Vitamin D Deficiency in Patients With Idiopathic and Traumatic Osteochondritis Dissecans of the Talus

2019 ◽  
Vol 40 (11) ◽  
pp. 1309-1318 ◽  
Author(s):  
Lukas Fraissler ◽  
Sebastian Philipp Boelch ◽  
Thomas Schäfer ◽  
Matthias Walcher ◽  
Jörg Arnholdt ◽  
...  

Background: Low vitamin D levels are common in patients with foot and ankle disorders. We have previously demonstrated that juveniles diagnosed with osteochondritis dissecans (OCD) have a high prevalence of vitamin D deficiency. Moreover, there is evidence that OCD might be related to vitamin D deficiency in general. However, whether or not hypovitaminosis D is associated with OCD of the talus has yet to be elucidated. Methods: The aim of this study was to determine serum vitamin D levels [25(OH)D] of patients diagnosed with traumatic and idiopathic OCD of the talus. The vitamin D status of patients was measured and correlated to age, sex, season, etiology, laterality, degree of disease, and nicotine abuse. Moreover, parathyroid hormone and serum calcium levels of patients were obtained to assess for severe vitamin D deficiency and secondary hyperparathyroidism. Between January 2015 and December 2017, 65 patients with a mean age of 38.9 years and a total of 68 lesions were identified. Results: In total, 75.4% of patients had low vitamin D levels with a mean overall 25(OH)D level of 24.2 ng/mL. Specifically, 35.4% of patients were vitamin D deficient; another 40% were vitamin D insufficient, and only 24.6% of patients presented with sufficient vitamin D levels. Statistical analysis showed no significant difference comparing vitamin D levels of patients with idiopathic OCD to patients with traumatic OCD. Conclusion: We could not find any significant differences in the vitamin D status of patients with OCD of the talus compared with patients with foot and ankle disorders in general. However, we found that vitamin D deficiency was frequent in patients presenting with traumatic and idiopathic OCD of the talus. We believe it might be beneficial to routinely assess and treat the vitamin D status of patients. Level of Evidence: Level III, retrospective comparative study.

2020 ◽  
Vol 90 (5-6) ◽  
pp. 470-476 ◽  
Author(s):  
Ozge Yagcioglu Yassa ◽  
Saime Fusun Domac ◽  
Gulay Kenangil

Abstract. Observational studies performed in homogeneous groups to objectively investigate the cause and effect relationship between vitamin D deficiency and sleep disorders are scarce. In this study, it was aimed to analyze the relationship between the severity of OSAS and vitamin-D levels among the participants whose features affecting serum vit-D levels were minimised. Serum 25-OH vitamin-D levels in 121 OSAS Male patients diagnosed by polysomnography without any systemic disease or vitamin-D supplement that may effect the vitamin-D metabolism were measured. The study was conducted in winter (latitude: 41°). Anthropometric measures and biochemical tests were also performed. The distribution of vitamin-D levels was determined as severe deficiency, deficiency, insufficiency and sufficiency. Apnea-hypopne index (AHI) < 5 was considered as a control group. Patients were categorized into four groups according to AHI as control, mild, moderate and severe. The groups were similar in terms of age, BMI, lipid profile, serum calcium, anthropometric measures and smoking. There was no significant difference in the distribution of vitamin-D levels between the patient and control groups and also within OSAS subgroups (p = 0.57, p = 0.86, respectively). Odds ratio to have OSAS in patients with vitamin-D deficiency was found as 0.745 (95 %CI: 0.33–1.7). Multinominal regression analysis showed no significant relationship between the OSAS severity and the extent of vitamin-D status. Correlation analysis showed no significant relationship between vitamin-D and AHI (r = 0.017, p = 0.877). Vitamin-D status does not alter the severity of OSAS. Vitamin-D deficiency might be the result of lifestyle changes due to OSAS rather than a cause.


2017 ◽  
Vol 19 (1) ◽  
pp. 22-29 ◽  
Author(s):  
Homayra Tahseen Hossain ◽  
Quazi Tarikul Islam ◽  
Md Abul Kashem Khandaker ◽  
HAM Nazmul Ahasan

Background: Recently, we see in our clinical practice that many patients who are coming with generalized body aches and pains and diagnosed as fibromyalgia or chronic fatigue, not adequately responding to treatment. When their vitamin D level was done, it was found to be low and correction of their low vitamin D level improved their symptoms dramatically. Despite abundant sunshine in Bangladesh, allowing vitamin D synthesis all the year round, why our people are developing hypovitaminosis D inspired us to do this current study. Our present study is designed to estimate the prevalence of vitamin D deficiency among adult patients presented with aches & pains as well as to study the association of low vitamin D levels with different socio-demographic parameters.Methods: A cross sectional observational study was conducted among 212 adult patients aged 18 years and above presented with generalized body aches and pains, attended both outpatient and inpatient departments of Popular Medical College Hospital during the period of March’16- August’16 ( 6 months). Association between vitamin D status & the individual specific variables was statistically analyzed.Results: The prevalence of vitamin D deficiency among the study population was found to be100% in all age groups. Among 212 study population, 73.6% were female (n=156) & 26.4% were male (n=56). Mean Vitamin D level among male was 14.29 (SD 4.68) & among female was 12.64 (SD 4.74). The factors associated with severely deficient Vitamin D level were female sex, urban population, &obesity. It is alarming that 64.2% of our study population were totally unaware about the importance of sun exposure.Conclusions: Vitamin D status was associated with a number of socio-demographic variables. Knowledge of these variables may improve targeted education and public health initiatives.J MEDICINE Jan 2018; 19 (1) : 22-29


Author(s):  
Ji-hyun Lee ◽  
Seo-rin Doo ◽  
Dongha Kim ◽  
Yoo-kyoung Park ◽  
Eun-jeong Park ◽  
...  

Abstract. Critically ill patients in intensive care units (ICUs) are exposed to various risk factors for vitamin D deficiency. Vitamin D deficiency in extended-stay patients may result in decreased muscle mass and increased fat tissue, which may impair rehabilitation and recovery. Our study aimed to evaluate the degree of serum vitamin D deficiency in critically ill surgical patients and its association with clinical outcomes. Clinical data from 186 adult male (n = 121; 65.1%) and female (n = 65; 34.9%) patients hospitalized in surgical ICUs at Ajou University Hospital from April 2015 to September 2016 were retrospectively analyzed. All adult surgical patients between the age of 18 and 88 years were enrolled. The mean serum 25-hydroxyvitamin D (25[OH]D) level of all patients was 17.8 ng/mL. A total of 120 patients (64.5%) with serum 25(OH)D levels < 20 ng/mL were classified as the deficiency group. A prolonged hospital stay was observed among the deficiency group but was not statistically significant ( p = 0.824). Serum 25(OH)D levels were significantly correlated with age but inversely correlated with Sequential Organ Failure Assessment (SOFA) score, selenium, triglyceride, and C-reactive protein levels. There was no significant difference in mortality rates between the group with a vitamin D injection and the group without a vitamin D injection (14.6% vs. 16.9%, p = 0.074). Vitamin D deficiency was common in surgical ICU patients; however, vitamin D levels were higher in older patients. In conclusion, vitamin D deficiency was inversely associated with the SOFA severity score (Correlation Coefficient –0.165, p = 0.024) but was not associated with the length of hospital or ICU stay and mortality.


2021 ◽  
pp. 1-2
Author(s):  
Firdushi Begum ◽  
Papori Borah

Introduction : Till the 20th century deficiency of vitamin D which is synthesized in the skin upon exposure to UVB light was largely unknown. But today vitamin D deficiency has taken an epidemic form and is linked with many disease conditions. Several studies have put forward a very high prevalence of vitamin D deficiency among Indians of all age groups. Aims and objectives : To study the vitamin D status of people visiting a tertiary care centre in India. Materials and Methods : This is a prospective observational study conducted in the Biochemistry section of Central Clinical Laboratory of Gauhati Medical College & Hospital (GMCH). All the vitamin D reports generated in the laboratory for a period of 9 months were recorded and analysed to estimate the prevalence. Similar to other vitamin D studies, 20ng/ml was taken as the cut-off for vitamin D deficiency, 30ng/ml for insufficiency, and 30-100ng/ml as the normal vitamin D range. Results and Observations : In this study Vitamin D data of 1000 patients admitted in GMCH was analysed. Of them females outnumbered males (68.7% vs 31.3%). Of the 1000 vitamin D reports analysed 51.9% were found to be in the insufficient range, followed by 30.1% in the normal range. In 17.5% vitamin D levels were found to be deficient Vitamin D status was found to be lower in females as compared to males. 86.75% of females were either vitamin D deficient or insufficient and 71.88% of males were either deficient or insufficient. Conclusion : In this study 17.5% of study subjects had vitamin D level <20ng/ml, which may be considered as deficient, as per the Institute of Medicine(IOM) which considers a serum vitamin D value of 20 ng/ml as optimal. According to the U.S. Endocrine Society 30 ng/ml is optimal. Due to this variation the recommended daily intakes of this nutrient also vary.


Author(s):  
JINAN Q MOHAMMED ◽  
ABDULSATAR J MATHKHOR ◽  
AMER S KHUDHAIRY

Objective: The objective of this study is to investigate the association between Vitamin D level and psoriasis, in particular in our city of the long, hot, and sunny weather, in an attempt to add a clarification to this controversial subject. Methods: A case–control study included 120 patients with psoriasis and 38 patients with psoriatic arthritis (PsA); 89 (56.3%) patients were male. Psoriasis area and severity index (PASI) was calculated for all patients with psoriasis and disease activity score using 28 joints (DAS28) and erythrocyte sedimentation rate (DAS28) was measured for all patients with PsA. The control group comprised 164 age- and sex-matched participants (91 males and 73 females). Vitamin D serum level was performed for both patients and controls. Results: Vitamin D levels in both patients and controls were 17.4±7.7 and 28.3±5.6, respectively. The level of Vitamin D was lower in a patient with disease duration equal and more than 10 years than those with a disease duration <10 years. There is no significant difference in Vitamin D levels between the two patient subgroups. Lower Vitamin D levels were associated with high PASI and high DAS28 in psoriasis and PsA, respectively. Conclusion: Patients with psoriasis and PsA associated with low levels of serum Vitamin D. Vitamin D deficiency was found to be associated with long disease duration in both psoriasis and PsA. Patients with active disease have lower Vitamin D levels.


2020 ◽  
Author(s):  
Jin Woo Park ◽  
Sung Taeck Kim ◽  
Kyu Sang Lee ◽  
Hyun Sik Gong

Abstract BackgroundDupuytren’s disease(DD) is a progressive fibroproliferative condition involving contractures of the fascia of the palm. Up to now, there are no relevant investigations on patients with DD in case of serum vitamin D deficiency. We hypothesized that transforming growth factor-β1 (TGF-β1) is increased in patients with DD in consequence of vitamin D deficiency, thereby leading to myofibroblast differentiation and subsequent progression of contractures. MethodsThe study’s aim was to analyze serum vitamin D levels and explore possible clinical and immunohistochemical correlates with vitamin D concentrations in a group of patients with DD. Vitamin D levels were measured in all DD patients and healthy controls. In the patient group, clinical characteristics were compared between vitamin D deficient and non-deficient subgroups. Diseased palmar fascia samples were obtained from 14 patients undergoing fasciectomy for DD. Correlations between vitamin D levels and vitamin D receptor(VDR), TGF-β1 expression levels in collected fascia samples were evaluated. ResultsVitamin D concentrations were significantly lower in patients than healthy controls. In addition, total extension deficit of involved fingers was higher in vitamin D deficient patients. Moreover, a positive correlation was found between vitamin D levels and expression of VDR in pathologic fascia in patients undergoing fasciectomy for contracture. Serum vitamin D levels were found to be low in DD patients. Expression of VDR was lower in the vitamin D deficient group.ConclusionsThe results suggest a potential link between vitamin D status and DD but causation is not yet established. The potential role of vitamin D and its interaction with VDR and the TGF-β1 signaling pathway in the pathogenesis of DD needs to be explored further.


2019 ◽  
Vol 99 (7) ◽  
pp. 460-463 ◽  
Author(s):  
Burçin Nalbantoğlu ◽  
Ayşin Nalbantoğlu

Background: Recurrent aphthous stomatitis is one of the most prevalent oral mucosa diseases and the etiology is unclear. As a potent anti-inflammatory and immunomodulating agent, vitamin D can significantly affect oral cavity homeostasis. However, to the best of our knowledge, no study has been conducted in pediatric population on the potential role of vitamin D in recurrent aphthous stomatitis to date. The aim of the present study is to determine the vitamin D status in recurrent aphthous stomatitis in children. Methods: This study is conducted retrospectively. Seventy-two patients with minor recurrent aphthous stomatitis and 70 age-matched healthy controls included in the study. 25-Hydroxyvitamin D levels were measured in all patients using enzyme immunoassay. Results: Serum vitamin D levels were 16.4 (8.6) ng/mL in patient group and 23.1 (11.5) ng/mL in healthy controls. There was a statistically significant difference between the groups in terms of serum vitamin D levels ( P = .002). There was no significant correlation between serum vitamin D levels and the severity of the recurrent aphthous stomatitis ( r = 0.54, P = .76). Conclusions: Our study showed a significant difference in vitamin D levels between patients with recurrent aphthous stomatitis and the healthy control group. We also found no correlation between vitamin D status and the severity of the disease.


2015 ◽  
Vol 37 (5) ◽  
pp. 1686-1692 ◽  
Author(s):  
Hui Zhang ◽  
Hui Zhang ◽  
Xiuhua Wen ◽  
Yonggang Zhang ◽  
Xueli Wei ◽  
...  

Background/Aims: Vitamin D status in relation to bladder carcinoma risk was still inconsistent. This study was carried out to evaluate the relationship between vitamin D status and bladder carcinoma risk through a meta-analysis approach. Methods: Pubmed, Web of Science, CNKI, and Embase were searched systemically to find eligible studies from the earliest available date to April 16, 2015. The search terms “vitamin D”, “25-hydroxyvitamin D”, “bladder cancer” or “bladder carcinoma” were used to retrieve relevant studies. The exposure of interest was intake of vitamin D or serum vitamin D levels, and the outcome of interest was bladder carcinoma incidence or mortality. The pooled risk ratio (RR) values and their 95%CIs were calculated through meta-analysis. Results: Seven studies with a total of 62,141 participants met the inclusion criteria and were finally included into the meta-analysis. There was no heterogeneity among those included studies (I2 = 0%, P = 0.53). The pooled RR of bladder carcinoma for the lowest category versus the highest category of vitamin D was 1.34 (95% CI 1.17-1.53, P < 0.0001). Sensitivity analysis by omitting one study by turns showed all the pooled RRs were statistically significant. Meta-analysis of 5 studies reporting outcomes of serum vitamin D levels also showed that the low serum vitamin D level was associated with increased risk of bladder carcinoma (RR = 1.32, 95%CI 1.15-1.52, P = 0.0001). No obvious risk of publication bias was observed. Conclusion: Vitamin D deficiency is associated with increased risk of bladder carcinoma in present study.


BMJ Open ◽  
2017 ◽  
Vol 7 (9) ◽  
pp. e017557 ◽  
Author(s):  
Xin Zhao ◽  
Yanli Yuan ◽  
Yan Lin ◽  
Tiejuan Zhang ◽  
Jianjun Ma ◽  
...  

ObjectiveThe association between tuberculosis (TB), diabetes mellitus (DM) and vitamin D status is poorly characterised. We therefore: (1) determined vitamin D status in patients with TB in relation to whether they had normal fasting blood glucose (FBG), pre-DM or DM and (2) assessed whether baseline characteristics in patients with TB, including their DM status, were associated with vitamin D deficiency.MethodsIn patients with TB consecutively attending six clinics or hospitals in China, we measured 25-hydroxycholecalciferol (25-(OH)D3) at the time of registration using electrochemiluminescence in a COBASE 601 Roche analyser by chemiluminescence immunoassay. Data analysis was performed using the χ2test, ORs and multivariate logistic regression.ResultsThere were 306 eligible patients with TB, including 96 with smear positive pulmonary TB, 187 with smear negative pulmonary TB and 23 with extrapulmonary TB. Of these, 95 (31%) had normal blood glucose, 83 (27%) had pre-DM and 128 (42%) had DM. Median serum vitamin D levels were 16.1 ng/mL in patients with TB with normal FBG, 12.6 ng/mL in patients with TB with pre-DM and 12.1 ng/mL in patients with TB with DM (p<0.001). The study highlighted certain baseline characteristics associated with vitamin D deficiency (25-(OH)D3<20 ng/mL). After adjusting for confounders, serum vitamin D deficiency was significantly more common in patients being registered in the cold season (November to April) (p=0.006) and in those with DM (p=0.003).ConclusionVitamin D levels are lower in patients with TB with pre-DM and DM and are also affected by certain baseline characteristics that include being registered in the cold season and having DM. TB programmes need to pay more attention to vitamin D status in their patients, especially if there is coexisting pre-DM or DM.


2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 1246.1-1246
Author(s):  
M. M. Sirufo ◽  
F. De Pietro ◽  
M. Raggiunti ◽  
M. De Martinis ◽  
L. Ginaldi

Background:Systemic Sclerosis (SSc) is a generalized and systemic autoimmune disease that affects the connective tissue of the skin and internal organs, especially kidneys, heart and lungs [1].Objectives:Numerous data from recent literature confirm the regulatory action of vitamin D on the immune system and, therefore, how a deficit of this micronutrient can lead to alterations in the immune response, as is known to happen in many allergic and autoimmune diseases [2]. We studied the association between vitamin D levels and SSc, evaluating their correlation with the characteristic manifestations of the pathology.Methods:We dosed the serum levels of 25 hydroxy-vitamin D in 42 patients with SSc (average age 64.63 +/-7.33) and 40 healthy controls comparable for sex and age. The diagnosis of SSc was formulated in accordance to 2013 ACR/EULAR criteria. None of the subjects involved in the study took vitamin D products.Results:Patients’ vitamin D levels (26.22+/-9.82 ng/ml), although they tended to be lower than controls (27.80 +/- 16.53 ng/ml), showed no significant decrease. In patients with pulmonary fibrosis, vitamin D levels were 23.28 +/- 12.30 lower than in patients with trophic ulcers and compared to patients without complications 26.07 +/- 9.92, although with not statistically significant values. No statistically significant difference was found between vitamin D levels in patients with trophic ulcers compared to controls without complications.Conclusion:According to the studies in the literature, in our sample, vitamin D deficiency was therefore greater in patients with SSc, especially with pulmonary fibrosis, than in controls [3,4]. Vitamin D levels in diffused-type SSc patients were significantly lower than those in limited-type SSc patients. Further studies are needed to clarify the role that vitamin D deficiency plays in SSc, but lower vitamin D levels in these patients may suggest the need to monitor blood levels of vitamin D and supplement it appropriately.References:[1]De Martinis M, Ciccarelli F, Sirufo MM, Ginaldi L. An overview of environmental risk factors in systemic sclerosis. Expert Rev Clin Immunol. 2016;12(4):465-78. doi: 10.1586/1744666X.2016.1125782. Epub 2015 Dec 19. PMID: 26610037.[2]Yang, CY., Leung, P.S.C., Adamopoulos, I.E. et al. The Implication of Vitamin D and Autoimmunity: a Comprehensive Review. Clinic Rev Allerg Immunol45, 217–226 (2013). https://doi.org/10.1007/s12016-013-8361-3.[3]Trombetta AC, SmithV, Gotelli E, Ghio M, Paolino S, Pizzorni C, et al. (2017) Vitamin D deficiency and clinical correlationsin systemic sclerosis patients: A retrospective analysis for possible future developments. PLoS ONE 12(6): e0179062.https://doi.org/10.1371/journal. pone.0179062.[4]Sarita Gupta, Vikram K. Mahajan, Rajinder S. Yadav1, Karaninder S. Mehta, Satya Bhushan1, et al. Evaluation of Serum Vitamin D Levels in Patients with Systemic Sclerosis and Healthy Controls: Results of a Pilot Study Article July 2018 DOI: 10.4103/idoj.IDOJ_328_17.Disclosure of Interests:None declared


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