Serum 25OHD Levels Research Articles

Vitamin D Status in Infants during the First 9 Months of Age and its Effect on Growth and Other Biochemical Markers: A Prospective Cohort Study.

Background:Despite food fortification policies in many countries and recommendations for Vitamin D supplementation of at-risk groups, Vitamin D deficiency (VDD) and infantile rickets remain major public health challenges in many developed and developing countries.Materials and Methods:Ninety-six participants at birth were enrolled and followed up until 9 months of age. Serum 25OHD was estimated in cord blood at birth and at 14 ± 1 weeks of life. Seventy-seven participants were followed up at 9 months for estimation of serum 25OHD, parathyroid hormone (PTH), alkaline phosphatase (ALP), calcium, and phosphorus. VDD was defined as serum 25OHD <15 ng/mL as per USIOM guidelines.Results:Serum 25OHD levels at 9 months of age (15.78 ± 8.97 ng/mL) were significantly increased in comparison to the level of 3 months of age (14.04 ± 7.10 ng/mL) and at birth (8.94 ± 2.24 ng/mL). At birth, all the participants (77) were deficient in 25OHD levels. It was found that 16/94 (17%) and 19/77 (24.7%) participants at 3 and 9 months of age, respectively, became Vitamin D sufficient without any Vitamin D supplementation. There was a significant inverse correlation between serum 25OHD and PTH concentration (r = −0.522, P < 0.001), serum 25OHD and ALP (r = −0.501, P < 0.001). It was found that reduction in serum Vitamin D level to <10.25 ng/mL results in a surge of serum PTH.Conclusion:VDD is common from birth to 9 months of age but incidence decreases spontaneously even without supplementation. Furthermore, a large number of babies may be falsely labeled as Vitamin D deficient with currently followed cutoffs. Hence a new cutoff for VDD needs to be established for neonates and infants.

Determination of serum vitamin D status of mothers and newborns and related outcomes

AbstractVitamin D deficiency (VDD) has been associated with severe adverse health outcomes during pregnancy is increasingly recognised as a public health concern and maternal and infant VDD is closely associated. The aim of this study was to evaluate the magnitude of VDD and associated factors in pregnant women and newborns in the postpartum period. A cross-sectional study was carried out in a total of 66 pregnant women at &gt; 37 weeks of gestation and newborns at the Gaziantep University Faculty of Medicine, Department of Obstetrics and Gynecology in Gaziantep, Turkey. Demographic characteristics, 24-h dietary recalls, intake of food supplements were determined in pregnant women, maternal and newborn anthropometric measurements and serum (25-OHD) levels were assessed. Mean age (± SD) of pregnant women was 28.8 ± 6.9 years. Although Turkey has “National Vitamin D Supplementation Programme for Pregnant Women” only 33.3% of women had VD supplementation during pregnancy, not all in the recommended levels (1200 IU/day). Mean (± SD) serum 25(OH)D levels in pregnant women and cord blood of newborns were 17.3 ± 9.0 ng/mL [non-supplemented women (NSW): 16.5 ± 7.9 ng/mL; supplemented women (SW): 18.8 ± 11.0 ng/mL] and 16.6 ± 9.9 ng/mL [newborns of non-supplemented women (NNSW): 13.9 ± 8.7 ng/mL and newborns of supplemented women (NSW): 22.1 ± 10.1 ng/mL], respectively. Vitamin D severe deficiency (&lt; 10 ng/dL) was noted in 22.7%, deficiency (11–19 ng/mL) 51.5%, insufficiency (20–29 ng/mL) 15.2% and sufficiency (≥ 30 ng/mL) 10.6% of the women whereas severe deficiency, deficiency, insufficiency and sufficiency respectively, were determined in 33.3%, 39.5%, 13.6% and 13.6% of newborns (NNSW vs NSW, p = 006, p &lt; 0.05). Median serum VD levels of NSW were statistically higher than NNSW (p = 0.000, p &lt; 0.05). Out of total, 86.4% of women were dressing traditionally covered, and had lower serum VD level (p = 0.049, p &gt; 0.05). SW had higher median body weight (p = 0.026) and body mass index (BMI) (p = 0.036) levels than NSW (p &lt; 0.05). No statistically significant differences were found between anthropometric measurements of NNSW and NSW groups, although birth weights of NNSW and NSW groups were determined as 3005.1 ± 456.1 g and 3153 ± 422.5 g (p &gt; 0.05), respectively. Maternal serum vitamin D levels strongly were correlated with newborn levels. Maternal vitamin D deficiency is a great problem and “National Vitamin D Supplementation Programme for Pregnant Women and Infants” should be effectively implemented and monitored. Also fortification programme should be a national policy.

Depressed Serum 25-Hydroxyvitamin D Levels Increase Hospital Stay and Alter Glucose Homeostasis in First-ever Ischemic Stroke.

Vitamin D deficiency is internationally recognized among the potentially modifiable risk factors for ischemic cardio-cerebrovascular diseases. However, the association between vitamin D deficiency and stroke morbidity or mortality remains insufficiently known. Our aim is to investigate their relevance to 25-hydroxyvitamin D [25(OH) D] levels and clinical severity and outcome after 3 months in first-ever ischemic stroke. Retrospective analysis of 356 consecutive patients in first-ever ischemic stroke between 2013 and 2015. Serum 25(OH) D levels were measured at baseline. Stroke severity was assessed at admission using the National Institutes of Health Stroke Scale (NIHSS) score. Functional outcome after 3 months of onset was evaluated using the modified Rankin scale (mRS). Among the 356 enrolled patients, HbA1c was higher in insufficiency/deficiency group than that in the sufficiency group (6.3 ± 1.7 vs. 5.9 ± 1.1, p =0.015). The hospital stay was longer in insufficiency/deficiency group than that in the sufficiency group (11 (8-17) vs. 9.5 (7-13), p = 0.035). There was a significant inversed trend between serum 25(OH) D levels and hospital stay (OR 0.960, P = 0.031), using logistic regression. 25(OH)D levels are associated with glucose homeostasis, 25(OH) D contributes to increase the length of hospital stay. Low serum 25-OHD level is an independent predictor for hospital stay in first-ever ischemic stroke. Vitamin D deficiency did not predict functional outcome in the span of 3 months.

Seasonal Variation in Serum 25-hydroxy Vitamin D and its Association with Clinical Morbidity in Healthy Infants from Northern India

To evaluate the seasonal change in serum 25-hydroxyvitamin D (25-OHD) level in healthy infants and to relate it to common childhood morbidities. 72 healthy breastfed infants residing in Delhi were enrolled at the end of summer and followed till the end of winter [mean (SD) duration 200 (10) d]. Serum 25-OHD was estimated at baseline and follow-up. Infants were monitored for common childhood diseases. Mean (SD) serum 25-OHD level was lower at the end of winter (20.7 (8.02) ng/mL) than summer (22.9 (8.70) ng/mL) [mean difference (95% CI) -2.14 ng/mL (-3.36, -1.06), P<0.001). The seasonal distribution of children according to vitamin D status in summer and winter - Deficient (15.3%, 12.5%), Insufficient (19.4%, 30.6%) and Sufficient (65.3%, 56.9%), respectively was comparable P=0.17). The morbidity profile remained unaffected by change in vitamin D status from summer to winter. Seasonal changes in vitamin D levels do not have significant clinical effect or effect on overall vitamin D status in apparently healthy infants from North India. This may have implications for results of population surveys for vitamin D status, irrespective of the season when they are conducted.

Effects of Vitamin D and Calcium Fortified Yogurts on Gait, Cognitive Performances, and Serum 25-Hydroxyvitamin D Concentrations in Older Community-Dwelling Females: Results from the GAit, MEmory, Dietary and Vitamin D (GAME-D2) Randomized Controlled Trial.

Background: Vitamin D3 fortified food may improve serum vitamin D level, suggesting that the prevention of adverse consequences of hypovitaminosis D is possible with food fortification. The aim of this randomized controlled trial (RCT) was to examine the effects of vitamin D and calcium fortified yogurt on spatiotemporal gait parameters, cognitive performance, handgrip strength, and serum 25OHD levels in healthy older females. Methods: Forty older community-dwelling females were recruited in a single-blind, randomized, controlled, superiority clinical trial in two parallel groups (20 participants in the intervention group and 20 in the control group) with intent-to-treat. The intervention group took fortified yogurts daily (i.e., 400 UI of vitamin D3 and 800 mg calcium) for 3 months. The non-fortified yogurts contained similar proteins, carbohydrates and lipids, as well as a lower dose of calcium (300 mg) and no vitamin D3 supplementation. Spatiotemporal gait parameters (mean value and coefficient of variation) were assessed using a computerized walkway. Handgrip strength was measured with hydraulic dynamometers. Cognitive performances, including global cognitive functioning assessed with the Mini Mental Status Examination (MMSE) were recorded. All the outcomes were assessed at baseline and at the end of follow-up. The primary outcome was the coefficient of variation of stride time. Results: The intervention group maintained its global cognitive performance and serum 25OHD concentrations, whereas these outcomes decreased (i.e., worst performance) in the control group. The changes in the MMSE score (p = 0.022) and serum 25OHD concentrations were different (p ≤ 0.001) with better values reported in the intervention group compared to the control group. There was no significant change in gait parameters (p ≥ 0.518) and handgrip strength (p ≥ 0.600). Conclusions: Fortified yogurts with vitamin D (i.e., 200 IU) and calcium (i.e., 400 mg) twice a day maintained global cognitive performance and vitamin D status in older females, but not gait performances, signifying that they mainly prevent hypovitaminosis D-related extra-skeletal disorders.

Pioglitazone Therapy Decreases Bone Mass Density and Increases Fat Mass: A Meta-Analysis.

Pioglitazone is mainly used for the management of type 2 diabetes and other insulinassociated diseases. However, the molecular mechanism of pioglitazone can lead to an imbalance in bone metabolism, thus decreasing bone mass density (BMD) and increasing the risk for fractures. To demonstrate the effect of pioglitazone therapy on bone metabolism and fat mass. A comprehensive search of the PubMed, EMBASE, Web of Science and Cochrane Central databases for randomized controlled trials (RCTs) on the effect of pioglitazone therapy on BMD and fat mass was performed. The primary outcome measures were the measured values of BMD, percentage changes in BMD, measured values of bone turnover markers and bone metabolic hormones, changes in BMI, body and leg fat mass, and fracture rates. The final search was performed in May 2019. Six RCTs were included. A total of 749 patients met the inclusion criteria. Pioglitazone therapy was shown to significantly reduce the BMD of the whole body, lumbar spine, and total hip and serum PTH levels and increase BMI, total body fat mass and leg fat mass. In addition, 30 mg/d and 30 mg/d initially for one month followed by 45 mg/d pioglitazone could reduce the BMD of the lumbar spine. Pioglitazone therapy exerted no significant influence on the BMD of the femoral neck, serum BSAP or 25-OHD levels, or fracture rates. Compared with placebo, pioglitazone therapy reduced BMD and serum PTH levels and increased fat mass and BMI with no difference in serum BSAP or 25-OHD levels or fracture rates; 30 mg/d pioglitazone was sufficient to reduce the BMD of the lumbar spine.

Adjunctive vitamin D for the treatment of active juvenile idiopathic arthritis: An open-label, prospective, randomized controlled trial.

Vitamin D has an important immunomodulatory effect, but no trial has examined the effect of boosting serum levels of 25-hydroxyvitamin D (25OHD) in individuals with juvenile idiopathic arthritis (JIA). The aim of the present study was to assess whether vitamin D supplementation reduced disease activity and adjusted/maintained bone mass in patients with active JIA. A 24-week randomized trial was undertaken at Children's Hospital of Chongqing Medical University. Treatment-naive patients with JIA were randomly assigned (1:1) to one of two groups: Standard treatment with high dose oral cholecalciferol [2,000 IU per day; experimental group (EG)] or without supplementation [control group (CG)]. The primary outcomes were the 27-joint Juvenile Arthritis Disease Activity Score (JADAS-27 score), the Z-score for bone mineral density (BMD), and serum levels of 25OHD. A per-protocol analysis set approach was used. The Mann-Whitney U test was the main tool used for data analysis. A total of 42 participants were assigned randomly to the EG (n=20) or the CG (n=22); of these, 36 (n=18 and n=18, respectively) were included in per-protocol analysis. After 24 weeks, the mean level of 25OHD in the EG was higher than that in the CG (P<0.05). At the end of the intervention, there were no clear differences between the two groups in terms of BMD or JADAS-27 score (both P>0.05). Cholecalciferol supplementation (2000 IU/day) for 24 weeks raised serum levels of 25OHD in JIA patients but did not reduce disease activity or improve BMD (registration no. ChiCTR-INR-16009235; Date of Registration: 2016-10-12).

Serum 25-hydroxyvitamin D, Selenium, Zinc and Copper in patients with keratoconus

PurposeTo assess the possible association between keratoconus (KC) and serum levels of 25-hydroxyvitamin D (25OHD), Selenium (Se), Zinc (Zn), and Copper (Cu) and to compare it with age-matched healthy subjects. MethodsOne hundred patients with KC and 100 normal subjects were included. The two groups were compared for serum 25OHD and serum levels of three trace elements: Se, Zn, and Cu. These factors were also compared between groups with different KC stages. ResultsSerum levels of vitamin D, Zn, Cu, and Se were significantly different between the KC and normal groups (P = 0.006, P = 0.015, P = 0.004, and P = 0.038, respectively). Although a lower level of 25OHD was found in severe stages of KC, it was not significantly different among different KC groups (P = 0.441). KC stage groups were not significantly different for mean serum Zn, Cu, and Se (P = 0.130, P = 0.98, P = 0.113, respectively). Although the Cu/Zn ratio was higher in cases than in controls, there was no significant difference between the two groups and between KC stages (P = 0.168, P = 0.143, respectively). ConclusionLower serum 25OHD, Cu, Zn, and Se were found in the KC group compared to the control group. The results of this study suggest that a lower antioxidative activity may be involved in the possible etiology of KC.

Effects of dietary calcium and phosphorus levels and supplementation of 25-hydroxycholecalciferol on performance and bone properties of broiler starters

ABSTRACTTo investigate effects of dietary calcium (Ca) and phosphorus (P) levels and 25-hydroxycholecalciferol (25OHD3) supplementation on performance and bone properties of broiler starters, 224 male Arbor Acre broilers were used in a 21-d trial. Broilers were allotted to one of four treatments in a 2 × 2 factorial arrangement including diets either normal or low in Ca and P, which were further supplemented or not with 69 μg 25OHD3/kg feed. Feeding low Ca and P diets significantly reduced performance of boilers and decreased ash, Ca, P and hydroxyproline contents in tibias and femurs (p < 0.05). Ultimate load, bending moment, stiffness and energy to fail were decreased (p < 0.05) in broilers fed diets deficient in Ca and P. Addition of 25OHD3 did not influence performance but significantly increased serum 25OHD3 levels. Furthermore, the addition of 25OHD3 caused an increased tibial and femoral bone density and femoral hydroxyproline content (p < 0.05), increased bending moment in tibias (p < 0.05), and enhanced ultimate load and bending moment in femurs (p < 0.05). No significant interactions were observed for bone properties. Overall, feeding 25OHD3 at 69 μg/kg feed to broilers had no effect on growth performance but partly improved bone biochemical and biomechanical properties of broiler starters.

Vitamin D deficiency in school-age Iranian children with attention-deficit/hyperactivity disorder (ADHD) symptoms: A critical comparison with healthy controls

ABSTRACTThe associations between serum vitamin D levels and the severity of attention-deficit/hyperactivity disorder (ADHD) symptoms were assessed among Iranian hospitalized children (50 ADHD cases and 50 healthy (non-ADHD) controls) during 2014–2015. Levels of ADHD severity and serum 25-hydroxyvitamin D (25OHD) were determined by the Conners’ Parent Rating Scale (CPRS) test and an ELISA kit, respectively. The serum 25OHD concentrations of <10, 10–29, and >30 ng/mL were respectively considered as deficient (severe deficiency), insufficient (mild deficiency), and sufficient levels of vitamin D. The association of nutrient bioavailability with ADHD was evaluated by statistical and regression analyses.There was no significant difference in the mean of socio-demographic variables (e.g., gender, age, weight, BMI, daily intake of dairy products, and daily sunlight exposure) between ADHD and non-ADHD subjects. The mean serum 25OHD concentration (16.57 ± 9.09 ng/mL) was found to be significantly lower in ADHD children with more parathyroid hormone (PTH) levels as compared to controls (22.01 ± 12.67ng/mL). The sufficient 25OHD concentration was more predominant in the controls than the cases (p = 0.002). A severe deficiency of vitamin D was more found in children with ADHD (3.36 times). There was a negative and significant association between the participants’ age and their serum 25OHD levels. Although 25OHD levels in boys were significantly more than those in girls, the reduction of serum 25OHD concentration among boys with ADHD was more severe compared to the patient girls(p = 0.014). The results support the importance of vitamins D role in ADHD patients through the regular monitoring of serum 25OHD levels.

Association between vitamin D status in early pregnancy and atopy in offspring in a vitamin D deplete cohort.

Vitamin D status may play a role in the development of atopic diseases due to its action on lung development and immune system development and function. Our objective was to assess whether 25-hydroxyvitamin D (25OHD) levels in maternal blood in pregnancy were associated with atopy in children. We analysed 279 mother-child pairs from the ROLO study conducted in Dublin, Ireland. Serum 25OHD was measured at 13 and 28weeks of pregnancy. Development of childhood atopy was self-reported by mothers at follow-up appointments at 6months, 2years or 5years. Logistic regression analysis was used to evaluate associations between maternal 25OHD status and development of atopy. The mean (SD) 25OHD levels in early and late pregnancy were 41.9 (19.2) nmol/L and 40.2 (21.6) nmol/L, respectively. Maternal 25OHD status in early pregnancy, but not in late pregnancy, was associated with a reduced risk of atopy at 2years (OR 0.972, CI 0.946-0.999). In early pregnancy, those with serum 25OHD levels < 30nmol/L compared with those with 25OHD > 50nmol/L had significantly greater risk of developing atopy at 2years (OR 4.76, CI 1.38-16.47). The development of childhood atopy may be associated with maternal vitamin D deficiency in early pregnancy among a cohort of women at risk of vitamin D deficiency. Further research is required to explore the relationship between vitamin D and atopy, particularly among women with poor vitamin D status, and whether supplementation should be prioritised in early pregnancy to reduce childhood atopy.

A study to evaluate the relationship between serum vitamin d level and chronic rhinosinusitis

&lt;p class="abstract"&gt;&lt;strong&gt;Background:&lt;/strong&gt; Chronic rhinosinusitis (CRS) places a relatively large socioeconomic burden on developed nations, yet remains a difficult disease to treat. Vitamin D3 (VD3) deficiency is reported to be associated with increased incidence of allergic airway diseases. The ability of VD3 to augment innate and adaptive immune responses has sparked interest in its immunologic role in allergy. The objective of the present study is to evaluate the relationship between serum vitamin D level and chronic rhinosinusitis.&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Methods:&lt;/strong&gt; Total 90 patients were included in the study and divided into three groups i.e., 30 patients of chronicrhinosinusitis with nasal polyposis (CRSwNP), 30 patients of chronic rhinosinusitis without nasal polyposis (CRSsNP) and 30 healthy subjects were used as control. The severity of CRSwNP was assessed with the Lund-Mackay (LM) score and polyp grading system. VD3 status was assessed by measuring circulating 25-hydroxyvitamin D (25OHD) by using ELISA. &lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Results:&lt;/strong&gt; Serum 25OHD levels (ng/ml±SD) were significantly lower in patients with CRSwNP (16.16±8.86) than in those with CRSsNP (23.28±5.35; p=0.001) and control 44.37±19.87. The incidence of vitamin D deficiency (&amp;lt;20 ng/ml) in CRSwNP and CRSsNP patients were 60% and 20%; however, the incidence of vitamin D insufficiency (20-30 ng/ml) in these patients were 37% and 70%, respectively. A significantly inverse relationship was found between serum 25OHD level and polyp grade (p=0.048), indicating lower serum 25OHD was associated with higher polyp grade. Serum 25OHD was inversely related to both LM endoscopic and LM CT scan score, which is found to be significant (p=0.001).&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Conclusions:&lt;/strong&gt; The available evidence indicates that there is a significant relationship between low VD3 levels and CRSwNP phenotype. Lower 25VD3 levels were associated with more severe mucosal inflammation on nasal endocscoy and CT scan.&lt;/p&gt;

Weight-Bearing Physical Activity Influences the Effect of Vitamin D on Bone Turnover Markers in Patients with Intellectual Disability.

Individuals with intellectual disabilities (IDs) are at increased risk for low bone mass and fragility fractures, and those who are nonambulatory may be at even higher risk. Patients with IDs often are vitamin D deficient, but there is little information concerning how vitamin D treatment of patients with IDs affects markers of bone formation and resorption. We performed a retrospective analysis of 23 institutionalized individuals with IDs who were the subject of a performance improvement continuing medical education project designed to reduce risk for fracture by optimizing serum vitamin D levels. Patients were divided into those with normal weight-bearing (NWB) physical activity (15 patients: 14 men, 1 woman) and those with low weight-bearing (LWB) physical activity (8 patients: 7 men, 1 woman). All of the subjects received 50,000 IU of vitamin D3 weekly for 4 to 8 weeks, followed by a maintenance dose of 50,000 IU monthly for 3 to 6 months. Bone turnover markers (type 1 cross-linked C-telopeptide [CTX], type 1 N-terminal propeptide [P1NP], and parathyroid hormone [PTH]) and 25(OH)-vitamin D levels were measured before and after vitamin D supplementation. At baseline, there were no significant differences in the serum levels of 25OH-D, PTH, P1NP, or CTX between the two groups (NWB and LWB). Vitamin D levels were increased to a higher value in LWB subjects than in NWB subjects (61 ± 4.1 vs 48.4 ± 2.2 ng/mL, P < 0.001). Vitamin D treatment suppressed PTH (20.5% ± 14.3% vs 31.4% ± 7.7%, P = not significant) and P1NP (33.0% ± 6.2% vs 29.4% ± 6.9%, P = not significant) similarly in both groups. Although CTX levels declined by 26.4% ± 5.3% (P = 0.0002) in NWB individuals (as anticipated), vitamin D supplementation resulted in an unexpected 25.8% ± 8% increase (P = 0.01) in CTX in LWB individuals, suggesting osteoclast activation. Although high-dose vitamin D appeared to suppress osteoclast activity in NWB adults with IDs, the increase in serum CTX levels in those with LWB activity implies activation of osteoclasts that could exacerbate their unique low bone mass and increase fracture risk. The results support the use of a lower-dose vitamin D regimen in this patient group with LWB.

Association of vitamin D status with lung function measurements in children and adolescents with cystic fibrosis

Vitamin D status is considered a potential determinant of lung function in cystic fibrosis (CF). The aim of this retrospective longitudinal study was to investigate the decline of spirometric values in association with vitamin D status. The data regarding 25-hydroxy vitamin D (25OHD) serum levels, spirometric measurements (FEV1, FVC, FEF25-75%), and factors known to be associated with the decline of lung function in CF were retrospectively collected over a 5-year period. The spirometric indices were recorded as the best and the average value of each year, as well as the value, recorded concurrently or closely with 25OHD level measurement. A significantly positive relationship was observed between 25OHD serum levels and the best annual value of FEV1 (P = .034), and the values of FEV1 (P = .010) and FVC (P = .018) measured concurrently or closely with serum 25OHD levels. The evolution of the best annual value of FEV1 was worse in patients with a mean 5-year value of 25OHD levels less than 20 ng/mL compared with patients with a mean 5-year value of ≥30 ng/mL (P < .001), or ≥20 to <30 (P < .001). There was no significant difference between patients with mean 5-year 25OHD levels ≥30 ng/mL and ≥20 to <30 ng/mL (P = .76). Vitamin D status is associated with lung function in patients with CF. Levels of 25OHD above 20 ng/mL were associated with higher best annual FEV1.

Patient characteristics and analgesic efficacy of antiviral therapy in postherpetic neuralgia

Postherpetic neuralgia (PHN) is the most common complication of shingles caused by reactivation of varicella zoster virus (VZV). Management of PHN is often suboptimal while using current conventional treatments. Antiviral therapy was used to reduce PHN-associated pain in two small trials which showed conflicting results. We hypothesize the analgesic efficacy of antiviral therapy on PHN is affected by patient characteristics including pathophysiology of the participants and serum vitamin D levels. Pathophysiology of PHN includes neuronal excitability and chronic VZV ganglionitis (persistent active VZV infection in ganglions). VZV-DNA positivity or a positive IgG coupled with a positive IgM indicates recent or current VZV infection. Positive VZV-DNA or IgG/IgM tests are used to confirm whether the patients experience chronic VZV ganglionitis. Antiviral therapy decreases pain in PHN patients with chronic VZV ganglionitis; whereas, antiviral therapy shows no effects in PHN patients with negative VZV-DNA or IgM. Vitamin D is a natural antiviral mediator. Studies show a high prevalence of vitamin D deficiency in hepatitis B/C virus-infected patients. Serum vitamin D levels and vitamin D supplementation are factors which affect the antiviral efficacy on hepatitis B/C virus infection. Serum 25-OHD levels of hospitalized patients with shingles were significantly lower compared to healthy controls. Accordingly, PHN patient may have a high prevalence of vitamin D deficiency which negatively affects the antiviral efficacy. Vitamin D supplementation may improve the antiviral efficacy on PHN. Future trials regarding antiviral therapy on PHN should consider patient characteristics and should be conducted among different subgroups of PHN patients.

25-OH-vitamin D deficiency identifies poor tumor response in hepatocellular carcinoma treated with transarterial chemoembolization.

Vitamin D is implicated linked to liver cancer and chronic liver diseases, but its association with tumor response in hepatocellular carcinoma (HCC) patients undergoing transarterial chemoembolization (TACE) remains unclear. This study aimed to determine whether vitamin D levels influence tumor response in HCC patients treated with TACE. A total of 58 HCC patients undergoing TACE were enrolled in the study. Serum 25-hydroxyvitamin D (25-OHD) levels were determined at baseline and 1 day after TACE using electrochemiluminescence immunoassay. Response to TACE was evaluated after a 4-6 week interval. Univariate and multivariate analyses with Cox regression model were performed to determine the risk factors associated with tumor response. Receiver operating characteristic (ROC) curve analysis was performed to assess the predictive performance of baseline 25-OHD levels on tumor response in HCC patients undergoing TACE. 43.1% of HCC patients showed 25-OHD deficiency. Baseline 25-OHD level was associated with liver cirrhosis (P = 0.025), vascular invasion (P = 0.031), Barcelona Clinic Liver Cancer stage (P = 0.002) and an alanine aminotransferase increase after TACE (P = 0.021). Serum 25-OHD level was significantly decreased 1 day after TACE (P = 0.045). Multiple tumor numbers (P = 0.034) and low baseline 25-OHD levels (P = 0.040) were independently correlated with poor tumor response after TACE. ROC curve analysis showed that baseline 25-OHD levels present better predictive performance for OR in those patients, compared with other current clinical test pointers. Our study suggested that 25-OHD deficiency at baseline is a prognostic indicator for a poor tumor response in hepatocellular carcinoma treated with TACE.

Vitamin D status and cardiovascular outcome.

Vitamin D is classically involved in maintaining bone and mineral health, but it has been shown to exert many extraskeletal functions, including pleiotropic effects on cardiovascular system. This review aims to summarize evidences in literature about vitamin D and cardiovascular outcome. Calcitriol or 1,25(OH)2D, the active hormone, binds to the specific nuclear receptor VDR, which is expressed in rat and human heart and vasculature and has effects on myocardiocytes, smooth cells, and endothelial cells. 25-Hydroxy-vitamin D (25OHD) represents the biomarker of vitamin D levels and reflects vitamin D status. There is consistent evidence that low serum 25OHD levels are associated with increased risk of cardiovascular diseases, including hypertension, coronary artery disease, ischemic heart disease, heart failure, stroke, and type 2 diabetes. Randomized-controlled trials and Mendelian randomization studies so far have not succeeded in proving a benefit of vitamin D supplementation. However, the latter investigations are affected by some methodological limitations, and therefore, it is still unclear if vitamin D deficiency has a causative role in cardiovascular diseases or is rather a marker of poor health in chronic disease.

Serum 25OHD concentration as a predictor of haemoglobin A1c among adults living in the USA: NHANES 2003 to 2010

BackgroundVitamin D status influences glucose metabolism. Serum 25-hydroxyvitamin D (25OHD) concentrations have been inversely associated with type 2 diabetes risk. The optimal serum 25OHD level needed for adequate glycaemic control...

Relationship between recurrent benign paroxysmal positional vertigo and serum 25-hydroxyvitamin D in middle-aged and elderly patients

Objective To investigate the correlation between serum 25-hydroxyvitamin D (25-OHD) and benign paroxysmal positional vertigo(BPPV) in middle-aged and elderly patients. Methods From October 2015 to October 2016, 250 middle-aged and elderly patients with idiopathic BPPV in Quhua Hospital of Zhejiang Province were selected in the research.According to whether the patients relapsed, the patients were divided into recurrence group(120 cases) and non-recurrent group(130 cases). And 100 healthy subjects who were examined in our hospital during the same period were selected as the healthy control group(control group). The serum 25-OHD levels and bone mineral density(BMD) were compared.The DHI scores of the three groups were scored and compared.Then, the correlation between 25-OHD, osteoporosis and DHI score and BPPV was analyzed. Results The levels of serum 25-OHD in the control group, non-relapse group and recurrence group were (35.12±3.95)μg/L, (21.62±4.32)μg/L and (16.25±3.86)μg/L, respectively, there were statistically significant differences among the three groups (F=4.567, P<0.05). The BMD in thecontrol group, non-relapsed group and recurrence group were (0.97±0.61), (-1.24±0.19), (-2.62±0.37), respectively, and the difference was statistically significant (F=6.478, P<0.05). The DHI scores in the control group, non-relapsed group and relapsed group were (4.62±3.15)points, (35.26±12.54)points, (53.28±11.68)points, respectively, there were statistically significant differences among the three groups (F=6.231, P<0.05). Regression analysis showed that the severity of BPPV in middle-aged and elderly patients was negatively correlated with 25-OHD level(r=-0.367, P<0.05). Conclusion The level of 25-OHD is negatively correlated with the severity of BPPV in middle-aged and elderly patients. Key words: Vertigo; 25-Hydroxyvitamin D; Bone density; Middle aged; Aged

Evolutionary Perspective in Rickets and Vitamin D.

Modern lifestyle limits our exposure to sunlight, which photosynthesizes vitamin D in the skin, and the incidence of nutritional rickets has been resurging. Vitamin D is one of the first hormones; it is photosynthesized in all organism from the phytoplankton to mammals. A selective sweep of the promoter of the vitamin D receptor (VDR) happened as soon as Homo sapiens migrated out of Africa; it co-adapted with skin color genes to provide adaptation to latitudes and the levels of exposure to ultraviolet (UV)B radiation along the route out of Africa. Exposure to UVB radiation balances the need for vitamin D photosynthesis and degradation of folic acid by UVB radiation. Skin color follows a latitude distribution: the darkest populations dwell in the tropical belt; and the fair-skinned populations inhabit the northern countries. Due to their greater need for calcium during their reproductive life, the skin color of women is lighter- than that of men. Vitamin D is essential for mineral homeostasis and has a wide variety of non-skeletal functions, of which the most important for natural selection is a regulatory function in the innate immune system. In the human fossil record, vitamin D deficiency coincided with bone tuberculosis. About 6,000 years ago, a diet which included cow's milk provided Neolithic humans with twice as much calcium and was more alkaline than that of its Paleolithic predecessors. Adiposity is negatively associated with the vitamin D status and obese individuals require 2–3 times more vitamin D than non-obese individuals to normalize circulating 25OHD levels. In an era of an obesity epidemic, we need more research to determine whether adiposity should be considered when determining the dietary requirements for vitamin D and calcium and the optimal serum 25OHD levels.