VitD Levels Research Articles

Translating vitamin D transcriptomics to clinical evidence: Analysis of data in asthma and chronic obstructive pulmonary disease, followed by clinical data meta-analysis

Vitamin D (VitD) continues to trigger intense scientific controversy, regarding both its bi ological targets and its supplementation doses and regimens. In an effort to resolve this dispute, we mapped VitD transcriptome-wide events in humans, in order to unveil shared patterns or mechanisms with diverse pathologies/tissue profiles and reveal causal effects between VitD actions and specific human diseases, using a recently developed bioinformatics methodology. Using the similarities in analyzed transcriptome data (c-SKL method), we validated our methodology with osteoporosis as an example and further analyzed two other strong hits, specifically chronic obstructive pulmonary disease (COPD) and asthma. The latter revealed no impact of VitD on known molecular pathways. In accordance to this finding, review and meta-analysis of published data, based on an objective measure (Forced Expiratory Volume at one second, FEV1%) did not further reveal any significant effect of VitD on the objective amelioration of either condition. This study may, therefore, be regarded as the first one to explore, in an objective, unbiased and unsupervised manner, the impact of VitD levels and/or interventions in a number of human pathologies.

The Potential Protective Role of Vitamin D Supplementation on HIV-1 Infection.

HIV infection remains a global and public health issue with the incidence increasing in some countries. Despite the fact that combination antiretroviral therapy (cART) has decreased mortality and increased the life expectancy of HIV-infected individuals, non-AIDS conditions, mainly those associated with a persistent inflammatory state, have emerged as important causes of morbidity, and mortality despite effective antiviral therapy. One of the most common comorbidities in HIV-1 patients is Vitamin D (VitD) insufficiency, as VitD is a hormone that, in addition to its physiological role in mineral metabolism, has pleiotropic effects on immune regulation. Several reports have shown that VitD levels decrease during HIV disease progression and correlate with decreased survival rates, highlighting the importance of VitD supplementation during infection. An extensive review of 29 clinical studies of VitD supplementation in HIV-infected patients showed that regardless of cART, when VitD levels were increased to normal ranges, there was a decrease in inflammation, markers associated with bone turnover, and the risk of secondary hyperparathyroidism while the anti-bacterial response was increased. Additionally, in 3 of 7 studies, VitD supplementation led to an increase in CD4+ T cell count, although its effect on viral load was inconclusive since most patients were on cART. Similarly, previous evidence from our laboratory has shown that VitD can reduce the infection of CD4+ T cells in vitro. The effect of VitD supplementation on other HIV-associated conditions, such as cardiovascular diseases, dyslipidemia or hypertension, warrants further exploration. Currently, the available evidence suggests that there is a potential role for VitD supplementation in people living with HIV-1, however, comprehensive studies are required to define an adequate supplementation protocol for these individuals.

Vitamin D deficiency associated with Crohn\u2019s disease and ulcerative colitis: a meta-analysis of 55 observational studies

PurposeTo investigate the association of serum levels of 25(OH)D and 1,25(OH)2D3 in healthy and non-healthy controls with Crohn’s disease (CD) and ulcerative colitis (UC).MethodsThree electronic databases: PubMed, EMbase and EBSCOhost CINAHL, were searched for observational studies to measure the relationship between serum levels of vitamin D (VitD) and CD (or UC).ResultsFifty-five studies were included in the meta-analysis. We found that mean serum 25(OH)D levels in patients with CD were significantly lower than those in healthy controls (MD: − 3.17 ng/mL; 95% CI − 4.42 to − 1.93). Results from the meta-analysis examining 1,25(OH)2D3 levels in Crohn’s patients revealed higher levels in the CD group than in healthy (MD: 3.47 pg/mL; 95% CI − 7.72 to 14.66) and UC group (MD: 5.05 pg/mL; 95% CI − 2.42 to 12.52). Serum 25(OH)D levels were lower in the UC group than in the healthy control group (MD: − 2.52 ng/mL; 95% CI − 4.02 to − 1.02). In studies investigating the level of 1,25(OH)2D3 in UC and healthy control groups, the level of 1,25(OH)2D3 in the UC groups were found to be higher than that in the control groups (MD: 3.76 pg/mL; 95% CI − 8.36 to 15.57). However, the 1,25(OH)2D3 level in patients with UC was lower than that in CD groups (MD: − 6.71 pg/mL; 95% CI − 15.30 to 1.88). No significant difference was noted between CD patients and UC patients in terms of average serum 25(OH)D levels.ConclusionsThis study found that VitD levels were inversely related to CD and UC. Serum levels of 25(OH)D were lower in patients with CD and UC than in healthy people, and more than half of the patients had insufficient vitamin D levels. The serum level of 1,25(OH)2D3 in both the CD and UC groups was higher than that in healthy people.

Is There Any Correlation Between The Grade of Coronary Collaterals and Vitamin D Levels In Patients with Coronary Chronic Total Occlusion?

Objective: There have been studies which revealed a possible relation with the grade of coronary collateral circulation (CCC) and the level of Vitamin D in the literature. The objective of this study was to assess whether there is a correlation between the grade of CCC and the level of Vitamin D according to both Rentrop and Werner classifications in patients with coronary chronic total occlusion (CTO) who underwent percutaneous coronary intervention. Material-Method: The present study is a single-centre, retrospective cohort study. A total of 101 consecutive patients, who were hospitalized to undergo coronary CTO procedure, were enrolled in the study. The patients were classified into 3 groups with regard to the grade of CCC according to both Rentrop and Werner classifications. These groups were compared with each other according to the 25(OH)VitD3 levels. Results: There was no significant difference among 3 groups with regard to 25(OH)VitD3 levels when the patients were classified according to the Rentrop classification [Rentrop 1: 15.7 ng/ml (7.0-77.0 ng/ml), Rentrop 2: 16.9 ng/ml (7.0-71.3), Rentrop 3: 16.6 ng/ml (7.0-28.7), p=0.925]. Moreover, there was no significant difference among 3 groups with regard to 25(OH)VitD3 levels when the patients were classified according to the Werner classification. [Werner 0: 19.6 ng/ml (7.0-77.0 ng/ml), Werner 1: 16.6 ng/ml (7.0-71.3), Werner 2: 17.0 ng/ml (7.0-28.3), p=0.411]. Conclusion: We deem that there may not be a direct correlation (one-to-one relationship) between the level of 25(OH)VitD3 and the grade of CCC in clinical practice.

Distinct Association of Serum Vitamin D Concentration with Disease Activity and Trough Levels of Infliximab and Adalimumab during Inflammatory Bowel Disease Treatment

Background: Studies of serum vitamin D (Vit-D) levels in patients with inflammatory bowel disease (IBD) treated with anti-tumor necrosis factor-alpha (anti-TNF-α) agents are scarce. The conjunction of Vit-D as well as zinc levels and anti-TNF-α-trough concentrations (TC) has not yet been explored. Objectives: To determine the association of serum Vit-D, zinc and C-reactive protein (CRP) levels with clinical and biochemical remission and a possible correlation with serum TC and antibody levels of anti-TNF-α. Methods: Serum Vit-D and zinc levels as well as Infliximab (IFX) and Adalimumab (ADA) TC during the maintenance phase of treatment were measured in 112 IBD patients. Statistical analysis were performed for clinical and biochemical remission. Results: Vit-D and zinc deficiency were detected in 58 and 4.5% of the patients respectively. In IFX-treated patients, IFX-TC, Vit-D and CRP levels were associated independently with clinical remission with an OR of 20 (95% CI 1.3–333, p = 0.03), 1.3 (95% CI 1.1–1.7, p = 0.02) and 0.4 (95% CI 0.2–0.8, p = 0.01) respectively. Serum IFX-TC and Vit-D levels correlated positively (r = 0.39, p = 0.001), while serum IFX-TC and CRP levels showed an inverse correlation (r = –0.43, p < 0.001). Only ­IFX-TC associated independently with biochemical remission with a threshold of 3.1 µg/mL. In ADA-treated patients, ADA-TC associated independently with clinical and biochemical remission with an OR of 2.5 (95% CI 1.1–5.0, p = 0.04) and 1.3 (95% CI 1.1–1.4, p = 0.03) respectively. The serum zinc level was associated neither with clinical nor with biochemical remission in either cohort. Conclusions: Our results indicate that serum Vit-D level may be a predictive marker in addition to drug trough levels in IBD patients treated with IFX. Furthermore, due to the correlation between serum IFX and Vit-D levels, Vit-D substitution should be conducted in patients with low Vit-D levels.

Vitamin D and LL-37 in cirrhotic patients with culture-positive spontaneous bacterial peritonitis

EnBackground and aimsSpontaneous bacterial peritonitis (SBP) is a common bacterial infection in patients with liver cirrhosis and ascites. Cirrhotic patients frequently have vitamin D (Vit-D) deficiency. Vit-D induces the production of LL-37, an important molecule of innate immunity, in macrophages. The aim of this study is to assess Vit-D and LL-37 levels in the ascitic fluid (AF) of cirrhotic patients with SBP in comparison to patients with simple ascites.Patients and methodsForty male cirrhotic patients with ascites were included and were divided into two groups, 20 with culture-positive SBP (group I) and 20 with simple ascites (group II). AF Vit-D and LL-37 levels were measured.ResultsVit-D and LL-37 levels were significantly lower in patients with SBP than those with simple ascites. In univariate analysis, the risk factors for SBP were lower platelet count, higher leukocytic count, higher serum bilirubin, lower prothrombin activity, lower serum albumin, higher Child–Pugh and model for end-stage liver diseases scores, and lower AF Vit-D and LL-37 levels, while in multivariate analysis, a lower AF Vit-D level was the only risk factor for SBP.ConclusionPatients with SBP have lower levels of AF Vit-D and LL-37 than simple ascites, where an inadequate expression of LL-37 in AF due to the low Vit-D level may increase the susceptibility to SBP.

Vitamin D: A New Perspective in Treatment of Cerebral Vasospasm After Subarachnoid Hemorrhage

Abstract INTRODUCTION Cerebral vasospasm (CVS) is a severe complication after subarachnoid hemorrhage (SAH). We explored vitamin D (VitD) as a possible therapeutic option for CVS. METHODS Between 2007 and 2015, 25-vitaminD3 (VitD3) levels and data of SAH patients admitted during the months with a peak vs nadir of VitD3-values were analyzed, retrospectively. Furthermore, VitD3 and vasospasm/outcome data in SAH patients admitted in 2017 were correlated prospectively. A mice SAH model and cell culture studies were used to determine the involved mechanisms of 1,25-dihydroxy-vitaminD3. RESULTS A significant lower vasospasm rate and improved outcome in SAH patients admitted in summer as compared to winter time was identified by the retrospective analysis. In the SAH mouse model, active 1,25-VitD3 attenuated CVS development, as determined by vessel diameter of basilar artery (BA) and reduced neurological deficit. 1,25-VitD3 attenuated the inflammation of the BA in response to blood. Deletion of the myeloid or endothelial VitD-receptor decreased the protective 1,25-VitD3 effect. Co-culture of myeloid and endothelial cells with blood confirmed the anti-inflammatory effect of 1,25-VitD3 and revealed a selective induction of SDF1a, VEGF, and eNOS. In mice, SDF1a mimicked the protective 1,25-VitD3 effect. In patients, high VitD3 levels were associated with a significant higher rate of favorable outcome, prospectively. CVS severity was inversely correlated with the VitD level. Patients with severe CVS exhibited attenuated expression of SDF1a on myeloid cells. CONCLUSION 1,25-VitD3 attenuates CVS after SAH. VitD chould be tested as potential treatment option to prevent CVS after SAH.

Vitamin D Deficiency and Its Response to Supplementation as “Stoss Therapy” in Children with Cyanotic Congenital Heart Disease Undergoing Open Heart Surgery

Abstract Background Data from many studies suggest that patients with congenital heart disease are vitamin D (vitD) deficient. Following cardiac surgery as a result of intraoperative institution of cardiopulmonary bypass (CPB), serum vitD levels become even low. This may affect postoperative convalescence in terms of mechanical ventilation, inotropic support, infection, and so forth. Objective We intended to study the prevalence of vitD deficiency pre and post cardiac surgery and the effect of vitD supplementation (stoss therapy) on postoperative convalescence of the children with tetralogy of Fallot (TOF) undergoing intracardiac repair (ICR). Methodology In this randomized controlled trial (RCT), 60 children younger than 18 years with TOF and serum vitD levels &lt; 20ng/dL were randomized into two groups. The study group received vitD supplementation as “stoss therapy” at 10,000 units/kg body weight. All these children underwent ICR with CPB. Demographic data, preoperative, intraoperative, and postoperative variables were compared between the study and the control groups. Results Prevalence of severe vitD deficiency was 93.1%. When compared with the control group, study group showed higher serum vitD levels in the immediate preoperative period (p = 0.001), postoperative period following CPB (p = 0.012), and on the first postoperative day (p = 0.003). No statistically significant difference was observed in postoperative mechanical ventilation (p = 0.35), intensive care unit (ICU) stay (p = 0.15), and inotropic duration (p = 0.19). Conclusion Children with TOF are highly deficient of vitD, its level falls further after CPB, and supplementing vitD preoperatively does not influence postoperative recovery pattern. Supplementation of vitD as “stoss therapy” was useful in raising the serum levels before and after cardiac surgery.

Determinants of the magnitude of response to vitamin D supplementation in adolescent girls identified using a decision tree algorithm.

Vitamin D (VitD) supplementation is an inexpensive and effective approach for improving VitD insufficiency/deficiency. However, the response to supplementation, with respect to the increase in serum 25(OH)D level varies between individuals. In this study, we have assessed the factors associated with the response to VitD supplementation using a decision-tree algorithm. Serum VitD levels, pre- and post-VitD supplementation was used as the determinant of responsiveness. The model was validated by constructing a receiver operating characteristic curve. Serum VitD at baseline levels was at the apex of the tree in our model, followed by serum low-density lipoprotein cholesterol and triglyceride, age, waist-hip ratio, and high-density lipoprotein cholesterol. Our model suggests that these determinants of responsiveness to VitD supplementation had sensitivity, specificity, and accuracy, 59.4, 75.8 and 69.3%, respectively. The decision tree model appears to be a relatively accurate, specific, and sensitive approach for identifying the factors associated with response to VitD supplementation.

Cardiac autonomic dysfunctions are recovered with vitamin D replacement in apparently healthy individuals with vitamin D deficiency.

Vitamin D (VitD) has important prohormone functions in a wide range of clinical processes. Although it is known that individuals with VitD deficiency have cardiac autonomic dysfunction, there are no convincing data regarding the effect of VitD replacement. We aimed to evaluate the impact of VitD replacement on cardiac autonomic dysfunction. Fifty-two apparently healthy subjects with VitD deficiency and 50 healthy control subjects were enrolled. Prior to VitD replacement, 24-hr Holter recordings were obtained, and HRV parameters were recorded. VitD levels were measured 2months later after replacement, and control 24-hr Holter recordings were analyzed. The mean age of the patients was 36.04±7.6years, and 53.9% were female. SDNN (68.58±13.53 vs. 121.02±27.45ms, p=.001), SDANN (95.96±22.26 vs. 166.48±32.97ms, p=.001), RMSSD (23 vs. 59ms, p<.001), and PNN50 (6.5% vs. 36%, p<.001) were significantly lower in patients with VitD deficiency compared with the control group. HRV parameters were improved after VitD replacement [SDNN (68.58±13.53 to 119.87±28.28ms, p<.001), SDANN (95.96±22.26 to 164.44±33.90ms, p<.001), RMSSD (23 to 58ms, p<.001), and PNN50 (6.5 to 33%, p<.001)]. The present study suggested that VitD deficiency was significantly correlated with impaired cardiac autonomic functions assessed by parameters of HRV, and cardiac autonomic dysfunction improved after VitD replacement in otherwise apparently healthy individuals.

When Less or More Isn't Enough: Renal Maldevelopment Arising From Disequilibrium in the Renin-Angiotensin System.

Environmental and nutritional factors during fetal and neonatal life can have long-lasting effects on renal functions and physiology and susceptibility to kidney disease in adulthood. All components of the renin-angiotensin system (RAS) are highly expressed in the kidneys during the period of renal development. The RAS plays a central role in the regulation of various cellular growth factors and stimulates adhesion molecules and cellular migration. The use of antagonists of this system during fetal development represents a major risk factor for hypertension, renal vascular dysfunction, and kidney medulla atrophy in adulthood. The inappropriate activation of the RAS by vitamin D (VitD) deficiency has been studied in recent years. Clinical and experimental studies have demonstrated an inverse relationship between circulating VitD levels and blood pressure, plasma and renin activity, and an increase in angiotensin II and the receptor AT1. These data raise new questions about the importance of the integrity of the RAS during development since RAS pathway inhibitors and VitD deficiency have opposing functions. This is a literature review on the possible mechanisms by which antagonists of the RAS and VitD deficiency during fetal development provoke disturbances in kidney structure and function. Potential mechanisms are presented and discussed, and the possible pathways by which an imbalanced maternal RAS may negatively impact fetal development and have consequences in adulthood are also explored.

STUDY OF THE SERUM LEVELS OF VITAMIN D AND CALCIUM IONIZED IN THYROID DISORDERS

Background&#x0D; Vitamin D deficiency is a global health problem, and its role as an immune modulator has been recently tightened. The main role of vitamin D is to maintain calcium and phosphorus homeostasis, thus maintaining bone health. Recent evidence has shown that vitamin D may play a role in a variety disorders such as endocrine diseases, adrenal diseases, polycystic ovary syndrome and particular type 1 diabetes, type 2 diabetes. We evaluated the association between thyroid disorders (subclinical or overt hypothyroidism and subclinical or overt hyperthyroidism) and serum vitamin D3 level in the Indian population and its association with ionized calcium.&#x0D; Methods&#x0D; The cross-sectional study, included patients who visited Shree Krishna Hospital, Karamsad for thyroid evaluation or follow-up. We conducted this study involving a total of 84 individuals with normal thyroid function, were recorded as control. The cases group included 75 patients with hypothyroidism (overt or subclinical) and 10 patients with hyperthyroidism (overt or subclinical). Serum levels of vitamin D3, thyroid function and calcium ionized were measured in all adult subjects. Deficiency of vitamin D is defined as the level of vitamin D3 in the serum less than 50 nmol/L. Vitamin D insufficiency is defined as serum vitamin D3 level between 50 - 75 nmol/L. Vitamin D sufficiency is defined as serum Vit D3 level &gt;75 nmol/L.&#x0D; Result &#x0D; The prevalence of vitamin D deficiency in subclinical and clinical hypothyroidism cases (36 of 40, 90%) was significantly higher than that observed in healthy individuals (0 of 40, 0%). The prevalence of vitamin D deficiency in subclinical and clinical hyperthyroidism cases (4 of 40, 10%). The prevalence of vitamin D insufficiency in subclinical and clinical hypothyroidism cases (24 of 62, 38.7%) was significantly lower than that observed in healthy individuals (controls) (35 of 62, 56.5%).The prevalence of vitamin D insufficiency in subclinical and clinical hyperthyroidism cases (3 of 62, 4.8%). The prevalence of vitamin D sufficiency in subclinical and clinical hypothyroidism cases (15 of 67, 22.4%) was significantly lower than that observed in healthy individuals (controls) (49 of 67, 73.1 %). The prevalence of vitamin D sufficiency in subclinical and clinical hyperthyroidism cases (3 of 67, 4.5%).&#x0D; Conclusion &#x0D; Vitamin D deficiency was associated with hypothyroidism especially clinical hypothyroidism. Low serum levels of vitamin D3 were associated with high serum TSH levels.&#x0D; Keyword: Vitamin D3, calcium ionized, hypothyroidism and hyperthyroidism.

Effect of Treating Vitamin D Deficiency in Uncontrolled Type 2 Diabetes: A Randomized, Placebo-Controlled Study.

Literature increasingly supports the inverse relationship of vitamin D (VitD) level and type 2 diabetes (T2DM). Proposed protective mechanisms of VitD include its anti-inflammatory effects, increased insulin secretion via pancreatic β-cell stimulation, and downregulation of parathyroid hormone levels. Interventional studies show mixed results of VitD therapy in prediabetic patients with VitD deficiency or diabetic patients with normal VitD levels. Does high-dose VitD replacement improve glycemic control and microalbuminuria (MAU) in uncontrolled T2DM and concurrent VitD deficiency? This placebo-controlled, double-blinded study randomized 30 subjects aged 30-65 years with an elevated HbA1c level of 7.5%-10% and a low total 25-hydroxyvitamin-D value of <20 ng/mL to either placebo (n = 16) or ergocalciferol 50,000 IU (n = 14) once weekly for 8 weeks then once monthly for 4 months. Primary outcome was difference in HbA1c from baseline to month 6 between the VitD-intervention group and the placebo-controlled group. Secondary end points were differences in total 25-hydroxyvitamin-D and MAU. Paired t tests and linear mixed-effects models were used for statistical analysis. No significant differences were seen in HbA1c or MAU between baseline versus postintervention visits within the placebo group (HbA1c: 8.4% ± 0.2 vs. 8.1% ± 0.3, P = 0.088; MAU: 94.1 mg/g ± 43.9 vs. 45.9 mg/g ± 20.2, P = 0.152) and the intervention group (HbA1c: 8.8% ± 0.3 vs. 8.7% ± 0.4, P = 0.692; MAU: 167.8 mg/g ± 70.1 vs. 108.5 mg/g ± 39.9, P = 0.356). The difference between placebo-slope and intervention-slope was nonsignificant for MAU (β = -0.1 mg/g ± 0.4, P = 0.835) but was significant for total 25-hydroxyvitamin-D (β = 11.7 ng/mL ± 2.5, P ≤ 0.001). Greater HbA1c reduction occurred unexpectedly in the placebo group ((Equation is included in full-text article.)= -0.4% ± 0.2) than in the intervention group ((Equation is included in full-text article.)= -0.2% ± 0.4), although the difference in slopes was not significant (β = 0.2% ± 0.4, P = 0.640). Our proof-of-concept study found no benefit of high-dose VitD therapy in glycemic control and MAU in uncontrolled T2DM and VitD deficiency. Post hoc analyses raise concerns for high-dose VitD therapy to delay glycemic improvement. Large-scale interventional trials are much needed in this patient population to substantiate our findings and elucidate VitD's mechanisms on glucose metabolism.

RELEVANCE OF WELL DEFINE LABORATORY TESTS MEMORY PANEL IN DEMENTIA WORKUP

To study associations between antinuclear antibodies (ANA), CRP, Vit D, Vit b12 and homocysteine level in patient with memory loss. There has been stigmatic approach to patients with memory loss as every elderly patient with memory loss get Alzheimer's disease by default, it not common for patients to ask do I have Alzheimer's. A consecutive cohort of 182 patients to present to neurology clinic was included; Set of blood test and Montreal Cognitive Assessment (MoCA) screening for the work of neurological complaint. ANA profiles were determined by line immunoassay with titer> 1:40 with positive and type, Vit B12 level < 300, VitD level <30, CRP>.05 Homocystine level >12 were positive. MoCA score of < 26 was MCI 25-20, 20–15 moderate & <15 sever memory loss. This data provides evidence that patients’ Vitamin B12 levels are significantly correlated with their homocysteine levels (t = −3.6375, df = 13, p-value = 0.003008). For every 1 umol/L increase in homocysteine, there is a 6.652 pg/mL decrease in Vitamin B12. In addition, Homocysteine levels are significantly linearly related with their MoCA scores (t = −3.9187, df = 141, p-value = 0.0001383). For every 1 umol/L increase in Homocysteine levels, there is a .25025 decrease in MoCA scores. In terms of Vitamin D, the data provides evidence that patients’ Vitamin D levels are significantly correlated with their MoCA scores (t = 2.6162, df = 44, p-value = 0.01214). For every 1 increase in Vitamin D, there is a 0.3455 increase in MoCA scores. Mean MoCA score for patients who are ANA positive is significantly less than 26 (t = −2.6437, df = 17, p-value = 0.008532). The memory blood panel work up should include the most cost effective way and should lead the physicians to invest time in treatable cause of the memory loss in early age dementia. The above results show direct correlation with memory loss and deficiency of Vit B12, Vit D and increase Blood homcysteine level.

RELATIONSHIP BETWEEN THE LEVELS OF VITAMIN D IN ELDERLY ADULTS WITH MILD COGNITIVE IMPAIRMENT AND DEMENTIA IN A TERTIARY CARE HOSPITAL

The prevalence of Vit-D deficiency in older adults with cognitive impairment is approximately 70% to 90%. Likewise, epidemiological studies have shown that low levels of Vit-D in the blood are associated with an increased risk of Alzheimer's disease (AD) and dementia. Primary objective: To determine the relationship between Vitamin D deficiency with mild cognitive impairment and dementia in patients over 65 years of age. Secondary Objectives. Describe the clinical and sociodemographic characteristics of patients with vitamin D alterations. Cross-sectional study was carried out in the cognition clinic of the Institute of Medical Sciences and Nutrition Salvador Zubirán. Patients with a diagnosis of Mild Cognitive Impairment, dementia and patients without cognitive impairment (controls) were included. They will have a determination of 25-Hydroxy vitamin D. Three categories were formed according to their level:> 20ng / ml normal, 12-20ng / ml mild deficiency and <12ng / ml severe deficiency. ANOVA was used to analyze continuous variables and non-parametric test according to the variable studied. By means of post hoc analysis, differences between groups were analyzed. Finally, a correlation analysis was performed using the Spearman rho coefficient between cognitive performance and vitamin D levels. The statistical package SPSS version 22 was used. 200 patients were evaluated, of which 31 belonged to the control group, 85 to the group with MCI and 84 to the dementia group. In the three groups were more women than man, in the control group showed statistically significant difference in mean age (p <0.01), year of education (p = 0.04) and functionality (p <0.01). In the group of severe deficiency there was worse performance, in the executive functions and the evocation. The correlation for executive functions was 0.250, p = <0.001, Pearson's correlation for vitamin D and total Mini-mental score was 0.203, p = <0.005. There is a relationship between vitamin D deficiency and global cognitive functioning. Likewise, severe deficiency affects specific domains of memory (evocation and executive functions).

Severe obesity and vitamin D deficiency treatment options before bariatric surgery: a randomized clinical trial

BackgroundObesity, which has various complications and co-morbidities, is an epidemic issue worldwide. Vitamin D deficiency (VDD) is a well-known metabolic disorder among patients with severe obesity. While they are good candidates for bariatric surgery, this deficiency can affect the outcome of surgery negatively. ObjectivesThe aim of this study was to compare 3 different VDD treatment strategies for use before bariatric surgery and compare serum vitamin D levels after 7 weeks. SettingsUniversity hospital, Isfahan, Iran. MethodsThis was a single-blinded, randomized clinical trial on 100 patients who were referred for bariatric surgery from 2016 to 2018. Vitamin D (VitD) level was checked before surgery for the patients included in the study, if their VitD level was <30 ng/mL. We rechecked their serum VitD in the 8th week, after 7 weeks of treatment. The participants were randomly allocated into 3 groups: 33 patients were treated with 50,000 units VitD3 capsules every week for 7 weeks; 33 patients were treated with a single dose of 300,000 units VitD3 ampoule; and 34 patients were treated with a combination of a half of the injection dose, followed by the oral capsule for 4 weeks. ResultsNo case was lost during the follow-up time. No significant differences were found among the 3 groups in terms of their age (P = .654), body mass index (P = .434), sex (P = .799), initial 25(OH) VitD level (P = .273), and history of supplement use (P = .45). Mean serum VitD levels were 15.21, 13.16, and 13.37 ng/mL, respectively, before the surgery and reached 32.91, 24.74, and 29.49 ng/mL after 7 weeks of treatment in oral, injection, and combined groups, respectively. Finally, the 7-week oral treatment option had significantly higher levels of VitD (P value = .034). ConclusionVDD treatment with 50,000 units VitD3 capsule every week for 7 weeks before bariatric surgery yields a higher level of VitD. Based on our findings, injectable supplements are not recommended for VDD treatment.

Dietary vitamin D improves performance and bone mineralisation, but increases parasite replication and compromises gut health in Eimeria-infected broilers

Coccidial infections reduce fat-soluble vitamin status and bone mineralisation in broiler chickens. We hypothesised that broilers infected with Eimeria maxima would benefit from increased dietary supplementation with vitamin D (vitD) or with 25-hydroxycholecalciferol (25(OH)D3 or 25D3). Broilers were assigned to diets with low (L) or commercial (M) vitD levels (25 v. 100 μg/kg) supplemented as cholecalciferol (D3) or 25D3. At day 11 of age, birds were inoculated with water or 7000 E. maxima oocysts. Pen performance was calculated over the early (days 1-6), acute (days 7-10) and recovery periods (days 11-14) post-infection (pi). At the end of each period, six birds per treatment were dissected to assess long bone mineralisation, plasma levels of 25D3, Ca and P, and intestinal histomorphometry. Parasite replication and transcription of cytokines IL-10 and interferon-γ (IFN-γ) were assessed at day 6 pi using quantitative PCR. Performance, bone mineralisation and plasma 25D3 levels were significantly reduced during infection (P < 0·05). M diets or diets with 25D3 raised plasma 25D3, improved performance and mineralisation (P < 0·05). Offering L diets compromised feed efficiency pi, reduced femur breaking strength and plasma P levels at day 10 pi in infected birds (P < 0·05). Contrastingly, offering M diets or diets with 25D3 resulted in higher parasite loads (P < 0·001) and reduced jejunal villi length at day 10 pi (P < 0·01), with no effect on IL-10 or IFN-γ transcription. Diets with M levels or 25D3 improved performance and mineralisation, irrespective of infection, while M levels further improved feed efficiency and mineralisation in the presence of coccidiosis.

Sexually Dimorphic Effects of Dietary Vitamin D3 Supplementation on Cognition and the Gut Microbiome in Aging Rats (P14-006-19)

ObjectivesIncreasing evidence suggests that vitamin D plays a role in maintaining cognitive function and that vitamin D deficiency may accelerate age-related cognitive decline. Here, we determined if a long-term enhanced vitamin D (VitD3, cholecalciferol) diet, higher than the standard dietary level, maintains or improves cognitive function in aging male and female rats. We also examined if the high VitD3 diet affected the gut microbiome. MethodsBeginning at 12 months of age 20 male and 20 female F344 rats were fed an AIN-93 diet containing either standard (1000 IU/kg diet) or higher (10,000 IU/kg) VitD3 for 6 months. The Morris water maze (MWM) was then used to assess learning and memory. Following the MWM, the gut microbiome from undigested chyme collected from the intestinal cecum was identified and taxonomically classified by Argonne National Laboratory using 16S rRNA sequences. ZRT Laboratory determined 25-(OH)VitD3 levels from cardiac blood. A two-way ANOVA and Tukey post-hoc was used to test for statistical significance. ResultsAfter 3 days of training the probe test on day 4 indicated that the higher VitD3 diet significantly reduced path length and latency (P = 0.01) to the digital platform in females but not males. On day 5 platform location was changed and animals received one day of reversal training. On day 8, three days after reversal training, the reversal probe indicated that higher dietary VitD3 improved performance in males but not females by significantly reducing path length and latency to the digital platform (P < 0.05). Analyses of the cecal microbiome content indicated that for numerous bacteria sex specific differences were present. Further, the Shannon Diversity Index of the gut microbiome indicated a significant treatment effect of higher dietary VitD3 in females (P = 0.01). The higher VitD3 diet significantly elevated 25-(OH)VitD3 blood levels. ConclusionsThese results indicate that a high VitD3 diet may preserve cognitive acuity during aging. Further, VitD3 may have sexually dimorphic effects on memory formation. The present results replicate our previous study that a high VitD3 diet preserves cognition in aging male rats (Latimer et al. 2014). The microbiome showed sexually dimorphic differences and the high VitD3 diet appeared to affect the microbiome in females more than males. The significance of this is not clear. Funding SourcesNIA, NIDDK.

The vitamin D paradox: high prevalence of deficiency in sunny Athens (Greece)

There is a universal hype regarding vitamin D (vitD) and a belief that we are over-screening and over-treating population for vitD deficiency, especially in Athens, one of the sunniest cities in Europe. We studied 271 postmenopausal women (mean age: 67.3 years old) who had been referred for vitD level assessment to the microbiology lab of Peristeri’s Health Center during a period of three months (January–March 2017). The mean serum 25-hydroxy vitD [25-(OH)D] was 16.53±6.41 (ng/mL), which was unexpectedly low for a population living in a Mediterranean region, while a significant proportion of postmenopausal women in Athens appeared to suffer from hypovitaminosis D, varying from 39.5% to 92.2%, depending on the cut-off values we utilise to define the vitD deficiency. These data justify screening of perimenopausal women for vitD deficiency, as they indefinitely consist a high-risk group.

Catalase but not vitamin D receptor gene polymorphisms are associated with nonsegmental vitiligo in Northwestern Mexicans.

Vitiligo is an acquired pigmentation disorder characterized by melanocyte loss via autoimmune mechanisms triggered by oxidative stress. Gene polymorphisms in antioxidant enzymes and immunomodulators such as catalase (CAT) and vitamin D receptor (VDR), respectively, have been linked to vitiligo in European and Asian populations. Our aim was to evaluate the role of CAT and VDR gene polymorphisms as well as CAT and vitamin D in nonsegmental vitiligo in Northwestern Mexicans. A total of 357 subjects, 173 nonsegmental vitiligo patients and 184 age-gendermatched healthy controls, were genotyped by PCR-restriction fragment length polymorphism. CAT activity was determined in 39 patients and in 39 controls and vitamin D (VitD) levels in 35 individuals per group. CAT 419 C/T gene polymorphism was not informative, -89 A/T was associated with risk (P=0.02), and 389 C/T conferred protection against vitiligoalong with AT haplotype (P<0.01 in both cases). VDR BsmI, ApaI, and TaqI gene polymorphisms were not associated with vitiligo, but BsmI was more prevalent in patients with Koebner phenomenon (P=0.02). Serum CAT activity and VitD levels were lower in patients than in controls, but they showed no association with any vitiligo clinical characteristics neither with their gene polymorphisms. Our results suggest a role for CAT gene polymorphisms in vitiligo susceptibility in the Mexican population and a lack of association with VDR gene polymorphisms.