The Impact of Vitamin D deficiency on Depression in Obese Adults.

BACKGROUND: There are studies showing associations between hypovitaminosis D and obesity, obesity and depression, and hypovitaminosis D and depression. This study aims to investigate the relationship between vitamin D levels and depression status of patients followed in an obesity center. METHODS: This retrospective study included 107 obesity patients followed up and treated at an obesity center. Patients were divided into two groups as serum 25(OH)D level < 20 ng/mL (deficient) and ≥ 20 ng/mL (not deficient) and compared in terms of Beck Depression Inventory scores. Patients were also divided into two groups according to BDI scores < 17 and ≥ 17, and serum 25(OH)D levels were evaluated. RESULTS: Patients at higher risk for depression (BDI score ≥ 17) had statistically significantly higher weight (p = 0.003) and BMI (p < 0.001), but had significantly lower serum 25(OH)D levels (p < 0.001). The BDI scores were found to be moderately positively related with the BMI (r = 0.404, p < 0.001), weakly negatively related with vitamin D levels (r = -0.383, p < 0.001), weakly positively related with weight (r = 0.293, p = 0.002). The BDI score me-dians (12 and 8, respectively) were found to be statistically significantly higher in patients with serum 25(OH)D levels of < 20 ng/mL compared to those with ≥ 20 ng/mL (p < 0.001). The increased BMI and decreased serum 25(OH)D levels have been found to independently increase the risk of depression in multivariate logistic regression analysis. The ROC analysis performed to evaluate the discriminative performance of serum 25(OH)D levels in predicting the risk of depression. The analysis showed that the serum 25(OH)D parameter was likely to reveal patients who were at higher risk for depression. For the cutoff point of 25(OH)D ≤ 19.21 level determined by Youden index, the sensitivity was found as 92.86% and the selectivity as 68.82%. CONCLUSIONS: In our study, the BMIs were higher and serum 25(OH)D levels were lower in obese individuals at risk for depression. Understanding or explaining the relationship between vitamin D deficiency and depression will contribute to revealing the preventive or therapeutic role of vitamin D supplementation for depression.

An Assessment of Anxiety about the Viral Epidemic and Work-Related Stress in Family Physicians in Turkey: How Does COVID-19 Vaccination Period Affect Anxiety and Stress?

BACKGROUND: Our study aimed to evaluate the extent of family physicians' anxiety about the viral epidemic and work-related stress associated with the viral epidemic as well as examining the effects of COVID-19 vaccination period on such situations. SUBJECTS AND METHODS: Data collection forms including the SAVE-9 scale, prepared for this cross-sectional study, were converted into online questionnaires and sent to family physicians in order to evaluate and examine the extent of anxiety and stress of family physicians working as family physicians in different provinces of Turkey via e-mails and communication groups between December, 2020 and March, 2021. The responses of 500 family physicians who were accessible in this way and volunteered to participate in the study were recorded to be analysed. Of all the 500 physicians, the SAVE-9 scale was re-administered to the subgroup of 50 family physicians in the post-vaccination period. The responses were compared with those received in the pre-vaccination period. RESULTS: Of all the 500 family physicians in this study, 40.6% of them were found to be in a state of anxiety about the viral epidemic. In particular, the scores of anxiety about the viral epidemic and of work-related stress were found much higher in female physicians and in those reporting that they had inadequate income. While there was a significant decline in the scores of anxiety about the viral epidemic in the subgroup in the post-vaccination period of health care workers, no statistically significant change was found in work-related stress scores. CONCLUSION: Family physicians have been suffering anxiety due to the pandemic. The vaccination period has a positive impact on anxiety levels.

25 (OH) Vitamin D Levels of Patients with COVID-19 are not Associated with the Length of Hospital Stay.

BACKGROUND: Vitamin D is known to suppress the release of proinflammatory cytokines, increase the release of anti-inflammatory cytokines, and present an immunomodulatory effect. In light of the foregoing, it is suggested that vitamin D may play an important role in the course of COVID-19 infection. This study, therefore, aimed to examine the relationship between vitamin D levels and length of hospital stay of COVID-19 patients. METHODS: This retrospective study was conducted between March 15th and October 15th, 2020, among 768 patients who were hospitalized due to the diagnosis of COVID-19 infection confirmed with PCR tests taken at the Health Sciences University, Antalya Training and Research Hospital. The study included 39 patients aged 18 - 65 years, whose 25 (OH) vitamin D levels were examined within 3 months prior to the diagnosis with PCR, and whose results were found ≥ 30 ng/mL, and those patients whose 25 (OH) vitamin D levels were examined within 3 months after the diagnosis with PCR, and whose results were found < 30 ng/mL. The patients were grouped according to 25 (OH) vitamin D levels and evaluated in terms of length of hospital stay. RESULTS: Of all the 39 patients in this study, 61.5% were female, 38.5% were male, with a mean age of 48.64 ± 11.79 years. The average of 25 (OH) vitamin D levels of the patients was 21.44 ± 11.17 ng/mL, the average length of hospital stay was 9.41 ± 8.90 days. The length of stay was found to increase significantly in participants who were 45 years and older, who were male, those with chronic diseases, and those with lung involvement detected on thoracic CT imaging at the time of admission. No statistically significant difference appeared with respect to the length of hospital stay when the patients were evaluated according to their 25 (OH) vitamin D levels. CONCLUSIONS: No statistically significant relationship was found between the patients' length of hospital stay due to the COVID-19 infection and their 25 (OH) vitamin D levels in patients aged 18 - 65 years. Further prospective clinical studies still need to be conducted with large numbers of patients excluding independent risk factors such as the presence of a chronic disease.

The Relationship between Vitamin D Levels and Iron Deficiency and Anemia in Adults Applied for Periodic Medical Examination.

BACKGROUND: Anemia and vitamin D deficiency are two important public health issues that may accompany many acute and chronic diseases. Several studies conducted in recent years have suggested that vitamin D deficiency is associated with anemia in healthy and patient populations. The aim of the study is to investigate the relationship between vitamin D deficiency and anemia. METHODS: The data of 9,590 adults aged 18 - 64, who applied for periodic medical examination to family medicine polyclinics of a training hospital between 2016 and 2018, were evaluated retrospectively. Individuals were classified into three groups as iron deficiency, iron deficiency anemia, and anemia; and 25 hydroxy vitamin D (25(OH)D) levels were classified into three groups as deficiency, insufficiency, and sufficiency. The groups were compared with respect to study parameters. RESULTS: Of the participants, 2,395 were male (25.0%) (mean age = 43.75 ± 13.43) and 7,195 (75.0%) were female (mean age = 42.93 ± 12.85). The number of anemic patients was 1,470 (15.3%) while the number of patients having no symptoms of anemia was 8,120 (84.7%). Serum hemoglobin (Hgb), iron, and ferritin levels were found to be significantly lower in the group with 25(OH)D deficiency than in the group of those with no deficiency. The mean 25(OH)D levels were observed to be significantly lower in those having anemia (17.4 ng/mL) than in those who do not (20.2 ng/mL), in those having iron deficiency (18.2 ng/mL) than in those who do not (20.5 ng/mL), and in those having iron deficiency anemia (16.6 ng/mL) than in those who do not (20.1 ng/mL) (all p-values are < 0.001). CONCLUSIONS: The findings of this large study population, who live in a Mediterranean city which is sunny for 300 days of the year, indicate that 25(OH)D deficiency is significantly associated with iron deficiency and/or anemia.

Pre-Diabetics with Hypovitaminosis D Have Higher Risk for Insulin Resistance.

BACKGROUND: Various studies have been reported on the relationship between vitamin D, whose deficiency has been identified in a pandemic way, and metabolic-endocrine diseases, including insulin resistance. Insulin resistance is an important public health issue since it is a common cause of death as it transforms into metabolic syndrome and type 2 diabetes mellitus (DM). In this study, the aim is to investigate the relationship between the level of serum 25 hydroxy vitamin D (25(OH)D) and insulin resistance. METHODS: A retrospective study was carried out including 2,008 patients aged between 18 - 67 chosen from among the patients who had applied to Saglik Bilimleri University Antalya Training and Research Hospital. Patients were divided into three groups as non-diabetic, pre-diabetic, and diabetic according to their blood glucose profile and into three categories according to their 25(OH)D levels. The relationship between serum vitamin D levels and insulin resistance was compared between the groups. Individuals with homeostasis model assessment of insulin re-sistance (HOMA-IR) > 2.5 were considered to have insulin resistance. RESULTS: The study was composed of 2,008 patients, 1,614 were female (80.4%). Of the participants, 216 (10.6%) were diabetics, 849 (42.3%) were pre-diabetics, and 943 (47.1%) were non-diabetics. It was identified that age, fasting blood glucose, HbA1c, triglyceride (Tg), very-low-density lipoprotein cholesterol (VLDL-C), fasting insulin, and HOMA-IR levels were significantly higher in diabetic patients than in pre-diabetic patients (all p < 0.001) and similarly higher in pre-diabetics than in non-diabetics. Tg, VLDL, fasting insulin, and HOMA-IR levels were significantly lower in the group with 25(OH)D ≥ 30 ng/mL. Especially in pre-diabetic individuals, a significant negative correlation was observed between the 25(OH)D level and HbA1c (p = 0.020), Tg (p = 0.001), VLDL-C (p = 0.001), fasting insulin (p < 0.001) and HOMA-IR (p < 0.001). While high HOMA-IR was positively associated with fasting blood glucose and total cholesterol values (all p < 0.001), it was negatively associated with age (p < 0.001), LDL-cholesterol (p < 0.001), HDL-cholesterol (p < 0.001) and 25(OH)D (p = 0.001). CONCLUSIONS: Diabetic subjects have lower plasma 25(OH)D levels and pre-diabetics with hypovitaminosis D have higher risk for insulin resistance. Thus, HOMA-IR must be well evaluated in pre-diabetic individuals with vitamin D deficiency/insufficiency, if there is associating abdominal obesity.