scholarly journals Vitamin D Deficiency Predicts for Poor Overall Survival in Caucasian but Not African American Patients with Multiple Myeloma

Blood ◽  
2018 ◽  
Vol 132 (Supplement 1) ◽  
pp. 1890-1890
Author(s):  
Sarvari Venkata Yellapragada ◽  
Anna Frolov ◽  
Nathanael Fillmore ◽  
Pallavi Dev ◽  
Sumaira Shafi ◽  
...  

Abstract Background: A number of studies have reported elevated incidence of 25-OH-vitamin D deficiency among patients with multiple myeloma (MM). Several studies have found association between vitamin D levels and factors associated with survival, including ISS stage at diagnosis. However, the impact of vitamin D deficiency on MM prognosis is not entirely clear. Also, in general, both the incidence and the impact of vitamin D deficiency differ substantially by race. Here, we investigate the impact of vitamin D deficiency on prognosis in a large and racially heterogenous patient population with MM in the Veterans Affairs (VA) system. Methods: We used the VA's nationwide Corporate Data Warehouse to identify patients diagnosed with symptomatic MM from 1999 to 2017. Various demographic and laboratory data was collected including age, race, 25-OH-vitamin D levels, and ISS stage at diagnosis as well as survival outcome data. Details of therapies received was also available which indicted similar access to all newer agents approved for myeloma for both African American (AA) and Caucasian patients. Results: We identified 15,717 patients diagnosed with MM (3353 AA and 9070 Caucasian), of whom 6675 had vitamin D measurements within 2 months of diagnosis (1959 AA and 4398 Caucasian). Median serum vitamin D levels were significantly lower among AA patients (21.8 ng/mL) than Caucasians (28.6 ng/mL; p<0.0001). No difference in median vitamin D levels was observed across ISS stage at diagnosis (p=0.7575), but a significant positive correlation (ρ=0.166; p<0.0001) was found between vitamin D levels and age at diagnosis. We evaluated the ability of serum vitamin D level to predict overall survival (OS) in patients with MM using a cut-off of 20ng/mL. Patients with vitamin D deficiency (<20ng/mL) had a significantly worse prognosis than patients with normal levels (≥20ng/mL) (Fig 1A). Specifically, median OS was 3.10 years (95% CI 2.73-3.52) for patients with vitamin D deficiency, compared to 3.91 years (95% CI 3.59-4.38) for patients with normal serum vitamin D. Univariate Cox proportional hazard analysis also showed that vitamin D deficiency is a significant predictor of OS after MM diagnosis (HR 1.24; P=0.0021), and vitamin D deficiency remained an independent predictor of OS under multivariate analysis in which adjustments were made for race, age, and stage at diagnosis (HR 1.28; P=0.0385). The analyses were repeated for AA and Caucasian patients separately. Among AA patients, serum vitamin D was not a significant predictor of OS in univariate (P=0.5096) or multivariate analysis (P=0.6923), while it was still a strong predictor among Caucasian patients in both univariate (HR 1.38; P=0.0006) and multivariate analysis (HR 1.45; P=0.0048). Median OS is 3.54 years (95% CI 2.99-5.52; n=255) for AA patients with vitamin D deficiency and 3.95 years (3.25-5.35; n=296) with normal levels. Among Caucasians, median OS is 2.71 years (2.18-3.47; n=273) for deficient and 3.87 years (3.59-4.42; n=885) for normal. Kaplan-Meier plots (Fig. 1B and 1C) illustrate the observed OS curves for the two subgroups. Since levels of vitamin D were lower in AA patients, a lower cut-off of 10 ng/mL was also tested. Even using this lower cutoff, vitamin D deficiency was not a statistically significant predictor of OS in univariate (HR 1.33; P=0.0781) or multivariate analysis (HR 1.09; P=0.7039), though the number of AA patients with vitamin D <10 ng/ML is small (n=73). Conclusions: Vitamin D deficiency is a significant predictor of survival among patients diagnosed with MM, even after accounting for race, age, and ISS stage. However, this relationship is only observed in Caucasian patients and not observed among AA patients. Studies are ongoing to evaluate impact of Vitamin D deficiency of disease presentation including bone disease as well as genetic characteristics. This investigation highlights the need to assess the underlying biological mechanism responsible for the observed impact of vitamin D deficiency across race in MM. Figure 1. Figure 1. Disclosures Yellapragada: Novartis: Employment; Celgene: Research Funding; Takeda: Research Funding. Munshi:OncoPep: Other: Board of director.

Vitamin D is highly essential for various functions of human body including proper immunity. Deficiency of vitamin D is mostly undetected and also a major underlying cause for various diseases and disorders .The Prevalence of Vitamin D deficiency in India is very high, detection and immediate management of severe vitamin D deficiency is an essential step especially given the current situation of the COVID 19 Pandemic where proper immunity is an important factor for survival. This case series is an update on the impact of 5 day continuous dosing with oral Nano Vit.D3 on serum vitamin D levels in individuals with severe vitamin D deficiency without co-morbidities


2021 ◽  
Vol 28 (1) ◽  
pp. E202113
Author(s):  
Sevil Karahan Yılmaz ◽  
Cuma Mertoğlu ◽  
Aylin Ayaz

Aim: This study is aimed to evaluate the relationship between serum vitamin D levels and metabolic syndrome in hemodialysis patients. Materials and Methods: This study was conducted with participation of 80 patients undergoing hemodialysis for more than 6 months three times a week, aged > 18 years. Their height, dry weight, waist circumference were measured. Biochemical parameters such as serum 25-hydroxyvitamin D, lipid profile, and fasting blood glucose were analyzed. Metabolic syndrome was defined using the National Cholesterol Education Program Adult Treatment Panel III criteria. Severe vitamin D deficiency, 25 (OH) vitamin D < 5 ng/ml; mild vitamin D deficiency, 25 (OH) vitamin D 5-15 ng/ml; vitamin D insufficiency, 25 (OH) vitamin D 16-30 ng/ml, and vitamin D sufficiency, 25 (OH) vitamin D > 30 ng/ml were categorized. Statistical analysis of the data was performed with the use of SPSS version 21.0. Results: 48.4% of hemodialysis patients were identified to have metabolic syndrome. According to the serum levels of vitamin D; 35.0% of patients had severe vitamin D deficiency, 37.4% of patients had mild vitamin D deficiency, 18.8% of patients had vitamin D insufficiency and 8.8% of patients had vitamin D sufficiency (> 30 ng/ml). Vitamin D insufficiency was significantly associated with metabolic syndrome and central obesity. Conclusions: Deficiency/insufficiency is observed in serum 25-hydroxyvitamin D levels in hemodialysis patients. Vitamin D insufficiency is associated with metabolic syndrome.


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 ◽  
Vol 3 (6) ◽  
pp. 111-116
Author(s):  
A. Mahmood ◽  
F. Rashid ◽  
D. Hawkes ◽  
W. J. Harrison

Purpose: There is controversy as to whether vitamin D deficiency is associated with increased mortality from coronavirus infection. The aim of the study was to assess the relationship between vitamin D levels and 30-day mortality in hip fracture patients co-infected with COVID-19. Methods: This was a national observational audit conducted between 23 March 2020 (start of UK lockdown) and 31st December 2020. The cohort consisted of patients aged >60 years presenting with a hip fracture. Patients were included if they had a vitamin D level done during the admission episode, diagnosis of COVID-19 infection via a viral reverse transcriptase PCR swab, and a hip fracture. There were 517 patients included in the study from 43 different hospital trusts. The primary outcome measure was 30-day mortality. Secondary outcomes were the percentage of patients who had vitamin D deficiency, the percentage of patients who were prescribed Vitamin D, and the impact of vitamin D prescribing on mortality Results: Vitamin D deficiency was not associated with a higher 30-day mortality. Low serum vitamin D was observed in 56% of the patients on admission. Vitamin D was prescribed prior to admission in 28% and during admission in a further 49%. Pre-hospital vitamin D therapy reduced the chance of vitamin D deficiency. Starting vitamin D before or on admission did not affect the mortality rates. Conclusion: Vitamin D deficiency was common, but not associated with a higher 30-day mortality in the hip fracture population co-infected with COVID-19.


2021 ◽  
Vol 10 (1) ◽  
pp. 21-27
Author(s):  
Esra Ulgen Temel ◽  
Kenan Kocabay ◽  
Aybars Ozkan

Aim: Vitamin D deficiency is an important public health problem, especially affecting children. The aim of our study is to evaluate the serum 25 (OH) vitamin D levels of children during the summer and to determine some features such as exposure to the sun, oral vitamin D supplementation, and to examine the parameters that affect serum vitamin D levels. Methods: In our study, children aged between 12 and 83 months were included. A questionnaire was answered by families. In this cross-sectional study, serum 25 (OH) vitamin D levels of children and biochemical parameters were examined. Results: The mean serum 25 (OH) vitamin D level was 27.0±12.4 ng/ml. Vitamin D deficiency was found 17%, and vitamin D insufficiency was 6%. The children that taking daycare indoors and body mass index <5th percentile had lower serum 25 (OH) vitamin D levels. Children between the ages of 12- 36 months and children with chronic diseases were found to have a shorter time to benefit from sunlight. Conclusion: The rate of vitamin D deficiency and insufficiency (<20 ng/ml) in children were found at 23% in summer season. Families and caregivers should be informed about vitamin D and should be aware of safe sun exposure. Keywords: Vitamin D, sunlight, summer, children, vitamin D deficiency


Author(s):  
Amrita Sandhu ◽  
Ruchira Nautiyal ◽  
Vinit Mehrotra ◽  
Sanober Wasim

Background: Maternal and fetal vitamin D deficiency has nowadays emerged as a frequent morbidity. Adequate vitamin D concentrations during pregnancy are necessary to maintain neonatal calcium homeostasis, bone maturation and mineralization. Objectives of this study were to evaluate serum vitamin D concentration in mothers and its correlation with neonatal cord blood vitamin D at the time of delivery and to study the impact of hypovitaminosis on neonatal anthropometry. Effect of related factors like calcium (Ca), alkaline phosphatase (ALP) and parathyroid hormone (PTH) on maternal vitamin D levels were to be evaluated.Methods: Cross sectional study was done on a total of 220 healthy uncomplicated antenatal females with singleton pregnancy attending labor room at the time of delivery. Maternal and neonatal cord blood samples were drawn in the delivery room and analyzed. Neonatal anthropometry was recorded. Correlations among various maternal and neonatal factors were studied.Results: Widespread vitamin D deficiency was observed in expectant subjects and neonates with 70.91% having deficient levels which were also reflected in newborns (71.82%). Maternal ALP (r= -0.5503, p=0.000) bears a weak negative correlation (p<0.05), maternal serum Ca positive correlation (r = 0.7486, p=0.000) and plasma PTH levels a negative correlation (r = -2.084, p=0.000) with hypovitaminosis. No significant correlation was observed between neonatal anthropometry and vitamin D levels.Conclusions: High prevalence of hypovitaminosis was observed among pregnant women and their neonates in this study. A positive linear relationship was seen between maternal and cord blood vitamin D (r 0.974, p 0.0001).


2015 ◽  
Vol 20 (3) ◽  
pp. 207-210 ◽  
Author(s):  
Masoud Maleki ◽  
Yalda Nahidi ◽  
Sahar Azizahari ◽  
Naser Tayyebi Meibodi ◽  
Ali Hadianfar

Background: Vitamin D has been shown to have immunomodulatory effects, and previous studies have proposed a role of vitamin D deficiency in multiple autoimmune diseases, including psoriasis. Objectives: The aim of this study was to investigate serum vitamin D levels in psoriatic patients and compare them with levels in controls. Methods: This study was carried out in 50 psoriasis patients. Serum vitamin D was measured by enzyme-linked immunosorbent assay. Results: The mean serum vitamin D levels in psoriatic patients and controls were 14.92 ± 6.31 and 12.52 ± 4.54 ng/mL, respectively. The difference was not statistically significant ( P = .06). The prevalence of vitamin D deficiency (<20 ng/mL) was 84.0% in psoriatic patients and 93.0% in controls ( P = .21). Conclusions: Most of the patients with psoriasis had vitamin D deficiency, which may have contributed to the evolution of their psoriasis. However, considering the high prevalence of vitamin D deficiency in Iran, no difference was noted between the psoriatic patients and the controls.


2016 ◽  
Vol 64 (5) ◽  
pp. 1025-1034 ◽  
Author(s):  
Giovanna Capolongo ◽  
Li Hao Richie Xu ◽  
Mariasofia Accardo ◽  
Alessandro Sanduzzi ◽  
Anna Agnese Stanziola ◽  
...  

Vitamin-D insufficiency and sarcoidosis are more common and severe in African Americans (AA) than Caucasians. In sarcoidosis, substrate-dependent extrarenal 1,25-dihydroxyvitamin-D (1,25-(OH)2D) production is thought to contribute to hypercalciuria and hypercalcemia, and vitamin-D repletion is often avoided. However, the anti-inflammatory properties of vitamin-D may also be beneficial. We prospectively examined serum vitamin-D levels, calcium balance, and the effects of vitamin-D repletion in 86 AA and Caucasian patients with biopsy-proven active sarcoidosis from the USA (US) and Italy (IT) in university-affiliated outpatient clinics. Clinical features, pulmonary function, and calciotropic hormones were measured. 16 patients with vitamin-D deficiency and normal serum ionized calcium (Ca2+) were treated with oral ergocalciferol (50,000 IU/week) for 12 weeks. Baseline mineral parameters were similar in US (93% AA) and IT (95% Caucasian) patients irrespective of glucocorticoid treatment. Pulmonary dysfunction was less pronounced in IT patients. Nephrolithiasis (in 11% US, 17% IT patients) was associated with higher urinary calcium excretion. Vitamin-D deficiency was not more prevalent in patients compared to the respective general populations. As serum 25-hydroxyvitamin-D (25-OHD) rose postrepletion, serum 1,25-(OH)2D, γ-globulins, and the previously elevated angiotensin converting enzyme (ACE) levels declined. Asymptomatic reversible increases in Ca2+or urinary calcium/creatinine (Ca/Cr) developed in three patients during repletion. In conclusion, Caucasian and AA patients show similar calcium and vitamin D profiles. The higher prevalence of hypercalciuria and nephrolithiasis in sarcoidosis is unrelated to endogenous vitamin-D levels. Vitamin-D repletion in sarcoidosis is generally safe, although calcium balance should be monitored. A hypothesis that 25-OHD repletion suppresses granulomatous immune activity is provided.


2020 ◽  
pp. 1-4
Author(s):  
Jyothi Vybhavi V. S.

The older population is at a high risk of Vitamin-D deficiency due to decreased cutaneous synthesis and dietary intake of Vitamin-D. Results from previous studies examining associations between serum 25- hydroxyvitamin D (25(OH)D) concentrations and depressive symptoms are equivocal. Hence this study was undertaken in order to find the association between vitamin D and symptoms of depression, anxiety and stress in a cross-sectional analysis of a population-based sample of elderly residing in Bangalore city. The objectives of this study are 1. To assess Serum 25(OH) Vitamin-D in the elderly. 2. To assess symptoms of depression, anxiety and stress in the elderly with different levels of Vitamin-D. This study involved 80 healthy elderly subjects with consideration of inclusion and exclusion criteria. Written informed consent was taken. For each subject, fasting blood sample of 4ml was collected for Serum 25(OH) Vitamin-D assessment. Anthropometric measurements were taken. 24-hour dietary recall, General History Questionnaire and Mental health symptoms were assessed using the 21-item Depression Anxiety Stress Scales (DASS-21). Associations between serum 25(OH)D concentrations and total DASS-21 scores and subscale scores of depression, anxiety and stress were explored using negative binomial regression, adjusting for age, race, BMI and physical activity. The comparison of Serum Vitamin-D levels and DASS-21 components showed that the mean scores for Depression, anxiety and Stress were significantly higher in the Vitamin-D deficient participants, indicating that the Vitamin-D deficient participants had worst Psychological consequences. It can be concluded that a significant correlation was found between Serum Vitamin-D deficiency and poor psychological health. Based on the results of this study, psychological health for elderly can be improved by providing regular examinations and checking their Serum Vitamin-D levels and supplementing Vitamin-D to the elderly to enhance their quality of Life.


2019 ◽  
Vol 10 (1) ◽  
pp. 44-50 ◽  
Author(s):  
Banafsheh Shahnazari ◽  
Jamileh Moghimi ◽  
Majid Foroutan ◽  
Majid Mirmohammadkhani ◽  
Amir Ghorbani

AbstractObjectiveOsteoporosis is the most common metabolic disease of the bones. Osteoporosis reduces bone density, predisposes a person to fractures, and imposes high costs on societies. Osteoporosis develops from a variety of causes, one of the most significant is vitamin D deficiency. This study investigates the impact of vitamin D on osteoporosis.Materials and MethodsIn this clinical trial, 400 patients referred to the Bone Density Clinic of Kowsar Hospital in Semnan were selected by convenience sampling method. Bone densitometry tests were carried out using DEXA (x-ray absorptiometry) and serum vitamin D levels were measured by the ELISA method. Subjects with vitamin D deficiency were treated for 8 weeks with (50,000 Vitamin D units per week. At the end of the treatment period, all subjects were evaluated for bone density and the results of both groups were compared.Results13% of subjects had osteoporosis and 14.2% had osteopenia. 19% of subjects had vitamin D deficiency, 38.8% had insufficient levels of vitamin D, and 42.3% had sufficient vitamin D levels. The level of vitamin D in patients with osteoporosis (5.50 ± 5.5 ng/ml) was less than those with osteopenia (7.83 ± 4.8 ng/ml) and those with normal bone mineral density (23.88 ± 18.42 ng/ml) (P <0.001). The prevalence of osteoporosis in the intervention group after intervention with vitamin D was significantly lower than the control group (32.3 versus 67.7 and P <0.001).ConclusionThe prevalence of serum vitamin D deficiency in osteopenic and osteoporotic individuals was higher than in normal subjects, with a significant relationship between age and sex. Thus, treatment with vitamin D improves bone density indices.


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