Severity Of Vitamin Research Articles

Relationship between thyroid-stimulating hormone levels and the severity of vitamin D deficiency by age group

Relationship between thyroid-stimulating hormone levels and the severity of vitamin D deficiency by age group

Витамин D и овариальный резерв у пациенток с эндометриозом, перенесших новую коронавирусную инфекцию

Aim: to study the effect of vitamin D on ovarian reserve in women with novel coronavirus infection (COVID-19). Patients and Methods: 137 women aged 25–35 years with infertility associated with lack of ovulation (ICD: N97.0) presenting as hypergonadotropic, hypoestrogenic anovulation were evaluated and treated. Of this sample, 67 women had laboratory-confirmed SARS- CoV-2 infection and 70 women had no history of infection. All women in the sample had serum vitamin D insufficiency or deficiency. The women were divided into 2 groups; each group was divided into 2 subgroups. Group 1 (n=67) included women with a history of COVID-19. Group 2 (n=70) included women without a history of COVID-19. In addition to standard infertility treatment, 35 and 34 women in groups 1 and 2, respectively, received vitamin D supplementation (Fortedetrim), the dosage of which was determined according to the manufacturer's instructions based on the severity of vitamin D insufficiency (these women were included in treatment sub-groups 1A and 2A). Results: women who experienced COVID-19 had higher follicle-stimulating hormone (FSH) levels and lower plasma estradiol concentrations than uninfected women. In these women, ultrasound also showed a decrease in the number of follicles per slice and in ovarian volume. Vitamin D improved reproductive function in women with a history of COVID-19 by decreasing FSH levels, increasing estradiol levels, and increasing antral follicle count and ovarian volume. No treatment-emergent adverse events, including clinically significant abnormalities in blood and urine tests, were reported. Conclusion: vitamin D supplementation in women of reproductive age with a history of COVID-19 and reduced ovarian reserve is a clinically effective and safe tool for the management of reproductive disorders. KEYWORDS: infertility, ovarian reserve, COVID-19, vitamin D, antral follicles, follicle-stimulating hormone, estradiol. FOR CITATION: Kalimatova D.M., Dobrokhotova Yu.E., Il'ina I.Yu. Vitamin D and ovarian reserve in women with endometriosis who experienced novel coronavirus infection. Russian Journal of Woman and Child Health. 2024;7(3):199–204 (in Russ.). DOI: 10.32364/2618-8430-2024-7-3-2.

The relationship between cardiovascular pathology and impaired glucose metabolism with vitamin D deficiency (literature review and own data)

Background. Vitamin D plays a significant role in many processes in the human body, which diversifies the symptoms of its insufficiency, so it is not always possible to diagnose its deficiency in a timely manner. At the same time, according to a number of clinical studies, an inverse relationship has been proven between a reduced level of vitamin D and mortality from all causes and cardiovascular diseases, the course of diabetes mellitus (DM), hypertension, chronic kidney disease, atherosclerosis, coronary heart disease; and the mechanisms of the influence of vitamin D deficiency on various metabolic processes have been revealed. The development and progression of cardiovascular diseases and vascular complications of DM are currently the main causes of disability and mortality of patients. All this substantiates the need to control and monitor the vitamin D supply in patients with this comorbid pathology. Aim of the study is to investigate the presence and severity of vitamin D deficiency in patients with type 2 DM and the presence of concomitant cardiac pathology. Materials and methods. Main group included 31 patients (17 men and 14 women aged 51.51 ± 1.73 years, with duration of DM of 8.59 ± 1.70 years) who were treated in the endocrinology clinic from October 2022 to May 2023. The comparison group consisted of 27 patients with type 2 DM who stayed in this clinic in 2020–2021. Serum level of 25-hydroxycholecalciferol (25(OH)D) was studied using the enzyme-linked immunosorbent assay. The level of vitamin D less than 20–30 ng/ml was considered as its insufficiency, and the level below 20 ng/ml as deficiency. Statistical processing was carried out using Microsoft Excel and Statistica 6.0. Results. In the main group, cardiac pathology manifested itself by the presence of hypertension detected in all patients (stage I — 6 cases; stage II — 21 and stage IІI — 4); coronary heart disease and cardiosclerosis — in 7 patients; heart failure of the first or second degree — in all individuals. All patients in the main group were vitamin D deficient or insufficient: 15 had a deficiency (12.96 ± 1.06 ng/ml), and 16 had an insufficiency (23.68 ± 0.72 ng/ml). In contrast to the comparison group, patients from the main group had a significantly lower average level of vitamin D (18.49 ± 1.16 ng/ml vs 28.98 ± 1.02 ng/ml, p < 0.001). Taking into account a decrease in the level of vitamin D supply of patients, including those with comorbid pathology examined in 2022–2023, which is obviously associated with a long stay in shelters and a stressful situation caused by the state of war, and its impact on the course of cardiovascular diseases and diabetes, it is necessary to pay more attention to the detection and timely appropriate correction of vitamin D deficiency. Conclusions. In patients with type 2 diabetes and comorbid cardiovascular pathology, there is a decrease in the level of vitamin D supply. During the war in Ukraine, there is a probable deepening of vitamin D deficiency. The negative impact of vitamin D deficiency on the course of diabetes and cardiovascular pathology justifies the need to monitor vitamin D supply in such patients.

The Functional States of the Participants of a Marine Arctic Expedition with Different Levels of Vitamin D in Blood.

(1) Background: The vitamin D level in blood is one of the markers of the functional reserves of the human body and can contribute to more successful adaptation in the Arctic. (2) Methods: The study involved 38 participants in the project "Arctic Floating University-2021". The determination of vitamin D content was carried out at the beginning of the expedition. A dynamic study was carried out for 20 days in the morning and in the evening. The functional state parameters of the participants were assessed using psychophysiological and questionnaire methods. Statistical methods: Mann-Whitney U-test and correlation analysis. (3) Results: It was found that at the beginning of the expedition, the functional state of participants with more severe vitamin D deficiency is characterized by a shorter average duration of RR intervals (p = 0.050) and reduced SDNN values (p = 0.015). The higher the content of vitamin D, the greater increase in speed (r = 0.510), the higher the increase in projective performance (r = 0.485), and the smaller the increase in projective stress (r = -0.334). Significant relationships between the subjective characteristics of functional states and the vitamin D of participants have not been established. (4) Conclusion: With an increase in the severity of vitamin D deficiency in the blood, the adaptive capabilities of participants decrease during an expedition to the Arctic.

Incidence and severity of vitamin d insufficiency among type diabetes patients and the impact of hyperglycemia on serum vitamin d levels: A case control study

Incidence and severity of vitamin d insufficiency among type diabetes patients and the impact of hyperglycemia on serum vitamin d levels: A case control study

IMPACT OF VITAMIN D DEFICIENCY ON MENTAL HEALTH OF MAURITIAN POPULATION-A PILOT STUDY

In this work, we aim to study any relationship between vitamin D deficiency and the prevalence of depression in the population of Mauritius aged between 18 and 40 years. The objectives are to identify the prevalence of depression in vitamin D deficient individuals, and to identify the impact of the level of vitamin D deficiency on the severity of depression. A survey was carried out on 25 individuals who were tested as vitamin D deficient by means of questionnaires. Statistical analysis was performed using SPSS, version 24. The resulting data showed that nineteen, 19 of the participants were suffering from depression and a strong relationship between severity of vitamin D deficiency and the severity of depression was noted (Pearson correlation coefficient, r -0.908 ).The study therefore calls for reinforcing efforts in terms of screening for depression as well as for vitamin D deficiency.

Relationship Between Vitamin D Deficiency and Non-alcoholic Fatty Liver Disease: A Cross-Sectional Study From a Tertiary Care Center in Northern India.

Background Vitamin D levels are strongly associated with myocardial infarction, coronary artery disease, heart dysfunction, and even mortality. Non-alcoholic fatty liver disease (NAFLD) is a prevalent hepatic illness whose incidence has grown dramatically over the past several decades. Methodology This observational, cross-sectional study was conducted over 1.5 years (January 2019 to June 2020) at the Department of General Medicine of a tertiary care hospital in northern India on 100 adult patients with NAFLD admitted to the emergency ward, intensive care unit, and medical ward. Results In our study, of the 100 patients, 45.0%, 16.0%, and 39.0% of patients exhibited vitamin D deficiency, insufficiency, and sufficiency, respectively. Vitamin D deficiency was the highest among those aged 41-50 (54.2%) and lowest among those aged 30-40 (29.0%). We observed that vitamin D deficiency was less prevalent in people with a normal body mass index (39.1%) than in those who were overweight (91.7%). There was a significant (p < 0.05) association between the severity of vitamin D deficiency and the presence of hepatomegaly, splenomegaly, and ascites. Overall, the incidence of fatty liver was 49% among patients. There was a significant (p = 0.0001) correlation between fatty liver and serum vitamin D levels. The association between the proportion of patients with fatty liver and the degree of vitamin D deficiency was found to be significant (p = 0.04). The relationship between the distribution of patients according to insulin resistance and the degree of vitamin D deficiency was also statistically significant (p < 0.001). Conclusions Vitamin D deficiency is associated with an increased risk of NAFLD, as well as with the severity of NAFLD.

25-Hydroxyvitamin-D deficiency in chronic kidney disease stages III, IV, and V in South Asian population: a retrospective cohort.

Vitamin D deficiency in Chronic Kidney Disease is a known fact, but the data regarding the prevalence and extent of vitamin D deficiency in different stages of Chronic Kidney Disease is scarce. This leads to a delay in addressing this issue. We conducted this study to assess vitamin-D deficiency in different stages of Chronic Kidney Disease to improve the evidence available to Physicians and Nephrologists which can help them better address this common finding in Chronic Kidney Disease. This retrospective study from a tertiary care hospital in Karachi, Pakistan, included adult Chronic Kidney Disease patients who had their serum 25 Hydroxy vitamin D levels done. The patients were classified according to stages of Chronic Kidney Disease using Estimated Glomerular Filtration Rate values. Appropriate statistical tests were performed to find a correlation between the severity of vitamin D deficiency in different stages of Chronic Kidney Disease with a statistically significant p value of <0.05 and a 95% confidence interval. In total, 148 patients were included in the study. All patients had serum 25 Hydroxy vitamin D levels less than 30 ng/ml. The severity of vitamin D deficiency was observed to increase progressively from stage 3A Chronic Kidney Disease through stage 5. Vitamin D levels in Chronic Kidney Disease stage 3 were significantly greater than in Chronic Kidney Disease stages 4 and 5 (p value < 0.001), and stage 5 patients had the lowest vitamin D levels in our study. Similar, statistically significant findings were observed for serum phosphate levels, too, with stage 5 Chronic Kidney Disease patients having a greater serum phosphate concentration than stages 3A and 3B (p value = 0.002, 0.006). All Chronic Kidney Disease patients in our study either had vitamin D insufficiency or deficiency. In addition, we observed a significant decrease in vitamin D levels from Chronic Kidney Disease stage 3 to stage 5. Greater serum phosphate levels were detected in stage 5 compared to stages 3A and 3B.

Vitamin D Status in Patients with Proximal Muscle Weakness

Vitamin D deficiency has emerged as a concerning public health issue, and almost 25-50% of patients with proximal muscle weakness suffer for this deficiency. It has been documented that myopathy could be a presentation of hypovitaminosis D. Most often, it remains unnoticed or undiagnosed because muscle weakness develops gradually over the years. As fewer studies are available on this topic, the study was designed to assess the vitamin D status in patients presenting with proximal muscle weakness. This hospital-based descriptive cross-sectional study was conducted at the Inpatient and outpatient Department of Medicine of Dhaka Medical College Hospital for 6 months following approval of this protocol. The Ethical Review Committee approved the protocol, and informed written consent was obtained from all the patients. The patients were selected as per inclusion and exclusion criteria with the purposive sampling method. Data were collected by a preformed semi-structured questionnaire. Total 50 patients were included in the final analysis. Collected data were analyzed by the Statistical Package for the Social Sciences version-22 (SPSS). Among 50 patients, 70% were females and mean age was 58.92 ± 12.3 years with a frequent age group&gt; 65 years (46%), where more than two third (68%) of the respondents were from urban area. Among the study subjects, the majority of them had involvement of the lower limb muscles (54%) and one-fifth of them (20%) had both upper and lower limb involvement, whereas more than one-fourth (26%) had only upper limb involvement. The mean duration of illness was 8. 6 ± 3.4 months. The study found more than three fourth, (78%) had hypovitaminosis D the and mean value of serum 25(0H) D was 22.3 ± 7.7 ng/ml. Among them 36% had mild insufficiency, 30% had a moderate deficiency, and 12% had severe deficiency. About two-thirds of proximal myopathy patients had hypovitaminosis D. Difficulties in walking, standing from sitting, climbing, raising hands above the head, bone and joint pain were significantly associated with the severity of vitamin D deficiency (P-value &lt; 0.05). The severity of muscle weakness was strongly associated with the severity of vitamin D deficiency (P-value &lt;0.05). Females were comparatively more affected than males, it was not statistically significant. However, further large-scale analytical studies are needed to find the association of this hypovitaminosis with the disease process.&#x0D; Bangladesh Med J. 2021 Sept; 50(3): 7-13

Comparison of vitamin D levels between mothers and infants with and without prolonged membrane rupture

Background. Premature membrane rupture is a known causes of preterm labor and accounts for approximately one-third of cases. Vitamin D deficiency may play a role in preterm labor as well. Objective. The present study aimed to compare vitamin D levels in mothers and infants with and without prolonged rupture of membranes (PROM). Materials and methods. This cross-sectional study was conducted with 241 babies, with and without a history of membrane rupture, in mothers in the neonatal ward of Ghaem Hospital, Mashhad, from 2019 to 2021 with available sampling methods. After confirmation of prolonged membrane rupture (more than 18 hours before birth) based on history and examination with a speculum, we completed a data collection tool, a checklist including laboratory evaluation and neonatal and maternal characteristics. The conditions of neonates with and without prolonged membrane rupture were compared. Data were analyzed by T-test and Chi-square. Results. We examined a total of 241 neonates including 148 (61.4%) without prolonged rupture of the membranes in mothers and 93 (38.6%) with PROM. There were statistically significant differences between the two groups regarding: maternal vitamin D level (p = 0.001); neonatal vitamin D level (p = 0.001); and fifth minute Apgar score (p = 0.003). These variables were lower in the group of neonates with PROM. Conclusion. Vitamin D deficiency in mothers was significantly associated with prolonged membrane rupture. With increasing severity of vitamin D deficiency, the probability of PROM increases and, therefore, the likelihood of preterm labor and its complications rises.

The Effectiveness of Vitamin D Supplementation on Oxidative and Inflammatory Markers in Patients Suffering from End-stage Renal Disease, a Randomized Controlled Trial.

Vitamin D insufficiency is common in patients suffering from end-stage renal disease (ESRD). In contrast, vitamin D supplementation could improve the status of ESRD patients (ESRDP). However, this effect's molecular mechanism is not fully understood. Therefore, this study aimed to assess vitamin D supplementation's impact on inflammation and oxidative signaling pathways in ESRDP. 104 ESRDP were divided into placebo (53) and vitamin D (51) groups. They were also categorized into four subgroups based on the severity of vitamin D deficiency. The dose of vitamin D3 (0.25-0.5mg/day) supplementation was determined based on plasma levels of calcium and parathyroid hormone (PTH). Vitamin D supplementation was performed for eight weeks. Serum levels of calcium, phosphorus, PTH, albumin, creatinine, ALP, and glomerular filtration along with antioxidant enzymes, malondialdehyde, and pro-inflammatory factors were measured. Moreover, the Nrf2 and NF-ĸB expression was evaluated in whole blood. According to the results, vitamin D supplementation improved the status of patients with ESRD significantly as compared with the placebo group (p<0.05). In addition, the expression of NF-ĸB and the serum levels of pro-inflammatory factors and malondialdehyde were significantly reduced. Finally, the expression of Nrf-2 and the serum of antioxidant enzymes were raised in the vitamin D group as compared with the placebo group (p<0.05). Vitamin D reduces clinical and metabolic symptoms in ESRDP by modulating gene expression (in oxidative stress and inflammation).

Comparison of Vitamin D Levels in Premature Infants with and without Retinopathy of Prematurity

Retinopathy of prematurity (RoP) is a cause of newborn blindness. Several predisposing factors have been reported to contribute to the disease process. The current study aimed to compare serum vitamin D levels in infants with and without RoP. This case-control study was conducted on 154 very low birth weight (VLBW) infants admitted to Ghaem hospital, Mashhad, Iran, during 2016-2019. Retinal examination for RoP was done at the 32nd week of pregnancy and vitamin D level was determined using the infants' first-day serum samples. A researcher-made questionnaire including maternal, infant, laboratory, and retinal examination information was used as the data collection tool. Out of 154 infants in the study, 56 (36.4%) were normal while 98 (63.6%) had RoP. Based on the severity of retinopathy, 43 infants (43.9%) were at stage I, 48 (49%) at stage II, and 7 (7.1%) at stage III. Significant differences in neonatal (P<0.001) and maternal (P=0.015) vitamin D levels, first and fifth minute Apgar scores (P=0.034 and P=0.001, respectively), and weight (P=0.014) were found between the infants with and without RoP. The incidence of RoP was higher in infants with lower gestational age, lower birth weight, low first and fifth minutes Apgar scores, and male sex. Low serum levels of vitamin D in premature infants and their mothers were associated with incidence of RoP. The higher the stage of RoP, the greater was the severity of vitamin D deficiency. Thus, controlling the maternal vitamin D level during pregnancy, consumption of vitamin D supplements, and investigation of serum vitamin D levels in premature infants are recommended. Early correction of vitamin D deficiency may lead to reduction of RoP.

Association of vitamin D and insulin resistance among the adults with newly detected prediabetes attending in a tertiary care hospital of Bangladesh

Several studies have found an inverse association between vitamin D level and insulin resistance (IR) causing prediabetes and diabetes. So the current study was done to find out the association between serum vitamin D level and IR among adults with prediabetes. This cross-sectional study was carried out in 140 newly detected adults with prediabetes according to ADA 2018 criteria. The 25(OH) D cutoffs to define deficiency and insufficiency were used according to Endocrine Society (USA) criteria, measurement of vitamin D &amp; insulin (fasting) was done by chemiluminescent microparticle immunoassay (CMIA). Data were analyzed using SPSS (version 22.0) and presented as table and figure. P-value ≤0.05 was considered significant. In this study, most of the population was 30 years and above (73%). The Male-female ratio was 1:7, the majority of participants came from urban areas (81%) and it was observed that there was an increasing trend of insulin resistance across increasing severity of vitamin D deficiency though it was not statistically significant (p= 0.74). In conclusion, vitamin-D deficiency/insuffi- ciency is common among individuals with prediabetes in our country, but there were no associ- ation had been found between vitamin D and insulin resistance in individuals with prediabetes BSMMU J 2021; 14(4): 157-162

Gebelik Yaşı ≤32 Hafta Olan Preterm Bebeklerde 25-Hidroksivitamin D Düzeyleri ve Respiratuvar Distres Sendromu Arasındaki İlişki

Objective: The aim of this study was to evaluate neonatal vitamin D status and effect of vitamin D levels on the development of respiratory distress syndrome (RDS) in preterm infants with a gestational age of ≤ 32 weeks. The association between RDS and severity of vitamin D deficiency was secondary outcome of this study.&#x0D; Method: Newborns having a gestational age of ≤32 weeks with RDS consisted the study group, while newborns hospitalized in the neonatal intensive care unit having ≤32 weeks of gestational age with no signs of RDS were the control group.&#x0D; Results: During the study period, 122 preterm infants having a gestational age of ≤ 32 weeks were included. From these, 56 (46%) had RDS (study group), while 66 (54%) newborns (control group) did not have RDS. There was no significant difference between the groups in terms of maternal age, multiple pregnancy, use of antenatal steroid, sex, mode of delivery, maternal age, antenatal steroid use, accompanying maternal diseases and birth season. Median 25-OHD levels of study group and control group were similar (12.3 ng/ml vs 15.6 ng/ml; p=0.38). The rates of preterm infants having low vitamin D levels (25-OHD level

Prevalence and Significance of Vitamin D Deficiency in Patients Undergoing Corrective Surgery for Adolescent Idiopathic Scoliosis.

The exact etiology of adolescent idiopathic scoliosis (AIS) is unknown, but recently, vitamin D has been suggested to be of importance in the pathophysiology of AIS. This article sought to (1) highlight the prevalence of vitamin D deficiency in patients undergoing corrective surgery for AIS within the United Kingdom and (2) evaluate the correlation and clinical relevance of preoperative back pain with vitamin D deficiency. Data were collected on 201 consecutive patients undergoing corrective surgery for AIS. Baseline data included patient demographics, medical diagnoses, and standing preoperative Cobb angles. All patients had a preoperative 25-hydroxyvitamin D level recorded. One hundred ninety-six patients completed preoperative Scoliosis Research Society-22 outcome scores to quantify preoperative back pain. A total of 177 (89%) patients were young women, and the mean age at time of surgery was 14.9 years (13-18 years). All patients were diagnosed with AIS. The mean Cobb angles at time of surgery was 64°. Only 11 (5.5%) patients had "normal" vitamin D levels (>75 nmol/L), with 147 (74%) patients having deficient levels requiring treatment with supplementation. There was no correlation between vitamin D levels and preoperative Cobb angles (r s = -0.12), and there was a moderate correlation identified between the severity of preoperative vitamin D levels and preoperative back pain scores (r s =0.42). Vitamin D deficiency is common in patients with AIS; however, it is comparable to the national prevalence of vitamin D deficiency in healthy adolescent children. There was a strong correlation between preoperative back pain scores and the severity of vitamin D deficiency. These findings suggest that all patients with AIS should be screened for vitamin D deficiency and that supplementation where appropriate may lead to improved pain scores. If vitamin D is prevelant and if vitamin D deficiency is found to cause back pain, then there is an easy/cheap/safe treatement with supplementation.

THE ROLE OF VITAMIN D IN PRE ECLAMPSIA AND ASSOCIATION OF ITS DEFICIENCY WITH SEVERITY OF PRE ECLAMPSIA

Aim: To assess the association of vitamin D status in preeclamptic and normal healthy pregnant women. Materials and Methods: Prospective case control study included 50 women with preeclampsia and 50 normotensive pregnant women. Serum vitamin D estimation was done. Correlation between vitamin D deficiency and preeclampsia was analysed statistically. Results: Prevalence of vitamin D deficiency was comparable in both groups. Mean vitamin D level (19.7±2.79 ng/ml) was statistically low in preeclampsia group while in that of control was 24.3±1.89 ng/ml. Severity of vitamin D deficiency correlated with the severity of preeclampsia. Age, parity and BMI were similar in both the groups. No statistically significant difference seen regarding mode of delivery in both the groups. Conclusion: Vitamin D deficiency is significantly associated with preeclampsia. Further studies are needed to document the role of vitamin D supplementation in prevention of preeclampsia.

Prevalence of Vitamin D Deficiency and Associated Factors in Critically Ill Patients: A Multicenter Observational Study.

Background: Vitamin D deficiency is common in the general population worldwide, and the prevalence and severity of vitamin D deficiency increase in critically ill patients. The prevalence of vitamin D deficiency in a community-based cohort in Northern Taiwan was 22.4%. This multicenter cohort study investigated the prevalence of vitamin D deficiency and associated factors in critically ill patients in Northern Taiwan.Methods: Critically ill patients were enrolled and divided into five groups according to their length of stay at intensive care units (ICUs) during enrolment as follows: group 1, <2 days with expected short ICU stay; group 2, <2 days with expected long ICU stay; group 3, 3-7 days; group 4, 8-14 days; and group 5, 15-28 days. Vitamin D deficiency was defined as a serum 25-hydroxyvitamin D (25(OH)D) level < 20 ng/ml, and severe vitamin D deficiency was defined as a 25(OH)D level < 12 ng/ml. The primary analysis was the prevalence of vitamin D deficiency. The exploratory analyses were serial follow-up vitamin D levels in group 2, associated factors for vitamin D deficiency, and the effect of vitamin D deficiency on clinical outcomes in critically ill patients.Results: The prevalence of vitamin D deficiency was 59% [95% confidence interval (CI) 55-62%], and the prevalence of severe vitamin D deficiency was 18% (95% CI 15-21%). The median vitamin D level for all enrolled critically ill patients was 18.3 (13.7-23.9) ng/ml. In group 2, the median vitamin D levels were <20 ng/ml during the serial follow-up. According to the multivariable analysis, young age, female gender, low albumin level, high parathyroid hormone (PTH) level, and high sequential organ failure assessment (SOFA) score were significantly associated risk factors for vitamin D deficiency. Patients with vitamin D deficiency had longer ventilator use duration and length of ICU stay. However, the 28- and 90-day mortality rate were not associated with vitamin D deficiency.Conclusions: This study demonstrated that the prevalence of vitamin D deficiency is high in critically ill patients. Age, gender, albumin level, PTH level, and SOFA score were significantly associated with vitamin D deficiency in these patients.

Vitamin D Deficiency in Preschool Children with Down Syndrome

Vitamin D is a fat-soluble secosteroid prohormone that is produced on the skin by contact with sunlight. Through various metabolic changes in the body, it transforms into a hormone known as calcitriol, with a key role in the calcium and phosphate metabolism (1). Vitamin D serves plenty of functions in the body. Therefore, its deficiency may cause musculoskeletal symptoms such as bone pain, muscle weakness, gait difficulty, skeletal deformity, in addition to extraskeletal symptoms such as autoimmune diseases, cardiovascular diseases, and neuropsychiatric diseases (2). Down Syndrome occurs as a result of trisomy, which occurs due to an extra copy of the whole or part of the long arm of chromosome 21 and is the most commonly known cause of delay in development. DS affects 1 in every 787 liveborn babies (3). DS is often accompanied by distinctive craniofacial features, congenital heart disease and immune, musculoskeletal and endocrine system abnormalities (4,5). In patients with this syndrome, various environmental and hormonal factors such as hypotonia, low physical activity, poor calcium and vitamin D intake, intrauterine growth restriction, hypogonadism and thyroid dysfunction may contribute to bone mass and quality (6,7). Among all the others, vitamin D may have a crucial role in the health of these people. Vitamin D levels differ with many factors, including exposure to sunlight, dietary intake, and supplement use (8,9). There is a lack of scientific evidence on the prevalence and severity of vitamin D deficiency in children with DS. Hence, this study aimed to determine vitamin D deficiency in children with DS, from infancy to toddler and particularly during the preschool period, and to raise awareness on the matter.

A hospital based research to determine the incidence and severity of vitamin d insufficiency in people with type 2 diabetes

Aims: The aim of the study to assess the prevalence and severity of vitamin D deficiency in type 2 DM. Material and methods: A 5 months case-control study was carried out at Dhawan Hospital in Ludhiana, Punjab, India, at the request of the researchers. A total of 240 volunteers participated in the study, with 120 type 2 diabetes patients serving as case participants (Group A) and 120 healthy volunteers serving as control participants (Group B). Laboratory testing on a regular basis CBC, FBS, RBS, PP2BS, haemoglobin A1C, blood urea, serum creatinine, lipid profile, urine albumin, and Vitamin D3 levels were all measured using conventional techniques at the institute's central laboratory, according to the guidelines. Results: When comparing groups A and B, the mean age of group A (case) was 51.42 9.25 years, while the mean age of group B (control) was 50.12 10.18 years. The prevalence of low vitamin D levels in the healthy population was just 19.2 percent, while the prevalence in the diabetic population was 84.2 percent. Vitamin D levels were found to be sufficient, insufficient, and deficient in 18.51 percent, 61.11 percent, and 16.67 percent, respectively, in patients with controlled diabetes according to HbA1C criteria, but only 10.60 percent, 68.18 percent, and 24.24 percent in patients with uncontrolled diabetes, according to the same criteria. In contrast to diabetic patients with managed condition, a higher proportion of diabetic patients with uncontrolled state (24.24 percent) had overt vitamin D insufficiency (16.67 percent). There is a statistically significant relationship between the maintenance of euglycemia and the degree of Vitamin D deficiency in diabetic patients, as shown by a p value less than 0.05. Conclusion: All patients with type-2 diabetes should have their vitamin D levels checked, and those who are found to have insufficiency or shortage of vitamin D should be prescribed vitamin D supplements. In order to avoid vitamin D insufficiency, it is also necessary to maintain tight control over one's diabetic condition.

Serum vitamin D in Indian children with vernal keratoconjunctivitis

AIM: To determine the vitamin D levels in vernal keratoconjunctivitis (VKC) patients in Indian population. METHODS: A total of 30 non-atopic healthy children and 30 children having VKC were included in the study. The serum vitamin D levels and the time spent outside was compared between the two groups (P&lt;0.05). RESULTS: The mean serum vitamin D level in the VKC group was significantly lower (mean 19.17±10.76 ng/mL) compared to the control group (mean 31.19±9.09 ng/mL) (P=0.0003). The vitamin D levels were found to be deficient (10-20 ng/mL) in 43.33%, whereas severe deficiency (&lt;10 ng/mL) was found in 20% of the VKC patients. The deficiency of vitamin D correlated with the level of severity of VKC (P&lt;0.02). The time spent outside in the VKC group was 1.07±0.76h, whereas in the healthy subjects it was 2.08±0.72h (P&lt;0.0001), and it showed a significant correlation with the serum 25 (OH) D3 levels (r=0.478, P&lt;0.001). CONCLUSION: The study shows that children with VKC had a significantly lower serum vitamin D levels as compared to the healthy children which correlated with time spent outside. The severity of VKC also correlated with the severity of vitamin D deficiency which suggests that vitamin D plays an important role in maintaining ocular surface health.