeconomic status (p = 0.044) and low-velocity trauma (p = 0.037). No significant association was found with age, sex, or residence. Interestingly, patients with multiple fractures were more prone to deficiency compared to those with single fractures. Conclusions This survey revealed a significant vitamin D deficiency among orthopedic trauma patients. Factors such as socioeconomic status and the nature of the injury emerged as significant risk factors. While conducting routine vitamin D assessments might pose challenges in developing nations, consistent supplementation could prove advantageous in enhancing fracture healing and overall health outcomes among this demographic. There is a call for future research to delve deeper into the role of vitamin D in trauma management and refine supplementation strategies.

Association Between Vitamin D Insufficiency and Impaired Bone Density Among Adolescents With Perinatally Acquired HIV Infection.

Stunting and pubertal delay are common among children growing up with human immunodeficiency virus (HIV) and are associated with bone and muscle impairments. We investigated factors associated with bone density and muscle function in adolescents living with HIV (ALWH). The VITALITY trial (PACTR202009897660297) investigated whether vitamin D and calcium supplementation improves musculoskeletal health among ALWH. A total of 842 ALWH aged 11-19 years, established on antiretroviral therapy (ART) for ≥6 months, were enrolled from HIV clinics in Zambia and Zimbabwe. Clinical history and examination were undertaken, and serum 25-hydroxyvitamin D3 (25[OH]D3) was measured. Dual-energy X-ray absorptiometry measured total-body-less-head bone mineral density adjusted for height (TBLH-BMDHT), and lumbar spine bone mineral apparent density (LS-BMAD) z scores. The association between a priori-defined covariates and musculoskeletal outcomes were investigated using baseline enrollment data and multivariable logistic regression. TBLH-BMDHT z scores were impaired (mean, -1.42 for male and -0.63 female participants), as were LS-BMAD z scores (mean -1.15 for male and -0.47 for female participants). In bivariate analysis, early pubertal stage, less physical activity, and older age at ART initiation were associated with lower TBLH-BMDHT z scores. Younger age, early pubertal stage, and low socioeconomic status were associated with lower LS-BMAD z scores. Grip-strength-for-height and jump-power-for-height z scores were associated with lower TBLH-BMDHT and LS-BMAD z scores. Low dietary vitamin D and calcium were associated with lower adjusted TBLH-BMDHT z scores. Lower 25(OH)D3 was associated with lower adjusted TBLH-BMDHT and LS-BMAD z scores. Deficits in bone density are common in ALWH. Vitamin D and calcium supplementation and promotion of exercise may improve musculoskeletal health among perinatally infected ALWH.

Association of serum 25-hydroxyvitamin D3 levels with carotid artery intima-media thickness and carotid atherosclerotic plaques in smokers

ObjectiveThis study explores the association of serum 25-hydroxyvitamin D3 (25(OH)D3) levels with carotid artery intima-media thickness (CIMT), and the presence of carotid atherosclerotic plaques in individuals with a history of smoking. MethodsA total of 469 patients suspected of having carotid atherosclerosis, aged 52 to 73 years with an average age of 65.26 ± 4.37 years, were recruited from the author's hospital from January 2023 to October 2023. All patients had a smoking history of nearly 5 years. Based on their serum 25(OH)D3 levels, they were divided into two groups: the normal group (serum level 30–50 ng/mL, n = 300) and the deficiency group (<30 ng/mL, n = 169). General details of the two patient groups were collected. Carotid artery ultrasound was employed to assess pulse wave velocity (PWV), carotid artery compliance coefficient (CC), and CIMT. Blood chemistry analysis measured serum lipid metabolism indicators including total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), and high-density lipoprotein cholesterol (HD-LC). The relationship between CIMT and each variable was analyzed through Pearson correlation, and logistic regression was used to identify risk factors influencing carotid artery plaque development. ResultsGeneral patient information between the two groups showed no significant differences (P > 0.05). Patients in the 25(OH)D3 deficiency group exhibited elevated left and right PWV and CC compared to the 25(OH)D3 normal group (P < 0.05). The deficiency group exhibited larger CIMT and plaque area compared to the normal group (P < 0.05). Additionally, the deficiency group demonstrated higher levels of TC, LDL-C, and HD-LC compared to the normal group (P < 0.05). A moderate positive correlation was found between TC, LDL-C, and CIMT (P < 0.05), while a strong positive correlation existed between 25(OH)D3 and CIMT (P < 0.05). In smokers, the formation of carotid artery plaque was associated with factors such as patient age, CIMT, serum LDL-C, and 25(OH)D3 levels (P < 0.05). As age, CIMT, LDL-C levels increased, and 25(OH)D3 levels decreased, the risk of carotid plaques in smokers increased (P < 0.05). ConclusionsSmokers with lower 25(OH)D3 levels exhibit higher CIMT and more prominent carotid atherosclerotic plaques, indicating increased arterial stiffness and elevated cardiovascular risk. These findings demonstrate crucial implications that insufficient levels of vitamin D may potentially contribute to a higher risk of atherosclerosis among smokers.

Vitamin D status in children in the South Marmara Region in Turkey

Aim: The aim of our study was to investigate the age, gender and seasonal differences in vitamin D levels in children and to determine the prevalence of vitamin D deficiency. Materials and Methods: Between January 2022 and December 2023, the records of children aged 0-17 years who underwent serum 25-hydroxyvitaminD (25 (OH) D) levels in the pediatric outpatient clinics of our hospital were retrospectively reviewed. Children were divided into four groups according to age (0-1, 2-5, 6-11 and 12-17 years); three groups according to 25 (OH) D levels (vitamin D deficiency (below 12 ng/mL), vitamin D insufficiency (between 12-20 ng/mL) and vitamin D sufficiency (above 20 ng/mL)); and four groups according to seasons. Results: The 25(OH)D levels of 41899 children, 19738 (47.1%) boys and 22161 (52.9%) girls, was 18.6 ng/mL (3-145); and was lower in girls than boys (16.8 ng/mL (3-136) in girls and 20.3 ng/mL (3-145) in boys p

Circulating 25-hydroxycholecalciferol and calcium levels, and alkaline phosphatase activity among people living with and without human immunodeficiency virus and injecting drugs in kenya

Background People who inject drugs (PWID) and living with the human immunodeficiency virus (PLHIV) are at higher risk of suffering marked derangements in micronutrient levels, leading to poor disease and treatment outcomes. Consequently, this can be monitored by measuring key biomarkers, such as total circulating (serum) 25-hydroxycholecalciferol (25(OH)D3), calcium, and alkaline phosphatase (ALP) for timely intervention. Therefore, circulating levels of 25(OH)D3 and calcium, and ALP activity were determined in PWID and are highly active anti-retroviral treatment (HAART)-experienced or -naive, along with those without HIV infection.MethodsThis cross-sectional study compared serum concentrations of 25(OH)D3, calcium, and ALP in Kenyan PLHIV and were HAART-naive (n = 30) or -experienced (n = 61), PWID and without HIV (n = 132).Results Circulating 25(OH)D3 levels were significantly different amongst the study groups (P < 0.001), and were significantly lower in the HAART-experienced (median, 17.3; IQR, 18.3 ng/ml; P < 0.001) and -naive participants (median, 21.7; IQR, 12.8 ng/ml; P = 0.015) relative to uninfected (median, 25.6; IQR, 6.8 ng/ml) PWID. In addition, the proportions of vitamin D deficiency (55.7%, 40.0%, and 17.4%) and insufficiency (31.1%, 53.3%, and 63.6%) compared to sufficiency (13.1%, 6.7%, and 18.9%; P < 0.001) were greater amongst HAART-experienced, -naive, and uninfected study groups, respectively. Likewise, serum total calcium concentrations were lower in the HAART-experienced relative to HIV-negative (P = 0.019) individuals. Serum ALP activity was also lower in the HAART-experienced in contrast to HIV-negative PWID (P = 0.048). Regression analysis indicated that predictors of circulating 25(OH)D3 were: age (β = 0.287; R2 = 8.0%; P = 0.017) and serum ALP (β = 0.283; R2 = 6.4%; P = 0.033) in the HAART-experienced PWID, and serum ALP (β = 0.386; R2 = 14.5%; P < 0.001) in the HIV-negative PWID.Conclusion This study suggests that HIV-1 infection and HAART, including injection substance use, decrease circulating 25(OH)D3, calcium and ALP activity. In addition, age and ALP activity are associated with low circulating vitamin D levels in HAART-experienced PWID. The results highlight the importance of incorporating vitamin D and calcium supplementation in treatment and rehabilitation protocols for PLHIV.

Prevalence of vitamin D deficiency and the effect of vitamin D3 supplementation on response to anti-tuberculosis therapy in patients with extrapulmonary tuberculosis

BackgroundWe aimed to assess serum 25-hydroxyvitamin D3 (25(OH)D3) concentrations in extrapulmonary tuberculosis (EPTB) patients and to evaluate the effect of vitamin D3 supplementation on their treatment course.MethodsSerum 25(OH)D3concentrations were measured in 47 newly diagnosed EPTB patients and 42 controls. Vitamin D-deficient EPTB patients were randomly assigned to receive 50,000 IU of vitamin D3 (cholecalciferol) orally once a week for 6 weeks (total 300,000 IU), followed by maintenance doses of 1000 IU a day besides anti-TB drugs or the first line anti-TB treatment only. Follow up serum 25(OH)D3 concentrations were measured after 3 months of starting vitamin D3 supplementation. Both groups were evaluated for clinical, laboratory, and radiological outcomes after treatment.ResultsSerum 25(OH)D3 concentrations were significantly lower among TB cases (17.1 ± 5.5 nmol/L) compared to healthy controls (51.8 ± 27.3 nmol/L), and vitamin D deficiency was observed in all EPTB patients (n = 47). Patients in VD3 supplementation group had significantly higher weight gain and serum albumin level at 2 months and end of treatment, higher hemoglobin concentration at the end of treatment, significantly lower CRP and ESR at 2 months and at the end of treatment. In cases with TB pleurisy, a significant higher rate of full resolution of pleural fluid after 6 months of anti-TB treatment and shorter treatment duration were noted compared to the other group.ConclusionsVitamin D deficiency is prevalent in EPTB patients, in whom, vitamin D supplementation is a useful adjunctive therapy to anti-TB drugs and improves treatment course.

Randomized controlled trial of enteral vitamin D supplementation (ViDES) in infants

BackgroundVitamin D is necessary to develop healthy lungs and other organs early in life. Most infants born before 28 weeks’ gestation have low vitamin D levels at birth and a limited intake during the first month. Enteral vitamin D supplementation is inexpensive and widely used. The appropriate supplementation regimen for extremely preterm infants is controversial, and the effect of different regimens on their blood levels and outcomes is unclear.MethodsRandomized, blinded comparative effectiveness trial to compare two vitamin D supplementation regimens for inborn infants <28 weeks gestation or <1000 g birth weight at a large academic center in the United States. Infants are stratified by birth weight and randomized within 96 h after birth to either routine supplementation (400 IU/day with established feedings) or increased supplementation (800 IU/day with any feedings) during the first 28 days after birth. We hypothesize that the higher and early vitamin D dose (800 IU/day with early feeding) compared to placebo plus routine dose (400 IU/day with established feeding) will substantially increase total 25-hydroxyvitamin D3 levels measured as state-of-art at 1 month, reduce respiratory support at 36 weeks’ postmenstrual age (on an ordinal scale predictive of later adverse outcomes), and improve or at least not worsen other important secondary outcomes. The infants in the study will follow up at 22–26 months’ corrected age (~2 years) with blinded certified examiners to evaluate neurodevelopmental outcomes. The sample size of a minimum of 180 infants provides >90% power to detect a >95% posterior probability of a 33% increase in serum 25-hydroxy vitamin D3 and >80% power to detect a >80% posterior probability of a relative risk decrease of 20% of reducing respiratory support by intention-to-treat Bayesian analyses using a neutral prior probability.DiscussionOur study will help clarify the uncertain relationship of vitamin D supplementation and its associated serum metabolites to clinical outcomes of extremely preterm infants. Confirmation of our hypotheses would prompt reconsideration of the supplementation regimens used in extremely preterm infants and justify a large multicenter study to verify the generalizability of the results.Trial registrationClinicalTrials.gov NCT05459298. Registered on July 14, 2022.

Randomized Controlled Trial of Enteral Vitamin D Supplementation (ViDES) in Infants

Vitamin D is necessary to develop healthy lungs and other organs early in life. Most infants born before 28 weeks' gestation have low vitamin D levels at birth and a limited intake during the first month. Enteral vitamin D supplementation is inexpensive and widely used. The appropriate supplementation regimen for extremely preterm infants is controversial, and the effect of different regimens on their blood levels and outcomes is unclear. Randomized, blinded comparative effectiveness trial to compare two vitamin D supplementation regimens for inborn infants <28 weeks gestation or <1000 grams birth weight at a large academic center in the United States.Infants are stratified by birth weight and randomized within 96 hours after birth to either routine supplementation (400 IU/day with established feedings) or increased supplementation (800 IU/day with any feedings) during the first 28 days after birth.We hypothesize that the higher and early vitamin D dose (800 IU/d with early feeding) compared to placebo plus routine dose (400 IU/d with established feeding) will substantially increase total 25-hydroxyvitamin D3 levels measured as state-of-art at one month, reduce respiratory support at 36 weeks' postmenstrual age (on an ordinal scale predictive of later adverse outcomes) and improve or at least not worsen other important secondary outcomes. The infants in the study will follow up at 22-26 months' corrected age (~2 years) with blinded certified examiners to evaluate neurodevelopmental outcomes.The sample size of a minimum of 180 infants provides >90% power to detect a >95% posterior probability of a 33% increase in serum 25-hydroxy vitamin D3 and >80% power to detect a >80% posterior probability of a relative risk decrease of 20% of reducing respiratory support by intention-to-treat Bayesian analyses using a neutral prior probability. Our study will help clarify the uncertain relationship of vitamin D supplementation and its associated serum metabolites to clinical outcomes of extremely preterminfants. Confirmation of our hypotheses would prompt reconsideration of the supplementation regimens used in extremely preterm infants and justify a large multicenter study to verify the generalizability of the results. ClinicalTrials.gov registered on July 14, 2022 (NCT05459298).

A Comparison between Serum 25-Hydroxyvitamin D3 Levels and Serum Ferritin in Children and Adolescents with Iron Deficiency Anemia, Thalassemia Minor, Thalassemia Major and Healthy People

Background: We aimed to determine the level of serum vitamin D and serum ferritin in four groups’ children and adolescents. Methods: This descriptive/analytical study was conducted in 2019 on children and adolescents with thalassemia aged 7-18 years in Ahvaz, Iran. Overall, 160 patients with the target inclusion and exclusion criteria were assigned into four groups (n=40) of people with thalassemia minor, thalassemia major, iron deficiency anemia and healthy individuals. The level of ferritin and vitamin D was assessed. Mann-Whitney test, Wilcoxon test and Spearman's correlation test were used as well as SPSS Statistics V21. Results: The mean age of the participants was 13.07 ± 3.82 yr and 100 people (62.5%) were male. In terms of vitamin D deficiency, 16 people (40%) had severe deficiency in iron deficiency group. The highest level of ferritin was found in thalassemia major group and the lowest in iron deficiency group. Regarding the level of vitamin D and ferritin in the healthy group, there was a statistically significant difference between mean vitamin D and serum ferritin levels (P=0.027). In iron deficiency group, this level of ferritin was observed with mild deficiency (P=0.017). In thalassemia major group, the increase in ferritin was associated with severe vitamin D deficiency (P=0.05. Conclusion: Severe vitamin D is seen in thalassemia major due to the increase in ferritin, but moderate deficiency of this vitamin in healthy people and mild deficiency in iron deficiency anemia group was observed considering the normal levels of ferritin.

Effect of vitamin D2 supplementation on 25-hydroxyvitamin D3 status: a systematic review and meta-analysis of randomised controlled trials

There are known differences in biological functionality between vitamin D2 and D3. It is suspected from randomised control trial (RCT) data that vitamin D2 supplementation causes a reduction in serum 25-hydroxyvitamin D3 (25(OH)D3) concentrations (1), but the size of the effect has yet to be fully assessed across multiple studies. The aim of this study was to undertake a systematic review and meta-analysis of the effect of vitamin D2 supplementation on serum 25(OH)D3 concentrations.PUBMED was searched for publications from 1st January 1975 to 1st February 2023. Of the 182 papers retrieved, 29 were included in the systematic review, and of those, 18 were suitable for meta-analysis.The meta-analysis found significant reductions in serum D3 after vitamin D2 supplementation compared with control, for both end of trial between groups data (weighted mean difference (WMD) (random) = −13.51 nmol/L; 95% CI: −20.14, −6.89; P &lt; 0.0001) and absolute change over the trial (WMD (random) = −9.25 nmol/L; 95% CI: −14.40, −4.10; P = 0.0004). Similar results were found when D2 supplementation was compared to D3 supplementation, although as expected, the magnitude of the difference was larger, with WMD (random) = −46.20 nmol/L (95% CI: −60.80, −31.60; P &lt; 0.00001) for end of trial data, and WMD (random) = −56.23 nmol/L (95% CI: -69.17, −43.28; P &lt; 0.00001) for absolute change.Overall, we found that vitamin D2 supplementation produces significant reductions in serum 25(OH)D3 concentrations, when compared to either control or vitamin D3 supplementation. An inverse relationship between vitamin D2 and D3 concentrations has been proposed in the literature (2). A regulatory mechanism that disposes of 25(OH)D after an increase in vitamin D concentrations could explain our results (3). Moreover, supplementation with vitamins D2 and D3 has differential effects on gene expression (4). However, longer-term research is needed to establish whether clinical advice should recommend vitamin D3 supplements over vitamin D2 supplements, where appropriate.

Association between serum 25-hydroxyvitamin D3 level and cognitive impairment in older chronic kidney disease patients

This study aims to examine whether hypovitaminosis D was associated with cognitive impairment among chronic kidney patients with different level of albuminuria. This population-based cross-sectional study was conducted on elderly (over 60 years old) with urine albumin to creatinine ratio (UACR) ≥ 30 mg/g from 2011 to 2014 in the US National Health and Nutrition Examination Survey (NHANES). Cognitive function was assessed by the Consortium to Establish a Registry for Alzheimer’s Disease Word List Learning (CERAD). Subjects were divided into 2 groups according to the absence or presence of cognitive impairment and a propensity score matching (PSM) was further conducted. The association was assessed with Spearman correlation and logistic regression analysis. The positive association of 25-hydroxyvitamin D3 (25(OH)D3) and cognitive score was presented. PSM analysis revealed that a higher level of 25(OH)D3 correlated to a better cognitive function in CKD patients with albuminuria, especially in patients with 30 mg/g ≤ UACR < 300 mg/g. This study indicated that a low 25(OH)D3 level was associated with poor cognitive performance, especially in patients with microalbuminuria. Thus, early diagnosis of vitamin D insufficiency and an effective intervention might be a useful therapeutic strategy to prevent cognitive decline in patients with the progression of renal dysfunction.

Vitamin D deficiency and inflammatory markers in type 2 diabetes: Big data insights.

The objective of this study was to investigate the prevalence of vitamin D deficiency or insufficiency and its association with inflammatory markers and type 2 diabetes. We conducted our research at Qingdao Endocrine and Diabetes Hospital, where serum 25-hydroxyvitamin D3 levels were determined for 2,806 individuals with type 2 diabetes aged 30 and older between January 2018 and December 2019. Medical records were analyzed, and data on health, blood lipids, HbA1c, and inflammation were collected. Our results revealed a high prevalence of vitamin D deficiency in the population. Among male and female patients, median serum 25(OH)D3 levels were 22.46 and 19.00 ng/mL, respectively. More than 60% of female patients had vitamin D deficiency, with over 80% having levels below 30 ng/mL. We observed a favorable connection between high-density lipoprotein cholesterol and 25(OH)D3, while triglycerides and HbA1c showed negative correlations. As 25(OH)D3 levels increased, inflammatory markers such as hypersensitive C-reactive protein (hsCRP), erythrocyte sedimentation rate (ESR), white blood cell count, neutrophil count, and monocyte count decreased (trend test, p < 0.05), although peripheral blood lymphocytes initially increased and then decreased. After controlling for age and gender, multiple linear regression analysis indicated negative correlations between ESR, hsCRP, and white blood cell count with 25(OH)D3 (p < 0.05). In conclusion, our study demonstrates that individuals with type 2 diabetes often exhibit vitamin D deficiency or insufficiency, which is associated with elevated levels of inflammatory markers in the blood.