What is known about the effects of vitamin D in neuropsychiatric lupus?

Abstract Systemic lupus erythematosus (SLE) is an autoimmune disease that can affect several organs and systems. The central and/or peripheral nervous system can suffer from complications known as neuropsychiatric lupus (NPSLE). Studies have associated the manifestations of SLE or NPSLE with vitamin D deficiency. It has been shown that hypovitaminosis D can lead to cognition deficits and cerebral hypoperfusion in patients with NPSLE. In this review article, we will address the main features related to vitamin D supplementation or serum vitamin D levels with neuropsychiatric manifestations, either in patients or in animal models of NPSLE.

Preliminary study of vitamin D deficiency and its associated risk factors in Libya

This study was conducted to investigate levels among the target population and its associated risk factors in Libya. A cross-sectional study was conducted to investigate level and its associated risk factors in Libya during 2022-2023. 192 serum samples were tested in private laboratories. A structured designated questionnaire was filled in containing all the relevant information. Descriptive analyses frequency and percent were measured for numerical data, number, and percent for qualitative data using SPSS version 22. The chi-square test and student t-test were used for the data analysis and to investigate the level of association among variables at the significance level of (p=0.894) The results showed that using supplements for hypovitaminosis did not significantly influence therapeutic outcomes. The mean average level among males was significantly higher than those in females; however, both levels in the two groups are in the deficiency category. Interestingly the group who received treatment of vitamin D, their level was lower than the group who did not receive treatment

HYPOVITAMINOSIS D EXACERBATES TYPE 2 DIABETIC COMORBIDITIES

Vitamin D deficiency is one of the prominent nutritional deficiencies in India that needs special attention. The effects of hypovitaminosis D on skeletal and cardiovascular functions are well known. However, its effect on metabolic disorders like type 2 diabetes mellitus (T2DM) is still left unexplored. In the present study, our primary aim is to find out the potential effect of hypovitaminosis D in T2DM patients. The study was conducted on 250 T2DM patients mainly from Madhya Pradesh, India. Among them, 125 had hypovitaminosis D (case group) and were compared against the control group of 125 patients with normal serum vitamin D. We were mainly investigating the major T2DM-related complications including chronic kidney disease (CKD), coronary heart disease (CHD and recurrent infections. Major organ functions including liver, kidney, and cardiac functions were affected by hypovitaminosis D in T2DM patients when compared to control counterparts. We also noticed an association between hypovitaminosis D and the exacerbation of T2DM comorbidities. Our findings show the importance of maintaining normal serum vitamin D levels in T2DM patients to avoid further complications.

Hypovitaminosis D causes suboptimal glycemic control in type 2 diabetic patients

Background: Vitamin D deficiency and associated complications are widely prevalent in the Indian subcontinent. Hypovitaminosis D is known to play deleterious effects on cardiovascular and skeletal functions in human beings. Yet, its effect on carbohydrate metabolism and diabetes mellitus (DM) is less known. Aim and Objectives: In the current case– control study, our primary aim is to find out the potential effect of hypovitaminosis D on glycemic control in type 2 DM (T2DM) patients. Materials and Methods: The study population comprised 250 T2DM patients recruited primarily from Madhya Pradesh, India. The case group of 125 T2DM patients with hypovitaminosis D was compared with a control group of 125 T2DM patients with sufficient vitamin D. We mainly investigated the effect of hypovitaminosis D (both deficiency and insufficiency) on glycemic control in T2DM patients. Results: We observed that both fasting and 2-h postprandial blood glucose were found to be elevated significantly in T2DM patients with hypovitaminosis D (P < 0.01). The glycated hemoglobin level was also elevated (P < 0.01) in the case group suggesting impaired glycemic control for a chronic period. An inverse association is found between glycemic status and serum vitamin D (OH)D3 levels. Conclusions: Our results show the significance of maintaining sufficient plasma vitamin D levels, along with hypoglycemic medication in T2DM patients to improve their glycemic control and avoid diabetic comorbidities.

A Review on Correlation of Vitamin A and D in Hypertensive Disorder of Pregnancy: Current Concepts

Vitamin A is essential for the health of the mother as well as for the health and development of the fetus. Vitamin A deficiency has affected 19 million pregnant women with the highest burden found in the WHO regions of Africa and South-East Asia. Vitamin A is available in multiple vitamin formulations for prenatal care in some countries. When provided alone, the compounds most commonly used are retinyl palmitate and retinyl acetate in tablet form or oil-based solutions. Hypertension is common in pregnancy and causes high maternal mortality. This includes gestational hypertension, preeclampsia, severe preeclampsia, and pregnancy with chronic hypertension. Preeclampsia is a high-mortality disease among the common complication of hypertensive disorder of pregnancy. in particular, severe preeclampsia possess a serious threat to the safety of mothers and children, and there are great difficulties in the treatment of hypertensive disorders of pregnancy during clinical work. therefore, we are adequate in dealing with hypertensive disorders of pregnancy. Any adverse pregnancy outcomes associated with hypovitaminosis D should be accessed through the perspective of immune dysregulation both at the systemic and placental levels. It signifies the supplementation of vitamin D in pregnancy have a role in the improvement of maternal hypertensive complication and improve the fetal outcome.

Investigação de surto de doença compatível com escorbuto em uma penitenciária masculina do Ceará, 2019-2020: um estudo de caso-controle / Investigation of an outbreak of disease compatible with scurvy in a male penitentiary in the state of Ceará, Brazil, 2019-2020: a case-control study / Investigación de un brote de enfermedad compatible con escorbuto en una penitenciaría masculina en el estado de Ceará, Brasil, 2019-2020: un estudio de casos y controlesInvestigação de surto

Objetivo: identificar ocorrência de surto compatível com escorbuto e fatores de exposição associados aos sinais/sintomas típicos de hipovitaminose, em penitenciária masculina, Ceará, Brasil, 2019-2020. Métodos: estudo de caso-controle populacional; foram utilizados registros clínicos e entrevistas com casos compatíveis - sinais/sintomas iniciados no período - e com controles; realizou-se análise multivariável. Resultados: 62 casos; idade média de 40,6 anos (DP = 10,8); principais sinais/sintomas foram edema e dor em membros inferiores (100,0%), dificuldade para deambular (91,9%), hematoma/equimose em membros inferiores (90,3%), febre (88,7%); identificou-se, como fator de exposição, média de idade > 40 anos (ORa = 1,10; IC95% 1,05;1,17; p-valor = 0,001); e como fatores protetores, trabalho (ORa = 0,11; IC95% 0,03;0,36; p-valor < 0,001) e participação em aulas (ORa = 0,21; IC95% 0,08;0,59; p-valor = 0,003) dentro da penitenciária. Conclusão: surto da penitenciária compatível com escorbuto pelos sinais/sintomas característicos, associados aos fatores identificados; recomendou-se oferta regular de dieta rica em vitamina C para todos os internos e acompanhamento clínico dos casos.

Objective: to identify the occurrence of an outbreak compatible with scurvy and exposure factors associated with typical signs/symptoms of hypovitaminosis that occurred in a male penitentiary in Ceará, Brazil between 2019-2020. Methods: this was a population-based case-control study; we used clinical records and interviews with compatible cases - based on sign/symptom onset during the study period - and with controls; we carried out multivariate analysis. Results: out of 62 cases, mean age was 40.6 years (SD = 10.8); main signs/symptoms were edema and pain in the lower limbs (100.0%), difficulty in walking (91.9%), hematoma/ecchymosis in the lower limbs (90.3%) and fever (88.7%); we identified being over 40 years old as an associated factor (aOR = 1.10; 95%CI 1.05;1.17; p-value = 0.001); and as protective factors: working (aOR = 0.11; 95%CI 0.03;0.36; p-value < 0.001) and taking part in classes (aOR = 0.21; 95%CI 0.08;0.59; p-value = 0.003) in the prison. Conclusion: we considered the penitentiary outbreak to be compatible with scurvy due to characteristic signs/symptoms, associated with the identified factors; we recommended regular provision of a diet rich in vitamin C to all male inmates and clinical follow-up of cases.

Objetivo: identificar la ocurrencia del brote compatible con escorbuto y los factores de exposición asociados con signos/síntomas típicos de hipovitaminosis que ocurrieron en una penitenciaría masculina en Ceará, Brasil entre 2019-2020. Métodos: estudio poblacional de casos y controles; se utilizaron historias clínicas y entrevistas con casos compatibles, con inicio de signos/síntomas durante el período de estudio, y controles; se realizó análisis multivariable. Resultados: de los 62 casos, edad media fue 40,6 años (DE = 10,8); principales signos/síntomas fueron edema y dolor en miembros inferiores (100,0%), dificultad para caminar (91,9%), hematoma/equimosis en miembros inferiores (90,3%) y fiebre (88,7%); la edad mayor de 40 años se identificó como factor asociado (ORa = 1,10; IC95% 1,05;1,17; p-valor = 0,001); y como factores protectores: trabajo (ORa = 0,11; IC95% 0,03;0,36; p-valor< 0,001) y participación en clases (ORa = 0,21; IC95% 0,08;0,59; p-valor = 0,003) dentro del centro penitenciario. Conclusión: el brote en centro penitenciario fue considerado compatible con escorbuto debido a los signos/síntomas característicos, asociados a los factores identificados; se recomendó oferta regular de dieta rica en vitamina C a todos los internos y seguimiento clínico de los casos.

Vitamina D: entre el brillo del sol y la oscuridad de la depresión / Vitamin D: Between the Brightness of the sun and the Darkness of Depression

RESUMEN Introducción: La literatura científica indica que hay relación entre la vitamina D (VitD) y el inicio, el tratamiento y el pronóstico de la depresión. Sin embargo, esta línea de investigación continúa siendo motivo de controversia. El propósito del trabajo es analizar la relación entre la depresión y los valores de VitD, controlando por la influencia de la estación. Material y métodos: Estudio observacional y transversal. La muestra quedó conformada por 150 voluntarias adultas (edad, 28-78 arios). Se estratificó la muestra en 3 grupos: depresión sin tratamiento, depresión en tratamiento con antidepresivos y sin depresión (control). Se compararon los valores de VitD. Resultados: Se hallaron diferencias significativas entre los 3 grupos de comparación. El grupo con depresión sin tratamiento obtuvo los valores de VitD más bajos (media, 18,62 ± 8,42 ng/ml), compatibles con una insuficiencia grave. El grupo de participantes con depresión en tratamiento obtuvo valores más altos que el grupo anterior, aunque en la franja de insufi ciencia (23,80 ± 11,30 ng/ml). El tercer grupo (control) obtuvo los valores más altos y acordes con el intervalo deseable (30,19 ± 10,21 ng/ml). No hubo diferencias de edad entre los grupos. Al controlar por posibles efectos de la estación del año, las diferencias previas de VitD entre los 3 grupos se mantuvieron, con un descenso ostensible de todas las medias en el periodo invernal. Conclusiones: La depresión se asocia con valores de VitD insuficientes. El tratamiento con antidepresivos mejora esos valores, aunque continúan siendo insuficientes. Los hallazgos de este estudio refuerzan la evidencia de una asociación entre la depresión y la VitD.

ABSTRACT Introduction: The scientific literature suggests a relationship between vitamin D (VitD) and the onset, treatment and prognosis of depression. However, this line of research continues to be controversial. The aim of the study was to analyse the relationship between depression and VitD values, controlling for the influence of the season. Material and methods: Observational and cross-sectional study. The sample was made up of 150 adult female volunteer participants (aged between 28 and 78 years). The sample was stratified into three groups: a) depression without treatment, b) depression under treat ment with antidepressants, and c) without depression (control). VitD values (ng/ml) were compared. Results: Significant differences were found between the three groups surveyed. The group of participants with depression without treatment obtained the lowest VitD values (mean 18.62 ng/ml; SD 8.42), compatible with severe insufficiency. The group of participants with depression in treatment obtained higher values than the previous group, although in an insufficient range (mean 23.80 ng/ml; SD 11.30). The third group (control) obtained the hig hest values and in accordance with the desirable range (mean 30.19 ng/ml; SD 10.21). There were no age differences between the groups. When controlling for possible effects of the season, the previous differences in VitD between the three groups were maintained, with an evident decrease of all the mean levels in the winter period. Conclusions: Depression is associated with insufficient VitD values. Treatment with antidepressants improves these values, although they continue to be insufficient. The findings of this study reinforce the evidence for an association between depression and VitD.

Treatment of chronic generalized periodontitis in patients with underlying hypovitaminosis D: randomized comparative clinical trial

Abstract Objectives This study aims to evaluate the dynamics of clinical and laboratory indicators of the periodontal state and hemodynamics in patients receiving pharmaceutical intervention for the treatment of vitamin D deficiency as a part of the complex therapy of chronic generalized periodontitis. Methodology This was a randomized prospective comparative clinical trial. It involved 110 patients with moderate generalized periodontitis and vitamin D deficiency (25(OH)<50 nmol/L) who were divided into two experimental groups. One experimental group received conventional treatment, whereas the other group received conventional treatment with pharmaceutical intervention for the treatment of vitamin D deficiency(vitamin D3 + calcium). Results A significant reduction in periodontal inflammation was observed across all study groups starting from day 14 of treatment. However, in a longer perspective (12 and 18 months after treatment), the indices analyzed remained fairly stable and corresponded to the chronic periodontitis clinical stabilization stage in both groups. The conventional treatment group demonstrated a marked tendency for all indicators to return to the baseline. Conclusions Pharmacotherapy of vitamin D deficiency contributed to the normalization of periodontal microcirculation (the σ and Kv values approached those of healthy periodontium) as evidenced by the immediate and long-term follow-up results. Clinical observation of patients suffering from moderate chronic generalized periodontitis with underlying hypovitaminosis D makes an argument to the use of vitamin D supplementation for the correction of vitamin D deficiency as a part of the complex treatment. Trial registration number: NCT67823273

Recurrencia de vértigo y discapacidad autopercibida en pacientes con hipovitaminosis D / Recurrencia de vértigo y discapacidad autopercibida en pacientes con hipovitaminosis D / Recurrence of vertigo and self-perceived disability in patients with hypovitaminosis D

El propósito de este estudio fue analizar el efecto de la deficiencia de vitamina D sobre la recurrencia de vértigo y la discapacidad auto percibida en pacientes diagnosticados con Vértigo Postural Paroxístico Benigno en un hospital de tercer nivel de la Ciudad de México. Se trata de un estudio retrospectivo y descriptivo. Se revisaron expedientes electrónicos (enero 2017 ­ diciembre 2019), de pacientes previamente diagnosticados, que presentaran valores deficientes de vitamina D sérica. Se contabilizó la cantidad de episodios de vértigo reportados, así como, la puntuación obtenida en el Dizzines Handicap Inventory para determinar el nivel de discapacidad auto percibida al momento del diagnóstico y a los 6 meses de seguimiento. Los niveles de vitamina D sérica de los pacientes seleccionados (n=30), demostraban hipovitaminosis (media de 17.1 ng/mL) al momento del diagnóstico. Seis meses después y habiendo recibido tratamiento con maniobras de reposicionamiento los pacientes reportaron desde ausencia absoluta de recurrencias (7 pacientes, 23.3%) hasta 8 recurrencias (1 paciente, 3.3%) en el mismo periodo. En cuanto al nivel de discapacidad auto percibida en la evaluación inicial predominó la discapacidad moderada (60%), mientras que, en la evaluación final, la preponderante fue la discapacidad leve (73.3%). No se encontró diferencia estadísticamente significativa entre la deficiencia de vitamina D y la recurrencia de episodios de vértigo. Se concluye que los resultados obtenidos posiblemente se deben a que la insuficiencia de vitamina D es muy común en la población mexicana, incluso en individuos sanos

The purpose of this study was to analyze the effect of vitamin D deficiency on vertigo recurrence and self-perceived disability in patients diagnosed with Benign Paroxysmal Postural Vertigo in a tertiary care hospital in Mexico City. This is a retrospective and descriptive study. Electronic records (January 2017 - December 2019) of previously diagnosed patients who presented deficient values of serum vitamin D were reviewed. The number of reported episodes of vertigo was counted, as well as the score obtained in the Dizzines Handicap Inventory to determine the level of self-perceived disability at the time of diagnosis and at 6-month follow-up. The serum vitamin D levels of the selected patients (n=30) showed hypovitaminosis (mean 17.1 ng/mL) at the time of diagnosis. Six months later and having received treatment with repositioning maneuvers, the patients reported from absolute absence of recurrences (7 patients, 23.3%) to 8 recurrences (1 patient, 3.3%) in the same period. Regarding the level of self-perceived disability in the initial evaluation, moderate disability predominated (60%), while, in the final evaluation, the predominant one was mild disability (73.3%). No statistically significant difference was found between vitamin D deficiency and recurrence of vertigo episodes. It is concluded that the results obtained are possibly due to the fact that vitamin D insufficiency is very common in the Mexican population, even in healthy individuals.

Deficiency of vitamins C and E in women of childbearing age in Brazil: a systematic review and meta-analysis

ABSTRACT BACKGROUND: Despite the several options available for supplements containing vitamins C and E, evidence regarding the prevalence of deficiency or insufficiency of these vitamins is weak. OBJECTIVES: To estimate the prevalence of deficiency or insufficiency of vitamins C and E and associated factors among women of childbearing age, in Brazil. DESIGN AND SETTING: Systematic review and meta-analysis conducted at a Brazilian public university. METHODS: A search from index inception until May 2020 was conducted. Meta-analyses were performed using inverse variance for fixed models, with summary proportions calculation using Freeman-Tukey double arcsine (base case). Reporting and methodological quality were assessed using the Joanna Briggs Institute tool for prevalence studies. RESULTS: Our review identified 12 studies, comprising 1,316 participants, especially breastfeeding women. There was at least one quality weakness in all studies, mainly regarding sampling method (i.e. convenience sampling) and small sample size. The prevalence of vitamin C deficiency ranged from 0% to 40%. Only vitamin E deficiency was synthetized in meta-analyses, with mean prevalences of 6% regardless of the alpha-tocopherol cutoff in plasma, and 5% and 16% for cutoffs of < 1.6-12.0 mmol/l and < 16.2 mmol/l, respectively. The cumulative meta-analysis suggested that a trend to lower prevalence of vitamin E deficiency occurred in recent studies. CONCLUSIONS: Although the studies identified in this systematic review had poor methodological and reporting quality, mild-moderate vitamin C and E deficiencies were identified, especially in breastfeeding women. Thus, designing and implementing policies does not seem to be a priority, because the need has not been properly dimensioned among women of childbearing age in Brazil. REGISTRATION NUMBER IN PROSPERO: CRD42020221605.

Vitamin D status and prevalence of hypovitaminosis D in different genders throughout life stages: A Brazilian cross-sectional study

OBJECTIVES: To evaluate the mean concentration of 25-hydroxivitamin D [25(OH) D] and prevalence of hypovitaminosis D in individuals residing in Rio de Janeiro, Brazil. METHODS: The data of 80,000 consecutive individuals who had 25(OH) D measurements performed by electrochemiluminescence between 1/2/2018 and 2/5/2018 were selected. Patients who reported the use of therapies/supplements were excluded. Levels of 25(OH) D ≥20 ng/mL (ages <60 years) and ≥30 ng/mL (ages ≥60 years) were considered adequate. RESULTS: We analyzed the data of 24,074 individuals (1-95 years old, 64.7% female). Descriptive curves showed that, in both sexes, the mean values of 25(OH) D decreased from the first years of life until adolescence, then slightly increased, and then tended to stabilize during adulthood. Levels of 25(OH) D <20 ng/mL were observed in 6% of girls versus 3.6% of boys and in 13.6% of adolescent girls versus 12.6% of adolescent boys and 11% of adults. The percentage of seniors with serum levels of 25(OH) D <20 ng/mL was 13.6% in women and 12.7% in men; 53.2% of women and 50.6% of men had levels <30 ng/mL. CONCLUSIONS: Mean 25(OH) D values were higher in children and lower in adolescents and women. Approximately 90% of non-seniors and presumably healthy residents of the urban metropolitan region of Rio de Janeiro presented satisfactory levels of 25(OH) D during the summer months; however, in over half of the elderly, the serum concentrations of 25(OH) D were inadequate. Therefore, strategies for the prevention of hypovitaminosis D should be considered in the senior population.

Hipovitaminosis D en niños y adultos en un prestador de salud del Uruguay y su relación con el uso de antiepilépticos / The effect of antiepileptic drugs in adult and child hypovitaminosis D in a Uruguayan health institution / Hipovitaminose D em crianças e adultos em um provedor de saúde uruguaio e sua relação com o uso de medicamentos antiepilépticos

Resumen: Introducción: la hipovitaminosis D se encuentra ampliamente extendida a nivel mundial, con consecuencias clínicas a nivel óseo y extraóseo. Entre los factores que la causan se encuentran los antiepilépticos (AE). En Uruguay no se conoce su prevalencia en niños ni en pacientes que reciben AE. Objetivos: conocer la prevalencia de hipovitaminosis D de niños y adultos en un prestador de salud y compararla con la prevalencia en pacientes bajo tratamiento con AE. Método: estudio descriptivo, transversal, realizado entre marzo y diciembre de 2017. Las variables analizadas fueron: niveles de vitamina D, calcio, fósforo, fosfatasa alcalina y parathormona intacta. Se consideró insuficiencia de vitamina D niveles menores de 30 ng/ml y déficit niveles menores de 20 ng/ml. Resultados: se incluyeron 113 pacientes, 60 niños y 53 adultos. La prevalencia global de insuficiencia de vitamina D fue de 89% y déficit de 60%. En niños expuestos a AE, la media de vitamina D fue 17,5 ng/ml, y en niños no expuestos 19,6 ng/ml. En adultos la media de vitamina D fue de 18,1 en expuestos a AE y 16,9 en no expuestos. La diferencia de medias no fue estadísticamente significativa en niños ni en adultos. Se observaron niveles de calcemia significativamente descendidos en niños y adultos con AE. Conclusiones: la insuficiencia de vitamina D fue cercana a 90% y el déficit superó el 50%. No se encontraron diferencias significativas entre grupos en hipovitaminosis D, pero se observaron niveles de calcemia reducidos en los expuestos a AE. Es necesario continuar analizando los factores que la causan y sus consecuencias clínicas.

Summary: Introduction: hypovitaminosis D is a highly spread condition worldwide, with clinical consequences that affect bone directly, among other manifestations. Antiepileptic drugs are among factors that cause this deficiency. In Uruguay, there is no information about hypovitaminosis D in children or patients who receive antiepileptic drugs. Objectives: to learn about the prevalence of hypovitaminosis D in children and adults in a health institution and to compare it with the prevalence in patients receiving antiepileptic drugs. Method: descriptive, transversal study conducted from March through December, 2017. The following variables were analysed: vitamin D, calcium, phosphorous, alkaline phosphatase and intact parathyroid hormone. Vitamin D insufficiency was defined as vitamin D levels of less than 30 ng per mL and deficiency as D levels of less than 20 ng per mL. Results: 113 patients were included in the study, 60 of which were children and 53 adults. Global prevalence of vitamin D insufficiency was 89% and deficiency was 60%. In children taking antiepileptic drugs, the average vitamin D value was 17.5 ng/ml and it was 19.6 ng/ml for those not exposed to those drugs. In adults, the average vitamin D value was 18.1 in the population taking antiepileptic drugs and 16.9 in patients not taking that medication. The difference between average values was not statistically significant in children or adults. Calcemia levels observed were significantly lower in both children and adults taking antiepileptic drugs. Conclusions: vitamin D insufficiency was close to 90% and deficiency was over 50%. No significant differences were found between hypovitaminosis D groups, although reduced calcemia was observed in patients exposed to antiepileptic drugs. Further studies are necessary to analyse factors that cause this condition and its clinical consequences.

Resumo: Introdução: a hipovitaminose D está amplamente difundida em todo o mundo, com consequências clínicas a nível ósseo e extraósseo. Entre os fatores que a causam estão os medicamentos antiepilépticos (AE). No Uruguai, sua prevalência em crianças ou em pacientes adultos recebendo AE não é conhecida. Objetivos: conhecer a prevalência de hipovitaminose D em crianças e adultos em um prestador de serviços de saúde e compará-la com a prevalência em pacientes em tratamento com AE. Método: estudo transversal descritivo realizado entre março e dezembro de 2017. As variáveis analisadas foram: níveis de vitamina D, cálcio, fósforo, fosfatase alcalina e paratormona intacta. Níveis menores que 30 ng / ml e níveis de déficit menores que 20 ng / ml foram considerados como insuficiência de vitamina D. Resultados: foram incluídos 113 pacientes, 60 crianças e 53 adultos. A prevalência global de insuficiência de vitamina D foi de 89% e déficit de 60%. Em crianças expostas à AE, a média de vitamina D foi de 17,5 ng / ml e em crianças não expostas de 19,6 ng / ml. Em adultos, a média de vitamina D foi de 18,1 nos expostos ao AE e de 16,9 nos não expostos. A diferença nas médias não foi estatisticamente significativa nas crianças nem nos adultos. Níveis de cálcio significativamente diminuídos foram observados em crianças e adultos com EA. Conclusões: a insuficiência de vitamina D foi próxima a 90% e o déficit ultrapassou 50%. Não foram encontradas diferenças significativas entre os grupos na hipovitaminose D, mas níveis reduzidos de cálcio foram observados naqueles expostos a EA. É necessário continuar analisando os fatores que o causam e suas consequências clínicas.

Alteración de las vitaminas en pacientes con cáncer: un estudio comparativo prospectivo / Vitamins disturbance in cancerous patients: A prospective comparison study

Cancers are a complex diseases that involve abnormal cell growth pattern and it is the leading cause of morbidity and mortality worldwide. The chemotherapy is one of the most common treatments for cancer. Cancer cause malnutrition and deficiencies of vitamins, in addition chemotherapy causes those deficiencies by induced anorexia, stomatitis, and alimentary tract disturbances. The study aims to determined and assessed the levels of serum vitamins (A, B12, B6, B9, E, D, and K) before and after chemotherapy administration. A prospective study carried out on newly diagnosed cancerous patients whom receiving chemotherapy. Fifty patients enrolling and recruited. Follow up will be recorded after the first, third, and sixth cycles of chemotherapy. The panel used for evaluation of vitamins concentration included the following six kits: Human Vitamin AV, E, VB6, B12, VD3 DIY, VK and FOLR3 ELISA kits. 38 females and 12 males included, with mean age was 48.35±15.28 years. The mostly distributed age group was belong to fifth decades. The mean body mass index (BMI) was 33.12±5.51 m2 /Kg. The majority of the sample treated were breast cancers females about 26(52%). Regarding chemotherapy regimens, the AC+Taxen protocol was mostly used. The mean level of vitamin A found to be declined to the half from (69.23±24.66 µg/dL) at C0 to (35.73±18.89 µg/dL) at C6. Normal mean value of vitamin B12 level was presented in the most of patients pre- and post- chemotherapy. Vitamin B6 concentrations in the most of patients risen by double post-chemotherapy. Vitamin D concentration not changed in pre- and post- chemotherapy. We observed a statistically significant differences among vitamin E concentration pre- and post- chemotherapy (ANOVA=3.213, P=0.033). In this study, most of patients pre-chemotherapy period had normal folate level, whereas it to decreased from (6.23±3.12 ng/mL) to reached (3.33±2.72 ng/mL) after anti-cancer, with strong statistically significant differences (ANOVA=6.56, P=0.012). In addition, vitamin K concentration was unchanged throughout chemotherapy cycles. Many factors in cancerous participants lead to vitamins deficiencies. Several vitamins remained within normal concentration throughout anti-cancer course might be due to vitamins supplement taken by persons during their regimens. Almost always vitamins concentration dropped during cycles, but still within normal value, except vitamin E, which was deficient in last cycle of chemotherapy. Vitamins replacement are mandatory for substitution dropping level because off those are essential for many body processes and regulation.

Association of low serum vitamin D level among pulmonary tuberculosis patients

Background: Recent studies suggest that the incidence and severity of tuberculosis is associated with low levels of Vitamin D, this is especially important in developing countries like India which carries a major portion of global Tuberculosis burden. Therefore, this study aimed to determine the prevalence of Vitamin D deficiency in newly diagnosed tuberculosis patients in our institute. Aims and objective is to study the deficiency of Vitamin D In newly diagnosed sputum positive pulmonary TB and to compare the level of Vitamin d with that of age matched healthy control population.Methods: This was a descriptive cross-sectional case control study to asses Vitamin D deficiency among 140 cases which included 2 categories of patients (a) Group 1: 70 sputum AFB positive newly diagnosed pulmonary TB patients, (b) Group 2: 70 apparently healthy people who came to the hospital with regular checkup.Results: Mean age of study groups and control in years were, Control: 40.3857±10.231, Cases: 36.885±11.076. Mean BMI was significantly higher in controls when compared with new TB cases (19.27±2.455 vs 15.215±1.774) kg/m2 p <0.05).There was significant decrease in mean Vitamin D3 value when new cases TB patients were compared with controls (18.212±9.3027 vs 36.1267±8.410 p <0.05).Conclusions: Patients with tuberculosis are significantly Vitamin D deficient as compared to normal people. This deficiency is more marked in females and those with low BMI. The present finding favours the role of Vitamin D in the prevention and treatment of tuberculosis in developing countries like India.

A study to correlate association between vitamin D with fibroid and its supplementation in the progression of the disease

Background: Uterine fibroids, or leiomyomas are the most common benign tumors of the female reproductive tract, affecting up to 60% of Indian women with only 25% of women who are symptomatic. Symptoms do not always correlate with the size, number, or location of the fibroids. Recent studies suggest that hypovitaminosis D is associated with an increased risk of uterine fibroids.Methods: Total 110 women diagnosed with fibroid in USG were included in the study. Inclusion and exclusion criteria were applied and size of the fibroid noted. 60 women were included in the study group who took Vitamin D supplementation and 50 women in the control group who didn’t perform the study properly.Results: The growth pattern of fibroids with study group under supplementation with 25-OH-D3 seems to be stable, with no increases or decreases in size or number of identified lesions. Instead, women in control group, who did not perform appropriate vitamin D supplementation seem to have a slight but significant increase in size of the lesions.Conclusions: It was seen that hypovitaminosis D was associated with fibroid and thus supplementation with Vitamin D helped in the shrinkage of fibroid or slower the progression of the disease.

Prophylactic Vitamin D Supplementation Practices for Infants: A Survey of Pediatricians From Delhi

This survey was conducted among 125 pediatricians working inpublic and private child care facilities of Delhi. Prescription ratesof routine vitamin D supplementation varied between 70-100%for various groups of infants, despite non-availability ofgovernment guidelines. Pediatricians in private practice morefrequently prescribed vitamin D supplementation to term healthyinfants as compared to government pediatrician (91.4% vs71.6%; P=0.005).

Hiperpigmentación cutánea secundaria a déficit de vitamina B12 en un lactante / Cutaneous hyperpigmentation secondary to vitamin B12 deficiency in an infant

La hiperpigmentación cutánea es una manifestación clínica poco frecuente del déficit de vitamina B12 (cobalamina). Su causa no se conoce con exactitud, y existen varias teorías en su etiopatogenia.Se presenta a una niña de 8 meses de edad, con antecedentes de retraso neuromadurativo, hipotonía, anemia y neutrope-nia, derivada a nuestro Servicio por hiperpigmentación cutá-nea del dorso de las manos y los pies de 3 meses de evolución. Ante la sospecha clínica de déficit de vitamina B12, se realizó un análisis de laboratorio, en el que se constató una marcada disminución de los niveles séricos de cobalamina, por lo que se indicó tratamiento sustitutivo con esta.Se destaca la importancia de la presunción diagnóstica de déficit de vitamina B12 como causa de hiperpigmentación cutánea y su resolución luego de la instauración del tratamiento adecuado.

Cutaneous hyperpigmentation is a rare clinical feature of vi-tamin B12 (cobalamin) deficiency. The cause is unknown and there are different hypothesis about the pathogenesis of the hyperpigmentation.We report the case of an 8-month-old girl, with history of neu-romadurative delay, hypotonia, anemia and neutropenia, who was referred to our Service by brownishhyperpigmentation on her hands and feet of 3 months of evolution. Based on the clinical suspicion of vitamin B12 deficiency, we performed a laboratory dosage that showed decreased levels of cobalamin, reason for which replacement therapy was indicated.It highlights the importance of the presumption of vitamin B12 deficiency as a cause of cutaneous hyperpigmentation and its rapid resolution after the establishment of the appro-priate treatment.

Vitamin D: role of vitamin D in human health beyond skeleton

Deficiency of vitamin D is now considered as epidemic in Indian subcontinent, with a prevalence of 70-94% in the general population. Like in US, Indian dairy products are rarely fortified with vitamin D. Socioreligious and cultural practices followed in India do not facilitate adequate sun exposure, thereby negating potential benefits of plentiful sunshine resulting in vitamin D deficiency. Deficiency is highly prevalent in both urban and rural settings. Vitamin D deficiency can lead to rickets, osteoporosis, cardiovascular diseases, diabetes, cancer and infections. In present review authors have revisited the details pertaining to vitamin D to increase the awareness on Vitamin D efficiency.

Study of correlation between maternal and cord blood vitamin D3 levels

Background: Vitamin D deficiency during pregnancy and in newborn period is common in this country. Vitamin D status of the mother is known to influence the vitamin D levels in the neonate, however how closely the maternal vitamin D level correlates with the cord blood Vitamin D is not clearly understood. To study the correlation between maternal and neonatal serum Vitamin D3 levels by as indicated by cord blood 25(OH)D levels and find out if there is a significant variation of cord blood 25(OH)D levels in Vitamin D sufficient and insufficient mothers.Methods: Healthy pregnant women between 18-45 years of age with no known history of chronic disease or long-term medication, consenting for the study were enrolled. Maternal blood sample was collected in peripartum period, cord blood sample was obtained after delivery from the umbilical cord after clamping. Vitamin D3 levels were measured by RIA and paired maternal and cord blood levels were statistically analyzed.Results: 569 paired samples of maternal and cord blood were analyzed. The mean maternal serum 25(OH)D level was 35.63ng/ml (sd 6.18, range 9.2-39.8) as compared to 13.52ng/ml (sd 3.79, range 7.9-27) for the neonates. 457 of the mothers were found to have sufficient, 101(18%) insufficient and 11(2%) deficient Vitamin D levels as per Endocrinological Society guidelines. In comparison, 535(94%) of the neonates had deficient levels, none of the neonates had sufficient Vitamin D levels, 34(5.99%) had insufficient levels. No significant correlation was found between maternal and neonatal serum vitamin 25(OH)D levels (r=0.007, P=0.85).Conclusions: Maternal and Cord blood serum Vitamin D3 levels were found to be poorly correlated in this study.

Prevalence and risk factors for Hypovitaminosis D among healthy adolescents in Kota Bharu, Kelantan / Journal of the ASEAN Federation of Endocrine Societies

@#Objective. We aim to study the prevalence and risk factors of hypovitaminosis D among healthy adolescents in Kota Bharu, Kelantan based on the most recent Paediatric Consensus guideline. Methodology. Ten public schools were selected from Kota Bharu, Kelantan. We analysed their demography (age, gender, ethnicity, income), measured their anthropometry (height, weight, BMI) and finally analysed their vitamin D and intact- Parathyroid hormone levels. Results. The prevalence of hypovitaminosis D was 16.9% among healthy teenagers with mean age of 15.9±1.39 years. Multivariate analysis showed female gender (adjusted OR, 95% CI): 23.7 (5.64, 100.3) and Chinese 0.24 (0.07, 0.84) were the significant predictors for hypovitaminosis D. Conclusion. The prevalence of healthy adolescents with hypovitaminosis D in Kota Bharu, Kelantan was 16.9% using the most recent cut off value of 30 nmol/L from the global consensus 2016. Female and Malay were the significant risk factors associated with hypovitaminosis D. Higher cut off value would result in overestimation of prevalence rate of hypovitaminosis D.