scholarly journals Effects of Monthly Intramuscular High-Dose Vitamin D2 on Serum 25-Hydroxyvitamin D and Immune Parameters in Very Elderly Chinese Patients with Vitamin D Deficiency

2021 ◽  
Vol 2021 ◽  
pp. 1-8
Author(s):  
Pingda Bian ◽  
Xue Jin ◽  
Zhangxuan Shou

Purpose. Vitamin D deficiency is highly prevalent among the very elderly and is associated with a wide variety of clinical conditions other than musculoskeletal diseases. This study aims to ascertain the efficacy and safety of high-dose intramuscular vitamin D2 in very elderly Chinese patients with vitamin D deficiency. Methods. Very elderly (aged 80 years or over) Chinese patients with vitamin D deficiency were recruited to receive monthly intramuscular injections of 600,000 IU vitamin D2 until their serum 25-hydroxyvitamin D (25(OH)D) reached ≥30 ng/mL. The serum levels of 25(OH)D2, 25(OH)D3, iPTH, BTMs, immune parameters, and other biochemical parameters were measured at baseline and one month after each dose. Results. Of the 30 very elderly Chinese patients who had been recruited into the study, 27 (90.0%) had their vitamin D deficiency corrected, and 26 (86.7%) reached vitamin D sufficiency. The mean time (±SD) was 3.1 (±1.3) months for vitamin D deficiency to be corrected, and 6.1 (±0.8) months for vitamin D sufficiency to be reached. The mean (±SD) serum level of 25(OH)D2 increased from 0.69 (±1.51) ng/mL to 29.07 (±5.68) ng/mL, while the mean (±SD) serum level of 25(OH)D3 decreased from 9.82 (±2.75) ng/mL to 5.30 (±3.09) ng/mL (both P < 0.001 ). The total T cells in serum remained unchanged ( P > 0.05 ), and the CD4 and B cells (CD19+) were increased significantly (both P < 0.05 ). In addition, no significant change was observed in the serum levels of iPTH and BTMs. Conclusion. Monthly intramuscular injection of 600,000 IU vitamin D2 is an effective and safe dosing regimen to reach vitamin D sufficiency and enhances immune function in the very elderly Chinese patients with vitamin D deficiency.

2013 ◽  
Vol 2013 ◽  
pp. 1-7 ◽  
Author(s):  
Rolf Jorde ◽  
Moira Strand Hutchinson ◽  
Marie Kjærgaard ◽  
Monica Sneve ◽  
Guri Grimnes

Data were pooled from four randomized clinical trials with vitamin D performed in Tromsø with weight reduction, insulin sensitivity, bone density, and depression scores as endpoints. Serum lipids, glycated hemoglobin (HbA1c), and high sensitivity C-Reactive Protein, (HS-CRP) were measured at baseline and after 6–12 months of supplementation with vitamin D 20 000 IU–40 000 IU per week versus placebo. A total of 928 subjects who completed the interventions were included. At baseline the mean serum 25-hydroxyvitamin D (25(OH)D) level in those given vitamin D was 55.9 (20.9) nmol/L and the mean increase was 82.4 (40.1) nmol/L. Compared with the placebo group there was in the vitamin D group at the end of the studies a slight, but significant, increase in HbA1c of 0.04%, an increase in HS-CRP of 0.07 mg/L in those with serum 25(OH)D < 50 nmol/L, and in those with low baseline HDL-C and serum 25(OH)D < 50 nmol/L a slight decrease serum HDL-C of 0.08 mmol/L (P<0.05). No serious side-effects were seen. In conclusion, in subjects without vitamin D deficiency, there is no improvement in serum lipids, HbA1c, or HS-CRP with high dose vitamin D supplementation. If anything, the effect is negative.


2020 ◽  
Vol 70 (12) ◽  
pp. 4332-4335

Vitamin D is essential for calcium absorption and for maintaining bone health in the pediatric population. We conducted a retrospective study to establish the profile of a child aged under 3 years old with vitamin D deficiency in the context of correct prophylaxis, on a cohort of 49 children from two general practitioner offices. From the study group 30.6% of children (15 cases) had low vitamin D levels. The mean serum 25(OH)D level was 41.5±16.6 ng/ml. Regarding nutrition in the first year of life, breastfeeding predominated (83.7% of patients), and only 8.16% of patients had clinical signs of rickets. So, low serum levels of vitamin D can also be found in children who have successfully received correct prophylaxis with vitamin D. Keywords: vitamin D, children, rickets


2019 ◽  
Vol 39 (4) ◽  
Author(s):  
Jing Ding ◽  
Lei Liu ◽  
Wei-Kuan Kong ◽  
Xiao-Bing Chen ◽  
Xudong Liu

Abstract Background: The present study aimed to evaluate serum 25-hydroxy vitamin D (25(OH) D) levels in Chinese patients with idiopathic benign paroxysmal positional vertigo (BPPV) and to investigate the possible relationship between the occurrence and recurrence of idiopathic BPPV and low 25(OH) D levels. Methods: Between 1 January 2017 and 31 May, 2018, consecutively older patients (age, older than 50 years) with idiopathic BPPV were recruited in the present study. For each patient, 2:1 sex and age matched healthy people were assigned as the control group. The influence of 25(OH) D levels on BPPV and recurrent BPPV were performed by binary logistic regression analysis. Results: In the present study, 174 patients with BPPV and 348 controls were included. The serum levels of 25(OH) D in those patients were lower than in those controls (P<0.001). One hundred eight patients were found to have vitamin D deficiency; thus, the prevalence was 62.1%, which was higher than that in the controls (42.8%). The data showed that patients with recurrent BPPV (N = 31) had lower serum levels of 25(OH) D compared with those who were not (11.2 ng/ml [interquartile range, 7.2–20.8 ng/ml] vs 18.7 ng/ml [14.2–24.8 ng/ml]). The regression analyses demonstrated that vitamin D deficiency was associated with BPPV and recurrent BPPV with an odds ratio of 2.15 (95% confidence interval [CI], 1.30–4.32; P=0.006) and 5.16 (95% CI, 1.00–34.12; P=0.05). Conclusion: Decreased serum levels of 25(OH)D were associated with the occurrence and recurrence of BPPV in a Chinese population, independent of other baseline markers.


Blood ◽  
2010 ◽  
Vol 116 (21) ◽  
pp. 4261-4261
Author(s):  
Ashutosh Lal ◽  
Ida Micaily ◽  
Drucilla Foote ◽  
Ellen Fung

Abstract Abstract 4261 Osteoporosis in thalassemia is extremely common and preventive approaches are required to avoid serious complications in adults. Vitamin D deficiency, which contributes to suboptimal bone mineralization, is frequently observed in thalassemia despite routine prescription for supplementation with 400–800 IU vitamin D per day. Screening for vitamin D status was conducted in 71 patients with thalassemia, of which 52 were transfusion-dependent and 19 were transfusion-independent (including 11 patients with hemoglobin H or H Constant Spring disease). Baseline assessment of plasma 25-OH vitamin D revealed 57 (80.3%) patients were either deficient (<20 ng/mL, 47.9%) or insufficient (20-30 ng/mL, 32.4%). Significantly more patients in the transfusion-independent group were deficient in vitamin D compared with transfusion-dependent group (78.9% versus 36.5%, p=0.003). The mean parathyroid hormone level in patients with 25-OH D <20 ng/mL was 35.4 ± 19.6 pg/mL compared to 28.2 ± 17.1 pg/mL in those with ≥20 ng/mL (p=NS). We studied the efficacy of supervised adminstration of high-dose (50,000 IU) oral ergocalciferol every 3 weeks during transfusion visits in 20 patients with transfusion-dependent thalassemia. The mean 25-OH D level increased from 14.0 to 22.9 ng/mL (p<0.001) over a four-month period. A single dose of ergocalciferol given every 3 weeks increased the plasma 25-OH D level by 2.2 ± 2.3 ng/mL. No patient developed toxic 25-OH D level (>80 ng/mL) during the course of the study. These results show that vitamin D deficiency remains widespread despite daily low-dose supplementation. Non-transfused patients are at even greater risk of vitamin D deficiency, which may reflect less attention to nutrition in this group compared to the transfusion-dependent patients. We have found that supervised high-dose oral ergocalciferol supplementation is simple, safe, non-invasive and predictable method to improve vitamin D status in thalassemia. Disclosures: No relevant conflicts of interest to declare.


2012 ◽  
Vol 30 (15_suppl) ◽  
pp. e12010-e12010
Author(s):  
Rong Li ◽  
Jing Wu ◽  
Liwen Xiong ◽  
Baohui Han

e12010 Background: Vitamin D deficiency is a global problem. Methods: We estimated the 25-hydroxyvitamin D (25(OH)D) concentrations to confirm whether patients with lung diseases in eastern China showed vitamin D deficiency and whether this deficiency was related to the risk of lung cancer.We used chemiluminescence to estimate the 25(OH)D concentrations in 250 patients from eastern China, of whom 197 had untreated stage III/IV lung cancer and 53 had benign lung diseases. Results: The mean serum 25(OH)D concentration of patients with lung cancer was 10.63 ± 7.04 ng/mL and that of patients with benign lung disease was 9.62 ± 6.37 ng/mL. Although there was no significant difference between the values, the mean serum concentrations of 25(OH)D obtained in patients with lung cancer and benign lung diseases were lower than the normal value (>20 ng/mL); p values in both cases were less than 0.0001. Among the 250 patients, 90 showed low serum 25(OH)D levels of ≤ 4 ng/mL. Conclusions: Patients with lung diseases in eastern China show low serum levels of 25(OH)D, and the average serum 25(OH)D level is much below the normal vitamin D level. Presently it cannot be concluded whether the low levels of 25(OH)D is a risk factor for lung cancer, because the average serum 25(OH)D levels in patients with lung cancer or benign lung diseases are very low.


2018 ◽  
Vol 12 (06) ◽  
pp. 448-453
Author(s):  
Fariba Keramat ◽  
Mohammad Yousef Alikhani ◽  
Jalal Poorolajal ◽  
Surur Akbari

Introduction: The human immune system including phagocytosis, has anessential role in pathogenesis, relapse and improvement of infectious diseases. The immune cells have vitamin D receptor, and vitamin D deficiency causes impaired immune system, specifically macrophages. The aim of study was to compare serum levelof 25-hydroxyvitamin D3 (25-OH- VitD3) among the patients with acute brucellosis and relapsed brucellosis with healthy individuals. Methodology: In this case-control study, 92 patients with acute brucellosis, 92 cases with relapsed brucellosis and 107 healthy persons who referred to Sina hospital and Imam Khomeini clinic were enrolled, and all groups were matched based on age, gender and habitat. The study was done from March 2016 to June 2017. The serum levels of 25-OH- VitD3 were measured based on the Enzyme Linked Fluorescent Assay (ELFA) technology, Vidassystem (France, Biomerieux Kit). The data were analyzed by using SPSS version 16 software. Results: The mean serum levels of 25-OH- VitD3 in acute brucellosis, relapsed brucellosis and healthy persons were 22.55 ± 15.72, 26.82 ± 20.78, 24.44 ± 17.29, respectively .In addition, the mean serum levels of 25-OH- VitD3 by male gender in acute brucellosis, relapsed brucellosis and healthy control groups were 20.35 ± 13.10, 24.88 ± 20.89 and 22.52 ± 13.79, respectively. However, there was no statistically significant difference among three groups (P = 0.275). Conclusions: According to the results, the prevalence of vitamin D deficiency was high in patients with acute or relapsed brucellosis and also healthy persons; however, there was no meaningful difference among three groups and between the patients and healthy persons.


2016 ◽  
Vol 86 (1-2) ◽  
pp. 9-17 ◽  
Author(s):  
Bekir Ucan ◽  
Mustafa Sahin ◽  
Muyesser Sayki Arslan ◽  
Nujen Colak Bozkurt ◽  
Muhammed Kizilgul ◽  
...  

Abstract.The relationship between Hashimoto’s thyroiditis and vitamin D has been demonstrated in several studies. The aim of the present study was to evaluate vitamin D concentrations in patients with Hashimoto’s thyroiditis, the effect of vitamin D therapy on the course of disease, and to determine changes in thyroid autoantibody status and cardiovascular risk after vitamin D therapy. We included 75 patients with Hashimoto’s thyroiditis and 43 healthy individuals. Vitamin D deficiency is defined as a 25-hydroxy vitamin D (25(OH)D3) concentration less than 20ng/mL. Vitamin D deficient patients were given 50.000 units of 25(OH)D3 weekly for eight weeks in accordance with the Endocrine Society guidelines. All evaluations were repeated after 2 months of treatment. Patients with Hashimoto’s thyroiditis had significantly lower vitamin D concentrations compared with the controls (9.37±0.69 ng/mL vs 11.95±1.01 ng/mL, p < 0.05, respectively). Thyroid autoantibodies were significantly decreased by vitamin D replacement treatment in patients with euthyroid Hashimoto’s thyroiditis. Also, HDL cholesterol concentrations improved in the euthyroid Hashimoto group after treatment. The mean free thyroxine (fT4) concentrations were 0.89±0.02 ng/dL in patients with Hashimoto’s thyroiditis and 1.07±0.03 ng/dL in the healthy control group (p < 0.001). The mean thyroid volumes were 7.71±0.44 mL in patients with Hashimoto’s thyroiditis and 5.46±0.63 mL in the healthy control group (p < 0.01). Vitamin D deficiency is frequent in Hashimoto’s thyroiditis and treatment of patients with this condition with Vitamin D may slow down the course of development of hypothyroidism and also decrease cardiovascular risks in these patients. Vitamin D measurement and replacement may be critical in these patients.


2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 908.2-908
Author(s):  
A. Sulli ◽  
E. Gotelli ◽  
A. Casabella ◽  
M. Grosso ◽  
C. Schenone ◽  
...  

Background:Vitamin D regulates the innate and adaptive immune system responses and low vitamin D levels have been associated with the increased risk of respiratory tract infections (1). Vitamin D deficiency has been recently reported to interfere with the prognosis of COVID-19 (2,3).Objectives:The aim of this study was to correlate the 25OH-vitamin D serum levels with lung involvement and disease severity, in a cohort of elderly patients hospitalized for SARS-CoV-2 infection.Methods:Sixty-five COVID-19 patients (mean age 76±13 years) and sixty-five sex- and age-matched control subjects (CNT) were included in the study. Respiratory parameters (PaO2, SO2, PaCO2, PaO2/FiO2), clinical and laboratory parameters (including 25OH-vitamin D, D-dimer, C-reactive protein) and type of radiological pulmonary involvement were collected at hospital admission. Statistical analysis was performed by non-parametric tests.Results:Vitamin D sufficiency (>30 ng/ml), insufficiency (between 20 and 30 ng/ml), deficiency (between 10 and 20 ng/ml) and severe deficiency (<10 ng/ml) were observed respectively in 11, 11, 21 and 57 % of COVID-19 patients. Vitamin D serum levels were found significantly lower in COVID-19 patients than in CNT (median 8 vs 16 ng/ml, p=0.001). A statistically significant positive correlation was observed between vitamin D serum levels and SO2 (p=0.05), PaO2 (p=0.03), PaO2/FiO2 (p=0.02). A statistically significant negative correlation was found between vitamin D serum levels and severity of radiologic pulmonary involvement: vitamin D was significantly lower in COVID-19 patients with either diffuse/severe interstitial lung involvement (p=0.05) or multiple lung consolidations (p=0.0001) than in those with mild radiological lung involvement. Significantly lower vitamin D serum levels were found in COVID-19 patients who died during hospitalization, compared to those who survived (median 3 vs 8 ng/ml, p=0.05). Finally, a statistically significant negative correlation was found between vitamin D serum levels and D-dimer (p=0.04), C-reactive protein (p=0.04) and disease duration (p=0.05).Conclusion:This study confirms that severe vitamin D deficiency is associated with more severe lung involvement, longer disease duration and risk of death in elderly COVID-19 patients.References:[1]Cutolo M, et al. RMD Open. 2020; 6(3):e001454.[2]Bilezikian JP, et al. Eur J Endocrinol. 2020; 183(5):R133-R147.[3]Weir EK, et al. Clin Med (Lond). 2020; 20:e107-e108.Disclosure of Interests:None declared


2016 ◽  
Vol 101 (2) ◽  
pp. 533-538 ◽  
Author(s):  
Gauree Gupta Konijeti ◽  
Pankaj Arora ◽  
Matthew R. Boylan ◽  
Yanna Song ◽  
Shi Huang ◽  
...  

Abstract Context: Although studies have linked vitamin D deficiency with immune-mediated diseases, data demonstrating a direct effect on T-cell function are sparse. Objective: Our objective was to determine whether oral vitamin D3 influences T-cell activation in humans with vitamin D deficiency. Design: This was a single-center ancillary study within Vitamin D Therapy in Individuals at High Risk of Hypertension, a double-blind, multicenter, randomized controlled trial. Setting: This study was undertaken in a single academic medical center. Participants: Adults with vitamin D deficiency and untreated pre- or early stage I hypertension were included. Intervention: In Vitamin D Therapy in Individuals at High Risk of Hypertension, participants were randomized to either low- (400 IU daily) or high- (4000 IU daily) dose oral vitamin D3 for 6 months. In this ancillary study of 38 patients, we measured CD4+ T-cell activation estimated by intracellular ATP release after stimulation of whole blood with plant lectin phytohemagglutinin collected at baseline (pretreatment) and 2-month follow-up. Main Outcome Measure: Determining whether ATP level changes were significantly different between treatment groups was the main outcome measure. Results: Treatment with 4000 IU of vitamin D3 decreased intracellular CD4+ ATP release by 95.5 ng/ml (interquartile range, −219.5 to 105.8). In contrast, 400 IU of vitamin D3 decreased intracellular CD4+ ATP release by 0.5 ng/ml (interquartile range, −69.2 to 148.5). In a proportional odds model, high-dose vitamin D3 was more likely than low-dose vitamin D3 to decrease CD4+ ATP release (odds ratio, 3.43; 95% confidence interval, 1.06–1.11). Conclusions: In this ancillary study of a randomized controlled trial, we found that high-dose vitamin D3 significantly reduced CD4+ T-cell activation compared to low-dose vitamin D3, providing human evidence that vitamin D can influence cell-mediated immunity.


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