RESUMO
INTRODUCTION: Vitamin D deficiency presents a notable public health concern, with reported prevalence rising in hospital and community settings. It's linked to various chronic health issues and most often remains undiagnosed in developing nations. This study aimed to determine the prevalence of hypovitaminosis D among adults attending general health check-ups at a tertiary care hospital. METHODS: This descriptive cross-sectional study was conducted among adult patients visiting for general health checkups in a tertiary care centre. The patients' data from 16 April 2023 to 24 November 2023 was retrieved from the hospital record. Serum 25(OH)D was measured by using the chemiluminescence micro particles immunoassay technique and classified as deficient, insufficient, and sufficient with values <20 ng/ml, 20-29 ng/ml, and 30-100 ng/ml, respectively. A convenience sampling method was used. The point estimate was calculated at a 95% Confidence Interval. RESULTS: Out of 357 adult patients, 291 (81.51%; 95% CI: 77.49%-85.54%) Confidence Interval) had hypovitaminosis D. Among them 124 (42.61%) were categorised as vitamin D insufficient and 167 (57.39%) as deficient. The mean age of patients was 43.25±12.99 years, with 205 (70.45%) female and 86 (29.55%) male. A total of 169 (58.08%) individuals were classified as obese. Dyslipidemia was observed in 249 (85.57%) patients, with 94 (32.30%) exhibiting hypercholesterolemia. CONCLUSIONS: The prevalence of hypovitaminosis D was higher than other studies done in similar settings. This higher prevalence necessitates public awareness of vitamin D's importance, urging proactive screening and management by physicians and implementation of cost-effective guidelines by policymakers.
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Centros de Atenção Terciária , Deficiência de Vitamina D , Vitamina D , Humanos , Deficiência de Vitamina D/epidemiologia , Deficiência de Vitamina D/diagnóstico , Estudos Transversais , Masculino , Feminino , Adulto , Nepal/epidemiologia , Pessoa de Meia-Idade , Prevalência , Vitamina D/sangue , Vitamina D/análogos & derivados , Adulto JovemRESUMO
BACKGROUND: Osteo-sarcopenia (OS) has become a global public health problem and a frontier research problem, as a combination of sarcopenia (SP) and osteoporosis (OP) diseases. The clinical performances include muscle weakness, systemic bone pain, standing difficulty, even falls and fractures, etc., which seriously affect the patient's life and work. The pathological mechanism of the OS may be the abnormal metabolism which disrupts the equilibrium stability of the musculoskeletal system. Therefore, this study combined vitamin D (Vit. D) and whole-body vibration training (WBVT) to intervene in subjects of OS, aiming to evaluate the effectiveness and safety of the diagnosis and treatment protocol and to explore the efficacy mechanism. METHODS: We propose a multicenter, parallel-group clinical trial to evaluate the efficacy and safety of Vit. D combined with WBVT intervention in OS. Subjects who met the inclusion or exclusion criteria and signed the informed consent form would be randomly assigned to the WBVT group, Vit. D group, or WBVT+ Vit. D group. All subjects will be treated for 1 month and followed up after 3 and 6 months. The primary outcomes are lumbar bone mineral density (BMD) and appendicular skeletal muscle mass (ASM) measured by dual-energy X-ray absorptiometry (DXA) and handgrip strength measured by grip strength meter. Secondary outcomes include serum markers of myostatin (MSTN), irisin and bone turnover markers (BTM), SARC-CalF questionnaire, 1-min test question of osteoporosis risk, patient health status (evaluated by the SF-36 health survey), physical performance measurement that includes 5-time chair stand test, 6-m walk, and the short physical performance battery (SPPB). DISCUSSION: If Vit. D combined with WBVT can well relieve OS symptoms without adverse effects, this protocol may be a new treatment strategy for OS. After therapeutic intervention, if the serum marker MSTN/irisin is significant, both have the potential to become sensitive indicators for screening OS effective drugs and treatments, which also indicates that WBVT combined with Vit. D plays a role in improving OS by regulating MSTN/irisin. TRIAL REGISTRATION: Chinese Clinical Trial Registry ChiCTR2400082269 . Registered on March 26, 2024.
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Densidade Óssea , Estudos Multicêntricos como Assunto , Osteoporose , Ensaios Clínicos Controlados Aleatórios como Assunto , Sarcopenia , Vibração , Vitamina D , Humanos , Sarcopenia/terapia , Sarcopenia/fisiopatologia , Sarcopenia/sangue , Vibração/uso terapêutico , Vitamina D/sangue , Vitamina D/uso terapêutico , Osteoporose/terapia , Pessoa de Meia-Idade , Feminino , Masculino , Resultado do Tratamento , Idoso , Força da Mão , Terapia Combinada , Adulto , ChinaRESUMO
The COVID-19 pandemic has emerged as a major global health crisis. Vitamin D, a crucial fat-soluble vitamin, has been recommended for COVID-19 patients, though evidence of its effectiveness is inconsistent. This systematic literature review and meta-analysis aimed to evaluate the impact of vitamin D supplementation on COVID-19-related outcomes. A comprehensive search was conducted across PubMed, Scopus, Web of Science, Embase, and Cochrane databases. Primary outcomes included mortality and hospital length of stay, while secondary outcomes encompassed C-reactive protein (CRP), ferritin, D-dimer, hemoglobin (Hb) concentrations, and lymphocyte, neutrophil, and platelet counts. Data analysis was performed using Stata™ Version 14. A total of 16 trials were analyzed. The meta-analysis revealed that vitamin D supplementation significantly reduced hospital length of stay (mean difference = -1.16; 95% confidence interval [CI]: -2.23, -0.09; p = .033) with significant heterogeneity (I2 = 69.2%, p = .002). Subgroup analysis showed a more pronounced reduction in studies with vitamin D dosages ≤10 000 international units (IU) (mean difference = -1.27; 95% CI: -1.96, -0.57; p < .001) and in patients over 60 years old (mean difference = -1.84; 95% CI: -2.53, -1.14; p < .001). Additionally, vitamin D significantly reduced CRP concentrations in older adults (>60 years) (mean difference = -1.13; 95% CI: -2.07, -0.18; p = .019). No significant changes were found in ferritin, D-dimer, Hb concentrations, or in lymphocyte, neutrophil, and platelet counts (p > .05). In conclusion, while vitamin D supplementation did not significantly affect most COVID-19-related biomarkers, however, it reduces the length of hospital stay.
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Tratamento Farmacológico da COVID-19 , COVID-19 , Suplementos Nutricionais , Ensaios Clínicos Controlados Aleatórios como Assunto , Vitamina D , Humanos , Vitamina D/sangue , Vitamina D/administração & dosagem , Vitamina D/uso terapêutico , COVID-19/mortalidade , SARS-CoV-2 , Tempo de Internação , Resultado do Tratamento , Proteína C-Reativa/análise , Proteína C-Reativa/metabolismo , Adulto , Vitaminas/administração & dosagem , Vitaminas/uso terapêutico , Produtos de Degradação da Fibrina e do Fibrinogênio/análise , Produtos de Degradação da Fibrina e do Fibrinogênio/metabolismo , Ferritinas/sangueRESUMO
BACKGROUND: Vitamin D is associated with vascular function; however, the impact of different vitamin D levels on vascular elasticity following prolonged exercise remains uncertain. The primary objective of this study was to investigate the association of vitamin D levels with changes in peripheral pulse wave velocity (pPWV) and the magnitude of acute post-exercise hypotension (PEH) following prolonged endurance exercise in healthy young men. METHODS: All the participants were divided into two groups: the 25-hydroxyvitamin D (25(OH)D) sufficiency group (25(OH)D â§50 nmol/L) and the deficiency group (25(OH)D < 50 nmol/L). A cardiopulmonary exercise test for maximal oxygen uptake (V.O2max) was performed on the graded cycling. The prolonged exercise was set at 60% V.O2max for 120 min of continuous riding on a stationary bicycle. The pPWV and blood pressure were measured at baseline and 0, 15, 30, 45, 60 min after prolonged endurance exercise. RESULTS: Post hoc analysis revealed that the vitamin D sufficient group had a greater magnitude of PEH than the deficiency group at post-45 min. Multiple linear regression analyses showed a significant correlation between 25(OH)D and both pPWV (p = 0.036) and PEH (p = 0.007), after adjusting for V.O2max, weight, height, and physical activity. In addition, the 25(OH)D deficiency group also had higher pPWV at post-15 min (5.41 ± 0.93 vs 4.84 ± 0.75 m/s), post-30 min (5.30 ± 0.77 vs 4.87 ± 0.50 m/s), post-45 min (5.56 ± 0.93 vs 5.05 ± 0.68 m/s) than the sufficiency group. CONCLUSIONS: There was a positive correlation between 25(OH)D levels and systolic PEH following prolonged endurance exercise. Individuals with sufficient 25(OH)D status may have better vascular elasticity and more efficient blood pressure regulation during exercise.
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Resistência Física , Hipotensão Pós-Exercício , Análise de Onda de Pulso , Rigidez Vascular , Deficiência de Vitamina D , Vitamina D , Humanos , Masculino , Rigidez Vascular/fisiologia , Deficiência de Vitamina D/complicações , Adulto Jovem , Vitamina D/sangue , Vitamina D/análogos & derivados , Resistência Física/fisiologia , Hipotensão Pós-Exercício/fisiopatologia , Hipotensão Pós-Exercício/etiologia , Pressão Sanguínea , Teste de Esforço , Adulto , Exercício Físico/fisiologia , Consumo de OxigênioRESUMO
BACKGROUND: Vitamin D deficiency following bariatric surgery is common and is expected to be associated with a deleterious impact on the skeleton. However, the benefits of vitamin D supplementation and the optimal dose in this population is currently unknown. The available guidelines on the topic are derived from experts' opinions, and are not evidence based. OBJECTIVES: To compare the effects of different doses of vitamin D supplementation (low dose (less than 600 international units (IU)/day), moderate dose (600 IU/day to 3500 IU/day), high dose (greater than 3500 IU/day)) to each other or to placebo in adults living with obesity undergoing bariatric surgery. SEARCH METHODS: We searched CENTRAL, MEDLINE, Embase, LILACS, two trial registries, and the reference lists of systematic reviews, articles, and health technology assessment reports without language restrictions. The last search of all databases was 27 June 2023, except Embase, which we searched on 14 August 2015. SELECTION CRITERIA: We included randomised controlled trials or controlled clinical trials on vitamin D supplementation comparing different doses or comparing vitamin D to placebo in people undergoing bariatric surgery. DATA COLLECTION AND ANALYSIS: We used standard Cochrane methods. Primary outcomes were fractures and adverse events. Secondary outcomes were vitamin D status, all-cause mortality, bone mineral change, secondary hyperparathyroidism, health-related quality of life, and muscle strength. We used GRADE to assess the certainty of the evidence for each outcome in each comparison. MAIN RESULTS: We identified five trials with 314 participants. We included three trials in the quantitative analysis. Moderate-dose vitamin D compared to placebo One trial compared moderate-dose vitamin D (3200 IU/day) to placebo. Moderate-dose vitamin D, compared to placebo, may improve vitamin D status and may result in little to no difference in the achieved parathyroid hormone level (achieved 25-hydroxyvitamin D level: mean difference (MD) 13.60 ng/mL, 95% confidence interval (CI) 7.94 to 19.26; achieved parathyroid hormone level: -6.60 pg/mL, 95% CI -17.12 to 3.92; 1 study, 79 participants; low-certainty evidence). The trial reported no adverse events in the moderate-dose vitamin D arm, but did not provide any information on adverse events in the placebo arm. There were no data on fractures, all-cause mortality, bone density change, health-related quality of life, and muscle strength. High-dose vitamin D compared to moderate-dose vitamin D Two trials in Roux-en-Y gastric bypass compared moderate-dose (equivalent dose 800 IU/day to 2000 IU/day) to high-dose (equivalent dose 5000 IU/day to 7943 IU/day) vitamin D. The evidence of high-dose vitamin D on adverse events is very uncertain (risk ratio (RR) 5.18, 95% CI 0.23 to 116.56; 2 studies, 81 participants; very low-certainty evidence). High-dose vitamin D may increase 25-hydroxyvitamin D levels compared to a moderate dose at 12 months, but the evidence is very uncertain (MD 15.55 ng/mL, 95% CI 3.50 to 27.61; I2 = 62%; 2 studies, 73 participants; very low-certainty evidence). High-dose vitamin D may have little to no effect on parathyroid hormone levels compared to a moderate dose at 12 months, but the evidence is very uncertain (MD 2.15 pg/mL, 95% CI -21.31 to 17.01; I2 = 0%; 2 studies, 72 participants; very low-certainty evidence). High-dose vitamin D may have little to no effect on mortality and bone mineral density at the lumbar spine, hip, and forearm, but the evidence is very uncertain. There were no data on fractures, health-related quality of life, or muscle strength. AUTHORS' CONCLUSIONS: No trials reported on fractures and the evidence available on adverse events is scarce. Moderate-dose vitamin D may improve vitamin D status and may result in little to no improvement in parathyroid hormone levels compared with placebo. High-dose vitamin D supplementation (greater than 3500 IU/day) may increase 25-hydroxyvitamin D levels, and may have little to no effect on parathyroid hormone levels, compared to a moderate dose, but the evidence for both is very uncertain. The currently available limited evidence may not have a significant impact on practice. Further studies are needed to explore the impact of vitamin D supplementation on fractures, adverse events, and musculoskeletal parameters in people undergoing bariatric surgery.
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Cirurgia Bariátrica , Ensaios Clínicos Controlados Aleatórios como Assunto , Deficiência de Vitamina D , Vitamina D , Vitaminas , Humanos , Vitamina D/administração & dosagem , Vitamina D/sangue , Cirurgia Bariátrica/efeitos adversos , Deficiência de Vitamina D/complicações , Deficiência de Vitamina D/tratamento farmacológico , Adulto , Vitaminas/administração & dosagem , Fraturas Ósseas , Suplementos Nutricionais , Qualidade de Vida , Administração Oral , Obesidade/complicações , Obesidade/cirurgia , Densidade Óssea/efeitos dos fármacos , Feminino , Complicações Pós-Operatórias/prevenção & controle , Causas de Morte , Pessoa de Meia-Idade , MasculinoRESUMO
Over time, researchers have accumulated significant evidence indicating that vitamin D deficiency not only impacts skeletal health but also contributes to the development and progression of various diseases, including cancer, diabetes, and cardiovascular conditions. The risk of low serum 1, 25(OH)2D3 level ultimately directs the way to morbidity, the beginning of new diseases, and numerous infections. Infections are the first entity that affects those with vitamin D deficiency. The common infection is urinary tract infection (UTI), and its relationship with vitamin D deficiency or insufficiency remains controversial. This infection affects both men and women, but comparatively, women are more prone to this infection because of the short length of the urethra, which makes an easy entry for the bacteria. The low level of serum vitamin D increases the risk of UTIs in children. Recurrent UTIs are one of the major weaknesses in women; if left untreated, they progress to appallingly serious conditions like kidney dysfunction, liver damage, etc. Hence improving the vitamin D status may help to improve the immune system, thus making it more resistant to infections. In this review, we have focused on examining whether vitamin D deficiency and insufficiency are the causes of UTIs and the association between them in women and children. We have also described the connection between vitamin D deficiency and insufficiency with UTIs and additional nanotechnology- based treatment strategies.
Assuntos
Infecções Urinárias , Deficiência de Vitamina D , Vitamina D , Humanos , Infecções Urinárias/sangue , Vitamina D/sangue , Deficiência de Vitamina D/sangue , Deficiência de Vitamina D/complicações , Criança , Feminino , Masculino , AdultoRESUMO
Several studies have suggested a correlation between serum vitamin D (VitD) level and multiple sclerosis (MS). MS has a known latitudinal distribution pattern, with greater incidence, prevalence, and mortality rates at higher latitudes. This study aims to assess levels of VitD and serum potassium in subjects with MS and the impact of gender and age as disease risk factors. A cross-sectional case-control study was conducted in a high-altitude region of Saudi Arabia. VitD deficiency was defined as serum 25 (OH)D level of ≤20 ng/mL and insufficiency as a serum level between >20 ng/mL and <30 ng/mL. Two hundred patients with MS volunteered for the study, and 160 healthy participants served as controls. VitD and serum potassium were measured in patients and controls. Student t test and regression analysis were used to analyze the data. The average MS patient age was 37.37â ±â 10.8 years. Most (73.02%) MS patients suffered from deficient vitamin D, while insufficiency (20-29 ng/mL) was found in 12.17%. Only 6.35% had sufficient vitamin D (30-40 ng/mL). VitD was significantly decreased in MS patients compared to the healthy controls (17.036 vs 25.01 ng/mL, Pâ <â .001), while serum potassium was also decreased (4.278 vs 4.329 mmol/L, Pâ =â .269). Risk factors found to have a statistically significant association with MS included female gender (odd ratio [OR]â =â 1.72, 95% confidence interval: 1.016-2.915; Pâ =â .044) and patient ageâ <â 40 years (ORâ =â 1.04, 95% confidence interval: 1.023-1.054; Pâ =â .044). VitD was significantly lower in MS patients. The prevalence of MS was higher among women and younger individuals in a high-altitude population in Saudi Arabia.
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Altitude , Esclerose Múltipla , Deficiência de Vitamina D , Vitamina D , Humanos , Feminino , Masculino , Adulto , Esclerose Múltipla/sangue , Esclerose Múltipla/epidemiologia , Estudos de Casos e Controles , Fatores de Risco , Vitamina D/sangue , Deficiência de Vitamina D/epidemiologia , Deficiência de Vitamina D/sangue , Deficiência de Vitamina D/complicações , Estudos Transversais , Arábia Saudita/epidemiologia , Pessoa de Meia-Idade , Potássio/sangue , Fatores Sexuais , Fatores EtáriosRESUMO
OBJECTIVE: Female sexual dysfunction (FSD) is highly prevalent and can result from hypovitaminosis D. Besides the role of vitamin D in normal bone development, studies showed it could reduce oxidative stress and lipid peroxidation. This prospective study aims to evaluate the relationship between serum vitamin D, testosterone, and oxidative stress levels in women with FSD. MATERIALS AND METHODS: In this cross-sectional study, a total of 40 women with FSD (age range: 18-45 years) were randomly assigned into two groups of intervention and control. In the intervention group, patients received vitamin D 300,000 IU intramuscularly (IM) and then 50,000 IU orally once a week for four weeks. We measured the serum vitamin D, testosterone, and oxidative stress levels, as well as the Female Sexual Function Index (FSFI) at baseline and monthly for three months. RESULTS: Serum testosterone levels significantly increased in the intervention group at the end of the third month (P = 0.014). Also, FSFI scores significantly improved (P < 0.01) in the intervention group compared to the control group. While there was positive a correlation between serum vitamin D levels with glutathione, total antioxidant capacity (TAC), testosterone, and FSFI score, there was a negative correlation between serum vitamin D levels with malondialdehyde (MDA), protein carbonyl, and nitric oxide. CONCLUSION: We witnessed that women with FSD had low serum vitamin D levels. So, modifying serum vitamin D levels must be considered as a treatment option. Moreover, vitamin D supplementation improved testosterone, serum oxidative stress, and sexual function.
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Estresse Oxidativo , Disfunções Sexuais Fisiológicas , Testosterona , Vitamina D , Humanos , Feminino , Testosterona/sangue , Estresse Oxidativo/efeitos dos fármacos , Adulto , Vitamina D/sangue , Estudos Transversais , Pessoa de Meia-Idade , Estudos Prospectivos , Adulto Jovem , Estudos de Casos e Controles , Disfunções Sexuais Fisiológicas/sangue , Disfunções Sexuais Fisiológicas/etiologia , Adolescente , Deficiência de Vitamina D/sangue , Deficiência de Vitamina D/tratamento farmacológico , Deficiência de Vitamina D/complicações , Vitaminas/administração & dosagem , Vitaminas/sangueRESUMO
BACKGROUND: Previous studies have shown significant associations between individual fat-soluble vitamins (FSVs) and metabolic syndromes (MetS). However, evidence on the multiple FSVs co-exposure and MetS odds is limited. Given that individuals are typically exposed to different levels of FSVs simultaneously, and FSVs can interact with each other. It's necessary to explore the association between multiple FSVs co-exposure and MetS odds. This study aims to address this gap in general U.S. adults aged ≥ 20 years. METHODS: We conducted a cross-sectional study utilizing data from the National Health and Nutrition Examination Surveys (NHANESs) 2003-2006 and 2017-2018. Three FSV, including vitamin A (VA), vitamin E (VE), and vitamin D (VD), and MetS diagnosed according to the ATP III guidelines were selected as exposure and outcome, respectively. Multivariable-adjusted logistic model was used to explore the associations of individual FSV exposure with MetS odds and MetS components. Restricted cubic splines were performed to explore the dose-response relationships among them. The quantile g-computation method was adopted to explore the associations of multiple FSVs co-exposure with MetS odds and MetS components. RESULTS: The presented study included a total of 13,975 individuals, with 2400 (17.17%) were diagnosed with MetS. After adjusting for various confounders, a positive linear pattern was observed for serum VA and VE and MetS associations. Serum VD was found to be negatively associated with MetS in a linear dose-response way. For each component of MetS, higher serum VA and VE were associated with higher triglyceride and high-density lipoprotein; higher serum VD was negatively associated with triglyceride, blood pressure, and fasting plasma glucose. MetS odds increased by 15% and 13%, respectively, in response to one quartile increase in FSVs co-exposure index (qgcomp) in the conditional model (OR = 1.15, 95%CI: 1.06, 1.24) and the marginal structural model (OR = 1.13, 95%CI: 1.06, 1.20). Besides, co-exposure to VA, VE, and VD was positively associated with triglyceride, high-density lipoprotein, and blood pressure levels. CONCLUSION: Findings in the present study revealed that high serum VA and VE levels were associated with elevated MetS odds, while serum VD was inversely associated with MetS odds. FSVs co-exposure was positively associated with MetS odds.
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Síndrome Metabólica , Inquéritos Nutricionais , Vitaminas , Humanos , Síndrome Metabólica/epidemiologia , Síndrome Metabólica/sangue , Síndrome Metabólica/etiologia , Estudos Transversais , Masculino , Feminino , Adulto , Estados Unidos/epidemiologia , Pessoa de Meia-Idade , Vitaminas/sangue , Vitamina E/sangue , Vitamina D/sangue , Bases de Dados Factuais , Adulto Jovem , Vitamina A/sangueRESUMO
OBJECTIVE: The prevalence of type 2 diabetes mellitus (T2DM) and bone metabolism disorders increase with age. Diabetic kidney disease (DKD) is one of the most serious microvascular complications of T2DM, and bone metabolism disorders are closely linked to the occurrence of DKD. The relationship between bone turnover markers(BTMs) and the kidney disease in elderly patients with T2DM remains unclear. Therefore, this study aims to investigate the association between common BTMs and DKD in a large sample of elderly patients. The goal is to provide a basis for early identification of high-risk individuals for DKD among elderly T2DM patients from a bone metabolism perspective. METHODS: In this cross-sectional study, BTMs were collected from a cohort of 2,051 hospitalized Chinese patients. The relationships between 25-hydroxyvitamin D (25-OH-D), ß-CrossLaps (ß-CTX), osteocalcin (OSTEOC), intact parathyroid hormone (iPTH), and total type I collagen N-terminal propeptide (TP1NP), and DKD, as well as urinary albumin-to-creatinine ratio (UACR) and estimated glomerular filtration rate (eGFR) were analyzed using regression analysis and restrictive cubic spline (RCS) curves. RESULTS: Higher 25-OH-D levels were independently linked to a lower incidence of DKD and decreased UACR. The RCS curves showed a linear association of 25-OH-D and DKD, approaching the L-shape. ß-CTX was independently and positively correlated with UACR. There is an independent positive correlation between OSTEOC and UACR and a negative correlation with eGFR. iPTH is independently and positively correlated with DKD incidence and UACR, and negatively correlated with eGFR. Additionally, the RCS curves showed a non-linear association of OSTEOC and iPTH and DKD, approaching the J-shape, and the point of inflection is 10.875 ng/L and 34.15 pg/mL respectively. There is an independent positive correlation between TP1NP and UACR incidence, and a negative correlation with eGFR. Risk estimates significantly increase with higher TP1NP levels in the RCS model. CONCLUSION: BTMs are closely associated with kidney disease in elderly patients with T2DM. These discoveries potentially assist clinicians in establishing more preventive measures and targeted treatment strategies for elderly patients with T2DM.
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Biomarcadores , Remodelação Óssea , Diabetes Mellitus Tipo 2 , Nefropatias Diabéticas , Humanos , Estudos Transversais , Diabetes Mellitus Tipo 2/complicações , Diabetes Mellitus Tipo 2/metabolismo , Masculino , Feminino , Idoso , Biomarcadores/sangue , Nefropatias Diabéticas/etiologia , Nefropatias Diabéticas/epidemiologia , Vitamina D/sangue , Vitamina D/análogos & derivados , Hormônio Paratireóideo/sangue , Taxa de Filtração Glomerular , Pessoa de Meia-Idade , Fragmentos de Peptídeos/sangue , Osteocalcina/sangue , Prognóstico , China/epidemiologia , Seguimentos , Pró-Colágeno/sangue , Idoso de 80 Anos ou maisRESUMO
The immunopathogenesis of recurrent vulvovaginal candidiasis (RVVC) is poorly understood. Recently, it was reported that patients with RVVC present a decrease in both the fungicidal capacity of neutrophils and the proliferative capability of peripheral blood mononuclear cells in response to Candida albicans infection, suggesting an alteration in the innate and adaptive immune response. The aim of this study was to determine the in-situ expression, in the vaginal mucosa, of genes associated with the immune response, as well as the serum concentrations of dectin-1, mannose-binding lectin (MBL), and vitamin D in patients with RVVC. A study was carried out on 40 patients with a diagnosis of RVVC and 26 healthy women. Vaginal scrapings were obtained, and the expression of genes that encode cytokines and transcription factors specific for Th1, Th2, Th17, Treg, pro-inflammatory profiles, and enzymes related to oxidative/microbicidal mechanisms was evaluated by quantitiative polymerase chain reaction (qPCR). Additionally, serum levels of vitamin D and the soluble receptors dectin-1 and MBL were determined by enzyme-linked immunosorbent assay (ELISA). In patients with RVVC, a decreased expression of T-bet, RORγ-T, IL-1ß, and IL-17, and an increase in the expression of FOXP3, IL-4, IL-8, IL-10, and IL-18 were observed when compared to healthy women: moreover, decreased levels of MBL were also observed in these patients. These results confirm that patients with RVVC present in-situ alterations in both the specific and adaptive immune response against Candida spp., a fact that could be associated with the exaggerated vaginal inflammatory response.
The study concerns the immune response of women with recurrent vulvovaginal candidiasis; we observed an alteration in the expression of genes that participate in the control of infection, a fact that could be associated with the exaggerated vaginal inflammatory response observed in those patients.
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Candidíase Vulvovaginal , Citocinas , Lectinas Tipo C , Vagina , Vitamina D , Humanos , Candidíase Vulvovaginal/imunologia , Candidíase Vulvovaginal/microbiologia , Feminino , Lectinas Tipo C/genética , Adulto , Citocinas/sangue , Vagina/microbiologia , Vagina/imunologia , Vitamina D/sangue , Adulto Jovem , Recidiva , Lectina de Ligação a Manose/sangue , Lectina de Ligação a Manose/genética , Mucosa/imunologia , Mucosa/microbiologia , Candida albicans/imunologiaRESUMO
OBJETIVES: To evaluate the impact of cholecalciferol (D3) supplementation using clinical and paraclinical variables in patients with RA and vitamin D insufficiency and deficiency. METHODS: A randomized, double-blind, placebo-controlled study included patients from 5 to 40 years with a diagnosis of RA and vitamin D insufficiency and deficiency. They were supplemented for 8 weeks with 4000 or 5000 IU, depending on age. Total nasal symptoms score (TNSS) was measured monthly and 25(OH)D3 levels at baseline and at the end of the study. RESULTS: A total of 31 patients were included, with a mean age of 18.19 years. In the active group, there was a significant improvement in symptomatology with respect to the TNSS score and an increase in serum vitamin D levels (p < 0.01). There were no adverse reactions with cholecalciferol or placebo. CONCLUSIONS: Supplementing patients with vitamin D3, at the evaluated dose, together with conventional treatent for allergic rhinitis results in symptoms and quality of life improvement in patients with this disease.
OBJETIVOS: Evaluar el impacto de la suplementación con colecalciferol (D3) mediante variables clínicas y paraclínicas en pacientes con RA e insuficiencia y deficiencia de vitamina D. MÉTODOS: Estudio aleatorio, doble ciego, placebo controlado, en el que se incluyeron pacientes de 5 a 40 años, con diagnóstico de RA e insuficiencia y deficiencia de vitamina D. Fueron suplementados con 4000 o 5000 UI, dependiendo de la edad, durante 8 semanas. Mensualmente se midió la puntuación total síntomas nasales (TNSS) y las concentraciones de 25(OH)D3 al inicio y al final del estudio. RESULTADOS: Se incluyeron 31 pacientes, con una edad promedio de 18.19 años. En el grupo activo existió una mejoría significativa en la sintomatología respecto a la puntación de TNSS y un incremento en los niveles séricos de vitamina D (p < 0.01). No se presentaron reacciones adversas con la ingesta de colecalciferol o placebo. CONCLUSIONES: Suplementar a los pacientes con vitamina D3, a la dosis evaluada, junto con el tratamiento convencional para la rinitis alergica resulta en una mejoría sintomática y en la calidad de vida de los pacientes con esta enfermedad.
Assuntos
Colecalciferol , Suplementos Nutricionais , Rinite Alérgica , Deficiência de Vitamina D , Humanos , Método Duplo-Cego , Masculino , Feminino , Adolescente , México , Adulto , Adulto Jovem , Colecalciferol/uso terapêutico , Colecalciferol/administração & dosagem , Deficiência de Vitamina D/tratamento farmacológico , Deficiência de Vitamina D/complicações , Criança , Rinite Alérgica/tratamento farmacológico , Pré-Escolar , Vitaminas/uso terapêutico , Vitaminas/administração & dosagem , Vitamina D/uso terapêutico , Vitamina D/sangueRESUMO
The association between vitamin D concentrations and the occurrence of diabetic foot ulcers (DFUs) remains a topic of ongoing debate. In order to provide a comprehensive and updated review, we conducted this meta-analysis to further investigate the relationship between vitamin D concentrations and DFUs occurrence. The following databases, including Cochrane Library, EMBASE, Web of Science, PubMed, CBM, CNKI, WANFANG DATA and VIP Database, were systematically searched for studies published up to Dec. 20th, 2023. The combined estimation was calculated using both fixed-effects and random-effects models. The overall effect size was reported as a weighted mean difference (WMD) with a corresponding 95% confidence interval (95%CI). Data analysis was performed utilizing Review Manager 5.4 and Stata 14. The Protocol has been registered in PROSPERO CRD42024503468. This updated meta-analysis, incorporating thirty-six studies encompassing 11,298 individuals with or without DFUs, demonstrated a significant association between vitamin D deficiency/insufficiency and an elevated risk of DFUs occurrence (< 25 nmol/L, OR 3.28, P < 0.00001; < 50 nmol/L, OR 2.25, P < 0.00001; < 75 nmol/L, OR 1.67, P = 0.0003). Vitamin D concentrations were significantly lower in individuals with DFUs compared to those without DFUs (P < 0.00001). Subgroup analyses consistently demonstrated this trend among the older population (> 50 years, P < 0.00001), individuals with long duration of diabetes (> 10 years, P < 0.00001), and those with poor glycemic control (mean HbA1c 8%-9% and > 9%, P < 0.00001).
Assuntos
Pé Diabético , Deficiência de Vitamina D , Vitamina D , Pé Diabético/sangue , Pé Diabético/epidemiologia , Humanos , Vitamina D/sangue , Deficiência de Vitamina D/sangue , Deficiência de Vitamina D/epidemiologia , Deficiência de Vitamina D/complicações , Fatores de RiscoRESUMO
This study aimed to determine if maternal fatty acids (FA) levels during pregnancy are associated with the occurrence of neural tube defects (NTDs) and to explore the correlation between FA and maternal vitamin D, homocysteine, vitamin B12, and folate in cases. Plasma FA composition was assessed using capillary gas chromatography. Comparisons between cases and controls were performed by independent samples t-test for continuous variables. Cases had significantly higher levels of heptadecanoic acid, linolelaidic acid, and arachidonic acid (ARA):(eicosapentaenoic acid+docosahexaenoic acid) ratio than controls (p < 0.05). Nervonic acid, ARA, adrenic acid, eicosapentaenoic acid, docosahexaenoic acid, and omega-3 polyunsaturated fatty acids (n-3 PUFA) levels were significantly lower in cases (p < 0.05). Maternal 25-hydroxyvitamin D (25(OH)D) levels were positively correlated with maternal polyunsaturated fatty acids and omega-6 polyunsaturated fatty acids. RBC folate levels were negatively correlated with n-3 PUFA.Further research is required to clarify the association of FA metabolism with NTDs.
Assuntos
Ácidos Graxos , Ácido Fólico , Defeitos do Tubo Neural , Vitamina D , Humanos , Feminino , Gravidez , Defeitos do Tubo Neural/sangue , Defeitos do Tubo Neural/diagnóstico , Adulto , Ácidos Graxos/sangue , Ácidos Graxos/metabolismo , Vitamina D/sangue , Vitamina D/análogos & derivados , Ácido Fólico/sangue , Estudos de Casos e Controles , Ácidos Docosa-Hexaenoicos/sangue , Vitamina B 12/sangue , Homocisteína/sangue , Ácido Araquidônico/sangue , Ácido Araquidônico/metabolismo , Ácido Eicosapentaenoico/sangue , Ácidos Graxos Ômega-3/sangue , Ácidos Graxos Ômega-3/metabolismo , Ácidos Graxos Monoinsaturados , Ácidos Graxos InsaturadosRESUMO
BACKGROUND: The rate of vitamin D deficiency (VDD) in critically ill children worldwide has been estimated at 50%. These children are at risk of multiple organ dysfunction, chronic morbidity, and decreased health related quality of life (HRQL). Pediatric and adult ICU clinical trials suggest that VDD is associated with worse clinical outcomes, although data from supplementation trials are limited and inconclusive. Our group's phase II multicenter dose evaluation pilot study established the efficacy and safety of an enteral weight-based cholecalciferol loading dose to rapidly restore vitamin D levels in critically ill children. METHODS: Our aim is to evaluate the impact of this dosing regimen on clinical outcomes. VITdALIZE-KIDS is a pragmatic, phase III, multicenter, double-blind RCT aiming to randomize 766 critically ill children from Canadian PICUs. Participants are randomized using a 1:1 scheme to receive a single dose at enrollment of enteral cholecalciferol (10,000 IU/kg, max 400,000 IU) or placebo. Eligibility criteria include critically ill children aged newborn (> 37 weeks corrected gestational age) to < 18 years who have blood total 25-hydroxyvitamin D < 50 nmol/L. The primary objective is to determine if rapid normalization of vitamin D status improves HRQL at 28 days following enrollment. The secondary objective is to evaluate the impact of rapid normalization of vitamin D status on multiple organ dysfunction. The study includes additional tertiary outcomes including functional status, HRQL and mortality at hospital discharge and 90 days, PICU and hospital length of stay, and adverse events related to vitamin D toxicity. Additionally, we are performing comprehensive vitamin D speciation and non-targeted metabolite profiling as part of a sub-study for the first 100 participants from whom an enrollment and at least one post-intervention blood and urine sample were obtained. DISCUSSION: The VITdALIZE-KIDS trial is the first phase III, multicenter trial to evaluate whether rapid normalization of vitamin D status could represent a simple, inexpensive, and safe means of improving outcomes following pediatric critical illness. Recruitment was initiated in June 2019 and is expected to continue to March 2026. TRIAL REGISTRATION: Clinicaltrials.gov, NCT03742505. Study first submitted on November 12, 2018 https://clinicaltrials.gov/study/NCT03742505.
Assuntos
Colecalciferol , Ensaios Clínicos Fase III como Assunto , Estado Terminal , Unidades de Terapia Intensiva Pediátrica , Estudos Multicêntricos como Assunto , Deficiência de Vitamina D , Vitamina D , Humanos , Método Duplo-Cego , Deficiência de Vitamina D/tratamento farmacológico , Deficiência de Vitamina D/sangue , Deficiência de Vitamina D/diagnóstico , Colecalciferol/administração & dosagem , Criança , Pré-Escolar , Vitamina D/análogos & derivados , Vitamina D/sangue , Vitamina D/administração & dosagem , Lactente , Adolescente , Canadá , Ensaios Clínicos Pragmáticos como Assunto , Resultado do Tratamento , Masculino , Feminino , Fatores de Tempo , Recém-Nascido , Biomarcadores/sangue , Qualidade de VidaRESUMO
Vitamin D plays a role in inflammatory skin conditions and can improve them. Hidradenitis suppurativa (HS) is an autoinflammatory chronic skin disease in which most patients exhibit a hypovitaminosis D. However, it is uncertain whether vitamin D supplementation could relieve the severity of HS. A systematic literature search of PubMed and Web of Science was conducted on 4 September 2023. Studies that investigated vitamin D and its potential implications for the severity of HS were included. In contrast, studies that focused on the prevalence of vitamin D deficiency were excluded, as well as studies on syndromic HS. Seven studies with a total of 575 patients were included in the qualitative synthesis, of which 3 utilized a cross-sectional design, 2 were pilot studies, 1 a controlled cohort study, and 1 a prospective case-control study. In all included studies, HS patients were vitamin D deficient. There was evidence indicating that serum vitamin D levels negatively correlated with the severity of the disease, and at least suggestive evidence that vitamin D supplementation could have a positive impact on the course of HS. To better understand these correlations, conducting a randomized controlled trial study on vitamin D and its effects on HS severity is imperative.
Assuntos
Hidradenite Supurativa , Índice de Gravidade de Doença , Deficiência de Vitamina D , Vitamina D , Humanos , Biomarcadores/sangue , Suplementos Nutricionais , Hidradenite Supurativa/sangue , Hidradenite Supurativa/diagnóstico , Hidradenite Supurativa/dietoterapia , Vitamina D/administração & dosagem , Vitamina D/sangue , Deficiência de Vitamina D/sangue , Deficiência de Vitamina D/diagnóstico , Deficiência de Vitamina D/dietoterapia , Deficiência de Vitamina D/epidemiologiaRESUMO
Background and Objectives: The anti-Müllerian hormone (AMH) is a crucial biomarker in regulating ovarian follicle development and female fertility. AMH levels predict ovarian responses in in vitro fertilization (IVF) cycles, helping clinicians tailor treatment strategies. This study aims to determine whether thyroid autoimmunity, age, body mass index (BMI), sexual hormone levels, and 25-hydroxyvitamin D levels influence serum AMH in non-polycystic-ovary-syndrome (PCOS) euthyroid women. Materials and Methods: This retrospective cross-sectional study examined 52 female patients at Zygota Fertility Clinic between 2018 and 2022. Women aged 20-45 years with regular menstrual cycles were included, while conditions such as abnormal thyroid-stimulating hormone (TSH) levels, PCOS, and systemic autoimmune diseases were excluded. A number of parameters were measured in the study, including the subjects' age, BMI, 25-hydroxyvitamin D, serum free thyroxine (fT4), TSH, various antibodies, and a range of reproductive hormones. An analysis of the relationships between AMH and other variables was conducted using Spearman's correlation coefficient, and an assessment of the impact of confounding factors on AMH levels was conducted using a multivariable linear regression model. Results: The results revealed significant negative correlations between AMH levels and age (rho: -0.484, p < 0.001) and follicle-stimulating hormone (FSH) (rho: -0.550, p < 0.001), while positive correlations existed between AMH and estradiol (rho: 0.352, p = 0.011) and total testosterone (rho: 0.542, p < 0.001). No significant correlations were found between AMH levels and BMI, LH, or 25-hydroxyvitamin D. Conclusions: In this study, ovarian reserve was influenced by age, estradiol, and total testosterone in non-PCOS euthyroid women undergoing IVF. Conversely, BMI and vitamin D status did not significantly impact AMH levels. In order to better understand and possibly manage ovarian reserve, a holistic approach is absolutely essential, taking into account age, weight, hormonal balance, nutrition, and thyroid health.
Assuntos
Hormônio Antimülleriano , Fertilização in vitro , Vitamina D , Humanos , Feminino , Hormônio Antimülleriano/sangue , Estudos Transversais , Estudos Retrospectivos , Adulto , Fertilização in vitro/métodos , Vitamina D/sangue , Vitamina D/análogos & derivados , Pessoa de Meia-Idade , Índice de Massa Corporal , Tireotropina/sangue , Biomarcadores/sangue , Adulto JovemRESUMO
High dose bolus cholecalciferol supplementation has been associated with falls and fracture, and this does not appear to be due to hypercalcaemia. The primary aim of this study was to determine the change in free vitamin D and metabolites after high dose bolus supplementation. This was a single centre, double-blinded, randomised, controlled trial of three different oral bolus doses of vitamin D3 (50,000 IU, 150,000 IU, and 500,000 IU) in otherwise healthy, vitamin D deficient (total 25-hydroxylated vitamin 25(OH)D < 30 nmol/L) postmenopausal women. Thirty-three women were randomized to one of the three treatment groups. Twenty-seven vitamin D sufficient (25(OH)D > 50 nmol/L) postmenopausal women were recruited as a concurrent control group. Participants attended five study visits over three months. We measured total 25(OH)D3 and free 25(OH)D, total and free 1,25(OH)2D, parathyroid hormone, fibroblast-growth factor-23, serum calcium, ionised calcium, urinary calcium excretion, and bone turnover markers (procollagen I N-propeptide (PINP), serum C-telopeptides of type I collagen (CTX-I) and Osteocalcin (OC)). We assessed muscle strength and function with grip strength and a short physical performance battery. Postural blood pressure and aldosterone:renin ratio (ARR) was also measured. Total 25(OH)D3 and free 25(OH)D increased in response to dose, and there were proportionate increases in total and free metabolites. Treatment did not affect serum calcium, postural blood pressure, ARR, or physical function. Bone turnover markers increased transiently one week after administration of 500,000 IU. High dose bolus cholecalciferol supplementation does not cause disproportionate increases in free vitamin D or metabolites. We did not identify any effect on blood pressure regulation or physical function that would explain increased falls after high dose treatment. A transient increase in bone turnover markers one week after a 500,000 IU bolus suggests that very high doses can have acute effects on bone metabolism, but the clinical significance of this transient increase is uncertain.
Assuntos
Biomarcadores , Remodelação Óssea , Colecalciferol , Suplementos Nutricionais , Deficiência de Vitamina D , Vitamina D , Humanos , Feminino , Colecalciferol/administração & dosagem , Remodelação Óssea/efeitos dos fármacos , Biomarcadores/sangue , Biomarcadores/urina , Vitamina D/análogos & derivados , Vitamina D/sangue , Vitamina D/administração & dosagem , Pessoa de Meia-Idade , Método Duplo-Cego , Idoso , Deficiência de Vitamina D/tratamento farmacológico , Deficiência de Vitamina D/sangue , Pós-Menopausa , Cálcio/sangue , Hormônio Paratireóideo/sangue , Fator de Crescimento de Fibroblastos 23 , Relação Dose-Resposta a DrogaRESUMO
INTRODUCTION/AIM: Vitamin D plays a crucial role in immune modulation, which may influence the development of graft-versus-host disease (GvHD) in patients undergoing hematopoietic stem cell transplantation (HSCT). This study aims to evaluate the impact of vitamin D levels and supplementation on the incidence of GvHD in HSCT patients. METHODS: A narrative review was conducted across PubMed/Medline, Cochrane Library, CINAHL, and Embase databases. RESULTS: The reviewed studies indicated widespread vitamin D deficiency among HSCT patients, with baseline levels ranging from 12.8 to 29.2 ng/mL. Supplementation protocols varied significantly, with dosages ranging from 1000 IU/day to 60,000 IU/week. Post-supplementation levels improved in some studies. Studies exploring the relationship between vitamin D and GvHD showed mixed results. Lower baseline vitamin D levels were associated with an increased risk of acute GvHD in some studies, while others found no significant correlation. However, a significant association between low levels of vitamin D and the incidence of chronic GvHD was observed. CONCLUSION: Vitamin D deficiency is prevalent in HSCT patients and may influence the risk of developing chronic GvHD. Future research should focus on larger and more rigorous studies to determine the optimal role of vitamin D as an adjuvant therapy in the context of HSCT.
Assuntos
Suplementos Nutricionais , Doença Enxerto-Hospedeiro , Transplante de Células-Tronco Hematopoéticas , Deficiência de Vitamina D , Vitamina D , Humanos , Transplante de Células-Tronco Hematopoéticas/efeitos adversos , Doença Enxerto-Hospedeiro/sangue , Vitamina D/sangue , Vitamina D/administração & dosagem , Deficiência de Vitamina D/sangue , Feminino , Incidência , MasculinoRESUMO
OBJECTIVE: In this study, we investigated 25-hydroxyvitamin D (25(OH)D, vitamin D), inflammatory hematologic ratios such as neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), systemic immune-inflammation index (SII), monocyte/HDL-C ratio (MHR) and plasma atherogenic index (PAI) and possible relationships with insulin resistance (IR) in children. METHODS: A total of 210 individuals, including 96 children with IR and 114 children without IR, aged 6-18 years, who were admitted to the Pediatric Endocrinology Outpatient Clinic at Medicine Hospital, Istanbul Atlas University were included in our study. RESULT: Compared to patients without IR, NLR, PLR, SII, and MHR were significantly higher in patients with IR. Fasting insulin, PAI, homeostasis model assessment of insulin resistance (HOMA-IR), and HOMA-ß were significantly higher and quantitative insulin sensitivity check index (QUICKI) was considerably lower in patients with IR compared to those without IR. NLR, SII, and MHR were lower in normal vitamin D groups than the others (p < 0.001). PLR was lower in the group with normal vitamin D levels than the groups with insufficient or deficient levels of vitamin D (D < 21). CONCLUSIONS: We found that vitamin D deficiency in childhood is related to increased levels of circulating inflammatory markers (NLR, PLR, MHR, PAI), IR, and decreased insulin sensitivity. According to our results, supplementation of vitamin D may be beneficial in averting IR and enhanced systemic inflammation.