scholarly journals Has vitamin D had its day? An audit of vitamin D, prolactin and HBA1C monitoring over one year in an in-patient secure service

BJPsych Open ◽  
2021 ◽  
Vol 7 (S1) ◽  
pp. S330-S331
Author(s):  
Oleg Lujanschi ◽  
Toral Thomas
Keyword(s):  
Vitamin D ◽  
Vitamin D Deficiency ◽  
Best Practice ◽  
Clinical Symptoms ◽  
Vitamin D Supplementation ◽  
Service Users ◽  
Reference Ranges ◽  
Mineral Density ◽  
Increased Risk ◽  
One Year

AimsTo ensure that service users in in-patient secure services have prolactin, vitamin D and HbA1c monitoring as per current best practice guidance.BackgroundService users prescribed antipsychotic medication are at risk of developing raised prolactin levels and metabolic syndrome. In both sexes, long-standing hyperprolactinaemia can lead to low bone mineral density with an increased risk of developing osteoporosis.In recent years there has been increasing controversy on the increase in Vitamin D monitoring despite the poor evidence for complications from vitamin D deficiency in adults. Not undertaking this test in the absence of symptoms will potentially reduce anxiety for service users could save £17 per test and £50 for a 12-week course of Vitamin D supplementation. Local and national guidance indicate Vitamin D monitoring should only be done in symptomatic people.MethodFifty-five service users in the five in-patient wards had their electronic records and pathology results reviewed over a one-year period. All service users were expected to have a minimum of an annual HbA1c and prolactin level but to only have vitamin D monitoring if symptomatic for deficiency.ResultAlthough 100% of service users in MSU were tested, vitamin D testing was consistently undertaken without documented clinical evidence of deficiency. The ranges across all units were: prolactin (72- 1384mU/L), HbA1c (30–90 mmol/mol) and vitamin D (15–124 nmol/L). Local reference ranges are prolactin (53- 360mU/L), HbA1c (<48 mmol/mol) and Vitamin D (50–120 nmol/L).Prolactin levels were highest on the male medium secure wards.The other two units had significantly less testing with prolactin and HbA1c levels being the least measured (18% of service users on male LSU and 23% on the female ward respectively). Vitamin D testing on these two wards were 38% on the female ward and 18% on the male ward for both tests.ConclusionNorthside House has a dedicated physical health team and this is likely to explain its 100% score. However, vitamin D testing was being undertaking automatically rather than based on symptoms.The recommendation is to add prolactin and HbA1c to the physical screens done before CPA meetings for all service users prescribed an antipsychotic but to stop Vitamin D testing in the absence of clinical symptoms of vitamin D deficiency.

scholarly journals Implications of Vitamin D Research in Chickens can Advance Human Nutrition and Perspectives for the Future

2021 ◽  
Author(s):  
Matthew F Warren ◽  
Kimberly A Livingston
Keyword(s):  
Vitamin D ◽  
Vitamin D Deficiency ◽  
Vitamin D Supplementation ◽  
The Body ◽  
Human Nutrition ◽  
Vitamin D Metabolites ◽  
Vitamin D Metabolism ◽  
Related Research ◽  
Vitamin D Intake ◽  
Increased Risk

Abstract The risk of vitamin D insufficiency in humans is a global problem that requires improving ways to increase vitamin D intake. Supplements are a primary means for increasing vitamin D intake, but without a clear consensus on what constitutes vitamin D sufficiency, there is toxicity risk with taking supplements. Chickens have been used in many vitamin D-related research studies, especially studies involving vitamin D supplementation. Our state-of-the-art review evaluates vitamin D metabolism and how the different hydroxylated forms are synthesized. We provide an overview with how vitamin D is absorbed, transported, excreted, and what tissues in the body store vitamin D metabolites. We also discuss a number of studies involving vitamin D supplementation with broilers and laying hens. Vitamin D deficiency and toxicity are also described and how they can be caused. The vitamin D receptor (VDR) is important for vitamin D metabolism. However, there is much more that can be understood with VDR in chickens. Potential research aims involving vitamin D and chickens should explore VDR mechanisms which could lead to newer insights with VDR. Utilizing chickens in future research to help with elucidating vitamin D mechanisms has great potential to advance human nutrition. Finding ways to increase vitamin D intake will be necessary because the coronavirus 2019 disease (COVID-19) pandemic is leading to increased risk of vitamin D deficiency in many populations. Chickens can provide a dual purpose with addressing pandemic-caused vitamin D deficiency: 1) vitamin D supplementation gives chickens added value with possibly leading to vitamin D-enriched meat and egg products; and 2) chickens’ use in research provides data for translational research. Expanding vitamin D-related research in chickens to include more nutritional aims in vitamin D status has great implications with developing better strategies to improve human health.

scholarly journals Association of vitamin D and osteocalcin levels in post-menopausal women with osteoporosis

2017 ◽  
Vol 6 (4) ◽  
pp. 1244
Author(s):  
Yogiraj Vaijanathrao Chidre ◽  
Amir Babansab Shaikh
Keyword(s):  
Vitamin D ◽  
Parathyroid Hormone ◽  
Vitamin D Deficiency ◽  
Fragility Fractures ◽  
Bone Fragility ◽  
Vitamin D Supplementation ◽  
Mineral Density ◽  
Age Related ◽  
Calcium Phosphorus ◽  
Post Menopausal

Background: Osteoporosis is a common age related problem especially in women, with a consequent increase in bone fragility and susceptibility to fracture. Apart from Calcium, another nutrient that plays an important role in the mineralization of skeleton in Vitamin D. Osteocalcin, which is produced primarily by osteoblasts during bone formation, is considered to be one of the markers for osteoporosis.Methods: 314 women above the age of 40 were included into the study. A thorough physical and clinical examination, assessment of vital parameters, anthropometry evaluation was done for all patients. Bone mineral density was calculated using central DXA osteodensitometer at lumbar spine L1-L4, hip and ultradistal radius (in some cases.). Blood samples were taken for the detection of ionized calcium, phosphorus, alkaline phosphatase, 25hydroxivitamin D (25 ODH) and serum parathyroid hormone (PTH) by chemiluminiscent assay. Bone markers such as osteocalcin were measured as required.Results: Out of the 314 women attending our OPD, 96 of them were diagnosed as having osteoporosis. 24 out of them had fragility fractures, mainly of the hip, and 82 had ostepenia. Elevated levels of calcium (8.96 mg/dl), parathyroid hormone (58.76 pg/ml) and osteocalcin (24.46 ng/ml) were observed. Vitamin D deficiency of ≤ 20 was seen in 59 (63%) of the cases, insufficient in 23 (24%) and only 12 (13%) of these women had normal Vitamin D levels.Conclusions: Osteocalcin is a promising marker for the detection of osteoporosis. There is a considerable Vitamin D deficiency among the women with osteoporosis, and it is under-treated. It is essential to provide Vitamin D supplementation to these women especially those who are at high risk for fragility fractures.

scholarly journals Osteomalacia in practice of endocrinologist: etiology, pathogenesis, differential diagnosis with osteoporosis

2020 ◽  
Vol 22 (2) ◽  
pp. 23-31
Author(s):  
Olga O. Golounina ◽  
Gyuzel E. Runova ◽  
Valentin V. Fadeyev
Keyword(s):  
Vitamin D ◽  
Differential Diagnosis ◽  
Vitamin D Deficiency ◽  
Clinical Symptoms ◽  
Fibroblast Growth Factor 23 ◽  
Bone Matrix ◽  
Bone Diseases ◽  
Mineral Density ◽  
Bone Formation Rate ◽  
Metabolic Bone Diseases

Osteoporosis is the most common cause of low bone mineral density (BMD) and low-traumatic fractures in adults. However, differential diagnosis should also consider other causes of decreased BMD, including osteomalacia, as treatment for these conditions vary significantly. Osteomalacia is a systemic disorder characterized by decrease in bone strength due to of excessive accumulation of non-mineralized osteoid and uncoupling between bone matrix formation and mineralization. Osteomalacia in adults mostly develops due to severe vitamin D deficiency of any etiology, less often along with kidney pathology, mesenchymal tumors secreting fibroblast growth factor 23 or hereditary metabolic bone diseases. Clinical symptoms of osteomalacia are nonspecific and mostly manifest by generalized diffuse bone pain, muscle weakness, skeletal deformities and often go unnoticed at initial stage of the disease. Histomorphometric examination is the most accurate method of the diagnosis, which allows assessment of bone formation rate and calcification. The utmost priority of the treatment of osteomalacia of any etiology is the elimination of vitamin D deficiency, hypocalcemia, hypophosphatemia and prevention of bone deformities progression and muscle hypotension.

THE EFFECT OF 'CONCERN FOR OSTEOPOROSIS' AND SELF-PERCEIVED 'RISK OF OSTEOPOROSIS AND FRACTURE' ON ANTI-OSTEOPOROSIS BEHAVIOR OF POST MENOPAUSAL WOMEN- A CROSS-SECTIONAL STUDY.

2021 ◽  
pp. 28-31
Author(s):  
Deepali Srivastava ◽  
Sandeepa Srivastava ◽  
Ashish Kumar ◽  
Sanjiv Kumar
Keyword(s):  
Vitamin D ◽  
Risk Perception ◽  
Perceived Risk ◽  
Vitamin D Supplementation ◽  
Medical Advice ◽  
Vitamin Supplementation ◽  
Cross Sectional ◽  
Increased Risk ◽  
Bmd Testing ◽  
One Year

Introduction: Osteoporosis is more prevalent in women, especially following menopause. The total affected population would have been around 35 to 40 million. Morbidity due to disease includes decreased mobility, decreased quality of life, and increased risk of mortality following an osteoporotic fracture. The morbidity due to the disease may be decreased through diet, exercise, supplementation, and medication. The objective of this study is to determine the effect of 'concern for osteoporosis' and self-perceived 'risk of osteoporosis and fracture' on antiosteoporosis behaviour such as (1) calcium and vitamin D supplementation, (2) seeking medical advice, (3) undergoing bone mineral (BMD) testing, and (4) taking antiosteoporosis medication (AOM). Material And Method:The study was conducted on women attending outpatient clinic of the Obstretics and Gynaecology and Orthopaedics department. Patients were required to ll up the Global Longitudinal Osteoporosis in Women Questionnaire. Enrolled patients were contacted after one year by means of telephone calls, hospital visits and home visits and data was collected for self-reported use of supplements, self-reported seeking of medical advice regarding osteoporosis, self-reported BMD testing, and self-reported use of antiosteoporosis medications etc. Results:Total of 1562 women were enrolled for the study out of which data of only 1000 women was analyzed at end of one year. At the end of one year period 360 women reported use of Calcium and or Vitamin D. Table 4 depicts the association between the use of vitamin supplementation and concern and risk perception. Concern (P=0.61), risk perception to osteoporosis (P=0.13), and risk perception to fracture (P=0.29) were not signicantly associated with use of vitamin supplementation in the next 12 months (i.e., calcium and/or vitamin D). Concern (p= <0.001), risk perception to osteoporosis (p=<0.001), and risk perception to fracture (p=<0.001) were signicantly associated with women seeking medical care during the next one year. Concern (p=0.35) was not signicantly associated with undergoing BMD examination. Risk perception to osteoporosis (p=0.03) and risk perception to fracture (p=0.03) were signicantly associated with women undergoing BMD medical examination in one year. Concern about osteoporosis (p=0.64) was not signicantly associated with treatment with anti-osteoporotic medication. Risk perception to osteoporosis (p=0.06) and risk perception to fracture (p=0.002) were signicantly associated with women. Conclusion: Concern for osteoporosis is associated with likelihood of seeking medical advice. Perception of risk for Osteoporosis and fractures is positively associated with seeking medical advice, BMD examination and AOM treatment

Prevalence of 25-hydroxyvitamin D deficiency in subgroups of elderly persons with anemia: association with anemia of inflammation

Blood ◽  
2011 ◽  
Vol 117 (10) ◽  
pp. 2800-2806 ◽  
Author(s):  
Todd S. Perlstein ◽  
Reena Pande ◽  
Nancy Berliner ◽  
Gary J. Vanasse
Keyword(s):  
Vitamin D ◽  
Vitamin D Deficiency ◽  
Serum Levels ◽  
The Elderly ◽  
Vitamin D Supplementation ◽  
World Health ◽  
Elderly Persons ◽  
Increased Risk ◽  
Health Organization ◽  
Anemia Of Inflammation

AbstractAnemia and vitamin D deficiency are conditions that both result in significant morbidity and increase with age. The potential relationship between them remains poorly understood, particularly in the elderly. We used the Third National Health and Nutrition Examination Survey to examine the association of vitamin D deficiency with anemia subtypes in persons aged ≥ 60 years. Vitamin D deficiency was defined as serum levels < 20 ng/mL, and anemia was defined according to World Health Organization criteria. Vitamin D deficiency was associated with anemia prevalence independent of age, sex, or race/ethnicity (odds ratio, 1.47; 95% confidence interval, 1.06-2.05; P = .02) and varied significantly by anemia subtype (P overall = .003). The prevalence of vitamin D deficiency was 33.3% in the nonanemic population, 56% in anemia of inflammation (AI; P = .008), and 33.0% in unexplained anemia (P = .55). Non-Hispanic blacks had a 7-fold increased risk of AI compared with whites, and this was partially attenuated after adjusting for vitamin D deficiency. These data show that vitamin D deficiency is associated with specific subtypes of anemia in the elderly, especially in those with AI. Vitamin D may suppress inflammatory pathways, and studies to determine whether vitamin D supplementation ameliorates AI are warranted.

scholarly journals Vitamin D Status in Patients Operated for Primary Hyperparathyroidism: Comparison of Patients from Southern and Northern Europe

2013 ◽  
Vol 2013 ◽  
pp. 1-6 ◽  
Author(s):  
Erik Nordenström ◽  
Antonio Sitges-Serra ◽  
Joan J. Sancho ◽  
Mark Thier ◽  
Martin Almquist
Keyword(s):  
Vitamin D ◽  
Primary Hyperparathyroidism ◽  
Disease Activity ◽  
Vitamin D Deficiency ◽  
Urinary Calcium ◽  
Vitamin D Status ◽  
Mineral Density ◽  
Before And After ◽  
25 Hydroxy Vitamin D ◽  
One Year

Aim. The interaction between vitamin D deficiency and primary hyperparathyroidism (PHPT) is not fully understood. The aim of this study was to investigate whether patients with PHPT from Spain and Sweden differed in vitamin D status and PHPT disease activity before and after surgery.Methods. We compared two cohorts of postmenopausal women from Spain(n=126)and Sweden(n=128)that had first-time surgery for sporadic, uniglandular PHPT. Biochemical variables reflecting bone metabolism and disease activity, including levels of 25-hydroxy vitamin D3(25(OH)D) and bone mineral density, BMD, were measured pre- and one year postoperatively.Results. Median preoperative 25(OH)D levels were lower, and adenoma weight, PTH, and urinary calcium levels were higher in the Spanish cohort. The Spanish patients had higher preoperative levels of PTH (13.5 versus 11.0 pmol/L,P<0.001), urinary calcium (7.3 versus 4.1 mmol/L,P<0.001), and heavier adenomas (620 versus 500 g,P<0.001). The mean increase in BMD was higher in patients from Spain and in patients with vitamin D deficiency one year after surgery.Conclusion. Postmenopasual women with PHPT from Spain had a more advanced disease and lower vitamin 25(OH)D levels. Improvement in bone density one year after surgery was higher in patients with preoperative vitamin D deficiency.

scholarly journals High Prevalence of Vitamin D Deficiency Despite Supplementation in Premenopausal Women With Breast Cancer Undergoing Adjuvant Chemotherapy

2009 ◽  
Vol 27 (13) ◽  
pp. 2151-2156 ◽  
Author(s):  
Katherine D. Crew ◽  
Elizabeth Shane ◽  
Serge Cremers ◽  
Donald J. McMahon ◽  
Dinaz Irani ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Vitamin D ◽  
Black Women ◽  
Adjuvant Chemotherapy ◽  
Vitamin D Deficiency ◽  
White Women ◽  
Premenopausal Women ◽  
Vitamin D Supplementation ◽  
Mineral Density ◽  
Vitamin D Levels

Purpose Vitamin D deficiency is associated with increased breast cancer risk and decreased breast cancer survival. The purpose of this study was to determine the prevalence of vitamin D deficiency, as measured by serum 25-hydroxyvitamin D (25-OHD), in premenopausal women at initiation of adjuvant chemotherapy for breast cancer and after 1 year of vitamin D supplementation. Patients and Methods The study included 103 premenopausal women from the northeastern United States with stages I to III breast cancer who received adjuvant chemotherapy and participated in a 1-year zoledronate intervention trial. All patients were prescribed vitamin D3 (cholecalciferol) 400 IU and calcium carbonate 1,000 mg daily. At baseline and at 6 and 12 months, bone mineral density (BMD) measurements were obtained and blood was collected and analyzed in batches for serum 25-OHD. Vitamin D deficiency was defined as serum 25-OHD less than 20 ng/mL, insufficiency as 20 to 29 ng/mL, and sufficiency as 30 ng/mL or greater. Results At baseline, 74% of women were vitamin D deficient (median, 17 ng/mL). Vitamin D deficiency was slightly less common in white women (66%) compared with black (80%) and Hispanic (84%) women. After vitamin D supplementation for 1 year, less than 15% of white and Hispanic women, and no black women, achieved sufficient 25-OHD levels. Vitamin D levels did not correlate with baseline BMD and were not altered by chemotherapy or bisphosphonate use. Conclusion Vitamin D deficiency is highly prevalent in women with breast cancer. The current recommended dietary allowance of vitamin D is too low to increase serum 25-OHD greater than 30 ng/mL. Optimal dosing for bone health and, possibly, improved survival has yet to be determined.

scholarly journals Are Indian obese children and adolescents at increased risk for Vitamin D deficiency?

2021 ◽  
Vol 0 ◽  
pp. 1-5
Author(s):  
Aashima Dabas ◽  
T. Aravind ◽  
Sangeeta Yadav ◽  
Mukta Mantan ◽  
Smita Kaushik
Keyword(s):  
Vitamin D ◽  
Vitamin D Deficiency ◽  
Vitamin D Supplementation ◽  
Obese Children ◽  
Indian Children ◽  
Hydroxyvitamin D ◽  
Increased Risk ◽  
High Risk Factor ◽  
25 Hydroxyvitamin D ◽  
Obese Subjects

Objectives: Obesity has been mentioned as a high risk factor for Vitamin D deficiency (VDD) requiring supplementation in Indian children. Material and Methods: Forty obese and age-matched non-obese subjects (age 5–18 years) were assessed for lifestyle parameters, metabolic profile, and serum 25-hydroxyvitamin D (25OHD). VDD was defined as serum 25OHD < 12 ng/mL. Results: Mean 25OHD was comparable among obese and controls (15.0 ± 9.95 and 15.1 ± 4.79 ng/mL; P = 0.97) with VDD seen in 82% of cases and 85% of controls. Pubertal cases had lower 25OHD values than prepubertal obese cases (10.78 ± 4.69 and 17.2 ± 11 ng/mL; P = 0.06). Mean duration of physical activity (<2 h/week) and screen time (>2 h/day) was similar across prepubertal and pubertal groups and between obese and controls. Obesity was not associated with risk for VDD among cases and controls (odds ratio 0.83, 95% C.I. 0.25–2.7, P = 0.76). Conclusion: Obese pubertal subjects were more at risk for VDD than prepubertal subjects. Routine Vitamin D supplementation to obese Indian children may be considered during adolescence.

scholarly journals Nutritional Supplementation of Naturally Occurring Vitamin D to Improve Hemorrhagic Stroke Outcomes

2021 ◽  
Vol 12 ◽  
Author(s):  
Rani Ashouri ◽  
Madison Fangman ◽  
Jordan Brielmaier ◽  
Zoe A. Fields ◽  
Natalie Campo ◽  
...  
Keyword(s):  
Vitamin D ◽  
Vitamin D Deficiency ◽  
Hemorrhagic Stroke ◽  
Delayed Cerebral Ischemia ◽  
Vitamin D Supplementation ◽  
Dietary Vitamin ◽  
Stroke Incidence ◽  
Stroke Outcomes ◽  
Increased Risk ◽  
The Impact

Vitamin D deficiency, if left untreated, is associated with bone disorders, cardiovascular damage, and an increased risk of ischemic stroke. While there are various nutritional options for the natural intake of vitamin D, we hope to elucidate the potential mechanisms dietary vitamin D may play in hemorrhagic stroke pathology. This scoping review outlines findings from studies relevant to the biochemical activity of vitamin D, the impact of vitamin D deficiency on hemorrhagic stroke outcomes, and the potential benefit of nutritional vitamin D on hemorrhagic stroke outcomes. Here, we analyze the relevant factors that can lead to vitamin D deficiency, and subsequently, a higher risk of hemorrhagic stroke incidence with worsened subsequent outcomes. The neuroprotective mechanisms through which vitamin D works to attenuate hemorrhagic stroke onset and post-stroke outcomes have not yet been thoroughly examined. However, researchers have proposed several potential protective mechanisms, including reduction of blood brain barrier disturbance by inhibiting the production of reactive oxygen species, mitigation of inflammation through a reduction of levels of proinflammatory cytokines, and prevention of cerebral vasospasm and delayed cerebral ischemia following subarachnoid hemorrhage and intracerebral hemorrhage. While more research is needed and there are limitations to vitamin D supplementation, vitamin D as a whole may play a significant role in the dynamics of hemorrhagic stroke. Further research should focus on expanding our understanding of the neuroprotective capacity and mechanisms of vitamin D, as well as how vitamin D supplementation could serve as an effective course of treatment of hemorrhagic strokes.

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