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OBJECTIVE: To evaluate the effectiveness of weekly vitamin D supplementation in reducing the number of acute respiratory infections (ARI) in preschool children. STUDY DESIGN: Randomized, double-blind, placebo-controlled trial in 303 children aged 1.5-3.5 years from 2014 to 2105 in 3 Chilean cities at different latitudes: Santiago (33°S, n = 101), Talcahuano (37°S, n = 103), and Punta Arenas (53°S, n = 99). Participants were allocated (1:1:1) to receive placebo, cholecalciferol (vitamin D3 (VD3)) 5600 IU/week (low-dose), or 11 200 IU/week (high-dose) for 6 months. Primary outcome was parent-reported number of ARI; secondary outcomes included number of ARI hospitalizations, change of serum 25-hydroxyvitamin D (25(OH)D) and LL-37/cathelicidin levels, and adverse events. RESULTS: The mean age of participants was 26 ± 6 months; 45% were female. Baseline 25(OH)D was 24.9 ± 6.1 ng/ml, with 23% having 25(OH)D <20 ng/ml. No significant baseline clinical or laboratory differences were observed among groups. Overall, 64% (n = 194) completed study participation, without baseline differences between subjects lost to follow-up vs those completing participation or differences in completion rates across groups. After 6 months, a dose-dependent increase in serum 25(OH)D was observed from the VD3 intervention (P < .001), with a higher proportion of subjects ending the trial with 25(OH)D <20 ng/ml in the placebo group (30.8%) vs the low-dose (7.4%) and high-dose groups (5.1%). However, no group differences were observed in number of ARI (P = .85), ARI hospitalizations (P = .20), LL-37/cathelicidin change (P = .30), or adverse events (P = .41). CONCLUSIONS: While weekly VD3 supplementation, in doses equivalent to 800 IU and 1600 IU daily, was associated with improved 25(OH)D levels in preschoolers, we did not find a reduced number of ARI in this sample.

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Introduction: Globally, up to 76.6% of the population may be affected by vitamin D (VD) deficiency, which has been linked to increased morbidity and mortality from COVID-19. This underscores the importance of further research into VD supplementation, particularly for health care workers, who are at higher risk due to indoor work environments and dietary challenges associated with shift schedules. Objective: This study aimed to identify factors associated with VD deficiency in Mexican health care workers exposed to SARS-CoV-2. Materials and methods: We conducted a cross-sectional study from June 2020 to January 2021 among frontline health care workers treating hospitalized COVID-19 patients. Blood samples were collected to measure 25-hydroxy VD levels via radioimmunoassay. We also assessed previous COVID-19 infection and comorbidities that could influence VD levels. Results: The study included 468 health care workers. The median serum VD concentration was 16.6 ng/mL. VD deficiency was found in 69.4% (n = 325) of participants, while only 5.1% (n = 24) had normal levels. Those with type 2 diabetes (13.3 ng/mL vs. 17.1 ng/mL) or obesity (15.7 ng/mL vs. 17.1 ng/mL) had significantly lower VD levels than their counterparts (p < 0.001 and p = 0.049, respectively). No significant differences were found among participants with high blood pressure. Multivariate analysis revealed that type 2 diabetes was independently associated with VD deficiency. Conclusion: There is a high prevalence of VD deficiency among health care workers, which is potentially linked to both personal health factors and occupational conditions.

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Skin pigmentation is negatively associated with circulating vitamin D (VD) concentration. Therefore, genetic factors involved in skin pigmentation could influence the risk of vitamin D deficiency (VDD). We evaluated the impact genetic variants related to skin pigmentation on VD in Mexican population. This cross-sectional analysis included 848 individuals from the Health Worker Cohort Study (ratio males to females ~ 1:3). Eight genetic variants: rs16891982 (SLC45A2), rs12203592 (IRF4), rs1042602 and rs1126809 (TYR), rs1800404 (OCA2), rs12913832 (HERC2), rs1426654 (SLC24A5), and rs2240751 (MFSD12); involved in skin pigmentation were genotyped. Skin pigmentation was assessed by self-report. Linear and logistic regression were used to assess the association between the variants of interest and VD and VDD, as appropriate. In our study, eight genetic variants were associated with skin pigmentation. A genetic risk score built with the variants rs1426654 and rs224075 was associated with lower VD levels (ß = - 1.38, 95% CI - 2.59, - 0.17, p = 0.025). Nevertheless, when examining gene-gene interactions, we observed that rs2240751 × rs12203592 were associated with VD levels (P interaction = 0.021). Whereas rs2240751 × rs12913832 (P interaction = 0.0001) were associated with VDD. Our results suggest that skin pigmentation-related gene variants are associated with lower VD levels in Mexican population. These results underscore the importance of considering genetic interactions when assessing the impact of genetic polymorphisms on VD levels.

Asunto(s)

Polimorfismo de Nucleótido Simple , Pigmentación de la Piel , Deficiencia de Vitamina D , Vitamina D , Humanos , Masculino , Femenino , México , Pigmentación de la Piel/genética , Deficiencia de Vitamina D/genética , Deficiencia de Vitamina D/sangre , Deficiencia de Vitamina D/epidemiología , Vitamina D/sangre , Vitamina D/análogos & derivados , Adulto , Persona de Mediana Edad , Estudios Transversales , Predisposición Genética a la Enfermedad

RESUMEN

Chronic low-grade inflammation is a common feature of obesity and plays a crucial role in the progression of its complications. Vitamin D (VitD) plays an important role in modulating the immune response and regulating inflammation. Thus, this systematic review and meta-analysis aimed to evaluate the effects of isolated VitD supplementation on main inflammatory markers in overweight and obese individuals with no comorbidities and with VitD deficiency. We hypothesized that the increase in serum VitD concentrations after supplementation would significantly reduce the concentrations of inflammatory markers. The search was conducted in Medline/PubMed, SCOPUS, EMBASE, and Web of Science. Eleven randomized placebo-controlled studies were included in the final analysis, with a total of 504 participants and daily (1000-7000 international units) or bolus (100,000-200,000 international units) doses of VitD lasting from 2 to 26 weeks. The VitD supplementation did not influence C-reactive protein (mean difference [MD]: 0.01; 95% confidence interval [CI] -0.37, 0.39; P = .97), interleukin-6 (MD: -0.34; 95% CI -1.09, 0.42; P = .38), and tumor necrosis factor concentrations (MD: -0.02; 95% CI -0.23, 0.19; P = .85). In the analysis considering the studies with a significant increase in serum VitD concentrations, VitD supplementation also did not influence C-reactive protein (MD: -0.17; 95% CI -0.88, 0.54; P = .64), interleukin-6 (MD: -0.47; 95% CI -1.31, 0.37; P = .27), and tumor necrosis factor concentrations (MD: 0.01; 95% CI -1.34, 1.37; P = .98). This meta-analysis suggests that VitD supplementation does not significantly alter inflammatory markers in overweight and obese individuals.

Asunto(s)

Suplementos Dietéticos , Inflamación , Obesidad , Sobrepeso , Vitamina D , Adulto , Femenino , Humanos , Masculino , Persona de Mediana Edad , Biomarcadores/sangre , Proteína C-Reactiva/análisis , Proteína C-Reactiva/metabolismo , Inflamación/sangre , Interleucina-6/sangre , Obesidad/sangre , Obesidad/complicaciones , Sobrepeso/sangre , Ensayos Clínicos Controlados Aleatorios como Asunto , Factor de Necrosis Tumoral alfa/sangre , Vitamina D/sangre , Vitamina D/uso terapéutico , Deficiencia de Vitamina D/sangre , Deficiencia de Vitamina D/complicaciones , Deficiencia de Vitamina D/tratamiento farmacológico

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OBJECTIVE: To evaluate the association between deficiency of vitamin A or D at diagnosis of pediatric acute lymphoblastic leukemia (ALL) and subsequent infectious complications during induction therapy. STUDY DESIGN: We conducted an institutional review board-approved, retrospective cohort study of children with newly diagnosed ALL from 2007 to 2017 at St. Jude Children's Research Hospital. We measured vitamin D, vitamin D binding protein, retinol binding protein as a surrogate for vitamin A, and immunoglobulin isotypes in serum obtained at ALL diagnosis, and we assessed the association between vitamin deficiencies or levels and infection-related complications during the 6-week induction phase using Cox regression models. RESULTS: Among 378 evaluable participants, vitamin A and D deficiencies were common (43% and 17%, respectively). Vitamin D deficiency was associated with higher risks of febrile neutropenia (adjusted hazard ratio [aHR], 1.7; P = .0072), clinically documented infection (aHR, 1.73; P = .025), and likely bacterial infection (aHR, 1.86; P = .008). Conversely, vitamin A deficiency was associated solely with a lower risk of sepsis (aHR, 0.19; P = .027). CONCLUSIONS: In this retrospective study, vitamin D deficiency was associated with an increased risk of common infection-related complications during induction therapy for ALL. Additional studies are warranted to evaluate whether vitamin D supplementation could mitigate this effect.

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Leucemia-Linfoma Linfoblástico de Células Precursoras , Deficiencia de Vitamina A , Deficiencia de Vitamina D , Humanos , Leucemia-Linfoma Linfoblástico de Células Precursoras/tratamiento farmacológico , Leucemia-Linfoma Linfoblástico de Células Precursoras/complicaciones , Estudios Retrospectivos , Masculino , Femenino , Niño , Preescolar , Deficiencia de Vitamina A/complicaciones , Deficiencia de Vitamina D/complicaciones , Quimioterapia de Inducción/efectos adversos , Lactante , Adolescente , Estudios de Cohortes

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INTRODUCTION: These guidelines aim to provide evidence-based recommendations for the supplementation of Vitamin D in maintaining bone health. An unmet need persists in Latin American regarding the availability of clinical and real-world data for rationalizing the use of vitamin D supplementation. The objective of these guidelines is to establish clear and practical recommendations for healthcare practitioners from Latin American countries to address Vitamin D insufficiency in clinical practice. METHODS: The guidelines were developed according to the GRADE-ADOLOPMENT methodology for the adaptation or adoption of CPGs or evidence-based recommendations. A search for high quality CPGs was complemented through a comprehensive review of recent literature, including randomized controlled trials, observational studies, and systematic reviews evaluating the effects of Vitamin D supplementation on bone health. The evidence to decision framework proposed by the GRADE Working Group was implemented by a panel of experts in endocrinology, bone health, and clinical research. RESULTS: The guidelines recommend Vitamin D supplementation for individuals aged 18 and above, considering various populations, including healthy adults, individuals with osteopenia, osteoporosis patients, and institutionalized older adults. These recommendations offer dosing regimens depending on an individualized treatment plan, and monitoring intervals of serum 25-hydroxyvitamin D levels and adjustments based on individual results. DISCUSSION: The guidelines highlight the role of Vitamin D in bone health and propose a standardized approach for healthcare practitioners to address Vitamin D insufficiency across Latin America. The panel underscored the necessity for generating local data and stressed the importance of considering regional geography, social dynamics, and cultural specificities when implementing these guidelines.

Asunto(s)

Suplementos Dietéticos , Osteoporosis , Deficiencia de Vitamina D , Vitamina D , Humanos , Vitamina D/uso terapéutico , Vitamina D/administración & dosificación , América Latina , Deficiencia de Vitamina D/tratamiento farmacológico , Deficiencia de Vitamina D/prevención & control , Osteoporosis/tratamiento farmacológico , Osteoporosis/prevención & control , Adulto , Anciano , Femenino , Masculino

RESUMEN

Background and Objectives: Vitamin D, as a steroid hormone, has multiple effects on human body and its deficiency has been associated with an increased risk of heart failure (HF) and unfavorable outcomes. The present study investigated the prevalence of vitamin D deficiency (VDD) and its relationship with cardiometabolic parameters in patients hospitalized for HF living in the city of Recife (latitude 8° South). Methods: Analytical cross-sectional study, with men and women aged 40-64 years. The HF group was recruited during hospitalization due to decompensation. A matched control group was recruited from the general endocrine clinics. Vitamin D status was assessed by measuring serum 25-hydroxyvitamin D (25OHD), considering deficiency when 25OHD <20 ng/mL (<50 nmol/L). Results: A total of 243 patients were evaluated (HF group: 161, control group: 82). Lower serum 25OHD levels were observed in the HF group (25.2±9.4 vs. 30.0±7.7ng/mL; p<0.001), as well as a higher prevalence of VDD (27.3% vs. 9.8%; prevalence ratio, 2.80; 95% confidence interval, 1.38-5.67; p=0.002). In patients with HF, VDD was associated with diabetes mellitus (65.9% vs. 41.0%; p=0.005) and female sex (65.9% vs. 44.4%; p=0.015). In the subgroup with VDD, higher values of hemoglobin A1c (7.9% [6.0-8.9] vs. 6.2% [5.7-7.9]; p=0.006) and dyslipidemia were also observed. Conclusions: We found higher rates of VDD in patients hospitalized for HF and this was associated with deleterious laboratory metabolic parameters.

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CONTEXT: There is a high prevalence of vitamin D deficiency and impaired cognitive function in people with type 2 diabetes mellitus (T2DM). OBJECTIVE: To critically and systematically review the literature on the association between vitamin D status and cognitive performance in people with type 2 diabetes. DATA SOURCES: This review was conducted according to PRISMA recommendations. MEDLINE, SCOPUS, the Cochrane Library, and Web of Science databases were searched using the terms "Diabetes Mellitus, Type 2", "Cognitive Function", and "Vitamin D". DATA EXTRACTION: Eight observational and 1 randomized study were included, containing data of 14 648 adult and elderly individuals (19-74 y). All extracted data were compiled, compared, and critically analyzed. DATA ANALYSIS: There is no strong evidence that lower serum concentrations of vitamin D and vitamin D-binding protein are associated with worsening cognitive function in individuals with T2DM. Vitamin D supplementation (12 wk) improved the scores of some executive functioning tests, although there was no difference between low doses (5000 IU/wk) and high doses (50 000 IU/wk). CONCLUSIONS: There is no high-quality evidence demonstrating an association between vitamin D status and cognitive function, or clinical benefits on cognition from vitamin D supplementation in individuals with T2DM. Future studies are needed. Systematic Review Registration: PROSPERO registration no. CRD42021261520.

Asunto(s)

Diabetes Mellitus Tipo 2 , Deficiencia de Vitamina D , Adulto , Humanos , Anciano , Vitamina D , Diabetes Mellitus Tipo 2/complicaciones , Suplementos Dietéticos , Vitaminas , Deficiencia de Vitamina D/complicaciones , Deficiencia de Vitamina D/epidemiología , Cognición

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ABSTRACT Purpose: This study aimed to investigate the correlation between serum vitamin D levels and disease activity in patients with noninfectious uveitis. Methods: We conducted a prospective case-control study, assessing 51 patients with noninfectious uveitis, categorized into active (n=22) and inactive (n=29) groups, along with 51 healthy controls. Serum 25-hydroxy vitamin D [25(OH)D] levels were measured. The uveitis group also completed a questionnaire regarding sunlight exposure habits and vitamin D supplementation. Results: Patients with inflammation-related uveitis exhibited low serum 25(OH)D levels in 68% of cases. The median 25(OH)D level in patients with active uveitis was 17.8 ng/mL (interquartile range [IQR], 15-21 ng/mL), significantly lower compared to the 31.7 ng/mL (IQR, 25-39 ng/mL) in patients with inactive uveitis (p<0.001) and the 27 ng/mL (IQR, 23-31 ng/mL) in the Control Group (p<0.001). Significantly, nearly all patients with uveitis taking vitamin D supplementation were in the Inactive Group (p<0.005). Moreover, reduced sunlight exposure was associated with active uveitis (p<0.003). Furthermore, patients with 25(OH)D levels below 20 ng/mL had ten times higher odds of developing active uveitis (p=0.001). Conclusions: This study revealed a prevalent 25(OH)D deficiency among patients with noninfectious uveitis and suggested a link between low 25(OH)D levels and disease activity. To prevent future episodes of intraocular inflammation, vitamin D supplementation and controlled sunlight exposure could be viable options.

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ABSTRACT Objective Micronutrient deficiencies are recognized as critical factors contributing to the global burden of disease. Phoenixin-14 and nesfatin-1 newly discovered neuropeptides which have been related to various physiological processes and potential therapeutic applications. This study was conducted to test whether circulating concentrations of nesfatin-1 and phoenixin-14 were altered in individuals with iron, vitamin B12, vitamin D and combined deficiencies. Method Our study group consists of 33 patients with iron deficiency, 30 patients with vitamin B12 deficiency, 33 patients with vitamin D deficiency, 32 patients with combined deficiency, 24 patients who received vitamin D supplementation and 32 control subjects. Serum nesfatin-1 and phoenixin-14 concentrations were determined measured by Enzyme-Linked ImmunoSorbent Assay method. Results Serum phoenixin-14 values were significantly lower in subjects with iron, vitamin B12, vitamin D and combined deficiency compared with the healthy group. After vitamin D supplementation, serum phoenixin-14 levels did not differ significantly with the healthy group. Serum nesfatin-1 concentrations were significantly lower in subjects with iron, vitamin B12 and combined deficiency compared with the healthy group. There was no significant difference in nesfatin-1 values between those with vitamin D deficiency, those taking vitamin D3 supplements and the healthy controls. Conclusion Significant differences in phoenixin-14 and nesfatin-1 levels between iron, vitamin D, vitamin B12 deficiency and the healthy control group supports that these molecules related to the pathogenesis of micronutrient deficiencies. Phoenixin-14 and nesfatin-1 may be considered potential biomarkers of micronutrient deficiencies.

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RESUMO Objetivo As deficiências de micronutrientes são reconhecidas como fatores críticos que contribuem para a carga global de doenças. Neuropeptídeos recém-descobertos Phoenixin-14 e nesfatin-1 que foram relacionados a vários processos fisiológicos e potenciais aplicações terapêuticas. Este estudo foi realizado para testar se as concentrações circulantes de nesfatina-1 e fenixina-14 estevam alteradas em indivíduos com deficiência de ferro, vitamina B12, vitamina D e combinada. Método Nosso grupo de estudo consiste em 33 pacientes com deficiência de ferro, 30 pacientes com deficiência de vitamina B12, 33 pacientes com deficiência de vitamina D, 32 pacientes com deficiência combinada, 24 pacientes que receberam suplementação de vitamina D e 32 controles. As concentrações séricas de nesfatina-1 e fenixina-14 foram determinados pelo método Enzyme-Linked ImmunoSorbent Assay. Resultados Os valores séricos de fenixina-14 foram significativamente menores em pacientes com deficiência de ferro, vitamina B12, vitamina D e combinada em comparação com o grupo controle. Após a suplementação de vitamina D, os níveis séricos de fenixina-14 não diferiram significativamente com o grupo controle. Os valores séricos de nesfatina-1 foram significativamente menores em pacientes com deficiência de ferro, vitamina B12 e combinada em comparação com o grupo controle. Não houve diferença nos níveis de nesfatina-1 entre aqueles com deficiência de vitamina D, recebendo vitamina D3 ou aqueles controles saudáveis. Conclusão Nosso estudo observou diferenças significativas nas concentrações de fenixina-14 e nesfatina-1 entre ferro, vitamina D, deficiência de vitamina B12 e o grupo controle. A fenixina-14 e a nesfatina podem estar relacionadas à patogênese das deficiências de micronutrientes.

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Objective: This study aimed to explore the relationship between vitamin D deficiency and comorbid heart disease in adult inpatients with mood disorders (depressive and bipolar disorders). Methods: A cross-sectional investigation was carried out employing the nationwide inpatient dataset, which encompassed 910,561 adult inpatients aged 18 to 50 years diagnosed with depressive and bipolar disorders. Additionally, the sample was categorized based on the presence of comorbid heart disease. We utilized a logistic regression model to assess the odds ratio (OR), pertaining to demographic features and coexisting medical conditions in relation to comorbid heart disease. Results: Comorbid heart disease was present in 1.3% of inpatients with mood disorders; they were middle-aged (mean age 42.7 years) men and White individuals. Inpatients with depressive disorder had a higher risk of comorbid heart disease (OR 1.19, 95% CI 1.15-1.24) compared to those with bipolar disorders. Inpatients with comorbid heart disease had a higher prevalence of medical and psychiatric comorbidities. The prevalence of vitamin D deficiency was 2.3% in mood disorders but higher in those with comorbid heart disease (2.9%). Vitamin D deficiency showed a notable correlation with comorbid heart disease, resulting in a 26% increased risk in the unadjusted regression model (OR 1.26, 95% CI 1.13-1.40). However, after accounting for potential confounding factors, including comorbidities, the risk did not exhibit statistical significance (OR 1.08, 95% CI 0.97-1.21). Among psychiatric comorbidities, trauma-related (OR 1.22, 95% CI 1.17-1.28) and tobacco-related (OR 1.31, 95% CI 1.26-1.37) disorders had a higher risk of association with comorbid heart disease. Conclusion: Middle-aged men with depressive disorders and from low-income families had a higher risk of developing comorbid heart disease. Trauma-related and tobacco-related disorders were associated with an increased risk by 20-30% for comorbid heart disease in inpatients with mood disorders. Vitamin D deficiency was not associated with the risk of comorbid heart disease after controlling demographics and comorbid cardiovascular risk factors.

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Various pathophysiologic mechanisms were proposed to underlie the effect of vitamin D on MetS components. In this systematic review, we reviewed randomized control clinical trials to verify whether vitamin D supplementation (VDS) at different doses is effective concomitantly in controlling high-density lipoprotein cholesterol (HDL-c), triglycerides (TG), fasting glucose level, blood pressure, and central obesity in adults diagnosed with MetS. The following scientific databases were searched from 1998 until April 2023: EMBASE, MEDLINE (PubMed), Web of Science, Latin American and Caribbean Health Sciences Literature (Lilacs), the Cochrane Central Register of Controlled Trials, clinicaltrial.gov, and Google Scholar. No language restrictions were applied. Seven studies were included, and they showed a high level of heterogeneity. All studies reported a significant increase in serum 25(OH)D levels in the intervention groups. Of these, only two noted a significant decrease in triglyceride (TG) level and waist circumference. However, the certainty levels of the evidence rating were very low and low for triglyceride (TG) level and waist circumference, respectively, and moderate for fasting glucose level, blood pressure, and HDL-c. In conclusion, despite these benefits, considering the low certainty, the evidence does not support that VDS decreases triglyceride (TG) level and waist circumference in adults with MetS.

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BACKGROUND: Sarcopenia is a condition associated with aging and multiple medical conditions such as CKD and hypovitaminosis D. METHODS: An observational cross-sectional study was carried out, based on patients registered in a database of specialized nephrology consultation in the city of Manizales, Colombia. 101 patients over 18 years of age who had stage 3 or 4 CKD were included. RESULTS: The frequency of sarcopenia was 10.9%. No relationship was found between sarcopenia alone and serum vitamin D levels. However, when sarcopenia was categorized as severe there was a direct relationship with hypovitaminosis D. There was also a direct relationship between dynapenia and hypovitaminosis D. In addition, patients who had serum vitamin D levels above 40 ng/ml had better muscle performance, and, consequently, probably a lower risk of frailty. CONCLUSION: When patients, within their treatment, received vitamin D supplementation, no effect on muscle performance was observed.

Asunto(s)

Insuficiencia Renal Crónica , Sarcopenia , Deficiencia de Vitamina D , Humanos , Adolescente , Adulto , Colombia/epidemiología , Sarcopenia/epidemiología , Estudios Transversales , Deficiencia de Vitamina D/complicaciones , Deficiencia de Vitamina D/epidemiología , Vitamina D , Insuficiencia Renal Crónica/complicaciones

RESUMEN

Insufficient vitamin D levels occur in 88.1% of the worlds population, which constitutes a global public health problem. We analyzed vitamin D deficiency and suggested vitamin D supplementation in the perinatal health of pregnant women living in geographical areas higher than 40° south-north latitude according to reviews from the last three decades and identifying midwives role. The methodology used was a qualitative systematic review of full text studies, conducted in geographical areas higher than 40°N and 40°S. Descriptors such as: "deficiency", "vitamin D", "pregnancy", "causes", "perinatal outcomes" and "supplementation", and their respective descriptors in Spanish. The matrices were tabulated according to the modified PRISMA. Eight studies were obtained in English from the Northern Hemisphere only, mostly with good quality evidence and related to the role of midwifing according to the expert round. The results showed risks such as: origin of the pregnant woman, ethnicity, low sun exposure, obesity, socioeconomic status, and perinatal risks. No studies were found in pregnant women from the Southern Hemisphere or related to the role of the midwife in this area. In conclusion, midwifery should considerer the social determinants of vitamin D deficiency in pregnant women, especially those in extreme southern areas where incorporation of supplementation are suggested as a public policy.

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Los niveles insuficientes de vitamina D se dan en el 88,1% de la población mundial, lo que constituye un problema de salud pública global. Se analizó la deficiencia y la sugerencia de suplementación de vitamina D en la salud perinatal de las gestantes residentes en áreas geográficas de latitud 40° sur-norte según revisiones de las últimas tres décadas identificando el rol de la matrona. La metodología utilizada fue una revisión sistemática cualitativa de estudios a texto completo, realizados en áreas geográficas mayores al paralelo 40°N y 40°S. Descriptores como: "deficiencia", "vitamina D", "embarazo", "causas", "resultados perinatales" y "suplementación", y sus respectivos descriptores en español. Las matrices se tabularon según el PRISMA modificado. Se obtuvo ocho estudios en inglés pertenecientes sólo al hemisferio norte, la mayoría con buena calidad de evidencia. Los resultados arrojaron factores como origen de la embarazada, etnia, baja exposición al sol, obesidad, nivel socioeconómico y riesgos perinatales. No se encontraron estudios en mujeres embarazadas del hemisferio sur o relacionados con el papel de la matrona. En conclusión, desde el ejercicio de la matronería se deben considerar los determinantes sociales de las mujeres embarazadas especialmente de zonas extremas del sur donde se sugiere investigación experimental e incorporación de la suplementación como política pública.

Asunto(s)

Humanos , Femenino , Embarazo , Vitamina D/administración & dosificación , Deficiencia de Vitamina D/prevención & control , Partería , Factores de Riesgo , Atención Perinatal , Clima Extremo

RESUMEN

BACKGROUND: Home confinement policies during the COVID-19 pandemic limited sun exposure and may have influenced on vitamin D levels. OBJECTIVE: To assess changes in 25(OH)D during the COVID-19 pandemic and the impact of Mandatory Preventive Social Isolation (MPSI) on UV radiation recommended dose modified by clouds for the synthesis of vitamin D (UVDVC). MATERIAL AND METHODS: A retrospective study was carried out on 15,908 patients in whom the level of 25(OH)D was determined between January 2019 and December 2021 in a centralized laboratory in Rosario, Argentina. RESULTS: Lower levels of 25(OH)D were documented in people younger than 40 years during 2020, as well as a variation during the pandemic period, with lower values in the first wave. Lower levels of 25(OH)D were recorded in the post-MPSI period in comparison with the MPSI period (p < 0.00001), in addition to a higher frequency of hypovitaminosis D (48.6% vs. 36.1%). These differences were not observed in the comparison of the same periods of 2019. UVDVC did not vary between 2019 and 2020. CONCLUSIONS: The restrictions due to the COVID-19 pandemic led to a higher frequency of hypovitaminosis D and lower frequency of optimal values.

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ANTECEDENTES: Las políticas de confinamiento domiciliario durante la pandemia de COVID-19 limitaron la exposición solar y pudieron influir en los niveles de vitamina D. OBJETIVO: Evaluar los cambios en 25(OH)D durante la pandemia de COVID-19 y el impacto del aislamiento social, preventivo y obligatorio (ASPO) en la dosis recomendada de radiación UV modificada por las nubes para la síntesis de vitamina D (UVDVC). MATERIAL Y MÉTODOS: Se realizó un estudio retrospectivo de 15 908 pacientes en quienes se determinó el nivel de 25(OH)D entre enero de 2019 y diciembre de 2021 en un laboratorio centralizado en Rosario, Argentina. RESULTADOS: Se constataron niveles más bajos de 25(OH)D en menores de 40 años durante 2020, así como una variación durante el período pandémico, con menores valores en la primera ola. Se registraron menores niveles de 25(OH)D en el período posterior al ASPO en comparación con el período de ASPO (p < 0.00001), además de mayor frecuencia de hipovitaminosis D (48.6 % versus 36.1 %). No se observaron estas diferencias en la comparación de los mismos períodos de 2019. La UVDVC no varió entre 2019 y 2020. CONCLUSIONES: Las restricciones por la pandemia de COVID-19 llevaron a mayor frecuencia de hipovitaminosis D y menor frecuencia de valores óptimos.

Asunto(s)

COVID-19 , Deficiencia de Vitamina D , Humanos , Rayos Ultravioleta , COVID-19/epidemiología , COVID-19/prevención & control , Pandemias , Estudios Retrospectivos , Control de Enfermedades Transmisibles , Vitamina D , Deficiencia de Vitamina D/epidemiología

RESUMEN

Resumen Antecedentes: Las políticas de confinamiento domiciliario durante la pandemia de COVID-19 limitaron la exposición solar y pudieron influir en los niveles de vitamina D. Objetivo: Evaluar los cambios en 25(OH)D durante la pandemia de COVID-19 y el impacto del aislamiento social, preventivo y obligatorio (ASPO) en la dosis recomendada de radiación UV modificada por las nubes para la síntesis de vitamina D (UVDVC). Material y métodos: Se realizó un estudio retrospectivo de 15 908 pacientes en quienes se determinó el nivel de 25(OH)D entre enero de 2019 y diciembre de 2021 en un laboratorio centralizado en Rosario, Argentina. Resultados: Se constataron niveles más bajos de 25(OH)D en menores de 40 años durante 2020, así como una variación durante el período pandémico, con menores valores en la primera ola. Se registraron menores niveles de 25(OH)D en el período posterior al ASPO en comparación con el período de ASPO (p < 0.00001), además de mayor frecuencia de hipovitaminosis D (48.6 % versus 36.1 %). No se observaron estas diferencias en la comparación de los mismos períodos de 2019. La UVDVC no varió entre 2019 y 2020. Conclusiones: Las restricciones por la pandemia de COVID-19 llevaron a mayor frecuencia de hipovitaminosis D y menor frecuencia de valores óptimos.

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Abstract Background: Home confinement policies during the COVID-19 pandemic limited sun exposure and may have influenced on vitamin D levels. Objective: To assess changes in 25(OH)D during the COVID-19 pandemic and the impact of Mandatory Preventive Social Isolation (MPSI) on UV radiation recommended dose modified by clouds for the synthesis of vitamin D (UVDVC). Material and methods: A retrospective study was carried out on 15,908 patients in whom the level of 25(OH)D was determined between January 2019 and December 2021 in a centralized laboratory in Rosario, Argentina. Results: Lower levels of 25(OH)D were documented in people younger than 40 years during 2020, as well as a variation during the pandemic period, with lower values in the first wave. Lower levels of 25(OH)D were recorded in the post-MPSI period in comparison with the MPSI period (p < 0.00001), in addition to a higher frequency of hypovitaminosis D (48.6% vs. 36.1%). These differences were not observed in the comparison of the same periods of 2019. UVDVC did not vary between 2019 and 2020. Conclusions: The restrictions due to the COVID-19 pandemic led to a higher frequency of hypovitaminosis D and lower frequency of optimal values.

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INTRODUCTION: We conducted a scoping review to analyze the effects and implications of vitamin D deficiency on female reproductive health during the last decade, considering temperate planetary zones and climate change impacts. METHODS: We used a qualitative methodology for a panoramic database review of PubMed, Web of Science, and Scopus covering articles from the last decade focused on populations living at latitudes higher than 40° N and 40° S. As descriptors, we used the phrases climate change, cholecalciferol or vitamin d3, pregnancy, and woman health and the Boolean operators AND and OR. We excluded letters to the editor, reviews, protocols, and clinical trials without human participants, as well as duplicate articles. RESULTS: We included 35 studies in English, the majority of which were from North America or Europe. No studies were found from the Southern Hemisphere or having any direct relation with climate change, although studies demonstrated that latitude and environmental factors affected vitamin D deficiency, which had an impact on pregnant women and their children. Supplementation guidelines were not well developed, and there was a lack of studies among at-risk groups of women (eg, darker skin, higher latitudes, immigrants) across the life span. DISCUSSION: Vitamin D deficiency is a global environmental problem that affects female reproductive health and depends on multiple environmental factors and human behavior. Therefore, we recommend consideration of environmental and sociocultural factors in public policy and clinical research and more research on the effectiveness of supplementation and fortification strategies. Health care professionals working in reproductive health need to generate actions for detection of, education on, and prevention of vitamin D deficiency among women across their life spans, considering the multicausality of the phenomenon, which includes environmental and climate factors in population health.

Asunto(s)

Deficiencia de Vitamina D , Vitamina D , Niño , Femenino , Humanos , Embarazo , Salud Reproductiva , Deficiencia de Vitamina D/epidemiología , Salud de la Mujer , Tiempo (Meteorología) , Suplementos Dietéticos

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Suicide is one of the leading causes of death worldwide. According to the World Health Organization (WHO), every year, more than 700 thousand people die from this cause. Therefore, suicide is a public health issue. The complex interaction between different factors causes suicide; however, depression is one of the most frequent factors in people who have attempted suicide. Several studies have reported that vitamin D deficiency may be a relevant risk factor for depression, and vitamin D supplementation has shown promising effects in the adjunctive treatment of this mood disorder. Among the beneficial mechanisms of vitamin D, it has been proposed that it may enhance serotonin synthesis and modulate proinflammatory cytokines since low serotonin levels and systemic inflammation have been associated with depression and suicide. The present narrative review shows the potential pathogenic role of vitamin D deficiency in depression and suicide and the potential benefits of vitamin D supplementation to reduce their risk.

Asunto(s)

Intento de Suicidio , Deficiencia de Vitamina D , Humanos , Vitamina D/uso terapéutico , Depresión/tratamiento farmacológico , Ideación Suicida , Serotonina , Vitaminas/uso terapéutico , Deficiencia de Vitamina D/complicaciones , Deficiencia de Vitamina D/tratamiento farmacológico

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INTRODUCTION: Recent studies have shown that low vitamin D levels constitute a potential risk factor for the development of cognitive impairment. The present study aimed to investigate the association between vitamin D levels and the suspicion of cognitive impairment in Chilean older adults. MATERIAL AND METHOD: We performed a cross-sectional study, including 1,287 participants ≥ 65 years (56.8% were women, age range 65 to 97 years) from the Chilean National Health Survey. Cognitive impairment was assessed using the Mini Mental State Examination (MMSE). Participants were classified into three groups according to their vitamin D levels (> 29 ng/ml sufficient, 12-29 ng/ml deficit, and < 12 ng/ml severe deficit). The association between vitamin D levels and cognitive impairment was explored using logistic regression analysis, adjusted for confounding factors. RESULTS: The prevalence of vitamin D deficit and vitamin D severe deficit was 37.7% and 21.0%, respectively. Compared to older adults with sufficient levels of vitamin D, those with severe deficits had a 94% (OR: 1.94 [95% IC: 1.27; 1.66], p = 0.002) higher odds of cognitive impairment (unadjusted model). Adjusting according to sociodemographic factors, lifestyle, adiposity, sunlight exposure, and multimorbidity slightly attenuated the association to 61% (OR: 1.61 [95%IC: 1.03; 2.19], p = 0.046), but remain significant. CONCLUSION: A severe deficit of vitamin D was associated with higher odds of cognitive impairment in Chilean older adults independent of major confounding factors. Future studies are needed to provide causal evidence between vitamin D and the suspicion of cognitive impairment.

Asunto(s)

Humanos , Masculino , Femenino , Anciano , Anciano de 80 o más Años , Deficiencia de Vitamina D/sangre , Deficiencia de Vitamina D/epidemiología , Disfunción Cognitiva/sangre , Disfunción Cognitiva/epidemiología , Factores Socioeconómicos , Vitamina D/sangre , Chile/epidemiología , Prevalencia , Estudios Transversales , Factores de Riesgo , Encuestas Epidemiológicas , Pruebas de Estado Mental y Demencia , Factores Sociodemográficos

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[This corrects the article DOI: 10.3389/fpsyg.2022.987203.].