VitD Deficiency Research Articles

Association Between Serum Vitamin D And TSH Status Levels And Thyroid Stimulating Hormone (TSH) In Postmenopausal Women

Introduction: Vitamin D (VitD) insufficiency is present in over half of population worldwide. Over a billion people worldwide are vitamin D deficient or insufficient. It has been long known that VitD insufficiency contributes to development of osteopenia and osteoporosis. Objective: To assess the serum vitamin D and TSH status in postmenopausal women who have undergone routine blood investigations. Methods: We performed a retrospective review of data of 61 patients in postmenopausal age group (45-75yrs) during their routine blood investigation for the first time at Dept. of Obstetrics and Gynaecology, Shaheed Tajuddin Ahmad Medical College Hospital, Gazipur, Bangladesh from January to March 2021. The data was collected from medical record section and appropriate statistical analysis was done using percentage and frequency. Results: Out of 61 patients Vitamin D was insufficient (10-30 ng/mL) in 34.4% and deficient (<10 ng/mL) in 18.0%, and remaining normal. In 4.9%, TSH was low (less than 0.3 mIU/L) and in 18.0% TSH was high (more than 4.5 mIU/L), while the remaining 77.0 had normal TSH levels (0.3-4.5 mIU/L). 54.5%(n-11) patients with high TSH, had vitamin D deficiency and 18% patients with high TSH had insufficient vitamin D. 100% (n-3) of patients with low TSH had normal vitamin D. 22 patients had normal TSH and normal vitamin D. Conclusion: Prospective longitudinal studies with larger subject numbers and more comprehensive measurement of thyroid function along with examining the indicators of innate immunity may shed light into the underlying pathophysiology and mechanisms involved in the interaction between thyroid function and VitD metabolism. High TSH levels was associated with low vitamin D levels, low TSH levels was associated with normal serum vitamin D level. Hence association was linear between TSH and vitamin D in post-menopausal women.

Relationship between serum vitamin D concentration and parameters of gonadal function in infertile male patients.

Vitamin D (vitD) deficiency could affect male reproductive function. Our objective was to investigate the relationship between serum vitD concentrations and hormonal and seminal parameters in infertile patients and to compare the results with those in healthy controls. Infertile patients (n = 29) and normozoospermic healthy donors (n = 27) were recruited for the study. Serum concentrations of vitD, total testosterone, estradiol, and sex hormone-binding globulin were determined using chemiluminescence assays, and free testosterone concentration was determined by radioimmunoassay. Semen analysis was performed as suggested by the World Health Organization. Statistical analysis was conducted using Student's t test, contingency tables, and linear regression studies. VitD concentrations were lower in patients than in controls (p < 0.001). A significant association (p < 0.001) was observed between vitD concentrations <20ng/mL and infertility. In the control group, significant correlations were reported between vitD concentrations >30 ng/mL and the concentrations of testosterone (p < 0.05), free testosterone (p < 0.01), and estradiol (p < 0.05). A direct correlation was found between vitD concentration and percentage of sperm vitality (p = 0.01). VitD also positively correlated with the percentage of progressive sperm motility (p <0.05) and sex hormone-binding globulin concentrations (p < 0.01). VitD may affect male reproductive parameters, and its deficiency could be associated with infertility.

A randomized, double-blind, placebo-controlled, 12-week trial of vitamin D augmentation in major depressive disorder associated with vitamin D deficiency

BackgroundRandomized controlled trials (RCTs) of vitamin D (VitD) supplementation for depression have yielded inconsistent results. We conducted the first RCT of VitD supplementation with multipoint serum 25(OH)D assessments in major depressive disorder (MDD) patients with concurrent severe VitD deficiency. MethodsWe randomized antidepressant-free depressed adults with mean baseline 25(OH)D of 11.5 ng/ml to VitD (60,000 IU every 5 days; n = 31) or placebo (n = 28) for 12 weeks. All patients also received escitalopram (10–20 mg/day). Patients were rated at baseline and at the end of weeks 4, 8, and 12. Serum 25(OH)D was estimated at baseline, week 8, and week 12. ResultsIn an intent-to-treat analysis, mean Hamilton Depression Scale scores dropped from 25.7 to 5.7 and from 25.8 to 5.0 in VitD and placebo groups, respectively (primary outcome; P = 0.92). VitD and placebo groups did not differ on other objective and subjective ratings of depression, or on global ratings. Similar findings characterized completer analyses. No significant correlations were observed between 25(OH)D levels and depression ratings across the course of the study. Importantly, endpoint escitalopram doses were 4 mg/day higher in placebo than in VitD patients, and 4 mg/day higher in VitD deficient than in VitD sufficient patients. LimitationsA ceiling effect with escitalopram may have prevented the discovery of benefits with VitD supplementation. ConclusionsVitD supplementation does not improve antidepressant outcomes with flexibly dosed escitalopram. VitD deficient depressed patients may require higher antidepressant doses to experience benefits similar to those whose deficiency is corrected by VitD supplementation.

Is serum vitamin D associated with diabetic retinopathy and its severity or with diabetes itself ?

ABSTRACT Clinical relevance Vitamin D (VitD) deficiency, which is found in approximately one-third of the population of the world, may play a role in the pathogenesis of diabetic retinopathy. Physicians following diabetes patients should be aware of this relationship and should refer patients to for ophthalmic care for control in a timely manner. Background Diabetic retinopathy is one of the most common complications of diabetic microvascular disease. VitD deficiency has been implicated in the pathogenesis and progression of diabetes and may have a role in development and severity of diabetic retinopathy. The aim of this study was to examine the relationship of serum VitD and some laboratory parameters with the presence of diabetes and retinopathy. Methods In this study, which has a retrospective epidemiological study design, comprehensive ophthalmologic examination data from the eye clinic, laboratory data from fasting blood tests, and internal medicine outpatient clinic examination data were reviewed. All participants were divided into four groups: 109 healthy controls, and 165 patients with type 2 diabetes of whom 54 did not have retinopathy, 64 had proliferative diabetic retinopathy, and 47 had non-proliferative diabetic retinopathy. Participants were also divided into four groups according to their serum VitD levels. Serum 25(OH)D, HbA1C, creatine, calcium, phosphate, triglyceride, low-density lipoprotein, and high-density lipoprotein levels were evaluated. Results In the whole study cohort, 152 (55.5%) were female and 122 (44.5%) were male. A statistically significant difference was observed in VitD between the healthy group and the diabetic and proliferative diabetic retinopathy groups (p ≤ 0.001). However, no significant correlation was observed between the presence of diabetes and retinopathy and serum VitD in logistic regression analyses (p > 0.05). Conclusion Diabetic patients have lower 25(OH)D than non-diabetic patients and there is no direct relationship between 25(OH)D and the development of diabetic retinopathy.

Effect of Replacement of Vit-D in Diabetic Painful Neuropathy among Chronic Type 2 Diabetic Patients

Background: Painful symptoms of diabetic neuropathy are more common in patients having type 2 diabetes. The objective in this trial was assessment of mean change in pain score upon giving Vit-D supplementation in patients with diabetic painful neuropathy.&#x0D; Methodology: This study was conducted from December 2019 to June 2020 in OPD of Fauji Foundation Hospital, Rawalpindi after the ethical approval. A total of 251 diagnosed cases of diabetes (both male and female patients), with high HbA1c and low Vit-D levels were included in the study. Patients having Vit-D deficiency and chronic diabetic neuropathy were given Vitamin supplementation and results were assessed after 1 month through change in pain score according to Douleur Neuropathique 4. A document of consent form was filled by patients who were recruited for this study. Data analysis was done on SPSS version 16.Paired sample t- test, was used to compare pain score where p value less than 0.05 was considered statistically significant.&#x0D; Results: Among the participants mean age was 48.22+17.06. There were 106 (42.2%) males and 145 (57.8%) female patients. A statistically significant (p&lt;0.05)mean reduction in pain score of 2.20±1.19 was observed, upon giving Vit-D supplementation in Vit-D deficient patients having painful diabetic neuropathy.&#x0D; Conclusion: Vit-D supplementation significantly reduced pain in patients having diabetic painful neuropathy.&#x0D; Keywords: Diabetes Mellitus, Diabetic Neuropathy, Vitamin D3

P1513: LOW VITAMIN D LEVELS ARE ASSOCIATED WITH INCREASED CARDIAC IRON UPTAKE IN THALASSEMIA MAJOR.

Background: Decreased vitamin D (VitD) levels stimulate the expression of the transmembrane L-type voltage-dependent calcium channels (LVDCC), which, in addition to calcium, absorb iron. However, there is little and controversial data on the correlation of VitD levels with cardiac iron. Aims: We investigated the association between vitamin D levels and cardiac iron and function in thalassemia major (TM) patients. Methods: We considered 278 TM patients (39.04±8.58 years, 56.8% females), consecutively enrolled in the Extension-Myocardial Iron Overload in Thalassemia Network. Myocardial iron overload (MIO) was quantified using a T2* segmental approach. Left ventricular (LV) function parameters were quantified by cine images. Measurement of serum 25(OH)D was carried out using a chemiluminescent immunoassay. Results: Vitamin D supplements were taken by 61.4% of our patients. VitD levels were deficient (<20 ng/dl) in 107 (38.5%) patients, insufficient (20–30 ng/dl) in 96 (34.5%) patients and adequate (>30 ng/dl) in 75 (27.0%) patients. Patients with deficient vitD levels were significantly younger than patients with adequate (36.96±7.64 yrs vs 41.26±8.19 yrs; P<0.0001) as well as insufficient vitD levels (36.96±7.64 yrs vs 39.63±9.39 yrs; P=0.042) while no difference was detected in male to female ratio. MIO (global heart T2*<20 ms) was significantly more frequent in patients with deficient VitD than in patients with adequate and insufficient VitD levels (Figure). Patients with deficient vitD levels had a significant higher risk of MIO than patients with adequate vitD levels (odds ratio-OR=20.62, 95%CI=2.67-153.72; P=0.004) and patients with insufficient VitD levels (OR=8.49, 95%CI=2.46-29.29; P=0.001). At receiver operating characteristic curve analysis, a vitD level≤ 17.3 ng/dl predicted MIO with a sensitivity of 81.5% and a specificity of 75.3% (P<0.0001). The area under the curve was 0.79 (95% confidence interval: 0.74–0.84). Compared to patients with normal VitD levels, patients with deficient vitamin levels showed significantly higher LV end-diastolic volume index (87.61±19.19 ml/m2 vs 79.17±14.27 ml/m2; P=0.003) and LV mass index (63.39±13.55 g/m2 vs 57.45±12.90 g/m2; P=0.006). The LV ejection fraction tended to be lower in patients with VitD deficiency, but no statistical difference versus the other groups was detected. Image:Summary/Conclusion: In thalassemia major vitamin D deficiency is associated with and increased risk of cardiac iron overload. Periodic and regular assessment of VitD levels can be useful in the prevention not only of bone disorders but also of cardiac iron accumulation and subsequent overt dysfunction.

The association between ambient UVB dose and ANCA-associated vasculitis relapse and onset

BackgroundThe aetiology of ANCA-associated vasculitis (AAV) and triggers of relapse are poorly understood. Vitamin D (vitD) is an important immunomodulator, potentially responsible for the observed latitudinal differences between granulomatous and non-granulomatous AAV phenotypes. A narrow ultraviolet B spectrum induces vitD synthesis (vitD-UVB) via the skin. We hypothesised that prolonged periods of low ambient UVB (and by extension vitD deficiency) are associated with the granulomatous form of the disease and an increased risk of AAV relapse.MethodsPatients with AAV recruited to the Irish Rare Kidney Disease (RKD) (n = 439) and UKIVAS (n = 1961) registries were studied. Exposure variables comprised latitude and measures of ambient vitD-UVB, including cumulative weighted UVB dose (CW-D-UVB), a well-validated vitD proxy. An n-of-1 study design was used to examine the relapse risk using only the RKD dataset. Multi-level models and logistic regression were used to examine the effect of predictors on AAV relapse risk, phenotype and serotype.ResultsResidential latitude was positively correlated (OR 1.41, 95% CI 1.14–1.74, p = 0.002) and average vitD-UVB negatively correlated (0.82, 0.70–0.99, p = 0.04) with relapse risk, with a stronger effect when restricting to winter measurements (0.71, 0.57–0.89, p = 0.002). However, these associations were not restricted to granulomatous phenotypes. We observed no clear relationship between latitude, vitD-UVB or CW-D-UVB and AAV phenotype or serotype.ConclusionOur findings suggest that low winter ambient UVB and prolonged vitD status contribute to AAV relapse risk across all phenotypes. However, the development of a granulomatous phenotype does not appear to be directly vitD-mediated. Further research is needed to determine whether sufficient vitD status would reduce relapse propensity in AAV.

The Association of Vitamin D and Its Pathway Genes' Polymorphisms with Hypertensive Disorders of Pregnancy: A Prospective Cohort Study.

Objective: We aimed to explore the effect of single nucleotide polymorphism (SNP) in the genes of the vitamin D (VitD) metabolic pathway and its interaction with VitD level during pregnancy on the development of hypertensive disorders of pregnancy (HDP). Methods: The study was conducted in the Zhoushan Maternal and Child Health Care Hospital, China, from August 2011 to May 2018. The SNPs in VitD metabolic pathway-related genes were genotyped. Plasma 25-hydroxyvitamin vitamin D (25(OH)D) levels was measured at first (T1), second (T2), and third (T3) trimesters. The information of systolic blood pressure (SBP) and diastolic blood pressure (DBP), and the diagnosis of HDP were extracted from the electronic medical record system. Multivariable linear and logistic regression models and crossover analysis were applied. Results: The prospective cohort study included 3699 pregnant women, of which 105 (2.85%) were diagnosed with HDP. After adjusting for potential confounders, VitD deficiency at T2, as well as the change of 25(OH)D level between T1 and T2, were negatively associated with DBP at T2 and T3, but not HDP. Polymorphisms in CYP24A1, GC, and LRP2 genes were associated with blood pressure and HDP. In addition, VitD interacted with CYP24A1, GC, and VDR genes’ polymorphisms on blood pressure. Furthermore, participants with polymorphisms in CYP24A1-rs2248137, LRP2-rs2389557, and LRP2-rs4667591 and who had VitD deficiency at T2 showed an increased risk of HDP. Conclusions: The individual and interactive association between VitD deficiency during pregnancy and SNPs in the genes of the VitD metabolic pathway on blood pressure and HDP were identified.

Vitamin D Supplementation Improves Mitochondrial Function and Reduces Inflammation in Placentae of Obese Women.

BackgroundAbout 30% of women entering pregnancy in the US are obese. We have previously reported mitochondrial dysregulation and increased inflammation in the placentae of obese women. Vitamin D (VitD) is a major player in calcium uptake and was shown to modulate mitochondrial respiration and the immune/inflammation system. Studies show decreased VitD levels in obese individuals; however, the effect of maternal obesity on VitD metabolism and its association with placental function remains understudied.MethodsMaternal and cord blood plasma and placental samples were collected upon C-section from normal-weight (NW, body mass index [BMI]<25) and obese (OB, BMI>30) women with uncomplicated pregnancies at term. We measured 25(OH)D3 (calcidiol) levels in maternal and cord blood plasma using ELISA. We assessed the expression of CYP27B1, an activator of calcidiol, and Vitamin D receptor (VDR) in placentae from NW and OB, and women with gestational diabetes and preeclampsia. In addition, we examined the effects of VitD supplementation on mitochondrial function and inflammation in trophoblasts from NW and OB, using the Seahorse Bioanalyzer and Western blot, respectively.ResultsVitamin D levels in blood from OB but not NW women and in cord blood from babies born to NW and OB women showed a significant inverse correlation with maternal pre-pregnancy BMI (r=-0.50, p<0.1 and r=-0.55, p=0.004 respectively). Cord plasma VitD levels showed a positive correlation with placental efficiency, i.e., the ratio between fetal and placental weight, as well as with maternal blood VitD levels (r=0.69 and 0.83 respectively, p<0.00). While we found no changes in CYP27B1 in OB vs. NW women, VDR expression were decreased by 50% (p<0.03) independent of fetal sex. No changes in VDR expression relative to BMI-matched controls were observed in the placentae of women with gestational diabetes or preeclampsia. Cytotrophoblasts isolated from placentae of OB women showed a dose-dependent increase in VDR expression after 24-hour treatment with calcitriol (10 nM and 100 nM), an active form of VitD. Trophoblasts isolated from OB women and treated with calcitriol improved mitochondrial respiration (p<0.05). We also found a two-fold increase in expression of the NLRP3 inflammasome and the pro-inflammatory cytokine IL-18 in trophoblasts isolated from placentae of OB women (p<0.05), with IL-18 expression being reversed by calcitriol treatment (100 nM).ConclusionsWe show that VitD deficiency is at least partially responsible for mitochondrial dysfunction and increased inflammation in the placentae of obese women. Vitamin D supplementation could be beneficial in improving placental dysfunction seen in obese women.

Evaluation of IGF-1, TNF-α, and TGF-β Gene Expression after Oral Vitamin D Supplementation in School-Aged Children with Chronic Bronchial Asthma

BACKGROUND: Airway remodeling in children with bronchial asthma is due to the effect of inflammatory mediators and growth factors on the bronchial epithelium. Vitamin D (VitD) has immunomodulatory effect in many inflammatory diseases as bronchial asthma. The ant-inflammatory and anti-fibrotic role of VitD could prevent or improve air way remodeling in asthmatic patients. AIM: The study investigated the effect of VitD supplementation on the expression of transforming growth factor-beta (TGF-β), tumor necrosis factor-alpha (TNF-α), and insulin growth factor 1(IGF-1) and to correlate them with asthma severity and level of control. METHODS: The serum level of VitD and the mRNA expression of IGF-1, TGF-β, and TNF-α were estimated in 50 patients and 20 healthy controls control subjects using quantitative PCR in real-time. Asthmatic patients with VitD deficiency received VitD supplementation for 2 months followed by remeasurement of serum VitD and the genes expression TGF-β, TNF-α, and IGF-1. RESULT: Pre-intake of VitD and serum level of VitD were lower in all patients than control subjects (p = 0.005). VitD level was directly correlated with IGF-1 mRNA expression, which was indirectly correlated with TGF-β, r = 0.5 and −0.57; p = 0.0001 and 0.002, respectively. After VitD supplementation, the expression of the TGF-β mRNA gene was the only gene that decreased significantly (p = 0.04) together with improved asthma control and spirometric parameters. CONCLUSIONS: VitD supplementation down regulated the gene expression of TGF-β and improved asthma control level, but it did not significantly affect the gene expression of TNF-α and IGF-1.

Vitamin D Status Presents Different Relationships with Severity in Metabolic-Associated Fatty Liver Disease Patients with or without Hepatitis B Infection.

Whether the associations between serum vitamin D (VitD) and metabolic-associated fatty liver disease (MAFLD) vary with chronic hepatitis B (CHB) infection has not been well established. This study aims to investigate the relationships between serum VitD and metabolism, liver fat content (LFC) and fibrosis among MAFLD patients with and without CHB. Consecutive subjects (healthy controls: 360, CHB: 684, MAFLD: 521, CHB with MAFLD: 206) were prospectively enrolled between January 2015 and December 2021. Anthropometric, laboratory, imaging, and histological evaluations were conducted, with LFC measured via magnetic resonance imaging-based proton density fat fraction (MRI-PDFF). Serum VitD levels were lower in MAFLD patients than in healthy controls and patients with CHB alone or overlapping with MAFLD (24.4 ± 8.1 vs. 29.0 ± 9.5 vs. 27.4 ± 9.6 vs. 26.8 ± 8.4 ng/mL respectively; p < 0.001 in one-way ANOVA test). After adjusting for confounding factors, including season, hypersensitive C-reactive protein, insulin resistance, liver stiffness measurements, sun exposure, exercise and dietary intake, multivariate linear regression analysis revealed that VitD remained significantly negatively correlated with LFC in MAFLD patients (β = −0.38, p < 0.001), but not in CHB with MAFLD patients. Moreover, quantile regression models also demonstrated that lower VitD tertiles were inversely associated with the risk of insulin resistance and moderate–severe steatosis in the MAFLD group (p for trend <0.05) but not in the MAFLD with CHB group. VitD deficiency was associated with the severity of metabolic abnormalities and steatosis independent of lifestyle factors in MAFLD-alone subjects but not in MAFLD with CHB subjects.

Conjunctival Histopathological Changes in Children With Vitamin D Deficiency.

The aim of this study was to investigate tear function-associated clinical findings and conjunctival histopathological changes in children with vitamin D (Vit-D) deficiency. This study used a prospective case-control design. Group 1 (n=38) comprised pediatric patients with Vit-D deficiency, and group 2 (n=45) was the control group. Tear break-up times (TBUTs), Schirmer-1 test measurements, ocular surface disease index (OSDI) scores, and conjunctival impression cytology (CIC) results of the groups were compared. The participant demographic characteristics, including the mean age and the male-to-female ratio, were similar (P>0.05). The median TBUT and Schirmer-1 test measurement were 10 s (5-15) and 12 mm (6-19) in group 1 and 11 s (6-16) and 15 mm (8-21) in group 2 (P=0.004 and P=0.013, respectively). The median OSDI scores were 16 (10-20) in group 1 and 17 (10-21) in group 2 (P=0.092). According to the CIC, 25 samples in group 1 and 40 samples in group 2 were categorized as grade 0, 11 samples in group 1 and 5 samples in group 2 were categorized as grade 1, and 2 samples in group 1 and no sample in group 2 were categorized as grade 2 (P=0.027). Significant conjunctival histopathological changes occur in children with Vit-D deficiency, and these changes have effects on some tear function-associated clinical findings including the Schirmer-1 test and TBUT measurements.

FC 126: Association Between Circulating Levels of 25-Hydroxyvitamin D and Metalloproteinase-10 (MMP 10) in Patients With Type 2 Diabetes Mellitus. Cross-Sectional Study

Abstract BACKGROUND AND AIMS Matrix metalloproteinases (MMP) play an important role in diabetic kidney disease (DKD) (1). MMP-10 levels have been shown to increase progressively starting from the early stages of DKD (2). Vitamin D (vitD) deficit is associated with a higher risk of microangiopathy in diabetes. In humans, vitD status correlates inversely with MMP-9 circulating levels and VitD supplementation is associated with a decrease in these levels (3). In vitro, studies demonstrated reduced expression of MMP-10 after an exposure to vitD (4). However, no studies have yet assessed how vitD status is related to MMP-10 circulating levels. We aimed (1) to evaluate the association between the serum levels of 25-hydroxyvitamin D [25(OH)D3] and MMP-10 in a cohort of type 2 diabetes (T2D) patients and (2) to study a potential effect of chronic kidney disease (CKD) stage or estimated glomerular filtration rate (eGFRcr) on this association. METHOD The cross-sectional association between MMP-10 and 25(OH)D3 levels (&amp;gt;30 ng/mL, normal; 20–30 ng/mL, insufficiency; &amp;lt;20 ng/mL, deficiency; and relevant cut-offs 45 and 15 ng/mL) was investigated, by multivariate linear regression analysis after MMP-10 logarithm transformation, in 256 T2D patients recruited (2009–2016) in the Clinica Universidad de Navarra (Spain). Study protocol was approved by the Ethical Committee (2021.183TFG). Covariates were smoking habit, body adiposity percentage estimated by CUN-BAE formula, CKD stage and vitD3 supplement use. Age and sex were already included in the CKD-EPI formula. Interactions and collinearities were also analysed. Statistical analysis was performed using STATA software and two-tailed P-values &amp;lt;0.05 were considered statistically significant. RESULTS Characteristics of patients are given in Table 1. VitD deficit was significantly (P &amp;lt;0.001) more prevalent in patients with CKD (61%) compared with those without CKD (40%). MMP-10 showed a significant negative correlation with 25(OH)D3 (rho = –0.246; P &amp;lt;0.001), which remained significant including only CKD patients (rho = –0.283; P &amp;lt;0.001) and stronger above 45 ng/mL (rho = –0.7308, P &amp;lt;0.001) or moderate between 30 and 45 ng/mL (rho = –0.3290, P = 0.0045) (Fig. 1). In the fully adjusted model, MMP-10 was negatively associated (P = 0.019) with severe vitD deficiency [estimated coefficient –0.86 (–0.76 to –0.97)]. There was no interaction between covariates and 25(OH)D levels and collinearities were also discarded. CONCLUSION In T2D patients, circulating MMP-10 was inversely associated with serum 25(OH)D3 levels, especially in those patients with CKD and at the extremes of vitD level range. These results suggest that higher values of 25(OH)D3 should be targeted in these patients. The efficacy of vitD supplementation in reducing circulating MMP-10 levels should be further examined.

Correlation of vitamin D with clinical, biochemical and anthropometrical parameters of PCOS patients

Objective: To find correlation of 25-hydroxy vitamin D (25OHD) levels with various clinical biochemicals, anthropometric parameters in patients of PCOS. Study design: Cross-sectional observational study. Materials and Methods: The study was conducted at Obstetrics and Gynaecological dept. of Jawaharlal Lal Nehru medical college, AMU, Aligarh, for a period of 2 years, 2018-2020. A total number of 100 PCOS patients satisfying inclusion criteria were enrolled for the study. Frequency of Vit-D deficiency in study group was estimated. Correlation of Vit-D levels with various clinical, anthropometrical, biochemical parameters was evaluated. Based on Vit –D levels the study population was divided in to Vit-D deficient and non-deficient individuals and Paired sample t-test was used to assess changes in quantitative variables. Pearson product moment co-relation analysis was used to see correlation among different variables. Qualitative variables were interpreted using Chi square test. Statistical analysis was performed using computer program SPSS version 25.0. Observations and Results: The results of 100 PCOS patients were analysed. Vit-D deficiency was found in 74% of PCOS population. Vitamin D correlated inversely with LH, FSH Prolactin and Testosteron levels (r=-0.213, p&lt;0.05,r=-0.176;p&gt;0.05,r=-0.101;p&gt;0.05; r = 0.246, p&lt;0.01).)Though significant correlation was found with LH and testosteron only.

The relationship between vitamin D deficiency, body composition, and physical/cognitive functions.

SummaryVitamin D deficiency is still an important subject due to its significant effects on various tissues and functions. We found a relationship between vitamin D deficiency and increase in adipose tissue thicknesses. This situation reveals the importance of vitamin D supplementation, the harms of weight gain and obesity, and the importance of a balanced diet. PurposeAlthough the relationship between vitamin D (VitD) levels with body composition and physical/cognitive functions have been investigated in various studies, however, there is no study evaluating all these parameters together. In accordance with, we aimed to evaluate the relationship between VitD deficiency with body composition (i.e., skin, subcutaneous fat, and muscle thicknesses) and physical/cognitive functions. MethodsA total of 203 adults (78 M, 125 F, aged 19–91 years) who had recent 25-OH-vitamin D measurements were included. Ultrasonographic (US) measurements (skin, subcutaneous fat, and muscle thicknesses) were made from the dorsum of the hand, and anterior sides of forearm, arm, and thigh. Handgrip strength, gait speed, Timed Up and Go Test, and Chair Stand Test were evaluated. Additionally, cognitive status was also evaluated with Mini-Mental State Exam.ResultsSubjects were classified as VitD deficient group (< 20 ng/ml, N = 125) and control group (≥ 20 ng/ml, N = 78). The groups were not significantly different as regards age, gender, and anthropometric measurements (all p > 0.05). Subcutaneous fat tissues were thicker in the VitD deficient group (all p < 0.05). All the other US measurements and functional/cognitive tests were not significantly different between the groups (all p > 0.05). According to linear regression analyses, body mass index (BMI) was independently related with all subcutaneous fat thicknesses in both genders, and VitD deficiency was related with all subcutaneous fat thicknesses in females and anterior forearm subcutaneous fat thickness in males (all p < 0.05).ConclusionWe imply that together with BMI, VitD deficiency is independently related with increased regional subcutaneous fat tissue. We also underscore the role of US measurements for evaluation of body composition in related clinical scenarios.

IDF21-0399 Association between Diabetic Peripheral Neuropathy and Vitamin D Deficiency in Georgian Patients with T2D by Sudoscan

Background: Diabetic peripheral neuropathy (DPN) is one of the major chronic complications of diabetes and leading high-risk factor of foot ulcers/amputations. Its early detection/management is therefore of primary importance. About 60-70% of diabetic patients will eventually develop DPN. The cause of diabetic neuropathy is multifactorial, including poor diabetes control, diabetes duration, metabolic/vascular factors, etc. Vitamin D (VitD) deficiency is a common global public health problem. VitD deficiency contributes significantly to pathogenesis of both types of diabetes by impairing insulin secretion and increasing insulin resistance. Aim: Our aim was to assess correlation between serum levels of 25(OH) VitD and DPN in Georgian patients with type 2 diabetes mellitus (T2DM). Method: Patients supervised and treated at our Center were selected; 80 T2DM patients (35 males and 45 females) with previously diagnosed DPN and VitD deficiency were enrolled in this study and comprised the Study Group/SG; their mean age was 45±5 yrs and diabetes duration varied from 5 to 10 yrs. Age and diabetes duration match 50 patients (22 males and 33 females ), without previously diagnosed DPN and normal VitD level were used as controls (CG). HbA1c in SG was 8.3±1.5% and in CG – 7.4±1.4%. Neurological tests and examinations with Sudoscan (a non–invasive method for the assessment of the small fiber function, Impeto Medical, France) were performed in all the patients. In the SG results of all neurological tests (monofilament test, tip-term/temperature test, vibration test) were positive, Sudoscan examination revealed presence of small fiber neuropathy in these patients. In CG patients all neurological tests were performed and all, except Sudoscan, were negative; while Sudoscan revealed presence of small fiber neuropathy in this group as well. Vitamin D was measured in both groups. Results: Comparison of the data obtained for the SG and CG showed that VitD concentration was significantly lower in T2DM patients with DPN (both large and small fiber), than in patients with only small fiber DPN and normal VitD levels. In 76 out of 80 SG patients the levels of 25(OH) VitD were low (<20 ng/ml); while in 44 out of 50 patients in the CG they were within the normal range (30-50 ng/ml). Discussion: This study showed that VitD deficiency is present in Georgian patients with DPN; it may play significant role in development of DPN; normalization and control of VitD level may prevent progression of the peripheral nerve damage. Thus, it is relevant to regularly check VitD levels and maintain them within the normal range. Observations will continue.

Effects of Vitamin D Supplementation and 25-Hydroxyvitamin D Levels on the Risk of Atrial Fibrillation

The effects of vitamin D (Vit-D) deficiency and Vit-D treatment (VDT) on atrial fibrillation (AF) remain inconclusive. This study sought to determine the effects of VDT and nontreatment on AF risk in Vit-D-deficient patients without a previous history of AF. In this nested case-control study, 39,845 individuals with low 25-hydroxy-Vit-D ([25-OH]D) levels (<20ng/ml) were divided into group-A (untreated, levels ≤20ng/ml), group-B (treated, levels 21 to 29ng/ml), and group-C (treated, levels ≥30ng/ml). The risk of AF was compared utilizing propensity score-weighted Cox proportional hazard models. Among the individuals receiving VDT for ≥6months, the risk of AF was significantly lower in group-B (hazard ratio [HR] 0.89, 95% confidence interval [CI] 0.80 to 0.98, p=0.03] and group-C (HR 0.84, 95% CI 0.73 to 0.0.95, p=0.007] than in group-A. A subgroup analysis of men >65years showed individuals with hypertension had a significantly lower risk of AF in group-C than in group-B (HR 0.79, CI 0.65 to 0.94, p=0.02) and group-A (HR 0.78, CI 0.64 to 0.96, p=0.012). A similar result was found in men >65years with diabetes mellitus in group-C compared with group-B (HR 0.69, CI 0.51 to 0.93, p=0.012) and group-A (HR 0.63, CI 0.47 to 0.84, p=0.002). In what is, to best of our knowledge, the largest observational study to date of patients with Vit-D deficiency and no previous history of AF, (25-OH)D level of >20ng/ml with VDT for ≥6months was associated with a significantly lower risk of AF. Additionally, men >65years with hypertension or diabetes mellitus had a further decrease in AF risk when the (25-OH)D levels were ≥30ng/ml.

Vitamin D Related Gene Polymorphisms and Cholesterol Levels in a Mediterranean Population.

In addition to its role in bone health, vitamin D (VitD) has been implicated in several pathological conditions. Specifically, VitD deficiency has been linked to an increased risk of dyslipidemia. Atherogenic dyslipidemia is characterized by increased low-density lipoprotein-cholesterol (LDL-C) and decreased high-density lipoprotein-cholesterol (HDL-C). In this study, we examined the association of six single nucleotide polymorphisms (SNPs) in VitD-related genes with VitD and lipid levels, in a cohort of 460 Lebanese participants free from chronic diseases. Our results showed no association of the examined SNPs with VitD concentrations. However, the presence of the minor allele in rs10741657G>A of CYP2R1 was associated with increased levels in LDL-C (β = 4.95, p = 0.04)] and decreased levels in HDL-C (β = −1.76, p = 0.007)]. Interestingly, rs10741657G>A interacted with gender to increase LDL-C levels in females (β = 6.73 and p = 0.03) and decrease HDL-C levels in males HDL-C (β = −1.09, p = 0.009). In conclusion, our results suggest that rs10741657 G>A in CYP2R1 is associated with circulating LDL-C and HDL-C levels in a Lebanese cohort. Although this association was gender-specific, where rs10741657G>A was associated with increased LDL in females and decreased HDL in males, the presence of the minor allele A was associated with increased cardiovascular risk in both genders. These findings need to be validated in a larger population. Further investigations are warranted to elucidate the molecular mechanism of VitD polymorphism and dyslipidemia.

Assessment of awareness level of pregnant women about vitamin D and its relation to pregnancy at a tertiary care centre

Vitamin D deficiency (VDD) during pregnancy has been associated with multiple adverse outcomes of pregnancy like preeclampsia, gestational diabetes mellitus, low birth weight, preterm delivery, and cesarean section. Vitamin D deficiency (VDD) is higher in females especially during pregnancy, breast feeding &amp; child bearing age. Studies have reported VDD during pregnancy ranging from 14% to more than ninety percent in our country. Several factors like age, nutrition, socio-cultural practices, geographical conditions etc. contribute to vitamin D deficiency. The lack of awareness about vitamin D is one of the biggest factors. To assess the level of awareness about Vitamin D and its relation to pregnancy among pregnant ladies. This cross-sectional study was conducted on 280 pregnant females using a self administered questionnaire. The awareness level of participants was labeled as Poor, Average &amp; Good according to the marks obtained. Statistical analysis was done using Excel Analysis Toolpak. The age of participants ranged from 19 years to 34 years (mean 24.85 ± 2.98). Majority of the participants were in the age group 20-25 years (66.79%). Most of the participants were living in rural areas (77.5%) while 22.5% belonged to urban areas. The mean score of all the participants was 6.25 with SD 2.29. Educational status showed a linear relationship with the awareness level. There is a lack of awareness about vitamin D. Awareness campaigns will reduce vit-D deficiency and improve pregnancy outcomes.

Relationship Between Vitamin D Status and Brain Perfusion in Neuropsychiatric Lupus.

Neuropsychiatric manifestation of lupus (NPSLE) is related with vitamin D (vit-D) deficiency which is possibly amenable to supplementation. This study was done to explore link of serum vit-D level and clinical mini-mental state examination (MMSE) with brain perfusion SPECT (BS) in patients with NPSLE. Patients who underwent BS with the diagnosis of NPSLE and had serum levels of vit-D and MMSE within a span of 1 month were retrospectively included. The BS DICOM data were used to generate 3D surface images of brain for visual identification of regional hypoperfusion, and the z-scores from eZIS software and then to perform voxel-based regression analysis in order to explore association between serum vit-D level and cerebral perfusion deficit using SPM8. Distribution of serum vit-D level was checked across MMSE and BS z-score using R. A total 19 patients with means ± SD age of 28.4 ± 9.2 years, having mean levels of serum vit-D of 18.7 ± 9.8 ng/ml and mean MMSE scores 24.2 ± 1.6, had undergone BS. The eZIS-derived z-score fall in the category of normal in six (31.6%), mild perfusion deficit (PD) in 10 (52.6%) and moderate PD in three (15.8%) with the means ± SD of z-score being 0.52 ± 0.2, 1.72 ± 0.2, and 2.33 ± 0.2. Voxel-based analysis revealed significant positive correlation between vit-D level and hypoperfusion in brain regions related to cognitive function (p<0.05). Serum vit-D levels were significantly lower in NPSLE patients with lower MMSE scores as well as in higher eZIS z-score (p < 0.01). Our results may support the utility of vit-D supplementation in NPSLE and applicability of BS as a clinical adjunct for monitoring response to vit-D supplementation.