Clinical identification of older adults with hypovitaminosis D: Feasibility, acceptability and accuracy of the ‘Vitamin D Status Diagnosticator’ in primary care

Study Design: Cross-sectional study. Objectives: Thus, this study aimed to assess the epidemiological profile of a patient sample that underwent spinal surgery regarding their nutritional and vitamin D status. Methods: Serum albumin and vitamin D (25-hydroxyvitamin D) levels were measured in patients with different spinal surgical approaches and various pathologies at a single institution. 112 patients were retrospectively identified for inclusion and stratified by age into 4 age groups and by pathology. The nutritional status of the patients was classified in vitamin D inadequacy (< 30ng/mL), vitamin D deficiency (<20ng/mL), and hypoalbuminemia (<3.5g/dL). Data was analyzed comparing vitamin D, and albumin means considering gender, age group, and pathologies. Results: Twenty-eight (25.2%) patients had hypoalbuminemia. There was no difference between gender (p = 0.988); there was a significant decrease in albumin concentration increasing the age (p < 0.001). The prevalence of hypoalbuminemia was significantly higher in patients with trauma, tumor and infection than in those patients with degenerative and deformity diseases (p = 0.003). The prevalence of vitamin D inadequacy was 33.7%, and that of deficiency was 62.2%, while severe deficiency (< 10 ng/mL) in 16.3%. The vitamin D concentration was significantly different among the pathologies (P = 0.047), the lower concentration occurring in patients with tumor. Conclusion: Older patients, as well as patients with tumor and infectious pathologies, seem to have a higher prevalence of hypoalbuminemia, inferring malnutrition. There was a low epidemic level of vitamin D concentration, almost all patients presenting some degree of hypovitaminosis D, independent of age, gender and nutritional status.

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Environmental and genetic determinants of vitamin D status among older adults in London, UK

The Journal of Steroid Biochemistry and Molecular Biology ◽

10.1016/j.jsbmb.2016.01.005 ◽

2016 ◽

Vol 164 ◽

pp. 30-35 ◽

Cited By ~ 19

Author(s):

David A. Jolliffe ◽

Yasmeen Hanifa ◽

Karolina D. Witt ◽

Timothy R. Venton ◽

Marion Rowe ◽

...

Keyword(s):

Older Adults ◽

Vitamin D ◽

Vitamin D Status ◽

Genetic Determinants

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Vitamin D status and resistance exercise training independently affect glucose tolerance in older adults

Nutrition Research ◽

10.1016/j.nutres.2013.03.005 ◽

2013 ◽

Vol 33 (5) ◽

pp. 349-357 ◽

Cited By ~ 3

Author(s):

Vanessa M. Kobza ◽

James C. Fleet ◽

Jing Zhou ◽

Travis B. Conley ◽

Munro Peacock ◽

...

Keyword(s):

Older Adults ◽

Vitamin D ◽

Exercise Training ◽

Glucose Tolerance ◽

Resistance Exercise ◽

Vitamin D Status ◽

Resistance Exercise Training

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Transglutaminase 2 Up-Regulation Is Associated with Inflammatory Response in PBMC from Healthy Subjects with Hypovitaminosis D

Medical Sciences ◽

10.3390/medsci6040103 ◽

2018 ◽

Vol 6 (4) ◽

pp. 103 ◽

Cited By ~ 2

Author(s):

Daniela Caccamo ◽

Nadia Ferlazzo ◽

Monica Currò ◽

Sergio Ricca ◽

Riccardo Ientile

Keyword(s):

Vitamin D ◽

Immune Response ◽

Molecular Mechanisms ◽

Nuclear Translocation ◽

Transglutaminase 2 ◽

Hypovitaminosis D ◽

Mrna Levels ◽

Vitamin D Status ◽

Vitamin D Levels ◽

Tnf Α

Recent evidence indicated that transglutaminase 2 (TG2) is involved in the adaptive immune response. Peripheral blood mononuclear cells (PBMC) have largely been used to characterize molecular mechanisms occurring in the activation of immune response. Given that the maintenance of immune system functions requires an optimal vitamin D status, we aimed to assess the involvement of TG2/NF-κB signaling in cytokine production in PBMC isolated from adult subjects with different vitamin D status. We observed TG2 up-regulation and a significant positive correlation between TG2 expression and tumor necrosis factor (TNF)-α mRNA levels in PBMC of recruited patients. The mRNA levels of TG2 and TNF-α were higher in PBMC of subjects having hypovitaminosis D, namely plasma 25(OH)vitamin D3 levels lower than 50 nmol/L, than in those with normal vitamin D levels. Moreover, NF-κB up-regulation and nuclear translocation were detected, concomitantly with TG2 as well as TNF-α increased expression, in PBMC of vitamin D-deficient subjects. The present findings confirm that an increase in TG2 expression exacerbates the activation of NF-κB and the production of pro-inflammatory cytokines, and suggest a link between vitamin D deficiency, TG2 up-regulation, and inflammation.

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Persistence with oral bisphosphonates and denosumab among older adults in primary care in Ireland

10.1101/2020.10.05.20207290 ◽

2020 ◽

Author(s):

Mary E. Walsh ◽

Tom Fahey ◽

Frank Moriarty

Keyword(s):

Older Adults ◽

Primary Care ◽

Vitamin D ◽

Fracture Risk ◽

Bone Health ◽

Pharmacological Treatment ◽

Age Group ◽

Oral Bisphosphonates ◽

Factors Associated ◽

Increase Fracture Risk

ABSTRACTPurposeGaps in pharmacological treatment for osteoporosis can reduce effectiveness. This study aimed to estimate persistence rates for oral bisphosphonates and denosumab in older primary care patients and identify factors associated with discontinuation.MethodsOlder patients newly prescribed oral bisphosphonates or denosumab between 2012 and 2017 were identified from 44 general practices (GP) in Ireland. Persistence without a coverage gap of >90 days was calculated for both medications from therapy initiation. Factors associated with time to discontinuation were explored using Cox regression analysis. Exposures included age-group, osteoporosis diagnosis, fracture history, calcium/vitamin D prescription, number of other medications, health cover, dosing frequency (bisphosphonates) and previous bone-health medication (denosumab).ResultsOf 41,901 patients, n=1,569 newly initiated on oral bisphosphonates and n=1,615 on denosumab. Two-year persistence was 49.4% for oral bisphosphonates and 53.8% for denosumab and <10% were switched to other medication. Having state-funded health cover was associated with a lower hazard of discontinuation for both oral bisphosphonates (HR=0.49, 95%CI=0.36-0.66, p<0.01) and denosumab (HR=0.71, 95%CI=0.57-0.89, p<0.01). Older age-group, number of medications and calcium/vitamin D prescription were also associated with better bisphosphonate persistence while having osteoporosis diagnosed was associated with better denosumab persistence.ConclusionPersistence for osteoporosis medications is sub-optimal. Of concern, few patients are switched to other bone-health treatments when denosumab is stopped which could increase fracture risk. Free access to GP services and medications may have resulted in better medication persistence in this cohort. Future research should explore prescribing choices in primary-care osteoporosis management and evaluate cost-effectiveness of interventions for improving persistence.SUMMARYGaps in pharmacological treatment for osteoporosis can reduce its effectiveness. This study found approximately half of older adults in primary care newly initiated on bisphosphonates or denosumab were still taking these after 2 years. Abrupt discontinuation of denosumab without switching to an alternative is concerning due to increased fracture risk.

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Investigating the Role of Functional Polymorphism of Maternal and Neonatal Vitamin D Binding Protein in the Context of 25-Hydroxyvitamin D Cutoffs as Determinants of Maternal-Neonatal Vitamin D Status Profiles in a Sunny Mediterranean Region

Nutrients ◽

10.3390/nu13093082 ◽

2021 ◽

Vol 13 (9) ◽

pp. 3082

Author(s):

Spyridon N. Karras ◽

Erdinç Dursun ◽

Merve Alaylıoğlu ◽

Duygu Gezen-Ak ◽

Cedric Annweiler ◽

...

Keyword(s):

Vitamin D ◽

Mediterranean Region ◽

Binding Protein ◽

Hypovitaminosis D ◽

Vitamin D Status ◽

Vitamin D Binding Protein ◽

Hydroxyvitamin D ◽

High Prevalence ◽

25 Hydroxyvitamin D ◽

Causative Effect

Recent results indicate that dysregulation of vitamin D-binding protein (VDBP) could be involved in the development of hypovitaminosis D, and it comprises a risk factor for adverse fetal, maternal and neonatal outcomes. Until recently, there was a paucity of results regarding the effect of maternal and neonatal VDBP polymorphisms on vitamin D status during pregnancy in the Mediterranean region, with a high prevalence of hypovitaminosis D. We aimed to evaluate the combined effect of maternal and neonatal VDBP polymorphisms and different maternal and neonatal 25-hydroxyvitamin D (25(OH)D) cut-offs on maternal and neonatal vitamin D profile. Blood samples were obtained from a cohort of 66 mother–child pairs at birth. Our results revealed that: (i) Maternal VDBP polymorphisms do not affect neonatal vitamin D status at birth, in any given internationally adopted maternal or neonatal cut-off for 25(OH)D concentrations; (ii) neonatal VDBP polymorphisms are not implicated in the regulation of neonatal vitamin D status at birth; (iii) comparing the distributions of maternal VDBP polymorphisms and maternal 25(OH)D concentrations, with cut-offs at birth, revealed that mothers with a CC genotype for rs2298850 and a CC genotype for rs4588 tended to demonstrate higher 25(OH)D (≥75 nmol/L) during delivery (p = 0.05 and p = 0.04, respectively), after adjustments for biofactors that affect vitamin D equilibrium, including UVB, BMI and weeks of gestation. In conclusion, this study from Southern Europe indicates that maternal and neonatal VDBP polymorphisms do not affect neonatal vitamin D status at birth, whereas mothers with CC genotype for rs2298850 and CC genotype for rs4588 demonstrate higher 25(OH)D concentrations. Future larger studies are required to establish a causative effect of these specific polymorphisms in the attainment of an adequate (≥75 nmol/L) maternal vitamin D status during pregnancy.

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Vitamin D Status Predicts Rates of Cognitive Decline in a Multi‐Ethnic Cohort of Older Adults

The FASEB Journal ◽

10.1096/fasebj.29.1_supplement.253.2 ◽

2015 ◽

Vol 29 (S1) ◽

Author(s):

Joshua Miller ◽

Danielle Harvey ◽

Ralph Green ◽

Bruce Reed ◽

John Olichney ◽

...

Keyword(s):

Older Adults ◽

Vitamin D ◽

Cognitive Decline ◽

Vitamin D Status

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Vitamin D status in pregnant Indian women across trimesters and different seasons and its correlation with neonatal serum 25-hydroxyvitamin D levels

British Journal Of Nutrition ◽

10.1017/s000711451100170x ◽

2011 ◽

Vol 106 (9) ◽

pp. 1383-1389 ◽

Cited By ~ 64

Author(s):

R. K. Marwaha ◽

N. Tandon ◽

S. Chopra ◽

N. Agarwal ◽

M. K. Garg ◽

...

Keyword(s):

Vitamin D ◽

Hypovitaminosis D ◽

First Trimester ◽

Strong Positive Correlation ◽

Vitamin D Status ◽

Second Trimester ◽

Third Trimester ◽

Indian Women ◽

Hydroxyvitamin D ◽

25 Hydroxyvitamin D

The present cross-sectional study was conducted to determine the vitamin D status of pregnant Indian women and their breast-fed infants. Subjects were recruited from the Department of Obstetrics, Armed Forces Clinic and Army Hospital (Research and Referral), Delhi. A total of 541 apparently healthy women with uncomplicated, single, intra-uterine gestation reporting in any trimester were consecutively recruited. Of these 541 women, 299 (first trimester, ninety-seven; second trimester, 125; third trimester, seventy-seven) were recruited in summer (April–October) and 242 (first trimester, fifty-nine, second trimester, ninety-three; third trimester, ninety) were recruited in winter (November–March) to study seasonal variations in vitamin D status. Clinical, dietary, biochemical and hormonal evaluations for the Ca–vitamin D–parathormone axis were performed. A subset of 342 mother–infant pairs was re-evaluated 6 weeks postpartum. Mean serum 25-hydroxyvitamin D (25(OH)D) of pregnant women was 23·2 (sd 12·2) nmol/l. Hypovitaminosis D (25(OH)D < 50 nmol/l) was observed in 96·3 % of the subjects. Serum 25(OH)D levels were significantly lower in winter in the second and third trimesters, while serum intact parathormone (iPTH) and alkaline phosphatase levels were significantly higher in winter in all three trimesters. A significant negative correlation was found between serum 25(OH)D and iPTH in mothers (r − 0·367, P = 0·0001) and infants (r − 0·56, P = 0·0001). A strong positive correlation was observed between 25(OH)D levels of mother–infant pairs (r 0·779, P = 0·0001). A high prevalence of hypovitaminosis D was observed in pregnancy, lactation and infancy with no significant inter-trimester differences in serum 25(OH)D levels.

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Differences in vitamin D status and calcium metabolism in Saudi Arabian boys and girls aged 6 to 18 years: effects of age, gender, extent of veiling and physical activity with concomitant implications for bone health

Public Health Nutrition ◽

10.1017/s1368980011003612 ◽

2012 ◽

Vol 15 (10) ◽

pp. 1845-1853 ◽

Cited By ~ 16

Author(s):

Maryam A Al-Ghamdi ◽

Susan A Lanham-New ◽

Jalal A Kahn

Keyword(s):

Physical Activity ◽

Vitamin D ◽

Saudi Arabia ◽

Parathyroid Hormone ◽

Bone Health ◽

Age Groups ◽

Hypovitaminosis D ◽

Vitamin D Status ◽

Kingdom Of Saudi Arabia ◽

Cross Sectional

AbstractObjectiveFew data exist looking at vitamin D status and bone health in school-aged boys and girls from Saudi Arabia. The present study aimed to determine the extent of poor vitamin D status in school boys and girls aged 6–18 years and to examine if there was any difference in status with age, physical activity and veiling and concomitant effects on bone.DesignCross-sectional study.SettingJeddah, Kingdom of Saudi Arabia.SubjectsA total of 150 boys (7–16 years) and 150 girls (6–18 years) from local schools were divided into age categories: 6–9 years (elementary school); 10–12 years (secondary school); 13–14 years (middle years); 15–18 years (high school).ResultsVitamin D status was significantly lower in girls than boys in all age groups (P < 0·01), with the 15–18-year-old girls having the lowest level (22·0 (sd 9·4) nmol/l) in comparison to the 15–18-year-old boys (39·3 (sd 14·0) nmol/l) and the 6–9-year-old girls (41·2 (sd 9·3) nmol/l). Parathyroid hormone status was highest in the 15–18-year-old girls in comparison to boys of the same age. A total of 64 % of 15–18-year-old girls had 25-hydroxyvitamin D (25OHD) status <25 nmol/l in comparison to 31 % in the 13–14 years age category, 26 % in the 10–12 years category and 2·5 % in the 6–9 years category. No boys had 25OHD status <25 nmol/l. Fully veiled girls had lower 25OHD status than partly veiled or unveiled girls (P < 0·05). Low 25OHD and high parathyroid hormone was associated with lower bone mass in the 6–9 years and 13–14 years age groups (P < 0·05).ConclusionsThese data suggest significant hypovitaminosis D in older adolescent females, which is a cause for concern given that there is currently no public health policy for vitamin D in the Kingdom of Saudi Arabia.

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