scholarly journals Vitamin D deficiency is associated with inflammatory cytokine concentrations in patients with diabetic foot infection

2014 ◽  
Vol 112 (12) ◽  
pp. 1938-1943 ◽  
Author(s):  
Shalbha Tiwari ◽  
Daliparthy Devi Pratyush ◽  
Sanjeev Kumar Gupta ◽  
Surya Kumar Singh
Keyword(s):  
Vitamin D ◽  
Vitamin D Deficiency ◽  
Diabetic Foot ◽  
Inflammatory Cytokine ◽  
Diabetic Foot Infection ◽  
Hydroxyvitamin D ◽  
Severe Vitamin ◽  
Tnf Α ◽  
25 Hydroxyvitamin D ◽  
Ifn Γ

Vitamin D has been recognised as a potent immunomodulator and its deficiency is common in different population groups including patients with diabetic foot infection. Diabetic foot infection reflects the altered immune status of the host. As cytokine regulation plays a significant role in infection and wound-healing processes, the present study aimed to evaluate the association between vitamin D status and inflammatory cytokine profiles in patients with diabetic foot infection. The serum concentrations of vitamin D (25-hydroxyvitamin D), IL-1β, IL-6, TNF-α and interferon-γ (IFN-γ) were measured in 112 diabetic foot infection cases and 109 diabetic controls. Severe vitamin D deficiency (25-hydroxyvitamin D concentration < 25 nmol/l) was more common in cases than in controls (48·2v.20·5 %). Although age, duration of diabetes, HbA1C(glycosylated Hb) concentration and BMI were similar, cases had significantly higher concentrations of IL-6 (P≤ 0·001), IL-1β (P≤ 0·02) and TNF-α (P≤ 0·006) than controls. A significant negative correlation was also observed between 25-hydroxyvitamin D concentration and circulating concentrations of IL-1β (r− 0·323;P≤ 0·001) as well as IL-6 (r− 0·154;P≤ 0·04), but not between 25-hydroxyvitamin D and TNF-α and IFN-γ concentrations. Furthermore, a significant difference in IL-1β (P≤ 0·007) and IL-6 (P≤ 0·02) concentrations was observed in patients with severe 25-hydroxyvitamin D deficiency compared with patients with 25-hydroxyvitamin D concentration ≥ 25 nmol/l, and this difference was remarkable for TNF-α. In conclusion, severe vitamin D deficiency is associated with elevated inflammatory cytokine concentrations in diabetic patients, particularly in those with foot infection. A 25-hydroxyvitamin D concentration value < 25 nmol/l is suggested as the ‘cut-off’ for such immunological alterations in patients with diabetes mellitus.

scholarly journals Prevalence and severity of vitamin D deficiency in patients with diabetic foot infection

2012 ◽  
Vol 109 (1) ◽  
pp. 99-102 ◽  
Author(s):  
Shalbha Tiwari ◽  
Daliparthy D. Pratyush ◽  
Balram Gupta ◽  
Awanindra Dwivedi ◽  
Sandeep Chaudhary ◽  
...  
Keyword(s):  
Vitamin D ◽  
Vitamin D Deficiency ◽  
Diabetic Foot ◽  
Vitamin D Supplementation ◽  
Diabetic Patients ◽  
Similar Data ◽  
Diabetic Foot Infection ◽  
Hydroxyvitamin D ◽  
Severe Vitamin ◽  
Diabetic Foot Infections

The aim of the present research was to study the prevalence and severity of vitamin D deficiency in patients with diabetic foot infection. Patients were enrolled in two groups: diabetic patients with foot infection (n 125) as cases and diabetic patients without the infection as controls (n 164). Serum 25-hydroxyvitamin D (25(OH)D) was measured by RIA. Data were presented as means and standard deviations unless otherwise indicated and were analysed by SPSS. Results revealed that 25(OH)D (nmol/l) was significantly lower (40·25 (sd 38·35) v. 50·75 (sd 33·00); P < 0·001) in cases than in controls. Vitamin D inadequacy (25(OH)D < 75 nmol/l) was equally common in cases and controls (OR 1·45, 95 % CI 0·8, 3·0; P = 0·32), but cases had a greater risk of vitamin D deficiency (25(OH)D < 50 nmol/l) than controls (OR 1·8, 95 % CI 1·1, 3·0; P = 0·02). Risk of severe vitamin D deficiency (25(OH)D < 25 nmol/l) was significantly higher in cases than in controls (OR 4·0, 95 % CI 2·4, 6·9; P < 0·0001). Age, duration of diabetes and HbA1c were significantly higher in cases than in controls and therefore adjusted to nullify the effect of these variables, if any, on study outcome. The study concluded that vitamin D deficiency was more prevalent and severe in patients with diabetic foot infection. This study opens up the issue of recognising severe vitamin D deficiency ( < 25 nmol/l) as a possible risk factor for diabetic foot infections and the need for vitamin D supplementation in such patients for a better clinical outcome. This could be substantiated by similar data from future studies.

scholarly journals A Case-control Study of Urinary Tract Infection, 25‑hydroxyvitamin D Status and Associated Inflammatory and Regulatory Responses

2021 ◽  
Vol 9 (1) ◽  
pp. 51-60
Author(s):  
Leila Pirdel ◽  
◽  
Manijeh Pirdel ◽  
Keyword(s):  
Vitamin D ◽  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Case Control ◽  
Hematological Indices ◽  
Lymphocyte Ratio ◽  
Hydroxyvitamin D ◽  
Tnf Α ◽  
25 Hydroxyvitamin D ◽  
Ifn Γ

Background: Vitamin D plays a key role in the modulation of numerous immune functions against infectious agents. We aimed to explore the association between serum 25‑hydroxyvitamin D (25[OH] D) levels and cytokine responses, along with hematological changes, in patients with urinary tract infection (UTI). Materials and Methods: Vitamin D level, cytokines (interferon [IFN]−γ, interleukin [IL]−4, IL−6, IL–10, IL−17A, tumor necrosis factor [TNF]−α, and transforming growth factor [TGF]−β), hematological indices (neutrophil-to-lymphocyte ratio [NLR], monocyte-to-lymphocyte ratio [MLR], neutrophil-to-monocyte ratio [NMR], platelet-to-lymphocyte ratio [PLR], and mean platelet volume [MPV]), C-reactive protein (CRP), and erythrocyte sedimentation rate (ESR) were evaluated in a case-control human study included 65 patients and 45 controls. Results: Among the enhanced cytokine levels in patients, the cytokines IFN-γ, IL-17A, and IL-10 had a significant association with 25(OH)D, but not IL-6, TNF-α, and TGF-β. The IL-4 levels remained unchanged. By comparing hematological indices, we found the association of increased NLR and MLR with 25(OH)D and the cytokines IFN-γ and IL-17A, along with a decrease in the PLR without showing such an association. The NMR did not show any significant difference. The platelet count showed an association with IL-6, IL-17A, and TGF-β, but the association of MPV with 25(OH)D was significant. The ESR results exhibited statistically non-significant differences. CRP elevation was directly associated with IL-6 and IL-17A, but not with 25(OH)D. Conclusion: 25(OH)D-mediated inflammatory cytokine milieu might alter the proportion and function of peripheral blood cells in a regulated manner to support bacterial clearance which needs further studies to be validated.

In COVID-19 patients, low 25-hydroxyvitamin D level in serum is associated with longer viral clearance time and higher risk of intensive care unit admission

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Jameela Al-Salman ◽  
Sarah Alghareeb ◽  
Eman Alarab ◽  
Haitham Jahrami ◽  
William B. Grant
Keyword(s):  
Vitamin D ◽  
Vitamin D Deficiency ◽  
Viral Clearance ◽  
Clearance Time ◽  
Rt Pcr ◽  
Content Type ◽  
Hydroxyvitamin D ◽  
Severe Vitamin ◽  
25 Hydroxyvitamin D ◽  
Age And Sex

Purpose This study aims to investigate the association between vitamin D measured in serum 25 hydroxyvitamin D [25(OH)D] and outcomes of COVID-19 patients in Bahrain. This paper hypothesized that lower serum 25(OH)D concentration in COVID 19 patients is associated with longer viral clearance time (VCT) and higher risk of admission to the intensive care unit (ICU). Design/methodology/approach This study used a retrospective cohort design of patients admitted to Salmaniya Medical Complex, Manama, Kingdom of Bahrain, from February to June 2020. This study included patients with positive, confirmed COVID-19 diagnosis made using reverse transcription-polymerase chain reaction (RT-PCR), World Health Organization diagnosis manual and local diagnostic guidelines. Primary outcome measures were: VCT measured as the time in days between the first positive RT-PCR test result and the first of two consecutive negative RT-PCR results on recovery and admission need to ICU. Findings A total of 450 patients were analyzed; mean age was 46.4 ± 12.4 years and 349 (78%) were men. Mean 25(OH)D concentration was 41.7 ± 23.7 nmol/L for the entire sample. Severe vitamin D deficiency (<25 nmol/L) was present in 20%, mild-to-moderate deficiency (25–50 nmol/L) in 55%, insufficiency (50 to <75 nmol/L) in 18% and sufficiency (=75 nmol/L) in 7%. The mean VCT was 12.9 ± 8.2 days. Multivariate linear regression analysis showed that severe vitamin D deficiency was associated with longer VCT, with an average of three extra days after correction for age and sex (β = 3.1; p = 0.001). Multinomial regression analysis showed that vitamin D deficiency was associated with an 83% increased risk of admission to ICU after correction for age and sex (odds ratio = 1.8; p = 0.03). Originality/value The results showed that severe vitamin D deficiency was associated with longer recovery time from COVID-19. Low serum 25(OH)D is associated with increased need for critical care in an ICU. Large-scale randomized controlled trials are necessary to further investigate the complex association between vitamin D and COVID-19 infection.

scholarly journals Severe vitamin D deficiency is a risk factor for renal hyperfiltration

2018 ◽  
Vol 108 (6) ◽  
pp. 1342-1351 ◽  
Author(s):  
Jong Hyun Jhee ◽  
Ki Heon Nam ◽  
Seong Yeong An ◽  
Min-Uk Cha ◽  
Misol Lee ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Vitamin D ◽  
Risk Factor ◽  
Glomerular Filtration Rate ◽  
Vitamin D Deficiency ◽  
Filtration Rate ◽  
Estimated Glomerular Filtration Rate ◽  
Hydroxyvitamin D ◽  
Severe Vitamin ◽  
25 Hydroxyvitamin D

ABSTRACT Background Vitamin D deficiency is associated with renal progression in chronic kidney disease. Moreover, improvement of clinical outcomes after vitamin D supplementation has been reported in the diabetic and chronic kidney disease population. Objective We investigated the association between renal hyperfiltration (RHF) and vitamin D status in a relatively healthy population. Design Data were retrieved from the Korean NHANES, a nationwide population-based cross-sectional study from 2008 to 2015. Overall, 33,210 subjects with normal renal function were included in the final analysis. Severe vitamin D deficiency was defined as serum 25-hydroxyvitamin D concentration <10 ng/mL. RHF was defined as estimated glomerular filtration rate with residual in the >95th percentile after adjustment for age, sex, height, weight, and history of hypertension or diabetes. Results The mean ± SD age of subjects was 48.1 ± 15.9 y, and the number of women was 18,779 (56.5%). Estimated glomerular filtration rate was negatively associated with serum 25-hydroxyvitamin D concentrations in multivariable linear regression analysis (β: −0.02; 95% CI: −0.02, −0.01; P < 0.001). Furthermore, 1637 (4.9%) subjects were categorized into the RHF group, and the prevalence of RHF was significantly higher in the severe vitamin D deficiency group than in the sufficiency group (5.8% compared with 5.0%, P < 0.001). In a multivariable logistic regression model, severe vitamin D deficiency was a significant risk factor for RHF (OR: 2.41; 95% CI, 1.72, 3.43; P < 0.001). Conclusions Severe vitamin D deficiency is significantly associated with increasing prevalence of RHF in a relatively healthy adult population.

Depressed Serum 25-Hydroxyvitamin D Levels Increase Hospital Stay and Alter Glucose Homeostasis in First-ever Ischemic Stroke

2019 ◽  
Vol 16 (4) ◽  
pp. 340-347
Author(s):  
Yuge Wang ◽  
Yanqiang Wang ◽  
Bingjun Zhang ◽  
Yinyao Lin ◽  
Sha Tan ◽  
...  
Keyword(s):  
Vitamin D ◽  
Ischemic Stroke ◽  
Hospital Stay ◽  
Functional Outcome ◽  
Vitamin D Deficiency ◽  
Glucose Homeostasis ◽  
Clinical Severity ◽  
Hydroxyvitamin D ◽  
25 Hydroxyvitamin D ◽  
Deficiency Group

Background and Objective: Vitamin D deficiency is internationally recognized among the potentially modifiable risk factors for ischemic cardio-cerebrovascular diseases. However, the association between vitamin D deficiency and stroke morbidity or mortality remains insufficiently known. Our aim is to investigate their relevance to 25-hydroxyvitamin D [25(OH) D] levels and clinical severity and outcome after 3 months in first-ever ischemic stroke. Methods: Retrospective analysis of 356 consecutive patients in first-ever ischemic stroke between 2013 and 2015. Serum 25(OH) D levels were measured at baseline. Stroke severity was assessed at admission using the National Institutes of Health Stroke Scale (NIHSS) score. Functional outcome after 3 months of onset was evaluated using the modified Rankin scale (mRS). Results: Among the 356 enrolled patients, HbA1c was higher in insufficiency/deficiency group than that in the sufficiency group (6.3 ± 1.7 vs. 5.9 ± 1.1, p =0.015). The hospital stay was longer in insufficiency/deficiency group than that in the sufficiency group (11 (8-17) vs. 9.5 (7-13), p = 0.035). There was a significant inversed trend between serum 25(OH) D levels and hospital stay (OR 0.960, P = 0.031), using logistic regression. Conclusions: 25(OH)D levels are associated with glucose homeostasis, 25(OH) D contributes to increase the length of hospital stay. Low serum 25-OHD level is an independent predictor for hospital stay in first-ever ischemic stroke. Vitamin D deficiency did not predict functional outcome in the span of 3 months.

scholarly journals Association of serum 25-hydroxyvitamin D with metabolic syndrome and type 2 diabetes: a one sample Mendelian randomization study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Jing Xiao ◽  
Jingyi Lv ◽  
Shiyu Wang ◽  
Yang Zhou ◽  
Lunwen Chen ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Metabolic Syndrome ◽  
Vitamin D ◽  
Vitamin D Deficiency ◽  
Mendelian Randomization ◽  
Middle Aged ◽  
Hydroxyvitamin D ◽  
25 Hydroxyvitamin D ◽  
Randomization Analysis

Abstract Background Vitamin D deficiency has been associated with type 2 diabetes (T2D) and metabolic syndrome (MS) and its components. However, it is unclear whether a low concentration of vitamin D is the cause or consequence of these health conditions. Thus, this study aimed to evaluate the association of vitamin D concentrations and its genetic risk scores (GRSs) with MS and its component diseases, such as T2D, in middle-aged and elderly participants from rural eastern China. Methods A subset of 2393 middle-aged and elderly individuals were selected from 70,458 participants of the Nantong Chronic Diseases Study of 2017–2018 in China. We used two 25-hydroxyvitamin D (25[OH]D) synthesis single-nucleotide polymorphisms (SNPs) (DHCR7-rs12785878 and CYP2R1-rs10741657) and two 25(OH) D metabolism SNPs (GC-rs2282679 and CYP24A1-rs6013897) for creating GRSs, which were used as instrumental variables to assess the effect of genetically lowered 25(OH) D concentrations on MS and T2D based on the Wald ratio. F statistics were used to validate that the four SNPs genetically determined 25(OH) D concentrations. Results Compared to vitamin D sufficient individuals, individuals with vitamin D insufficiency had an odds ratio (OR [95% confidence interval {CI}]) of MS of 1.30 (1.06–1.61) and of T2D of 1.32 (1.08–1.64), individuals with vitamin D deficiency had an ORs (95% CI) of MS of 1.50 (1.24–1.79) and of T2D of 1.47 (1.12–1.80), and those with vitamin D severe deficiency had an ORs (95% CI) of MS of 1.52 (1.29–1.85) and of T2D of 1.54 (1.27–1.85). Mendelian randomization analysis showed a 25-nmol/L decrease in genetically instrumented serum 25(OH) D concentrations using the two synthesis SNPs (DHCR7 and CYP2R1 genes) associated with the risk of T2D and abnormal diastolic blood pressure (DBP) with ORs of 1.10 (95%CI: 1.02–1.45) for T2D and 1.14 (95%CI: 1.03–1.43) for DBP. Conclusions This one sample Mendelian randomization analysis shows genetic evidence for a causal role of lower 25(OH) D concentrations in promoting of T2D and abnormal DBP in middle-aged and elderly participants from rural China.

Serum 25-Hydroxyvitamin D Concentrations and Cardiometabolic Biomarkers in Chinese Rural Population

2021 ◽  
Vol 53 (02) ◽  
pp. 105-111
Author(s):  
Dongdong Zhang ◽  
Cheng Cheng ◽  
Yan Wang ◽  
Yuan Xue ◽  
Yiming Liu ◽  
...  
Keyword(s):  
Vitamin D ◽  
Vitamin D Deficiency ◽  
Rural Population ◽  
Density Lipoprotein ◽  
Cubic Spline ◽  
Lipoprotein Cholesterol ◽  
Linear Regression Models ◽  
Hydroxyvitamin D ◽  
Linear Association ◽  
25 Hydroxyvitamin D

AbstractThere is a paucity of data on the relation between serum 25-hydroxyvitamin D [25(OH)D] concentration and cardiometabolic biomarkers in the Chinese population. To comprehensively and quantitatively examine the association of 25(OH)D and cardiometabolic traits, we conducted a cross-sectional study in the Chinese rural population. Serum 25(OH)D and eight cardiometabolic biomarkers were measured in 1714 individuals from Henan province, China. Scatter plot was used to visualize the distribution and correlation of 25(OH)D and cardiometabolic indicators. Moreover, multivariate linear regressions and restricted cubic spline (RCS) functions were performed to examine the quantitative association between the serum 25(OH)D and cardiometabolic parameters. The median serum 25(OH)D level was 19.94 ng/ml in all participants, with an estimated 50.12% presenting vitamin D deficiency. Serum 25(OH)D level showed significantly modest association with cardiometabolic parameters (p<0.05) except for diastolic blood pressure (r=0.03, p=0.22). Multiple linear regression models showed that 25(OH)D concentration was positively associated with high-density lipoprotein cholesterol (HDL-C) and negatively associated with low-density lipoprotein cholesterol (LDL-C) and fasting serum glucose (GLU). The results of restricted cubic spline models indicated a positively linear association of 25(OH)D with HDL-C (p for overall<0.001, p for nonlinearity=0.191) and a negatively linear association with GLU (p for overall=0.024, p for nonlinearity=0.095). Overall, vitamin D deficiency was very common among Chinese rural population living near the 34 degrees north latitude. Besides, there were significant association between 25(OH)D concentrations and cardiometabolic biomarkers including HDL-C and GLU levels. Future longitudinal studies and randomized trials are warranted to clarify the causal relationship.

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