Alert for the high prevalence of vitamin D deficiency in adolescents in a large Brazilian sample

Abstract Objective: To estimate the prevalence of vitamin D deficiency and severe deficiency in children and adolescents, in a large Brazilian sample. Methodology: Results of 413,988 25(OH)D measurements in children and adolescents aged 0 to 18 years collected between 01/2014 and 10/2018 were obtained from the database of a Clinical Laboratory. In this population, 25 hydroxyvitamin D concentrations below 20 ng/mL are considered deficient, and below 12 ng/mL as severe deficiency. All measurements were performed by immunoassay and the results were distributed by gender, age group, seasonality, and latitude. Results: The mean of 25(OH)D levels was 29.2 ng/mL with a standard deviation of 9.2 ng/mL. Of the total samples, 0.8% had a concentration < 12 ng/mL, and 12.5% of the samples had a concentration < 20 ng/mL, with a higher prevalence in females. Children under 2 years of age had the lowest prevalence. The effects of latitude and seasonality were quite evident. In samples of female adolescents from the southern region in winter, 36% of vitamin D deficiency and 5% of severe deficiency were found. Conclusion: In this large number of measurements of 25(OH)D in children and adolescents, 12.5% had a deficiency and 0.8% had severe deficiency. A greater deficiency was observed among adolescents, especially females, which raises questions about the need for supplementation during this period of life.

Ingesta de calcio y vitamina D: relación con exceso de peso en población costarricense / Calcium and vitamin D intake, its relationship with weight excess in Costa Rican population

Introducción: La presencia de sobrepeso y obesidad aumentan la morbimortalidad de la población latinoamericana. La deficiencia de micronutrientes como el calcio y la vitamina D se han relacionado con un aumento del riesgo de obesidad. Objetivo: Determinar la relación entre la ingesta de vitamina D y de calcio con los factores de riesgo para obesidad en la población urbana costarricense incluidas en el Estudio ELANS. Materiales y métodos: Se incluyeron 798 participantes costarricenses del Estudio ELANS. Se determinó la distribución del consumo de calcio y vitamina D según las características socioeconómicas, la actividad física y los datos antropométricos. Se compararon los grupos con las pruebas U de Mann ­ Whitney y Kruskal-Wallis. Se realizaron modelos de regresión lineal y logística. Resultados: El consumo de calcio y vitamina D fue inadecuado en más del 98% de los participantes. Las mujeres, las personas con menor nivel socioeconómico, baja actividad física, de menor edad, con exceso de peso y obesidad abdominal presentaron un consumo menor de calcio y de vitamina D. El consumo de calcio y vitamina D es mayor en los grupos que tienen un menor IMC (p= 0,023 para calcio y p= 0,252 para vitamina D). Las personas con menor circunferencia de la cintura tuvieron más consumo de calcio y vitamina D (p= 0,002 para calcio y p= 0,008 para vitamina D). No hubo asociación del consumo en los modelos de regresión. Conclusiones: El consumo de calcio y vitamina D es deficiente en la población urbana costarricense y, presentó una relación inversa con el IMC(AU)

ntroduction: The presence of overweight and obesity increase the morbimortality of people in Latin America. Micronutrient deficiencies, such as calcium and vitamin D, are associated with an increased risk of obesity. Objective: To determine the relationship between vitamin D and calcium intake with risk factors for obesity in the Costa Rican urban population included in the ELANS Study. Materials and methods: For this analysis we used the 798 Costa Rican participants of the study (ELANS). The distribution of calcium and vitamin D intake was determined according to socioeconomic status, physical activity, and anthropometric measures. The Mann ­ Whitney and Kruskal-Wallis U tests were used, as well as linear and logistic regression models were performed. Results: Calcium and vitamin D intake was inadequate in more than 98% of the participants. Women, individuals with a lower socioeconomic level, low physical activity, younger age and those with excess weight and abdominal obesity presented lower consumptionofcalciumandvitamin D. Theconsumption of calcium and vitamin D was greater in the groups that have a lower BMI (p= 0.023 for calcium and p= 0.252 for vitamin D). The smaller the waist circumference, the greater the consumption of calcium and vitamin D (p= 0.002 for calcium and p= 0.008 for vitamin D). No association of the consumption of calcium and vitamin D was found in the regression models. Conclusions: Consumption of calcium and vitamin D is deficient in the Costa Rican urban population, and more prevalent among those with higher BMI. Arch Latinoam Nutr 2024(AU)

Síndrome de Klinefelter, testosterona y sueño: a propósito de un caso clínico / Klinefelter's syndrome, testosterone and sleep: a clinical case

Se presenta un caso clínico de Síndrome de Klinefelter y se revisan que los aspectos en relación al sueño en estos pacientes, siendo relevante a ser abordado y estudiado debido a la relación causal entre el metabolismo de esteroides sexuales afectados. En especial la testosterona y cómo esto influye en la microarquitectura del sueño y la probabilidad de presentar síndrome de apnea obstructiva del sueño, con las repercusiones cognitivas que pueden sumarse a las ya descritas por el síndrome en si. De allí la importancia de un seguimiento y abordaje dirigido en este aspecto, al momento del diagnóstico y en el seguimiento a largo plazo.

A clinical case of Klinefelter's Syndrome is presented and the aspects related to sleep in these patients are reviewed, being relevant to be addressed and studied due to the causal relationship between the metabolism of affected sex steroids, especially testosterone and how this influences the microarchitecture of sleep and the probability of presenting obstructive sleep apnea syndrome with the cognitive repercussions that can be added to those already described by the syndrome itself. Hence the importance of a targeted follow-up and approach in this aspect, at the time of diagnosis and in long-term follow-up.

Progress of chronic obstructive pulmonary disease patients with different muscle mass levels / 公共卫生与预防医学

Objective To investigate the difference of the disease progression in patients with chronic obstructive pulmonary disease (COPD) with different muscle mass levels and the influence of related factors on the disease progression. Methods A total of 308 newly diagnosed patients with COPD from February 2021 to February 2022 were selected for this study. All patients were below moderate COPD. The patients were divided into two groups according to their muscle mass levels: sarcopenia group (98 cases) and control group (210 cases). The diagnostic criteria for sarcopenia were based on sarcopenia diagnostic thresholds: RSMI 2 in men and 2 for women. All subjects were followed up for 4 months to observe the progress of the patient's condition. The correlation between the muscle mass level and pulmonary function level, as well as the results of 6-minute walking test and CAT score was evaluated, and the influence of muscle mass level on the patient's disease progress was analyzed. At the same time, the potential influence of related factors (body fat rate, vitamin D level, etc.) on the condition of patients with different muscle mass levels was discussed. SPSS 19.0 software was used to perform statistical analysis. Results Under the same treatment intervention, the baseline and follow-up lung function improvement levels of patients in the sarcopenia group were lower than those in the control group, and the difference was statistically significant (P<0.05). At the same time, the baseline and follow-up 6-minute walk test results of the patients in the sarcopenia group were also worse than those of the control group, and the difference was statistically significant (P<0.05). Further correlation analysis was carried out between the patient's muscle mass level and the post-treatment pulmonary function indicators and 6MWD test level. The results showed that the muscle mass level was positively correlated with several pulmonary function indicators (FEV1, FEV1% predict) and 6MWD (both P<0.05). Considering the possible influence of other factors on the control and progress of the patient's condition, the present study used follow-up CAT score results to distinguish the prognosis of the patient's condition improvement, and used improvement and non-improvement as dependent variables to analyze the influence of various potential influencing factors. The results of regression model analysis showed that lower baseline muscle mass, women, lower body fat percentage, and lower vitamin D level were the main risk factors. Conclusion Under the same treatment condition, COPD patients with different muscle mass levels improve more slowly when complicated with sarcopenia and have poor prognosis. Women, lower body fat percentage and lower vitamin D level are potential risk factors for poor prognosis.

Analysis of laboratory indicators such as vitamin D and blood lipids and pregnancy outcomes in pregnant women with preeclampsia / 重庆医学

Objective To explore the relationship among serum vitamin D,calcium ion,blood lipid lev-els and preeclampsia in pregnant women,and analyze the pregnancy outcomes of pregnant women with pre-eclampsia.Methods A total of 166 pregnant women with preeclampsia who underwent pregnancy examina-tion and delivered in Urumqi Municipal Maternal and Child Health Care Hospital from January 1,2021 to Jan-uary 1,2023 were selected as the observation group,and 200 healthy pregnant women during the same period were selected as the control group.The levels of serum vitamin D,calcium ion,phosphorus ion,blood lipid in-dicators,uric acid,and creatinine were detected in the two groups,and the pregnancy complications and preg-nancy outcomes were observed.The influencing factors of preeclampsia were analyzed by using multivariate logistic regression model.Results The levels of serum vitamin D,calcium ion,and high density lipoprotein in the observation group were lower than those in the control group,and the levels of serum uric acid and creati-nine were higher than those in the control group,with statistical significance(P＜0.05).The incidence of fetal growth retardation,placental abruption,oligohydramnios,cesarean section,low birth weight infants,premature delivery,and postpartum hemorrhage in the observation group were significantly higher than those in the con-trol group(P＜0.05).Multivariate logistic regression analysis showed that serum vitamin D(OR=15.141,95％CI:1.831-125.204,P=0.012),calcium ion(OR=4.625,95％CI:2.654-8.059,P＜0.001),high-den-sit y lipoprotein(OR=0.395,95％CI:0.235-0.666,P＜0.001),creatinine(OR=1.034,95％CI:1.005-1.063,P=0.020)and uric acid(OR=1.006,95％CI:1.003-1.010,P＜0.001)were independent factors for the occurrence of preeclampsia in pregnant women.Conclusion The levels of serum vitamin D,calcium ions,blood lipids,uric acid and creatinine may be correlated with the occurrence of preeclampsia.

Analysis of Vitamin D in Children with Henoch-Schonlein Purpura / 昆明医科大学学报

Objective To analyze the changes of vitamin D in children with Henoch-Schonlein purpura(HSP).Methods 130 children with HSP from Kunming Children's Hospital between July 2022-July 2023 were selected as the study subjects and 100 healthy children were selected during the same period as the control group.The blood samples were collected from the children with HSP and the healthy children.The content of vitamin D was measured by Kunming Kingmed Institute for Clinical Laboratory.Results The content of 25(OH)D in children with HSP was lower than that in healthy children,and the difference was statistically significant(P<0.01).The proportion of vitamin D insufficiency in children with HSP was higher than that in healthy children,and the difference was statistically significant(P<0.01).Conclusion The children with HSP are prone to vitamin D insufficiency.Vitamin D supplementation may provide a new method for the treatment of HSP.

Analysis on Nutritional Status of Vitamin D Among Adults of 6 Ethnic Minority Groups Native to Yunnan Province / 昆明医科大学学报

Objective To assess the nutritional status of vitamin D and associated factors among adults of six ethnic minority groups native to Yunnan Province,and provide evidence for policy making.Methods Between May 2019 and August 2020,a total of 690 adults were selected from Jinuo,Bulang,Jingpo,Deang,Achang and Pumi ethnic groups according to the sex and age composition in the 6th national census.A questionnaire survey and an anthropometric examination were conducted by trained health workers,and serum 25(OH)D levels were determined with high-performance liquid chromatography-tandem mass spectrometry.Results The median of serum 25(OH)D was 28.7(P25～P75∶24.3～33.8)ng/mL,and the prevalence of vitamin D sufficiency,insufficiency and deficiency were 44.2%、47.5%and 8.3%,respectively.There were significant differences in serum 25(OH)D levels among the six ethnic groups(χ2=139.29,P<0.01).Multivariate logistic regression showed that ethnic groups living in higher latitude areas(Pumi,Jingpo,Deang,and Achang),women,and those whose BMI≥24.0 were more likely to be vitamin D insufficient or deficient.Conclusion More than half of the ethnic adults suffer from vitamin D malnutrition which also varies across ethnicities.Further surveillance and interventions among key areas and populations are needed.

Primary hyperparathyroidism with negative 99mTc-MIBI imaging:one case report / 复旦学报（医学版）

This article reports the diagnosis and treatment of a patient with primary hyperparathyroidism(PHPT)and vitamin D deficiency.The patient was a young male with a insidious onset.Multiple tests have shown hypercalcemia,hypophosphatemia,hypercalciuria,and hyperparathyroidism.There was no renal dysfunction,and the diagnosis of PHPT was clear.There were kidney stones and vitamin D deficiency at the same time.The patient met the surgical indications,but the difficulty in preoperative localization was that ultrasound examination showed suspicious masses in both parathyroid regions,and the 99mTc-MIBI imaging result was negative.Finally,accurate preoperative localization was achieved through 18F-fluorocholine PET/CT,and the patient was cured after surgery.

Research on Serum 25-Hydroxy Vitamin D Level in Healthy Children Aged 0～12 Years for Physical Examination in Xi'an Area / 现代检验医学杂志

Objective To investigate and evaluate the nutrition status in serum 25-hydroxy vitamin D[25(OH)D]levels of 0～12 years old children in Xi'an.Methods A total of 2 670 patients aged 0～12 years old who underwent routine physical examinations in Children's Health Department of the Second Hospital of Air Force Medical University were selected from March 2020 to July 2023,and the 25(OH)D data of these patients were conducted in retrospective analysis.The nutritional status of vitamin D in these children of different genders,ages and seasons were also analyzed.Results ①This study included 2 670 children aged 0～12 years old in Xi'an,with the average level of serum 25(OH)D was 40.80±18.00 ng/ml.Among them,38 cases(1.42%)had serum 25(OH)D deficiency,333 cases(12.47%)had serum 25(OH)D insufficience,and 2 299 cases(86.11%)had sufficient serum 25(OH)D.②There was a statistically significant difference in serum 25(OH)D levels among different age groups(H=1 524.23,P=0.000).The group aged 1～<4 has the highest value of 52.51±13.57 ng/ml,while the group aged 8～12 has the lowest value of 21.65±6.75 ng/ml.③The levels of serum 25(OH)D in summer(39.44±17.46 ng/ml)were lower than those in spring(41.96±17.76 ng/ml)and autumn(42.71±18.15 ng/ml),with statistical significant differences(Z=101.57,-134.06,all P<0.01).However,the deficiency and inadequate rate of serum 25(OH)D in winter(18.95%)was higher than those in spring,summer and autumn(13.52%,12.75%,12.36%),with statistical significant differences(χ2=14.32,P=0.026).④There was no statistically significant difference in serum 25(OH)D levels between genders(H=0.933,P=0.351).However,the deficiency and inadequate rate of serum 25(OH)D in boys(12.51%)was lower than that in girls(15.46%),and the difference was statistically significant(χ2=9.257,P=0.010).Conclusion The nutritional status of serum 25(OH)D in children aged 0～12 years in Xi'an area is comparatively fine,and it is necessary to strengthen the intake and supplementation of vitamin D in over 3 years old children.

Vitamin D3 attenuates high-glucose exposure-induced oxidative stress to promote osteogenic differentiation of human umbilical cord mesenchymal stem cells / 中国组织工程研究

BACKGROUND:Diabetic osteoporosis is gaining public attention.However,few studies have reported the effect of a high-glucose environment on the osteogenic differentiation of human umbilical cord mesenchymal stem cells and the corresponding therapeutic strategies. OBJECTIVE:To investigate whether vitamin D3 can restore the osteogenic differentiation potential of human umbilical cord mesenchymal stem cells in a high-glucose environment. METHODS:The viability of human umbilical cord mesenchymal stem cells was detected by CCK-8 assay to screen the appropriate vitamin D3 intervention concentration.Under the high-glucose environment,RT-qPCR,western blot assay,immunofluorescence,JC-1 mitochondrial membrane potential,alizarin red staining,and β-galactosidase staining were used to evaluate the osteogenic differentiation potential,intracellular reactive oxygen species accumulation,mitochondrial membrane potential alteration,and cell senescence of human umbilical cord mesenchymal stem cells after vitamin D3 intervention.The underlying mechanism was also discussed. RESULTS AND CONCLUSION:(1)Vitamin D3 significantly promoted the proliferation of human umbilical cord mesenchymal stem cells in the range of 0.1 μmol/L to 1 mmol/L.(2)High-glucose environment down-regulated the mRNA and protein level expressions of osteogenic-related genes α1-I collagen,alkaline phosphatase,Runt-associated transcription factor 2,and osteocalcin in human umbilical cord mesenchymal stem cells,which induced oxidative stress and cellular senescence.(3)Vitamin D3 at an intervention concentration of 10 μmol/L significantly restored the osteogenic phenotype of human umbilical cord mesenchymal stem cells under high-glucose conditions and attenuated intracellular oxidative stress and cellular senescence by activating the Nrf2/HO-1 signaling pathway.(4)These findings suggested that the osteogenic differentiation ability of human umbilical cord mesenchymal stem cells was reduced in the high-glucose environment,and vitamin D3 could partially improve their osteogenic differentiation ability and reduce cell damage.

Luzhongjiangu decoction for the treatment of femoral head necrosis in rats:changes in intestinal flora and serum hormones / 中国组织工程研究

BACKGROUND:Osteonecrosis of the femoral head is a common and disabling disease,which is mainly characterized by microcirculation disorders and bone cell metabolism disorders.Luzhongjiangu decoction was developed by Shandong Academy of Chinese Medicine and used in the form of soup in the clinic,which has good efficacy in the treatment of osteonecrosis of the femoral head.However,its mechanism of action has not been clarified. OBJECTIVE:To study the effect mechanism of Luzhongjiangu decoction on intestinal flora in rats with osteonecrosis of the femoral head based on 16S rDNA sequencing technique. METHODS:The model of osteonecrosis of the femoral head was established in Wistar rats by intragastric administration of retinoic acid.The therapeutic effect of Luzhongjiangu decoction was evaluated by serum hormone,bone histopathology and serum hormone levels.16s rDNA sequencing technique was used to detect the intestinal flora of rats in the blank control group,model group and middle-dose Luzhongjiangu decoction group.The corresponding library was constructed and OTU clustering and microbial community diversity and abundance analysis were carried out to determine the composition of intestinal flora and the changes of species and diversity among groups. RESULTS AND CONCLUSION:Luzhongjiangu decoction could significantly increase the expression of osteocalcin,osteopontin and other osteogenic related factors,alleviate the destruction of bone trabeculae,increase bone mineral density,and had a significant therapeutic effect on osteonecrosis of the femoral head,of which the middle dose group showed the most significant effect.The results of intestinal flora sequencing showed that Luzhongjiangu decoction improved the flora disorder of rats with osteonecrosis of the femoral head to some extent,and screened out different colonies such as Bacillus,Desulfurizans,Desulfurization,Isobacteria,Bifidobacterium and so on;it could up-regulate the abundance of beneficial bacteria such as Bifidobacterium,down-regulate the abundance of harmful bacteria such as Desulfovibrio,and improve the structure of intestinal flora.Functional prediction analysis indicated that Luzhongjiangu decoction could mainly affect amino acid metabolism and energy metabolism.Correlation analysis showed that the differential bacteria of Bifidobacterium and Intestinimonas in the middle dose group of Luzhongjiangu decoction were positively correlated with vitamin D3,estradiol and calcitonin,and negatively correlated with prostaglandin E2.In the model group,Escherichia-Shigella,Desulfovibrio,Globicatella and Streptococcus were positively correlated with prostaglandin E2 and negatively correlated with vitamin D3,estradiol and calcitonin.To conclude,Luzhongjiangu decoction may play a role in the treatment of osteonecrosis of the femoral head by regulating the structure of intestinal flora,up-regulating the abundance of beneficial bacteria and affecting the secretion of vitamin D3,estradiol,calcitonin and prostaglandin E2.

Impact of maternal serum vitamin D status on fetal long bone development / 中华内分泌代谢杂志

Objective:To investigate the effect of maternal serum vitamin D on fetal long bone development.Methods:A retrospective collection of 1 193 first-time pregnant women who visited our hospital′s prenatal diagnosis center from July 2018 to June 2020 was conducted. All underwent prenatal fetal ultrasound examination and serum vitamin D level detection. Based on the dosage of vitamin D administered after the first vitamin D test, participants were divided into the basic dosage group(vitamin D 3, 1 600 IU/d, orally) and the adequate supplementation group(vitamin D 2 injection 600 000 IU/2 weeks, intramuscular injection). The serum 25-(OH)D levels of the two groups of pregnant women were compared at 12 and 24 weeks of treatment, as well as the long bone growth of their fetuses. Multivariable logistic regression analysis was used to analyze the factors influencing fetal long length. Results:Compared to the basic dosage group, the adequate supplementation group showed a significant increase in serum 25-(OH)D levels in pregnant women at 8 weeks, 12 weeks, and 24 weeks of treatment. The adequate supplementation group also significantly increased fetal long bone length at 12 weeks[(4.93±0.75) cm vs(4.61±0.73) cm, P<0.05] and 24 weeks of treatment [(7.92±0.84) cm vs(7.25±0.92) cm, P<0.05], with the difference between the two groups being more pronounced at 24 weeks of treatment. Maternal height, basal vitamin D level, and vitamin D level at 24 weeks of gestation were positively correlated with fetal long bone length. Conclusion:Pregnant women should maintain a relatively high level of basal vitamin D, and pay attention to the effect of vitamin D level on the fetus. A sufficient amount of vitamin D supplementation is of great significance for the long bone development of the fetus.

Research progress in the relationship between vitamin D deficiency and central precocious puberty in children / 中国儿童保健杂志

Central precocious puberty (CPP) is an endocrine disease of children due to the early onset of hypothalamic-pituitary-gonadal axis function. This leads to increased secretion of gonadotropin release impulse, causing the development of internal and external genitalia and the presentation of secondary sex characteristics. Studies have found that the onset of CPP in children may be related to vitamin D deficiency. Vitamin D, affected by sunlight duration, acts on neurons and neurotransmitters in the hypothalamic-pituitary-gonadal axis, promotes obesity and affects the expression level of insulin-like growth factor-1, which are four factors involved in the occurrence and development of CPP. The overall effect of vitamin D combined with gonadotropin-releasing hormone analogues on CPP is significant. This article reviews the correlation between vitamin D deficiency and CPP, as well as the possible mechanism of action, in order to provide some theoretical basis for researchers.

Serum vitamin D level of children aged 0 to 3 years and its correlation with nutritional knowledge, attitude and behavior of caregivers in Yibin / 中国儿童保健杂志

【Objective】 To explore the correlation of serum vitamin D level of children aged 0 to 3 years with their caregivers′ nutritional knowledge, attitude and practice (KAP) in Yibin, in order to provide reference for the prevention of vitamin D deficiency in children. 【Methods】 A total of 783 children aged 0 to 3 years who underwent child health care at the First People′s Hospital of Yibin from January to December 2020 were selected into this study. Children′s general conditions (feeding, growth and development, lifestyle, etc.) were collected, and venous blood samples were taken to detect serum 25-(OH)D concentration using the chemiluminescence method. The caregivers′ nutritional KAP was investigated using a self-designed knowledge-attitude-practice questionnaire. The relationship between the children′s vitamin D nutritional status and their caregivers′ nutritional KAP was analyzed using pearson correlation analysis. 【Results】 1) The exclusive breastfeeding rate of children aged 0 to 3 years was about 62.2%. Significant differences were found in outdoor activity time and average vitamin D supplementation among different age groups (t=9.030, 10.260, P<0.05). 2) The average concentration of serum 25-(OH)D was (36.8±8.7)ng/mL, and the incidence of vitamin D deficiency was 21.84%. Significant differences were found in serum 25-(OH)D level and the incidence of vitamin D deficiency among children of different ages, body shapes, outdoor activities, and vitamin D supplementation (t/F: 2.220 - 6.302, χ2: 5.346 - 33.134, P<0.05). 3) The caregivers′ nutritional KAP scores were 78.9±9.9, 88.1±8.3, and 78.3±11.8, respectively, with parents scoring higher than other caregivers (P<0.05). 4) Serum 25-(OH)D level was positively correlated with the nutritional knowledge, attitude, and behavior scores of caregivers (r=0.805, 0.650, 0.831, P<0.05). The caregivers′ nutritional KAP grade was correlated with vitamin D deficiency (P<0.05). 5) Overweight/obesity was a possible risk factor for vitamin D deficiency in children (OR=2.126, 95%CI: 1.162 - 3.887). Outdoor activity duration ≥2h/d (OR=0.592, 95%CI: 0.392 - 0.895), regular vitamin D supplementation (OR=0.618, 95%CI: 0.456 - 0.838), and good nutritional behavior of caregivers(OR=0.725, 95%CI: 0.563 - 0.933) were protective factors for vitamin D deficiency in children (P<0.05). 【Conclusions】 The prevalence of vitamin D deficiency is high among children aged 0 to 3 years in Yibin, and it is related to the nutritional KAP of their caregivers. Improving the nutritional KAP of caregivers can help prevent and manage vitamin D deficiency in children.

Status of vitamin A, vitamin D and comorbidity of both deficiency in Chinese children / 中国儿童保健杂志

Vitamin A and vitamin D deficiencies or insufficiencies in children remain global public health problems. The deficiencies of both vitamin A and vitamin D exist in Chinese children, the deficiency of vitamin A is mainly marginal (about 30%) in children aged 0 - 12 years.Vitamin D deficiency and prevalence are common in healthy children aged 0 - 18 years, among which the severe deficiency rate is 2.46%, the deficiency rate is 21.57%, and the marginal deficiency rate is 28.71%.The deficiency rate gradually increases with the increase of age.Since the respective bioactive metabolites of vitamin A and vitamin D, retinoic acid and 1 and 25-dihydroxyvitamin D3 have hormone-like properties, and both metabolites are synthesized from their vitamin precursors by different tissues and cells in the body, there may be a synergistic effect between both on target cells remotely by binding to nuclear hormone receptors.A high proportion of concurrent vitamin A and vitamin D deficiencies (comorbidities) in malnourished children under 5 years of age in low- and middle-income countries and poor areas will affect the immune response in a highly specific way, in addition to causing growth and developmental disorders (e.g., growth retardation, motor retardation), it also increases susceptibility to infectious diseases (e.g., recurrent respiratory infections, diarrhea), allergic diseases (e.g., asthma, atopic dermatitis), and neurodevelopmental disorders (touretic disorder, autism spectrum disorder).Therefore, children in the period of growth and development may benefit from supplementing with vitamin A and vitamin D.

The effects and molecular mechanisms of vitamin D3 on airway inflammation and oxidative stress response in a mouse model of bronchial asthma / 安徽医科大学学报

Objective @#To investigate the role and related molecular mechanisms of vitamin D3 ( VitD3 ) in airway inflammation and oxidative stress response in bronchial asthma mice．@*Methods @#Twenty-eight female C57BL/6 mice were randomly divided into a control group ( Ctrl) and a model group．The model group mice were sensitized using ovalbumin ( OVA) to establish an asthma model，and were further divided into an asthma (Asthma) group， VitD3 treatment (Asthma + VitD3 ) group，and Forkhead Box O1 (FOXO1) inhibitor AS1842856 treatment (Asth- ma + AS) group．Lung resistance (LR) changes were measured in each group of mice．Enzyme-linked immunosor- bent assay (ELISA) was used to detect the levels of tumor necrosis factor-alpha (TNF-α) ，interleukin ( IL) -1 β , and IL-18 in bronchoalveolar lavage fluid ( BALF) ．Western blot was used to determine the expression levels of FOXO1，NOD-like receptor pyrin domain containing 3 (NLRP3) ，Caspase-1，and apoptosis-associated speck-like protein (ASC) in lung tissue. @*Results @#ompared to the Ctrl group mice，LR increased in the Asthma group mice (P＜0. 01) ．Compared to the Asthma group，LR decreased in the Asthma + VitD3 and Asthma + AS group mice (P＜0. 05) ，with no significant difference in LR change between Asthma + VitD3 and Asthma + AS group mice. Compared to the Ctrl group，TNF-α , IL-1 β , and IL-18 levels in BALF，as well as NLRP3，Caspase-1，and ASC protein expression levels in lung tissue，increased in the Asthma，Asthma + VitD3 ，and Asthma + AS group mice (P＜0. 05) ．Compared to the Asthma group，the Asthma + VitD3 and Asthma + AS group mice showed decreased levels of the mentioned inflammatory factors in BALF and reduced protein expression of NLRP3，FOXO1，Caspase- 1，and ASC in lung tissue (P＜0. 05) ．Compared to the Asthma + VitD3 group，the Asthma + AS group showed in- creased FOXO1 protein expression (P ＜0. 05) ，with no statistically significant differences in the other measured indicators．@*Conclusion @#VitD3 can alleviate asthma symptoms induced by OVA in mice，improve the degree of air- way inflammation，and reduce oxidative stress levels．The mechanism may be related to the downregulation of the FOXO1/ NLRP3 axis.

Effect of Icariin on Peripheral Blood Dendritic Cells and Th17/Treg Balance in Myocardial Remodeling Model of Dahl Salt-sensitive Rats / 中国实验方剂学杂志

ObjectiveTo investigate the effect of icariin （ICA）-mediated vitamin D system on peripheral blood dendritic cells （DCs） and helper T cells 17 （Th17）/regulatory T cells （Treg） balance in myocardial remodeling model of Dahl salt-sensitive rats. MethodFifty SPF Dahl salt-sensitive rats were divided into model group， vitamin D group （3×10-5 mg·kg-1·d-1）， and high-， medium-， and low-dose ICA groups （120， 60， 30 mg·kg-1·d-1）， and 10 Dahl salt-resistant rats were used as normal group. The myocardial remodeling model was established by feeding rats with a high-salt diet containing 8% NaCl. After six weeks of modeling， the normal group and the model group were given an equal volume of ultrapure water by gavage， and other groups were continuously administrated for six weeks. Cardiac echocardiography， hematoxylin-eosin （HE） staining， and Masson staining were used to observe the pathological changes in cardiac structure and fibrosis. The levels of serum 25（OH）D3， B-type N-terminal pro-brain natriuretic peptide （NT-ProBNP）， interleukin （IL）-17， transforming growth factor （TGF）-β1， IL-12， and IL-10 were detected by enzyme-linked immunosorbent assay （ELISA）. The phenotype of peripheral blood DCs and the ratio of Th17/Treg cells of rats were detected by flow cytometry. Real-time fluorescence quantitative polymerase chain reaction （Real-time PCR） and Western blot were used to detect the mRNA and protein expressions of vitamin D receptor （VDR），1α-hydroxylase （CYP27B1）， and 24-hydroxylase （CYP24A1） in peripheral blood DCs of rats. ResultCompared with the control group， the rats in the model group had pathological changes such as disordered arrangement of myocardial cells and cytoplasmic hypertrophy and swelling. Myocardial collagen fibers proliferated significantly， and the arrangement of myocardial fibers was disordered. The levels of serum 25（OH）D3 and IL-10 were significantly decreased， and the levels of serum IL-17， TGF-β1， IL-6， IL-12， and NT-ProBNP were significantly increased （P<0.05）. The costimulatory molecules CD40， CD80， CD86， and MHC-Ⅱ were highly expressed in the peripheral blood DCs， and the expression of CD11 and CD11b was lower （P<0.05）. The proportion of Th17 cells in the peripheral blood was significantly increased， and the proportion of Treg cells was decreased. The ratio of Th17/Treg was increased （P<0.05）. The mRNA and protein expressions of CYP24A1 in peripheral blood DCs increased， and the mRNA and protein expressions of CYP27B1 and VDR decreased （P<0.05）. Compared with the model group， the arrangement of myocardial fibers in each drug administration group was relatively regular， and the swelling of myocardial cells was significantly reduced. The pathological morphology of myocardial tissue was improved to varying degrees. The pathological changes in myocardial tissue were improved and alleviated to varying degrees. The drug could reduce the serum levels of NT-ProBNP， IL-17， TGF-β1， IL-6， and IL-12 and increase the level of serum 25（OH）D3 and IL-10 （P<0.05）. The expression of costimulatory molecules CD40， CD80， CD86， and MHC-Ⅱ in the peripheral blood DCs of rats was decreased， and the expression of CD11 and CD11b molecules was increased （P<0.05）. The drug could reduce the proportion of Th17 cells in peripheral blood and the ratio of Th17/Treg cells and increase the proportion of Treg cells （P<0.05）. It could decrease the mRNA and protein expressions of CYP24A1 in peripheral blood DCs of rats and elevate the mRNA and protein expression of VDR and CYP27B1 （P<0.05）. ConclusionICA can regulate the phenotype of peripheral blood DCs and the ratio of Th17/Treg cells by regulating the vitamin D system and play a role in improving myocardial remodeling from the perspective of immune balance.

Expression and prognostic value of serum VitD,FRT and HB-EGF in sep-sis patients / 中国感染控制杂志

Objective To explore and analyze the expression and prognostic value of serum vitamin D(VitD),fer-ritin(FRT)and heparin-binding epidermal growth factor(HB-EGF)in sepsis patients.Methods 86 sepsis patients who were admitted to the intensive care unit(ICU)of a hospital from January 2021 to January 2022 were selected as the case group,and 60 non-sepsis patients in the ICU were selected as the control group.According to the prognosis of sepsis patients one month later,patients were divided into survival group and death group.Patient's serum upon admission was taken,levels of serum VitD,FRT and HB-EGF were detected,the correlation with the prognosis of sepsis patients was analyzed,and the prognostic value was evaluated by area under curve(AUC)of receiver opera-ting characteristic curve.Results Levels of white blood cell count(WBC),C-reactive protein(CRP),procalcitonin(PCT),tumor necrosis factor-α(TNF-α),interleukin(IL)-6,IL-1β and FRT of case group were all higher than those of non-sepsis patients in the control group,while the VitD and HB-EGF levels were lower than those of non-sepsis patients in the control group,differences were all statistically significant(all P＜0.05).One month follow-up on the prognosis of sepsis patients showed that 55 patients survived and 31 died.Acute physiology and chronic health evaluationⅡ(APACHE IⅡ)score,sequential organ failure assessment(SOFA)score,PCT,TNF-α,L-1βand FRT score in patients in the death group were all higher than those in patients in the survival group,while VitD and HB-EGF were lower than patients in the survival group,differences were all statistically significant(all P＜0.05).The Pearson correlation analysis results showed that VitD were negatively correlated with APACHE Ⅱ score,SOFA score,WBC,CRP,PCT and TNF-α(all P＜0.05),HB-EGF was negatively correlected with APACHE Ⅱ,score,CRP,PCT,TNF-α,IL-6 and IL-1β(all P＜0.05);while FRT was positively correlated with APACHE Ⅱscores,CRP,PCT,TNF-α,IL-6 and IL-1β(all P＜0.05).The AUC,sensitivity,and specificity of combined de-tection of serum VitD,FRT and HB-EGF in predicting the prognosis of sepsis patients were 0.82(95％CI:0.72-0.86),84.39％,and 69.35％,respectively.Conclusion Serum levels of VitD and HB-EGF are lower and FRT is higher in sepsis patients,their expression levels are closely related to patient prognosis,and have good predictive value for predicting the prognosis of sepsis patients.

Clinical research on sensitivity to thyroid hormones and its association with nutrition and metabolism: progress and perspectives / 中华临床营养杂志

Thyroid hormones are crucial for energy metabolism. Thyroid dysfunction is closely related to a variety of metabolic disorders. However, evaluation relying solely on thyroid function indicators may come up short, considering the complex relationship between thyroid hormones and metabolic issues. There has been a growing recognition of sensitivity to thyroid hormones as a measure of thyroid function complementary to traditional indices. The indicators of thyroid hormone sensitivity include free triiodothyronine/free thyroxine, thyrotroph thyroxine resistance index, thyroid-stimulating hormone index and thyroid feedback quantile-cased index. It has been reported that impaired sensitivity to thyroid hormones can potentially interact with various nutritional imbalances and metabolic abnormalities, such as metabolic syndrome, osteoporosis and decreased vitamin D, which are not only of concern to those with thyroid dysfunction, but also to euthyroid individuals in terms of prevention and prophylaxis. With the aim of providing comprehensive insights, this review is intended to systematically summarize the existing evidence on the association between sensitivity to thyroid hormones and metabolic disorders.

Effect of vitamin D on the structure and diversity of intestinal flora in spontaneously diabetic rats / 中国比较医学杂志

Objective To investigate the effect of vitamin D(VD)on intestinal flora in spontaneously diabetic rats.Methods Zucker diabetic fatty rats(ZDF rats)were randomised to control(Con)group,VD control(VD)group,model(T2DM)group,and VD intervention(VD+T2DM)group.Fasting blood glucose profiles and oral glucose tolerance levels were determined in rats of each group.16S rDNA sequencing was used to assess changes in rat intestinal flora.OTU analysis(Venn diagram),α diversity analysis(chao1,observed species,PD whole tree,and shannon and simpson),βdiversity analysis(principal coordinate analysis(PCoA)),flora structure,and colony species variability analysis(linear discriminant analysis and influence factor(LEfSe)analysis)were also performed.Results VD intervention significantly improved fasting blood glucose levels and insulin resistance in T2DM rats(P＜0.05).α diversity showed no significant differences in chao1,observed species,PD whole tree,and shannon and simpson indices between T2DM and VD+T2DM groups(P＞0.05).β diversity analysis showed that the VD+T2DM group had more species similarity to the Con group than the T2DM group.The dominant bacteria of rat intestinal flora in each group were significantly different.In comparison to the T2DM group,the VD+T2DM group showed a decrease in abundance of Bacteroidetes and increases in abundances of Firmicutes and Clostridium XIVa.Conclusions VD improves fasting glucose elevation and insulin resistance in T2DM rats.VD improves the structure of intestinal flora,decreases Bacteroidetes,and elevates Firmicutes and Clostridium XIVa abundances in T2DM rats.