scholarly journals Screening of serum 25-hydroxyvitamin D levels among elderly Egyptians admitted to the orthogeriatric unit by fracture hip

2020 ◽  
Vol 32 (1) ◽  
Author(s):  
Ahmed Rabiee ◽  
Mohamed AboElsoud ◽  
Sayed M. Seif El Nasr ◽  
Sameh Abouzeid

Abstract Background Vitamin D deficiency increases muscle weakness and pain leading to reduced power and function, increased bone turnover and increased risk of falls and hip fractures in elderly. We postulated that vitamin D deficiency in sunny Egypt should be lower than western countries so we screen for prevalence of vitamin D deficiency among all elderly patient admitted to orthogeriatric unit by fracture hip. Results Our study showed that vitamin D deficiency is common in elderly Egyptian patients admitted to orthogeriatric unit with hip fractures. Of the study group (n 290 patients) vitamin D levels were sufficient (30 ng/dl or more) in 24 patients (8.3%) and insufficient (between 20 ng and 30 ng) in 125 patients (43.1%) and deficient (less than 20) in 141 patients (48.7%). Among the study group, female patients had lower levels of vitamin D (18.8 ± 6.9) compared to males (20.5 ± 6.7) P value 0.034. Although our study failed to link different levels of vitamin D with activity of daily life: P value was (0.116) in bathing, (0.058) in dressing, (0.115) in toileting and (054) in transfer. A little difference was found in feeding (0.036) and previous fall (0.011) and cognitive impairment; MiniCOG < 3 P value 0.017. Both previous falls and cognitive decline are in turn linked to increased fracture risk Conclusion Hypovitaminosis D is common among older patients with hip fractures even in sunny Egypt remaining slightly lower than its prevalence in western countries. Although no direct significant correlations with activity of daily life, vitamin D deficiency was associated with higher risks of previous falls and cognitive impairment both in turn increases the risk of fractures.

2013 ◽  
Vol 2013 ◽  
pp. 1-10 ◽  
Author(s):  
Chaoxun Wang

Vitamin D deficiency is a highly prevalent condition. Low vitamin D levels have long been associated with bone diseases, such as rickets in children and osteomalacia and osteoporosis in adults. However, it has become apparent in recent years that adequate vitamin D levels are also important for optimal functioning of many organs and tissues throughout the body, including the cardiovascular system. Evolving data indicate that vitamin D deficiency is associated with an increased risk of cardiovascular disease (CVD). Studies have shown that low vitamin D levels are associated with hypertension, diabetes, metabolic syndrome, left ventricular hypertrophy, and chronic vascular inflammation, all of which are risk factors for CVD. This paper reviews the definition and pathophysiology of vitamin D deficiency, clinical evidence linking vitamin D and CVD risk, diabetes and its complications, and metabolic syndrome.


2017 ◽  
Vol 3 ◽  
pp. 233372141769784 ◽  
Author(s):  
Adrian H. Heald ◽  
Simon G. Anderson ◽  
Jonathan J. Scargill ◽  
Andrea Short ◽  
David Holland ◽  
...  

Introduction: There is increasing evidence concerning adverse health consequences of low vitamin D levels. We determined whether there is any surrogate for measuring vitamin D in people older than 70 years and the relation between index of multiple deprivation (IMD) and vitamin D levels. Methods: Blood samples from 241 patients were included in this analysis. Concurrent measurements for 25-hydroxyvitamin D (25(OH)D), parathyroid hormone (PTH), and bone profile are reported. Results: The prevalence of total vitamin D insufficiency/deficiency (defined as total vitamin D <50 nmol/L) was 57.5% overall. Even for patients with vitamin D deficiency, a significant proportion had PTH, normal calcium, phosphate, and alkaline phosphatase levels. For patients with vitamin D <25 nmol/L, 62.7% had a PTH within reference range, 83.1% had normal serum-adjusted calcium, 80.6% had normal phosphate, and 85.1% had a normal serum alkaline phosphatase. With increasing quintiles of IMD, there was a 22% increased risk of vitamin D deficiency/insufficiency from quintiles 1 to 5, in age- and sex-adjusted logistic regression models (odds ratio [OR] = 1.22, 95% confidence interval [1.01, 1.47]; p = .034). Conclusion: No other parameter is currently adequate for screening for vitamin D deficiency in older people. A higher IMD is associated with lower vitamin D levels in older people.


Author(s):  
Dr. Sonpal Jindal ◽  
Dr. Mukesh Kumar Taneja

Vitamin D deficiency is a common health problem worldwide. Many parts of the human eye, including the epithelium of the cornea, lens, ciliary body, and retinal pigment epithelium, as well as the corneal endothelium, ganglion cell layer, and retinal photoreceptors, contain vitamin D receptor. Physiological effects of vitamin D From an ocular point of view, the role in macular and retinal health had been advanced, as well as the involvement in corneal inflammatory response, wound healing, and dry eye disease. The most important effect of vitamin D is on, phosphorus, calcium metabolism and on bone mineralization. Recently, it was observed that vitamin D deficiency and insufficiency are related with common cancers, cardiovascular diseases, metabolic syndromes, infectious, and many chronic diseases including autoimmune disease. Benefits of vitamin D may be amplified through synergistic interaction with topical corticosteroids which accelerates improvement in corneal shape and optics, substantially benefiting the control of ocular surface disease and dry eye symptoms. Aqueous humour is the primary source responsible for the feeding of corneal endothelial layer hence endothelial abnormalities can be expected due to accumulated inflammatory cytokines and multiple toxic products in the aqueous humour of the patients with vitamin D deficiency. MATERIAL AND METHODS: Subjects were selected with vitamin D deficiency in the age group of 20–55 years. 50 patients having serum vitamin D levels <15 ng/ml were included in the study. Serum vitamin D levels of <15 ng/ml were included in the control group. Vitamin D levels in tear fluid were measured by direct competitive chemiluminescent enzyme linked immunoassay. A complete ophthalmic evaluation was performed in all participants which includes assessment of visual acuity, anterior segment evaluation and posterior segment evaluation. Specular microscopy was performed on the eyes of the patients with vitamin D deficiency and healthy control group individuals. Corneal endothelial cell density (CD) and central corneal thickness (CCT) values were calculated automatically using the software of the specular microscope.  RESULTS: The study group included 23 male and 27 female subjects while study group included 24 male and 26 female. Mean age of male in study group was 46.4 ± 12.56 and female was 45.6 ± 11.77. In control group mean male age was 48.5 ± 9.25 and female age was 49.56 ± 12.55. In study group Mean Corneal endothelial cell density (CD)  was observed as 2632.89 ± 189.25 cells/mm 2  and Mean central corneal thickness (CCT) was 587.2 ± 25.89 μ. In control group Mean Corneal endothelial cell density (CD) was observed as 2954.97 ± 116.89 cells/mm 2  and Mean central corneal thickness (CCT) was 546.0 ± 36.22 μ. Vitamin D levels of Tears in study group was 8.4 ± 1.7 ng/ml  and in control group it was 16.2 ± 2.3 ng/ml. CONCLUSION: It has been observed that there is statistically significant difference in the corneal endothelial cell density (CD) and central corneal thickness (CCT) in patients with vitamin D deficiency. It was observed that Vitamin D is present in tear fluid and there is significant difference in the levels of vitamin D in study and control group.


2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. A729-A729
Author(s):  
Betânia Rodrigues dos Santos ◽  
Gislaine Casanova ◽  
Thaís Rasia Silva ◽  
Lucas Bandeira Marchesan ◽  
Karen Oppermann ◽  
...  

Abstract Postmenopausal status has been associated with an unfavorable phenotype tied to hormonal and metabolic changes, which collectively could contribute to an increased risk of cardiovascular disease. Vitamin D deficiency is frequent in postmenopausal women and may be linked to this phenotype and especially to an increased risk of developing hypertension. Vitamin D actions are modulated by the vitamin D receptor (VDR), and metabolic abnormalities have been associated with VDR gene variants in different populations. The aims of the present study were to assess the vitamin D levels, prevalence of vitamin D deficiency and genotypes of Fok-I, Bsm-I, Apa-I and Taq-I polymorphisms in the VDR gene and to determine whether vitamin D deficiency and VDR gene variants are associated with blood pressure levels and systemic arterial hypertension by the 2017 ACC/AHA definition in postmenopausal women. We conducted a cross-sectional study of biobanked blood samples from 339 postmenopausal women with no evidence of clinical disease. Blood pressure strata were defined according to the 2017 ACC/AHA cutoffs. Circulating 25(OH)D levels were considered deficient if &lt;20 ng/mL. Genotype analysis was performed by RT-PCR with allelic discrimination assays. Mean serum total 25(OH)D levels were 22.99±8.54 ng/mL, and 40.1% of participants were deficient in vitamin D. Overall, 7.7% had elevated blood pressure, 36.6% had stage 1 and 37.8% had stage 2 hypertension. Mean total (p=0.014) and free 25(OH)D levels (p=0.029) were lower in women with stage 2 hypertension than in those with normal blood pressure. The CC+CT genotypes of Bsm-I and the AA+AG genotypes of Taq-I polymorphisms were more frequent in women with stage 2 hypertension (Bsm-I CC+CT: 85.8% vs. TT: 14.2%, p=0.045; Taq-I AA+AG: 91.3% vs. GG: 8.7%, p=0.021). A higher prevalence ratio of stage 2 hypertension was associated with age (PR 1.058; 95%CI 1.033-1.083; p&lt;0.001), BMI (PR 1.046; 95%CI 1.025-1.068; p&lt;0.001), vitamin D deficiency (PR 1.333; 95%CI 1.016-1.749; p=0.038) and Taq-I polymorphism (PR 1.764; 95%CI 1.030-3.019; p=0.039). Women with vitamin D deficiency and the AA+AG genotype of Taq-I polymorphism were 33% and 76% more likely to have stage 2 hypertension, respectively, but these analyses lost significance when adjusted for age and BMI. In conclusion, the present results suggest that vitamin D deficiency and Taq-I polymorphism are associated with stage 2 hypertension, depending on age and BMI, in postmenopausal women.


2021 ◽  
Author(s):  
Jason Garcia ◽  
Kirsten Krieger ◽  
Candice Loitz ◽  
Lillian M Perez ◽  
Zachary A Richards ◽  
...  

Vitamin D deficiency associates with an increased risk of prostate cancer (PCa) mortality and is hypothesized to contribute to PCa aggressiveness and disparities in African Americans. We reported a relationship between African-ancestry, circulating and intraprostatic vitamin D metabolites and prostatic expression of megalin, an endocytic membrane receptor that internalizes globulin-bound hormones. Here, we show that megalin imports sex hormone-binding globulin (SHBG)-bound testosterone, potentially regulating intraprostatic hormone levels. Vitamin D levels regulated megalin expression in cell lines, patient-derived prostate epithelial cells, and prostate tissue explants, and mice with prostatic knockout of Lrp2 (megalin) showed reduced prostatic testosterone. Notably, prostatic 5α-dihydrotestosterone levels were higher in African American men and correlated inversely with serum vitamin D status, while megalin protein levels were reduced in PCa tissue. Our findings highlight the negative impact of vitamin D deficiency on PCa and the potential link to PCa disparities observed in African Americans.


Nutrients ◽  
2020 ◽  
Vol 12 (5) ◽  
pp. 1400
Author(s):  
Niv Ben-Shabat ◽  
Abdulla Watad ◽  
Aviv Shabat ◽  
Nicola Luigi Bragazzi ◽  
Doron Comaneshter ◽  
...  

In this study, we aimed to examine the effect of vitamin D deficiency on all-cause mortality in ankylosing spondylitis (AS) patients and in the general population. This is a retrospective-cohort study based on the electronic database of the largest health-maintenance organization in Israel. AS patients who were first diagnosed between 2002–2007 were included. Controls were matched by age, gender and enrollment-time. Follow-up continued until death or end of study follow-up on 1 July 2019. Laboratory measures of serum 25-hydroxyvitamin-D levels during the entire follow-up period were obtained. A total of 919 AS patients and 4519 controls with a mean time of follow-up of 14.3 years were included. The mean age at the time of enrollment was 52 years, and 22% of them were females. AS was associated with a higher proportion of vitamin D deficiency (odds ratio 1.27 [95% confidence-interval (CI) 1.03–1.58]). In AS patients, insufficient levels of vitamin D (<30 ng/mL) were significantly associated with increased incidence of all-cause mortality (hazard ratio (HR) 1.59 [95% CI 1.02–2.50]). This association was more prominent with the decrease in vitamin D levels (< 20 ng/mL, HR 1.63 [95% CI 1.03–2.60]; <10 ng/mL, HR 1.79 [95% CI 1.01–3.20]) and among male patients (<30 ng/mL, HR 2.11 [95% CI 1.20–3.72]; <20 ng/mL, HR 2.12 [95% CI 1.19–3.80]; <10 ng/mL, HR 2.23 [95% CI 1.12–4.43]). However, inadequate levels of vitamin D among controls were not associated with an increased all-cause mortality. Our study has shown that vitamin D deficiency is more common in AS patients than controls and is linked to an increased risk for all-cause mortality. These results emphasize the need for randomized-controlled trials to evaluate the benefits of vitamin D supplementation as a secondary prevention of mortality in patients with chronic inflammatory rheumatic disease.


2019 ◽  
Vol 20 (1) ◽  
Author(s):  
Letícia Veríssimo Dutra ◽  
Fernando Alves Affonso-Kaufman ◽  
Fernanda Ramires Cafeo ◽  
Milene Saori Kassai ◽  
Caio Parente Barbosa ◽  
...  

Abstract Background Premature birth is the main cause of mortality in children under 1 year, and vitamin D deficiency during gestation is associated with prematurity. The effects of vitamin D are mediated by its receptor, which is encoded by the VDR gene. VDR variants—such as single nucleotide variation (SNV)—are associated with increased risk of prematurity, but there are conflicting results. We evaluated serum vitamin D concentrations and the frequency of TaqI/A > G, BsmI/C > T, ApaI/C > A, and FokI/A > T VDR variants in mothers and preterm (PTN) and full-term (FTN) newborns. Methods We conducted a case-control study comprising 40 pairs of mothers and their PTNs (gestational age < 32 weeks and/or weight < 1500 g), and 92 pairs of mothers and FTNs as controls. Genotyping was performed by real-time PCR, and plasma vitamin D concentrations were measured by electrochemiluminescence. Results Vitamin D levels were significantly lower in PTN mothers. Genotypes TaqI/GG and BsmI/TT, and haplotypes AAG (TaqI/A-ApaI/A-FokI/G) and GCA (TaqI/G-ApaI/C-FokI/A) were significantly more frequent in PTN mothers, and genotypes TaqI/AG, ApaI/AA, and FokI/AG resulted in significantly lower vitamin D levels. Genotypes BsmI/TT and ApaI/AA were associated with vitamin D deficiency and 2.36 and 7.99 times greater likelihood of PTB, respectively. Vitamin D levels were also lower in PTNs, although it was not statistically significant. Genotypes BsmI/TT, ApaI/AA, and FokI/GG, and haplotype GAG (TaqI/G-ApaI/A-FokI/G) were significantly more frequent in PTNs. Those with FokI/GG genotypes had significantly lower vitamin D levels. Conclusions VDR variants contribute to variations in vitamin D concentrations and the increased risk of prematurity.


Author(s):  
Jyoti Prabha ◽  
Abhijeet Kumar

Background: Vitamin D deficiency is widely prevalent in all parts of the world. Pregnant women and neonates are highly vulnerable to vitamin D deficiency. Pregnant women receive very less amount of sunlight especially in parts of Southeast Asia due to traditional norms and customs. A strong positive correlation was found between low maternal vitamin D levels with gestational hypertension/preeclampsia, gestational diabetes mellitus, preterm labour, low birth weight, intra uterine growth restriction, neonatal intensive care unit admission and Apgar score. Therefore, the present study was designed to know the prevalence of vitamin D deficiency in pregnant females and to evaluate adverse effects associated with it.Methods: Total 250 nulliparous pregnant females attending Tirath Ram Shah Hospital for delivery and carrying a viable (>/28 weeks) singleton pregnancy were selected. Women with serum 25-hydroxy vitamin D level <10 ng/ml, 10-20 ng/ml and <20 ng/ml, were diagnosed as vitamin D deficient, insufficient and sufficient groups respectively and the adverse outcomes was correlated.Results: In this study, out of 250 cases, 159 cases (63.6%) had vitamin D deficiency, 43 cases (17.2%) had insufficiency, and 48 cases (19.2%) had sufficient vitamin D levels (vitamin D ≥20 ng/ml). And, Vitamin D deficiency was associated with preeclampsia, preterm labour and increased risk of caesarean section.Conclusions: This study indicates that vitamin D deficiency is highly prevalent in pregnant females thus implicating the need of a uniform strategy of vitamin D supplementation to pregnant females.


2021 ◽  
Vol 14 ◽  
pp. 117863882110187
Author(s):  
Hedyeh Saneifard ◽  
Marjan Shakiba ◽  
Ali Sheikhy ◽  
Leila Baniadam ◽  
Fatemeh Abdollah Gorji ◽  
...  

Background: Vitamin D deficiency is common among children and adolescents and can be affected by several factors such as puberty and obesity. Objective: The aim of this study was to evaluate vitamin D status in children and adolescents and to analyse the influence of puberty and obesity on its level. Method: A cross-sectional study was carried-out, in which clinical and biochemical data were gathered from 384 healthy children and adolescents between May 2019 to May 2020. Results: 220 females and 164 males were enrolled (aged 7-16 years; mean ± SD: 11 ± 2.5). Vitamin D deficiency was found in 49% of the total cases and was significantly more prevalent in females than males (33.1% in female; 15.9% in male, P < .001). Mean vitamin D level was lower in obese children compared with non-obese ( P < .001). Non-obese group had significantly higher levels of vitamin D in Tanner stage IV of puberty than obese individuals (20.1 ± 17.0 vs 5.4 ± 2.0) ( P = .03). Vitamin D levels were significantly lower in females than males only in Tanner stage II (12.3 ± 9.0 vs 19.6 ± 16.6) ( P = .005). The lowest level of Vitamin D was in Tanner stage Ⅳ-Ⅴ in boys and in Tanner stage Ⅱ-Ⅲ in girls ( P < .001). Conclusion: Puberty is an additional risk factor for vitamin D deficiency especially in girls and obese children. This increased risk, together with the fact that most important time for building a proper skeleton is during childhood and adolescent, makes it essential to monitor vitamin D in these age groups.


2019 ◽  
Vol 3 (1) ◽  
pp. 12-25
Author(s):  
Robert W. Motl ◽  
Grace M. Niemiro ◽  
Michael De Lisio ◽  
Sarah Sommer ◽  
Barry J. Riskin ◽  
...  

Background There is substantial evidence, from well-conducted epidemiological studies, that low vitamin D levels are correlated with increased risk for MS, and multiple case control studies have implicated the involvement of vitamin D deficiency in MS etiology. Narrow-band Ultraviolet B (NB-UVB; 300nm - 311 nm) induced vitamin D production has not previously been studied in a multiple sclerosis (MS) randomized placebo-controlled trial (RCT). Objectives To investigate NB-UVB induced vitamin D production, immunomodulation and MS symptomology following NB-UVB phototherapy in a MS cohort. Methods Using a blinded RCT study design, twelve individuals 18 years or older with MS were enrolled and assigned (1:1) into individualized NB-UVB dose (10-30kJ/m) phototherapy, or into placebo treatment, delivered 3 times per week, for 8-weeks. Serum vitamin D levels, walking performance, strength, cognitive function, mood and circulating progenitor cells (CPCs: CD34+CD45dim), monocyte populations (Intermediate CD14+CD16+, Classical CD14+CD16-), and T regulatory cell (CD4+/CD25+/FoxP3+Tregs) count were assesed. The data were analyzed by 2 x 3 mixed factor ANOVA. Results A statistically significant condition by time interaction on vitamin D levels (F=7.14, p<.005, partial η2=.42) was identified. NB-UVB phototherapy may provide immunomodulation in a select group of MS individuals. Conclusion UVB phototherapy corrects vitamin D deficiency. This study adds to the growing research investigating UVB treatment in MS.


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