scholarly journals Characterizing the Assessment and Management of Vitamin D Levels in Patients with Osteoporosis in Clinical Practice: A Chart Review Initiative

2015 ◽  
Vol 2015 ◽  
pp. 1-7
Author(s):  
Jonathan D. Adachi ◽  
Jacques P. Brown ◽  
George Ioannidis

Though vitamin D is important for bone health, little is known about the monitoring and management of vitamin D levels in patients with osteoporosis in clinical practice—a deficit this chart review initiative aimed to remedy. A total of 52 physicians completed profiles for 983 patients being treated for osteoporosis between November 2008 and April 2009. Information collected included demographics; fracture risk factors; availability and level of serum vitamin D measurements; and information on osteoporosis medications and calcium and vitamin D supplementation. Physicians also evaluated patients’ current regimens and detailed proposed changes, if applicable. Nearly 85% of patients were prescribed calcium and vitamin D supplements. Serum 25-hydroxy vitamin D levels were available for 73% of patients. Of these patients, approximately 50% had levels less than 80 nmol/L, which contrasts with the 37% thought to have “unsatisfactory” vitamin D levels based on physician perceptions. Physicians felt 26% of patients would benefit from additional vitamin D supplementation. However, no changes to the osteoporosis regimen were suggested for 48% of patients perceived to have “unsatisfactory” vitamin D levels. The results underscore the importance of considering vitamin D status when looking to optimize bone health.

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Ahmed Adly Mohamed ◽  
Marwa Mohamed EL-Begermy ◽  
Ahmed Abdelmoneim Teaima ◽  
Mohamed Ali Abdelghafar

Abstract Objective To investigate the relationship between otitis media with effusion (OME) and serum vitamin D level in children. Methods This prospective case control study was conducted at Ain Shams University Hospitals between February 2018 and May 2019. The study population included 50 children with OME confirmed by tympanometry type (B) who will undergo adenotonsillectomy and grommet tube insertion compared to 50 children without OME confirmed by tympanometry type (A) who will undergo adenotonsillectomy. Measurement of serum 25-hydroxy vitamin D using electrochemiluminescence technique from a blood sample (3cm) taken from them on the day of surgery. Results In this study, the mean age of the cases was 4.24 ± 0.80 and 5.34 ± 1.19 years for the controls besides 23 (46%) of the OME group were boys and 27 (54%) were girls, compared with 29 (58%) boys and 21 (42%) were girls in the control group. The mean levels of vitamin D in children with OME was 16.24 ± 7.14 ng/mL and in children in the control group was 15.89 ± 5.84 ng/mL (P = 0.815) and it was statistically non significant. Conclusion There was no significant relation between vitamin D serum level and the incidence of OME in children.


2020 ◽  
Author(s):  
Elahe Allahyari ◽  
Parichehr Hanachi ◽  
Seyed Jamal Mirmoosavi ◽  
Gordon A. Ferns ◽  
Afsane Bahrami ◽  
...  

Abstract BackgroundAccumulating data have highlighted the prominence of supplementation as an effective approach for vitamin D deficiency. But individuals vary in their response to vitamin D supplementation. In this study, the effect of cardiometabolic risk factors were evaluate on magnitude of response to vitamin D supplementation by using novel statistical analysis, artificial neural networks(ANNs).Methods608 participants aged between 12 to 19 years old were assed in this prospective interventional study. Nine vitamin D capsules containing 50000IU vitamin D/weekly were given to all participants over the 9 week period. The change in serum 25(OH)D level was calculated as the difference between post-supplementation and basal levels. Suitable ANNs model were selected between different algorithms in the hidden and output layers and different numbers of neurons in the hidden layer. Then, the major determinants in predicting response to vitamin D supplementations were identified (Trial registration: IRCT201509047117N7; 2015-11-25; Retrospectively registered)ResultsSigmoid in both hidden and output layers with 4 hidden neurons had acceptable sensitivity, specificity and accuracy area under the ROC curve in our study. Baseline serum vitamin D (30.4%), waist to hip ratio (10.5%), BMI (10.5%), systolic blood pressure (8%), heart rate (6.4%), and waist circumference (6.1%) were the greatest importance in predicting the response in serum vitamin D levels. ConclusionWe provide the first attempt to relate anthropometric specific recommendations to attain serum vitamin D targets. With the exception of cardiometabolic risk factor, the relative importance of other factors and the mechanisms by which these factors may affect the response requires further analysis in future studies.


2020 ◽  
Vol 3 (Supplement_1) ◽  
pp. 35-36
Author(s):  
R A MacMillan ◽  
T Ponich

Abstract Background Vitamin D is a critical factor in bone remodelling, calcium absorption and may promote anti-inflammatory cytokines in the gut. Inflammatory bowel disease (IBD) is associated with a reduction in serum Vitamin D levels and a chronic inflammatory state, both of which are strong risk factors for bone density loss affecting IBD patients. Despite European and North American IBD maintenance guidelines for Vitamin D monitoring and bone density scans, there are limited North American investigations into factors influencing serum Vitamin D levels in the IBD patient population specifically. Aims We investigated whether patient demographics, disease severity indexes and/or inflammatory markers were linked to low serum Vitamin D levels in our IBD patients. We also established the extent of Vitamin D serum deficiencies and supplementation rates in our IBD patients. Methods A retrospective chart review of a single clinician’s practice at London Health Science Centre, Victoria Hospital, over the past 20 months, was performed to: 1) assess the frequency of low serum 25-OH Vitamin D (25-OH D) in the IBD patient population and 2) determine whether patient disease severity was linked to lower 25-OH D levels. A multivariate regression analysis was performed assessing Crohn’s Disease (CD) or Ulcerative Colitis (UC) patient factors: age, sex, disease duration, seasonality, current pharmacologic treatments, past surgeries, CD Activity Index, UC Mayo score, C-reactive protein, and fecal calprotectin (Fcal) level. Results 175 IBD patients had at least one 25-OH D measurement with 71 patients actively on Vitamin D therapy. Of UC and CD patients who were not on Vitamin D therapy, 63% (17/27) and 79% (61/77) were 25-OH D deficient, respectively. 25-OH D levels in the CD population was associated with Vitamin D supplementation (regression coefficient [RC] 23.99, 95% confidence interval [CI] 14.54 to 33.45), summer season ([RC] 9.90, [CI] 0.56 to 19.24), and past bowel resection ([RC] -10.61, [CI] -20.48 to -0.76). 25-OH D levels in the UC population was associated with Vitamin D supplementation (regression coefficient [RC] 47.23, 95% confidence interval [CI] 27.62 to 66.83), and Mayo severity scores ([RC] -23.01, [CI] -41.82 to -4.20). Fcal (78 patients) was inversely associated with 25-OH D levels but the trend was not significant. Conclusions Overall, 25-OH D levels were lower in both the UC and CD patient populations relative to the already deficient Canadian population. However, IBD patients are responsive to Vitamin D supplementation. Tools with more objective evidence of disease severity such as UC Mayo score and fcal should be prioritized for identifying the IBD population requiring supplementation. Funding Agencies None


2019 ◽  
Vol 34 (4) ◽  
pp. 253-257
Author(s):  
Kimberly Lowe ◽  
Khadija Tul Kubra ◽  
Ze Yang He ◽  
Katherine Carey

For the past 15 years, cardiovascular disease (CVD) has been the leading cause of death for both men and women in the United States and worldwide. With an aging population, there has been increasing use of statin therapy to reduce the risk of CVD. However, statin-associated muscle symptoms (SAMS) remain an obstacle to this treatment, leading to discontinuation and nonadherence to statin therapy. Signs and symptoms of SAMS include muscle pain, tenderness, and increased serum creatine kinase. Despite the idiopathic pathophysiology of SAMS, some studies have shown an association between vitamin D deficiency and SAMS; the use of vitamin D supplements can lead to relief of these symptoms. The purpose of this review was to critique evidence for the association between low serum vitamin D and SAMS and the use of vitamin D supplementation for treatment.


2012 ◽  
Vol 2012 ◽  
pp. 1-11 ◽  
Author(s):  
Khanh Lương ◽  
Lan Nguyễn

Parkinson’s disease (PD) is the second most common form of neurodegeneration in the elderly population. Clinically, it is characterized by tremor, rigidity, slowness of movement, and postural imbalance. A significant association between low serum vitamin D and PD has been demonstrated, suggesting that elevated vitamin D levels might provide protection against PD. Genetic studies have helped identify a number of proteins linking vitamin D to PD pathology, including the major histocompatibility complex (MHC) class II, the vitamin D receptor (VDR), cytochrome P450 2D6 (CYP2D6), chromosome 22, the renin-angiotensin system (RAS), heme oxygenase-1 (HO-1), poly(ADP-ribose) polymerase-1 gene (PARP-1), neurotrophic factor (NTF), and Sp1 transcription factor. Vitamin D has also been implicated in PD through its effects on L-type voltage-sensitive calcium channels (L-VSCC), nerve growth factor (NGF), matrix metalloproteinases (MMPs), prostaglandins (PGs) and cyclooxygenase-2 (COX-2), reactive oxygen species (ROS), and nitric oxide synthase (NOS). A growing body of evidence suggests that vitamin D supplementation may be beneficial for PD patients. Among the different forms of vitamin D, calcitriol (1,25-dihydroxyvitamin D3) is best indicated for PD, because it is a highly active vitamin D3 metabolite with an appropriate receptor in the central nervous system (CNS).


Author(s):  
Kishore A. Manek

<p><strong>Background:</strong> In India more than 90% of apparently healthy Indians have subnormal 25(OH) D levels. To maintain sufficient vitamin D level, apart from sunlight and food containing vitamin D, supplementation with vitamin D is also required. The objective of this study was to find out effectiveness of nanoparticle based vitamin D formulations in patient of vitamin D deficiency and insufficiency</p><p><strong>Methods:</strong> This was a prospective, open label, single arm, non-comparative, dose response post-marketing efficacy study (PMS) – phase-4 study to find the effectiveness of a nanoparticle based vitamin D formulation in adult patients between 18 to 65 years of either gender, attending/visiting the study site with documented deficiency or insufficiency of vitamin D (&lt;30 ng/ml) or sign and symptoms of deficiency or insufficiency of vitamin D. Each subject planned to receive 60,000 IU of nanoparticle based vitamin D, once weekly, for 8 weeks orally. Serum 25(OH) D levels were measured at baseline, 4 and 8 week.</p><p><strong>Results:</strong> The mean baseline serum 25[OH] D levels were 15.90. After treatment with nanoparticle based vitamin D there was a significant increase in the serum vitamin D levels at 4 weeks (41.03) and 8 weeks (31.38) (p&lt;0.0001). Patients who have received treatment for at least 4 weeks’ period (n=38), the improvement (serum 25[OH] D &gt;30 ng/ml) was seen in 84.2% patients (n=32) at the end of 4 weeks itself. There is significant increased (&lt;0.0001) in the physical component scores of the SF-12 QOL questionnaire after 8 weeks of therapy.</p><p><strong>Conclusions:</strong> Nanoparticle based formulation of vitamin D<sub>3</sub> is effective and safe in correction of vitamin D levels in patients with documented deficiency or insufficiency of vitamin D. Also the safety and tolerability is well accepted and reported good to excellent by patients and physician.</p><p> </p>


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.


2021 ◽  
Author(s):  
Yuqin Wu ◽  
Yanfei Yang ◽  
Xiao Xiao ◽  
Lin Wang ◽  
Zheng Yin ◽  
...  

Abstract Aim: To investigate the vitamin D levels in children aged 0–4 years in Yunnan Province.Methods: This study selected children aged 0 to 4 years who underwent physical examination in the special needs clinic of the Hospital from October 2019 to December 2020 as subjects to analyze serum 25(OH)D levels.Result: Vitamin D deficiency was more common in girls than in boys. There was no significant difference in serum vitamin D levels between boys and girls at any age. However, there was a significant decrease in vitamin D levels after 2 years old in all chidren at all ages. The levels of vitamin D in children were highest in summer, which were significantly higher than other seasons, and were lowest in winter. At the same time, vitamin D levels were significantly different based on the economic level of cities. The serum vitamin D contents of infants and young children in the top five cities with the highest economic levels were significantly higher than in lower-ranked cities. There was a significant correlation between vitamin D content and serum calcium. Conclusion: This study preliminarily determined a reasonable reference range for serum 25 hydroxyvitamin D content in infants aged 0–4 years in Yunnan Province. Which will be of significance for the establishment of official guidelines on vitamin D supplementation in infants and young children in Yunnan and for policy formulation.


2016 ◽  
Vol 30 (5) ◽  
pp. 521-527 ◽  
Author(s):  
Jenny H. Kang ◽  
Quynh-Nhu Nguyen ◽  
Juleann Mutka ◽  
Quang A. Le

Background: Statins are the primary class of medications used to lower cholesterol and reduce risks for coronary heart disease. However, statin muscular adverse effects are one of the main reasons for statin nonadherence and a barrier to cardiovascular risk reduction. Objectives: The primary objective of our study was to examine the effect of replenishing vitamin D on statin-induced myopathy in veteran patients who failed to maintain statin therapy in a pharmacist-run ambulatory care setting. Secondary objectives were to examine changes in patients’ vitamin D levels, fasting lipid profiles, and achievement of lipid goals after reinitiation of statin therapy. Methods: This was a retrospective cohort study of veteran patients conducted at a pharmacist-managed cholesterol-optimization clinic. Patients with low-serum vitamin D, history of statin-induced myopathy, and who received vitamin D replenishment prior to rechallenging statin therapy between December 1, 2008, and April 1, 2015, were identified. The primary outcome was the percentage of patients who maintained their statin therapy at 12 months after statin reinitiation. Results: Twenty-seven patients met the study criteria. All patients were able to maintain their statin therapy without myalgia after vitamin D supplementation. Eleven patients (40.7%) tolerated their previously failed statins. The most frequently restarted statins were atorvastatin, pravastatin, and rosuvastatin. A 22% to 30% increase in the number of patients who achieved cholesterol goals based on the national lipid guidelines was observed at 12-month follow-up. Conclusion: Replenishing low vitamin D in patients with statin-induced myopathy appears to be an effective strategy in improving medication adherence and subsequently preventing cardiovascular and mortality events.


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