Establishing Benefit from Vitamin D Supplementation — Adherence to Defined Criteria and Targeting of High-Risk Groups Essential?

Abstract Background Vitamin D deficiency represents a global health problem, affecting children and adolescents worldwide. Objects To confirm that vitamin D deficiency can present as a spectrum of clinical pictures. Methods We diagnosed nutritional rickets in a 10-month-old infant of Senegal origin with several risk factors for vitamin D deficiency. As many of these factors affected also his cohabitant relatives, we evaluate infant’s family members (mother and 4 brothers) looking for other vitamin D deficiency-related comorbidities. Results 3 brothers had asymptomatic vitamin D deficiency and 2 of them (9.8 and 13.4 years-old) showed secondary hyperparathyroidism. The fourth brother (11.3 years-old) had nutritional rickets. Their mother was affected by osteomalacia. None of them received vitamin D supplementation. Conclusion Vitamin D deficiency may present as a spectrum of clinical pictures, representing a continuum ranging from asymptomatic/subtle conditions to overt rickets/osteomalacia. Immigrant families are at high risk for vitamin D deficiency at every age. If a case of symptomatic vitamin D deficiency is recognized, then the evaluation of the all family members is recommended, as they can have the same and/or other risk factors for vitamin D deficiency.

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Solar ultraviolet B exposure and global variation in tuberculosis incidence: an ecological analysis

European Respiratory Journal ◽

10.1183/13993003.01979-2016 ◽

2017 ◽

Vol 49 (6) ◽

pp. 1601979 ◽

Cited By ~ 7

Author(s):

Tjarda M. Boere ◽

Douwe H. Visser ◽

A. Marceline van Furth ◽

Paul Lips ◽

Frank G.J. Cobelens

Keyword(s):

Vitamin D ◽

National Level ◽

Risk Groups ◽

Vitamin D Supplementation ◽

Ultraviolet B ◽

Tuberculosis Incidence ◽

Global Variation ◽

Relevant Variables ◽

Solar Uv ◽

Solar Ultraviolet

Epidemiological evidence supports vitamin D deficiency as a risk factor for tuberculosis. Differences in solar ultraviolet B (UV-B) exposure, the major source of vitamin D, might therefore partially explain global variation in tuberculosis incidence.In a global country-based ecological study, we explored the correlation between vitamin D-proxies, such as solar UV-B exposure, and other relevant variables with tuberculosis incidence, averaged over the period 2004–2013.Across 154 countries, annual solar UV-B exposure was associated with tuberculosis incidence. Tuberculosis incidence in countries in the highest quartile of UV-B exposure was 78% (95% CI 57–88%, p<0.001) lower than that in countries in the lowest quartile, taking into account other vitamin D-proxies and covariates. Of the explained global variation in tuberculosis incidence, 6.3% could be attributed to variations in annual UV-B exposure. Exposure to UV-B had a similar, but weaker association with tuberculosis notification rates in the multilevel analysis with sub-national level data for large countries (highestversuslowest quartile 29% lower incidence; p=0.057).The potential preventive applications of vitamin D supplementation in high-risk groups for tuberculosis merits further investigation.

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Abstract P1-07-01: Safety of High-Dose Vitamin D Supplementation in Premenopausal Women at High Risk for Breast Cancer

10.1158/0008-5472.sabcs10-p1-07-01 ◽

2010 ◽

Cited By ~ 1

Author(s):

SF Refice ◽

DL Hershman ◽

MA Maurer ◽

K Kalinsky ◽

S Feldman ◽

...

Keyword(s):

Breast Cancer ◽

Vitamin D ◽

High Risk ◽

Premenopausal Women ◽

Vitamin D Supplementation ◽

High Dose ◽

High Dose Vitamin

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The effect of vitamin D supplementation on survival in patients with colorectal cancer: systematic review and meta-analysis of randomised controlled trials

British Journal of Cancer ◽

10.1038/s41416-020-01060-8 ◽

2020 ◽

Vol 123 (11) ◽

pp. 1705-1712 ◽

Cited By ~ 1

Author(s):

Peter G. Vaughan-Shaw ◽

Louis F. Buijs ◽

James P. Blackmur ◽

Evi Theodoratou ◽

Lina Zgaga ◽

...

Keyword(s):

Colorectal Cancer ◽

Vitamin D ◽

High Risk ◽

Meta Analysis ◽

Vitamin D Supplementation ◽

Risk Of Bias ◽

Survival Outcomes ◽

Vitamin D Levels ◽

Randomised Controlled ◽

Incident Cases

Abstract Background Low circulating vitamin D levels are associated with poor colorectal cancer (CRC) survival. We assess whether vitamin D supplementation improves CRC survival outcomes. Methods PubMed and Web of Science were searched. Randomised controlled trial (RCTs) of vitamin D supplementation reporting CRC mortality were included. RCTs with high risk of bias were excluded from analysis. Random-effects meta-analysis models calculated estimates of survival benefit with supplementation. The review is registered on PROSPERO, registration number: CRD42020173397. Results Seven RCTs (n = 957 CRC cases) were identified: three trials included patients with CRC at outset, and four population trials reported survival in incident cases. Two RCTs were excluded from meta-analysis (high risk of bias; no hazard ratio (HR)). While trials varied in inclusion criteria, intervention dose and outcomes, meta-analysis found a 30% reduction in adverse CRC outcomes with supplementation (n = 815, HR = 0.70; 95% confidence interval (CI): 0.48–0.93). A beneficial effect was seen in trials of CRC patients (progression-free survival, HR = 0.65; 95% CI: 0.36–0.94), with suggestive effect in incident CRC cases from population trials (CRC-specific survival, HR = 0.76; 95% CI: 0.39–1.13). No heterogeneity or publication bias was noted. Conclusions Meta-analysis demonstrates a clinically meaningful benefit of vitamin D supplementation on CRC survival outcomes. Further well-designed, adequately powered RCTs are needed to fully evaluate benefit of supplementation in augmenting ‘real-life’ follow-up and adjuvant chemotherapy regimens, as well as determining optimal dosing.

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Successful public health action to reduce the incidence of symptomatic vitamin D deficiency

Archives of Disease in Childhood ◽

10.1136/archdischild-2012-302287 ◽

2012 ◽

Vol 97 (11) ◽

pp. 952-954 ◽

Cited By ~ 32

Author(s):

Robert John Moy ◽

Eleanor McGee ◽

Geoff D Debelle ◽

Ian Mather ◽

Nicholas J Shaw

Keyword(s):

Vitamin D ◽

High Risk ◽

Vitamin D Deficiency ◽

Incidence Rate ◽

Uptake Rate ◽

Public Awareness ◽

Vitamin D Supplementation ◽

Minority Population ◽

Vitamin Supplement ◽

Vitamin D Levels

BackgroundIn response to a resurgence of symptomatic cases of vitamin D deficiency in a high-risk predominantly ethnic minority population, a programme of universal rather than targeted vitamin D supplementation was begun with a public awareness campaign about the importance of vitamin D.ObjectiveTo evaluate the effectiveness of this programme in reducing case numbers.MethodsCases of symptomatic vitamin D deficiency in children under 5 years resident in a primary care trust catchment area presenting at local hospitals were identified through laboratory records of low vitamin D levels which were cross-checked against medical records to confirm the diagnosis. Comparisons were made of the case incidence rate, level of public knowledge and vitamin supplement uptake rate at the onset of the programme in 2005 and 4 years later.ResultsThe number of cases of symptomatic vitamin D deficiency in those under 5 years fell by 59% (case incidence rate falling from 120/100 000 to 49/100 000) despite the supplement uptake rate rising only to 17%. Public awareness of vitamin D deficiency rose to near universal levels.ConclusionsA programme of universal rather than targeted Healthy Start vitamin D supplementation for pregnant and lactating women and young children has led to a substantial decrease in cases of symptomatic vitamin D deficiency in a high-risk population. Supplementation was also started at a younger age than in the national programme. This approach has implications for the delivery of vitamin D supplementation programmes in similar populations.

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COvid-19 and high-dose VITamin D supplementation TRIAL in high-risk older patients (COVIT-TRIAL): study protocol for a randomized controlled trial

Trials ◽

10.1186/s13063-020-04928-5 ◽

2020 ◽

Vol 21 (1) ◽

Author(s):

Cédric Annweiler ◽

◽

Mélinda Beaudenon ◽

Jennifer Gautier ◽

Romain Simon ◽

...

Keyword(s):

Vitamin D ◽

Randomized Controlled Trial ◽

High Risk ◽

Older Patients ◽

Standard Dose ◽

Controlled Trial ◽

Vitamin D Supplementation ◽

High Dose ◽

Randomized Controlled ◽

High Dose Vitamin

Abstract Background With the lack of effective therapy, chemoprevention, and vaccination against SARS-CoV-2, focusing on the immediate repurposing of existing drugs gives hope of curbing the COVID-19 pandemic. A recent unbiased genomics-guided tracing of the SARS-CoV-2 targets in human cells identified vitamin D among the three top-scoring molecules manifesting potential infection mitigation patterns. Growing pre-clinical and epidemiological observational data support this assumption. We hypothesized that vitamin D supplementation may improve the prognosis of COVID-19. The aim of this trial is to compare the effect of a single oral high dose of cholecalciferol versus a single oral standard dose on all-cause 14-day mortality rate in COVID-19 older adults at higher risk of worsening. Methods The COVIT-TRIAL study is an open-label, multicenter, randomized controlled superiority trial. Patients aged ≥ 65 years with COVID-19 (diagnosed within the preceding 3 days with RT-PCR and/or chest CT scan) and at least one worsening risk factor at the time of inclusion (i.e., age ≥ 75 years, or SpO2 ≤ 94% in room air, or PaO2/FiO2 ≤ 300 mmHg), having no contraindications to vitamin D supplementation, and having received no vitamin D supplementation > 800 IU/day during the preceding month are recruited. Participants are randomized either to high-dose cholecalciferol (two 200,000 IU drinking vials at once on the day of inclusion) or to standard-dose cholecalciferol (one 50,000 IU drinking vial on the day of inclusion). Two hundred sixty participants are recruited and followed up for 28 days. The primary outcome measure is all-cause mortality within 14 days of inclusion. Secondary outcomes are the score changes on the World Health Organization Ordinal Scale for Clinical Improvement (OSCI) scale for COVID-19, and the between-group comparison of safety. These outcomes are assessed at baseline, day 14, and day 28, together with the serum concentrations of 25(OH)D, creatinine, calcium, and albumin at baseline and day 7. Discussion COVIT-TRIAL is to our knowledge the first randomized controlled trial testing the effect of vitamin D supplementation on the prognosis of COVID-19 in high-risk older patients. High-dose vitamin D supplementation may be an effective, well-tolerated, and easily and immediately accessible treatment for COVID-19, the incidence of which increases dramatically and for which there are currently no scientifically validated treatments. Trial registration ClinicalTrials.govNCT04344041. Registered on 14 April 2020 Trial status Recruiting. Recruitment is expected to be completed in April 2021.

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An Update on Preventive Outlook for Supplementation of Vitamin-D against SARS-CoV-2 Infection

10.31219/osf.io/4u5xc ◽

2021 ◽

Author(s):

Abu Saim Mohammad Saikat ◽

Muhammad Torequl Islam

Keyword(s):

Vitamin D ◽

Risk Groups ◽

Vitamin D Supplementation ◽

Health Interventions ◽

World Population ◽

Public Health Interventions ◽

Pharmacological Agents ◽

Inflammatory Reactions ◽

High Death Rate ◽

High Death

The pandemic COVID-19 has a high death rate, which threatens nearly most of the world's population. The main reason for mortality in severe acute respiratory syndrome is intensified inflammatory activity followed by oxidative stress and inflammatory reactions on the lungs. To date, this pathology does not have a clear and conclusive cure troubling the world population, particularly elderly adults who are the major risk groups. In this sense, assessing the effectiveness of current pharmacological agents, which can be used to resolve or attenuate this pulmonary complication's seriousness that has threatened the lives of so many people globally, is of particular importance. In contrast to quarantine, public health interventions are urgently needed, reducing the risk of illness and death. Evidence reveals that vitamin D supplementation may be possible in treating COVID-19. Additionally, numerous trials and studies started to study the effect of vitamin D supplementation on patients with SARS-CoV-2 infection.

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