scholarly journals Peripheral Neuropathy and Hypovitaminosis D Are Associated in Multiple Myeloma Patients

Blood ◽  
2019 ◽  
Vol 134 (Supplement_1) ◽  
pp. 5506-5506
Author(s):  
Berdien Oortgiesen ◽  
Hans Kroes ◽  
Petra Scholtens ◽  
Jitske Hoogland ◽  
Pauline Dannenberg-de Keijzer ◽  
...  

Introduction New strategies in the treatment of multiple myeloma (MM) have improved response rates, progression-free survival and overall survival (OS). Despite the advances in treatment, patients frequently experience adverse events such as chemotherapy-induced peripheral neuropathy (CIPN). CIPN decreases quality of life, and requires dose adjustment, delay or premature termination of treatment, resulting in a negative influence on time to progression and survival. In addition, several studies have found that up to 54% of MM patients have peripheral neuropathy (PN) at diagnosis. A possible mechanism of vitamin D deficiency and PN was found in animal trials, where an increase of nerve growth factor was observed in diabetic rats after supplementation of vitamin D. Furthermore, correction of hypovitaminosis D through vitamin D supplementation was found to reduce PN in patients with DM type 2. Objectives The primary objective of this study was to determine the correlation between the 25-hydroxyvitamin D serum levels and PN in patients with smoldering or symptomatic MM. Secondary objectives were to gain insight into the number of patients with inadequate 25-hydroxyvitamin D serum levels (< 75 nmol/L); to evaluate the influence of different vitamin D levels on the severity of CIPN; to determine the correspondence of the ICPNQ results and patients' records; and to search for differences in prevalence of CIPN for each drug. Methods In this multicentre study, performed in the Medical Center Leeuwarden and Deventer Hospital in the Netherlands, smoldering and symptomatic MM patients were included in the study, regardless of stage or previous treatment. Patients had to be older than 18 years, and able to give informed consent. Blood samples were collected to determine vitamin D levels, and hypovitaminosis D was defined as a 25-hydroxyvitamin D level (vitamin D) below 75 nmol/L. The Indication for Common Toxicity Criteria (CTC) Grading Peripheral Neuropathy Questionnaire (ICPNQ), a validated questionnaire to distinguish different PN grades in MM patients, was used to determine the severity of PN. Visual Analog Scale (VAS) scores were used to grade the intensity of PN. Results We included 120 MM patients with a median age of 68 years (min-max; 48-84), and 57,5% were male. The median vitamin D level was 49.5 nmol/L (min-max; 10-138), and 84% had a serum 25-hydroxyvitamin D level <75 nmol/L. The percentage of patients with PN grade 1 or higher was 69%. In the medical records, absence or presence of PN was mentioned in 40% of the patients by clinicians. The percentage of patients with PN categorized in the vitamin D groups <25, 25-49.9, 50-74.9, and ≥75 nmol/L, was 88, 72, 54, and 79%, respectively. However, patients in the vitamin D group ≥75 nmol/L were diagnosed with MM for a shorter period of time, and received more intensive treatment. A trend was found between lower vitamin D levels (grouped <25, 25-49.9, 50-74.9, and ≥75 nmol/L) and higher incidence of PN (p = 0.036). Conclusions PN and hypovitaminosis D are common in MM patients, and low vitamin D levels are possibly associated with the occurrence of PN. In addition, more attention for PN is needed, as PN is underreported by clinicians. Further research is necessary to clarify the relationship between vitamin D and PN, and whether vitamin D supplementation could positively influence PN in MM patients. Disclosures No relevant conflicts of interest to declare.

2005 ◽  
Vol 11 (3) ◽  
pp. 266-271 ◽  
Author(s):  
M Soilu-Hänninen ◽  
L Airas ◽  
I Mononen ◽  
A Heikkilä ◽  
M Viljanen ◽  
...  

Past sun exposure and vitamin D supplementation have been associated with a reduction in the risk of MS. We measured the serum concentration of 25-hydroxyvitamin D (25[OH]D) at the time of MS diagnosis in 40 MS patients and 40 controls. We found no difference in the serum levels of 25(OH)D between MS patients and controls when all samples or samples obtained during winter months were compared, but MS patients had significantly lower serum 25(OH)D concentrations in June to September than the controls. The vitamin D stores were adequate for bone metabolism (> 37 nmol/L) in 70% of MS patients throughout the year and within the hypovitaminosis level (< 37 nmol/L) in 30% of MS patients at some time of the year. During MS-relapses, 25(OH)D levels were lower than in remission, but mostly within the reference range observed in relation with normal bone metabolism. We conclude that the vitamin D stores in most MS patients are adequate for their normal bone metabolism. However, lower vitamin D levels during MS relapses than in remission suggest that vitamin D could be involved in the regulation of the clinical disease activity of MS. The optimal serum levels of vitamin D for the regulation of immune responses remain to be determined.


Author(s):  
B. E. Oortgiesen ◽  
J. A. Kroes ◽  
P. Scholtens ◽  
J. Hoogland ◽  
P. Dannenberg - de Keijzer ◽  
...  

Abstract Purpose Peripheral neuropathy (PN) is common in patients with multiple myeloma (MM). We hypothesized that the relationship between hypovitaminosis D and PN described in diabetes mellitus patients may also be present in MM patients. Methods To study this potential association, we assessed the incidence of hypovitaminosis D (vitamin D < 75 nmol/L [= 30 ng/mL]) in smouldering and active MM patients in two Dutch hospitals. Furthermore, a validated questionnaire was used to distinguish different PN grades. Results Of the 120 patients included between January 2017 and August 2018, 84% had an inadequate vitamin D level (median vitamin D level 49.5 nmol/L [IQR 34–65 nmol/L]; mean age: 68 years [SD ± 7.7]; males: 58%). PN was reported by 69% of patients (n = 83); however, of these 83 patients, PN was not documented in the medical records of 52%. An association was found between lower vitamin D levels and higher incidence of PN in the total population (P = 0.035), and in the active MM patients (P = 0.016). Conclusion This multi-centre cohort study showed that PN and hypovitaminosis D are common in MM patients, and addressing low vitamin D levels in the treatment of MM patients might be beneficial in reducing the risk of PN. More attention for PN is warranted, as PN is underreported by clinicians. Further research is needed to fully understand the implications of vitamin D in the development of PN in patients with MM. Clinical trial registration Netherland Trial Register NL5835, date of registration July 28, 2016


Author(s):  
Catarina Magalhães Porto ◽  
Natalia Santos Barbosa da Silva ◽  
Cecília Magalhães Porto Lira ◽  
Rayana Porpino Magalhães ◽  
José Luiz Oliveira Magalhães ◽  
...  

Background: One of the risk factors for suicide includes the presence of depressive disorder and symptoms, which may be related to the reduction of 25-hydroxyvitamin D serum levels. In this scenario, evidence shows vitamin D deficiency as an important aspect, directly related to depressive disorder chronicity. Objective: To assess the association between Vitamin D serum levels and the intensity of depressive symptoms and suicidal behavior in a clinical sample of depressed patients. Methods: A cross-sectional study with 146 patients aged between 18 and 59, seen in two psychiatry ambulatories. Data collection involved measurement of serum 25-hydroxyvitamin D levels and assessment of the intensity of depressive symptoms and suicide risk. Results: In the sample, 35% presented low Vitamin D serum levels and, in these individuals, the incidence of family history of Depressive Disorder (95.2%) and chronicity of severe depressive symptoms (47.8%) was higher. As to suicidal behavior, both groups presented high active suicide risk, with higher rates in the group with hypovitaminosis D. Only suicidal ideation was linked to lower Vitamin D levels (67.4% p= 0,005). Conclusion: In this study, hypovitaminosis D was associated with negative mental health outcomes, such as more severe chronicity of depressive symptoms and suicidal behavior, characterized by active suicidal ideation.


Author(s):  
Dina Keumala Sari ◽  
Nurfida Khairina Arrasyid ◽  
Y. S. Harahap

Previous studies have not been able to show with certainty the effect of vitamin D supplementation in tuberculosis patients. The objective of this study is to determine whether vitamin D supplementation to patients with tuberculosis could influence 25-hydroxyvitamin D (25(OH)D) and calcium serum levels. The results, after 28 days, the vitamin D supplementation showed significant increase of 25(OH)D serum level at the end point (p=0.001), but not for the calcium serum level (p=0.3). The Conclusions is supplementation with 1,000 IU vitamin D per day increased the 25(OH)D serum level but there was no association with the calcium serum level.


2020 ◽  
Vol 5 (2) ◽  
pp. e34-e34
Author(s):  
Yasaman Koohshoori ◽  
Ehsan Ramanian ◽  
Nasrin Moradi ◽  
Shahrzad Shadabi ◽  
Minoo Motahhar ◽  
...  

Introduction: Coronavirus disease 2019 (COVID-19) from the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is one of the most important epidemiological events in the past 100 years has become, the consequences for public health and economic systems around the world. Vitamin D is an important micronutrient that has been reported to improve immunity and protect against respiratory diseases. In this study, we intend to review articles that examine the relationship between COVID-19 and vitamin D. Methods: This is a review that uses articles from studies published in 2020 on the relationship between COVID-19 and vitamin D in databases such as; Web of Science, Science Direct, SID, Magiran, Google Scholar and PubMed. Keywords used included; serum levels of 25-hydroxyvitamin D, vitamin D, COVID-19, SARS-COV-2 and coronavirus 2. With this search, 32 articles were finally selected for this purpose and their results were reviewed Results: Of the 32 studies reviewed, only three showed no association between vitamin D levels in the blood and COVID-19 disease. Other studies had a relationship between the severity of the disease, mortality rate and length of hospital stay, in different age, gender and location groups. Conclusion: It seems that the level of vitamin D in the blood has a potential effect on COVID-19 disease. Checking the serum vitamin D levels and supplementation in people with hypovitaminosis D can be a good solution to reduce the complications and problems caused by COVID-19.


Author(s):  
Anna Grzegory ◽  
Lech Pomorski ◽  
Konrad Pagacz ◽  
Karol Sieniawski ◽  
Krzysztof Kaczka

IntroductionHypocalcaemia remains the most common postoperative complication after total thyroidectomy. The purpose of the study was to evaluate the clinical usefulness of routine preoperative oral calcium and vitamin D supplementation in the prevention of hypocalcaemia after total thyroidectomy.Material and methodsOne hundred fifty-three consecutive patients with nontoxic multinodular goitre were randomly assigned to routinely receive (group B) or not to receive (group A) calcium carbonate (3 g/d) and alfacalcidol (1 µg/d) on the day before surgery and calcium carbonate (1 g/d) and alfacalcidol (1 µg/d) taken once in the morning on the day of operation. Their preoperative 25-hydroxyvitamin D (25-OHD) levels, hypocalcemic symptoms, serum calcium and parathyroid hormone (iPTH) levels were determined 6 and 24 hour postoperatively and 6 weeks after surgery.ResultsSymptomatic hypocalcaemia was observed in 41/153(26.79%) patients. The incidence of symptomatic hypocalcaemia was significantly lower in the supplemented group than in the group not receiving supplementation: 10 of 77 participants (12.99%) versus 31 of 76 patients (40.79%) (p<0.05). The rates of laboratory and severe hypocalcaemia (corrected calcium <2.0 mmol/l) were 67.11% and 28.95% in group A and 50.65% and 9.09% in group B, respectively (p=0.04, p<0.05). There were no significant differences between groups A and B in corrected calcium levels after surgery and postoperative decreases in corrected calcium levels (p=0.06). 112(73.20%) participants had 25-OHD<20 ng/ml. Vitamin D levels did not influence corrected calcium level changes (p=0.98).ConclusionsOral supplementation of calcium and alfacalcidol may help in the prevention of postthyroidectomy hypocalcaemia. Vitamin D deficiency was widespread among operated patients.


2014 ◽  
Vol 2014 ◽  
pp. 1-6 ◽  
Author(s):  
Devi Dayal ◽  
Suresh Kumar ◽  
Naresh Sachdeva ◽  
Rakesh Kumar ◽  
Meenu Singh ◽  
...  

Plasma levels of 25-hydroxyvitamin D [25(OH)D] were measured by competitive Electrochemiluminescence Immunoassay (ECLIA) in 92 children (67 boys, 25 girls) aged 3 months to 12 years at admission to hospital (timepoint 1, T1) and at discharge (timepoint 2, T2). There was a significant fall in the mean 25(OH)D from T1 (71.87 ± 27.25 nmol/L) to T2 (49.03 ± 22.25 nmol/L) (mean change = 22.84 nmol/L,Pvalue = 0.0004). Proportion of patients having VDD (levels <50 nmol/L) at admission (25%, 23/92) increased significantly at the time of discharge (51.09%, 47/92) (P=0.0004). There was a trend towards longer duration of hospital stay, requirement of ventilation and inotropes, development of healthcare-associated infection, and mortality in vitamin D deficient as compared to nondeficient patients though the difference was statistically insignificant. In conclusion, vitamin D levels fall significantly and should be monitored during hospital stay in children. Large clinical studies are needed to prospectively evaluate the effect of vitamin D supplementation in vitamin D deficient hospitalized children on various disease outcome parameters.


2020 ◽  
Vol 29 (Sup7) ◽  
pp. S24-S30 ◽  
Author(s):  
Karen Smith ◽  
Susan Hewlings

Objective: Hard-to-heal wounds are a major biological, psychological, social and financial burden on both individual patients and the broader health system. They are associated with a variety of comorbidities and have a complex aetiology, but are typically associated with nutritional deficiencies, such as low vitamin D levels. This systematic literature review evaluates the current research regarding the connection between inadequate vitamin D status and wound healing. Method: PubMed and EBSCO databases were searched following PRISMA guidelines for primary research studies relating to pressure ulcers, diabetic ulcers or venous ulcers and vitamin D status. Results: A total of 10 studies, involving 2359 participants, met the inclusion criteria. There was a strong correlation between low levels of 25-hydroxyvitamin D and the presence of all three types of hard-to-heal wounds. Conclusion: Research suggests a correlation between low vitamin D levels and hard-to-heal wounds. However, it is not clear if the relationship is causal or only correlational. There is also emerging evidence on the use of vitamin D supplementation for the treatment of hard-to-heal wounds. More research is needed to understand the correlation between vitamin D and hard-to-heal wounds.


Author(s):  
V Fonseca ◽  
J E Agnew ◽  
D Nag ◽  
P Dandona

Measurements of bone mineral index, mean metacarpal cortical thickness, plasma calcium, alkaline phosphatase and serum 25-hydroxyvitamin D and parathyroid hormone concentrations were carried out in 39 Asian vegetarian patients with hypovitaminosis D. It was concluded that PTH is probably the major determinant of osteopenia in patients with osteomalacia and secondary hyperparathyroidism; and that the presence of secondary hyperparathyroidism in association with hypovitaminosis D should be an absolute indication for vitamin D supplementation even in asymptomatic patients.


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