Suboptimal Serum Vitamin Research Articles

Evaluation of the role of vitamin D in patients with psoriasis

Objectives: Investigate whether there is any association between the levels of vitamin D in the blood and the seriousness of psoriasis or its development. Methods: The study is characterized as observational, retrospective, composed of 40 patients with psoriasis who had serum vitamin D levels, who underwent clinical care at a dermatology outpatient clinic in Passo Fundo/RS, from August 2019 to June 2021. Results: Of the 40 interviewees, 60% were female and 40% male. Phototypes II and III prevailed. Regarding family health history, 50% had a history of the disease. Regarding the duration of psoriasis, the predominant group was between 1-10 years (57.5%). The most prevalent psoriasis subtype was vulgaris (62.5%). Regarding serum vitamin D results, the lowest index was 15.2 ng ̸ mL, the highest was 42.3 ng ̸ mL and the average was 25.99 ng ̸mL. In the predominant age group, between 20-40 years, the proportion of patients with vitamin D was less than 30 ng ̸mL is 83.33%. The lower the phototype, the greater the proportion of patients with suboptimal serum vitamin D. In the group of patients with disease duration > 10 years, vitamin D levels were lower. There is no extreme difference in the effectiveness of treatments when analyzing the average, minimum and maximum serum levels of vitamin D. Conclusion: There was no relationship between serum levels of 25-hydroxyvitamin D (25OHD) and the development of psoriasis or even control – worsening of the clinical picture of disease.

Influence of Vitamin D on the Incidence of Metabolic Syndrome and Hormonal Balance in Patients with Polycystic Ovary Syndrome.

Polycystic ovary syndrome (PCOS) is a heterogeneous endocrine disorder that affects 8-13% of women of reproductive age. It is one of the most common causes of infertility and is associated with hyperandrogenism in the form of hirsutism and acne, non-ovulatory cycles, and characteristic ovarian morphology. The available research on serum vitamin D deficiency in patients with PCOS and the appropriateness of vitamin D supplementation in this group of women is inconclusive, so we decided to investigate the influence of vitamin D on the incidence of metabolic syndrome and hormonal balance in patients with polycystic ovary syndrome. The study comprised 120 women aged between 18 and 42 years, who were divided into two groups: a group with diagnosed polycystic ovary syndrome (PCOS) and a group of regularly menstruating women without features of androgenisation, in whom polycystic ovary syndrome was excluded. Each patient underwent a history and physical examination, including a gynecological examination, anthropometric measurements were taken, including height, weight, waist, and hip circumference, and blood pressure was measured using the Korotkow method. In the female patients, the following parameters were also determined from the blood: follicle-stimulating hormone (FSH), luteinizing hormone (LH), oestradiol, TSH, ft4, prolactin (PRL), total testosterone, DHEASO4, 17-hydroxyprogesterone (17-OHP), sex-hormone-binding globulin (SHBG), androstendione, 25(OH) vitamin D3 metabolite. The majority of the patients with polycystic ovary syndrome were found to have deficient or suboptimal serum vitamin D levels, and the effects of vitamin D on the SHBG levels and free-androgen indices in these patients was examined. The effects of vitamin D on the incidence of metabolic syndrome and BMI, waist-to-hip ratio, waist circumference, and blood pressure in patients with polycystic ovary syndrome were also found.

Association of Serum Vitamin D level and COVID-19 infection: A Case-control Study.

Vitamin D is considered a potent modulator of the immune system, albeit its role in COVID-19 infection is a matter of debate. The present study aimed to estimate the association between serum vitamin D levels and COVID-19 among people in Qatar. This case-control study, approved by the Institutional Review Board of Primary Health Care Corporation (PHCC) Qatar, retrospectively evaluated the principal public healthcare sector population data repository retrieved from the cloud-based Electronic Health Record (EHR) software-Cerner, during April 2020-2021. The health records of all adult patients aged >18 years who had undergone the reverse transcription-polymerase chain reaction (RT-PCR) test and whose medical records had documented serum 25-hydroxyvitamin D [25 (OH)D] levels were analyzed. A total of 924,173 EHRs were extracted, of which 62,451 EHR comprised of 16,446 (26.3%) COVID-19 patients and 46,005 (73.7%) negative-control group patients met the inclusion criteria. The odds ratio (OR) among different categories of vitamin D deficiency (VDD) revealed that people with mild/moderate VDD were 1.18 times (95% CI 1.126-1.258) and those with severe VDD were 1.90 times (95% CI 1.116-1.251) more likely to have COVID-19 infection when compared to the people with optimal serum vitamin D level. On applying multiple logistic regression, the odds of having COVID-19 infection were found to be 1.27 times (95% CI 1.184-1.371) higher among those with mild/moderate VDD and 1.32 times (95% CI 1.206-1.405) higher among those with severe VDD when compared to people with optimal vitamin D level (p<0.001). Our findings demonstrated a significant association between the suboptimal serum vitamin D level and COVID-19 infection. Further studies are required to determine the effects of VDD on the severity and outcomes of COVID-19 infections.

Suboptimal Plasma Vitamin C Is Associated with Lower Bone Mineral Density in Young and Early Middle-Aged Men: A Retrospective Cross-Sectional Study.

Background: This study was conducted to evaluate associations between bone mineral density (BMD) and four selected circulating nutrients, particularly vitamin C, among adults aged 20–49 years. Methods: In this retrospective cross-sectional study, the lumbar spine BMD of 866 men and 589 women were measured by dual-energy X-ray absorptiometry and divided into tertiles, respectively. Logistic regressions were used to identify the predictors of low BMD by comparing subjects with the highest BMD to those with the lowest. Results: Multivariate logistic regressions identified suboptimal plasma vitamin C (adjusted odds ratio (AOR) 1.64, 95% confidence interval (CI) 1.16, 2.31), suboptimal serum vitamin B12 (AOR 2.05, 95% CI 1.02, 4.12), and low BMI (BMI < 23) (AOR 1.68, 95% CI 1.12, 2.53) as independent predictors for low BMD in men. In women, low BMI was the only independent predictor for low BMD. Plasma vitamin C, categorized as suboptimal (≤8.8 mg/L) and sufficient (>8.8 mg/L), was positively significantly correlated with the lumbar spine BMD in men, but there was no association in women. Conclusions: Plasma vitamin C, categorized as suboptimal and sufficient, was positively associated with the lumbar spine BMD in young and early middle-aged men. A well-designed cohort study is needed to confirm the findings.

Correlation of Gut Microbiota, Vitamin D Status, and Pulmonary Function Tests in Children With Cystic Fibrosis.

BackgroundChildren with cystic fibrosis (CF) are expected to have suboptimal serum vitamin D status and altered gut microbiota. The altered gut microbiota is hypothesized to have a pro-inflammatory effect that further complicates the existing respiratory inflammation. Emerging evidence suggests an association between vitamin D and gut microbiota. The aim of this study was to assess the relationships between 25-hydroxyvitamin D [25(OH)D] status, pulmonary function, and fecal bacteria in children with CF.MethodsIn this cross-sectional study, a total of 35 children with CF (8.7 ± 2.83 years) and 24 controls without CF (9 ± 2.7 years) were included in this study. Serum 25(OH)D status was measured using the Elecsys vitamin D total II assay. In the CF group, gut microbiota composition was assessed using real-time PCR analysis. Pulmonary function tests (PFTs) were measured using spirometry. Comparisons between the CF and non-CF controls were conducted using the independent sample t-test. In the CF group, one-way analysis of variance (ANOVA) was used to assess differences in PFTs and gut microbiota composition across the three vitamin D subgroups. The correlations between 25(OH)D status and PFTs, or gut microbiota composition, and PFTs with gut microbiota composition were analyzed using the Pearson's correlation coefficient test.ResultsChildren with CF had significantly lower serum 25(OH)D levels compared with children without CF (44.3 ± 22.4 vs. 59 ± 25.5, respectively, P = 0.026). Children with CF with optimal serum 25(OH)D level had significantly higher levels of Bacteroidetes, Firmicutes, and total bacteria (P = 0.007, P = 0.007, and P = 0.022, respectively). The level of Firmicutes was found to be significantly higher in mild forced expiratory volume in 1 s (FEV1) compared with moderate FEV1 (P = 0.032), whereas the level of the other bacteria species was comparable across FEV1 severity groups.ConclusionOur findings may encourage studies that target and modify gut microbiota to potentially achieve better outcomes in terms of respiratory function in CF.

Vitamin D and its association with symptom severity in knee osteoarthritis: a cross sectional study at a national referral hospital in Uganda

BackgroundVitamin D deficiency is highly prevalent among patients with osteoarthritis. It is associated with joint pain, stiffness and worse physical function. Whether vitamin D deficiency is associated with osteoarthritis is controversial. We investigated serum vitamin D levels and its association with symptom severity in patients with knee osteoarthritis.MethodsBetween January 2020 to March and May 2020, we conducted a cross sectional study at a national referral hospital in Uganda. Using the American College of Rheumatology clinical criteria, 107 consenting adults were diagnosed with knee osteoarthritis. A questionnaire captured patient demographics and clinical characteristics. Joint pain, stiffness and physical function severity were assessed and graded based on the Western Ontario and McMaster Universities Arthritis Index (WOMAC). We determined serum vitamin D levels by electrochemilumniscence immunoassay. The data were analysed and adjusted for age, sex, education, occupation, family history, body mass index (BMI) and calcium supplementation.ResultsOf the 107 patients, 92 (86%) patients were females, mean (SD) age was 58.1 (12.6) years. Nearly 65% of the patients had suboptimal serum vitamin D levels < 30 ng/ml. The median (Q1, Q3) WOMAC joint scores were as follows: pain 8.0 (5, 11), stiffness 1 (0, 2), physical function 29.0 (16, 41) and total WOMAC 39.0 (21, 54). Spearman correlations between serum vitamin D levels with symptom severity were as follows: joint pain (r = 0.18, p = 0.06), stiffness (r = 0.13, p = 0.17), physical function (r = 0.09, p = 0.36) and total WOMAC (r = 0.13, p = 0.19).ConclusionSerum vitamin D levels are not associated with joint pain, stiffness and physical function severity. Older age and higher BMI are associated with vitamin D deficiency in patients with knee osteoarthritis attending a national referral hospital rheumatology clinic in Uganda. Suboptimal vitamin D is an independent risk factor for total mortality in the general population. Clinical guidelines and further studies to determine age and BMI ranges required for vitamin D screening are needed in patients with osteoarthritis in Uganda. Patients are advised to keep a normal BMI.

Relationship between serum 25-hydroxyvitamin D, total antioxidant capacity and pneumonia incidence, severity and outcome in Nigerian children

BackgroundThe pathologic basis of childhood community-acquired pneumonia (CAP) involves the generation of reactive oxygen species by immune cells leading to cellular damage and lung congestion. Serum antioxidants and vitamin D with immunomodulatory properties therefore hold prospects in the prevention and management of pneumonia in children. This case–control study set out to compare the serum 25-hydroxyvitamin D (25-OHD) and total antioxidant capacity (TAC) in Nigerian children with CAP and age- and sex-matched controls and to relate these parameters with pneumonia severity and outcome—length of hospital stay (LOH).ResultsA total of 160 children (80 each for CAP and controls) were recruited. The median (IQR) age was 1.8 (0.6–4.0) years, male:female 1.7:1, 63 (78.8%) and 11 (13.8%) of CAP group had severe pneumonia and parapneumonic effusions, respectively. Serum 25-OHD (33.8 (18.3) ng/ml vs. 41.9 (12.3) ng/ml; p = 0.010) and TAC (6.1 (4.4–8.1) ng/dl vs. 7.2 (4.7–17.5) ng/dl; p = 0.023) were lower in children with CAP than controls. Lower serum 25-OHD was observed in severe than non-severe pneumonia (30.5(17.1) ng/ml vs. 46.3 (17.6) ng/ml; p = 0.001) but LOH did not correlate with serum 25-OHD and TAC.ConclusionChildren with CAP had lower serum vitamin D and antioxidants than controls, and severe pneumonia was significantly associated with suboptimal serum vitamin D. They however were not related to pneumonia outcome. Optimal serum vitamin D and antioxidants may play a role in reducing the incidence of childhood CAP in Nigerian children.

Vitamin D levels in patients with non-Hodgkin lymphoma/diffuse large B-cell lymphoma, chronic lymphocytic leukemia and multiple myeloma.

PurposeTo investigate serum vitamin D levels in patients newly diagnosed with non-Hodgkin lymphoma/diffuse large B-cell lymphoma (NHL-DLBCL), multiple myeloma (MM) and chronic lymphocytic leukemia (CLL).Patients and methodsWe measured serum levels of vitamin D by ELISA in 103 patients prior to initiation of treatment, of whom 37 were diagnosed with MM, 32 with CLL and 34 with NHL-DLBCL.ResultsSuboptimal serum vitamin D levels (<30 ng/mL) were observed in all 103 patients. In 14 patients, serum vitamin D levels were between 20 and 30 ng/mL, while all other patients had vitamin D deficiency (<20 ng/mL). Severe vitamin D deficiency (<10 ng/mL) was observed in 32.3% of NHL-DLBCL patients, 28.1% of CLL patients and 81% of MM patients.ConclusionWe observed low serum vitamin D levels in the majority of patients newly diagnosed with NHL-DLBCL, CLL and MM.

Relationship between serum 25-hydroxyvitamin D and inflammatory cytokines in Nigerian children with asthma

Background: Childhood asthma involves a network of mutually interacting inflammatory mediators and cytokines. The influence of serum vitamin D (an immunomodulatory agent) on these cytokines is poorly understood. This study sets out to determine the relationship between serum T-helper cells type 1 cytokines (Interleukins ILs-1β, 2, 6, 8 and 10), type 2 cytokines (ILs 3, 4,5,9,13), ILs-12, 17 and 25-hydroxyvitamin D (25-OHD) in Nigerian children with asthma.Methods: Children with physician-diagnosed asthma and non-asthmatics aged 2-15 years were consecutively recruited at a tertiary center in Nigeria. Serum 25-OHD and cytokines were assayed using chromatography method and association between these parameters determined.Results: A total of 180 children (90 for each group; mean age 7.5 ± 3.9 years; M:F 1.9:1) were recruited. Fifty-six (76.7%) asthmatics had mild intermittent form and symptoms were sub-optimally controlled in 16 (21.9%). The mean (SD) serum Vitamin D was lower in children with asthma (38.8 ± 17.0 ng/ml vs. 45.5 ± 16.6 ng/ml vs. p = 0.023). Also more proportion of children with asthma had suboptimal serum vitamin D level (26.0% vs. 8.8%; p = 0.022). Deficient vitamin D state was associated with higher serum Th1 and Th2 cytokines compared to insufficient state, but the highest cytokine levels were observed in normal vitamin D state. There was significant positive correlation between serum vitamin D and Th1 cytokines IL-2 and IL-8 as well as Th2 cytokines (ILs-3, 4, 5 and 9), but negative correlation with IL-13Conclusions: Serum Vitamin D and cytokines were lower in a sample of Nigerian children with asthma than controls. Vitamin D status was not related to asthma severity and control. Serum 25-OHD seems to have a non-linear relationship with Th1 and Th2 cytokines in Nigerian asthmatics.

Dental caries and vitamin D status in children in Asia.

Dental caries and vitamin D inadequacy are known to affect children worldwide. Vitamin D has a vital role in tooth formation. There is growing evidence linking suboptimal serum vitamin D level with dental caries in children. This paper reviews the literature on both the prevalence of dental caries and of vitamin D deficiency in children in four Asian regions, discusses their associated risk factors, and reviews the global evidence on the association between dental caries and vitamin D in children. Caries prevalence in children ranged from 40% to 97% in Eastern Asia, 38-73.7% in Southern Asia, and 26.5-74.7% in Western Asian countries. Moreover, a higher prevalence of vitamin D deficiency in Asian children was identified, even in countries in equatorial regions, ranging from 2.8% to 65.3% in Eastern Asia, 5-66.7% in Southern Asia, 4-45.5% in Western Asia and 38.1-78.7% in Central Asian countries. Obesity, age, female gender, higher latitude, season, darker skin pigmentation, sunlight protection behaviors, less sunlight exposure and low intake of food containing vitamin D were important factors associated with lower serum vitamin D in Asia. Suboptimal vitamin D level in children may be a significant risk factor for dental caries, and requires further research to ascertain such an association in children in Asia, as well as to understand its exact influence on caries risk and development.

Vitamin D status of female UAE college students and associated risk factors.

Vitamin D deficiency is now recognized as a pandemic with implications for bone health and chronic diseases. The study investigated the vitamin D status and risk factors of subnormal serum vitamin D levels in female college students. Cross-sectional study. American University of Sharjah, United Arab Emirate. Serum 25-hydroxyvitamin D (25(OH)D) levels were measured for the participating female undergraduate college students using a radioimmunoassay kit. All participants answered a questionnaire that included 30 questions, which covered among others the demographic information, dietary intake, sun exposure and autoimmune diseases. Undergraduate college female students (n, 480), aged 18-26 years. Overall, 47.92% had suboptimal serum vitamin D levels. Results indicated that vitamin D deficiency and other health problems are prevalent among female university students. Risk factors included: wearing hijab by 37.5% of the students that might have interfered with the penetration of UVB radiation into the skin, short time sun exposure, use of sunscreens and limited intake of foods rich in vitamin D. Vitamin D deficiency is a problem in female college students due to lifestyle, and avoidance of sun exposure. Poor vitamin D status has been associated with increased risk for development of several autoimmune diseases, and other health conditions. This problem needs to be addressed, where prevention of future health consequences in this young group is still possible.

Serum vitamin C and spinal pain: a nationwide study.

Back pain brings about one of the heaviest burden of disease. Despite much research, this condition remains poorly understood, and effective treatments are frustratingly elusive. Thus, researchers in the field need to consider new hypotheses. Vitamin C (ascorbic acid) is an essential cofactor for collagen crosslinks, a key determinant of ligament, tendon, and bone quality. Recent studies have reported high frequency of hypovitaminosis C in the general population. We hypothesized that lack of vitamin C contributes to poor collagen properties and back pain. We conducted this study to examine the associations between serum concentration of vitamin C and the prevalence of spinal pain and related functional limitations in the adult general population. This study used nationwide cross-sectional data from the U.S. National Health and Nutrition Examination Survey (NHANES) 2003-2004. Data were available for 4742 individuals aged ≥20 years. Suboptimal serum vitamin C concentrations were associated with the prevalence of neck pain (adjusted odds ratio [aOR]: 1.5; 95% confidence interval [CI]: 1.2-2.0), low back pain (aOR: 1.3; 95% CI: 1.0-1.6), and low back pain with pain below knee (aOR: 1.3; 95% CI: 1.0-1.9) in the past 3 months, self-reported diagnosis of arthritis/rheumatism (aOR: 1.4; 95% CI: 1.2-1.7), and related functional limitations' score (adjusted difference of means [aB]: 0.03; 95% CI: 0.00-0.05). The prevalence of hypovitaminosis C in the general population is high. Our study shows associations between vitamin C and spinal pain that warrant further investigation to determine the possible importance of vitamin C in the treatment of back pain patients.

Effect of cholecalciferol supplementation on urine podocyte-associated messenger RNAs in patients with chronic kidney disease.

Vitamin D reduces albuminuria in patients with chronic kidney disease (CKD) but its effects on glomerular podocytes are not entirely understood. To evaluate if cholecalciferol supplementation reduces the levels of podocyte-associated urine mRNAs in patients with CKD. A total of 27 patients with stages 2 to 4 CKD and suboptimal serum vitamin D [25(OH)D] levels were treated with cholecalciferol for 6 months. Serum 25(OH)D level, estimated glomerular filtration rate (eGFR), proteinuria, and urine mRNA of nephrin, podocin, podocalyxin, transient receptor potential cation channel 6, vascular endothelial growth factor A, and transforming growth factor beta were assessed before and after intervention. eGFR declined at an average rate of -4.71 mL/min/1.73 m2 (p = 0.010 vs. baseline), being 28 ± 16 mL/min/1.73 m2 at six months. No changes in proteinuria or mineral and bone metabolism parameters were observed after cholecalciferol supplementation. Urinary podocyte-associated mRNAs did not change significantly after treatment. However, patients who achieved 25(OH)D level > 20 ng/mL at six months showed a trend of reduction of urinary nephrin and podocin mRNA levels; in patients with 25(OH)D that remained < 20 ng/mL there was a significant increase in urinary podocalyxin, and a trend of higher expression of urinary nephrin and podocin mRNA. Six months of cholecalciferol supplementation had no effect on urine podocyte-associated mRNA profile of patients with advanced CKD. The protective effect of vitamin D or its analogues on the glomerular podocyte should be investigated in early stages of CKD with a longer treatment period.

To study the masking effect of folic acid on Vitamin B12deficiency anemia

Background and Aim: A deficiency of either Vitamin B 12 or folate can lead to megaloblastic anemia. Folate and Vitamin B 12 metabolism is linked in transfer of a methyl group from N5-methyltetrahydrofolate to cobalamin. Methods: This was an observational study carried out among healthy adults (students and staff) of a medical college in rural Northwest India. Results: Despite the occurrence of suboptimal serum Vitamin B 12 in more than half of our healthy study population on one hand, we observed normal hematological variables such as hemoglobin or lack red blood cell macrocytosis (mean corpuscular volume > 100 fL) among participants as a rule. Folic acid deficiency usually coexists with that of Vitamin B 12 , and this has been reported by many studies in past. Strikingly, our study population had 16.98 ± 5.44 ng/ml as mean serum folic acid which was toward higher side of normal range. This sufficiency of folic acid in the group having suboptimal Vitamin B 12 might have masked the manifestations of Vitamin B 12 deficiency. Conclusion: The sufficiency of folic acid in the study group might have masked the overt manifestations of Vitamin B 12 deficiency.

Vitamin D Status of College Students: Implications for Health Leaders

Vitamin D Status of College Students: Implications for Health Leaders by Eileen McKenna Cress Vitamin D deficiency is considered to be a pandemic with implications for compromised bone health and other chronic diseases. Few studies have examined vitamin D status in college-aged individuals where prevention of future health consequences is still possible. Serum vitamin D 25(OH)D status and vitamin D intake were examined in 98 college students ages 18-29 years during winter. BMI was classified as < 25and 25 or greater. Race was categorized as Caucasian or other. Overall, 69.5% had suboptimal serum vitamin D levels, <30ng/mL. Only 8 students (8.2%) met the EAR (400 IU) per day for vitamin D intake. t tests were used to determine if there were significant differences in serum vitamin D level and dietary intake based on gender, race and BMI. Significant differences were found in serum vitamin D level when compared by gender and race. Females tended to have a higher serum vitamin D level than males. Those representing minorities had lower serum vitamin D levels than Caucasians; One hundred percent of the minority students had suboptimal serum vitamin D levels. Based on these findings, dietitians should increase efforts to target college-aged individuals in educational programming related to factors affecting vitamin D synthesis, vitamin D intake, and health consequences of suboptimal vitamin D status, particularly in winter. Consideration should be given to vitamin D fortification of foods that meet the preferences of today’s consumer.

Correlation between homocysteine and Vitamin B12 levels: A post-hoc analysis from North-West India

Background: Homocysteine has been shown to be a risk factor for cardiovascular disease and is a degradation product of sulfur containing amino acids. The aim of this post-hoc analysis was aimed at arriving at homocysteine levels among voluntarily consenting healthy adults in the context of other hematological parameters. Methods: The data for this post-hoc analysis were derived from an observational study carried out at a medical college in rural North-west India. Results: About 77.42% of those participants enrolled in this study having serum homocysteine level more than 30 μmol/L were seen to possess suboptimal serum Vitamin B 12 (<200 pg/ml). On subjecting data to regression analysis, serum homocysteine was observed to possess an inverse correlation with serum level of Vitamin B 12, in general. Conclusions: Hyperhomocysteinemia observed in our study was sufficiently common and wholly ascribable to low Vitamin B 12 concentration as we did not find any case of subnormal serum folic acid level.

Frail Elderly Hip Fracture Patients and Vitamin D

Background: According to Danish national guidelines, elderly should take vitamin D supplements. The aims of this study were to examine the prevalence of non-supplemented and the prevalence of suboptimal serum vitamin D level among frail elderly hip fracture patients. Furthermore, to determine the gain from serum-25- hydroxyvitamin D (25(OH)D) analysis upon admission and three months later. Methods: The subjects were frail elderly, defined as 65+ year olds living in nursing homes or sheltered housings, admitted with a hip fracture to the orthopaedic ward. We assessed vitamin D supplementation before and after hip fracture surgery and measured serum-25-(OH)D upon admission and three months later. Serum levels below 75 nmol/l were defined as suboptimal. Results: A total of 121 patients (59%) did not receive vitamin D supplements, and 73% had suboptimal levels upon admission. We found that the serum-25(OH)D level did not influence the subsequent decision of whether or not to start treatment in the non-supplemented patients. Three months after hip fracture surgery all patients that started treatment, or whose dose was increased, reached optimal vitamin D levels. Conclusions: A high percentage of frail elderly hip fracture patients did not receive vitamin D supplements. Furthermore a high percentage had a suboptimal level upon admission. Measurement of serum-25(OH)D upon admission seems unnecessary in non-supplemented patients, and may also be so three months later if compliance to vitamin D supplements is closely monitored and no antiresorptive treatment is intended.