Evaluation of Vitamin D Supplementation Doses during Pregnancy in a Population at High Risk for Deficiency

Abstract Background Vitamin D deficiency represents a global health problem, affecting children and adolescents worldwide. Objects To confirm that vitamin D deficiency can present as a spectrum of clinical pictures. Methods We diagnosed nutritional rickets in a 10-month-old infant of Senegal origin with several risk factors for vitamin D deficiency. As many of these factors affected also his cohabitant relatives, we evaluate infant’s family members (mother and 4 brothers) looking for other vitamin D deficiency-related comorbidities. Results 3 brothers had asymptomatic vitamin D deficiency and 2 of them (9.8 and 13.4 years-old) showed secondary hyperparathyroidism. The fourth brother (11.3 years-old) had nutritional rickets. Their mother was affected by osteomalacia. None of them received vitamin D supplementation. Conclusion Vitamin D deficiency may present as a spectrum of clinical pictures, representing a continuum ranging from asymptomatic/subtle conditions to overt rickets/osteomalacia. Immigrant families are at high risk for vitamin D deficiency at every age. If a case of symptomatic vitamin D deficiency is recognized, then the evaluation of the all family members is recommended, as they can have the same and/or other risk factors for vitamin D deficiency.

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Abstract P1-07-01: Safety of High-Dose Vitamin D Supplementation in Premenopausal Women at High Risk for Breast Cancer

10.1158/0008-5472.sabcs10-p1-07-01 ◽

2010 ◽

Cited By ~ 1

Author(s):

SF Refice ◽

DL Hershman ◽

MA Maurer ◽

K Kalinsky ◽

S Feldman ◽

...

Keyword(s):

Breast Cancer ◽

Vitamin D ◽

High Risk ◽

Premenopausal Women ◽

Vitamin D Supplementation ◽

High Dose ◽

High Dose Vitamin

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The effect of vitamin D supplementation on survival in patients with colorectal cancer: systematic review and meta-analysis of randomised controlled trials

British Journal of Cancer ◽

10.1038/s41416-020-01060-8 ◽

2020 ◽

Vol 123 (11) ◽

pp. 1705-1712 ◽

Cited By ~ 1

Author(s):

Peter G. Vaughan-Shaw ◽

Louis F. Buijs ◽

James P. Blackmur ◽

Evi Theodoratou ◽

Lina Zgaga ◽

...

Keyword(s):

Colorectal Cancer ◽

Vitamin D ◽

High Risk ◽

Meta Analysis ◽

Vitamin D Supplementation ◽

Risk Of Bias ◽

Survival Outcomes ◽

Vitamin D Levels ◽

Randomised Controlled ◽

Incident Cases

Abstract Background Low circulating vitamin D levels are associated with poor colorectal cancer (CRC) survival. We assess whether vitamin D supplementation improves CRC survival outcomes. Methods PubMed and Web of Science were searched. Randomised controlled trial (RCTs) of vitamin D supplementation reporting CRC mortality were included. RCTs with high risk of bias were excluded from analysis. Random-effects meta-analysis models calculated estimates of survival benefit with supplementation. The review is registered on PROSPERO, registration number: CRD42020173397. Results Seven RCTs (n = 957 CRC cases) were identified: three trials included patients with CRC at outset, and four population trials reported survival in incident cases. Two RCTs were excluded from meta-analysis (high risk of bias; no hazard ratio (HR)). While trials varied in inclusion criteria, intervention dose and outcomes, meta-analysis found a 30% reduction in adverse CRC outcomes with supplementation (n = 815, HR = 0.70; 95% confidence interval (CI): 0.48–0.93). A beneficial effect was seen in trials of CRC patients (progression-free survival, HR = 0.65; 95% CI: 0.36–0.94), with suggestive effect in incident CRC cases from population trials (CRC-specific survival, HR = 0.76; 95% CI: 0.39–1.13). No heterogeneity or publication bias was noted. Conclusions Meta-analysis demonstrates a clinically meaningful benefit of vitamin D supplementation on CRC survival outcomes. Further well-designed, adequately powered RCTs are needed to fully evaluate benefit of supplementation in augmenting ‘real-life’ follow-up and adjuvant chemotherapy regimens, as well as determining optimal dosing.

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Successful public health action to reduce the incidence of symptomatic vitamin D deficiency

Archives of Disease in Childhood ◽

10.1136/archdischild-2012-302287 ◽

2012 ◽

Vol 97 (11) ◽

pp. 952-954 ◽

Cited By ~ 32

Author(s):

Robert John Moy ◽

Eleanor McGee ◽

Geoff D Debelle ◽

Ian Mather ◽

Nicholas J Shaw

Keyword(s):

Vitamin D ◽

High Risk ◽

Vitamin D Deficiency ◽

Incidence Rate ◽

Uptake Rate ◽

Public Awareness ◽

Vitamin D Supplementation ◽

Minority Population ◽

Vitamin Supplement ◽

Vitamin D Levels

BackgroundIn response to a resurgence of symptomatic cases of vitamin D deficiency in a high-risk predominantly ethnic minority population, a programme of universal rather than targeted vitamin D supplementation was begun with a public awareness campaign about the importance of vitamin D.ObjectiveTo evaluate the effectiveness of this programme in reducing case numbers.MethodsCases of symptomatic vitamin D deficiency in children under 5 years resident in a primary care trust catchment area presenting at local hospitals were identified through laboratory records of low vitamin D levels which were cross-checked against medical records to confirm the diagnosis. Comparisons were made of the case incidence rate, level of public knowledge and vitamin supplement uptake rate at the onset of the programme in 2005 and 4 years later.ResultsThe number of cases of symptomatic vitamin D deficiency in those under 5 years fell by 59% (case incidence rate falling from 120/100 000 to 49/100 000) despite the supplement uptake rate rising only to 17%. Public awareness of vitamin D deficiency rose to near universal levels.ConclusionsA programme of universal rather than targeted Healthy Start vitamin D supplementation for pregnant and lactating women and young children has led to a substantial decrease in cases of symptomatic vitamin D deficiency in a high-risk population. Supplementation was also started at a younger age than in the national programme. This approach has implications for the delivery of vitamin D supplementation programmes in similar populations.

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COvid-19 and high-dose VITamin D supplementation TRIAL in high-risk older patients (COVIT-TRIAL): study protocol for a randomized controlled trial

Trials ◽

10.1186/s13063-020-04928-5 ◽

2020 ◽

Vol 21 (1) ◽

Author(s):

Cédric Annweiler ◽

◽

Mélinda Beaudenon ◽

Jennifer Gautier ◽

Romain Simon ◽

...

Keyword(s):

Vitamin D ◽

Randomized Controlled Trial ◽

High Risk ◽

Older Patients ◽

Standard Dose ◽

Controlled Trial ◽

Vitamin D Supplementation ◽

High Dose ◽

Randomized Controlled ◽

High Dose Vitamin

Abstract Background With the lack of effective therapy, chemoprevention, and vaccination against SARS-CoV-2, focusing on the immediate repurposing of existing drugs gives hope of curbing the COVID-19 pandemic. A recent unbiased genomics-guided tracing of the SARS-CoV-2 targets in human cells identified vitamin D among the three top-scoring molecules manifesting potential infection mitigation patterns. Growing pre-clinical and epidemiological observational data support this assumption. We hypothesized that vitamin D supplementation may improve the prognosis of COVID-19. The aim of this trial is to compare the effect of a single oral high dose of cholecalciferol versus a single oral standard dose on all-cause 14-day mortality rate in COVID-19 older adults at higher risk of worsening. Methods The COVIT-TRIAL study is an open-label, multicenter, randomized controlled superiority trial. Patients aged ≥ 65 years with COVID-19 (diagnosed within the preceding 3 days with RT-PCR and/or chest CT scan) and at least one worsening risk factor at the time of inclusion (i.e., age ≥ 75 years, or SpO2 ≤ 94% in room air, or PaO2/FiO2 ≤ 300 mmHg), having no contraindications to vitamin D supplementation, and having received no vitamin D supplementation > 800 IU/day during the preceding month are recruited. Participants are randomized either to high-dose cholecalciferol (two 200,000 IU drinking vials at once on the day of inclusion) or to standard-dose cholecalciferol (one 50,000 IU drinking vial on the day of inclusion). Two hundred sixty participants are recruited and followed up for 28 days. The primary outcome measure is all-cause mortality within 14 days of inclusion. Secondary outcomes are the score changes on the World Health Organization Ordinal Scale for Clinical Improvement (OSCI) scale for COVID-19, and the between-group comparison of safety. These outcomes are assessed at baseline, day 14, and day 28, together with the serum concentrations of 25(OH)D, creatinine, calcium, and albumin at baseline and day 7. Discussion COVIT-TRIAL is to our knowledge the first randomized controlled trial testing the effect of vitamin D supplementation on the prognosis of COVID-19 in high-risk older patients. High-dose vitamin D supplementation may be an effective, well-tolerated, and easily and immediately accessible treatment for COVID-19, the incidence of which increases dramatically and for which there are currently no scientifically validated treatments. Trial registration ClinicalTrials.govNCT04344041. Registered on 14 April 2020 Trial status Recruiting. Recruitment is expected to be completed in April 2021.

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Safety, Feasibility, and Biomarker Effects of High-Dose Vitamin D Supplementation Among Women at High Risk for Breast Cancer

International Journal of Food Science Nutrition and Dietetics ◽

10.19070/2326-3350-si01001 ◽

2015 ◽

pp. 1-9 ◽

Cited By ~ 1

Author(s):

Crew KD ◽

◽

Xiao T ◽

Thomas PS ◽

Terry MB ◽

...

Keyword(s):

Breast Cancer ◽

Vitamin D ◽

High Risk ◽

Vitamin D Supplementation ◽

High Dose ◽

High Dose Vitamin

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Randomized Double-Blind Placebo-Controlled Biomarker Modulation Study of Vitamin D Supplementation in Premenopausal Women at High Risk for Breast Cancer (SWOG S0812)

Cancer Prevention Research ◽

10.1158/1940-6207.capr-18-0444 ◽

2019 ◽

Vol 12 (7) ◽

pp. 481-490 ◽

Cited By ~ 2

Author(s):

Katherine D. Crew ◽

Garnet L. Anderson ◽

Dawn L. Hershman ◽

Mary Beth Terry ◽

Parisa Tehranifar ◽

...

Keyword(s):

Breast Cancer ◽

Vitamin D ◽

High Risk ◽

Premenopausal Women ◽

Vitamin D Supplementation ◽

Double Blind ◽

Double Blind Placebo

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Vitamin D Supplementation to Prevent COVID-19 Infections and Deaths—Accumulating Evidence from Epidemiological and Intervention Studies Calls for Immediate Action

Nutrients ◽

10.3390/nu13020411 ◽

2021 ◽

Vol 13 (2) ◽

pp. 411 ◽

Cited By ~ 1

Author(s):

Hermann Brenner

Keyword(s):

Vitamin D ◽

High Risk ◽

Large Scale ◽

Intervention Studies ◽

Health Care Systems ◽

Vitamin D Insufficiency ◽

Vitamin D Supplementation ◽

High Dose ◽

World Population ◽

High Risk Populations

The COVID-19 pandemic poses an unprecedented threat to human health, health care systems, public life, and economy around the globe. The repertoire of effective therapies for severe courses of the disease has remained limited. A large proportion of the world population suffers from vitamin D insufficiency or deficiency, with prevalence being particularly high among the COVID-19 high-risk populations. Vitamin D supplementation has been suggested as a potential option to prevent COVID-19 infections, severe courses, and deaths from the disease, but is not widely practiced. This article provides an up-to-date summary of recent epidemiological and intervention studies on a possible role of vitamin D supplementation for preventing severe COVID-19 cases and deaths. Despite limitations and remaining uncertainties, accumulating evidence strongly supports widespread vitamin D supplementation, in particular of high-risk populations, as well as high-dose supplementation of those infected. Given the dynamics of the COVID-19 pandemic, the benefit–risk ratio of such supplementation calls for immediate action even before results of ongoing large-scale randomized trials become available.

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