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ObjectiveTo investigate the association between serum 25-hydroxy vitamin D [25(OH)D] and the occurrence and outcome of stroke-associated pneumonia (SAP) in patients with acute ischemic stroke (AIS) in emergency ward. MethodsThe clinical data of 256 patients with AIS from January, 2019 to December, 2021 were collected in the emergency department of Beijing Bo'ai Hospital. Blood routine, biochemical indicators and serum concentration of 25(OH)D were detected within 24 hours after enrollment; meanwhile, National Institute of Health Stroke Scale (NIHSS) and A2DS2 score were evaluated. The patients were divided into non-SAP group (n = 164) and SAP group (n = 92) according to whether pneumonia occurred during hospitalization. Multivariable logistic regression model was used to analyze the influencing factors of SAP. The predictive ability of serum 25(OH)D and A2DS2 for SAP were evaluated by receiver operating characteristic (ROC) curves. The 28-day survival of patients with SAP was followed up. Multivariable Cox proportional hazard regression model was used to investigate the association between vitamin D nutritional status and 28-day all-cause mortality. ResultsSerum 25(OH)D was significantly lower in the SAP group than that in the non-SAP group (Z = 6.896, P < 0.001). After adjusting age, sex, infarct volume, A2DS2 score and other factors, lower serum 25(OH)D level (OR = 0.934, 95%CI 0.884 to 0.986, P = 0.014) was an independent risk factor for SAP. The areas under curve (95%CI) of serum 25(OH)D, A2DS2 score and their combined model for predicting SAP were 0.774 (0.718 to 0.824), 0.832 (0.781 to 0.876) and 0.851 (0.802 to 0.893) (P < 0.001), respectively; and the optimum cut-off values were 25(OH)D < 10.2 ng/mL, A2DS2 score > 5 points, combined prediction > 0.207, and the Youden index were 0.493, 0.662 and 0.616, respectively. A2DS2 score could improve the prediction efficiency of serum 25(OH)D (Z = 2.106, P = 0.035). After adjusting age, sex, infarct volume and NIHSS score, vitamin D deficiency was an independent risk factor for all-cause mortality after 28 days of SAP (HR = 2.871, 95%CI 1.004 to 8.208, P = 0.049) . ConclusionSerum 25(OH)D is independently associated with the occurrence and outcome of SAP in patients with AIS in emergency ward, which could serve as an independent predictor for SAP.
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Background: Emerging data from in vivo and in vitro investigations have proven that Vitamin D deficiency may be a risk factor for the etiology of diabetes and its consequences; however, individual published studies have yielded conflicting results. The current study’s goal was to evaluate and correlate Vitamin D levels in the blood of diabetic patients with and without diabetic retinopathy (DR), as well as to correlate Vitamin D with duration of diabetes, age and HbA1C. Aim and Objectives: The aim of the study was to evaluate and correlate Vitamin D levels in the blood of diabetic patients with and without DR, and to correlate Vitamin D levels with age, duration of diabetes, and HbA1C. Materials and Methods: A cross-sectional case-control study of 150 Type 2 diabetes mellitus (T2DM) patients (aged 35–70 years) was included. The 150 Type 2 Diabetic patients were separated into three groups: Group 1 (no DR, n = 52), Group 2 (non-proliferative DR [NPDR], n = 58), and Group 3 (PDR, n = 42). Enrolled participants were subjected to a thorough physical examination to rule out the occurrence of microvascular problems, which included microfilament testing and a thorough fundus examination. Serum samples were used to test fasting blood sugar, HbA1C, and serum Vitamin D. Results: T2DM subjects with DR had lower mean serum 25 (OH) D concentrations than patients without DR (21.5 ± 9.5 vs. 17.7 ± 10.2 vs. 14.4 ± 5.9; P = 0.04). Mean HbA1C concentration was significantly lower in No DR (NDR) in comparison to NPDR and PDR (7.6 ± 1.5; vs. 8.5 ± 1.9; vs. 9.3 ± 1.8; P = 0.037. In addition, there was a significant negative correlation between the blood 25 (OH) D level and age (–0.165; P = 0.015), diabetes duration (–0.172; P = 0.014), and HbA1C (–0.148; P = 0.040). Conclusion: The current investigation showed that patients with DR have lower levels of 25 [OH] D than those with non DR subjects. 25 [OH] D levels were negatively associated with age, duration of diabetes, and HbA1C.
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Objective:Using 24-hour urinary sodium excretion (24h-UNa) as the surrogate measure of sodium intake, to evaluate the joint association of 24h-UNa and serum 25-hydroxy vitamin D (25-OHD) levels with the risk of albuminuria in patients with type 2 diabetes mellitus (T2DM).Methods:This retrospective study included 670 hospitalized T2DM cases in the Department of Endocrinology and Metabolic Diseases, the First Affiliated Hospital of Zhengzhou University from January 2018 to October 2021. Patients were divided into the albuminuria-positive group or negative-group according to the level of 24-hour urinary albumin excretion (24h-UAE); They were also divided into the high-sodium group or low-sodium group according to the level of 24h-UNa; Patients were divided into the low-VD group or high-VD group according to the level of 25-OHD. Combining 24h-UNa and 25-OHD, the patients were further divided into four groups: high-VD low-sodium group ( n=85), high-VD high-sodium group ( n=122), low-VD low-sodium group ( n=248), and low-VD high-sodium group ( n=215). The effect of 24h-UNa and 25-OHD association on albuminuria was analyzed by binary regression. Results:There were significant differences in 24h-UAE level among the four groups ( P<0.01), the level of 24h-UAE in the low-VD high-sodium group was significantly higher than that in low-VD low-sodium group, high-VD low-sodium group, and high-VD high-sodium group [39.00(13.00, 319.00)mg/24 h vs 22.00(10.00, 99.00)mg/24 h, 22.00(9.00, 72.50)mg/24 h, 22.45(9.69, 72.75)mg/24 h; P=0.047, P=0.019, P=0.030]. Correlation analysis showed a positive correlation between 24h-UNa and 24h-UAE in the low-VD group ( P=0.017), but not in the high-VD group ( P=0.411). Binary regression analyses showed that both 24h-UNa ( P=0.017) and 25-OHD( P=0.023) were independent risk factors for positive albuminuria in patients with T2DM. The risk of positive albuminuria in the low-VD high-sodium group was 1.789 times higher than that in the high-VD low-sodium group ( P=0.037). Conclusion:24h-UAE in T2DM patients was affected by the combination of 24h-UNa and 25-OHD. A low level of 25-OHD increased the risk of albuminuria in high sodium intake T2DM patients.
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Objective:To investigate the postoperative changes in levels of 25-hydroxy vitamin D (25-[OH]D], parathyroid hormone (PTH) and other relevant biomarkers in obese patients receiving metabolic surgery and analyze the dynamic changes in relevant biomarkers in the short term (after 3-6 months) and the long term (after 12-24 months).Methods:A total of 96 obese patients who underwent metabolic surgery and received follow-up examinations from January 2018 to January 2020 were included. Baseline and postoperative data were collected, including anthropometric data (height, weight, neck circumference, waistline and hipline) and laboratory test results (fasting glucose, glycated hemoglobin, 25-[OH)D, PTH, serum calcium and serum phosphorus). Body mass index (BMI) and waist-hip ratio were calculated. The anthropometric data were analyzed by repeated measures analysis of variance and laboratory data were compared between groups using t test and Kruskal-Wallis test. Results:96 patients (33 males and 63 females) were included, of whom 49 were complicated with diabetes. Prior to surgery, 79 (79.17%) of the patients had 25-(OH)D deficiency (< 20 μg/L), 16 (16.67%) had 25-(OH)D insufficiency (≥ 20 μg/L and < 30 μg/L) and 23 (23.96%) had high PTH levels (> 70 ng/L). After the surgery, 25-(OH)D level was transiently increased in the short term ( P = 0.01) but declined thereafter in the long term ( P < 0.01) to levels lower than baseline ( P = 0.023). Long-term PTH level was higher than baseline ( P = 0.012), with 11 patients showing PTH levels higher than normal (> 70 ng/L). Serum phosphorus level was increased in both the short term and the long term ( P < 0.01). Conclusions:Obese patients have 25-(OH)D deficiency/insufficiency before metabolic surgery and experience further decrease in the long term after surgery, despite a transient increase. Secondary increase in PTH level occurs in some of the patients after surgery. Long-term nutritional supplements and comprehensive nutritional management play important roles in postoperative management of obese patient.
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Objective:This was a retrospective study to compare the serum 25-hydroxy vitamin D [25(OH)D], retinol binding protein 4(RBP-4) and other clinical data in type 2 diabetes mellitus (T2DM) patients with or without diabetic nephropathy (DN) and to explore the clinical significance of these indicators in DN.Methods:1946 T2DM patients were enrolled in this study. The T2DM patients were divided to group with diabetic nephropathy (DN group) and without diabetic nephropathy (NDN group). According to the urine albumin to creatinine ratio (UACR), DN patients were further divided into microalbuminuria subgroup (UACR 30~300 mg/g) and massive proteinuria subgroup (UACR> /g). Clinical characteristics including serum 25(OH)D, RBP-4 and other biochemical indicators were collected.Results:Compared with NDN group, DN group showed longer disease duration, older age and higher levels of HbA1c, RBP-4, hs-CRP, TC and TG; 25(OH)D and HDL-C in DN group were lower than those in NDN group ( P<0.05). Within DN group, massive proteinuria subgroup showed higher RBP-4, younger age and lower 25(OH)D and HDL-C than microalbuminuria subgroup ( P<0.05). After adjusted for age, gender and disease duration in DN, partial correlation analysis showed that 25(OH)D is positively correlated with eGFR, and negatively correlated with RBP-4 and UACR ( P<0.05). UACR is positively correlated with RBP-4 and TC, and negatively correlated with eGFR (all P<0.05). eGFR is negatively correlated with RBP-4, TC and UACR (all P<0.05). Multivariate logistic regression showed that disease duration, HbA1c, RBP-4 and hs-CRP are risk factors for DN, and 25(OH)D is the protective factor for DN. Conclusions:Decreased 25(OH)D and increased RBP-4 are associated with increased DN risk in T2DM patients, and also associated with exacerbated albuminuria and deteriorated renal function in DN patients. There is a negative correlation between 25(OH)D and RBP-4 in DN. Therefore, it is necessary to strengthen the monitoring of serum 25(OH)D and RBP-4 and enhance vitamin D supplementation in T2DM patients to prevent the occurrence and delay the progression of diabetic nephropathy.
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Objective:To detect serum levels of vitamin A (Vit A), vitamin D(Vit D)25-hydroxy vitamin D[25-(OH)D] and vitamin E(Vit E) in children aged 0-6 years in Tibetan Plateau of Garzi Prefecture, thus providing references for physical examinations and prevention of 4 key diseases (rickets, malnutrition anemia, pneumonia and diarrhea) in children in plateau areas by relevant government departments.Methods:A total of 2 122 children who participated in physical examination in 12 townships of Xiangcheng County and 14 townships of Daocheng County, Garzi Tibetan Autonomous Prefecture, Sichuan Province from April 2017 to April 2019 with 0-6 years old were recruited for surveying physical measurements and collection of venous blood.Serum Vit A and Vit E levels were detected by high performance liquid chromatography.Serum levels of 25-(OH)D were detected by high performance liquid chromatography tandem mass spectrometry.The relationship between Vit A, Vit E and 25-(OH)D levels with the gender, age, seasonal change and altitude was analyzed.Results:The serum Vit A level, subclinical Vit A deficiency rate and marginal vitamin A deficiency rate were(1.05±0.27) μmol/L, 8.15%(173/2 122 cases) and 45.99%(976/2 122 cases), respectively in 2 122 children with 0-6 years old.There were significant differences in the serum Vit A level, the subclinical Vit A deficiency rate and the marginal vitamin A deficiency rate in children with different ages, seasons and altitudes (all P<0.05). The serum level of 25-(OH)D and 25-(OH)D deficiency rate insufficient rate were (24.65±6.45) ng/L, 6.03%(128/2 122 cases) and 16.59%(352/2 122 cases), respectively.There were significant differences in the serum level of 25-(OH)D, 25-(OH)D deficiency rate and 25-(OH)D insufficient rate in children with different ages and seasons (all P<0.05). The mean serum Vit E level, Vit E deficiency rate and Vit E insufficient rate were (7.81±1.74) mg/L, 2.78%(59/2 122 cases) and 29.59%(628/2 122 cases), respectively.There were significant differences in serum Vit E level, Vit E deficiency rate and Vit E insufficient rate in children with different ages and seasons (all P<0.05). The mean serum levels of Vit A and Vit D remained the lowest before the age of 1 year, and their deficiencies at this age were the most significant.The mean serum level of Vit E remained the lowest in >1-2 years old, and its deficiency and insufficient at this age were the most significant.Vit A, D and E levels were significantly affected by seasonal changes, which were significantly higher in the summer than in the spring, autumn and winter.In addition, Vit A and 25-(OH)D were significantly affected by the altitude, which were the lowest above 4 km altitude. Conclusions:The overall serum levels of Vit A, 25-(OH) D and E in children with 0-6 years old in Tibetan Plateau areas of Ganzi Prefecture are lower than those in plain areas.Vit A, 25-(OH) D and Vit E levels significantly differed in the age, season and altitude, which are related to the lack of local resources, insufficient maternal nutrition during pregnancy and insufficient intake after birth, as well as temperature and light caused by changes in local seasons and altitude.Therefore, it is necessary to make reasonable supplements during pregnancy to prevent vitamin deficiency.
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OBJECTIVE@#To investigate the application value of serum 25-hydroxy vitamin D [25(OH)D] in systemic lupus erythematosus (SLE).@*METHODS@#Data of 158 patients with SLE in Department of Rheumatology and Immunology in the People's Hospital of Xinjiang Uygur Autonomous Region from July 2016 to July 2019. All the SLE patients were divided into two groups by SLE scores of the disease activity index (SLEADI): 59 cases of active group (SLEADI > 4), 99 cases of non-active group (SLEDAI ≤4). Fifty healthy people were selected as healthy control group. The patients' general information and their laboratory data including serum 25(OH)D levels were collected. Statistical methods used were t-test, Spearman's correalation analysis and Logistic regression analysis.@*RESULTS@#(1) A total of 208 cases were included in this study. The level of 25(OH)D in SLE group [10.4(5.6, 15.8) μg/L] was significantly lower than that in healthy control group [25.5(22.8, 32.3) μg/L, P < 0.01]. 25(OH)D level in active SLE patients [6.2(3.7, 13.8) μg/L] was significantly lower than that in remission SLE patients [12.3(7.2, 16.7) μg/L, P < 0.01]. The serum 25(OH)D level in lupus nephritis [6.7 (4.4, 12.9) μg/L] was significantly lower than that in SLE without renal involvement [13.3 (7.4, 18.7) μg/L, P < 0.01]. (2) A significant negative correlation was demonstrated between the serum level of 25(OH)D and SLEDAI (r=-0.35, P < 0.01), and the 24h urinary protein excretion (r=-0.39, P < 0.01).Positive correlation was demonstrated between the serum level of 25(OH)D and C3 that decreased (r=0.249, P < 0.05). (3) Univariate analysis showed anti- dsDNA antibodies(ds-DNA), anti-Sm antibodies(Sm), IgG, C3, C4, erythrocyte sedimentation rate (ESR), 24h urinary protein quantification(24h-pro) and 25(OH)D were associated with disease activity in the SLE patients; Multivariate Logistic regression analysis showed that 25(OH)D was associated with the disease activity of the lupus patients.@*CONCLUSION@#The decrease of vitamin D level is related to the disease activity of SLE patients, and may be related to lupus nephritis, which plays an important role in the occurrence and development of SLE.
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Humans , Antibodies, Antinuclear , Lupus Erythematosus, Systemic , Lupus Nephritis , Vitamin D/analogs & derivativesABSTRACT
Background: Vitamin D deficiency is widely prevalent in all parts of the world. Pregnant women and neonates are highly vulnerable to vitamin D deficiency. Pregnant women receive very less amount of sunlight especially in parts of Southeast Asia due to traditional norms and customs. A strong positive correlation was found between low maternal vitamin D levels with gestational hypertension/preeclampsia, gestational diabetes mellitus, preterm labour, low birth weight, intra uterine growth restriction, neonatal intensive care unit admission and Apgar score. Therefore, the present study was designed to know the prevalence of vitamin D deficiency in pregnant females and to evaluate adverse effects associated with it.Methods: Total 250 nulliparous pregnant females attending Tirath Ram Shah Hospital for delivery and carrying a viable (>/28 weeks) singleton pregnancy were selected. Women with serum 25-hydroxy vitamin D level <10 ng/ml, 10-20 ng/ml and <20 ng/ml, were diagnosed as vitamin D deficient, insufficient and sufficient groups respectively and the adverse outcomes was correlated.Results: In this study, out of 250 cases, 159 cases (63.6%) had vitamin D deficiency, 43 cases (17.2%) had insufficiency, and 48 cases (19.2%) had sufficient vitamin D levels (vitamin D ≥20 ng/ml). And, Vitamin D deficiency was associated with preeclampsia, preterm labour and increased risk of caesarean section.Conclusions: This study indicates that vitamin D deficiency is highly prevalent in pregnant females thus implicating the need of a uniform strategy of vitamin D supplementation to pregnant females.
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Background: The study was to compare 25-hydroxy vitamin D levels in women with benign and malignant breast disease patients to the age-matched controls in a tertiary care center in North India.Methods: This was a prospective study carried out in the Department of Surgery, S.R.N. Hospital associated with M.L.N. Medical College, Allahabad. The levels of vitamin D are measured by electrochemiluminescence and the serum levels divided into normal, mild, moderate, and severe vitamin D deficiency.Results: Overall 60 patients were included. 30 was having malignant breast disease and 30 having benign breast disease. On comparing the mean value of serum vitamin D level between malignant breast disease and controls, the serum vitamin D level was found to be lesser in the former group and the difference was highly significant. On comparing the mean value of serum vitamin D level between benign breast disease and controls, the serum vitamin D level was found to be elevated in the former group, the difference was nonsignificant.Conclusions: Our study supports the hypothesis that vitamin D deficiency is an important risk factor in the development of malignant breast disease. The study was also concluded that vitamin D is not associated with the etiogenesis of benign breast diseases. There is also a possibility of using 25-hydroxy vitamin D as an adjuvant therapy during the treatment of breast malignancy.
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Background: Smoking is an essential determinant of various diseases. The study is aimed to understand the influence of smoking on serum vitamin D2/D3 levels and serum calcium levels in healthy young/middle-aged men.Methods: Prospective observational study was done among young and middle-aged healthy male smokers in a rural territory care center. Two hundred patients were studied and analyzed, who fulfill the inclusion and exclusion criteria.Results: The prevalence of vitamin D deficiency (25(OH)D <20 ng/ml) was 50.3%. Only 8.8% of the participants had vitamin D sufficiency (25 hydroxyvitamin D ?30 ng/ml). There is a strong correlation between 25(OH)D and smoking in the participants (p<0.001). 25 hydroxyvitamin D level was lower by approximately 4.3 ng/ml (p<0.001) in a smoker compared to a non-smoker among the total participants, this value increased to 9.2 ng/ml in the 40-50y subgroup (p=0.003). A multinomial logistic regression model demonstrated that a young smoker (20-29y) had a 58% increased likelihood of having vitamin D deficiency compared to a non-smoker of the same age group (p=0.041). Irrespective of age and chronicity of smoking, there was a significantly increased level of serum calcium and significant vitamin D2/D3 deficiency in smokers.Conclusion: A high prevalence of vitamin D deficiency was identified in young and middle-aged male smokers, which is not likely to be explained by other confounding lifestyle factors. The depression of the vitamin D-PTH system seen among smokers may represent another potential mechanism for the harmful effects of smoking on the skeleton
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Objective To explore the expression and significance of vitamin D (VitD) in patients with rheumatoid arthritis (RA),and analyze the relationship between its expression and clinical indicators.Methods Clin-ical parameters and laboratory examinations of RA cases (n=250) were collected.Clinical parameters included were gender,age,disease course,swollen joints number,tenderness joints number,visual analog pain score (VAS),disease activity score (DAS)28 score.Laboratory examinations included erythrocyte sedimentation rate (ESR),C-reactive protein (CRP),rheumatoid factor (RF) and anti-cyclic citrullinated peptide (CCP) antibody,antinuclear (ANA) antibody,antikeratin (AKA) antibody,anti-perinuclear factor (APF),anti-mutated citrullinated vimentin (MCV),antibody and anti-6-glucose phosphate isomerase (GPI) antibody,lymphocyte subsets in the peripheral blood and lymphocyte subsets of CD4+T cells.The level of 25-(OH)-Vit-D and clinical parameters,laboratory examinations were analyzed retrospectively.One-way ANOVA and KruskalWallis test were used for comparison among the groups;and the correlation analysis was performed by Pearson and Spearman rank correlation analysis.Results ① The level of 25-(OH) D in RA patients was significantly lower than that in healthy controls (t=11.676,P＜0.01).② According to 25-(OH)D level,RA patients were divided into the deficiency group,insufficient group and normal group,the tender joints count (x2=17.793,P＜0.001),the number of swollen joints (x2=12.635,P=0.002),ESR (F=6.330,P=0.002),VAS score (F=5.095,P=0.007,DAS28 (F=4.990,P=0.008) were different significantly amorg the three groups.③RF (x2=6.742,P=0.034) and anti-CCP antibody (x2=6.836,P=0.033) were different significantly among the three groups and the level of 25-(OH) D was negatively correlated with RF (r=-0.202,P=0.001),anti-CCP antibody (r=-0.220,P＜0.01),anti-MCV antibody (r=-0.109,P=0.002) and AKA (r=-0.215,P=0.001).④ The level of 25-(OH) D in the RF (t=-2.715,P=0.007),anti-CCP antibody (t=-2.03,P=0.044),AKA (t=-2.108,P=0.036) negative group was significantly higher than that in patients with antibody positive group.⑤ The level of Th1 (IFN-γ) cells (F=3.259,P=0.043) and Treg (CD4+CD25+Foxp3+) cells (F=4.342,P=0.031) were significantly different among the three groups and the level of 25-(OH) D was positively correlated with Treg (CD4+CD25+Foxp3+) cells (r=0.146,P=0.025).Conclusion Vitamin D is generally deficient in RA patients,which is significantly correlated with disease activity,RF,anti-CCP antibody,anti-MCV antibody,AKA and Th1,Treg cells.It is suggested that vitamin D may play an important role in the immunological pathogenesis and disease progression of RA.
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Objective To investigate the association between serum 25(OH) D levels and the inci-dence of early-onset sepsis(EOS) in the very low birth weight infants(VLBWI) and the gestational age be-low 34 weeks. Methods The cord blood of 159 VLBWI were collected between January and December 2017,including 31 clinically diagnosed EOS and 128 non-EOS patients. Serum 25(OH)D<10 ng/ml was de-fined as severe vitamin D deficiency,25(OH)D 10 to 20 ng/ml as vitamin D deficiency,25(OH)D 20 to 30 ng/ml as vitamin D insufficiency and 25(OH)D >30 ng/ml as vitamin D sufficiency. Results There were no differences in gender,gestational age,birth weight and Apgar score between the EOS group and the non-EOS group(P>0. 05). Serum 25(OH) D was(9. 08 ± 4. 21) ng/ml in the EOS group and(11. 91 ± 5. 37) ng/ml in the non-EOS group(P＝0. 007). The rate of severe vitamin D deficiency was 67. 7%(21/31)in the EOS group and 41. 4%(53/128) in the non-EOS group. The rate of vitamin D deficiency was 32. 3%(10/31)in the EOS group and 52. 3%(67/128)in the non-EOS group. But there was no difference of vitamin D deficiency distribution in the two groups(P＝0. 152). The cut-off value of serum 25(OH)D level in predic-ting EOS was 10. 06 ng/ml. Conclusion The incidence of vitamin D deficiency is as high as 95%,calling for urgent attention on vitamin D supplementation in those VLBWI. Low 25(OH)D level( <10 ng/ml)might be predictive of EOS.
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Objective: To investigate the correlation between vitamin D concentration and gestational anemia. Methods: For this study we recruited 4532 pregnant women (≤12 pregnant weeks) who received the pregnancy care in obstetrics outpatient in The First Affiliated Hospital of Xi'an Jiaotong University from December 2015 to February 2016; those with anemia were excluded. Baseline survey and follow-up till childbirth were conducted among them. We carried out a nested case-control study with a 1:2 ratio. Three hundred and eighty-eight pregnant women with anemia detected in this study served as case group, while 766 pregnant women without anemia randomly selected and matched by age (±2 years), gestational habitual residence served as control group. And t test, χ2 test, Mann-Whitney U test and logistic regression analysis were conducted to identify the association between vitamin D concentration and gestational anemia. Results: Among the 383 pregnant women with anemia, 71.5% of them had serum 25(OH)D concentration <50.0 nmol/L, while 60.1% in the control group. The difference of vitamin D level in the two groups was significant (P<0.05). Logistic regression analysis indicated that women with 25(OH)D concentration <30 nmol/L and 30-50 nmol/L had an increased risk of gestational anemia when compared with women with the concentration of 50-75 nmol/L. After adjustment for confounders, for women with concentration <50.0 nmol/L, they had an 74% (OR:1.74, 95% CI: 1.27-2.38) increase in anemia risk when compared with those with the concentration of 50-75 nmol/L. Conclusion: Vitamin D deficiency is significantly associated with gestational anemia, suggesting that we should pay attention to monitoring women's vitamin D concentration.
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Objective:To detect the serum levels of CTRP3 and 25(OH) D in the individuals with different glucose metablism states,and to discuss the influence factors and analyze their relationships with insulin resistance(IR).Methods:Forty-four patients newly diagnosed T2DM(T2DM group),42 patients with impaired glucose regulation(IGT group),and 54 cases of normal controls(normal control group) were selected.The serum CTRP3, FPG,HbA1c,FIns,TG,TC,HDL-C, LDL-C,FIns of the subjects in various groups were determined, respectively;the BMI,HOMA-IR,HOMA-β were calculated.Pearson correlation analysis was used to analyze the correlation between two factors and multivariate stepwise regression analysis was used to analyze the influencing factors of HOMA-IR and HOMA-β.Results:Compared with normal control group, the serum levels of HDL-C, 25(OH)D and HOMA-β of the patients in IGT group were significantly decreased (P<0.05); the levels of serum FPG, HbA1c, TG, TC, FIns and BMI, HOMA-IR of the patients in T2DM group were significantly increased (P<0.05), while the levels of serum CTRP3, HDL-C, 25(OH)D and HOMA-β were significantly decreased(P<0.05). Compared with IGT group, the levels of serum FPG, HbA1c, TG, FIns, and HOMA-IR of the patients in T2DM group were significantly increased (P<0.05), and the level of serum HDL-C and HOMA-β were significantly decreased (P<0.05).The serum CTRP3 level was negatively correlated with the levels of HbA1c, FIns and HOMA-IR (r=-0.391,P<0.05;r=-0.198,P<0.05;r=-0.481,P<0.05); the 25(OH)D level was negatively correlated with the TG, FPG levels and HOMA-IR (r=-0.209,P<0.05 r=-0.406, P<0.05;r=-0.306,P<0.05), and positively correlated with HOMA-β (r=0.329, P<0.05) in the different glucose tolerance individuals. HbA1c and CTRP3 were the independent influencing factors of HOMA-IR, and 25(OH)D, FPG and HbA1c were the independent influencing factors of HOMA-β.Conclusion:The serum CTRP3 and 25(OH)D levels are negatively correlated with IR,and they have the inhibitory effects in the occurrence and development of diabetes mellitns.
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Objective@#To investigate the correlation between cord blood vitamin D level and recurrent respiratory tract infection in infants.@*Methods@#From August 2014 to July 2015, 298 neonates in the Second Hospital of Jiaxing were selected in this study.The serum levels of 25-hydroxyvitamin D[25(OH)D] were measured by enzyme-linked immunosorbent assay(ELISA) in umbilical cord blood of neonates.The incidence of respiratory tract infection in infants was followed up.@*Results@#There were 53.1%(158/298) newborns with vitamin D deficiency(deficiency group), 24.8%(74/298) neonates with inadequate vitamin D(inadequate group), 22.1%(66/298) infants with adequate vitamin D(adequate group). The incidence rates of recurrent respiratory infections in vitamin D deficiency group, inadequate group and adequate group were 29.7%(47/158), 17.6%(13/74), 10.6%(7/66), respectively.The incidence of recurrent respiratory tract infection among the three groups was statistically significantly different(χ2=11.114, P=0.01).@*Conclusion@#Vitamin D nutrition level of neonates has a significant correlation with infants with respiratory tract infection, especially lower respiratory tract infection.Therefore, it is necessary to pay attention to the supplement and detection of vitamin D during pregnancy, so as to reduce the incidence of infant respiratory diseases in the region.
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ABSTRACT Objective: This study was conducted to assess the serum 25-hydroxy (OH) vitamin D levels in patients with breast cancer compared to healthy controls and to identify its association with aggressive breast cancer phenotypes. Materials and methods: Serum 25-OH vitamin D levels of 78 breast cancer patients and 78 matched healthy controls were estimated using ELISA. The cases and controls were matched with respect to age, menopausal status, parity, weight, height and co-morbidities. Prognostic factors like grade of tumour, hormone receptor status, HER2 neu status and lymphovascular invasion were compared with 25-OH vitamin D levels. Results: The mean serum 25-OH vitamin D levels of cases were significantly lower compared to the controls (22.33 ± 8.19 vs. 37.41 ± 12.9 ng/mL; p = 0.0001). Patients with higher grades of tumour, non-luminal types of breast cancer and breast cancers with estrogen receptor negativity had significantly lower serum 25-OH vitamin D levels than their opposing groups. Patients with excellent and good Nottingham's prognostic Index (NPI) had significantly higher serum 25-OH vitamin D levels than the moderate and poor NPI groups. Conclusion: Newly diagnosed breast cancer patients have significantly lower serum 25-OH vitamin D levels than healthy controls. Lower level of serum 25-OH vitamin D correlates with aggressive breast cancer phenotypes.
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Humans , Female , Adult , Middle Aged , Vitamin D/analogs & derivatives , Vitamin D Deficiency/blood , Breast Neoplasms/blood , Phenotype , Prognosis , Vitamin D/blood , Vitamin D Deficiency/complications , Breast Neoplasms/etiology , Breast Neoplasms/genetics , Case-Control Studies , Neoplasm Grading , Tertiary Care Centers/statistics & numerical data , IndiaABSTRACT
Objective To investigate the serum 25-hydroxy vitamin D concentrations and related factors in early pregnancy. Methods Plasma was collected in the first trimester from 23 396 pregnant women to inves-tigate the vitamin D level, and its distribution and differences in different age, body maxx index ( BMI) and seasons between primipara and multipara. Preterm birth was used as an indicator of clinical outcomes. Vitamin D concentrations were measured using chemiluminescence microparticle immunoassay. Results 25-hydroxy vi-tamin D level was 42. 0 (17. 6-76. 6) nmol/L in totally 23 396 pregnant women with early pregnancy, and 5% and 95% percentile sites of vitamin D level were 20. 2 nmol/L and 70. 7 nmol/L respectively. There were 18 170 (77. 7%) primiparas and 5 226 (22. 3%) multiparas, with the mean age of 30. 0 (24. 0-38. 0) years and BMI of 20. 7 (16. 5-27. 6) kg/m2. The number of cases detected in spring (March, April and May), summer (June, July and August), autumn (September, October and November months) and winter (Decem-ber, January and February) were 5 878, 5 554, 5 974, and 5 990, respectively, and the vitamin D levels were 40. 0 (29. 3, 52. 7) nmol/L, 46. 2 (35. 6, 57. 2) nmol/L, 43. 8 (33. 1, 54. 8) nmol/L and 37. 2 (26. 9, 49. 9) nmol/L respectively, with the difference in vitamin D levels statistically significant among the four seasons (P<0. 001). According to BMI, all pregnant women were divided into four groups as BMI<18. 5 kg/m2, 18. 5 kg/m2≤BMI≤23. 9 kg/m2, 24 kg/m2≤BMI≤27. 9 kg/m2, BMI≥28 kg/m2, and the levels of 25-hydroxy vitamin D were 43. 5 (30. 9, 56. 9) nmol/L, 42. 1 (30. 8, 53. 8) nmol/L, 39. 9 (30. 7, 50. 4) nmol/L and 39. 7 (30. 7, 49. 4) nmol/L respectively with the difference statistically significant among the four groups. The levels of vitamin D detected in pregnant women with age<25 years, 25~29 years, 30~34 years,≥35 years were 39. 1 ( 28. 4, 52. 3) nmol/L, 41. 3 ( 30. 1, 52. 9) nmol/L, 42. 4 ( 31. 2, 54. 1) nmol/L and 43. 8 (31. 9, 55. 7) nmol/L respectively and the difference was statistically significant (P<0. 001). The levels of 25-hydroxy vitamin D in primary and multiparas were 41. 6 (30. 2, 52. 9) nmol/L and 43. 5 (32. 5, 56. 8) nmol/L with the difference statistically significant (P<0. 001). Among women of different gestational age during childbirth, the differences in serum 25-hydroxy vitamin D in early pregnancy were not statistically significant (P=0. 121). The severe deficiency of vitamin D in early pregnancy was defined as serum level of 25-hydroxy vita-min D less than 5th level. There were statistical differences in the probability of severe vitamin D deficiency of dif-ferent ages, seasons and BMI between primiparas and multiparas. Conclusions Pregnant women of lower weight, lower age and primiparity have higher incidence of the severe vitamin D deficiency in early trimester of pregnancy. There is significant difference in 25-hydroxy vitamin D level among the different seasons (winter<spring<autumn<summer). Vitamin D level in early pregnancy is not associated with preterm birth.
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Objective To investigate the correlation of serum 25-hydroxy-vitamin D (25-OH-D) with lipid profiles in middle-aged and elderly patients.Methods A total of 284 patients aged over 40 years and admitted in our hospital from May 2016 to May 2017 were selected and divided into four groups according to 25-OH-D levels as the group of normal level which was not less than 30 ng/ml,the group of slight deficiency which was between 20 and 29 ng/ml,the group of moderate deficiency which was between 10 and 19 ng/ml,and the group of severely deficiency which was under 10 ng/ml.Fasting blood draw were taken to detect liver and renal functions,lipids,calcium,phosphorus and 25-OH-D levels.The level of lipids between groups was compared by one-way ANOVA,and the association between lipid profiles and 25-OH-D levels was assessed by Pearson correlation and multiple linear regression.Results The levels of triglyceride (TG),low density lipoprotein cholesterin (LDL-C) and total cholesterol/high density lipoprotein cholesterol (TC/HDL-C) were significantly higher and the HDL-C levels were significantly lower in the groups of severely deficiency,moderate deficiency and slight deficiency than in the normal group (P=0.035,P=0.015,P=0.013).The levels of serum 25-OH-D were significantly higher in HDL-C ≥ 1.04 mmol/L group than in H DL-C＜ 1.04 mmol/L group (Female P =0.007,male P=0.034).The correlation analysis showed that serum 25-OH-D level was positively associated with HDL-C (female r =0.309,P=0.002,male r =0.241,P=0.002).The multiple linear regression analysis showed that 25-OH-D level was positively correlated with HDL-C,after adjusting age,BMI,liver and kidney function,serum calcium and serum phosphorus (femaleβ =0.259,P =0.047,maleβ =0.217,P =0.049).Conclusion The incidence of vitamin D deficiency is high in middle-aged and elderly patients,and the level of serum 25-OH-D is positively correlated with HDL-C.
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Objective: To investigate the correlation between mild cognitive impairment (MCI) and bone metabolism level in the elderly. Methods: Fifty patients with MCI and ninety controls with normal cognitive function were recruited from Department of Gerontology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine. Plasma levels of calcium and phosphorus metabolism indicators, bone resorption markers and bone formation markers were measured. Cognitive function was assessed by mini mental state examination (MMSE) and Montreal cognitive assessment (MoCA). Results: Plasma level of osteocalcin was elevated in patients with MCI (P=0.001) compared with controls, while plasma level of calcium was decreased in the MCI group (P=0.045). Among patients with MCI, the score of MMSE positively correlated with plasma level of 25-hydroxy vitamin D3 (r=0.290, P=0.041), while negatively correlated with plasma level of parathyroid hormone (r=-0.349, P=0.025). Conclusion: MCI may be correlated with bone metabolism level in the elderly.
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Objective To investigate the relationship among retinol binding protein 4(RBP-4), 25-hydroxy vitamin D [25(OH)D]concerntrations and lower extremity arterial disease (LEAD)in type 2 diabetes mellitus (T2DM) patients. Methods A total of 197 T2DM patients and 80 healthy subjects were recruited in this study.The diabetic patients were assigned to group without complications (non-LEAD)and group complicated with LEAD (LEAD).Biochemical indications,serum RBP4 and 25(OH)D concentrations were measured. Results Serum RBP4 levels in LEAD group[(39.14 ± 2.14) μg/ml] increased as compared with that in group non-LEAD [(30.01 ± 2.09)μg/ml]and NC group [(14.09 ± 1.88)μg/ml](P<0.01).Serum 25(OH)D concentrations in LEAD group [(11.63 ± 6.83)ng/ml]were lower than that in Non-LEAD group [(18.02 ± 6.42)ng/ml]and NC group[(23.39 ± 4.68)ng/ml](P<0.05).Serum RBP-4 was positively associated with triglycerides (TG),low density lipoprotein cholesterol (LDL-C),homeostasis model assessment for insulin resistance (HOMA-IR),body mass index (BMI), waist-hip ratio (WHR)and negatively associated with 25(OH)D and high density lipoprotein cholesterol (HDL-C).Serum 25(OH)D had a negative correlation with RBP-4,HbA1c,fasting plasma glucose(FPG),HOMA-IR and duration.Logistic regression analysis showed that HDL-C and 25(OH)D were protective factors of LEAD. Conclusion Increased serum RBP-4 levels and reduced 25(OH)D concentrations are significantly associated with the occurrence of LEAD in patients with T 2DM.