Hypovitaminosis D in an Italian population of healthy subjects and hospitalized patients

The present study aimed to investigate the prevalence and seasonal variation of hypovitaminosis D (defined as serum 25-hydroxyvitamin D level below 30 nmol/l) among healthy subjects and hospitalized patients living in central Italy. We studied 297 subjects, 131 in February 1997 and 166 in July 1997, subdivided into four groups: (a) young healthy blood donors; (b) healthy postmenopausal women; (c) inpatients with various medical diseases and (d) inpatients engaged in long-term rehabilitation programmes because of various neurological disorders. In all subjects and patients serum levels of 25-hydroxyvitamin D were measured by radioimmunoassay. We found a significant seasonal variation (P< 0·0001) of serum 25-hydroxyvitamin D levels, mean values being higher in summer in all groups, except in patients with a longer hospitalization time (group (d)). In each group, a significantly higher prevalence of hypovitaminosis D was found in winter compared with summer time (P< 0·001), being unexpectedly high in postmenopausal women (winter 32 % and summer 4·5 %); furthermore, in both seasons, inpatients were characterized by the highest incidences of hypovitaminosis, particularly those in group (d) (winter 82·3 % and summer 57·8 %). The results of the present study emphasize the importance of 25-hydroxyvitamin D measurement, and the need to increase vitamin D intake in Italy; foodstuff fortification and supplement use must be considered in order to prevent negative effects of vitamin D deficiency on skeletal integrity.

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Vitamin D Status and Seasonal Variation among Danish Children and Adults: A Descriptive Study

Nutrients ◽

10.3390/nu10111801 ◽

2018 ◽

Vol 10 (11) ◽

pp. 1801 ◽

Cited By ~ 20

Author(s):

Louise Hansen ◽

Anne Tjønneland ◽

Brian Køster ◽

Christine Brot ◽

Rikke Andersen ◽

...

Keyword(s):

Vitamin D ◽

Seasonal Variation ◽

Vitamin D Status ◽

Hydroxyvitamin D ◽

Supplement Use ◽

Wide Range ◽

Adults And Children ◽

25 Hydroxyvitamin D ◽

Vitamin D Supplement ◽

Very High

The aim of the present study was to describe vitamin D status and seasonal variation in the general Danish population. In this study, 3092 persons aged 2 to 69 years (2565 adults, 527 children) had blood drawn twice (spring and autumn) between 2012 and 2014. A sub-sample of participants had blood samples taken monthly over a year. Serum 25-hydroxyvitamin D (25(OH)D) concentrations were measured by liquid chromatography mass spectrometry, and information on supplement use was assessed from questionnaires. Seasonal variations in 25(OH)D concentrations were evaluated graphically and descriptively, and status according to age, sex, and supplement use was described. It was found that 86% of both adults and children were vitamin D-sufficient in either spring and or/autumn; however, many had a spring concentration below 50 nmol/L. A wide range of 25(OH)D concentrations were found in spring and autumn, with very low and very high values in both seasons. Among adults, women in general had higher median 25(OH)D concentrations than men. Furthermore, vitamin D supplement use was substantial and affected the median concentrations markedly, more so during spring than autumn. Seasonal variation was thus found to be substantial, and bi-seasonal measurements are vital in order to capture the sizable fluctuations in vitamin D status in this Nordic population.

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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 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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Analysis of Suicidal Behavior and Chronicity of Depressive Symptoms in the Presence of Hypovitaminosis D

Current Psychiatry Research and Reviews ◽

10.2174/2666082217666211122155401 ◽

2021 ◽

Vol 17 ◽

Author(s):

Catarina Magalhães Porto ◽

Natalia Santos Barbosa da Silva ◽

Cecília Magalhães Porto Lira ◽

Rayana Porpino Magalhães ◽

José Luiz Oliveira Magalhães ◽

...

Keyword(s):

Vitamin D ◽

Depressive Symptoms ◽

Suicidal Ideation ◽

Depressive Disorder ◽

Suicidal Behavior ◽

Suicide Risk ◽

Hypovitaminosis D ◽

Serum Levels ◽

Hydroxyvitamin D ◽

25 Hydroxyvitamin D

Background: One of the risk factors for suicide includes the presence of depressive disorder and symptoms, which may be related to the reduction of 25-hydroxyvitamin D serum levels. In this scenario, evidence shows vitamin D deficiency as an important aspect, directly related to depressive disorder chronicity. Objective: To assess the association between Vitamin D serum levels and the intensity of depressive symptoms and suicidal behavior in a clinical sample of depressed patients. Methods: A cross-sectional study with 146 patients aged between 18 and 59, seen in two psychiatry ambulatories. Data collection involved measurement of serum 25-hydroxyvitamin D levels and assessment of the intensity of depressive symptoms and suicide risk. Results: In the sample, 35% presented low Vitamin D serum levels and, in these individuals, the incidence of family history of Depressive Disorder (95.2%) and chronicity of severe depressive symptoms (47.8%) was higher. As to suicidal behavior, both groups presented high active suicide risk, with higher rates in the group with hypovitaminosis D. Only suicidal ideation was linked to lower Vitamin D levels (67.4% p= 0,005). Conclusion: In this study, hypovitaminosis D was associated with negative mental health outcomes, such as more severe chronicity of depressive symptoms and suicidal behavior, characterized by active suicidal ideation.

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Analytical Bias in the Measurement of Plasma 25-Hydroxyvitamin D Concentrations in Infants

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph17020412 ◽

2020 ◽

Vol 17 (2) ◽

pp. 412

Author(s):

Kristina Rueter ◽

Lucinda J. Black ◽

Anderson Jones ◽

Max Bulsara ◽

Michael W. Clarke ◽

...

Keyword(s):

Vitamin D ◽

Hypovitaminosis D ◽

Concordance Correlation ◽

Hydroxyvitamin D ◽

Paired Samples ◽

Liquid Chromatography Tandem Mass ◽

Treatment Plans ◽

25 Hydroxyvitamin D ◽

Chemiluminescent Immunoassay ◽

Abbott Architect

Hypovitaminosis D is prevalent worldwide; however, analytical bias in the measurement of circulating 25-hydroxyvitamin D (25(OH)D) concentrations may affect clinical treatment decisions and research. We performed parallel plasma 25(OH)D analyses using the Abbott Architect i2000 chemiluminescent immunoassay (CIA) and liquid chromatography–tandem mass spectrometry (LC–MS/MS) for paired samples from the same infants at 3 (n = 69), 6 (n = 79) and 12 months (n = 73) of age. To test agreement, we used Lin’s concordance correlation coefficient and corresponding 95% confidence interval, Bland–Altman’s limits of agreement, and Bradley–Blackwood (BB) test. Agreement was high at 3 months (coefficient between difference and mean −0.076; BB F = 0.825; p = 0.440), good at 12 months (−0.25; BB F = 2.41; p = 0.097) but missing at 6 months of age (−0.39; BB F = 12.30; p < 0.001). Overall, 18 infants had disparate results based on the cut-off point for vitamin D deficiency (25(OH)D < 50 nmol/L), particularly at three months, with seven (10%) infants deficient according to CIA but not LC–MS/MS, and four (6%) deficient by LC–MS/MS but not CIA. To our knowledge, this is the first study to show that the reported 25(OH)D concentration may be influenced by both age and assay type. Physicians and researchers should be aware of these pitfalls when measuring circulating 25(OH)D concentrations in infants and when developing treatment plans based on measured vitamin D status.

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Prolonged treatment with vitamin D in postmenopausal women with primary hyperparathyroidism

Endocrine Connections ◽

10.1530/ec-12-0008 ◽

2012 ◽

Vol 1 (1) ◽

pp. 13-21 ◽

Cited By ~ 12

Author(s):

Ranganathan R Rao ◽

Harpal S Randeva ◽

Sailesh Sankaranarayanan ◽

Murthy Narashima ◽

Matthias Möhlig ◽

...

Keyword(s):

Vitamin D ◽

Primary Hyperparathyroidism ◽

Vitamin D Deficiency ◽

Postmenopausal Women ◽

Prolonged Treatment ◽

Serum 25Ohd ◽

Hydroxyvitamin D ◽

Significant Difference ◽

25 Hydroxyvitamin D ◽

Serum Pth

Introduction/backgroundVitamin D deficiency further increases circulating parathyroid hormone (PTH) levels in patients with primary hyperparathyroidism (pHPT), with potential detrimental effects on bone mass.MethodsThis was an observational clinical study in consecutive conservatively treated postmenopausal women (n=40) with pHPT and coexistent 25-hydroxyvitamin D deficiency (25OHD ≤50 nmol/l (≤20 ng/ml)). Patients who showed an increase in serum 25OHD above the threshold of vitamin D deficiency (>50 nmol/l; n=28) using treatment with various commonly prescribed vitamin D preparations were, for the purposes of statistical analyses, allocated to the treatment group. Patients who were retrospectively identified as having received no treatment with vitamin D and/or remained vitamin D deficient were considered as non-responders/controls (n=12). Adjusted calcium (adjCa), PTH and 25OHD concentrations were monitored in all subjects up to 54 months (mean observation period of 18±2 months).ResultsProlonged increased vitamin D intake, regardless of the source (serum 25OHD, increase from 32.2±1.7 nmol/l at baseline to 136.4±11.6 nmol/l, P<0.0001), significantly reduced serum PTH (13.3±1.1 vs 10.5±1.0 pmol/l, P=0.0001), with no adverse effects on adjCa levels (2.60±0.03 vs 2.60±0.02 mmol/l, P=0.77) and renal function tests (P>0.73). In contrast, serum PTH remained unchanged (15.8±2.6 vs 16.3±1.9 pmol/l, P=0.64) in patients who remained vitamin D deficient, with a significant difference between groups in changes of PTH (P=0.0003). Intrapartial correlation analyses showed an independent negative correlation of changes in 25OHD with PTH levels (ric=−0.41, P=0.014).ConclusionsProlonged treatment with vitamin D in various commonly prescribed preparations appeared to be safe and significantly reduced PTH levels by 21%.

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25-Hydroxyvitamin D concentration, vitamin D intake and joint symptoms in postmenopausal women

Maturitas ◽

10.1016/j.maturitas.2010.10.006 ◽

2011 ◽

Vol 68 (1) ◽

pp. 73-78 ◽

Cited By ~ 18

Author(s):

Rowan T. Chlebowski ◽

Karen C. Johnson ◽

Dorothy Lane ◽

Mary Pettinger ◽

Charles L. Kooperberg ◽

...

Keyword(s):

Vitamin D ◽

Postmenopausal Women ◽

Hydroxyvitamin D ◽

Vitamin D Intake ◽

Joint Symptoms ◽

25 Hydroxyvitamin D

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Vitamin D Dosing Strategies Among Jordanians With Hypovitaminosis D

Journal of Pharmacy Practice ◽

10.1177/0897190015626334 ◽

2016 ◽

Vol 30 (2) ◽

pp. 172-179 ◽

Cited By ~ 1

Author(s):

Nahla Khawaja ◽

Mohammed Liswi ◽

Mohammed El-Khateeb ◽

Dana Hyassat ◽

Dalila Bajawi ◽

...

Keyword(s):

Body Mass Index ◽

Vitamin D ◽

Hypovitaminosis D ◽

Hydroxyvitamin D ◽

Dosing Strategies ◽

Optimal Maintenance ◽

Group A ◽

25 Hydroxyvitamin D ◽

The Mean ◽

Group B

Objective: To compare between weekly and daily cholecalciferol in patients with hypovitaminosis D and to determine the optimal maintenance dose. Methods: Seventy-one volunteers with hypovitaminosis D were randomly assigned to 2 dose regimens: cholecalciferol 50 000 IU weekly for 8 weeks, then 50 000 IU monthly for 2 months (group A) and 7000 IU daily for 8 weeks, then 12 500 IU weekly for 2 months (group B). Cholecalciferol was stopped for 2 months and reintroduced as 50 000 IU bimonthly for group A and 50 000 IU monthly for group B. Results: Two months after therapy, the mean serum 25-hydroxyvitamin D (25(OH)D) level increased from 11.4 to 51.2 ng/mL and from 11.7 to 44.9 ng/mL in groups A and B, respectively ( P = .065). The levels of 25(OH)D declined similarly in both groups during maintenance and after holding therapy. After resuming cholecalciferol, 25(OH)D levels increased to 33.8 and 28.8 ng/mL in groups A and B, respectively ( P = .027). There was a negative correlation between serum 25(OH)D levels and body mass index (BMI; P = .040). Conclusion: Timing and frequency of the dosing (daily vs weekly) have no effect on the rise in serum 25(OH)D levels as long as the accumulative dose of cholecalciferol is similar. Cholecalciferol 50 000 IU bimonthly is required to maintain sufficient 25(OH)D levels.

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Influence of Vitamin D Binding Protein on Accuracy of 25-Hydroxyvitamin D Measurement Using the ADVIA Centaur Vitamin D Total Assay

International Journal of Endocrinology ◽

10.1155/2014/691679 ◽

2014 ◽

Vol 2014 ◽

pp. 1-12

Author(s):

James Freeman ◽

Kimberly Wilson ◽

Ryan Spears ◽

Victoria Shalhoub ◽

Paul Sibley

Keyword(s):

Vitamin D ◽

Healthy Subjects ◽

Binding Protein ◽

Reference Method ◽

Total Serum ◽

Vitamin D Binding Protein ◽

Hydroxyvitamin D ◽

Liquid Chromatography Tandem Mass ◽

25 Hydroxyvitamin D ◽

Different Populations

Vitamin D status in different populations relies on accurate measurement of total serum 25-hydroxyvitamin D [25(OH)D] concentrations [i.e., 25(OH)D3and 25(OH)D2]. This study evaluated agreement between the ADVIA Centaur Vitamin D Total assay for 25(OH)D testing (traceable to the NIST-Ghent reference method procedure) and a liquid chromatography tandem mass spectrometry (LC-MS/MS) method for various populations with different levels of vitamin D binding protein (DBP). Total serum 25(OH)D concentrations were measured for 36 pregnant women, 40 hemodialysis patients, and 30 samples (DBP-spiked or not) from healthy subjects. ELISA measured DBP levels. The mean serum DBP concentrations were higher for pregnancy (415 μg/mL) and lower for hemodialysis subjects (198 μg/mL) than for healthy subjects and were highest for spiked serum (545 μg/mL). The average bias between the ADVIA Centaur assay and the LC-MS/MS method was −1.4% (healthy), −6.1% (pregnancy), and 4.4% (hemodialysis). The slightly greater bias for samples from some pregnancy and hemodialysis subjects with serum DBP levels outside of the normal healthy range fell within a clinically acceptable range—reflected by analysis of their low-range (≤136 μg/mL), medium-range (137–559 μg/mL), and high-range (≥560 μg/mL) DBP groups. Thus, the ADVIA Centaur Vitamin D Total assay demonstrates acceptable performance compared with an LC-MS/MS method for populations containing different amounts of DBP.

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Vitamin D Status in a Rural Italian Population

Reports ◽

10.3390/reports5010001 ◽

2021 ◽

Vol 5 (1) ◽

pp. 1

Author(s):

Ornella Morsilli ◽

Raffaella Guerriero ◽

Luigi Palmieri ◽

Cinzia Lo Noce ◽

Tanja Zeller ◽

...

Keyword(s):

Vitamin D ◽

Critical Role ◽

Central Italy ◽

Hypovitaminosis D ◽

Solar Irradiation ◽

Italian Population ◽

Vitamin D Status ◽

Serum Samples ◽

Younger Women ◽

Hydroxyvitamin D

Vitamin D is known as an antirachitic factor, although it also plays a critical role in several nonskeletal diseases. In our study, we evaluated vitamin D status and sex, age and seasonal association in a general population cohort living in central Italy. Data from 1174 men and 2274 women aged 20–81 were analyzed, and stored serum samples were assayed for 25-hydroxyvitamin D (25(OH)D). Vitamin D was low in both sexes with values significantly lower in women than in men; furthermore, its deficiency was highly correlated with age. The younger men had just sufficient 25(OH)D levels (32.3 ng/mL ± 13.2), which decreased with increasing age. The younger women showed insufficient 25(OH)D levels (24.8 ng/mL ± 11.9) that, as with men, further decreased with increasing age. This study demonstrated that hypovitaminosis D may be a very frequent condition also in a rural central Italian area with remarkable solar irradiation throughout the year. Our data clearly indicated an evident seasonal trend: at the end of the winter, serum 25(OH)D levels of the examined cohort were below the official sufficient value for both adult sexes. Sufficient levels were just reached in summer for men and only at the end of summer for young women.

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