Vitamin D deficiency plays an important role in cardiac disease and affects patient outcome: Still a myth or a fact that needs exploration?

OBJECTIVEHypovitaminosis D is prevalent in neurocritical care patients, but the potential to improve patient outcome by replenishing vitamin D has not been investigated. This single-center, double-blinded, placebo-controlled, randomized (1:1) clinical trial was designed to assess the effect on patient outcome of vitamin D supplementation in neurocritical care patients with hypovitaminosis D.METHODSFrom October 2016 until April 2018, emergently admitted neurocritical care patients with vitamin D deficiency (≤ 20 ng/ml) were randomized to receive vitamin D3 (cholecalciferol, 540,000 IU) (n = 134) or placebo (n = 133). Hospital length of stay (LOS) was the primary outcome; secondary outcomes included intensive care unit (ICU) LOS, repeat vitamin D levels, patient complications, and patient disposition. Exploratory analysis evaluated specific subgroups of patients by LOS, Glasgow Coma Scale (GCS) score, and Simplified Acute Physiology Score (SAPS II).RESULTSTwo-hundred seventy-four patients were randomized (intent-to-treat) and 267 were administered treatment within 48 hours of admission (as-treated; 61.2% of planned recruitment) and monitored. The mean age of as-treated patients was 54.0 ± 17.2 years (56.9% male, 77.2% white). After interim analysis suggested a low conditional power for outcome difference (predictive power 0.12), the trial was halted. For as-treated patients, no significant difference in hospital LOS (10.4 ± 14.5 days vs 9.1 ± 7.9 days, p = 0.4; mean difference 1.3, 95% CI −1.5 to 4.1) or ICU LOS (5.8 ± 7.5 days vs 5.4 ± 6.4 days, p = 0.4; mean difference 0.4, 95% CI −1.3 to 2.1) was seen between vitamin D3 and placebo groups, respectively. Vitamin D3 supplementation significantly improved repeat serum levels compared with placebo (20.8 ± 9.3 ng/ml vs 12.8 ± 4.8 ng/ml, p < 0.001) without adverse side effects. No subgroups were identified by exclusion of LOS outliers or segregation by GCS score, SAPS II, or severe vitamin D deficiency (≤ 10 ng/ml).CONCLUSIONSDespite studies showing that vitamin D can predict prognosis, supplementation in vitamin D–deficient neurocritical care patients did not result in appreciable improvement in outcomes and likely does not play a role in acute clinical recovery.Clinical trial registration no.: NCT02881957 (clinicaltrials.gov)

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The Effect of Supplementation of Vitamin D in Neurocritical Care Patients With Hypovitaminosis D: A Randomized Controlled Clinical Trial

Neurosurgery ◽

10.1093/neuros/nyz310_182 ◽

2019 ◽

Vol 66 (Supplement_1) ◽

Author(s):

Andrea Archambault Brock ◽

Michael Karsy ◽

Jian Guan ◽

Ilyas Eli ◽

Sarah Tamara Menacho ◽

...

Keyword(s):

Patient Outcome ◽

Clinical Trial ◽

Vitamin D ◽

Vitamin D Deficiency ◽

Vitamin D3 ◽

Neurocritical Care ◽

Hypovitaminosis D ◽

Mean Difference ◽

Saps Ii ◽

Saps Ii Score

Abstract INTRODUCTION Hypovitaminosis D is prevalent in neurocritical care patients, but the potential to improve patient outcome by replenishing vitamin D has not been investigated. This single-center, double-blinded, placebo-controlled, randomized (1:1) clinical trial was designed to assess the effect on patient outcome of vitamin D supplementation in neurocritical care patients with hypovitaminosis D (NCT02881957). METHODS From October 2016 to April 2018, emergently admitted neurocritical care patients with vitamin D deficiency (=20 ng/ml) were randomized to receive vitamin D3 (cholecalciferol, 540 000 IU) (n = 134) or placebo (n = 133). Hospital length of stay (LOS) was the primary outcome; secondary outcomes included intensive care unit (ICU) LOS, repeat vitamin D levels, patient complications, and patient disposition. Exploratory analysis evaluated specific subgroups of patients by LOS, Glasgow Coma Scale (GCS), and Simplified Acute Physiology Score (SAPS II). RESULTS A total of 274 patients were randomized (intent-to-treat) and 267 were administered treatment within 48 hr (as-treated; 61.2% of planned recruitment) and monitored. The mean age of as-treated patients was 54.0 ± 17·2 yr (56.9% male, 77.2% White). After interim analysis suggested a low conditional power for outcome difference (predictive power: 0.12), the trial was halted. For as-treated patients, no significant difference in hospital (10.4 ± 14.5 vs 9.1 ± 7.9 d, P = .4; mean difference = 1.3, 95% CI = −1.5, 4.1) or ICU (ICU: 5.8 ± 7.5 vs 5.4 ± 6.4 d, P = .4; mean difference = .4, 95% CI = −1.3, 2.1) LOS was seen between vitamin D3 and placebo groups. Vitamin D3 supplementation significantly improved repeat serum levels compared with placebo (20.8 ± 9.3 vs 12.8 ± 4.8 ng/ml, P < .001) without adverse side effects. No subgroups were identified by exclusion of LOS outliers or segregation by GCS score, SAPS II score, or severe vitamin D deficiency (=10 ng/ml). CONCLUSION Despite studies showing vitamin D can predict prognosis, supplementation in vitamin D deficient neurocritical care patients did not result in appreciable improvement in outcomes and likely does not play a role in acute clinical recovery.

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Su1489 Increased Neutrophil and Monocyte Oxidative Burst, But Not Vitamin D Deficiency, Is Associated With Adverse Patient Outcome in Stable Cirrhosis

Gastroenterology ◽

10.1016/s0016-5085(16)33745-3 ◽

2016 ◽

Vol 150 (4) ◽

pp. S1108

Author(s):

Konstantina Sargenti ◽

Åsa Johansson ◽

Sara Bertilsson ◽

Daniel Klintman ◽

Evangelos Kalaitzakis

Keyword(s):

Patient Outcome ◽

Vitamin D ◽

Vitamin D Deficiency ◽

Oxidative Burst ◽

Adverse Patient Outcome

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Prevalence of Metabolic Disorder in Adolescent Residing in Al-dawadmi and Shaqra Regions of Saudi Arabia

Journal of Advances in Medical and Pharmaceutical Sciences ◽

10.9734/jamps/2019/v20i130100 ◽

2019 ◽

pp. 1-5

Author(s):

Ghaith Saleh Suliman Alabdullatif ◽

Hallal Badi Hallal Alotaibi ◽

Sanjay Kumar Deshwali ◽

Mohammad Arshad

Keyword(s):

Risk Factors ◽

Vitamin D ◽

Saudi Arabia ◽

Vitamin D Deficiency ◽

Cardiac Disease ◽

Metabolic Disorder ◽

Metabolic Disorders ◽

Clinical History ◽

Relationship Of ◽

The Relationship

The recent study was aimed to estimate the prevalence and develop the relationship of the clinical history like diabetes, cardiac disease and vitamin D deficiency and obesity and their impact on metabolic disorders for adolescent residing near Dawadmi and Shaqra region. Two hundred samples (142 Females & 58 Males) were utilized in the study with an age ranging 13-20 and distributed the questionnaire to record the responses. The results exhibited that 38% subjects responded positively for clinical history with cardiac disease, while 70.5 and 47% responded positively for the clinical history with diabetes and vitamin D deficiency. The clinical history with diabetes, cardiac disease and vitamin D deficiency was observed the major risk factors acting in descending order diabetes-cardiac disease-vitamin D deficiency.

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