Preoperative Vitamin D Deficiency is a Risk Factor for Postthyroidectomy Hypoparathyroidism: A Systematic Review and Meta-Analysis of Observational Studies

Abstract Context Whether preoperative vitamin D deficiency (VDD) contributes to postoperative hypoparathyroidism (hypoPT) risk is unknown. Objective This work aimed to meta-analyze the best available evidence regarding the association between preoperative vitamin D status and hypoPT risk. Methods A comprehensive literature search was conducted in PubMed, CENTRAL, and Scopus databases, up to October 31, 2020. Study selection included patients undergoing thyroidectomy with preoperative vitamin D status and postoperative hypoPT data. Two researchers independently extracted data from eligible studies. Data were expressed as risk ratio (RR) with 95% CI. The I2 index was employed for heterogeneity. Results Thirty-nine studies were included in the quantitative analysis (61 915 cases with transient and 5712 with permanent hypoPT). Patients with VDD demonstrated a higher risk for transient hypoPT compared with those with preoperative vitamin D sufficiency (RR 1.92, 95% CI, 1.50-2.45, I2 = 85%). These results remained significant for patients with preoperative 25-hydroxyvitamin D concentrations less than or equal to 20 ng/mL (mild VDD; RR 1.46, 95% CI, 1.10-1.94, I2 = 88%) and less than or equal to 10 ng/mL (severe VDD; RR 1.98, 95% CI 1.42-2.76, I2 = 85%). The risk of permanent hypoPT was increased only in cases with severe VDD (RR 2.45, 95% CI, 1.30-4.63, I2 = 45%). No difference was evident in subgroup analysis according to study design or quality. Conclusion Patients with preoperative VDD are at increased risk of transient hypoPT following thyroidectomy. The risk for permanent hypoPT is increased only for those with severe VDD.

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Gestational vitamin D deficiency and autism spectrum disorder

BJPsych Open ◽

10.1192/bjpo.bp.116.004077 ◽

2017 ◽

Vol 3 (2) ◽

pp. 85-90 ◽

Cited By ~ 44

Author(s):

Anna A. E. Vinkhuyzen ◽

Darryl W. Eyles ◽

Thomas H. J. Burne ◽

Laura M. E. Blanken ◽

Claudia J. Kruithof ◽

...

Keyword(s):

Vitamin D ◽

Vitamin D Deficiency ◽

Critical Period ◽

Autism Spectrum ◽

Vitamin D Status ◽

Hydroxyvitamin D ◽

Increased Risk ◽

25 Hydroxyvitamin D ◽

Spectrum Disorders ◽

Clinical Records

BackgroundThere is growing interest in linking vitamin D deficiency with autism spectrum disorders (ASDs). The association between vitamin D deficiency during gestation, a critical period in neurodevelopment, and ASD is not well understood.AimsTo determine the association between gestational vitamin D status and ASD.MethodBased on a birth cohort (n=4334), we examined the association between 25-hydroxyvitamin D (25OHD), assessed from both maternal mid-gestation sera and neonatal sera, and ASD (defined by clinical records; n=68 cases).ResultsIndividuals in the 25OHD-deficient group at mid-gestation had more than twofold increased risk of ASD (odds ratio (OR)=2.42, 95% confidence interval (CI) 1.09 to 5.07, P=0.03) compared with the sufficient group. The findings persisted in analyses including children of European ethnicity only.ConclusionsMid-gestational vitamin D deficiency was associated with an increased risk of ASD. Because gestational vitamin D deficiency is readily preventable with safe, inexpensive and readily available supplementation, this risk factor warrants closer scrutiny.

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Skeletal and extra-skeletal consequences of vitamin D deficiency

Orvosi Hetilap ◽

10.1556/oh.2011.29186 ◽

2011 ◽

Vol 152 (33) ◽

pp. 1312-1319 ◽

Cited By ~ 7

Author(s):

András Szabó

Keyword(s):

Vitamin D ◽

Vitamin D Deficiency ◽

Health Care Professionals ◽

Active Form ◽

The Body ◽

Vitamin D Status ◽

Vitamin D Receptors ◽

Hydroxyvitamin D ◽

Increased Risk ◽

25 Hydroxyvitamin D

Vitamin D is obtained from cutaneous production when 7-dehydrocholesterol is converted to vitamin D(3) (cholecalciferol) by ultraviolet B radiation or by oral intake of vitamin D. Rickets appeared to have been conquered with vitamin D intake, and many health care professionals thought the major health problems resulting from vitamin D deficiency had been resolved. However, rickets can be considered the tip of the vitamin D deficiency iceberg. In fact, vitamin D deficiency remains common in children and adults. An individual’s vitamin D status is best evaluated by measuring the circulating 25-hydroxyvitamin D (25(OH)D3) concentration. There is increasing agreement that the optimal circulating 25(OH)D3 level should be approximately 30 ng/mL or above. Using this definition, it has been estimated that approximately three-quarters of all adults have low levels. In utero and during childhood, vitamin D deficiency can cause growth retardation and skeletal deformities and may increase the risk of hip fracture later in life. Vitamin D deficiency in adults can exacerbate osteopenia and osteoporosis, cause osteomalacia and muscle weakness, and increase the risk of fracture. More recently, associations between low vitamin D status and increased risk for various non-skeletal morbidities have been recognized; whether all of these associations are causally related to low vitamin D status remains to be determined. The discovery that most tissues and cells in the body have vitamin D receptors and that several possess the enzymatic machinery to convert the 25-hydroxyvitamin D3, to the active form, 1,25-dihydroxyvitamin D3, has provided new insights into the function of this vitamin. Of great interest is its role in decreasing the risk of many chronic illnesses, including common cancers, autoimmune diseases, infectious diseases, and cardiovascular disease. In this review I consider the nature of vitamin D deficiency, discuss its role in skeletal and non-skeletal health, and suggest strategies for prevention and treatment. Orv. Hetil., 2011, 152, 1312–1319.

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COVID-19 Disease Severity and Death in Relation to Vitamin D Status among SARS-CoV-2-Positive UAE Residents

Nutrients ◽

10.3390/nu13051714 ◽

2021 ◽

Vol 13 (5) ◽

pp. 1714

Author(s):

Habiba AlSafar ◽

William B. Grant ◽

Rafiq Hijazi ◽

Maimunah Uddin ◽

Nawal Alkaabi ◽

...

Keyword(s):

Vitamin D ◽

United Arab Emirates ◽

Blood Levels ◽

Vitamin D Status ◽

Hospital Visit ◽

Serum Samples ◽

Hydroxyvitamin D ◽

Increased Risk ◽

Multiethnic Population ◽

25 Hydroxyvitamin D

Insufficient blood levels of the neurohormone vitamin D are associated with increased risk of COVID-19 severity and mortality. Despite the global rollout of vaccinations and promising preliminary results, the focus remains on additional preventive measures to manage COVID-19. Results conflict on vitamin D’s plausible role in preventing and treating COVID-19. We examined the relation between vitamin D status and COVID-19 severity and mortality among the multiethnic population of the United Arab Emirates. Our observational study used data for 522 participants who tested positive for SARS-CoV-2 at one of the main hospitals in Abu Dhabi and Dubai. Only 464 of those patients were included for data analysis. Demographic and clinical data were retrospectively analyzed. Serum samples immediately drawn at the first hospital visit were used to measure serum 25-hydroxyvitamin D [25(OH)D] concentrations through automated electrochemiluminescence. Levels < 12 ng/mL were significantly associated with higher risk of severe COVID-19 infection and of death. Age was the only other independent risk factor, whereas comorbidities and smoking did not contribute to the outcomes upon adjustment. Sex of patients was not an important predictor for severity or death. Our study is the first conducted in the UAE to measure 25(OH)D levels in SARS-CoV-2-positive patients and confirm the association of levels < 12 ng/mL with COVID-19 severity and mortality.

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Skeletal and Extraskeletal Actions of Vitamin D: Current Evidence and Outstanding Questions

Endocrine Reviews ◽

10.1210/er.2018-00126 ◽

2018 ◽

Vol 40 (4) ◽

pp. 1109-1151 ◽

Cited By ~ 110

Author(s):

Roger Bouillon ◽

Claudio Marcocci ◽

Geert Carmeliet ◽

Daniel Bikle ◽

John H White ◽

...

Keyword(s):

Vitamin D ◽

Vitamin D Deficiency ◽

Human Subjects ◽

Osteoporotic Fractures ◽

Vitamin D Supplementation ◽

Current Evidence ◽

Elderly Subjects ◽

Vitamin D Status ◽

Hydroxyvitamin D ◽

25 Hydroxyvitamin D

AbstractThe etiology of endemic rickets was discovered a century ago. Vitamin D is the precursor of 25-hydroxyvitamin D and other metabolites, including 1,25(OH)2D, the ligand for the vitamin D receptor (VDR). The effects of the vitamin D endocrine system on bone and its growth plate are primarily indirect and mediated by its effect on intestinal calcium transport and serum calcium and phosphate homeostasis. Rickets and osteomalacia can be prevented by daily supplements of 400 IU of vitamin D. Vitamin D deficiency (serum 25-hydroxyvitamin D <50 nmol/L) accelerates bone turnover, bone loss, and osteoporotic fractures. These risks can be reduced by 800 IU of vitamin D together with an appropriate calcium intake, given to institutionalized or vitamin D–deficient elderly subjects. VDR and vitamin D metabolic enzymes are widely expressed. Numerous genetic, molecular, cellular, and animal studies strongly suggest that vitamin D signaling has many extraskeletal effects. These include regulation of cell proliferation, immune and muscle function, skin differentiation, and reproduction, as well as vascular and metabolic properties. From observational studies in human subjects, poor vitamin D status is associated with nearly all diseases predicted by these extraskeletal actions. Results of randomized controlled trials and Mendelian randomization studies are supportive of vitamin D supplementation in reducing the incidence of some diseases, but, globally, conclusions are mixed. These findings point to a need for continued ongoing and future basic and clinical studies to better define whether vitamin D status can be optimized to improve many aspects of human health. Vitamin D deficiency enhances the risk of osteoporotic fractures and is associated with many diseases. We review what is established and what is plausible regarding the health effects of vitamin D.

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Recommended intakes of vitamin D to optimise health, associated circulating 25-hydroxyvitamin D concentrations, and dosing regimens to treat deficiency: workshop report and overview of current literature

Journal of Nutritional Science ◽

10.1017/jns.2015.10 ◽

2015 ◽

Vol 4 ◽

Cited By ~ 33

Author(s):

Michiel G. J. Balvers ◽

Elske M. Brouwer-Brolsma ◽

Silvia Endenburg ◽

Lisette C. P. G. M. de Groot ◽

Frans J. Kok ◽

...

Keyword(s):

Vitamin D ◽

The Netherlands ◽

Vitamin D Deficiency ◽

Vitamin D Status ◽

Hydroxyvitamin D ◽

Vitamin D Intake ◽

Skeletal Disease ◽

Health Council ◽

Dosing Regimens ◽

25 Hydroxyvitamin D

AbstractVitamin D is a fat-soluble hormone that traditionally has been linked to bone health. Recently, its involvement has been extended to other (extra-skeletal) disease areas, such as cancer, CVD, energy metabolism and autoimmune diseases. Vitamin D deficiency is a worldwide problem, and several recommendation-setting bodies have published guidelines for adequate vitamin D intake and status. However, recommendations from, for example, the Health Council of the Netherlands do not provide advice on how to treat vitamin D deficiency, a condition that is often encountered in the clinic. In addition, these recommendations provide guidelines for the maintenance of ‘minimum levels’, and do not advise on ‘optimum levels’ of vitamin D intake/status to further improve health. The NutriProfiel project, a collaboration between the Gelderse Vallei Hospital (Ede, the Netherlands) and the Division of Human Nutrition of Wageningen University (Wageningen, the Netherlands), was initiated to formulate a protocol for the treatment of vitamin deficiency and for the maintenance of optimal vitamin D status. To discuss the controversies around treatment of deficiency and optimal vitamin D status and intakes, a workshop meeting was organised with clinicians, scientists and dietitians. In addition, a literature review was conducted to collect recent information on optimal intake of vitamins, their optimal circulating concentrations, and effective dosing regimens to treat deficiency. This information has been translated into the NutriProfiel advice, which is outlined in this article.

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Vitamin D status of children in Kerala, southern India

Public Health Nutrition ◽

10.1017/s1368980018003622 ◽

2019 ◽

Vol 23 (7) ◽

pp. 1179-1183 ◽

Cited By ~ 1

Author(s):

Madhava Vijayakumar ◽

Vijayalakshmi Bhatia ◽

Biju George

Keyword(s):

Vitamin D ◽

Vitamin D Deficiency ◽

Sun Exposure ◽

Southern India ◽

Fish Diet ◽

Vitamin D Status ◽

Cross Sectional ◽

Dietary Recall ◽

Hydroxyvitamin D ◽

25 Hydroxyvitamin D

AbstractObjectiveTo study plasma 25-hydroxyvitamin D (25(OH)D) status of children in Kerala, southern India, and its relationship with sociodemographic variables.DesignCross-sectional observational study.SettingTertiary government hospital.ParticipantsChildren (n 296) with trivial acute illness were enrolled. Sun exposure and Ca and vitamin D intakes (7 d dietary recall) were documented. Serum Ca, P, alkaline phosphatase, plasma 25(OH)D and parathyroid hormone (PTH) were measured.ResultsPrevalence of vitamin D deficiency (plasma 25(OH)D <30 nmol/l) was 11·1% (median, interquartile range (IQR): 52·6, 38·4–65·6 nmol/l). Children who ate fish daily had significantly higher plasma 25(OH)D than those who did not (median, IQR: 52·5, 40·8–68·9 v. 49·1, 36·2–60·7 nmol/l; P = 0·02). Those investigated in the months of March–May showed highest 25(OH)D v. those enrolled during other times (median, IQR: 58·7, 45·6–81·4 v. 45·5, 35·6–57·4 nmol/l; P <0·001). Plasma 25(OH)D correlated positively with serum P (r = 0·24, P <0·001) and Ca intake (r = 0·16, P 0·03), negatively with age (r = −0·13, P 0·03) and PTH (r = −0·22, P <0·001.). On linear regression, summer season (March–May), lower age, daily fish intake and higher Ca intake were independently associated with plasma 25(OH)D.ConclusionsPrevalence of vitamin D deficiency is low in Kerala. The natural fish diet of coastal Kerala and the latitude may be protective. Public health policy in India should take account of this geographical diversity.

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

Indian Journal of Medical Sciences ◽

10.25259/ijms_510_2020 ◽

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.

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Vitamin D insufficiency is high in Malaysia: A systematic review and meta-analysis of studies on vitamin D status in Malaysia

10.21203/rs.3.rs-833384/v1 ◽

2021 ◽

Author(s):

Shamin Mohd Saffian ◽

Nor Aini Jamil ◽

Nor Asyikin Mohd Tahir ◽

Ernieda Hatah

Keyword(s):

Vitamin D ◽

Rural Areas ◽

Urban Areas ◽

Meta Analysis ◽

Vitamin D Insufficiency ◽

Vitamin D Status ◽

Hydroxyvitamin D ◽

25 Hydroxyvitamin D ◽

Malaysian Chinese ◽

Healthy Participants

Abstract Vitamin D plays an important role in the immune system and many non-communicable diseases. The prevalence of vitamin D deficiency for the overall population of Malaysia is unknown. This study systematically reviewed and pooled studies that report vitamin D status from participants residing in Malaysia. PubMed, Scopus, Web of Science and MyJurnal were searched up to June 2021 without language restrictions. We include studies that reported the 25-hydroxyvitamin D (25(OH)D) concentrations and defined their cut-off for deficiency or insufficiency from healthy participants residing in Malaysia. Random effects model was used to pool vitamin D status using established cut-offs of < 30nmol/L, < 50nmol/L, and < 75nmol/L according to age group. We identified 203 studies, of which we included 31 studies in the meta-analysis. The pooled proportion for < 30nmol/L was 21% (95% CI 9–36, n = 2,438 from 10 studies), while the pooled proportion < 50nmol/L was 64% (95% CI 55–72, n = 13,927 from 29 studies), and < 75nmol/L was 85% (95% CI 61–100, n = 1,376 from 5 studies). Heterogeneity was high (I² ranged from 98–99%). Higher proportions of vitamin D insufficiency (defined as < 50nmol/L) were found in participants living in the urban areas (compared to rural areas), in females (compared to males), and in Malays and Malaysian Indians (compared to Malaysian Chinese) ethnicities. In conclusion, vitamin D insufficiency is highly prevalent in Malaysia, despite being a country that is close to the equator. We strongly urge prompt public health measures to improve the vitamin D status in Malaysia.

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Prevalence of vitamin D deficiency and insufficiency among schoolchildren in Greece: the role of sex, degree of urbanisation and seasonality

British Journal Of Nutrition ◽

10.1017/s0007114517002422 ◽

2017 ◽

Vol 118 (7) ◽

pp. 550-558 ◽

Cited By ~ 14

Author(s):

Yannis Manios ◽

George Moschonis ◽

Toine Hulshof ◽

Anne-Sophie Bourhis ◽

George L. J. Hull ◽

...

Keyword(s):

Vitamin D ◽

Vitamin D Deficiency ◽

Urban Areas ◽

Urban Region ◽

Vitamin D Status ◽

Hydroxyvitamin D ◽

Primary Schoolchildren ◽

Region Of Residence ◽

25 Hydroxyvitamin D

AbstractThe current study was aiming to report the prevalence of suboptimal vitamin D status among schoolchildren in Greece and investigate the role of sex, urbanisation and seasonality on vitamin D status. A sample of 2386 schoolchildren (9–13 years old) from four distinct prefectures was examined. The prevalence of 25-hydroxyvitamin D (25(OH)D) concentration <30 and <50 nmol/l (vitamin D deficiency and insufficiency respectively) was 5·2 and 52·5 %, respectively. Girls had a higher prevalence of 25(OH)D<30 (7·2 v. 3·2 %) and 50 nmol/l (57·0 v. 48·0 %) than boys (P<0·001). The highest prevalence rates of 25(OH)D<30 and 50 nmol/l (9·1 and 73·1 %, respectively) were observed during spring (April to June), whereas the lowest (1·5 and 31·9 %, respectively) during autumn (October to December). The prevalence of 25(OH)D<50 nmol/l was higher in urban/semi-urban than rural regions, particularly during spring months (74·6 v. 47·2 %; P<0·001). Female sex, urban/semi-urban region of residence and spring months were found to increase the likelihood of vitamin D deficiency and insufficiency, with the highest OR observed for spring months (7·47; 95 % CI 3·23, 17·3 and 5·14; 95 % CI 3·84, 6·89 for 25(OH)D<30 and 50 nmol/l respectively). In conclusion, despite the southerly latitude, the prevalence of low vitamin D status among primary schoolchildren in Greece is comparable to or exceeds the prevalence reported among children and adolescents on a European level. Sub-populations at highest risk are girls in urban/semi-urban areas during spring months, thus indicating the need for effective initiatives to support adequate vitamin D status in these population groups.

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Association between Vitamin D Level and Acne, and Correlation with Disease Severity: A Meta-Analysis

Dermatology ◽

10.1159/000517514 ◽

2021 ◽

pp. 1-8

Author(s):

Yusuf Hasamoh ◽

Kunlawat Thadanipon ◽

Premjit Juntongjin

Keyword(s):

Vitamin D ◽

Vitamin D Deficiency ◽

Meta Analysis ◽

Inverse Association ◽

Hydroxyvitamin D ◽

Vitamin D Levels ◽

Newcastle Ottawa Scale ◽

25 Hydroxyvitamin D ◽

The Relationship ◽

Ottawa Scale

Background: Vitamin D deficiency is frequently associated with several medical conditions. However, a comprehensive meta-analysis assessing the association between vitamin D level and acne is lacking. Objective: To determine the relationship between vitamin D level and acne, and to assess the association between vitamin D level and acne severity. Methods: This meta-analysis was assessed by using the PubMed, EMBASE, Cochrane, and Scopus databases following the PRISMA guidelines. Serum/plasma 25-hydroxyvitamin D (25[OH]D) level, vitamin D deficiency, and the severity association between acne patients and healthy controls (HCs) were evaluated. The quality assessment was performed by using the Newcastle-Ottawa Scale. Results: Thirteen articles with a total of 1,362 acne patients and 1,081 HCs were included. The circulating 25(OH)D levels were significantly lower in patients with acne than in HCs (pooled MD = –9.02 ng/mL, 95% CI = –13.22 to –4.81, p < 0.0001). Vitamin D deficiency was more prevalent in acne patients than in HCs (pooled OR = 2.97, 95% CI = 1.68–5.23, I2 = 72%). Also, vitamin D levels were negatively correlated with acne severity. Conclusion: This meta-analysis demonstrated the significantly low vitamin D levels in acne patients. Also, there was evidence of an inverse association between vitamin D levels and acne severity. Therefore, vitamin D might be involved in the pathogenesis of acne.

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