scholarly journals Attenuation of Oxidative Stress, Interleukin-6, High-Sensitivity C-Reactive Protein, Plasminogen Activator Inhibitor-1, and Fibrinogen with Oral Vitamin D Supplementation for Six Months in Patients with Type 2 Diabetes Mellitus having Vitamin D Deficiency

Author(s):  
Pullaiah Pasupuleti ◽  
M.M. Suchitra ◽  
Aparna R. Bitla ◽  
Alok Sachan

Abstract Objectives Type 2 diabetes mellitus (T2DM) associated with oxidative stress and inflammation causes endothelial dysfunction, which promotes cardiovascular risk. Vitamin D with its pleiotropic effect is said to protect against cardiovascular risk. However, with vitamin D deficiency being more prevalent in T2DM, the cardiovascular risk may get compounded. Materials and Methods An interventional study was conducted on 100 patients with T2DM having vitamin D deficiency (vitamin D < 20 ng/mL), who were given oral supplementation of 2,000 IU/day of vitamin D for a period of 6 months. Serum vitamin D, biomarkers of oxidative stress, malondialdehyde (MDA), oxidized LDL (OxLDL), ferric reducing ability of plasma (FRAP), biomarkers of inflammation, high-sensitivity C-reactive protein (hsCRP), interleukin-6 (IL-6), plasminogen activator inhibitor-1 (PAI-1), and fibrinogen were measured at baseline and at the end of the third and sixth month of vitamin D supplementation. Statistical Analysis Repeated measures analysis of variance (ANOVA) was applied for comparison between baseline and third- and sixth-month data after vitamin D supplementation. Linear regression by generalized estimating equations (GEE), which grouped repeated measures for each subject and accounted for correlations that may occur from multiple observations within subjects, was applied. Results Serum vitamin D levels reached normal levels with a significant decrease in OxLDL, hsCRP, IL-6, PAI-1, and fibrinogen levels, with a significant increase in FRAP (p = 0.001) levels at the end of 6 months of vitamin D supplementation. These changes were observed even after correction with glycemic control (HbA1c). However, a significant decrease in MDA was observed only at the end of the sixth month of vitamin D supplementation. Vitamin D levels showed a significant negative association with Ox-LDL, Hs-CRP, IL-6, PAI-1, and fibrinogen, even after adjusting for BMI and statin use (p = 0.001). Conclusion Supplementation of vitamin D for a period of 6 months in patients with T2DM having vitamin D deficiency is beneficial in the attenuation of oxidative stress and inflammation.

2021 ◽  
Vol 14 (1) ◽  
pp. 303-309
Author(s):  
Mostafa Hassan Ragab ◽  
Eman Monir Sherif ◽  
Nadia Badawy Abd- El Gawad ◽  
Safaa Mohamed Elserougy ◽  
Eman Essam Shaban ◽  
...  

Diabetes is one of the commonest chronic diseases worldwide. Vitamin D deficiency showed to be increasing, and have a potential role in autoimmune diseases among which in type 1 diabetes. The aim The aim of the study was to assess the impact of oral vitamin D supplementation on blood glucose (HbA1C) in T1DM patients and to find out the role of vitamin D as a biomarker for follow of T1DM patients compared to HbA1C. Subjects and methods: A randomized interventional clinical study was designed. The study enrolled 60 children patients with T1DM. Only 45 children continued to the end of study. Initial (pre-intake) assessment included history taking, clinical examination, and measurement of serum 25-OH vitamin D3 and serum HbA1C. These children received oral vitamin D supplements for 3 months then post-intake assessment were done again. Results: The study showed that serum vitamin D was deficient among Egyptian children and adolescents with T1DM (mean 11.4±3.4 ng/ml). , 53.33% of the patients had vitamin D deficiency with a 35.6% had insufficiency and 11.11% were VD sufficient. Patients received oral vitamin D supplementation for 3 months after which marked improvement in the levels of serum vitamin D levels and HA1C, 87.5% and 86.5% respectively.


2016 ◽  
Vol 24 (3) ◽  
pp. 122-128
Author(s):  
Hasan Abdul Cader Segana ◽  
Reghunandanan Nair ◽  
Fahim Ahmed Shah

Introduction Vitamin D deficiency has multitude of causes and can present with varying clinical manifestations. Studies show that it can lead on to recurrent respiratory infections, ear infections and deafness. Vitamin D also has immunomodulant action. Here we discuss the varying features concerning an Otolaryngologist in general as far as Vitamin D metabolism is concerned. Materials and Methods This retrospective study was performed on 800 patients 152 males and 648 females of different socioeconomic background at secondary level regional referral hospital under Ministry of Health in Sultanate of Oman. The patients attending the outpatient clinic with various complaints and not responding to conventional treatment were advised for assessment of vitamin D [25 (OH) D] level in blood. The patients were evaluated with general history, blood samples of serum calcium, phosphate, alkaline phosphatase and serum vitamin D level were measured by the most standardized laboratory of the country. Results Out of 800 patients, 275 cases had Vitamin D levels below 20 ng/ml and 167 patients had values greater than 30 ng/ml in serum.81% patients with vitamin D deficiency were females.56.25% patients were between third and sixth decade. Otolaryngologic manifestations were acute and recurrent URTI (n=352) 44%. 7% of the patients presented with recurrent ear infection (otitis externa). The rest of them presented to a lesser extent with deafness, otosclerosis. Discussion Vitamin D deficiency has been reported worldwide as one of the commonest deficiency diseases. It can lead to autoimmune dysfunctions, Beta cell dysfunction in pancreas, Multiple sclerosis, recurrent chest infections and congestive cardiac failure. Studies have shown the involvement of cochlea with sensorineural hearing loss and otosclerosis. Conclusion Vitamin D deficiency has multi system implications as patients presenting with different signs and symptoms. Mass level screening and vitamin D supplementation should be planned to decrease its varied and multidimensional ill effects on health. Adequate vitamin D supplementation and sensible sunlight exposure to reach optimal vitamin D status are among the front line factors of prophylaxis for spectrum of disorders.


Author(s):  
Munmun Yadav ◽  
Mahendra Kumar Verma ◽  
Mohan Bairwa ◽  
Govardhan Meena ◽  
Lata Rajoria

Background: Vitamin D deficiency is widely prevalent throughout the world. Pregnant women, neonates and infants form most vulnerable groups for vitamin D deficiency. Hypovitaminosis D in pregnancy has been reported to cause various fetomaternal effect, i.e. increased risk of preeclampsia (PE), gestational diabetes mellitus (GDM), caesarean section, hypocalcemia, subclinical myopathy, neonatal tetany, hyperbilirubinemia congenital rickets and infantile rickets, etc. Only few Indian studies are available in this regard. The objectives are to find prevalence of vitamin D deficiency in pregnant women and to evaluate the effect of supplementation with cholecalciferol in improving vitamin D levels in pregnant women and evaluate its correlation with feto-maternal outcome.Methods: A prospective observational was conducted on 120 Pregnant women on their first visit to hospital irrespective of gestational age were offered the test and on the basis of inclusion and exclusion criteria are included in study and vitamin D level was done to know the prevalence of vitamin D deficiency. Apart from routine obstetrical investigation, serum vitamin D (total) level was estimated. All results were recorded and analyzed statically.Results: Out of 120 patients 101 (84.1%) were found to be vitamin D deficient. Mean age of vitamin D deficient group was 28.31±3.86 and sufficient group was 26.37±2.83.81 (67.5%) were vegetarian and 39 (32.5%) were nonvegetarian.75 (92.59%) vegetarian and 26 (66.66%) non-vegetarian found to be vitamin D deficient. (p<0.05). Vitamin D supplementation has been observed to reduce risk of preeclampsia. (p<0.05) and vitamin D sufficiency associated with reduced risk of low birth weight babies.Conclusions: Vitamin D supplementation reduces risk of maternal comorbidities and helps improve neonatal outcomes.


2020 ◽  
Vol 79 (OCE2) ◽  
Author(s):  
Ufuk Ayşe Kepkep ◽  
Ayla Gulden Pekcan

AbstractVitamin D deficiency (VDD) has been associated with severe adverse health outcomes during pregnancy is increasingly recognised as a public health concern and maternal and infant VDD is closely associated. The aim of this study was to evaluate the magnitude of VDD and associated factors in pregnant women and newborns in the postpartum period. A cross-sectional study was carried out in a total of 66 pregnant women at > 37 weeks of gestation and newborns at the Gaziantep University Faculty of Medicine, Department of Obstetrics and Gynecology in Gaziantep, Turkey. Demographic characteristics, 24-h dietary recalls, intake of food supplements were determined in pregnant women, maternal and newborn anthropometric measurements and serum (25-OHD) levels were assessed. Mean age (± SD) of pregnant women was 28.8 ± 6.9 years. Although Turkey has “National Vitamin D Supplementation Programme for Pregnant Women” only 33.3% of women had VD supplementation during pregnancy, not all in the recommended levels (1200 IU/day). Mean (± SD) serum 25(OH)D levels in pregnant women and cord blood of newborns were 17.3 ± 9.0 ng/mL [non-supplemented women (NSW): 16.5 ± 7.9 ng/mL; supplemented women (SW): 18.8 ± 11.0 ng/mL] and 16.6 ± 9.9 ng/mL [newborns of non-supplemented women (NNSW): 13.9 ± 8.7 ng/mL and newborns of supplemented women (NSW): 22.1 ± 10.1 ng/mL], respectively. Vitamin D severe deficiency (< 10 ng/dL) was noted in 22.7%, deficiency (11–19 ng/mL) 51.5%, insufficiency (20–29 ng/mL) 15.2% and sufficiency (≥ 30 ng/mL) 10.6% of the women whereas severe deficiency, deficiency, insufficiency and sufficiency respectively, were determined in 33.3%, 39.5%, 13.6% and 13.6% of newborns (NNSW vs NSW, p = 006, p < 0.05). Median serum VD levels of NSW were statistically higher than NNSW (p = 0.000, p < 0.05). Out of total, 86.4% of women were dressing traditionally covered, and had lower serum VD level (p = 0.049, p > 0.05). SW had higher median body weight (p = 0.026) and body mass index (BMI) (p = 0.036) levels than NSW (p < 0.05). No statistically significant differences were found between anthropometric measurements of NNSW and NSW groups, although birth weights of NNSW and NSW groups were determined as 3005.1 ± 456.1 g and 3153 ± 422.5 g (p > 0.05), respectively. Maternal serum vitamin D levels strongly were correlated with newborn levels. Maternal vitamin D deficiency is a great problem and “National Vitamin D Supplementation Programme for Pregnant Women and Infants” should be effectively implemented and monitored. Also fortification programme should be a national policy.


Author(s):  
Ritu Karoli ◽  
Shobhit Shakya ◽  
Prem Shanker Singh

Background: Comorbidity of diabetes and tuberculosis has serious health implications. Presence of diabetes at least three times increases the risk of tuberculosis which may be mediated by an abnormal innate immune response due to hyperglycaemia or low vitamin D levels.Aim of the study- Present study was carried out to investigate whether lower serum 25(OH) D might be associated with higher prevalence of pulmonary or extra pulmonary tuberculosis which might provide an evidence for a role of vitamin D in the comorbidity of these two diseases and does it have any correlation with glycemic status.Methods: In a hospital based cross sectional study, 264 patients with newly diagnosed tuberculosis were enrolled and according to glycemic status they were divided into three groups. They were assessed for vitamin D deficiency in addition to routine laboratory and biochemical parameters.Results: The patients with diabetes had significantly lower vitamin D levels. The prevalence of severe vitamin D deficiency was highest in patients who had diabetes with tuberculosis. There was negative correlation between vitamin D levels and Hba1C and extensiveness of pulmonary tuberculosisConclusions: Serum vitamin D levels were significantly lower in tuberculosis patients with pre-diabetes and type 2 diabetes compared with those, who had normal glycemic status. We suggest that there is a need to pay more attention to vitamin D status in this country and if there is coexisting diabetes or impaired glucose intolerance, emphasis on vitamin D supplementation can be of utmost importance.


2014 ◽  
Vol 18 (3) ◽  
pp. 379-391 ◽  
Author(s):  
Glen B Taksler ◽  
David M Cutler ◽  
Edward Giovannucci ◽  
Nancy L Keating

AbstractObjectiveBlack and Hispanic individuals synthesize less vitamin D per unit of sun exposure than white individuals. The relationship between UV radiation and vitamin D insufficiency in minorities has not been well explored.DesignProspective cohort study.SettingUsing the National Health and Nutrition Examination Survey, we obtained serum vitamin D levels for non-Hispanic Whites, Hispanics and non-Hispanic Blacks aged ≥18 years from 2000–2006. We linked these data with the average monthly solar UV index by census tract and data on sun exposure, vitamin D supplementation, health and demographics. We used multivariable regression analyses to assess vitamin D deficiency (<15 ng/ml) and insufficiency (<20 ng/ml) in January (when the UV index was lowest) by race/ethnicity and geography.SubjectsAdults (n 14 319) aged ≥18 years.ResultsA 1-point increase in the UV index was associated with a 0·51 ng/ml increase in vitamin D (95 % CI 0·35, 0·67 ng/ml; P<0·001). Non-Hispanic Black race and Hispanic ethnicity were associated with a 7·47 and 3·41 ng/ml decrease in vitamin D, respectively (both P<0·001). In January, an estimated 65·4 % of non-Hispanic Blacks were deficient in vitamin D, compared with 28·9 % of Hispanics and 14·0 % of non-Hispanic Whites. An estimated 84·2 % of non-Hispanic Blacks were insufficient in vitamin D v. 56·3 % of Hispanics and 34·8 % of non-Hispanic Whites. More non-Hispanic Blacks were estimated to be deficient in vitamin D in January in the highest UV index quartile than were non-Hispanic Whites in the lowest UV index quartile (60·2 % v. 25·7 %).ConclusionsWintertime vitamin D insufficiency is pervasive among minority populations, and not uncommon among non-Hispanic Whites.


2020 ◽  
Vol 90 (3-4) ◽  
pp. 346-352
Author(s):  
Vincenzo Pilone ◽  
Salvatore Tramontano ◽  
Carmen Cutolo ◽  
Federica Marchese ◽  
Antonio Maria Pagano ◽  
...  

Abstract. We aim to assess the prevalence of vitamin D deficiency (VDD) in patients scheduled for bariatric surgery (BS), and to identify factors that might be associated with VDD. We conducted a cross-sectional observational study involving all consecutive patients scheduled for BS from 2017 to 2019. The exclusion criteria were missing data for vitamin D levels, intake of vitamin D supplements in the 3 months prior to serum vitamin D determination, and renal insufficiency. A total of 206 patients (mean age and body mass index [BMI] of 34.9 ± 10.7 years, and 44.3 ± 6.99 kg/m2, respectively) met the inclusion criteria and were enrolled for data analysis. VDD (<19.9 ng/mL), severe VDD (<10 ng/mL), and vitamin D insufficiency (20–29.9 ng/mL) were present in 68.8 %, 12.5 %, and 31.2 % of patients, respectively. A significant inverse correlation was found between vitamin D levels and initial BMI, parathyroid hormone, and homeostatic model assessment of insulin resistance (r = −0.280, p < 0.05; r = −0.407, p = 0.038; r = −0.445, p = 0.005), respectively. VDD was significantly more prevalent in patients with higher BMI [−0.413 ± 0.12, CI95 % (−0.659; −0.167), p = 0.006], whereas no significant association between hypertension [−1.005 ± 1.65, CI95 % (−4.338; 2.326), p = 0.001], and diabetes type 2 (T2D) [−0.44 ± 2.20, CI95 % (−4.876; 3.986), p = 0.841] was found. We observed significant association between female sex and levels of vitamin D [6.69 ± 2.31, CI95 % (2.06; 11.33), p = 0.006]. The present study shows that in patients scheduled for BS, VDD deficiency is common and was associated with higher BMI, and female sex.


2021 ◽  
pp. 205141582199360
Author(s):  
Ghanshyam Kumawat ◽  
Vijay Chaudhary ◽  
Anurag Garg ◽  
Nishkarsh Mehta ◽  
Gagan Talwar ◽  
...  

Objective: We aimed to find out the association of low serum vitamin D levels with the incidence of prostate cancer through a prospective case-control study. Material and methods: This study was carried out in the tertiary care hospital (India). All newly diagnosed patients of prostate cancer and age-matched controls were included. Serum vitamin D levels were measured in all of them. Vitamin D status (ng/mL) was classified as severe deficiency <10, moderate deficiency 10–<30, normal 30–100, and toxicity >100. Normality of the data was tested by the Kolmogorov–Smirnov test, statistical analysis was done with Statistical Package for the Social Sciences version 26.0, p-value of <0.05 was considered significant. Results: In our study, 320 cases and 320 controls were included. The mean vitamin D levels in cases and controls were 15.71 ± 6.5 (ng/mL) and 17.63 ± 4.54 (ng/mL), respectively, ( p-Value <0.01). Patients with severe vitamin D deficiency (73.58%) had a Gleason score ⩾8 on biopsy and 79.24% of them had a serum prostate specific antigen (PSA) level >20 ng/mL. Conclusion: We had concluded that there was no significant association between vitamin D deficiency and increased risk of prostate cancer, although patients with higher-grade prostate cancer and with higher PSA level had severe vitamin D deficiency. Level of evidence: Not applicable for this multicentre audit.


2021 ◽  
Vol 7 (4) ◽  
pp. 320-323
Author(s):  
Ritika Gujrati ◽  
Krishnendra Varma ◽  
Ujjwal Kumar

Psoriasis is an immuno-mediated chronic systemic disease involving cytokines of helper Th1 pathway. Vitamin D has an effect on keratinocyte proliferation, differentiation and immune modulation of immune system especially Th1 pathway, which is altered in psoriatic skin suggesting that Vitamin D may have a role in pathogenesis of psoriasis. To study correlation between psoriasis vulgaris and serum vitamin D. To evaluate serum vitamin D level in psoriasis cases and in control group and correlating vitamin D level with severity and duration of the psoriasis. 57 cases (&#62;15years of age) with psoriasis and 57 healthy subjects were recruited. Psoriasis was clinically diagnosed and severity evaluated by PASI scale. Vitamin D was analysed by enhanced chemilumine scence on vitrus Eci autoanalyzer of Orth clinical diagnostic. Vitamin D deficiency defined as &#60;20ng/ml, insufficiency 20-30ng/ml and sufficient 30-100ng/ml. Vitamin D deficiency in the study was 22.8% in patients and 14% in control group. Vitamin D insufficiency was found in 42.1% of cases and 19.3% of control. According to chi-square the p-value is 0.003 showing significant association. There was a tendency towards decrease in vitamin D level with increase in disease duration. There was negative correlation between vitamin D and PASI score. The study found a significant relationship between vitamin D and psoriasis. Further metanalysis involving larger study population will be required to establish whether vitamin D levels benefits patient with psoriasis vulgaris.


Author(s):  
A. V. Rudenko ◽  
T. D. Tyabut ◽  
A. E. Buglova ◽  
G. A. Babak ◽  
P. M. Morozik ◽  
...  

Vitamin D deficiency is an important environmental risk factor that influences the prevalence and severity of several autoimmune diseases, including rheumatoid arthritis (RA). The aim of this study was to determine the incidence of vitamin D insufficiency and deficiency in patients with RA, to establish the relationship between serum vitamin D levels and indicators of disease activity. 156 patients with RA were included in the study, mean age 60.2 ± 13.9 years. Assessment of clinical status was performed, serum concentrations of rheumatoid factor (RF), C-reactive protein (CRP), total vitamin D (25(OH)D), antibodies to cyclic citrullinated peptide (ACCP) were determined. RA disease activity was evaluated using DAS28 (disease activity score), SDAI (Simplified Disease Activity Index) и CDAI (Clinical Disease Activity Index) scores. Average levels of 25(OH)D in the surveyed sample were 25.2 ± 13.2 ng/ml. The results of the study indicate a high prevalence of vitamin D deficiency in patients with RA. Normal indicators of vitamin D, its insufficiency and deficiency were observed in 47 (30.3 %), 45 (28.7 %) and 64 (40.7 %) patients, respectively. Low level of serum 25(OH)D was associated with higher indices of RA activity according to DAS28, SDAI and CDAI, as well as with greater tender joint count. Vitamin D should be prescribed as an adjunctive therapy in patients with active RA due to its potential immunomodulatory effect, as well as for the prevention and treatment of bone metabolism disorders.


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