Serum Concentrations Of 25-hydroxyvitamin Research Articles

Randomized trial of influence of vitamin D on the prevention and improvement of symptomatic COVID-19

We aimed to investigate the preventive effect of vitamin D2 on COVID-19 and the improvement of symptoms after COVID-19 infection. The study recruited 228 health care workers who tested negative PCR or antigen for COVID-19. Subjects were randomly allocated to vitamin D2 or non-intervention at a ratio 1:1. Subjects recorded PCR or antigen tests and the symptoms of COVID-19 twice a week during the follow-up visit. The concentration of serum 25-hydroxyvitamin D (25(OH)D), C-reaction protein (CRP), complement component C1q and inflammatory cytokines were measured. The rates of COVID-19 infection were 50.5% in the vitamin D2 group and 52.4% in the non-intervention group (P = 0.785). There was no difference in the COVID-19 symptoms between the two groups. The mean 25(OH)D level significantly increased from 14.1 to 31.1 ng/mL after administration (P < 0.001). The difference between the two groups was not significant for the concentrations of CRP, C1q and inflammatory cytokines on the thirtieth day of the trial. According to the second level of vitamin D, there was a 14.3% difference in positive infection rates between the vitamin D adequate (> 30 ng/mL) and deficient groups (< 20 ng/mL). Adequate vitamin D had a tendency to prevent COVID-19.Trial registration: ClinicalTrials.gov NCT05673980, dated: 12/2022.

Effect of the Addition of an Ultraviolet B Light Bulb for 6 Months to the Enclosure of Client-Owned Cockatiels (Nymphicus hollandicus) on Serum 25-Hydroxyvitamin D Concentrations

BackgroundThe objective of this study was to determine the effects of ultraviolet B (UVB) radiation on the serum concentration of 25-hydroxyvitamin D [25(OH)D] in pet cockatiels (Nymphicus hollandicus) living in their home environments. MethodsThirty client-owned cockatiels were allocated to an intervention group, consisting of exposure to a commercial coil fluorescent bulb, or a control group, with no exposure to supplemental lighting. Blood samples were collected at baseline (Day 0) and 6 months after simple randomization for measurement of 25(OH)D (Day 180). A linear mixed model was used to determine if serum 25(OH)D concentrations were influenced by time, group, age, or sex. ResultsAt baseline, median 25(OH)D concentration for the whole study population was 13nmol/L (range, 0.0-15.0nmol/L). At the end of the study, median 25(OH)D concentration for the whole study population was 6.5 nmol/L (0.0-15.0nmol/L), for the UVB group was 3 nmol/L (0.0-8.0nmol/L) and for the control group was 7.5nmol/L (6.0-11.0nmol/L). There was a statistically significant 50% reduction in 25(OH)D concentrations from the baseline to the final sampling period for the overall population, but no differences by group, age, or sex. Conclusion and clinical relevanceThe addition of a UVB bulb for 6 months to the enclosures of cockatiels did not increase their serum 25(OH)D concentrations. There was an unexplained decrease in both groups when comparing Day 0 to the Day 180 sampling period. The 50% attenuation in the UVB lighting group, although not statistically significant, may be clinically relevant and deserves further investigation.

Dairy consumption and vitamin D concentration in adolescents with challenge-confirmed cow's milk allergy during infancy.

Milk is an important source of dietary calcium and, if fortified, vitamin D. Cow's milk allergy (CMA) is treated with a milk elimination diet. Although most children become tolerant by age 3 years, some continue dairy avoidance. It remains unclear whether adolescents with a history of CMA adopt similar milk consumption as their peers. We assessed dairy consumption and concentration of serum 25-hydroxyvitamin D (25(OH)D) in adolescents with either confirmed CMA or a negative CMA challenge in infancy (CMA-refuted group) and age-matched controls. This study is based on a previously reported randomized controlled trial from 1999 to 2002 on the treatment effect of probiotics on atopic eczema in participants aged <12 months (n = 230) with data on CMA status. We followed up these participants, aged 15-18 years, in 2017 (n = 104). A 20-item food frequency questionnaire assessed dairy consumption. An automated immunoassay measured 25(OH)D concentration. Median dairy product consumption did not differ between adolescents with CMA (449 g/d, n = 40), the CMA-refuted group (566 g/d, n = 36), and controls (235 g/d, n = 51) (P = 0.117). Median 25(OH)D concentrations were 76.0, 79.3, and 80.8 nmol/l, respectively (P = 0.844). Among participants, 93% were vitamin D sufficient (25(OH)D ≥ 50 nmol/l), with no differences between groups (P = 0.914). Among adolescents with a history of CMA during infancy, our study found no reintroduction failure of milk and no difference in vitamin D insufficiency rate compared with peers. Current management of CMA seems to adequately minimize later nutritional disadvantages associated with a cow's milk elimination diet.

Vitamin D for the Prevention of Disease: An Endocrine Society Clinical Practice Guideline.

Numerous studies demonstrate associations between serum concentrations of 25-hydroxyvitamin D (25[OH]D) and a variety of common disorders, including musculoskeletal, metabolic, cardiovascular, malignant, autoimmune, and infectious diseases. Although a causal link between serum 25(OH)D concentrations and many disorders has not been clearly established, these associations have led to widespread supplementation with vitamin D and increased laboratory testing for 25(OH)D in the general population. The benefit-risk ratio of this increase in vitamin D use is not clear, and the optimal vitamin D intake and the role of testing for 25(OH)D for disease prevention remain uncertain. To develop clinical guidelines for the use of vitamin D (cholecalciferol [vitamin D3] or ergocalciferol [vitamin D2]) to lower the risk of disease in individuals without established indications for vitamin D treatment or 25(OH)D testing. A multidisciplinary panel of clinical experts, along with experts in guideline methodology and systematic literature review, identified and prioritized 14 clinically relevant questions related to the use of vitamin D and 25(OH)D testing to lower the risk of disease. The panel prioritized randomized placebo-controlled trials in general populations (without an established indication for vitamin D treatment or 25[OH]D testing), evaluating the effects of empiric vitamin D administration throughout the lifespan, as well as in select conditions (pregnancy and prediabetes). The panel defined "empiric supplementation" as vitamin D intake that (a) exceeds the Dietary Reference Intakes (DRI) and (b) is implemented without testing for 25(OH)D. Systematic reviews queried electronic databases for publications related to these 14 clinical questions. The Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) methodology was used to assess the certainty of evidence and guide recommendations. The approach incorporated perspectives from a patient representative and considered patient values, costs and resources required, acceptability and feasibility, and impact on health equity of the proposed recommendations. The process to develop this clinical guideline did not use a risk assessment framework and was not designed to replace current DRI for vitamin D. The panel suggests empiric vitamin D supplementation for children and adolescents aged 1 to 18 years to prevent nutritional rickets and because of its potential to lower the risk of respiratory tract infections; for those aged 75 years and older because of its potential to lower the risk of mortality; for those who are pregnant because of its potential to lower the risk of preeclampsia, intra-uterine mortality, preterm birth, small-for-gestational-age birth, and neonatal mortality; and for those with high-risk prediabetes because of its potential to reduce progression to diabetes. Because the vitamin D doses in the included clinical trials varied considerably and many trial participants were allowed to continue their own vitamin D-containing supplements, the optimal doses for empiric vitamin D supplementation remain unclear for the populations considered. For nonpregnant people older than 50 years for whom vitamin D is indicated, the panel suggests supplementation via daily administration of vitamin D, rather than intermittent use of high doses. The panel suggests against empiric vitamin D supplementation above the current DRI to lower the risk of disease in healthy adults younger than 75 years. No clinical trial evidence was found to support routine screening for 25(OH)D in the general population, nor in those with obesity or dark complexion, and there was no clear evidence defining the optimal target level of 25(OH)D required for disease prevention in the populations considered; thus, the panel suggests against routine 25(OH)D testing in all populations considered. The panel judged that, in most situations, empiric vitamin D supplementation is inexpensive, feasible, acceptable to both healthy individuals and health care professionals, and has no negative effect on health equity. The panel suggests empiric vitamin D for those aged 1 to 18 years and adults over 75 years of age, those who are pregnant, and those with high-risk prediabetes. Due to the scarcity of natural food sources rich in vitamin D, empiric supplementation can be achieved through a combination of fortified foods and supplements that contain vitamin D. Based on the absence of supportive clinical trial evidence, the panel suggests against routine 25(OH)D testing in the absence of established indications. These recommendations are not meant to replace the current DRIs for vitamin D, nor do they apply to people with established indications for vitamin D treatment or 25(OH)D testing. Further research is needed to determine optimal 25(OH)D levels for specific health benefits.

Prevalence of the Double Burden of Malnutrition among Adolescents: Associations with Lifestyle Behaviors and Clusters of Social Determinants.

The double burden of malnutrition (DBM) is a condition in which malnutrition coexists with overweight, reflecting a new layer of malnutrition. Our objectives were to assess prevalence; test associations between DBM and 24-hour movement behaviors; and investigate whether DBM is associated with clusters of social determinants. Methods: This multicenter cross-sectional study included 1152 adolescents (12 to 17 years old) from four Brazilian cities. Body mass index (BMI, kg/m2) was used to estimate overweight, and the adopted cutoff points took into account the curves established for age and sex: Z-score > 1 and ≤2 (overweight) and Z-score > 2 (obesity). The serum concentration of 25-hydroxyvitamin D [25(OH)D] was stratified into three levels: vitamin D deficiency ≤ 20 ng/mL; vitamin D insufficiency = 21-29 ng/mL; optimal vitamin D ≥ 30 ng/mL. We used multilevel Poisson regression models to estimate prevalence ratios (PRs) and their respective 95% confidence intervals (95%CI) and to analyze the association between DBM and covariates. A significance level of p < 0.05 was considered. Cluster analyses were performed by applying a combination of hierarchical and non-hierarchical methods. Results: A population prevalence of DBM of 7.3% (95% CI: 5.9-8.9) was revealed. A percentage of 19.2% (95% CI: 17.0-21.6) of adolescents were overweight, and 8.3% (95% CI: 6.8-10.1) were obese. A total of 41.5% (95% CI: 38.7-44.4) had vitamin D deficiency, and 25.8% (95% CI: 23.4-28.4) had vitamin D insufficiency. However, 24-hour movement behaviors were not associated with DBM. Adolescents living in the southern region of the country, from public schools whose mothers have higher education, have a 1.94 [PR = 2.94 (95% CI: 1.20-7.23)] times greater chance of developing DBM. These results highlight the importance of specific factors to improve the nutritional health of adolescents, considering the specific social determinants identified in this study.

High Prevalence and Risk Factors Associated with Vitamin D Deficiency Among Chinese Hospital Staff: A Cross-Sectional Study.

To determine the current status of vitamin D status and the associated factors for its deficiency among Chinese hospital staff. The physical examination data of 2509 hospital staff members was analyzed alongside that of 1507 patients who visited the hospital during the corresponding period of the examination. Serum concentration of 25-hydroxyvitamin D (25(OH)D) were measured in the participants. The hospital staff also completed surveys about general information, laboratory examination, and occupational characteristics. The median vitamin D status (serum 25(OH)D concentration) of the participants was 9.0 ng/mL, ranging from 6.5 to 44.7 ng/mL, and the prevalence of deficiency (<12.3 ng/mL) was 81.47% (2044/2509). The multivariable logistic regression revealed that nurses (OR = 1.54, 95% CI 1.09-2.19, p = 0.015), BMI below 18 (OR = 2.39, 95% CI 1.02-5.58, p = 0.045) associated with higher prevalence of vitamin D deficiency. In the contrast, age above 30 (OR = 0.69, 95% CI 0.53-0.91, p = 0.009) and a high level of uric acid (OR = 0.56, 95% CI 0.41-0.78, p = 0.001) associated with lower prevalence of vitamin D deficiency. The prevalence of vitamin D deficiency was higher among the hospital staff (81.47%) compared to the patients who visited the hospital during the same time period (65.69%). A substantial disparity was observed in the propensity score matching dataset (69.14% vs 79.94%, p < 0.001). Hospital staff are a high-risk group for vitamin D deficiency. Paying attention to vitamin D status and supplementation of this vitamin are pertinent aspects of hospital staff health care. Outdoor activities, vitamin D supplementation, and foods rich in vitamin D should be advocated.

Vitamin D Deficiency Is Associated with Advanced Liver Fibrosis and Impaired Fasting Glucose in Alcohol Use Disorder.

Vitamin D deficiency is a risk factor for liver disease, insulin resistance, and beta cell dysfunction. Individuals with alcohol use disorder (AUD) have many comorbidities, with a heavy burden of liver disease and metabolic complications, including type 2 diabetes mellitus (T2DM). We aimed to analyze the prevalence and associations of vitamin D deficiency in patients admitted for in-hospital treatment of AUD. A cross-sectional study was conducted in patients consecutively admitted for the treatment of AUD between January 2017 and October 2023. Sociodemographic data, substance use characteristics, and blood parameters were available at admission. Vitamin D status was assessed through the serum concentrations of 25-hydroxyvitamin D [25(OH)D] levels using a direct competitive chemiluminescent immunoassay method. Deficiency of vitamin D was defined as a concentration less than 20 ng/mL; impaired fasting glucose (IFG) was defined by fasting blood glucose >100 mg/dL (5.6 mmol/L), and advanced liver fibrosis by an FIB-4 index >3.25. Two hundred and forty-three patients were included (75% male) with a mean age of 49 ± 10 years, mean BMI of 26.4 ± 7.3, mean alcohol consumption of 163 ± 81 g/day, and a mean duration of AUD of 18.1 ± 11.2 years. Mean 25(OH)D, fasting blood glucose, AST, ALT, and platelets were 14.4 ± 10.2 ng/mL, 103.4 ± 40.9 mg/dL, 55.1 ± 75.8 U/L, 44.8 ± 76.6 U/L, and 206.3 ± 84.8 × 109/L, respectively. The prevalence of vitamin D deficiency was 80.6%, and 41.1% of patients had levels less than 10 ng/mL. IFG was present in 32.3% of patients, and 20.5% had FIB-4 values >3.25. In the multivariable analysis, IFG (OR, 2.51; 95% CI: 1.02-6.17, p = 0.04) and advanced liver fibrosis (OR, 4.27; 95% CI: 1.21-15.0, p = 0.02) were the only factors associated with vitamin D deficiency. Vitamin D deficiency was very prevalent in this series of patients with AUD and was associated with impaired fasting glucose and advanced liver fibrosis.

PSV-27 Serum Mineral and Vitamin Concentrations in Central Performance Tested Rambouillet Rams with and Without Angular Limb Deformities

Abstract Angular limb deformities (ALD) have historically affected 3 to 18% of Rambouillet ram lambs enrolled in central performance tests in the Northern great plains. Osteochondrosis, the underlying pathology of ALD, results in varying degrees of abnormal ossification in long bones and limits ram welfare and performance under extensive rangeland conditions. The objective of this research was to quantify serum mineral and 25-hydroxyvitamin D differences in rams with and without (non-affected) ALD. A total of 25 ram lambs (age = 189 ± 19 d; n = 13 ALD, n = 12 non-affected) were evaluated. Serum and body weight (BW) were collected on d 0, 28, 56, 83, and 112 of the test. Serum concentrations of 25-hydroxyvitamin D, macrominerals (Ca, Cl, K, Mg, Na, P, and S), and microminerals (Co, Cr, Cu, Fe, Mn, Mo, Se, and Zn) were quantified. Traits were analyzed as repeated measures with fixed effects of ALD status, sampling timepoint, and their interaction. An autoregressive type-I covariance structure with heterogenous variance was used to model the random ram effect. The ALD status x sampling timepoint interaction was significant (P ≤ 0.03) for serum 25-hydroxyvitamin D and Mg concentrations. Rams with ALD had greater 25-hydroxyvitamin D concentration at d 83 and 112 and greater Mg concentration at d 28 and 112 (P ≤ 0.05; Table 1). The main effect of ALD status was significant for serum Cl and greater for ALD than non-affected rams (3,672 ± 38.8 vs. 3,500 ± 38.3 mg/L; P &amp;lt; 0.001). Ram BW and serum concentration of all other minerals were similar between ALD and non-affected. Sampling timepoint affected several serum mineral concentrations as Ca generally increased with time, Co peaked at d 28, and Na decreased with time (P ≤ 0.03). Not surprisingly, BW also increased over time (P &amp;lt; 0.001). The range in serum mineral concentrations and percentage of rams deficient were: 25-hydroxyvitamin D (non-affected 32 to 241 mmol/L, 17%; ALD 35 to 160 mmol/L, 15%), Mg (non-affected 10.7 to 44.1 mg/L, 14%; ALD 11.7 to 45.0 mg/L, 14%), Cl (non-affected 3,066.3 to 4,024.5 mg/L, 21%; ALD 3,068.4 to 4,072.5 mg/L, 12%). While ALD and non-affected rams differed in key serum vitamin and mineral element concentrations, it’s a multifaceted disorder in which perinatal, endocrine, genetic, and nutritional conditions need to be researched to fully understand the etiology and mitigate its incidence.

Association of rs2282679 polymorphism in vitamin D binding protein gene (GC) with the risk of vitamin D deficiency in an iranian population: season-specific vitamin D status

BackgroundGenome-wide association studies in Western countries indicate a considerable impact of variations in vitamin D binding protein (GC) genes on serum concentrations of 25-hydroxyvitamin D (25(OH)D). We aimed to investigate an association between rs2282679 polymorphism in GC and vitamin D deficiency.MethodsA cross-sectional study conducted in the framework of the Tehran Cardio-Metabolic Genetic Study (TCGS) cohort. A total of 1568 participants aged > 18 years were randomly selected, and their 25(OH) D concentration was measured. Vitamin D deficiency was assessed concerning rs2282679 by descriptive and multivariate analysis, odds ratio (OR), and 95% confidence intervals (95%CI) calculated. Since the interaction term between rs2282679 and recruitment season was significant, we performed regression analysis separately for individuals whose blood was taken in high sunny and those whose blood was drawn in the low sunny season.ResultsThe rs2282679 polymorphism was in Hardy-Weinberg equilibrium (P > 0.05) in the studied population. The serum concentration of 25(OH) D median was 15.0 ng/mL, and the prevalence of VDD was 27.8%. The presence of the G allele in rs2282679 increases the risk of VDD in additive (OR = 1.35, 95% CI: 1.06–1.73) and dominant (OR = 1.33, 95% CI: 1.06–1.68) genetic models. After separating participants based on the recruitment season, the unfavorable association was observed in the additive and dominant only in the low sunny season.ConclusionThe finding of the current study indicates that the GC rs2282679 SNP is associated with vitamin D deficiency. It seems that the impact of risk allele increased in the low sunny season when UV exposure has been declined.

Serum Vitamin D Status and Cognitive Function in Iranian Older Adults: Evidence from the Birjand Longitudinal Aging Study

BackgroundThere is evidence of the role of vitamin D deficiency in cognitive decline. However, the results of studies regarding the relationship between the reduction of vitamin D concentrations and cognitive impairment are heterogeneous. ObjectivesWe aimed to answer the question of whether vitamin D deficiency is associated with cognitive decline in older adults. MethodsIn this cross-sectional study, the baseline data of the Birjand Longitudinal Aging Study (BLAS) were analyzed. Of 1420 participants in the BLAS, 1219 participants aged ≥60 y old were included in the present study. Serum concentrations of 25-hydroxyvitamin D [25(OH)D] were measured by the enzyme-linked immunosorbent assay method. The 6-item Cognitive Impairment Test (6-CIT), Mini-Mental State Examination (MMSE), Category Fluency Test (CFT), and Abbreviated Mental Test Score (AMTS) were used to assess cognitive function. Multiple logistic regression analysis, adjusted for potential confounders, was employed to estimate the association between cognitive function and 25(OH)D concentrations. ResultsAmong study participants, 905 (74.24%) had sufficient vitamin D concentrations (≥20 ng/ml), 209 (17.15%) had insufficient vitamin D concentrations (12–20 ng/ml), and 105 (8.61%) had vitamin D deficiency (<12 ng/ml). There was no significant correlation between serum 25(OH)D concentrations and scores of 6-CIT (P = 0.279), AMTS (P = 0.181), MMSE (P = 0.118), and CFT (P = 0.259). Also, the prevalence of cognitive impairment had no significant relationship with vitamin D status. Finally, in the multiple logistic regression analysis, there was no association between the insufficient or deficient concentrations of 25(OH)D and impaired cognitive function both before and after adjustment for various cofounders. ConclusionsThe present study found no significant association between vitamin D status and cognitive impairment.

Serum Levels of 25-Hydroxyvitamin D in Chronic Plaque Psoriasis

Background: Psoriasis is an immune mediated inflammatory disease that involves the innate and acquired arm of immunologic system. The regulatory role for vitamin D in immune system is suggested by presence of vitamin D receptors on activated lymphocytes and suppressive or inhibiting effect of 1,25-dihydroxyvitamin D in different autoimmune diseases. Hence, the current proposed study aims to study the 25-hydroxyvitamin D status of patients with psoriasis.&#x0D; Objective: The primary objective of this study was to analyze the 25-hydroxyvitamin D status of patients with chronic plaque psoriasis in comparison to healthy control subjects.&#x0D; Materials and Methods: A comparative cross-sectional study, including forty patients with chronic plaque psoriasis and forty age- and sex-matched control subjects, was conducted from April 2021 to December 2022, at our dermatology department. After informed consent, all patients were subjected to detailed clinical and anthropometric examination. Serum concentration of 25-hydroxyvitamin D was evaluated in chronic plaque psoriasis cases and healthy control subjects. Data was be analyzed as per standard statistical protocol.&#x0D; Results: The mean serum 25-hydroxyvitamin D level in psoriatic group and control group were 18.02 (±SD 9.82) ng/ml and 24.47 (±SD 6.77) ng/ml, respectively. (p=.001) Serum 25-hydroxyvitamin D was negatively correlated with Psoriatic area and severity index (PASI) score (r=-.11). However, this correlation was not significant (p=.493).&#x0D; Conclusion: Serum 25-hydroxyvitamin D levels were significantly lower in psoriatic patients than in control subjects.

Untreated caries and serum vitamin D levels in children and youth of the United States: NHANES 2013-2014.

This cross-sectional study used data from the National Health and Nutrition Examination Survey (2013-2014). In total, 3,072 participants with ages ranging from 1 to 19 years were included in our sample. The main dependent variable, untreated caries, was defined as having at least one untreated carious surface in any tooth. Serum concentration of 25-hydroxyvitamin D [25(OH)D] was categorized into four groups: ≥75 nmol/ml, 50-74.9 nmol/ml, 25-49.9 nmol/ml, and <25 nmol/ml. Data were analyzed using a binary logistic regression. For children aged 1-5 years, age (OR = 1.68, 95% confidence intervals (95% CI) 1.38-2.04) and low levels of vitamin D (25-49.9 nmol/ml, and <25 nmol/ml: OR = 2.55, 95% CI 1.06-6.13) were associated with untreated caries. For children aged 6-11 years, low levels of vitamin D (50-74.9 nmol/ml: OR=1.45, 95% CI 1.16-1.82) remained associated with untreated caries. No associations were found in those between 12 and 19 years of age. Our findings show an association between low levels of 25(OH)D and untreated caries in children between 1 and 11 years of age, suggesting that this nutrient might interfere in the caries process.

Circulating 25-hydroxyvitamin D is associated with metabolic phenotypes of obesity: National Food and Nutrition Surveillance

Different phenotypes of obesity are each related with different complications and comorbidities. We hypothesized that suboptimal vitamin D status is directly associated with an unhealthy metabolic status, especially if allied with obesity. This cross-sectional study was performed in the framework of the National Food and Nutrition Surveillance. Overall, 1098 men and women participated in this study. In addition to height and weight, serum concentrations of 25-hydroxyvitamin D (25(OH)D) and glycemic and lipidemic status were evaluated. Then participants were classified into 4 groups based on body mass index and lipidemic and glycemic profile status, as follows: hyperglycemic-dyslipidemic obese (HDO), hyperglycemic-dyslipidemic nonobese (HDNO), normoglycemic-normolipidemic obese (NNO), and normoglycemic-normolipidemic nonobese (NNNO). In this study, 31.6% of participants were classified as HDO, 7.5% as HDNO, 34.5% as NNO, and 26.4% as NNNO. The frequency of suboptimal vitamin D status was more prevalent in HDO (81.8%) than in other phenotypes (HDNO, 80%; NNO, 77.6%; NNNO, 73.8%; P = .015). In the multivariate model, suboptimal vitamin D status significantly increased the odds of being NNO (odds ratio [OR], 1.28; 95% CI, 0.84-1.95), HDNO (OR, 1.48; 95% CI, 0.77-2.83), and HDO (OR, 1.73; 95% CI, 1.11-2.7) compared with the NNNO group. Likewise, in multivariate model, per each unit (ng/mL) increment in 25(OH)D concentration, the odds of HDNO and HDO decreased significantly by 4% (OR, 0.96; 95% CI, 0.94-0.98) and 7% (OR, 0.93; 95% CI, 0.92-0.95), respectively. The results of the study showed a significant relationship between serum 25(OH)D concentrations and metabolic obesity phenotypes; these data confirm the association between suboptimal vitamin D status and metabolic complications, especially in obese individuals.

ODP096 Hypercalcemia Secondary to Vitamin D Supplementation with Normal 25-Hydroxyvitamin D Level in an Elderly Female - Case Report

Abstract Case presentation A 92-year-old female with a history of heart failure, dementia (alert and oriented to time, place and person at baseline), osteoporosis and hypothyroidism presented to the emergency department with altered mental status and constipation. She was oriented to time and person only. Labs included: WBC count 6.2 (4 - 11k/mm cu), Creatinine 1.23 (0.6 - 1.2 mg/dL), Calcium 12.8 (8.6 - 10.3 mg/dL), Albumin 3.9 (3.5 - 5.7 g/dL) and Glucose 94 (70 - 99 mg/dL). CT head showed no acute abnormality. Medication reconciliation revealed that she was taking Cholecalciferol (Vitamin D3) 2000 units daily, which was held. Intravenous fluids were started and further workup was done: PTH &amp;lt; 6 (12 - 88 pg/mL), serum 25 Hydroxyvitamin D 45.1 (30 - 100 ng/mL), serum 1, 25 Dihydroxyvitamin D 79 (19.9 - 79.3 pg/ml) and PTHrP 2.6 (0 - 3.4 pmol/L). Endocrinology was consulted for management of PTH independent hypercalcemia and recommended Zoledronic acid. Serum calcium levels normalized with bisphosphonate therapy and withholding of Vitamin D3 supplementation in addition to symptomatic improvement. Repeat 1-25-Dihydroxyvitamin D level decreased to 38.3 pg/mL while repeat PTH normalized at 20.8 pg/mL. Subsequently, serum calcium levels remained within normal limits, and she was discharged. Discussion Vitamin D, the "sunshine Vitamin", has claimed much fame and popularity for its varied benefits. With a growing user base, there is concern for potential adverse effects, primarily involving the population with an underlying propensity for hypercalcemia. According to the NIH, the safe upper limit of daily Vitamin D intake is 4000 IU; however, for adults &amp;gt; 70 years of age, 800 IU is the recommended dose. Our patient was taking 2000 IU (almost 2.5 times the recommended dose) of Vitamin D3, the most potent form which raises Vitamin D levels twice as fast as Vitamin D2. In addition, her serum 1,25 Dihydroxyvitamin D levels normalized when supplementation was withheld pointing to a cause - effect relationship and thus, effectively ruling out an endogenous source. Moreover, other factors such as prolonged duration of supplement intake, advanced age, immobility, osteoporosis and hypothyroidism contributed to her hypercalcemia. Current review of literature suggests that serum concentrations of 25-Hydroxyvitamin D at which hypercalcemia arises remains undefined. With this case, we wish to emphasize that a holistic approach should be utilized to advise patients regarding Vitamin D supplementation considering pre-existing risk factors for hypercalcemia, concurrent medical conditions, diet and functional status. Although current guidelines detail the ideal dosage and duration of Vitamin D supplementation therapy for different sectors of population, streamlining and individualizing therapy to mitigate potential harm to patients is pivotal. Presentation: No date and time listed

25-Hydroxyvitamin D Increases Insulin-Stimulated Glucose Uptake by Enhancing Adipocyte Differentiation.

Vitamin D and its receptor (vitamin D receptor; VDR) regulate calcium homeostasis in mammals. Recently, studies have shown that serum concentrations of 25-hydroxyvitamin D (25VD) are negatively associated with insulin resistance and the incidence of type 2 diabetes. In adipose tissues, glucose transporter 4 (GLUT4) contributes to insulin-stimulated glucose uptake; however, the effect of 25VD on glucose uptake in adipocytes remains unclear. We examined the role of 25VD in glucose uptake and the differentiation of adipose-derived stromal cells. Insulin-stimulated glucose uptake in adipocytes was increased by treatment with 25VD and decreased by VDR knockdown. The expression levels of GLUT4 were upregulated by 25VD treatment. 25VD exposure increased the expression of adipocyte differentiation-related genes including peroxisome proliferator-activated receptor γ and CCAAT/enhancer-binding proteins through VDR, thereby enhancing the formation of mature adipocytes. Moreover, 25VD increased the expression levels of 11β-hydroxysteroid dehydrogenase 1 (HSD11B1), which catalyzes the conversion of cortisone to cortisol in a concentration-dependent manner. 25VD-stimulated adipocyte differentiation was suppressed by HSD11B1 knockdown. Cortisone together with 25VD enhanced adipocyte differentiation, whereas synthesized glucocorticoid dexamethasone-induced adipocyte differentiation is not promoted by 25VD. Overall, these results indicate that 25VD stimulates adipocyte differentiation through the induction of HSD11B1 expression, leading to increased insulin-induced glucose uptake in adipocytes.

Influence of Nordic walking with poles with an integrated resistance shock absorber on carbohydrate and lipid metabolic indices and white blood cell subpopulations in postmenopausal women.

BackgroundRegular and individualised physical activities have been shown to prevent adverse changes associated with the aging process. The main purpose of this study was to evaluate changes in carbohydrate and lipid metabolism and white blood cell (WBC) subpopulations in postmenopausal women participating in Nordic walking (NW) training and to compare the use of poles with an integrated resistance shock absorber (RSA) with the use of classic poles.Materials & MethodsA total of 23 postmenopausal women participated in a 8-week programme of systematic physical activity between February and April. Before and after the training programme, somatic features and serum concentrations of 25-hydroxyvitamin D, glucose, and insulin, were assessed, as well as lipid profile and WBC count and its specific subpopulations.ResultsAnalysis of differences in somatic features and biochemical indices before and after training in the group of women who used RSA poles showed significant decreases in fat mass content (p < 0.05), insulin (p < 0.05), homeostatic model assessment of insulin resistance (p < 0.05), triglycerides (p < 0.05), total cholesterol (p < 0.05) and monocytes (p ≤ 0.01). In the group of women who used classic poles (NW), there was a significant decrease in WBC (p ≤ 0.01), lymphocytes (p < 0.05), monocytes (p ≤ 0.01) and granulocytes (p < 0.05).ConclusionIncreasing the training load through the use of RSA poles resulted in greater changes in carbohydrate and lipid metabolic indices compared to the use of classic NW poles. In turn, the more significant effect on WBC and its specific subpopulations count in the NW, compared to the RSA training programme, may indicate that specificity of training load is an important factor in modifying the immune system response.

Effect of vitamin blend supplementation on the ingestive, digestive, and ruminal parameters of Nellore cattle

Rumen cannulated Nellore bulls (n = 4) were used in a 4 × 4 Latin square design, with a 2 × 2 factorial scheme to evaluate the effects of vitamin supplementation on: (1) ingestive, digestive, and ruminal parameters; (2) serum concentrations of 25-hydroxyvitamin D (25(OH)D); and (3) in situ degradability of complete diets. The factors consisted of two fat-soluble vitamin blend (ADE) supplementation levels (ADE− or ADE+) and two B vitamin blend (biotin, niacin, and thiamine) supplementation levels (B-blend− or B-blend+). Thus, the treatments evaluated consisted of no vitamin supplementation (ADE− B-blend−), supplementation of a B vitamin blend (ADE− B-blend+), supplementation with a fat-soluble vitamin blend (ADE+ B-blend−), or a combination of these two blends (ADE+ B-blend+). Nutrient intake and DM, as well as ruminal digestibility were not affected (P > 0.05) by any of the vitamin supplementations. The apparent total-tract digestibility of DM, organic matter (OM), neutral detergent fiber corrected for residual ash and protein (apNDF), crude protein (CP), and non-fiber carbohydrates (NFC) were not influenced by the experimental diets (P > 0.05). Furthermore, an increase in starch total-tract digestibility was verified with ADE supplementation in the diets (P = 0.031). None of the in situ parameters were affected (P > 0.05) by vitamin supplementation. Further, the treatments did not affect ruminal kinetics (ki, kp, and kd,) of DM, OM, and starch (P > 0.05). The omasal flow of total N, NH3-N, non-ammonia N, microbial N, and non-ammonia non-microbial N (P > 0.05) or the efficiency of microbial protein synthesis (P > 0.05) were not affected by vitamin blend supplementation. The total fat volatile acid (VFA) concentrations, as well lactate concentration were not affected (P > 0.05) by vitamin blend supplementation. Bulls that consumed the combination of ADE and B-blend supplementation had lower ruminal NH3-N concentrations (P = 0.008). B-blend vitamin supplementation decreased ruminal pH (P = 0.003). As expected, concentrations of serum 25(OH)D increased (P = 0.001) in Nellore bulls fed diets with the combination of fat-soluble vitamin (ADE) and B-blend supplementation. Supplementing Nellore bulls with a vitamin blend containing 25(OH)D3 was a successful strategy for increasing circulating concentrations of 25(OH)D. The B vitamin blend (biotin, niacin, and thiamine) supplementation did not improve ruminal fermentation, ingestive or digestive parameters. However, the fat-soluble vitamin blend (ADE) supplementation increased total-tract starch digestibility.

Associations Between Vitamin D Levels and Risk of Heart Failure: A Bidirectional Mendelian Randomization Study.

BackgroundAlthough studies suggest that concentrations of serum 25-hydroxyvitamin D (25(OH)D) are lower in individuals with Heart Failure (HF), the beneficial effects of vitamin D supplementation are controversial. Therefore, in this study, we aimed to determine whether there is a causal relationship between serum Vitamin D (VD) levels and HF.MethodsWe obtained genetic instruments from the largest available genome-wide association study (GWAS) of European descent for 25(OH)D (443, 734 individuals) to investigate the association with HF (47,309 cases, 930,014 controls), and vice versa. Two-sample bidirectional Mendelian Randomization (MR) analysis was performed to infer the causality. In addition to the primary analysis using inverse variance-weighted (IVW) MR, we applied five additional methods to control for pleiotropy [MR-Egger, weighted median, Maximum-likelihood, MR-robust adjusted profile score (MR-RAPS) and MR-pleiotropy residual sum and outlier (MR-PRESSO)] and compared their respective MR estimates. We also performed a sensitivity analysis to ensure that our results were robust.ResultsMendelian randomized analysis showed that increased serum 25(OH)D was associated with a lower risk of HF in the IVW method (odds ratio [OR] = 0. 81;95%CI, 0.70–0.94, P = 0.006). In the reverse MR analyses, the genetic predisposition to HF was negatively correlated with serum 25(OH)D level (OR = 0. 89;95%CI, (0.82–0.97), P = 0.009).ConclusionOur study revealed the possible causal role of 25(OH)D on decreasing the risk for HF. Meanwhile, reverse MR analysis suggested that HF may be associated with lower vitamin D levels, it could be the potential implications for dietary recommendations.

Correlation Between Serum 25-Hydroxyvitamin D Levels in Albuminuria Progression of Diabetic Kidney Disease and Underlying Mechanisms By Bioinformatics Analysis.

AimThis study aimed to assess the correlation between serum concentration of 25-hydroxyvitamin D and albuminuria progression of diabetic kidney disease (DKD) and to use bioinformatics methods to determine the potential mechanism in the pathological process of advanced DKD.MethodsA total of 178 type 1 diabetes mellitus (T1DM) patients with microalbuminuria complications who were hospitalized at least twice (with an interval > 24 months) in the Department of Endocrinology of The First Affiliated Hospital of USTC were included in this study. According to the urinary albumin creatinine ratio (UACR), we classified DKD stages as follows: microalbuminuria (UACR, 30-300 mg/g), and macroalbuminuria (UACR, >300 mg/g). We divided the patients into DKD progression (N=44) and stable group (N=134) on account of urinary albumin-to-creatinine ratio (UACR) by at least two randomized measurements. Stable group was defined as UACR between 30 and 300 mg/g, whereas progression group was defined as UACR >300 mg/g at the end of follow-up. Data were obtained from participants’ medical records, and the 25-hydroxyvitamin D level was categorized into three groups as follows: G1 (N=45), <10 ng/mL; G2 (N=80), 10-20 ng/ml; and G3 (N=53), ≥20 ng/mL. The Nephroseq database (http://v5.nephroseq.org) was used to identify VDR expression in diabetic nephropathy. The dataset GSE142025 from GEO (http://www.ncbi.nlm.nih.gov/geo) was downloaded. After stratification by the median-centered log2 VDR expression value, the 21 advanced DKD samples were divided into two groups (low VDR expression group and high VDR expression group). Gene set enrichment analysis (GSEA) (http://software.broadinstitute.org/gsea/index.jsp). Differentially expressed genes (DEGs) were screened by the limma package (adjusted p < 0.05, |logFC| > 1). The Gene Ontology (GO; http://www.geneontology.org/) database and pathway analysis within the Kyoto Encyclopedia of Genes and Genomes (KEGG; https://www.kegg.jp/) were performed using the R package ClusterProfile. The CIBERSORT (Cell type Identification By Estimating Relative Subsets Of known RNA Transcripts) algorithm was utilized for calculating the infiltrated immune cells in advanced kidney tissues.Results1) A multivariate Cox regression analysis revealed that DR (diabetic retinopathy), eGFR (estimated glomerular filtration rate), and 25-hydroxyvitamin D were significant independent predictors of DKD progression (HR: 2.57, 95% CI: 1.44.4.24, p=0.007; HR: 2.13, 95% CI: 1.58.3.79, p = 0.011; HR: 0.732, 95% CI: 0.232–0.816, p = 0.023, respectively). 2) Kaplan–Meier survival curves of DKD progression by serum 25-hydroxyvitamin D stratification showed that the G2 and G3 groups were significantly different when compared with the G1 group (log-rank χ2 = 14.69, p <0.001; χ2 = 28.26, p <0.001, respectively). 3) There was a weak negative correlation between 25-hydroxyvitamin D level and UACR at baseline,and the overall mean rate of change in eGFR was 1.121 ± 0.19 ml/min/1.73 m2/year. Neither crude nor adjusted rate of decline in eGFR was significantly different among patients classified according to baseline serum 25-hydroxyvitamin D levels (all p<0.05). 4) The high expression of VDR group was most positively correlated with enriched gene sets like reactome innate immune system and reactome G alpha I signaling events when compared with the low expression of VDR group. 5) The CIBERSORT algorithm showed decreased M2 macrophage infiltration in advanced kidneys in comparison to low VDR expression and high VDR expression.ConclusionThis study concluded that low 25-hydroxyvitamin D levels can predict an increased risk of DKD albuminuria progression and eGFR decline. Decreased M2 macrophage infiltration may be a potential mechanism involved in this pathogenesis.

Association between bruxism severity and serum concentrations of 25-hydroxyvitamin D levels.

ObjectivesThe aim of this study was to investigate the possible relationship between bruxism and blood levels of 25‐hydroxyvitamin D.Material and MethodsOne hundred male and female patients from Damascus joined the study. Their ages were in the range of 18–40 years. Two groups were considered in this study, the first group included patients who were already suffering from bruxism (76 patients) and the second group consisted of patients who were not suffering from any bruxism (24 patients). The analysis of the blood samples for 25‐hydroxyvitamin D levels of the two groups was carried out.ResultsThe recorded results showed that there is a relationship between the levels of bruxism and 25‐hydroxyvitamin D concentration in the blood (p < .05), enhancing that the bruxism activity has been shown the associated deficiency in 25‐hydroxyvitamin D levels, which can be divided into five different categories.ConclusionsWithin the limitations of this study in spite of the number of patients (one hundred), according to the reported study, it appears that there is a significant relationship between bruxism and the level of 25‐hydroxyvitamin D in the blood.