Serum 25-hydroxyvitamin D levels in patients with slipped upper femoral epiphysis - A physiological pre-disposition for an anatomical disorder?

Background: Slipped upper femoral epiphysis (SUFE) is a common adolescent hip disorder with a multifactorial etiology affecting the growth plate. 25-hydroxy (OH) Vitamin D has a main role in maintaining adequate bone mineralization. There are only few studies in India that relates the association between SUFE and serum 25(OH)vitamin D deficiency. Aim and Objective: The objective of the study was to estimate the serum levels of 25(OH)vitamin D in diagnosed cases of SUFE and to compare the levels with healthy controls. Materials and methods: Our study was a case–control study conducted in a tertiary care center. The Institutional Ethics Committee approved the study. Serum 25(OH)vitamin D levels in a total of 40 subjects including 20 confirmed cases of SUFE and 20 healthy controls were estimated and statistical analysis was carried out. Results: Serum 25(OH) vitamin D levels were found to be decreased in SUFE cases when compared to control group and the difference is statistically significant with P < 0.001 by independent t-test. Conclusion: Our study establishes the need for estimation of serum 25(OH) vitamin D levels in diagnosed cases of SUFE and adequate correction of the deficiency in its management.

Vitamina d, sus acciones "no clásicas" y su utilidad en la pandemia del covid-19 / Vitamin d, its "non-classic" actions and it utility in the covid-19 pandemic

RESUMEN El descubrimiento de que la síntesis de 1,25 vitamina D no fue solo renal, la enzima 1 alfa hidroxilasa se encuentra en numerosos tejidos del organismo, además de la evidencia de que la asociación entre el déficit de vitamina D y la presencia de enfermedades no óseas (cáncer, esclerosis múltiple, enfermedades autoinmunes, etc.) nos ofrece la posibilidad de intentar prevenir estas afecciones. Los estudios de suplementación contra placebo no han dado resultados positivos para algunas afecciones, aunque algunos de esos trials se realizaron en población "suficiente" y no "deficiente" de vitamina D. Sin embargo, otros metaanálisis han demostrado prevención en los grupos suplementados con déficit para algunas patologías (infecciones respiratorias, prediabetes). Además, existe evidencia de efecto antiviral de la misma. La acción antiinfecciosa e inmunomoduladora que ejerce y su efecto sobre el sistema renina angiotensina, estimulando la enzima convertidora de angiotensina 2 (que es el receptor virus del SARS-CoV), permiten sospechar, actualmente, que con niveles elevados podría ser más difícil, o menos grave, la infección por COVID-19. La suplementación con vitamina D es conveniente para prevenir enfermedades en sujetos con déficit, pero en medio de la grave pandemia 2020 administrarla, aún sin tener un dosaje previo en las poblaciones de mayor riesgo, podría disminuir la chance de esta enfermedad.

ABSTRACT The discovery that the synthesis of 1-25-vitamin D is not only renal and that the enzyme 1 alpha hydroxylase is found in numerous tissues of the body, together with the evidence of the association between vitamin D deficiency and the presence of non-bone diseases (cancer, multiple sclerosis, autoimmune diseases, etc.), gives us the possibility of trying to prevent these conditions. Placebo-controlled supplementation studies have not provided positive results for certain conditions, but some of these trials have been carried out on populations with "sufficient" and not "deficient" vitamin D levels. However, other meta-analyses have shown prevention of some conditions (respiratory infections, prediabetes) in groups of patients with deficiencies who were given supplements. There is also evidence of antiviral effect of vitamin D. Its anti-infective and immunomodulatory action and its effect upon the renin-angiotensin system, stimulating the angiotensin-converting enzyme 2 (the SARS-CoV virus receptor), nowadays allow us to think that, in high levels, COVID-19 infection could be less likely or serious. Vitamin D supplementation is adequate for preventing diseases in patients with deficiencies; administering vitamin D within the 2020 pandemic, even without having tested it in high-risk populations, could diminish the incidence of this disease.

Vitamin D and non-alcoholic fatty liver disease in children / 国际儿科学杂志

Objective The aim of this study was to explore the serum 25-(OH) Vitamin D and its correlation with liver function in children who have suffered from non-alcoholic fatty liver disease (NAFLD),and to explore the necessity of vitamin D treatment of NAFLD in children.Methods Forty children with NAFLD diagnosed by imaging were selected from the outpatient of pediatric digestive department of Shengjing Hospital of China Medical University,selected as observation group from July 2017 to August 2019,and 37 healthy children were selected as control group.The clinical data were collected and serum 25-(OH) Vitamin D were detected at the same time.Results There was no significant difference in 25-(OH) Vitamin D among children with NAFLD at different ages and gender (P ＞ 0.05).The level of 25-(OH) Vitamin D in children with NAFLD [(21.30 ±8.77) μg/L]was significantly lower than that in the control group [(28.53 ± 10.18) μg/L] (t =3.343,P ＜ 0.01).The incidence of vitamin D deficiency (＜ 20 μg/L) and insufficiency (＜30 μg/L)in children with NAFLD (35/40 =87.50％) was significantly higher than that in the control group (22/37 =59.46％) (x2 =10.035,P ＜ 0.05).Serum 25-(OH) Vitamin D was negatively correlated with fasting insulin (r =-0.464,P ＜ 0.01) and homeostasis model assessment of insulin resistance (r =-0.444,P ＜0.01),but not correlated with BMI,transaminase level (ALT,AST),uric acid and blood lipid (TG,TC,HDL-C,LDL-C,sd-LDL,Apo-A1,Apo-B).Vitamin D deficiency was the risk factor of NAFLD (OR =1.088,P ＜ 0.01).Conclusion Vitamin D deficiency is common in pediatric NAFLD,which may be a risk factor of NAFLD.The mechanism may be that vitamin D deficiency aggravates insulin resistance and further aggravates liver damage in children with NAFLD.

Is there an association between vitamin D and risk of stroke?: a North Indian study

Background: Vitamin D deficiency is present in India in epidemic proportions despite plenty of sunshine. Reduced plasma 25(OH) D concentrations as a diagnostic marker of vitamin D deficiency have been in past decade associated with several well-established risk factors for ischaemic stroke, such as arterial hypertension, thrombosis, atherosclerosis. The aims and objectives of this study was to compare the serum 25(OH) D levels between the first ever acute stroke patients and healthy controls.Methods: A cross-sectional, case control study was conducted in a tertiary care hospital in New Delhi situated in north India. Serum 25‑hydroxyvitamin D (25(OH) D) levels in 85 patients of ischemic stroke, presenting within 7 days of onset of stroke was measured and was compared with 70 age and gender matched controls.Results: The mean age was 61.02±11.58 years and 58.63±11.28 years in cases and controls respectively. Females constituted 37.6% of the total number of cases and 43.4% of the controls. The age and gender-distribution were comparable between the cases and controls. The median value (IQR) of serum 25(OH) vitamin D level was 7.94 ng/mL (4.59-14.00) in the cases and it was 8.82 ng/mL (5.59-14.70) in the controls. The difference between the serum 25(OH) vitamin D levels of the two groups was not found to be statistically significant.Conclusions: There is a high prevalence of biochemical hypo-vitaminosis D in apparently healthy Indians of all age and sex groups despite adequate sunshine. There is no association between low vitamin D levels and stroke.

Association of vitamin D deficiency with early onset sepsis in term neonates

Background: Vitamin D is a fat-soluble steroid hormone. Vitamin D also has immunomodulatory effects on immune function. Early onset sepsis (EOS) is characterized by signs and symptoms of infection with or without accompanying bacteremia in the first three days of life. The objective of the study was to determine the possible association between neonatal vitamin D levels and EOS in term neonates.Methods: 100 term neonates with clinical and laboratory findings of EOS (study group) and 100 healthy infants with no signs of clinical/laboratory infection (control group) were enrolled. Sera was drawn during first 3 postnatal days of life in both groups for measurement of 25-hydroxyvitamin D (25-OHD) levels.Results: Neonatal 25-OHD levels (17.4ng/dL) in the study group were significantly lower than those of the control group (26.8 ng/dL) (p=0.001). In present study negative correlation was found between vitamin D level and CRP.Conclusions: Lower neonatal 25-OHD levels are associated with EOS. Adequate vitamin D supplementation during pregnancy may be helpful to prevent EOS in term neonates.

Correlation between serum 25(OH) vitamin D and liver fat content in nonalcoholic fatty liver disease / 南方医科大学学报

OBJECTIVE@#To investigate the relationship between serum 25(OH) vitamin D and liver fat content in nonalcoholic fatty liver disease (NAFLD).@*METHODS@#A total of 120 patients with NAFLD admitted in our hospital between June and August, 2017 were enrolled and divided into 4 groups with different serum 25 (OH) vitamin D levels: >75 nmol/L (group A, =25), 50-75 nmol/L (group B, =35), 25-50 nmol/L (group C, =32), and < 25 nmol/L (group D, =28). For all the patients, serum 25 (OH) vitamin D level was measured by ELISA, and liver fat content was determined using in-phase opposed-phase TWI sequences. The measurement data were compared among the 4 groups to assess the association between serum 25(OH) vitamin D level and liver fat content.@*RESULTS@#The liver fat content appeared to be higher in group B (28.66±6.45%) and group C (38.74±11.47%) than in group A (22.79 ± 6.10%), but the difference was not statistically significant (>0.05); the liver fat content in group D (54.79 ± 5.28%) was significantly higher than that in the other 3 groups (>0.05). Liver fat content increased significantly as serum 25(OH) vitamin D level decreased, showing an inverse correlation between them in these patients ( < 0.05, =-0.125).@*CONCLUSIONS@#In patients with NAFLD, a decreased serum 25(OH) vitamin D level is associated with an increased liver fat content, suggesting the value of serum 25(OH) vitamin D as a predictor of NAFLD.

Normal physiological functions in two animal species with highly different vitamin d status compared to that of humans / Funciones fisiológicas normales en dos especies animales con estatus de vitamina d muy diferentes del actual en seres humanos

Mole rats live in permanent darkness, in networks of underground tunnels (which extend up to 1 km in the subsoil), excavated with their incisors, in warm and semi-arid areas of South Africa. Mole rats have an unusually impoverished vitamin D3 status with undetectable and low plasma concentrations of 25- hydroxyvitamin D3 and 1α,25-dihydroxyvitamin D3, respectively. They express 25-hydroxylase in the liver and 1-hydroxylase and 24-hydroxylase in their kidneys. The presence of specific receptors (VDR) was confirmed in the intestine, kidney, Harderʼs glands and skin. In spite of their poor vitamin D3 status, the apparent fractional intestinal absorption of calcium, magnesium and phosphate was high, always greater than 90%. Oral supplementation with cholecalciferol to mole rats did not improve the efficiency of gastrointestinal absorption of these minerals. Mole ratsdo not display the typical lesion of rickets: hypertrophic and radiolucent growth cartilages. Histological studies reported normal parameters of trabecular and cortical bone quality. Marmosets (monkeys of the New World) are not hypercalcaemic, eventhough they exhibit much higher levels of 25-hydroxyvitamin D3, 1α,25-dihydroxyvitamin D3 and parathyroid hormonethan that of rhesus monkeys and humans. Fed a high vitamin D3 intake (110 IU/day/100 g of body weight), a fraction of the experimental group was found to display osteomalacic changes in their bones: distinct increases in osteoid surface, relative osteoid volume, and active osteoclastic bone resorption. These findings suggest that some marmosets appears to suffer vitamin D-dependent rickets, type II. The maximum binding capacity of the VDR or the dissociation constant of VDR1α,25(OH)2D3 complex of mole rats and New World monkeys are distinctly different of VDR isolated from human cells. Health status of those species appears to be adaptations to the mutations of their VDR. Though rare, as mutations may occur at any time in any patient, the overall message of this review to clinicians may be: recent clinical studies strongly suggests that the normality of physiological functions might be a better indicator of the health status than the serum levels of vitamin D metabolites. (AU)

Las ratas topo viven en la oscuridad permanente, en redes de túneles subterráneos excavadas con sus incisivos (que se extienden hasta 1 km en el subsuelo), en áreas cálidas y semiáridas de Sudáfrica. Las ratas topo tienen un estatus de vitamina D3 inusualmente empobrecido con concentraciones plasmáticas indetectables de 25-hidroxivitamina D3 y bajas de 1α, 25-dihidroxivitamina D3. Poseen 25-hidroxilasa en el hígado y 1-hidroxilasa y 24-hidroxilasa en sus riñones. La presencia de receptores específicos (VDR) ha sido confirmada en el intestino, el riñón, las glándulas de Harder y la piel. A pesar de su pobre estatus de vitamina D3,la absorción fraccional intestinal aparente de calcio, magnesio y fosfato fue alta, siempre superior al 90%. La suplementación oral con colecalciferol a las ratas topo no mejoró la eficacia de la absorción gastrointestinal de estos minerales. No muestran la lesión típica del raquitismo: cartílagos de crecimiento hipertróficos y radiolúcidos. Varios estudios histológicos confirman los hallazgos radiológicos y se informan parámetros normales de la calidad ósea trabecular y cortical. Los titíes (monos del Nuevo Mundo) exhiben calcemias normales con niveles más elevados de 25-hidroxivitamina D3, 1α,25-dihidroxivitamina D3 y hormona paratiroidea que los monos rhesus y los seres humanos. Un tercio de un grupo de titíes alimentados con una alta ingesta de vitamina D3 (110 I/día/100 g de peso corporal) exhibió cambios osteomalácicos en sus huesos: aumento en la superficie osteoide, volumen osteoide y activa reabsorción osteoclástica. Estos hallazgos sugieren que una fracción de la población de titíes padece raquitismo dependiente de vitamina D, tipo II. Debido a mutaciones ocurridas hace millones de años, las máximas capacidades de ligamiento del VDR o los valores de la constante de disociación del complejo VDR-1α,25(OH)2D3 de las ratas topo o monos del Nuevo Mundo son muy diferentes de los verificables en receptores aislados de células humanas actuales. El mensaje de esta revisión a los médicos clínicos podría ser: varios estudios clínicos recientes indican que la normalidad de las funciones fisiológicas de un paciente es un mejor indicador de su salud que los niveles séricos de los metabolitos de la vitamina D. (AU)

Comparative Study of Vitamin D Deficiency between PCOD and Normal Women: A Prospective Hospital Based Study

Background: - Polycystic ovary syndrome (PCOS) is the most common endocrine disorder in women of reproductive age, with a prevalence of 6–10% in the general population. PCOS is characterized by the following: ovulatory dysfunction resulting in oligo-amenorrhea and/or anovulation, hyperandrogenism and/or hirsutism and the presence of polycystic ovarian morphology by ultrasound. Vitamin D also plays a physiologic role in reproduction including ovarian follicular development and luteinization via altering anti- Müllerian hormone (AMH), signaling, follicle- stimulating hormone sensitivity and progesterone production in human granulosa cells. The aim of this study aimed to compare levels of vitamin D in women with PCOS and normal women. Methodology: - Total fifty women were included in this study. Among the fifty cases 50% were from PCOD group and 50% were normal. This study were conducted in the Dept. of Obs/Gynae, Madhubani Medical College, Bihar. Blood sample was taken and serum vitamin D concentration was measured. Result: - Mean serum 25(OH) vitamin-D level in PCOD group and in control group is clinically significant. Conclusion: - This study concludes that 25(OH) vitamin-D was clinically significant, but not sufficient to be a diagnostic tool for PCOS.

Avaliação dos níveis séricos de vitamina D em crianças e adolescentes com diabetes mellitus tipo I / Evaluation of vitamin D serum levels in children and adolescents with diabetes mellitus type 1

Introdução: A deficiência de vitamina D é considerada um problema de saúde pública no mundo todo em razão de suas implicações no desenvolvimento de diversas doenças, incluindo a Diabetes Mellitus tipo I (DMI). Os objetivos deste estudo são avaliar os níveis séricos de 25 OH Vitamina D, Cálcio, Fosfatase alcalina, fósforo e hemoglobina glicada em crianças diabéticas tipo I e correlacionar os níveis de vitamina D com a hemoglobina glicada e com a presença de Tireoidite de Hashimoto, microalbuminúria e Doença celíaca. Métodos: Estudo do tipo quantitativo, observacional transversal obtido pela analise de exames laboratoriais de 48 pacientes, maiores de 3 anos, com diagnóstico de Diabetes Mellitus tipo I. Os dados foram obtidos mediante análise dos prontuários. Resultados: Dezenove pacientes (59,4%) apresentaram vitamina D deficiente/insuficiente. A média dos níveis de cálcio, fósforo, fosfatase alcalina e HbA1c foram de 9,24, 281,17, 4,69 e 9,34, respectivamente. Em 31 pacientes (91,17%) o controle da DMI foi considerado ruim ou regular, sendo este avaliado pelo valor da hemoglobina glicosilada. Dez pacientes (29,41%) apresentaram uma ou mais das comorbidades associadas à DMI. Conclusão: Em 59,4 % dos pacientes o nível de vitamina D foi deficiente ou insuficiente. A média dos níveis de cálcio, fósforo e fosfatase alcalina dos pacientes estavam dentro dos valores normais. Em 31 pacientes (91,17%) o controle da DMI, avaliado pela HbA1c, foi considerado ruim ou regular. Não houve associação significativa entre a presença de Tireoidite de Hashimoto, doença celíaca ou microalbuminúria e os níveis de vitamina D.

Introdução: Vitamin D deficiency is considered a public health problem worldwide because of its implications in the development of various diseases, including diabetes mellitus type I (DMI). The aims of this study are to evaluate the serum levels of 25 OH Vitamin D, calcium, alkaline phosphatase, phosphorus and glycated hemoglobin in diabetic children type I and correlate vitamin D levels with glycated hemoglobin and presence of Hashimoto's thyroiditis, microalbuminuria and celiac disease. Methods: A quantitative, observational cross-sectional study performed by analysis of laboratory tests from 48 patients over three years of age and diagnosed with diabetes mellitus type I. The data were obtained by analyzing medical charts. Results: Nineteen patients (59.4%) were vitamin D deficient/insufficient. Calcium, phosphorus, alkaline phosphatase and HbA1c mean levels were 9.24, 281.17, 4.69, and 9.34, respectively. In 31 patients (91.17%), control of DMI was considered poor or fair, as measured by the value of glycosylated hemoglobin. Ten patients (29.41%) had one or more comorbidities associated with DMI. Conclusion: In 59.4% of the patients vitamin D level was deficient or insufficient. Patients’ mean levels of calcium, phosphorus and alkaline phosphatase were within the normal range. In 31 patients (91.17%) the control of DMI, assessed by HbA1c, was considered poor or fair. There was no significant association between presence of Hashimoto's thyroiditis, celiac disease or microalbuminuria and vitamin D levels.

Effects of Oxcarbazepine and Levetiracetam on Calcium, Ionized Calcium, and 25-OH Vitamin-D3 Levels in Patients with Epilepsy

OBJECTIVE: The primary objective of the present study was to further elucidate the effects of oxcarbazepine (OXC) and levetiracetam (LEV) monotherapies on the bone health status of patients with epilepsy. METHODS: This study included 48 patients who attended our epilepsy outpatient clinic, had a diagnosis of epilepsy, and were undergoing either OXC or LEV monotherapy and 42 healthy control subjects. The demographic and clinical features of the patients, including gender, age, onset of disease, daily drug dosage, and duration of disease, were noted. Additionally, the calcium, ionized calcium, and 25-OH vitamin-D3 levels of the participants were prospectively evaluated. RESULTS: The 25-OH vitamin-D3, calcium, and ionized calcium levels of the patients taking OXC were significantly lower than those of the control group. These levels did not significantly differ between the patients taking LEV and the control group, but there was a significant negative relationship between daily drug dose and ionized calcium levels in the LEV patients. CONCLUSION: In the present study, anti-epileptic drugs altered the calcium, ionized calcium, and 25-OH vitamin-D3 levels of epilepsy patients and resulted in bone loss, abnormal mineralization, and fractures. These findings suggest that the calcium, ionized calcium, and 25-OH vitamin-D3 levels of patients with epilepsy should be regularly assessed.

Significance of serum 25 (OH)-vitamin D in its diagnostic value of primary biliary cirrhosis / 中国免疫学杂志

Objective:To investigate the significance of 25 ( OH )-vitamin D in its diagnostic value of primary biliary cirrhosis. Methods:44 cases with PBC,41 cases with Hepatitis B cirrhosis and 110 normal people as control group were all analyzed bi-ochemical results and significance of serum 25 ( OH )-vitamin D. We Used receiver operator characteristic curve ( ROC ) to analyze serum 25(OH)-vitamin D in its diagnostic value of primary biliary cirrhosis. Results:Biochemical results of TBIL,DBIL,IBIL,GLB, AST,ALT,ALP,γ-GT were higher in PBC than that in normal people and Hepatitis B cirrhosis. While the serum 25(OH)-vitamin D of PBC was much more lower than that in normal and people and Hepatitis B cirrhosis. The difference between them were statistical difference(P<0. 05). The area under the ROC curve of PBC was 0. 926,it showed serum 25(OH)-vitamin D diagnosis for PBC had quite value. When the cut-off level of serum 25(OH)-vitamin D was 17. 275 ng/ml,the sensitivity for the diagnosis was 92. 8%,the re-spectively was 84. 1%. Conclusion:Serum 25(OH)-vitamin D diagnosis for PBC has quite value,the cut-off level of serum 25(OH)-vitamin D is 17. 275 ng/ml.

Vitamin D intake, Outdoor Activity Time and Serum 25-OH Vitamin D Concentrations of Korean Postmenopausal Women by Season and by Age / 대한지역사회영양학회지

OBJECTIVES: The purpose of this study was to examine the relative impact of seasonal differences and age on dietary vitamin D intakes, outdoor activity time and serum vitamin D status among Korean postmenopausal women. METHODS: A cross-sectional study was conducted with 164 free-living postmenopausal women (mean age=55.4 years) in Daegu, Korea. Dietary intake, daily physical activity patterns and fasting blood samples were collected during summer and winter. We compared the results from 75 women during summer and 89 women during winter. Dietary intake of vitamin D was assessed by 24-hour recall method. Daily outdoor activity time was derived from physical activity diary. RESULTS: The average dietary intake of vitamin D of the participants was 3.7 microg during summer, 3.3 microg during winter, showing no significant difference between the two seasons. The average time spent on outdoor activities was not significantly different between summer (=35.1 +/- 75.0 min/d) and winter (=48.5 +/- 76.8 min/d). The average serum 25-(OH) vitamin D concentrations of participants was 17.5 +/- 7.5 ng/mL in the summer and 13.4 +/- 4.3 ng/mL in the winter, showing no significant differences by season. Dietary intake of vitamin D was not related to age. When total subjects were divided into two groups by age, the average serum 25-(OH) vitamin D concentration was significantly higher in older group (p=0.047) and time spent on outdoor activities was also (p=0.018) significantly higher in the older group. CONCLUSIONS: In order to improve the current vitamin D status of Korean postmenopausal women, nutrition education programs should focus more on adequate intake of vitamin D, while maintaining enough outdoor activities over the season.

Seasonal Differences in Outdoor Activity Time and Serum 25-(OH) Vitamin D Status of Korean Young Women / 대한지역사회영양학회지

OBJECTIVES: This study was intended to examine the seasonal differences in outdoor activity times and dietary vitamin D intakes, and explicates their relative impact on improving serum 25-(OH) vitamin D status among Korean young women. METHODS: A cross-sectional study was conducted with 135 free-living women aged 19-39 years in Daegu-Kyungbook, Korea. We compared the results from 52 women for the summer and 83 women for the winter. Dietary intake of vitamin D was assessed by 24 hour recall method for non-consecutive three days as well as by food frequency method. Daily outdoor activity times were derived from 24 hour physical activity diary. RESULTS: The average dietary intake of vitamin D of the participants by 24 hour recall method was 3.1 microg during the summer, 3.3 microg during the winter, showing no significant difference between the two seasons. Times spent on outdoor activities (p < 0.01) in the summer (= 23.8 +/- 23.6 min) were much longer than that in the winter (= 10.8 +/- 13.4 min). The serum 25-(OH) vitamin D levels of participants were 17.5 +/- 7.5 ng/mL in the summer and 13.4 +/- 4.3 ng/mL in the winter, showing that the latter was significantly lower than that of the former (p < 0.001). The serum 25-(OH) vitamin D levels of subjects were positively related to outdoor activities (r = 0.315, p < 0.05) during the summer, while related to dietary intake (r = 0.252, p < 0.05) during the winter. CONCLUSIONS: In order to improve the current vitamin D status of Korean young women, nutrition education programs should focus on increasing more dietary intake especially during the winter, and performing more outdoor activities in other seasons.

Comparison of Proportions of Lymphocyte Subsets According to Serum 25(OH) Vitamin D Levels in Postmenopausal Women / 대한골다공증학회지

BACKGROUNDS: Many reports have proposed a significant role for vitamin D in immune mediated disease. This study analyzed the lymphocyte subsets according to serum 25(OH) vitamin D levels in postmenopausal women to determine the potential effect of vitamin D on immune-mediated disease. METHODS: We enrolled 31 postmenopausal women who underwent health checkup in a university hospital. Peripheral blood samples were taken for the investigation of the levels of T, B, and natural killer (NK) cells and the, proportion of CD3+, CD4+ ,CD8+, Th1, Th2, Th17 and Treg subsets of T lymphocyte in the morning after overnight fast. We also measured serum 25(OH) Vitamin D and evaluated the relationship between vitamin D levels and lymphocyte subpopulations. RESULTS: The subjects were divided into three groups according to serum vitamin D levels. There was no significant correlation between the level of vitamin D and the percentages of three lymphocyte subtypes. The proportion of CD4+ T cell (P for trend 0.024) and the CD4+/CD8+ T cell ratio(P for trend 0.000) was declined across increasing tertiles of vitamin D levels. The proportion of CD8+T cell was increased with increasing of tertiles of vitamin D levels (P for trend 0.004). And the results showed that the CD4+/CD8+ T cell ratio differed significantly between the groups with lowest and the middle vitamin D levels and between the groups with lowest and the highest. CONCLUSIONS: Serum vitamin D levels in postmenopausal women are associated with changes in the peripheral T cell compartment. These results provide insight into the immunomodulatory properties of vitamin D andthe possible beneficial associations between vitamin Dand immune-mediated disease.

Hipovitaminosis D en pacientes hemodiálizados (HD): factores relacionados e influencia sobre la fuerza muscular / Hypovitaminosis D in patients on hemodialysis (HD): related factors and influence on muscle strength

Introducción: La deficiencia de 25 (OH) vitamina D es una alteración prevalente en los pacientes con enfermedad renal crónica (ERC) , sin embargo en nuestro medio no es medida de manera rutinaria y por ende no suele hacerse reposición vitamínica. Nuestro objetivo fue determinar la prevalencia y los factores relacionados a deficiencia de 25 (OH) D en pacientes con ERC en hemodiálisis (HD), particularmente la relación con la función y masa muscular. Métodos: Efectuamos un estudio prospectivo, multicéntrico, en pacientes adultos en HD crónica que no estuvieran recibiendo ningún derivado de la vitamina D. Se midieron en sangre los niveles de 25(OH) D, Hemoglobina, PCR, Albúmina, Ca, P, FAL, PTHi. Se realizó la medición de la fuerza del puño con dinamómetro, y la prueba de sentado-parado. Se aplicó el índice de Karnofsky para clasificar el estado funcional., Se realizó una bioimpedanciometría (BCM; Frese nius Medical Care) en aquellos pacientes sin, contraindicación. Resultados: Se incluyeron 138 pacientes. La 25(OH) vitamina fue de 20.43 ± 10.5 ng/ml, la prevalencia de insuficiencia /defi ciencia 87% (37% con menos de 15 ng/ml). Las concentraciones de vitamina D/deficiencia mostraron correlación/relación significativa con la edad, la presencia de diabetes, los niveles de hemoglobina y albúmina, la fuerza y la masa muscular y la clase funcional (p<0.05) . Conclusión: Alta prevalencia de hipovitaminosis D en pacientes hemodializados particularmente gerontes y diabéticos. Esto estaría relacionado con la desnutrición, anemia, clase funcional y la fuerza/masa muscular de los pacientes, estos últimos dos factores no reportados hasta ahora. Todos estos factores deben ser considerados al momento de la sustitución vitamínica y en la evaluación de la efectividad de la misma.

Background: 25 (OH) vitamin D deficiency is a prevailing alteration in patients with chronic kidney disease (CKD); however, in our environment, it is not routinely measured and, therefore, vitamin replacement is unusual. Our purpose was assessing the prevalence of and the factors related to 25 (OH) vitamin D deficiency in patientswith CKD in hemodialysis (HD), especially the relation to function and muscle mass. Methods: We conducted a prospective, multicenter study in adult patients on chronic HD who were not receiving any vitamin D derivative. Blood levels of 25 (OH) D, Hemoglobin, CRP, Albumin, Ca,P, ALP and PTHi were measured. The handgrip strength was measured with a dynamometer and the sitting-rising test was carried out. A bioimpedance analysis (BCM; Fresenius Medical Care) was conducted in the patients who had no contraindications. Results: 138 patients were included. The levels of 25 (OH) vitamin D were 20.43±10.5 ng/ml; the insufficiency/deficiency had 87% prevalence (and 37% prevalence with less than 15 ng/ml). Vitamin D concentrations/ deficiency showed a significant correlation with/ relation to age, diabetes, hemoglobin and albumin levels, muscle strength and mass, and functional class (p<0.05). Conclusion: High prevalence of hypovitaminosis D in patients on hemodialysis, particularly in the elderly and in patients with diabetes. This should be related to undernutrition, anemia, the functional class and the muscle strength/mass of patients, the latter two being unreported factors until now. All these factors should be considered when vitamin replacement is conducted and when its effectiveness is assessed.

Association between Plasma Vitamin D Level and Brachial-ankle Pulse Wave Velocity / 대한골다공증학회지

OBJECTIVES: Low 25 (OH) vitamin D increases the risk of cardiovascular disease and mortality. Pulse wave velocity (PWV), which is related with arterial stiffness, can be used evaluate the severity of systemic atherosclerosis. Brachial-ankle PWV (baPWV) is affected by sex, age, systolic blood pressure, body mass index, and waist circumference. We evaluated determinants of PWV in Korean adults andits associationwith the plasma vitamin D level and arterial stiffness. MATERIALS AND METHODS: The study was conducted on 178 adults (>age of 20) who visited thehealth promotion center. We investigated medical history, medication, smoking and alcohol use by means of questionnaire. We measuredblood pressure, pulse rate, fasting glucose, fasting insulin, lipid profile, hs-CRP, plasma 25 (OH) vitamin D level, and baPWV. We then analyzed retrospectively the relationship between baPWV and various risk factors. RESULTS: The mean ages in 97 males and 81 females were 47.9+/-13 and 43.6+/-11.4 years, respectively. baPWV is correlated with age, BMI, waist, blood pressure, fasting glucose, HTN, DM, total cholesterol, triglyceride, hs-CRP, and 25 (OH) vitamin D. We found out that age (beta=7.49, P<0.001), BMI (beta=-10.05, P=0.023), SBP (beta=7.69, P<0.001), TG (beta=111.41, P=0.039), and fasting glucose (beta=1.447, P=0.561) were independent predictors of baPWVafter performing multiple linear regression analysis. CONCLUSIONS: baPWV was affected by age, SBP, BMI, TG, and fasting glucose. Deficiency of 25 (OH) vitamin Dwas not associated with baPWV after adjusting the risk factors of cardiovascular diseases in this study group.

The correlation between PTH, Vitamin D and bone mineral density in elderly man with type 2-diabetes / 中国综合临床

Objective To explore the impact of calciotropic hormones,such as parathyroid hormone (PTH)and vitamin D,on bone mineral density(BMD)in the old men with type 2-Diabetes.Methods Sixty elderly men with type 2-Diabetes were submitted to dual-energy X-ray absorptiometry to evaluate the BMD at lumbar spine and hip.Fasting blood samples were collected to evaluate the indexes of bone metablism and blood glucose.PTH and 25-(OH)-Vitamin D3 were measured and analyzed for their correlation with BMD at different sites.Results In all patients,the percentage of osteoporosis and osteopenia accounted for 20.0％ and 53.3％ of the patients according to BMD at lumbar or hip.Compared with the patient group with normal BMD,serum PTH was significantly higher in the patient group with osteopenia or osteoporsis([44.87 ± 10.62]μg/L vs[36.96 ±12.36]μg/L,P ＜ 0.05 ;[50.24 ± 20.32]μg/L vs[36.96 ± 12.36]μg/L,P ＜ 0.05).But there was no difference in 25-(OH)-Vitamin D3 levels between all groups.PTH was correlated negatively with BMD at hip (r =-0.224,P ＜ 0.05),but not significantly correlated with BMD at lumbar(r =-0.187,P ＞ 0.05)Conclusions Serum PTH was correlated negatively with BMD at hip in elderly man with type 2-Diabetes.

Vitamin D deficiency and human diseases / 国际儿科学杂志

itamin D plays a crucial role in human health and diseases.Researches have showed that 50％ of the population have a risk for vitamin D deficiency in the world.Vitamin D deficiency is caused by the lack of sunlight or by deficient dietary supplement.It does not only lead to rickets and osteomalacia, can also cause cancers, cardiovascular disease, endocrine system diseases, autoimmune diseases, nervous system diseases and tuberculosis susceptibility.

25 (OH) vitamin D level in Crohn’s disease: association with sun exposure & disease activity.

Background & objectives: Western studies show that up to 65 per cent of patients with Crohn’s disease have low serum 25-hydroxy vitamin D concentrations, and 45 per cent of these patients have metabolic bone disease. No data are available from India or from any country with comparable climatic conditions or ethnicity. We carried out this study to measure the serum 25 (OH) vitamin D levels of Crohn’s disease patients and compare with matched controls and to assess the consequences of low 25 (OH) vitamin D levels on bone and mineral metabolism in these patients. Methods: Adult patients with Crohn’s disease were compared with age and sex matched patients diagnosed to have irritable bowel syndrome. Serum 25 (OH) vitamin D, the effect of disease characteristics, sunlight exposure and milk consumption on 25 (OH) vitamin D level, and the consequences of low 25 (OH) vitamin D level on bone and mineral metabolism were assessed. Results: Thirty four patients with Crohn’s disease (M:F, 24:10, age 39.2 ± 12.9 yr) and 34 controls (M:F, 24:10, age 38.9 ± 13.4 yr) were studied. 25 (OH) vitamin D levels were significantly lower in patients with Crohn’s disease as compared to controls (Crohn’s disease vs controls: 16.3 ± 10.8 vs 22.8 ± 11.9 ng/ml; P<0.05). The severity of disease activity as assessed by the Harvey Bradshaw score correlated negatively (Correlation coefficient -0.484, significance P<0.004), and the duration of sunlight exposure correlated positively (Correlation coefficient 0.327, significance P=0.007) with the serum 25 (OH) vitamin D level. Interpretation & conclusions: Serum 25 (OH) vitamin D levels were significantly lower among patients with Crohn’s disease as compared to age and sex matched controls. Further, 25 (OH) vitamin D levels in patients with Crohn’s disease were lower in those with severe disease activity and less sun exposure. Further studies need to be done to correlate low 25 (OH) vitamin D level with bone density and assess the effect of vitamin D supplementation in these patients.

Biochemical Markers and Health Behavior Related with Bone Mineral Density in Adult Men / 가정의학회지

BACKGROUND: More than half of the causes of male osteoporosis is due to secondary osteoporosis. Therefore, it is important to detect and modify its related factors. The aim of this study was to find related lifestyle factors and biochemical markers with low bone mineral density (BMD) in Korean men. METHODS: A cross-sectional analysis was performed in men aged 40-69 years who visited a hospital for health checkup from January to March 2007. BMD was measured at proximal femur and lumbar spine by dual energy x-ray absorptionmetry. Lifestyle factors were estimated by a self-administered questionnaire and fasting glucose, uric acid, gamma glutamyltransferase, alkaline phosphatase, creatinine, free testosterone, 25-OH vitamin D, urine deoxypyridinoline, osteocalcin were measured. Multivariate logistic regression was used to find the association to the lowest tertile of BMD. RESULTS: A total of 152 subjects were included. After multivariate analysis adjusted with age, BMI, smoking, alcohol and exercise, different factors were correlated with low bone density in each site of femoral neck and lumbar spine. Factors correlated at both sites were BMI and exercise; lower BMI and doing no exercise increased risks of low bone density. Increasing age and alcohol intake > or = 14 drinks/week were associated with lower BMD at femoral neck. The factors associated with lower lumbar spine BMD only were lower level of uric acid and higher level of urine deoxypyridinoline. CONCLUSION: Different factors were associated with low bone density at femoral neck and lumbar spine in men. BMI and exercise were related in both sites; age, alcohol intake, uric acid and deoxypyridinoline were related on either site.