scholarly journals Prevalence of Insufficient Serum 25-hydroxyvitamin D (25(OH)D) Greater Among Medicaid Residents Living in Long-Term Care Communities (P01-011-19)

2019 ◽  
Vol 3 (Supplement_1) ◽  
Author(s):  
Ronna Robbins ◽  
Nalini Ranjit ◽  
Sara Sweitzer ◽  
Maragaret Briley

Abstract Objectives Evaluate the association between insufficient 25-hydroxyvitamin D [25(OH)D] serum levels and healthcare payer source of older adults living in long-term care (LTC) communities. Methods Residents (age >65 yo) of five LTC communities in Central, Texas were recruited to participated in the multi-site, cross-sectional study. A one-year medical history was abstracted from medical records using double-blinded data abstraction and entry protocols. Medical history included but not limited to: diagnosis, medications, history of supplementation, BMI, mini-nutritional assessment, diet order, total mood assessments, hospitalizations and number of infections. Data on payer source and other demographics were also obtained via medical records. Blood draws were collected to measure serum 25(OH)D levels. Logistic regression models were uses to assess the association between insufficient25(OH)Dserum levels (defined as <30 ng/ml) and healthcare payer source. Total vitamin D supplemented per day along with amount provided in meals, body mass index, race, gender, age, years living in community, and diagnosis of liver and renal disease were used as confounders. Results The 174 participants (89% Caucasian, mean age 83 yo) included 63% females. Payer source was distributed as follows: 55% private pay, 8.6% Medicare, 35% Medicaid, and 1% insurance. Fifty-five % had insufficient25(OH)D serum levels (mean serum level = 32.6 ng/ml; mean supplementation rate of 1138 IU per/d). Insufficient serum levels were seen in 48% of participants with private pay (mean serum level = 36 mg/ml) and 58% with Medicaid (mean serum level = 30.5 ng/ml). Adjusted logistic regression showed that payer source was a significant determinant of insufficient25(OH)D serum levels. Medicaid residents had significantly greater odds of having insufficient 25(OH)D serum levels (adjusted odd ratio (OR) 3.26; CL: 1.25, 8.48; P = 0.015) than private pay participants. Conclusions Practitioners working in LTC can use these results to ensure equity in the provision of medical nutritional therapy across Medicaid residents and private pay residents. Funding Sources Funding for study was provided through the private funds of research team.

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 678-678
Author(s):  
Ronna Robbins ◽  
Monica Serra ◽  
Margaret Briley

Abstract Insufficient serum 25-hydroxyvitamin D (25(OH)D) concentrations are associated with increased respiratory tract infections, influenza, and other infectious diseases. As the world deals with the COVID-19 pandemic, the interest of adequate serum levels to reduce the risk of infection has surfaced. This study determined if the number of infections per year are associated with serum 25(OH)D concentrations in long-term care (LTC). Participants (≥ 65 years) in a cross-sectional study were recruited across five LTC communities in Texas. Medical records were used to collect a one-year medical history using double-blind protocols. Blood draws were collected to measure serum 25(OH)D concentrations. Medical records were used to classify infections based upon documentation of signs and symptoms of infection concurrent with either a physician’s note or antibiotic/antiviral medication prescription. Race, BMI, sex, age, and liver and renal disease diagnoses were used as confounders. Of the 177 participants (89% Caucasian, 63% female, mean age 83 years) 69% had ≥1 infection over year and 55% had insufficient serum 25(OH)D concentrations &lt;30 mg/mL (mean 32.6 ng/mL). Linear regression did not show a significant association between serum 25(OH)D concentrations and number of infections (β 0.003; 95% CI -0.014, 0.018; p=0.760). Additionally, insufficient serum concentration did not increase the odds of having an infection (OR 1.02; 95% CI 0.05, -19.34; p=0.987). This study did not show a significant association between infection rates and serum 25(OH)D concentrations. However, further research is needed to determine if vitamin D supplementation could be an effective therapeutic intervention to reduce infection rates, including COVID-19.


2021 ◽  
pp. 1-24
Author(s):  
Ronna N Robbins ◽  
Monica Serra ◽  
Nalini Ranjit ◽  
Deanna M Hoelscher ◽  
Sara J Sweitzer ◽  
...  

ABSTRACT Objective: The aims of this study were to examine the efficacy among various vitamin D supplementation regimens on serum 25(OH)D concentrations and determine the minimal dose rate required to achieve sufficient serum concentrations (≥75 nmol/L) among older adults in long-term care (LTC). Design: A one-year medical history was abstracted from medical records, and a one-time blood draw to measure serum 25(OH)D concentrations was obtained. Individuals were stratified into vitamin D supplemented and non-supplemented groups. The supplemented group was further categorized into four treatment forms: single ingredient vitamin D2or3, multivitamin, calcium with vitamin D, or combination of the three, and by daily prescribed doses: 0-399, 400-799, 800-1999, 2000-3999, and >4000 IU/day. Setting: Five LTC communities in Austin, Texas. Participants: 173 older (≥65 years) adults. Results: Of the participants, 62% received a vitamin D supplement and 55% had insufficient (≤75 nmol/L) 25(OH)D serum concentrations. Individuals receiving single ingredient vitamin D2or3 supplementation received the highest daily vitamin D mean dose (2900 IU/d), while combination of forms was the most frequent treatment (44%) with the highest mean serum concentration (108 nmol/L). All supplementation doses were successful at reaching sufficient serum concentrations, except those <800 IU/d. Using a prediction model, it was observed that one IU/d of vitamin D supplementation resulted in a 0.008 nmol/L increase in serum 25(OH)D concentrations. Conclusion: Based on the predictive equation, results suggest that supplementation of 1500 IU/d of vitamin D2or3 or combination of vitamin D is most likely to achieve sufficient serum 25(OH)D concentrations in older adults in LTC.


2020 ◽  
Author(s):  
Kumiko Ito ◽  
Hisashi Kawai ◽  
Harukazu Tsuruta ◽  
Shuichi Obuchi

Abstract Background: Predicting incidence of long-term care insurance (LTCI) certification in the short term is of increasing importance in Japan. The present study examined whether the Kihon Checklist (KCL) can be used to predict incidence of LTCI certification (care level 1 or higher) in the short term among older Japanese persons.Methods: In 2015, the local government in Tokyo, Japan, distributed the KCL to all individuals older than 65 years who had not been certified as having a disability or who had already been certified as requiring support level 1–2 according to LTCI system. We also collected LTCI certification data within the 3 months after collecting the KCL data. The data of 17785 respondents were analyzed. First, we selected KCL items strongly associated with incidence of LTCI certification, using stepwise forward-selection multiple logistic regression. Second, we conducted receiver operating characteristic (ROC) analyses for three conditions (1: Selected KCL items, 2: The main 20 KCL items (nos. 1–20), 3: All 25 KCL items). Third, we estimated specificity and sensitivity for each condition.Results: During a 3-month follow-up, 81 (0.5%) individuals required new LTCI certification. Eight KCL items were selected by multiple logistic regression as predictive of certification. The area under the ROC curve in the three conditions was 0.92–0.93, and specificity and sensitivity for all conditions were greater than 80%.Conclusions: Three KCL conditions predicted short-term incidence of LTCI certification. This suggests that KCL items may be used to screen for the risk of incident LTCI certification.


2021 ◽  
Vol 6 ◽  
pp. 79-82
Author(s):  
V.N. Peregoedova ◽  
◽  
I.K. Bogomolova ◽  

Aim of study. To study the total level of 25-hydroxyvitamin D in children with SARS-CoV-2 infection (COVID-19). Material and мethods. A total of 82 children aged 0-17 diagnosed with SARS-CoV-2 infection were enrolled. Depending on the severity of clinical symptoms, all children were divided into three groups according to the COVID-19 severity: asymptomatic, mild and moderate. The serum level of vitamin D in all patients was tested via the immunochemical method. Results. It was found that children with SARS-CoV-2 infection had lower serum level of vitamin D (29.92 [22.22; 28.07] ng/ml) as compared with the control group (36.43 [32.05; 44.08] ng/ml; p<0.001). A total of 90% of the children with SARS-CoV-2 infection were diagnosed with insufficiency or deficiency of vitamin D (<30 ng/ml). Only 10 % of the patients had normal levels of vitamin D. The insufficiency of vitamin D was found more often amongst children aged 0-11 and deficiency of total 25-hydroxyvitamin D was more common for children aged 12-17. The difference in serum levels of vitamin D depending on the severity of SARS-CoV-2 infection was not found. Male children with SARS-CoV-2 infection showed lower levels of vitamin D (p=0.013). Conclusion. A total of 90 % of the children with SARS-CoV-2 infection had insufficiency or deficiency of vitamin D regardless of the severity of clinical symptoms.


Author(s):  
Dina Keumala Sari ◽  
Nurfida Khairina Arrasyid ◽  
Y. S. Harahap

Previous studies have not been able to show with certainty the effect of vitamin D supplementation in tuberculosis patients. The objective of this study is to determine whether vitamin D supplementation to patients with tuberculosis could influence 25-hydroxyvitamin D (25(OH)D) and calcium serum levels. The results, after 28 days, the vitamin D supplementation showed significant increase of 25(OH)D serum level at the end point (p=0.001), but not for the calcium serum level (p=0.3). The Conclusions is supplementation with 1,000 IU vitamin D per day increased the 25(OH)D serum level but there was no association with the calcium serum level.


2021 ◽  
Vol 13 (4) ◽  
pp. 426-32
Author(s):  
Theresia Ilyan ◽  
Dwi Retnoningrum ◽  
Meita Hendrianingtyas ◽  
Dian Widyaningrum ◽  
Banundari Rachmawati

BACKGROUND: Serum levels of 25-hydroxyvitamin D (25(OH)D), prostaglandin E2 (PGE2), and cyclooxygenase 2 (COX2) expression differ between breast cancer stages. Since, previous studies showed mixed results, in this study, we aimed to analyze vitamin D levels related to breast cancer stages and serum levels of COX2 and PGE2 in Indonesia.METHODS: This was a cross sectional study involving 75 breast cancer patients. Subjects were divided into 3 groups, namely operable early stage (K1), locally advanced stage (K2), and advanced stage (K3). Venous blood samples were taken from each subject, then were analyzed for the 25(OH)D, COX2, and PGE2 serum levels by enzyme-linked immunosorbent assay (ELISA) method.RESULTS: There were significant differences in 25(OH)D among groups (p=0.012); between K1 and K2 (p=0.009) and between K1 and K3 (p=0.023). However, there was no significant difference in serum COX2 level (p=0.328). There were significant differences of PGE2 among groups (p=0.002); between K1 and K2 (p=0.036) and between K1 and K3 (p=0.001). Correlation test showed that there were differences between 25(OH)D serum levels and PGE2 serum level (r=0.306, p=0.008) and also between 25(OH)D serum level and breast cancer stage (r=-0.229; p=0.048).CONCLUSION: There were differences in serum Vitamin D and PGE2 levels at various stages of breast cancer. Serum 25(OH)D levels had weak correlation with breast cancer stage and PGE2 serum level. Serum vitamin D level in advanced breast cancer were lower than early stage breast cancer and indicate a poor prognosis.KEYWORDS: breast cancer, 25-hydroxyvitamin D, cyclooxygenase 2, prostaglandin E2


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