scholarly journals Vitamin D monitoring and management within men's secure services

BJPsych Open ◽  
2021 ◽  
Vol 7 (S1) ◽  
pp. S337-S338
Author(s):  
Jason Niblett ◽  
Shay-Anne Pantall ◽  
Anis Ahmed
Keyword(s):  
At Risk ◽  
Vitamin D ◽  
Vitamin D Deficiency ◽  
Treatment Effectiveness ◽  
Average Length ◽  
Vitamin D Insufficiency ◽  
Vitamin D Supplementation ◽  
High Rate ◽  
List Type ◽  
Electronic Patient Records

AimsTo audit the investigation, identification and treatment of Vitamin D deficiency within Men's Secure Services.BackgroundVitamin D and/or vitamin D deficiency has been suggested to play a role in the pathogenesis of mental illness. There is evidence that Vitamin D inadequacy is pandemic among rehabilitation patients in inpatient settings. Patients within secure hospitals are similarly considered to be at high risk, due to their limited solar exposure during often lengthy admissions. It has been suggested that these patients should be considered an ‘at-risk’ cohort, for whom Vitamin D supplementation should be routine. Men's secure services in Birmingham comprise of two medium secure units and a low secure rehabilitation unit. Here we present an audit of Vitamin D monitoring and treatment completed in 2019.MethodA three year retrospective review of electronic patient records, for all inpatients admitted within men's secure services as of 1 September 2019 (n = 188). Standards were based on the Trust accepted guidelines for management of Vitamin D deficiency.ResultKey findings included:- The majority of inpatients were Caucasian (43%) and African-Caribbean (24%). Ages ranged from 18 to 70, with a mean age of 39.Approximately two-thirds (65%) had been in hospital for over a year, of which 44% had been admitted for more than 3 years. The average length of admission was 885 days.Only 47% of patients had their Vitamin D level checked within the study period.Of those checked, 24% were tested within 1 month of admission. The mean duration between admission and Vitamin D testing was 464 days.Results ranged from 10.3 to 118.5nmol/L. A high rate of Vitamin D deficiency was identified (54%), whilst a further 16% had ‘inadequate’ levels.23% of those identified as requiring treatment did not receive any supplementation, whilst 59% of those with sufficient Vitamin D were prescribed treatment.Only 48% had their levels rechecked following treatment; of these, only 59% now had an adequate Vitamin D status.ConclusionThis audit demonstrates limited Vitamin D monitoring within male forensic inpatients. There was a high prevalence of Vitamin D insufficiency in this population, yet a substantial proportion of patients with identified deficiency were not prescribed any treatment. Ongoing monitoring and review of treatment effectiveness was poor. We argue that more consideration should be given to this population, with robust guidelines introduced for the treatment of this specific ‘at-risk group’.

Effects of Stratified Vitamin D Supplementation in Middle-Aged and Elderly Individuals with Vitamin D Insufficiency

2018 ◽  
Vol 50 (10) ◽  
pp. 747-753
Author(s):  
Yanhui Lu ◽  
Xiaomin Fu ◽  
Lili Zhang ◽  
Minyan Liu ◽  
Xiaoling Cheng ◽  
...  
Keyword(s):  
Vitamin D ◽  
Vitamin D Deficiency ◽  
Vitamin D3 ◽  
Intervention Group ◽  
Vitamin D Insufficiency ◽  
Vitamin D Supplementation ◽  
Control Group ◽  
Middle Aged ◽  
Oral Vitamin ◽  
Severe Vitamin

AbstractThe incidence of vitamin D deficiency is high globally, and vitamin D supplementation draws particular attention. The objective of this study was to investigate the effects of stratified vitamin D supplementation in middle-aged and elderly individuals with vitamin D insufficiency in Beijing. A total of 448 subjects aged over 40 years old were selected from a community in Beijing. Among them, 100 middle-aged and elderly people with vitamin D insufficiency were randomly selected on a voluntary basis. They were further divided into control group and intervention group. The control group received health education and lifestyle guidance, and the intervention group received lifestyle guidance and vitamin D supplementation for nine months. The doses were stratified as follows: for vitamin D insufficiency, oral vitamin D3 supplement was given at 5000 IU/w; for mild vitamin D deficiency, oral vitamin D3 supplement was given at 10 000 IU/w; for severe vitamin D deficiency, oral vitamin D3 supplement was given at 15 000 IU/w. Safety evaluation was conducted after three-month treatment. The intervention group consisted of 8%, 62%, and 30% of cases who had vitamin D insufficiency, mild vitamin D deficiency, and severe vitamin D deficiency, respectively, which were similar with the control group. It showed that the blood 25(OH)D level increased significantly in the intervention group, from 14.30±4.30 ng/ml to 33.62±6.99 ng/ml (p<0.001), in contrast to insignificant change in the control group. Stratified vitamin D supplementation effectively increased the blood 25(OH)D level, as well as the number of cases with corrected vitamin D insufficiency or deficiency.

scholarly journals Vitamin D Insufficiency May Account for Almost Nine of Ten COVID-19 Deaths: Time to Act. Comment on: “Vitamin D Deficiency and Outcome of COVID-19 Patients”. Nutrients 2020, 12, 2757

Nutrients ◽  
2020 ◽  
Vol 12 (12) ◽  
pp. 3642 ◽  
Author(s):  
Hermann Brenner ◽  
Ben Schöttker
Keyword(s):  
Vitamin D ◽  
Vitamin D Deficiency ◽  
Observational Studies ◽  
Vitamin D Insufficiency ◽  
Vitamin D Supplementation

Evidence from observational studies is accumulating, suggesting that the majority of deaths due to SARS-CoV-2 infections are statistically attributable to vitamin D insufficiency and could potentially be prevented by vitamin D supplementation [...]

scholarly journals Vitamin D in schizophrenia and depression: a clinical review

2019 ◽  
Vol 25 (4) ◽  
pp. 240-248 ◽  
Author(s):  
John Lally ◽  
Fiona Gaughran
Keyword(s):  
Vitamin D ◽  
Mental Disorders ◽  
Physical Health ◽  
Vitamin D Deficiency ◽  
Vitamin D Supplementation ◽  
Research Centre ◽  
List Type ◽  
Potential Association ◽  
Health And Social Care ◽  
Randomised Controlled

SUMMARYEvidence from preclinical and clinical studies supports a role for vitamin D deficiency in many mental disorders. In this review, we discuss the role of vitamin D in the aetiology and treatment of schizophrenia and depression and their physical health comorbidities. Although observational studies support a potential association between vitamin D and schizophrenia and depression, sufficient high-quality evidence from clinical trials does not yet exist to establish a place for vitamin D supplementation in optimising clinical response or promoting physical health. Completed randomised controlled trials are needed to provide insights into the efficacy and safety of vitamin D in the management of mental disorders.LEARNING OBJECTIVESAfter reading this article you will be able to: •outline the epidemiology of vitamin D deficiency in schizophrenia•describe the associations of vitamin D with schizophrenia and depression•know how to assess, and consider treatment for, vitamin D deficiency.DECLARATION OF INTERESTF.G. has received support or honoraria for CME, advisory work and lectures from Bristol-Myers Squibb, Janssen, Lundbeck, Otsuka, Roche and Sunovion, and has a family member with professional links to Lilly and GSK, including shares. She is in part funded by the National Institute for Health Research's (NIHR) Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King's College London and the South London Collaboration for Leadership in Applied Health Research & Care Funding scheme, and by the Maudsley Charity. The views expressed in this article are those of the authors and not necessarily those of the NHS, the NIHR or the Department of Health and Social Care.

P06 A study to assess the effectiveness of vitamin d supplementation in paediatric cystic fibrosis patients

2018 ◽  
Vol 103 (2) ◽  
pp. e1.9-e1
Author(s):  
Christiansen Nanna ◽  
Ashraf Saleha
Keyword(s):  
Cystic Fibrosis ◽  
Vitamin D ◽  
Vitamin D Deficiency ◽  
Dose Range ◽  
Vitamin D Supplementation ◽  
High Dose ◽  
List Type ◽  
Current Guideline ◽  
Paediatric Patients ◽  
Significant Difference

AimsPatients with cystic fibrosis (CF) require supplementation of fat-soluble vitamins due to the effects of the disease on the pancreas and the resulting inability of absorb fat effectively.1The study aimed to assess the effectiveness of current of vitamin D supplementation to achieve adequate serum Vitamin D (25OHD) levels in paediatric CF patients.2 Secondly, this study assessed the effectiveness of ‘Stoss’ therapy (a high dose vitamin D therapy administered every three months) as an alternative to daily vitamin D supplementation for patients with known poor compliance.3MethodsVitamin D doses and serum 25OHD levels between January and December 2016 were reviewed for paediatric CF patients at a UK centre. Data was collected for 138 paediatric patients. The ‘clinical record summary’ system was used to extract the data which included age, hospital number, weight in 2015 and 2016, 25OHD levels from 2015 and 2016, vitamin D dose before each level and pancreatic status.Data was entered onto Statistical Package for the Social Sciences (SPSS) system for analysis. A paired T-test was conducted to ascertain if there was a significant difference in weekly/kg doses between patients that were sufficient (25OHD>50 nmol/L) and insufficient (25OHD<50 nmol/L).ResultsData was collected for a total of 138 patients. The data from only 70 patients was analysed when investigating the first objective, as all other patients did not have 25OHD levels available for both 2015 and 2016. A further five patients wereexcluded and analysed seperately due to receiving Stoss therapy. The weekly Vitamin D dose range was very wide for both years with 43% (n=40) of patients requiring additional vitamin D in addition to Aquadeks (CF multivitamin preparation). There was no significant difference in Vitamin D doses between patients with sufficient and insufficient 25OHD levels. This was thecase for both 2015 (p=0.432) and 2016 (p=0.192). The daily supplementation doses were successful at maintaining vitamin D sufficiency for 83% of patients in 2015 and 93% in 2016.Out of the 5 patients who received ‘Stoss’ therapy, 3 had an increase in 25OHD levels. However, only one of the patients had a significant increase leading to sufficient 25OHD levels. In 2 cases there was actually a 60%–68% decrease in 25OHD levels, which lead to these patients developing vitamin D deficiency.ConclusionThis study was useful in determining the effectiveness of current Vitamin D dosing. The results suggest that patients having insufficient 25OHD levels may not be due to an inadequacy of doses provided in the current guideline, as there was no significant difference in dose between patients with sufficient and insufficient 25OHD levels. Given the patient group, the difference could be attributable to a lack of compliance to daily therapies in the patients with insufficient 25OHD levels or even differences in individual responses to therapy.In this sample, ‘Stoss’ therapy is not effective in maintaining sufficient 25OHD levels. Although the data for this part of the study was very limited, it identifies a need to investigate the effectiveness of ‘Stoss’ therapy further.ReferencesFerguson JH, Chang AB. Vitamin D supplementation for cystic fibrosis. Cochrane Database of Syst Rev [Internet] 2014. http://onlinelibrary.wiley.com/ & doi:10.1002/14651858.CD007298.pub3/pdf [Available: 2017April 12].Green D, Carson K, Leonard A, et al. Current treatment recommendations for correcting vitamin D deficiency in paediatric patients with cystic fibrosis is inadequate. J Pediatr2008;4:554–559.Shepherd D, Belessis Y, Katz, et al. Single high-dose oral vitamin D3 (stoss) therapy: A solution to vitamin D deficiency in children with cystic fibrosis?J Cyst Fibros2013;2:177–182.

scholarly journals An evaluation of association of vitamin D insufficiency with gestational hypertension in pregnant women

2018 ◽  
Vol 7 (8) ◽  
pp. 3109
Author(s):  
Khan Arshiya ◽  
Srivastava Meenakshi
Keyword(s):  
Blood Pressure ◽  
Vitamin D ◽  
Pregnant Women ◽  
Vitamin D Deficiency ◽  
Task Force ◽  
Gestational Hypertension ◽  
Fasting Blood Glucose ◽  
Vitamin D Insufficiency ◽  
Vitamin D Supplementation ◽  
Cross Sectional

Background: Preeclampsia (PE) is a disease specific to pregnancy affecting many bodily systems. This is characterized by high blood pressure and proteinuria after the 20th week of pregnancy. The objective of this study was to evaluate of association of vitamin D insufficiency with gestational hypertension in pregnant women.Methods: This was a cross-sectional study. A total of 104 pregnant women were included in the study. The diagnosis of gestational hypertension was confirmed using the “Report of the American College of Obstetricians and Gynaecologists’ Task Force on Hypertension in Pregnancy” criteria. Based on these criteria, patients with systolic blood pressure ≥140 mmHg and/or diastolic blood pressure ≥90 mmHg (measured after a period of rest of four hours, twice daily) and proteinuria (≥300 mg protein/24 h) were diagnosed as gestational hypertension.Results: Vitamin D deficiency was found among 78.9% (90/114) women. There was no significant (p >0.05) difference in age of women between vitamin D deficient and sufficient. Vitamin D level was significantly (p = 0.0001) lower among the women between Vitamin D deficient (15.93±4.66) and sufficient (35.70±3.25). There was no significant (p >0.05) association of Vitamin D level with parity, family history of hypertension, blood pressure, gestational age and fasting blood glucose. There was significant (p = 0.0001) difference in BMI between Vitamin D deficient (30.10±4.95) and sufficient (24.04±2.75). Tobacco consumption was also associated with the level of Vitamin D. There was significant negative correlation between BMI and Vitamin D level (r = -0.56, p = 0.00011).Conclusions: The present study demonstrates that vitamin D plays a role in the ethology and pathophysiology of gestational hypertension. Among the population having the risk of vitamin D deficiency, the risk of pregnancy induced hypertension may be decreased through vitamin D supplementation.

scholarly journals Status and influential factors of vitamin D among children aged 0 to 6 years in a Chinese population

2020 ◽  
Author(s):  
Heng Zhang ◽  
Zhijuan Li ◽  
Yarong Wei ◽  
Jinyan Fu ◽  
Yaling Feng ◽  
...  
Keyword(s):  
Vitamin D ◽  
Vitamin D Deficiency ◽  
Chinese Population ◽  
Vitamin D Insufficiency ◽  
Vitamin D Supplementation ◽  
Influential Factors ◽  
Enzyme Linked Immunosorbent Assay ◽  
Group 3 ◽  
Wuxi City ◽  
Group 1

Abstract Background : Vitamin D insufficiency and deficiency in childhood are common. However, the status and influential factors of vitamin D during different ages are not clear. This study aimed to survey vitamin D concentrations in children aged 0 to 6 years and explore its influential factors. Methods: A total of 6953 children were recruited in Wuxi City of East China from January to December in 2016. Enzyme-linked immunosorbent assay was used to determine the serum concentrations of 25-hydroxyvitamin D [25(OH)D]. Results: The median vitamin D concentrations in the infant group (0-1 years of age) was 69.40 nmol/L, which were higher than that in both the toddlerhood group (1-3 years of age; 62.30 nmol/L) and the preschool group (3-6 years of age; 50.85 nmol/L). In addition, the median vitamin D concentrations were 71.70 nmol/L in summer, which was higher than that in spring (64.25 nmol/L), autumn (62.95 nmol/L) and winter (64.10 nmol/L). However, no difference was observed between genders ( P = 0.974). Furthermore, the prevalence of vitamin D deficiency (<50 nmol/L) was 48.1% in the preschool group (3-6 years of age), which was higher than the 21.2% vitamin D deficiency in the toddlerhood group (1-3 years of age) and the 17.9% vitamin D deficiency in the infant group (0-1 years of age). Interestingly, a nonlinear association between 25(OH)D and air temperature was observed. Conclusions: A high prevalence of vitamin D deficiency was common in a Chinese population of children 0-6 years old, especially in the preschool-aged children. Therefore, we suggested that we should pay more attention to vitamin D supplementation in Chinese young children.

25-OHD response to vitamin D supplementation in children: effect of dose but not GC haplotype

2021 ◽  
Author(s):  
Christine A. Simpson ◽  
Jane H. Zhang ◽  
Dirk Vanderschueren ◽  
Lei Fu ◽  
Teresita C. Pennestri ◽  
...  
Keyword(s):  
At Risk ◽  
Vitamin D ◽  
Vitamin D Deficiency ◽  
Vitamin D3 ◽  
Randomized Study ◽  
Vitamin D Supplementation ◽  
Children At Risk ◽  
Double Blind ◽  
Baseline Levels ◽  
To Receive

Objective: GC/DBP effects on response to vitamin D supplementation have not been well-studied. Thus we assessed free and total 25-OHD after vitamin D treatment across the 6 common GC haplotypes. Design: This double-blind, randomized study compared two vitamin D3 doses in healthy, urban-dwelling 6-month to 10-year-old children at-risk for vitamin D deficiency. Randomization was stratified by GC haplotype. Methods: Children were randomized to receive 2800 or 7000 International Units of vitamin D3 weekly. 25-OHD and 1,25(OH)2D were sampled at baseline and after 1 and 6 months of supplementation. Results and Conclusions: 192 of 225 enrolled subjects completed the study. After one month, total 25-OHD increased with both doses, and were higher with 7000 IU/week (85.5 ± 22.8 nmol/L) compared to 2800 IU/week (76.8 ± 18.0 nmol/L), despite equivalent baseline levels. No further significant increase occurred at 6 months (89.8 ± 35.5 and 74.3 ± 18.3 nmol/L, respectively). Free 25-OHD similarly changed. 25-OHD differed among GC groups at baseline. Although no significant effects of individual GC haplotypes on incremental changes were evident, a trend towards an effect of combined “at risk” GC alleles on response was evident (P=0.06). Total 1,25(OH)2D showed modest increases, moreso with the larger dose. In urban-dwelling children at-risk for vitamin D deficiency, one month of vitamin D3 2800 IU/week increased 25-OHD across all GC haplotype groups, and somewhat enhanced with 7000 IU/week with no further significant increases after 6 months of supplementation. Free 25-OHD measures offer no monitoring advantage over total 25-OHD.

scholarly journals Significant Independent Predictors of Vitamin D Deficiency in Inpatients and Outpatients of a Nephrology Unit

2013 ◽  
Vol 2013 ◽  
pp. 1-5 ◽  
Author(s):  
Recep Bentli ◽  
Hulya Taskapan ◽  
Halil Toktaş ◽  
Ozkan Ulutas ◽  
Adnan Ozkahraman ◽  
...  
Keyword(s):  
Vitamin D ◽  
Vitamin D Deficiency ◽  
Female Gender ◽  
Vitamin D Insufficiency ◽  
Vitamin D Supplementation ◽  
Documentary Evidence ◽  
Hydroxyvitamin D ◽  
Nitrogen Levels ◽  
25 Hydroxyvitamin D ◽  
Higher Doses

Aims. Kidney disease was found to be a major risk factor for vitamin D deficiency in a population study of patients hospitalized. The aims of the study were to describe the prevalence of vitamin D deficiency inpatients and outpatients in a nephrology department during fall and to evaluate effect of assessing serum 25-hydroxyvitamin D (25(OH)D) levels and previous supplementation of cholecalciferol on vitamin D status.Methods. We studied 280 subjects in total, between October and January. The subjects were recruited from the following two groups: (a) inpatients and (b) outpatients in nephrology unit. We examined previous documentary evidence of vitamin D supplementation of the patients.Results. The prevalence of vitamin D deficiency among these 280 patients was 62,1% (174 patients). Fifty-three patients (18.9%) had severe vitamin D deficiency, 121 patients (43.2%) moderate vitamin D deficiency, and 66 patients (23.6%) vitamin D insufficiency. In logistic regression analysis female gender, not having vitamin D supplementation history, low serum albumin, and low blood urea nitrogen levels were significant independent predictors of vitamin D deficiency while no association of vitamin D deficiency with diabetes mellitus, serum creatinine, eGFR, and being hospitalized was found.Conclusion. Vitamin D deficiency, seems to be an important problem in both inpatients and outpatients of nephrology. Monitoring serum 25(OH)D concentrations regularly and replacement of vitamin D are important. Women in Turkey are at more risk of deficiency and may therefore need to consume higher doses of vitamin D.

scholarly journals Correlation of Vitamin D Serum Level of Mothers and Their Newborns

2021 ◽  
Vol 18 (2) ◽  
Author(s):  
Hassan Boskabadi ◽  
Elahe Heidari
Keyword(s):  
Vitamin D ◽  
Vitamin D Deficiency ◽  
Serum Levels ◽  
Cross Sectional Study ◽  
Vitamin D Supplementation ◽  
High Rate ◽  
Cross Sectional ◽  
Maternal Vitamin ◽  
Premature Newborns ◽  
Vitamin D Levels

Background: The possibility of vitamin D deficiency is high among mothers and their premature newborns. Objectives: Due to the high rate of vitamin D deficiency in Iranian women, this study aimed to determine the association between the serum levels of vitamin D in the blood of premature newborns and their mothers in the Iranian population. Methods: This cross-sectional study was conducted on 324 mothers and their 324 newborns with gestational age less than 37 weeks, who were referred to Ghaem Hospital affiliated to Mashhad University of Medical Sciences, Mashhad, Iran, during 2016-2020. After clamping, 1.5 cc blood samples were obtained through the umbilical cord to determine the neonates’ vitamin D levels. Finally, the serum levels of vitamin D were measured, and the correlation between the levels of vitamin D of mothers and their newborns was calculated. Results: The mean vitamin D levels of newborns and mothers were 15.75 ± 11.18 and 20.16 ± 13.41 ng/mL, respectively. Moreover, there was a high correlation between the vitamin D levels of mothers and their newborns (r = 0.672; P < 0.001). Furthermore, a significant correlation was observed between the vitamin D levels of mothers, who used vitamin D supplementation during pregnancy and their neonates’ levels (r = 0.773; P < 0.001). Conclusions: The findings suggest a positive correlation between neonatal and maternal vitamin D levels. Moreover, it seems that maternal vitamin D levels can predict neonatal vitamin D deficiency.

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