Serum Vitamin D3 Levels Research Articles

Assessment of serum levels of vitamin D and tissue levels of vitamin D receptors in acanthosis nigricans

Background Acanthosis nigricans (AN) is a skin disorder characterized by symmetrical, thickened, dark plaques comprising hyperkeratosis and acanthosis. Vitamin D (VD) plays an important role in the regulation of skin proliferation and differentiation, and mediates its action by binding to specific vitamin D receptors (VDR) in the nuclei of target cells. Objective To measure the serum levels of VD and tissue levels of VDR in a group of Egyptian patients with AN in comparison to healthy controls, in order to shed more light on the possible relation between VD, VDR, and AN. Patients and methods This study included 25 AN patients and 25 age-matched and sex-matched healthy controls. Blood samples and skin biopsies were taken from all participants for the evaluation of serum VD, glucose, insulin, and tissue VDR levels. Results Serum VD and tissue VDR were significantly lower (P<0.001 for both), while serum insulin and homeostatic model for insulin resistance were significantly higher (P<0.001 and P=0.002, respectively) in patients than controls. Patients had a more deficient pattern of VD status than controls (P<0.001). There was a statistically significant positive correlation between serum VD and tissue VDR in patients (r=0.632, P=0.001). Conclusion The present study suggests a possible role for low serum VD and tissue VDR levels in causing AN, in genetically predisposed individuals.

Correlation between Serum Vitamin D3 Levels and Severity of COVID-19, Experience from a COVID-19-Dedicated Tertiary Care Hospital from Western India.

It is postulated that 25(OH)D deficiency is associated with a worse prognosis of COVID-19. We aimed to find out whether baseline serum 25-hydroxy vitamin D levels were correlated with COVID-19 disease severity or not in Indian population. It is a prospective observational study. We prospectively recruited 200 COVID-19-positive adult patients and measured their baseline vitamin D levels on admission and prospectively followed their clinical course for their outcome and correlated the association. The continuous data were represented as mean (±SD) or median (IQR), while the categorical data were represented as proportions. Parametric data were analysed using unpaired T-test and ANOVA for two and more than two groups, and for categorical, nonparametric data, Chi-square test were applied. A two-sided P value of <0.05 was considered as statistically significant with 95% confidence interval. Eighty-six per cent (172/200) of patients had hypovitaminosis D (<30 ng/mL). The prevalence of 25(OH) severe deficiency, deficiency and vitamin D insufficiency was 23%, 41% and 22%, respectively. Clinical severity was graded as asymptomatic (11%), mild (14%), moderate (14.5%), severe (37.5%) and critical (22%). Sixty per cent of patients had clinically severe or critical disease requiring oxygen support with eleven per cent (n = 22) mortality overall. Age (P: 0.001), HTN (P: 0.049) and DM (P: 0.018) were negatively associated with clinical severity. No linear association was found between vitamin D levels and clinical severity. Low vitamin D levels had a significant inverse association with inflammatory markers like neutrophil-lymphocyte ratio (NLR, P: 0.012) and IL-6 (P: 0.002). Vitamin D deficiency was not associated with worse outcomes of COVID-19 infection in Indian population.

Prediction of Rise in Alkaline Phosphatase at Different Vitamin D Levels

Background: Vitamin D deficiency with a resurgence of rickets and tetany is increasingly being reported in young infants from temperate regions, African Americans, and also from India. The data on Vitamin D status of healthy term breastfed Indian infants and mothers are scant. In fact, the correlation between Vitamin D deficiency and alkaline phosphatase (ALP) is inaccurate in many studies. Aim and Objective: The aim and objective of this study are to determine whether serum Vitamin D levels are correlated with serum levels of ALP or not and to study the point, at which ALP surge occurs in Vitamin D deficiency. Materials and Methods: Ninety-six participants at birth were enrolled and followed up till 9 months of age. Serum 25 (OH) D along with ALP was estimated in cord blood at birth and 14 ± 1 weeks of life. Seventy-seven participants were followed up at 9 months for estimation of serum 25 (OH) D, parathyroid hormone, ALP, calcium, and phosphorus. Vitamin D deficiency was defined as serum 25 (OH) D &lt;15 ng/mL as per the United States Institute of Medicine guidelines. Results: At 9 months out of 96 samples, 16 had mild insufficient (≥15–20 ng/mL) (20.8%), 42 had moderate deficient (&lt;15 ng/mL) (54.5%), and 0 had severe deficient (&lt;5 ng/mL) Vitamin D deficiencies. Serum alkaline phosphate were found to be normal in all the three groups of patients and the receiver operating characteristic curve demonstrated that low Vitamin D level is predicted by a high ALP cutoff of ALP is 190.90 IU/L with reasonable sensitivity and specificity. The correlation coefficient of ALP and serum Vitamin D3 levels was r = 0.501 (P = 0.001). Conclusion: Serum Vitamin D3 levels correlated well with increased serum ALP levels but the level, at which the ALP surge occurs was on the lower side.

Immunological Study of IFN-γ, ICAM-4, and Vitamin D3 Markers among Gastrointestinal Tumor Patients in Babylon Province, Iraq.

The current study was conducted to investigate the roles of ICAM-4, IFN-γ, and vitamin D3 markers among benign and malignant gastrointestinal stromal tumors (GISTs). Eighty-eight participants, admitted to the Babylon GIT Center, Merjan Medical City, Iraq from April to December 2020, were recruited for the study. Blood samples were collected from the participants, who were divided into four groups: malignant GIT tumor (N = 42), benign GIT tumor (N = 29), irritable bowel disease as a positive control (N = 10), and healthy individuals as a negative control (N = 7). Serum ICAM-4, IFN-γ, and vitamin D3 levels were determined using the blood samples. The younger males were more affected by malignant GIT tumors at a mean age of 53.39 years than benign GIT tumors, IBD, and healthy individuals. There is also an increase in ICAM-4, IFN-γ, and a decrease in vitamin D3 levels compared to healthy individuals. The vitamin D3 level decreased progressively with age and rose in ICAM-4 with a decrease in vitamin D3 level in patients, increasing the probability of infection with GIT tumor. ICAM-4 levels may grow and increase as interferon levels rise. The younger males are more prone to malignant GIT and the serum levels of ICAM-4, vitamin D3, and IFN-γ are high in malignant patients compared with benign GIT tumors and lower than the control.

The Effect of Vitamin D Supplement on the Relapsing Incidence of Rhinosinusitis with Nasal Polyposis after Fuctional Endoscpoic Sinus Surgery.

Nasal polyp (NP) is the most common benign tumor that can cause nasal obstruction and more annoying problems in patients. Recently, investigators have been focusing on complementary therapies alone or in conjunction with endoscopic nasal and sinus surgery. However, given the association of Vitamin D (VD) deficiency and chronic rhinosinusitis with nasal polyposis (CRSwNP) in previous studies, it may be possible to prevent the recurrence of NP and the development of rhinosinusitis by controlling serum levels of VD and maintaining it at a normal level. The current study aimed to investigate the efficacy of VD supplementation in preventing CRSwNP recurrence after endoscopic surgery. This clinical trial composed of vitamin D deficient patients with CRSwNP who were candidates for endoscopic sinus surgery in two groups of cases and controls. After endoscopic sinus surgery for all patients, we administered VD supplementation (50,000 IU) once a week for 8 weeks for cases and no further intervention for controls. The severity of symptoms was assessed using Sino-nasal outcome test (SNOT-22) and NP recurrence and recorded pre- and postintervention. The findings indicated a higher mean change of SNOT-22 in the case group compared to that of the control group (36.03 ± 10.71 vs. 29.90 ± 11.99; P = 0.041). Moreover, the percentage of NP recurrence in cases was lower than controls; so that receiving VD supplementation has significantly reduced the chance of NP recurrence (odd ratio [95% confidence interval]: 0.298 [0.099-0.900]; P = 0.032). According to the result of the study, the administration of VD supplementation after endoscopic sinus surgery can reduce the severity of CRSwNP symptoms and NP recurrence significantly.

Фактическое питание и обеспеченность витаминами: анализ взаимосвязи на примере молодых женщин с нормальной массой тела

Objective. To assess the vitamin status and vitamins deficiencies rates in young women (18–45 years old) with normal body weight, the Central Federal District of the Russian Federation habitats. Patients and methods. The study included 66 young women (average age 29.18 ± 7.36 years) with normal body weight (average BMI 21.88 ± 2.58 kg/m2), living in Moscow city, Moscow, Yaroslavl and Tula regions. After 4 weeks of wash-out from medications, fortified and specialized food products that are a source of vitamins and minerals, serum levels of vitamins B1, B2, B6, B9, B12, C, A, D3, E, K2 were assessed. Based on the assessment of vitamin status, participants were divided into groups of normal vitamin status, deficiency of one and deficiency of two vitamins. A comparative analysis of 72-hour food diaries was performed for diet assessment. Results. Mean serum vitamin D3 levels were below reference values (27.88 ± 12.77 ng/ml), mean/median levels of other vitamins were within normal limits. 62% of women had deficiency/insufficiency of vitamin D, 21% of vitamin B6, and 17% vitamins B1 and K2 equally. 21.2% of participants had a normal vitamin status, 36.4% had a deficiency of one and two vitamins eqully, 4 participants (6.1%) had a deficiency of three vitamins. Individuals with normal vitamin status had a significantly lower BMI. An analysis of macro- and micronutrients diet intake showed a significantly higher consumption of vitamin A in the group with normal vitamin status; and the main food groups intake analysis revealed a relisably lower consumption of eggs in the group of one vitamin deficiency and a higher consumption of fish and seafood in the group with normal vitamin status. Average daily consumption of fish and seafood served as a predictor of normal vitamin status according to Kendall's Tau-b correlation analysis (ρ = 0.391, p = 0.005). Conclusion. The study results performed a high incidence of vitamin deficiency (primarily D3, B1, B6 and K2), including deficiencies of two and three vitamins, among young women with normal body weight. Individuals with normal vitamin status have a lower BMI and consume more fish and seafood. The results of the study confirm the need for active prevention of vitamin deficiency among the population, updating and introducing educational programs on the principles of healthy nutrition. Key words: dietary assessment, nutritional status, vitamin, vitamin deficiency, healthy adults, females

Vitamin-D Levels of Patients with ST-elevation Myocardial Infarction and Association with In-hospital Prognosis: An Exploratory Observational Study in Southern India

Introduction: The role of vitamin-D in various diseases, including heart disease, has been a subject of interest in recent years. Many studies revealed low vitamin-D status in patients with Acute Coronary Syndrome (ACS). Studies have shown statistically significant low Vitamin-D levels in patients with Myocardial Infarction (MI) in recent years with some studies showing association of vitamin-D deficiency with worse outcome in patients with severe deficiency. Aim: To determine serum vitamin-D levels in patients with acute ST-Elevation Myocardial Infarction (STEMI), and its association with in-hospital prognosis. Materials and Methods: An exploratory observational study was conducted in 100 patients with STEMI consulting a General Medicine Department, JSS Hospital (Tertiary Healthcare Centre), Mysuru, Karnataka, India, from May 2015 to June 2016. The patients were followed-up for in-hospital prognosis. Serum vitamin-D was estimated by ECLIA (Enhanced Chemiluminiscence Immunoassay) method. Electrocardiogram (ECG), Echocardiogram (ECHO) and Coronary Angiogram (CAG) were done in all patients using standard procedures. In-hospital prognosis of the subjects with vitamin-D deficiency and those with normal vitamin-D levels were compared. Data was analysed using Statistical Package for the Social Sciences (SPSS) software version 21.0. Results: Of total 100 patients, majority (n=59, 15.36%) were in the age group of 50-69 years and there were 81 males and 19 females. The results showed 72% of the subjects were deficient and 19% had insufficient vitamin-D levels, therefore, a total of 91% of the STEMI patients had abnormally low vitamin-D levels. Those with Diabetes Mellitus (DM) (n=52) and past Ischaemic Heart Disease (IHD) (n=9) had significantly low vitamin-D levels, suggesting that the association of vitamin-D deficiency with these risk factors may also contribute to the role of vitamin-D deficiency in STEMI. Among those with cardiac failure (44%), 86.3% had deficient and 11.6% had insufficient vitamin-D levels. Conclusion: Vitamin-D deficiency was seen in majority of the STEMI patients. Significantly deficient level of vitamin-D was observed in STEMI patients who progressed to cardiac failure (44%) as a complication.

Association of serum level of vitamin D3 and pulmonary function in bronchial asthma Patients in tertiary care hospital of South Gujarat

Introduction: Asthma is a chronic lung disease characterised by reversible airway obstruction, cellular infiltration, and airway inflammation. The reaction is characterised by the interaction of genetic and environmental variables, as well as the activation of cells in the innate and adaptive immune systems. Method: The study was conducted in the Department of General medicine, in Tertiary Care Center, to study association of serum level of Vitamin D3 and pulmonary function in bronchial asthma patients. As per inclusion and exclusion criteria ,137 patients of bronchial asthma were included in the study. Result: In cases having serum vitamin D3 level &lt;20 ng/ml mean value of FVC, FEV1, FEV1/FVC ratio, was 108.10±14.89, 68.56±13.40, and 62.35±5.17. In cases having serum vitamin D3 20-29 ng/ml, mean value of FVC, FEV1, and FEV1/FVC ratio was 109.72±12.22, 72.34±13.48, and 64.39±6.97. In cases having serum vitamin D3 &gt;30 ng/ml mean value of FVC, FEV1, and FEV1/FVC ratio, was 115.0±4.27, 81.0±7.09, and 70.52±5.00. Conclusion: Vitamin D3 deficiency was highly prevalent in asthmatic patients, there was a strong correlation between asthma severity and vitamin D3 concentrations and there was a direct and a positive significant correlation between vitamin D3 levels and pulmonary function test in asthmatic patients.

Parallelism between hypovitaminosis D3 and recently detected myopia in children with amplified screen use in the COVID-19 era-A preliminary study.

This introductory study aims to analyze the association of serum vitamin D3 levels with recently detected myopia in Indian children following home confinement post-COVID-19 pandemic. Children aged 5-15 years who had not attended physical school in the past 1 year and visited the ophthalmology department with various ocular symptoms were divided into two groups: the myopic group with recently detected myopia and the non-myopic group with ocular ailments other than myopia. All children underwent basic ophthalmic evaluation and a general physical examination. Blood samples were collected for serum vitamin D3 levels. A pretested questionnaire inquiring about the duration of exposure to a digital screen, outdoor activities, and socioeconomic status was filled out for all children. The mean serum vitamin D3 level in the myopic group was 28.17 ± 15.02 ng/dl in comparison to 45.36 ± 17.56 ng/dl in the non-myopic group (P value < 0.05). Linear regression of the data establishes that myopia is associated with hypovitaminosis D3 (OR- 13.12, 95% CI 2.90-50.32, a P value of 0.001). The correlation between spherical equivalent and vitamin D3 levels was significant (Pearson correlation value: 0.661). In the myopic group, 63.3% of children had screen use >6 hours against 43.3% of children in the non-myopic group. In the myopic group, 33.3% of the children had an outdoor activity duration of <2 hours against 6.6% of children in the non-myopic group. This study proposes hypovitaminosis D3 as a strong factor associated with the development of myopia in children. Although it is a preliminary study, it suggests that the trial for vitamin D3 supplementation in young children to delay or cease the development of myopia is warranted.

Evaluation of the Status of Vitamin D3 and Vitamin K2 of Bangladeshi Postmenopausal Women: A Cross-Sectional Study

Background: Postmenopause is the name given to the time when a woman stops periodical bleeding for an entire year. In this stage of postmenopause, women remain at increased risk of several health anomalies, such as osteoporosis, diabetes, vision problem, dental problem, and heart disease. Hence, the purpose of the study was to assess the status of vitamin D3 and vitamin K2 [menaquinone-4 (MK-4)] among Bangladeshi postmenopausal women especially those confined to Dhaka city. Methods: A cross-sectional analytical study was done in the Retired Government Employees Hospital in the year 2019 where 55 postmenopausal women below 60 years were selected. The blood sample was collected from them and the level of serum vitamin D3 [25(OH)D] and vitamin K2 [menaquinone-4 (MK-4)] were determined by the high-performance liquid chromatography (HPLC) method. Binary logistic regression was used for model fitness and its significance. Results: The mean ages of the postmenopausal women were 55.80±3.55 years. Their body mass index and waist-hip ratio were 26.03±2.66 kg/m2 and 0.93±0.05 cm, respectively. Serum levels of vitamin D3 [25(OH) D] and menaquinone-4 (MK-4) from postmenopausal women were 14.80±6.36 ng/mL and0.38±0.21 ng/mL, respectively. The regression model used in this study was 74% fit, and diabetes, cardiovascular disease (CVD), dental problems, vision problems, and hearing problems were significant for postmenopausal women. However, serum vitamin D3 and serum vitamin K2 were non-significant at the 5% significance level. A high incidence of insufficient serum vitamin D3 [25(OH) D] level and sufficient serum vitamin K2 (MK-4) level were found among postmenopausal women with pre-obese and high waist-hip ratio (WHR). Conclusion: The level of serum vitamin D3 and K2 and their correlation with BMI, WHR, and overall health status may provide insight to medical professionals and dietitians to take necessary action to address various health issues faced by postmenopausal women.

The Impact of Serum Levels of Vitamin D3 and Its Metabolites on the Prognosis and Disease Severity of COVID-19.

Vitamin D is among the increasingly consumed dietary supplements during the COVID-19 pandemic. It plays a regulatory role in the immune system and moderates the renin-angiotensin system, which is implicated in infection pathogenesis. However, the investigation of serum levels of vitamin D3 forms and their relative ratios in COVID-19 patients is worth investigation to understand the impacts of disease severity. Hence, we investigated the serum levels of vitamin D3 (cholecalciferol) and its metabolites (calcifediol and calcitriol), in addition to their relative ratios and correlations with angiotensin-converting enzyme 2 (ACE2), interleukin-6 (Il-6), and neutrophil-lymphocyte ratio (NLR) in COVID-19 patients compared with healthy controls. Oropharyngeal specimens were collected from the study subjects for polymerase chain reaction testing for COVID-19. Whole blood samples were obtained for blood count and NLR testing, and sera were used for the analysis of the levels of the vitamin and its metabolites, ACE2, and IL-6. We enrolled 103 patients and 50 controls. ACE2, Il-6, and NLR were significantly higher in the patients group (72.37 ± 18.67 vs. 32.36 ± 11.27 U/L, 95.84 ± 25.23 vs. 2.76 ± 0.62 pg/mL, and 1.61 ± 0.30 vs. 1.07 ± 0.16, respectively). Cholecalciferol, calcifediol, and calcitriol were significantly lower in patients (18.50 ± 5.36 vs. 29.13 ± 4.94 ng/mL, 14.60 ± 3.30 vs. 23.10 ± 3.02 ng/mL, and 42.90 ± 8.44 vs. 65.15 ± 7.11 pg/mL, respectively). However, their relative ratios were normal in both groups. Levels of the vitamin and metabolites were strongly positively, strongly negatively, and moderately negatively correlated with ACE2, Il-6, and NLR, respectively. COVID-19 infection severity is associated with a significant decrease in vitamin D3 and its metabolites in a parallel pattern, and with a significant increase in ACE2, Il-6, and NLR. Higher levels of vitamin D and its metabolites are potentially protective against severe infection.

Somatization is associated with altered serum levels of vitamin D, serotonin, and brain-derived neurotrophic factor in patients with predominant diarrhea irritable bowel syndrome.

Patients with irritable bowel syndrome (IBS) often show psychological disorders, including somatization, usually driven by an altered gut-brain axis. These changes are also accompanied by modifications in the circulating levels of vitamin D (VD) and neurotransmitters such as serotonin (5-HT) and brain-derived neurotrophic factor (BDNF). The present study aimed to evaluate the relationship between gastrointestinal (GI) symptoms and circulating levels of VD, 5-HT, and BDNF in IBS patients with diarrhea (IBS-D) categorized according to somatization. Fifty-three IBS-D patients were recruited and profiled for GI symptoms by validated questionnaires. The fasting serum concentrations of VD, 5-HT, and BDNF were assessed. The health of the intestinal barrier, minimal inflammation, and dysbiosis was also evaluated. Thirty patients showed high somatization scores, IBS-D(S+), and 23 low somatization scores, IBS-D(S-). IBS-D(S+) patients reported higher "Abdominal pain" and the "Abdominal pain duration in days" scores, lower serum VD levels and increased 5-HT and BDNF concentrations than IBS-D(S-). Besides, in IBS-D(S+) patients, the GI symptoms correlated with 5HT, BDNF, and VD concentrations. These parameters were associated with impaired small intestinal permeability and increased inflammation markers. These data support the multifactorial IBS pathogenesis in which organic and psychological factors interact. An active role by VD, 5-HT, and BDNF in affecting the clinical and biochemical profiles in IBS-D(S+) patients may be conceivable. Therefore, the routine VD estimation and the assay of circulating levels of 5-HT and BDNF could be considered a new approach for managing these patients.

VITAMIN D AND OPHTHALMOPATHIAS. A REVIEW.

The importance of vitamin D3 (hydroxycholecalciferol) as one of the liposoluble vitamins is known in the prevention and treatment of metabolic bone diseases (rickets, osteomalacia, osteoporosis). In recent years, however, information has increased on the importance of vitamin D3 in numerous organ systems and in the pathogenesis of various diseases, e. g. ophthalmopathies. The immunological functions of vitamin D3 are the subject of studies dealing with autoimmune optic nerve disorders and their results appear to have a positive effect on demyelinating diseases. It also plays an important role in maintaining the thickness of the retinal nerve fiber layer, but its additional administration has not been successful. Optical neuritis may be the first sign of multiple sclerosis. It appears that sufficient serum vitamin D3 levels may protect patients from deterioration in the form of a further attack of demyelination. The course of diabetic retinopathy is probably also influenced by vitamin D3, inter alia, by correlating the fact that its receptor and the enzymes of its metabolism are expressed on the retina. Low serum levels of vitamin D3 may even trigger age-related macular degeneration. Conversely, higher dietary intake of vitamin D3 may positively affect neovascularization. The optimal level of hydroxycholecalciferol is between 60 and 200 nmol /l, the severe deficit represents a decrease below 25 nmol/l. The body can normally produce up to 10,000 IU of this vitamin after exposure to sunlight. However, the demonstration of its protective character in connection with the mentioned diseases of the retina and optic nerve will require a sufficient number of studies to confirm the facts found so far about this rediscovered vitamin.

Evaluation of vitamin D3 serum level of microemulsion based hydrogel containing Calcipotriol drug

The aim of this study was to formulate and characterize a nanocarrier for topical delivery of hydrophobic Calcipotriol drug for treatment of psoriasis disease. Microemulsion based chitosan hydrogel was selected as nanocarrier. Various microemulsion formulations were prepared and characterized to achieve a nanocarrier with minimum particle size, maximum zeta potential and high stability during the storage time. Characterization results confirmed the successful formation of a sample with the particle size of 26.09±2.2 nm and high stability over six months. The hydrogel formulation of this sample had an appropriate viscosity with pseudo-plastic behavior as a non-Newtonian fluid. Then, in vitro drug release as well as the vitamin D3 serum level of nanocarriers at in vivo media were evaluated. Drug release profile from commercial psoriasis ointment showed a burst release behavior in which 95% of the drug was released after 5 hours, while the same amount of drug was released through microemulsion based hydrogel after 24 hours in a controlled manner. In addition, drug penetration studies showed that a large amount of Calcipotriol from nanocarriers retained in the skin and its penetration through the skin was very low. Results of vitamin D3 analogue in rats showed a statistically reduction of vitamin D3 level in rats treated with hydrogel form in comparison to rats treated with commercial Calcipotriol ointment. Finally, it can be concluded that changing the usual form of Calcipotriol drug ointment into MBH has higher impact on psoriasis treatment. • Microemulsion based chitosan hydrogel containing Calcipotriol drug was prepared. • Optimum formulation has low particle size, high stability and appropriate viscosity. • Drug release from commercial and MBH showed burst and controlled profiles, respectively. • Drug penetration through the skin was very low. • Vitamin D3 level in rats treated with hydrogel was lower than that of commercial ointment.

Association of Serum Vitamin D with Active Human Cytomegalovirus Infections in Chinese Children with Systemic Lupus Erythematosus

Vitamin D (VD) plays an important role in infectious and autoimmune diseases. We investigated the association between the serum VD levels and active human cytomegalovirus (HCMV) infections in pediatric systemic lupus erythematosus (SLE) patients. From January 2015 to June 2021, 120 children were diagnosed with SLE, and 100 healthy children were enrolled. The serum 25-hydroxyvitamin D [25(OH)D] levels were detected using ELISA. The serum anti-HCMV IgM antibodies were measured by a chemiluminescence immunoassay. Comparisons of the 25(OH)D levels between SLE patients and healthy children were performed, as well as subgroups of SLE patients with or without active HCMV infections. The serum 25(OH)D levels of SLE patients were significantly lower than those of healthy children (35.3 ± 12.9 vs. 49.3 ± 15.3, P < 0.001). The VD deficiency ratio was higher in SLE patients (89.2%) than that in healthy children (52.0%). The serum 25(OH)D levels in the positive anti-HCMV IgM group were significantly lower than those of the negative anti-HCMV IgM group (30.6 ± 12.3 vs. 38.2 ± 12.5, P < 0.001). A severe VD deficiency ratio was significantly higher in HCMV-IgM(+)-SLE patients (42.2%) than that in HCMV-IgM(-)-SLE patients (13.3%). This study suggested that the serum VD level is associated with active HCMV infections in pediatric SLE patients.

Impact of dietary vitamin D on immunoregulation and disease pathology in lupus-prone NZB/W F1 mice.

Vitamin D (VD) deficiency is a highly prevalent worldwide phenomenon and is extensively discussed as a risk factor for the development of systemic lupus erythematosus (SLE) and other immune-mediated diseases. In addition, it is now appreciated that VD possesses multiple immunomodulatory effects. This study aims to explore the impact of dietary VD intake on lupus manifestation and pathology in lupus-prone NZB/W F1 mice and identify the underlying immunological mechanisms modulated by VD. Here, we show that low VD intake accelerates lupus progression, reflected in reduced overall survival and an earlier onset of proteinuria, as well higher concentrations of anti-double-stranded DNA autoantibodies. This unfavorable effect gained statistical significance with additional low maternal VD intake during the prenatal period. Among examined immunological effects, we found that low VD intake consistently hampered the adoption of a regulatory phenotype in lymphocytes, significantly reducing both IL-10-expressing and regulatory CD4+ T cells. This goes along with a mildly decreased frequency of IL-10-expressing B cells. We did not observe consistent effects on the phenotype and function of innate immune cells, including cytokine production, costimulatory molecule expression, and phagocytic capacity. Hence, our study reveals that low VD intake promotes lupus pathology, likely via the deviation of adaptive immunity, and suggests that the correction of VD deficiency might not only exert beneficial functions by preventing osteoporosis but also serve as an important module in prophylaxis and as an add-on in the treatment of lupus and possibly other immune-mediated diseases. Further research is required to determine the most appropriate dosage, as too-high VD serum levels may also induce adverse effects, possibly also on lupus pathology.

Comparison of the effects of therapeutic exercise with either an educational booklet or vitamin-D3 supplement in the management of chronic low back pain: study protocol for an assessor blinded multicenter randomized clinical trial

Background: It is important to know the best intervention approach to replenish serum vitamin D levels along with therapeutic interventions for chronic low back pain (CLBP) patients. From the researcher’s knowledge, no study compared “vitamin D supplement” or “booklet education on sun exposure, nutrition and lifestyle” with therapeutic exercise for CLBP cases. Researchers hypothesize that multidimensional comprehensive management of therapeutic exercise and an education booklet (TEB) on sun exposure, nutrition, and lifestyle might be superior to therapeutic exercise and oral vitamin D supplement (TED) for CLBP patients with vitamin D deficiency. Methods: We planned for an assessor-blinded two-arm multicenter Randomized Clinical Trial (RCT) protocol to compare the efficacy of TEB compared to TED for CLBP patients with vitamin D deficiency at 2 months and 6 months after baseline recruitment in designated centers in Dhaka city. The primary outcome measures will include pain by Brief Pain Inventory (BPI), and serum vitamin D3 level and secondary outcome measures will include disability by Ronald Morris Disability Questionnaire (RMDQ). Discussion: This study will provide evidence for an appropriate prescription for the management of CLBP patients having vitamin D deficiency. Registration: Clinical Trials Registry India (CTRI/2022/11/047074).

Ankylosing spondylitis disease activity and serum vitamin D levels: A systematic review and meta-analysis.

To prove that serum vitamin D (VD) levels are strongly associated with ankylosing spondylitis (AS) disease activity, the association between serum VD levels and key monitoring indicators of AS disease activity has been analyzed, such as the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), erythrocyte sedimentation rate (ESR), and C-reactive protein (CRP). Studies published in PubMed, Cochrane Library, EMBASE, and China National Knowledge Infrastructure by August 30, 2022 were searched, and 6 studies finally met the selection criteria. Serum 25-hydroxyvitamin D (25(OH)D), ESR, CRP levels, and correlation coefficients between serum VD and BASDAI, ESR, CRP in AS, and control in these studies were extracted for the meta-analysis. When compared to controls, patients with AS had considerably lower blood 25(OH)D levels (MD = -7.53 ng/mL, 95% CI, -9.78 to -5.28, P < .001) and significantly higher ESR and CRP levels (ESR: MD = 11.75 mm/h, 95% CI, 4.20 to 19.31, P = .002; CRP: MD = 15.36 mg/L, 95% CI, 4.95 to 25.77, P = .004). Additionally, a negative correlation was discovered between serum VD levels and BASDAI, ESR, and CRP (Fisher' Z = -0.34, -0.38, -0.35, respectively). The findings of our meta-analysis demonstrated a negative correlation between serum VD levels and the main monitoring indices of disease activity in patients with AS and verified that the differences in the continent and ethnicity may be one of the major contributors to this finding.

Vitamin D: A Factor affecting the Success of Type 1 Tympanoplasty.

Vitamin D (VD) plays role in wound healing and protection against infections. The relationship between plasma VD level and the outcomes of Type 1 tympanoplasty (T1T) has not been studied before. A total of 101 patients with chronic otitis media scheduled for T1T were divided into four groups in relation with their VD levels as severe insufficiency, insufficiency, mild-to-modest deficiency and optimal VD level groups. Graft success, hearing improvement and postoperative infection rates were compared among the groups in 12-month follow-up period. The graft success rate (P = 0.014) and air-bone gap gain (P = 0.004) were significantly higher, and postoperative infection rate was significantly lower (P < 0.001) in optimal VD level group. 25-OH VD deficiency should be considered as a factor for failure in T1T. VD replacement may increase success of tympanoplasty in patients with low preoperative serum VD levels.

The Relationship Between Vitamin D Serum Levels and Metabolic Syndrome in Patients Referred to Central Laboratory of ACECR in Mashhad, Iran

Background: Vitamin D3 deficiency, which is associated with several other diseases such as high blood sugar levels, insulin resistance, and the risk of developing metabolic syndrome (MetS) is prevalent all over the world. Objectives: This study aimed to determine the prevalence of vitamin D3 deficiency and MetS and evaluate their association in patients referred to the central laboratory of Academic Center for Education, Culture, and Research (ACECR) in Mashahd, Iran. Methods: This cross-sectional study was conducted on 1,214 patients aged 15 - 75 years referred to the central laboratory of ACECR in Mashhad, Iran, in 2018. Participants with MetS were identified using the Adult Treatment Panel III (ATPIII) criteria. Biochemical parameters and vitamin D3 levels were assessed using the Mindray instrument and the high-performance liquid chromatography (HPLC) method, respectively. The subjects were divided into four groups in terms of serum vitamin D3 concentration as follows: Deficient (&lt; 10 ng/mL), insufficient (10 - 30 ng/mL), sufficient (30 - 80 ng/mL), and toxic (80 &lt; ng/mL). Results: From a total of 1,214 subjects, 15.0% had vitamin D3 deficiency, 53.2% showed insufficiency, 31.1% were normal with sufficient vitamin D3, and 0.7% suffered from vitamin D3 toxicity. Therefore, 437 (49.7%) females and 209 (62.6%) males suffered from vitamin D3 insufficiency. Overall, 27.6% of females and 33.2% of males had MetS (P &lt; 0.05). Subjects with and without MetS showed no significant difference in serum levels of vitamin D3 (P = 0.608). In addition, there was a significant direct correlation between vitamin D3 levels and systolic blood pressure (SBP) in the group with MetS. Conclusions: A high proportion of subjects had MetS and insufficient vitamin D3 levels. There were no significant differences between the serum vitamin D3 levels in participants with and without MetS.