To Compare Serum Vitamin D Levels with Severity of Liver Cirrhosis According to Child-Pugh Score in Amritsar, Punjab

2021 ◽  
Vol 8 (33) ◽  
pp. 3090-3096
Author(s):  
Jaskiran Kaur ◽  
Gurinder Mohan ◽  
Manish Chandey

BACKGROUND Cirrhosis of liver and its extrahepatic manifestations like hepatic osteodystrophy has been linked to vitamin D deficiency, and has been proposed as a potential therapeutic target. Its metabolism to 25-hydroxylation, makes liver necessary for its activation. In this study sources of vitamin D, functions and its metabolism with a focus on its variation with severity of liver cirrhosis is discussed. METHODS This is an observational study conducted on 60 patients with liver cirrhosis. The severity of liver cirrhosis was assessed according to the Modified CPS. By technique of enhanced chemiluminscence values of vitamin D were obtained. The results were statistically analyzed using SPSS Statistics-20.0 version. Association among different variables were calculated using Chi-Square Test and One Way ANOVA. Results were considered significant if p value obtained was below 0.05 and highly significant if it was below 0.001. RESULTS Mean age group of study population was 54.83 ± 13.56 years. 27 patients had Alcoholic cirrhosis, 11 patients were HCV positive, 2 patients were HBsAg positive and 20 patients had cirrhosis due to other etiologies. Mean vitamin D level of the study population was 35.34 ± 22.4. 27 patients (45 %) had sufficient vitamin D, 18 patients (30 %) were deficient and 14 patients had insufficient vitamin D levels. 1 patient had vitamin D toxicity. There was no significant correlation between mean vitamin D and etiology of liver cirrhosis (P value = 0.457; Not Significant). There was significant correlation between vitamin D levels with severity of liver disease (p value < 0.001). CONCLUSIONS In conclusion, low concentrations of 25 (OH) D are correlated with severity of liver dysfunction irrespective of the etiology. KEYWORDS Child-Pugh Score, Liver cirrhosis, Serum Vitamin D

2021 ◽  
Vol 3 (6) ◽  
pp. 78-81
Author(s):  
Harika Putra ◽  
Efrida ◽  
Rismawati Yaswir

Coronavirus Disease 2019 (COVID-19) causes immune system dysregulation and an exaggerated systemic inflammatory response. Vitamin D acts as an immunomodulator that enhances the immunity defense. Low levels of vitamin D affect the severity of COVID-19 infection. This study aims to determine vitamin D levels in hospitalized and non-hospitalized COVID-19 patients. A case-control study was conducted involving 62 COVID-19 patients, equally divided into hospitalized and non-hospitalized groups at RSUP dr. M. Djamil, Padang from February to September 2020. Serum vitamin D levels were measured using the Chemiluminescent Microparticle Immunoassay. Vitamin D deficiency was defined as a level less than 20 ng/mL. The hospitalized group consisted of moderate to critical COVID-19 patients, whereas the non-hospitalized group consisted of the asymptomatic and mild COVID-19 patients according to the Indonesian Ministry of Health Guidelines. All data were analyzed using a T-test and Chi-square with a significant p-value of 0.05. The results showed that most subjects were women between 21–60 years. The mean level of vitamin D (ng/mL) in the hospitalized group was lower than in the non-hospitalized group (15.5 ± 7.72 vs. 19.2 ± 14.30; 95% CI -9.509–2.167; p=0.213). Vitamin D deficiency affected hospitalized group more than the non-hospitalized group, but not statistically significant (71% vs. 64.5%, p=0.566). It indicated the role of vitamin D in preventing immune system hyperactivation causing COVID-19 cytokine storm. This study concluded no difference in vitamin D levels among the study groups. Nevertheless, further research on vitamin D is needed to determine its role and benefits against COVID-19 infection.


2019 ◽  
Vol 3 (2) ◽  

Objectives: To identify any correlation and its severity with the levels of serum vitamin D with the level of maxillary sinus pneumatization. Study Design: Descriptive cross-sectional survey. Setting: Oral and Maxillofacial Department, Fatima Memorial Hospital, Lahore. Materials and Methods: A sample size of 100 subjects met the inclusion criteria. Serum Vitamin D levels of the patients was done using liquid chromatography tandem mass spectrometry, also known as LC/MS/MS. While level of sinus pneumatization was recorded according to Sharan and Majdar classification of maxillary sinus pneumatization. Data was collected and entered into the Statistical Package for Social Science (SPSS) version 25.0 for analysis. Parametric analysis was performed that included the Pearson’s Chi- Square test to determine an association between excessive maxillary sinus pneumatization and hypovitaminosis. A p-value of <0.05 was defined as the level of significance. Results: A statistically significant relationship was found between levels of hypovitaminosis and levels of pneumatization with a chi square value to be 0.002 (p<0.05) While there was no statistically significant relationship of age or gender with levels of maxillary sinus pneumatization and hypovitaminosis D (p>0.05). Conclusion: There is a significant relationship between levels of hypovitaminosis and levels of pneumatisation.


Background: The risk factors for asthma exacerbations are well understood. However, the effect of vitamin D levels on number of asthma exacerbations per year is not clearly studied. The objective of the study was to find out the association of serum vitamin D levels and asthma risk factors on asthma exacerbations. Methods: In this study, ninety-nine subjects from 5 to 15 years of age were recruited at an episode of acute exacerbation. It was a cross sectional study and carried out from 2012 to 2015. Pulmonary function test was done by spirometry. Asthma exacerbation was labeled when forced expiratory volume/ forced vital capacity (FEV1/FVC) ratio was less than 80% (American Thoracic Society). Global Initiative for Asthma (GINA) guidelines were used to classify asthma into mild, moderate and severe persistent asthma. Serum vitamin D levels were measured by chemiluminescence method. Pearson Chi-square test was applied and p value (p<0.05) was considered as statistically significant. Results: Children who had exposure to animal dander had significantly lower asthma exacerbations per year (p-value <0.046). There was no significant association between vitamin D levels and number of exacerbations per years (p-value <0.099). Asthma was prevalent in girls of low socioeconomic status (SES) compared to males. However, there was no significant association between smoke, exercise, home environment, food allergies, weather, pollen and dust with asthma exacerbations. Conclusion: Low levels of vitamin D were not associated with increased number of asthma exacerbations per year. However, children exposed to animal dander had lesser number of exacerbations per year (p-value <0.046). Keywords: Asthma; Vitamin D; Children; Exacerbations, Risk factors.


2021 ◽  
pp. 205141582199360
Author(s):  
Ghanshyam Kumawat ◽  
Vijay Chaudhary ◽  
Anurag Garg ◽  
Nishkarsh Mehta ◽  
Gagan Talwar ◽  
...  

Objective: We aimed to find out the association of low serum vitamin D levels with the incidence of prostate cancer through a prospective case-control study. Material and methods: This study was carried out in the tertiary care hospital (India). All newly diagnosed patients of prostate cancer and age-matched controls were included. Serum vitamin D levels were measured in all of them. Vitamin D status (ng/mL) was classified as severe deficiency <10, moderate deficiency 10–<30, normal 30–100, and toxicity >100. Normality of the data was tested by the Kolmogorov–Smirnov test, statistical analysis was done with Statistical Package for the Social Sciences version 26.0, p-value of <0.05 was considered significant. Results: In our study, 320 cases and 320 controls were included. The mean vitamin D levels in cases and controls were 15.71 ± 6.5 (ng/mL) and 17.63 ± 4.54 (ng/mL), respectively, ( p-Value <0.01). Patients with severe vitamin D deficiency (73.58%) had a Gleason score ⩾8 on biopsy and 79.24% of them had a serum prostate specific antigen (PSA) level >20 ng/mL. Conclusion: We had concluded that there was no significant association between vitamin D deficiency and increased risk of prostate cancer, although patients with higher-grade prostate cancer and with higher PSA level had severe vitamin D deficiency. Level of evidence: Not applicable for this multicentre audit.


2021 ◽  
Vol 7 (4) ◽  
pp. 320-323
Author(s):  
Ritika Gujrati ◽  
Krishnendra Varma ◽  
Ujjwal Kumar

Psoriasis is an immuno-mediated chronic systemic disease involving cytokines of helper Th1 pathway. Vitamin D has an effect on keratinocyte proliferation, differentiation and immune modulation of immune system especially Th1 pathway, which is altered in psoriatic skin suggesting that Vitamin D may have a role in pathogenesis of psoriasis. To study correlation between psoriasis vulgaris and serum vitamin D. To evaluate serum vitamin D level in psoriasis cases and in control group and correlating vitamin D level with severity and duration of the psoriasis. 57 cases (&#62;15years of age) with psoriasis and 57 healthy subjects were recruited. Psoriasis was clinically diagnosed and severity evaluated by PASI scale. Vitamin D was analysed by enhanced chemilumine scence on vitrus Eci autoanalyzer of Orth clinical diagnostic. Vitamin D deficiency defined as &#60;20ng/ml, insufficiency 20-30ng/ml and sufficient 30-100ng/ml. Vitamin D deficiency in the study was 22.8% in patients and 14% in control group. Vitamin D insufficiency was found in 42.1% of cases and 19.3% of control. According to chi-square the p-value is 0.003 showing significant association. There was a tendency towards decrease in vitamin D level with increase in disease duration. There was negative correlation between vitamin D and PASI score. The study found a significant relationship between vitamin D and psoriasis. Further metanalysis involving larger study population will be required to establish whether vitamin D levels benefits patient with psoriasis vulgaris.


2017 ◽  
Vol 4 (4) ◽  
pp. 1397
Author(s):  
Pragalatha Kumar ◽  
Aruna Gowdra ◽  
Arathi Arathi ◽  
Ananya Sampath

Background: Vitamin D deficiency has been rediscovered as a public health problem worldwide. Few studies have shown that vitamin D deficiency is associated with asthma severity. The objective of present work was to study the serum vitamin D levels and its relationship with asthma severity in children.Methods: A prospective cohort study of 100 children with asthma between the age group of 5 to 15 years and age and sex matched 40 healthy controls who had come to Indira Gandhi Institute of Child Health, Bengaluru was done. These children’s serum vitamin D levels were estimated and correlated with asthma severity.Results: A total of 100 children with asthma and 40 healthy age and sex matched controls were evaluated. The study group had lower vitamin D (34.95 ng/ml) levels as compared to the control group (57.94 ng/ml) which was statistically significant (p<0.05). 68.4% children had significantly low vitamin D levels and severe form of asthma (p value <0.001). There was also a marked rise in absolute eosinophil count in those who had low vitamin D levels (56.6%) (p-value <0.0001).Conclusions: Vitamin D deficiency is an important risk factor for asthma severity. It modifies the immune system and reduces the inflammation. In the present study, low serum vitamin D levels were significantly correlated with severe form of asthma. There was a significant rise in the absolute eosinophil count in those who exhibited deficiency of vitamin D.  


2019 ◽  
Vol 20 (1) ◽  
Author(s):  
Jian Liu ◽  
Yong-Quan Dong ◽  
Jie Yin ◽  
Jian Yao ◽  
Jie Shen ◽  
...  

Abstract Background There is growing literature suggesting a link between vitamin D and asthma lung function, but the results from systematic reviews are conflicting. We conducted this meta-analysis to investigate the relation between serum vitamin D and lung function in asthma patients. Methods Major databases, including OVID, MEDLINE, Web of Science and PUBMED, were searched until 10th October 2018. All published observational studies related to vitamin D and asthma were extracted. All meta-analyses were performed using Review Manager 5.3.5. Results This quantitative synthesis found that asthma patients with low vitamin D levels had lower forced expiratory volume In 1 s (FEV1) (mean difference (MD) = − 0.1, 95% CI = − 0.11 to − 0.08,p < 0.01;I2 = 49%, p = 0.12) and FEV1% (MD = − 10.02, 95% CI = − 11 to − 9.04, p < 0.01; I2 = 0%, p = 0.82) than those with sufficient vitamin D levels. A positive relation was found between vitamin D and FEV1 (r = 0.12, 95% CI = 0.04 to 0.2, p = 0.003; I2 = 59%,p = 0.01), FEV1% (r = 0.19, 95% CI = 0.13 to 0.26, p < 0.001; I2 = 42%, p = 0.11), forced vital capacity (FVC) (r = 0.17, 95% CI = 0.00 to 0.34, p = 0.05; I2 = 60%, p = 0.04), FEV1/FVC (r = 0.4, 95% CI = 0.3 to 0.51, p < 0.001; I2 = 48%, p = 0.07), and the asthma control test (ACT) (r = 0.33, 95% CI = 0.2 to 0.47, p < 0.001; I2 = 0%, p = 0.7). Subgroup analysis indicated that the positive correlation between vitamin D and lung function remained significant in both children and adults. Conclusions Our meta-analysis suggested that serum vitamin D levels may be positively correlated with lung function in asthma patients. Future comprehensive studies are required to confirm these relations and to elucidate potential mechanisms.


Author(s):  
Kishore A. Manek

<p><strong>Background:</strong> In India more than 90% of apparently healthy Indians have subnormal 25(OH) D levels. To maintain sufficient vitamin D level, apart from sunlight and food containing vitamin D, supplementation with vitamin D is also required. The objective of this study was to find out effectiveness of nanoparticle based vitamin D formulations in patient of vitamin D deficiency and insufficiency</p><p><strong>Methods:</strong> This was a prospective, open label, single arm, non-comparative, dose response post-marketing efficacy study (PMS) – phase-4 study to find the effectiveness of a nanoparticle based vitamin D formulation in adult patients between 18 to 65 years of either gender, attending/visiting the study site with documented deficiency or insufficiency of vitamin D (&lt;30 ng/ml) or sign and symptoms of deficiency or insufficiency of vitamin D. Each subject planned to receive 60,000 IU of nanoparticle based vitamin D, once weekly, for 8 weeks orally. Serum 25(OH) D levels were measured at baseline, 4 and 8 week.</p><p><strong>Results:</strong> The mean baseline serum 25[OH] D levels were 15.90. After treatment with nanoparticle based vitamin D there was a significant increase in the serum vitamin D levels at 4 weeks (41.03) and 8 weeks (31.38) (p&lt;0.0001). Patients who have received treatment for at least 4 weeks’ period (n=38), the improvement (serum 25[OH] D &gt;30 ng/ml) was seen in 84.2% patients (n=32) at the end of 4 weeks itself. There is significant increased (&lt;0.0001) in the physical component scores of the SF-12 QOL questionnaire after 8 weeks of therapy.</p><p><strong>Conclusions:</strong> Nanoparticle based formulation of vitamin D<sub>3</sub> is effective and safe in correction of vitamin D levels in patients with documented deficiency or insufficiency of vitamin D. Also the safety and tolerability is well accepted and reported good to excellent by patients and physician.</p><p> </p>


2017 ◽  
Vol 19 (1) ◽  
pp. 22-29 ◽  
Author(s):  
Homayra Tahseen Hossain ◽  
Quazi Tarikul Islam ◽  
Md Abul Kashem Khandaker ◽  
HAM Nazmul Ahasan

Background: Recently, we see in our clinical practice that many patients who are coming with generalized body aches and pains and diagnosed as fibromyalgia or chronic fatigue, not adequately responding to treatment. When their vitamin D level was done, it was found to be low and correction of their low vitamin D level improved their symptoms dramatically. Despite abundant sunshine in Bangladesh, allowing vitamin D synthesis all the year round, why our people are developing hypovitaminosis D inspired us to do this current study. Our present study is designed to estimate the prevalence of vitamin D deficiency among adult patients presented with aches & pains as well as to study the association of low vitamin D levels with different socio-demographic parameters.Methods: A cross sectional observational study was conducted among 212 adult patients aged 18 years and above presented with generalized body aches and pains, attended both outpatient and inpatient departments of Popular Medical College Hospital during the period of March’16- August’16 ( 6 months). Association between vitamin D status & the individual specific variables was statistically analyzed.Results: The prevalence of vitamin D deficiency among the study population was found to be100% in all age groups. Among 212 study population, 73.6% were female (n=156) & 26.4% were male (n=56). Mean Vitamin D level among male was 14.29 (SD 4.68) & among female was 12.64 (SD 4.74). The factors associated with severely deficient Vitamin D level were female sex, urban population, &obesity. It is alarming that 64.2% of our study population were totally unaware about the importance of sun exposure.Conclusions: Vitamin D status was associated with a number of socio-demographic variables. Knowledge of these variables may improve targeted education and public health initiatives.J MEDICINE Jan 2018; 19 (1) : 22-29


Genes ◽  
2020 ◽  
Vol 11 (8) ◽  
pp. 897
Author(s):  
Joana T. Almeida ◽  
Dircea Rodrigues ◽  
Joana Guimarães ◽  
Manuel C. Lemos

Vitamin D has immunomodulatory effects, and its deficiency has been implicated in the autoimmune process of type 1 diabetes. Serum vitamin D levels are influenced by variants in genes involved in the synthesis, transport, hydroxylation and degradation of vitamin D. The aim of this study was to assess if single nucleotide polymorphisms (SNPs) at the DHCR7 (rs12785878), GC (rs2282679), CYP2R1 (rs2060793) and CYP24A1 (rs6013897) loci are associated with type 1 diabetes in the Portuguese population. Genotype and allele frequencies were determined in 350 cases of type 1 diabetes and in 490 controls. The frequency of each SNP alone was not significantly different between patients and controls. However, the combined analysis of the four SNPs showed that minor alleles of these variants clustered more frequently in patients. The proportion of individuals with three or more minor alleles was significantly higher in patients than in controls (56.3% vs. 48.5; odds ratio (OR) 1.37; 95% confidence interval (CI) 1.04–1.81; p-value 0.027). These results suggest a cumulative effect of SNPs at the DHCR7, GC, CYP2R1 and CYP24A1 loci on the susceptibility to type 1 diabetes, due to the roles of these genes in the vitamin D metabolic pathway.


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