Vitamin D deficiency, incidence, and response to oral supplementation among various gastrointestinal malignancies

2009 ◽  
Vol 27 (15_suppl) ◽  
pp. 9586-9586
Author(s):  
C. Gilmore ◽  
J. James ◽  
B. Zubal ◽  
D. Thomas ◽  
B. Tan

9586 Background: Vitamin (vit) D dficiency is prevalent amongst patients (pts) with colorectal and pancreatic cancers. Data for other GI malignancies are limited and the impact of short-course vit D supplementation is unclear. Methods: An IRB-approved retrospective review of 202 pts with GI cancers from 12/2007 to 9/2008 was done to evaluate the incidence of vitamin D deficiency defined as serum 25-OH vit D levels of ≤ 30 ng/ml (severe=<10 ng/ml; moderate=10–20 ng/ml; mild=21–30 ng/ml) and incidence of ‘low-normal' (31–50 ng/ml) and normal (>50 ng/ml) vit D levels. Oral supplementation with vit D at 50,000 ‘u' weekly x 8–12 weeks were done and serum levels were redrawn at 2–3 months for pts with low normal and deficient vit D, respectively. Results: 87.6% of all 202 pts is vit D deficient (61% severe to moderate). (see Table ). 92 pts were re-evaluated after 2–3 months of oral vit D supplementation. Among this cohort, the incidence of pts with vitamin deficiency decreased from 91.3% to 57.6% after first re- evaluation. Severe/moderate deficiency rates also decreased from 71.7% to 13%. There were no significant difference in response between males/females, age < or ≥ 65, caucasian or non-caucasian or tumor type. Conclusions: Vitamin D levels should routinely be evaluated for patients with GI maligancies. Oral supplementation decreases the rate 'any' vit D deficiency from 91% to 57%, and of 'severe to moderate' deficiency from 72% to 13%. Prospective studies on the impact of vit D deficiency and supplementation on various clinical outcomes among patients with GI cancers would improve supportive care management of these patients. [Table: see text] No significant financial relationships to disclose.

Blood ◽  
2013 ◽  
Vol 122 (21) ◽  
pp. 1819-1819 ◽  
Author(s):  
Joerg Thomas Bittenbring ◽  
Bettina Altmann ◽  
Frank Neumann ◽  
Marina Achenbach ◽  
Joerg Reichrath ◽  
...  

Abstract Background To investigate the impact and underlying mechanisms of vitamin-D-deficiency (VDD) on outcome of elderly (61 to 80 year-old) DLBCL patients. Methods Pretreatment 25-OH-vitamin-D serum levels from 359 patients treated in the prospective multicenter RICOVER-60 trial with 6 or 8 cycles of CHOP-14 with and without 8 cycles rituximab and 63 patients in the RICOVER-noRT study treated with 6xCHOP-14 + 8xR were determined determined by LIASION®, a commercially available chemoluminescent immunoassay. Results RICOVER-60 patients with VDD (defined as serum levels ≤8 ng/m l) and treated with rituximab had a 3-year event-free survival of 59% compared to 79% in patients with >8 ng/ml; 3-year overall survival was 70% and 82%, respectively. These differences were significant in a multivariable analysis adjusting for IPI risk factors with a hazard ratio of 2.1 [p=0.008] for event-free survival and 1.9 [p=0.040] for overall survival. In patients treated without rituximab 3-year EFS was not significantly different in patients with vitamin-D levels ≤8 and >8 ng/ml (HR 1.2; p=0.388). These results were confirmed in an independent validation set of 63 patients treated within the RICOVER-noRT study. Rituximab-mediated cellular toxicity (RMCC) against the CD20+ cell line Daudi as determined by LDH release assay increased significantly (p<0.005) in 5/5 vitamin-D-deficient individuals after vitamin-D substitution and normalization of their vitamin-D levels. Conclusions VDD is a significant risk factor for elderly DLBCL patients treated with rituximab. Our results show that VDD impairs RMCC and that RMCC can be improved by vitamin-D substitution. This together with the differential effect of VDD in patients treated with and without rituximab suggests that vitamin-D substitution might result in a better outcome of these patients when treated with CHOP plus rituximab. Supported by a grant from Deutsche Krebshilfe. Disclosures: No relevant conflicts of interest to declare.


QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Randa Reda Mabrouk ◽  
Afaf Abdelalim Mostafa ◽  
Dina Aly Mohamed Aly Ragab ◽  
Fouad Mohamed Fouad zaki

Abstract Background The extraskeletal role of vitamin D is being increasingly recognized. This has important clinical implications, as vitamin D deficiency has reached epidemic proportions worldwide. Vitamin D has proposed anti-inflammatory properties as recent data suggests that low vitamin D concentrations are associated with increased levels of inflammatory markers. Interleukin-37(IL-37) is an IL1 family cytokine discovered in recent years and has 5 different isoforms. As an immunosuppressive factor, IL-37 can suppress excessive immune response .IL37 plays a role in protecting the body against endotoxin shock, ischemia reperfusion injury, autoimmune diseases, and cardiovascular diseases. In addition, IL-37 has a potential antitumor effect. IL-37 and its receptors may serve as novel targets for the study, diagnosis, and treatment of immune-related diseases and tumors. Aim of the Work The aim of this study is to determine the relation between the level of interleukin-37 and 25-hydroxy Vitamin D among Ain Shams University medical students. Subjects and Methods The study was conducted at Clinical Pathology Department, Ain Shams University Hospitals. Ninety individuals, from medical students of Ain Shams University who participated in the Nutritional Assessment of Ain Shams University Medical Students (NAMESASU) Project, were selected to be in the study. The study included 2 groups: Group I: included 45 subjects selected from the NAMES-ASU project with deficient vitamin D serum levels. Group II: included 45 subjects selected from the NAMES-ASU project with sufficient vitamin D serum levels. Results There was a highly significant difference between the two groups regarding vitamin D levels. Serum IL-37 levels were significantly higher in group I subjects compared to group II subjects. No significant difference was observed between group I and group II regarding BMI, BFM, PBF and hsCRP. No significant difference was observed between the two subgroups regarding IL-37 levels and hsCRP levels. A highly significant negative correlation was observed between vitamin D levels and IL-37. A significant negative correlation was observed between hsCRP and vitamin D levels. However, no correlation was observed between hsCRP and IL-37 levels. Conclusion Data from our study showed that present study denote that in case of vitamin D deficiency, irrespective of BMI, a subclinical state of inflammation may be present as reflected by the increased hsCRP levels and this state of inflammation might induce an increase in IL-37, an anti-inflammatory cytokine, in an attempt to reduce the inflammation.


2021 ◽  
Author(s):  
Shyamajit Samaddar ◽  
Manvi Singh ◽  
Joseph Mathew ◽  
Naresh Sachdeva ◽  
Meenu Singh

Abstract Aim: To study the vitamin D levels in toddlers with recurrent wheezing.Methods: In this prospective observational study, 108 children aged 1-3 years with recurrent wheezing and 41 healthy age and sex matched controls were included. The clinical, demographic, socio-economic, food habits, and sun exposure of both the groups were assessed. The serum levels of vitamin D were measured and Asthma predictive index (API) of all the cases was calculated. Spearman or Pearson correlation coefficients were used to see relationship of different variables with Vitamin D.Results: Among 108 cases and 41 controls we enrolled, majority of them had vitamin D deficiency or insufficiency. The difference in vitamin D levels in the two groups was not statistically significant (p=0.0619). We found no significant difference in the vitamin D levels between, urban and rural population, vegetarians and non-vegetarians, adequately and inadequately sun light exposed children. There was also no correlation between the vitamin D levels and the number of wheezing episodes in the last 1 year. There was no significant correlation between the number of criteria of API positive and the vitamin D levels.Conclusion: Our study showed that the overall prevalence of vitamin D deficiency is very high among toddlers with recurrent wheezing. We conclude that vitamin D rich diet and sunlight exposure cannot prevent vitamin D deficiency in Indian toddlers. National programme for universal supplementation of vitamin D is required to control this epidemic of vitamin D deficiency.


2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 1354.1-1354
Author(s):  
V. Deshani ◽  
M. Khalid ◽  
K. Jadoon

Background:Primary hyperparathyroidism (PHPT) is a common endocrine condition, commonly seen with increasing age. In vast majority, it is diagnosed incidentally and causes no particular symptoms. Symptoms are usually related to acute hypercalcaemia or the complications of chronically elevated serum calcium level. Vitamin D deficiency is common among general population and in patients with PHPT. Studies in secondary hyperparathyroidism (SHPT) have shown that parathyroid hormone (PTH) response is affected by age, with those over 80 showing greater rise in PTH levels. We wanted to see if age has a similar impact on PTH response to vitamin D in those with PHPT.Objectives:To evaluate the impact of age on PTH response to vitamin D insufficiency in those with PHPT.Methods:Patients with primary hyperparathyroidism (PHPT), attending general endocrine clinic of a district general hospital, were divided into two groups based on age; less than 70 (n=73) and 70 and above (n=61).Each group was subdivided into vitamin D insufficient (VDI) and vitamin D sufficient (VDS) subgroups. We compared calcium and parathyroid hormone levels and forearm BMD (presented as T score) in VDI and VDS subgroups in the two age groups, at the time of diagnosis. Data were analyzed using unpaired t-test and presented as mean ± SEM, using Graphpad Prism 9.0.1.Results:There was significant difference in Vitamin D levels in VDI and VDS subgroups, in both age groups (<70; mean vitamin D 27.98 vs. 68.44, p<0.0001; ≥70; mean vitamin D 34.44 vs. 75.74, p<0.0001). The two groups were significantly different in terms of age (mean age 58 vs. 76, p<0.0001). Although there was no difference in calcium and forearm BMD in VDI and VDS, in both age groups, those under 70 showed a greater PTH response to vitamin D insufficiency (mean PTH 19.29 vs. 12.91 respectively, p<0.001).Conclusion:While in SHPT, those with increasing age show greater rise in PTH levels, our data show that in PHPT, younger patients show a greater PTH rise in response to vitamin D insufficiency. Further work is needed to elucidate the underlying mechanisms.References:[1]Wyskida et al., Parathyroid hormone response to different vitamin D levels in population-based old and very-old Polish cohorts, Experimental Gerontology, Volume 127, 2019, 110735, ISSN 0531-5565, https://doi.org/10.1016/j.exger.2019.110735.[2]Malik M Z, Latiwesh O B, Nouh F, et al. (August 15, 2020) Response of Parathyroid Hormone to Vitamin D Deficiency in Otherwise Healthy Individuals. Cureus 12(8): e9764. doi:10.7759/cureus.9764Disclosure of Interests:None declared.


2021 ◽  
Vol 10 (3) ◽  
pp. e57310313607
Author(s):  
Sarah Carvalho Oliveira Lima Dóro ◽  
Andréia Vitor Couto do Amaral

In dogs, the synthesis of vitamin D in the skin is considered inefficient, making dietary supplementation the main source of this vitamin for these animals. In humans, there are established values for 25-hydroxyvitamin D (25(OH)D) deficiency, insufficiency and sufficiency levels, however in dogs, the serum concentrations of these values are not well established. The purposes of this study were to evaluate the 25(OH)D serum levels in dogs carrying myoclonus as sequelae of distemper, to evaluate the response to vitamin D levels on oral supplementation, to evaluate PTH, calcium, phosphorus, alanine aminotransferase (ALT), aspartate aminotransferase (AST), blood count and leukogram levels, in addition to conduct clinical observations of myoclonus. Venous blood samples were collected from nine dogs carrying myoclonus derived from distemper, however with no other clinical or laboratorial change, of varied breeds and same age group (1 - 8 years old). Screening laboratory tests were performed to attest to the health of the animals in a 30-day period and the collections were divided into three periods: days 0, 15 and 30. After the initiation of treatment, the animals underwent physical and laboratorial evaluations every 15 days, for 90 days, completing a total of 120 days. The dose used for oral supplementation of vitamin D3 was 1000IU/kg administered every day, once a day, during the entire experimental period. For clinical evaluation, parameters of anatomical distribution, speed and rhythm, and distribution of myoclonic changes over time were observed. The laboratory results were subjected to analysis of variance and, when significant (P<0.05), submitted to regression analysis. Descriptive statistics were used to analyze clinical results. There was a significant difference in blood concentrations of 25(OH)D, PTH, calcium and phosphorus, however there was no significant effect of vitamin D on the other parameters evaluated. It was possible to conclude that the dose of vitamin D3 used was sufficient to increase 25(OH)D serum levels in the blood, to levels of sufficiency, having influence on PTH, phosphorus and calcium levels, not changing the other hematological and clinical parameters evaluated. However, the dose and duration of the treatment used did not change the myoclonus derived from distemper in dogs.


Author(s):  
Nazanin Alavi ◽  
Mahbod Ebrahimi ◽  
Firoozeh Akbari-Asbagh

Background: Vitamin D deficiency and infertility are two important health problems in Iran. Some studies suggest that vitamin D may influence Anti-Müllerian hormone (AMH) and antral follicle count (AFC) as an ovarian reserve. Objective: The present study aimed to investigate the impact of vitamin D on AMH serum concentrations/AFC. Materials and Methods: three hundred and five infertile women referred to the IVF Unit of Yas hospital, between July and December 2017, were enrolled in this cross-sectional study. The demographic characteristics of the participants, as well as the serum levels of vitamin D, AMH, and ultrasonic examination of AFC were recorded. Results: Finally, 287 infertile women were included in the analysis with a mean age of 29.95 ± 4.73 yr (18-45 yr) and a mean Body mass indexof 25.11 ± 4.41 kg/m2. The median AMH and vitamin D levels were 3.20 and 22.82 ng/ml, respectively. Considering the cut-off level of 20 ng/ml, 58.7% were vitamin D deficient. Regression analysis showed no association between AMH and vitamin D levels (p = 0.161), even after adjusting for baseline variables (p = 0.182). A total of 120 patients had an AFC < 6 and 164 ≥ 6, which was not statistically different between the groups with normal level or deficient vitamin D (p = 0.133). Conclusion: The present cross-sectional study showed no significant association between serum levels of vitamin D and AMH or AFC in infertile women, even after adjusting for baseline variables. Key words: Anti-Müllerian hormone, Infertility, Vitamin D deficiency, Ovarian follicle.


Author(s):  
Poonam Rani ◽  
Seema Gupta ◽  
Gaurav Gupta

Background: Deficiency of vitamin D is quite prevalent among elderly population or postmenopausal women worldwide and may affect various function of the body. The status of its deficiency with their relation with other variables are not well explored in perimenopausal women.Methods: 100 perimenopausal women from the department of obstetrics and gynaecology were selected without having known risk of thyroid disorder and cardiovascular disease. The age group criteria for these women were 40 to 50 years. Thyroid profile including TSH, T3, and T4 were estimated by using enzyme linked immunesorbent assay. Serum levels of 25(OH) D3 was estimated by using spectrophotometric method. Lipid profile including TC, TG and HDL-C were estimated CHOD-POD method, GPO-PAP method, and CHOD-POD/Phosphotungustate method. LDL-C was calculated by friedewald formula.Results: There 58 women were presented with insufficient amount of vitamin D. They were characterised with increased BMI, elevated thyrotropin alongwith lower concentrations of T3 and T4. Increased levels of TC, TG and LDL-cholesterol alongwith lower concentration of HDL-C were also observed in women with vitamin d deficiency. Women having vitamin D deficiency were presented with overweight (OR-18.0, p-value=<0.001) and dyslipidemia (OR-12.13, p-value≤0.001). Vitamin D was negatively correlated with variable i.e. BMI, TSH, TC, TG and LDL-C. This negative association was significant (<0.001) while HDL-C and T4 were positively correlated with vitamin D levels in this study population.Conclusions: Vitamin D deficiency frequently occurs in middle aged perimenopausal women. Negative correlation of it with BMI, TSH and lipid variables may suggest the development of cardiovascular disease and hypothyroidism in coming years. Vitamin D supplements or vitamin D containing diet and regular exposure to sun is highly recommended to perimenopausal women.


2020 ◽  
Vol 14 (Supplement_1) ◽  
pp. S536-S537
Author(s):  
D Vranesic Bender ◽  
V Domislović ◽  
M Brinar ◽  
D Ljubas Kelečić ◽  
I Karas ◽  
...  

Abstract Background Vitamin D deficiency is frequently present in inflammatory bowel disease (IBD) with a higher incidence in Crohn’s disease (CD) than in ulcerative colitis (UC). Given the involvement of the alimentary tract, many factors can contribute to vitamin D deficiency. The aim of the study was to investigate the association of vitamin D deficiency according to body mass index (BMI) in adult patients with IBD. Methods A cross-sectional study was conducted on a cohort of 152 IBD patients, 68.1% (n = 104) CD and 31.9% (n = 48) UC. The mean age of the total study population was 37.3±11.8 years and 57.3% (n = 87) were male. All patients were adult, Caucasian and without vitamin D supplementation. Patients were recruited during one year period. Results Out of all IBD patients, 60.5% (n = 92) had vitamin D deficiency, 32.2%, (n = 49) insufficiency and 7.2% (n = 11) sufficiency. According to BMI categories there were 12.5% (n = 19) obese patients, 27.6% (n = 42) overweight, 51.3% (n = 78) with normal body weight, and 8.6% (n = 13) underweight. There was a significant difference in vitamin D levels according to different BMI categories in terms of underweight patients having the lowest vitamin D levels; underweight 29.84±11.94 mmol/l, normal 46 ± 20.7 mmol/l, overweight 48±20.1 mmol/l, obese 51±15.3 mmol/l. In addition, there was a significant correlation of vitamin D levels and BMI values (Rho = 0.212, 95% CI 0.069–0.345, p = 0.004), which was more clearly observed in the lower range of BMI values (Figure 1). Male underweight patients had lower levels of vitamin D compared with female patients (26.6 ± 9 vs. 34.7 ± 5.6, p &lt; 0.05). Both patients with CD and UC had significant positive correlation of vitamin D levels and BMI values (UC Rho=0.40, 95% CI 0.16–0.59, p = 0.001, UC Rho = 0.27, 95% CI 0.01–0.05, p = 0.044). However, when comparing vitamin D levels according to phenotype, a significant difference in vitamin D levels was observed in underweight CD (28.4 ± 11.1) comparing to underweight UC patients (40.6 ± 10.6), p &lt; 0.05. In logistic regression analysis, CD phenotype was risk factor for vitamin D deficiency (OR 2.18 95% CI 1.01–4.72, β = 1.22, p = 0.04). Conclusion Our results on untreated IBD patients show a high proportion of vitamin D deficiency both in CD and UC, and significant correlation of vitamin D levels and BMI values, especially in the lower range of BMI values. Moreover, underweight CD patients have lower vitamin D levels comparing to UC. This suggests the need for regular vitamin D monitoring and supplementation especially in IBD patients at risk.


Author(s):  
Paul Zajic ◽  
Stefan Heschl ◽  
Michael Schörghuber ◽  
Petra Srekl-Filzmaier ◽  
Tatjana Stojakovic ◽  
...  

Summary Background There is controversy about the impact of acute illness on vitamin D levels. This study was carried out to assess the influence of perioperative fluid loading on 25-hydroxy-vitamin D [25(OH)D] levels. The study evaluated the clinical utility of a commonly available chemiluminescence assay (ECLIA, IDS-iSYS) and liquid chromatography/mass spectrometry (LC-MS/MS) in the diagnosis of vitamin D deficiency in this setting. Methods In this prospective observational pilot study in adult patients undergoing cardiovascular surgery on cardiopulmonary bypass (CPB), blood samples drawn at preoperative baseline (t1), after weaning from CPB (t2), on intensive care unit (ICU) admission (t3) and on the first (t4) and second (t5) postoperative days were analyzed. Results A total of 26 patients (130 samples) were included in this study. Fluid loading by CPB led to a median reduction of 25(OH)D by −22.6% (range −54.5% to −19.5%) between t1 and t2. Cohen’s kappa (κ) for method agreement for vitamin D deficiency (tested cut-off values 20 ng/ml and 12 ng/ml), was κ = 0.291 (p < 0.001) and κ = 0.469 (p < 0.001), respectively. The mean difference between measurements by ECLIA and LC-MS/MS was 4.8 ng/ml (±5.7), Pearson’s r for correlation was 0.73 (p < 0.001). The biologically inactive C3-epimer did not contribute to 25(OH)D levels assessed by LC-MS/MS. Conclusion The 25(OH)D measurements by chemiluminescence assays can noticeably deviate from those measured by LC-MS/MS, which can be considered the unequivocal gold standard. These assays may still be acceptably reliable in the screening for vitamin D deficiency, especially in the setting of low vitamin D levels. Stricter definitions, e.g. serum 25(OH)D levels lower than 12 ng/ml, may be used to diagnose deficiency with low false positive rate. Trial Registration DRKS00009216, German Clinical Trials Registry (www.drks.de)


2020 ◽  
Vol 30 (6) ◽  
pp. 375-382
Author(s):  
Andrea Melis ◽  
Davide Rizzo ◽  
Roberto Gallus ◽  
Maria Eleonora Leo ◽  
Nicola Turra ◽  
...  

BACKGROUND: Benign paroxysmal positional vertigo (BPPV) has a reported recurrence ranging from 26.8 to 50%. Osteoporosis and Vitamin D deficiency seems to have an impact on recurrence of BPPV. OBJECTIVE: to evaluate the impact of osteoporosis and Vitamin D deficiency on recurrence of BPPV. METHODS: 73 consecutive patients were divided in two groups according to the presence (group 1) or absence (group 0) of a recurrent episode. BMD, femoral and lumbar T-scores and Vitamin D levels were recorded. Statistical analysis was performed to investigate correlations. RESULTS: patients in group 1 had statistically significant lower values of both femoral (–1,62±1,06 vs. –0,53±1,51; p = 0,001), lumbar T-score (–2,10±1,19 vs –0, 53±1.51, p = 0.001) and Vitamin D (19.53±15.33). The values of femoral T-score and Vitamin D could be combined in a model able to properly classify 65.8% of the cases (p = 0.002) as isolated or recurrent BPPV, with high accuracy (AUC 0.710 [0.590 –0.830]). CONCLUSION: present data show a probable correlation between osteoporosis and Vitamin D with recurrent BPPV.


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