scholarly journals Vitamin D deficiency: a global perspective

2006 ◽  
Vol 50 (4) ◽  
pp. 640-646 ◽  
Author(s):  
Francisco Bandeira ◽  
Luiz Griz ◽  
Patricia Dreyer ◽  
Catia Eufrazino ◽  
Cristina Bandeira ◽  
...  
Keyword(s):  
Vitamin D ◽  
Vitamin D Deficiency ◽  
Vitamin D3 ◽  
Skin Pigmentation ◽  
Hypovitaminosis D ◽  
Good Health ◽  
Time Of Day ◽  
Ultraviolet B ◽  
Global Perspective ◽  
Increased Risk

Vitamin D is essential for the maintenance of good health. Its sources can be skin production and diet intake. Most humans depend on sunlight exposure (UVB 290315 nm) to satisfy their requirements for vitamin D. Solar ultraviolet B photons are absorbed by the skin, leading to transformation of 7-dehydrocholesterol into vitamin D3 (cholecalciferol). Season, latitude, time of day, skin pigmentation, aging, sunscreen use, all influence the cutaneous production of vitamin D3. Vitamin D deficiency not only causes rickets among children but also precipitates and exacerbates osteoporosis among adults and causes the painful bone disease osteomalacia. Vitamin D deficiency has been associated with increased risk for other morbidities such as cardiovascular disease, type 1 and type 2 diabetes mellitus and cancer, especially of the colon and prostate. The prevalence of hypovitaminosis D is considerable even in low latitudes and should be taken into account in the evaluation of postmenopausal and male osteoporosis. Although severe vitamin D deficiency leading to rickets or osteomalacia is rare in Brazil, there is accumulating evidence of the frequent occurrence of subclinical vitamin D deficiency, especially in elderly people.

scholarly journals Prevalence of Vitamin D Deficiency in Exclusively Breast Fed Infants in Suburban Area Lucknow, Uttar Pradesh

2021 ◽  
Vol 10 (44) ◽  
pp. 3730-3735
Author(s):  
Rohit Kumar Agrawal ◽  
Preeti Sharma ◽  
Pradeep Kumar ◽  
Mehek Jaggi ◽  
Rachna Sharma
Keyword(s):  
Vitamin D ◽  
Vitamin D Deficiency ◽  
Vitamin D3 ◽  
Urban Areas ◽  
Skin Pigmentation ◽  
Serum Vitamin ◽  
Tall Buildings ◽  
Hypovitaminosis D ◽  
The Body ◽  
Cross Sectional

BACKGROUND Exclusive breastfeeding is recommended up to 6 months of age with all its beneficial effects on child survival. Several studies have shown that adequate intake of vitamin D cannot be met with human milk as the sole source of vitamin D, although risk factors for developing vitamin D deficiency may be low maternal levels of vitamin D, indoor confinement during the day, living at higher altitudes, living in urban areas with tall buildings, air pollution, darker skin pigmentation, use of sunscreen and covering much over the body when outside. An infant who is entirely on breastfeeding and has minimal to no exposure to sunlight is more prone to the development of hypovitaminosis-D. The main purpose of the study was to identify the prevalence & high-risk groups of hypovitaminosis D in exclusively breastfed babies. METHODS It was a cross-sectional observational study consisting of 30 entirely breastfed healthy full-term babies with a birth weight > 2.5 kg. Babies born to mothers with a history of pre-eclampsia, gestational diabetes, antepartum haemorrhage, tuberculosis, and other chronic medical illnesses were excluded from the study. The period of study was from 1st August 2019 to 30th September 2019. Their serum vitamin D3, serum calcium, serum phosphate, and alkaline phosphatase levels were measured using appropriate methods. RESULTS In our study, 25 infants out of 30 came out as vitamin D deficient. The prevalence of vitamin D3 was found to be 83 %. CONCLUSIONS Breastfeeding is of utmost importance but the nutritional status of the mother, proper exposure to the sun, and vitamin D supplementation are the factors that should be taken care of for the prevention of hypovitaminosis D. KEY WORDS Vitamin D3, Hypovitaminosis D, Exclusive Breast Feeding, term babies, infants, Sun Exposure, Rickets

scholarly journals Ethnic aspects of vitamin D deficiency

2014 ◽  
Vol 58 (5) ◽  
pp. 540-544 ◽  
Author(s):  
Aline Correia ◽  
Maria do Socorro Azevedo ◽  
Fernando Gondim ◽  
Francisco Bandeira
Keyword(s):  
Vitamin D ◽  
Vitamin D Deficiency ◽  
High Latitude ◽  
Sun Exposure ◽  
Hypovitaminosis D ◽  
Bone Fragility ◽  
Time Of Day ◽  
Tropical Regions ◽  
Increased Risk ◽  
Vitamin D Levels

Vitamin D deficiency has been linked to bone fragility in children and adults, and to an increased risk of chronic diseases. The main sources of vitamin D are the diet and cutaneous synthesis, the latter being the most important one, since foods are relatively poor in vitamin D. The main factors influencing this endogenous production are the seasons, the time of day, latitude and skin phototype. Due to the contribution of sun exposure in maintaining vitamin D levels, it would be expected that this deficiency would be more prevalent in countries at a high latitude; it has been shown, however, that hypovitaminosis D is commonly found in tropical regions such as Brazil. In high latitude regions in which extreme skin phototypes have been compared, the prevalence of vitamin D deficiency is more common in people with originally darker skin who have a natural barrier to the already lower UV irradiation penetrating the skin. In Brazil, particularly in the areas where sun rays are more abundant, the difference in sunlight exposure between subjects showed no significant variation in serum 25-hydroxyvitamin D (25OHD).

Vitamin D3 and women's health

GYNECOLOGY ◽  
2019 ◽  
Vol 21 (1) ◽  
pp. 44-51
Author(s):  
Iuliia E Dobrokhotova ◽  
Ekaterina I Borovkova ◽  
Sofya A Zalesskaya ◽  
Victoria S Skalnaya ◽  
Ivan M Borovkov ◽  
...  
Keyword(s):  
Vitamin D ◽  
Vitamin D Deficiency ◽  
Vitamin D3 ◽  
Negative Impact ◽  
Perinatal Outcomes ◽  
Hypovitaminosis D ◽  
Malignant Neoplasms ◽  
Cellular Functions ◽  
Prophylactic Drug ◽  
Drug Doses

Background. Vitamin D is an essential component that regulates calcium homeostasis and many other cellular functions. Hypovitaminosis D is associated with a risk of osteopenia, obesity, type 1 and type 2 diabetes, malignant neoplasms and immune disorders. Inadequate vitamin D intake during pregnancy increases a risk of pre-eclampsia, preterm birth, low birth weight as well as it has a negative impact on both children’s and adolescents’ health. It is important for the clinician to be known administrating of vitamin D prophylactic and therapeutic regimens according to serum 25(OH)D levels. Aim. To determine causes and effects of vitamin D deficiency and to elaborate ways of their correction. Materials and methods. To write this review a search for domestic and foreign publications in Russian and international search systems (PubMed, eLibrary, etc.) for the last 2-15 years was conducted. The review includes articles from peer-reviewed literature. Results. The article shows that vitamin D has a significant impact on both the cardiovascular, endocrine, digestive, respiratory and other systems functioning and perinatal outcomes that necessitates vitamin D deficiency correction. It provides schemes for effective therapeutic and prophylactic drug doses calculating depending on vitamin D3 blood serum concentration. Conclusion. Preference should be given to cholecalciferol (vitamin D3) due to its better absorption properties and more efficient conversion to active vitamin metabolites (class IIC).

The effect of supplementation of vitamin D in neurocritical care patients: RandomizEd Clinical TrIal oF hYpovitaminosis D (RECTIFY)

2020 ◽  
Vol 133 (4) ◽  
pp. 1103-1112 ◽  
Author(s):  
Michael Karsy ◽  
Jian Guan ◽  
Ilyas Eli ◽  
Andrea A. Brock ◽  
Sarah T. Menacho ◽  
...  
Keyword(s):  
Patient Outcome ◽  
Clinical Trial ◽  
Vitamin D ◽  
Vitamin D Deficiency ◽  
Vitamin D3 ◽  
Neurocritical Care ◽  
Hypovitaminosis D ◽  
Mean Difference ◽  
Saps Ii ◽  
Gcs Score

OBJECTIVEHypovitaminosis D is prevalent in neurocritical care patients, but the potential to improve patient outcome by replenishing vitamin D has not been investigated. This single-center, double-blinded, placebo-controlled, randomized (1:1) clinical trial was designed to assess the effect on patient outcome of vitamin D supplementation in neurocritical care patients with hypovitaminosis D.METHODSFrom October 2016 until April 2018, emergently admitted neurocritical care patients with vitamin D deficiency (≤ 20 ng/ml) were randomized to receive vitamin D3 (cholecalciferol, 540,000 IU) (n = 134) or placebo (n = 133). Hospital length of stay (LOS) was the primary outcome; secondary outcomes included intensive care unit (ICU) LOS, repeat vitamin D levels, patient complications, and patient disposition. Exploratory analysis evaluated specific subgroups of patients by LOS, Glasgow Coma Scale (GCS) score, and Simplified Acute Physiology Score (SAPS II).RESULTSTwo-hundred seventy-four patients were randomized (intent-to-treat) and 267 were administered treatment within 48 hours of admission (as-treated; 61.2% of planned recruitment) and monitored. The mean age of as-treated patients was 54.0 ± 17.2 years (56.9% male, 77.2% white). After interim analysis suggested a low conditional power for outcome difference (predictive power 0.12), the trial was halted. For as-treated patients, no significant difference in hospital LOS (10.4 ± 14.5 days vs 9.1 ± 7.9 days, p = 0.4; mean difference 1.3, 95% CI −1.5 to 4.1) or ICU LOS (5.8 ± 7.5 days vs 5.4 ± 6.4 days, p = 0.4; mean difference 0.4, 95% CI −1.3 to 2.1) was seen between vitamin D3 and placebo groups, respectively. Vitamin D3 supplementation significantly improved repeat serum levels compared with placebo (20.8 ± 9.3 ng/ml vs 12.8 ± 4.8 ng/ml, p < 0.001) without adverse side effects. No subgroups were identified by exclusion of LOS outliers or segregation by GCS score, SAPS II, or severe vitamin D deficiency (≤ 10 ng/ml).CONCLUSIONSDespite studies showing that vitamin D can predict prognosis, supplementation in vitamin D–deficient neurocritical care patients did not result in appreciable improvement in outcomes and likely does not play a role in acute clinical recovery.Clinical trial registration no.: NCT02881957 (clinicaltrials.gov)

scholarly journals Reducing hypovitaminosis D among Somali immigrants in Minnesota: a narrative review

2019 ◽  
Vol 12 (1) ◽  
pp. 50-59
Author(s):  
Leah Qubty ◽  
Basil Aboul-Enein ◽  
Lori Bechard ◽  
Joshua Bernstein ◽  
Joanna Kruk
Keyword(s):  
Vitamin D ◽  
Vitamin D Deficiency ◽  
Light Exposure ◽  
Hypovitaminosis D ◽  
Narrative Review ◽  
Future Health ◽  
Somali Refugees ◽  
Content Type ◽  
Increased Risk ◽  
The Usa

PurposeSomalia is an East African nation with a history of civil unrest that produced a significant influx of refugees in the USA in the last 25 years. Between 2000 and 2010, 40 percent of all US Somali refugees settled in Minnesota, which produces new cultural and health challenges for local communities and the state government. One such challenge is vitamin D deficiency, or hypovitaminosis D (Hv-D). Hv-D is developed through insufficient exposure to sunlight and low nutrient intake leading to increased risk for weakness and inflammation, oral health problems, diabetes, cardiovascular and autoimmune diseases and malignancies. The paper aims to discuss these issues.Design/methodology/approachIn this narrative review, demographic, geographic and cultural information about Somali immigration are discussed.FindingsRecent data suggest Somalis living in northern climates (Minnesota, the USA, Helsinki, Finland, Sweden and the UK) experience significant deficiencies in vitamin D. Vitamin D is stimulated by ultraviolet light exposure, a balanced and healthy diet, and dietary supplementation. High unemployment rates affecting access to health information and clinical services, significant cultural differences and climate differences pre-dispose this population to Hv-D. Health education and health promotion programming at the community and state levels in Minnesota should recognize the risk factors associated with Hv-D and the vulnerability of Somali refugees.Originality/valueCurrent and future health programming should be re-assessed for adequate attention to vitamin D deficiency and cultural competency associated with the Somali immigrant population.

scholarly journals Ultraviolet B Phototherapy Intervention in Patients with Multiple Sclerosis: A Prospective, Randomized Pilot Trial

2019 ◽  
Vol 3 (1) ◽  
pp. 12-25
Author(s):  
Robert W. Motl ◽  
Grace M. Niemiro ◽  
Michael De Lisio ◽  
Sarah Sommer ◽  
Barry J. Riskin ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Vitamin D ◽  
Vitamin D Deficiency ◽  
Pilot Trial ◽  
Serum Vitamin ◽  
Ultraviolet B ◽  
Serum Vitamin D ◽  
Increased Risk ◽  
Vitamin D Levels ◽  
Uvb Phototherapy

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.

scholarly journals The Essential Role of Vitamin D in the Biosynthesis of Endogenous Antimicrobial Peptides May Explain Why Deficiency Increases Mortality Risk in COVID-19 Infections

2020 ◽  
Author(s):  
Patrick J. McCullough ◽  
Jeffrey Amend ◽  
William P. McCullough ◽  
Steven J. Repas ◽  
Jeffrey B. Travers ◽  
...  
Keyword(s):  
Vitamin D ◽  
Antimicrobial Peptides ◽  
Vitamin D3 ◽  
Skin Pigmentation ◽  
Sun Exposure ◽  
Ultraviolet B ◽  
Whole Body ◽  
High Risk Population ◽  
Uvb Radiation ◽  
Vitamin D Receptors

Abstract: A primary action of vitamin D is regulation of gene transcription. Many cell types possess genes that make antimicrobial peptides (AMPS) (endogenous antibiotics), recently discovered to be regulated by vitamin D. Two examples are cathelicidin and beta defensins, both bioactive against many different bacteria, fungi, mycobacteria, parasites and viruses. The signal transduction pathway is triggered by sensing microorganisms via cell surface receptors, causing intracellular production of calcitriol (1,25(OH)2D) and vitamin D receptors, leading to upregulation of AMP production. Serum 25(OH)D concentrations required to sustain adequate AMP production to eradicate infections are unknown. Vitamin D3 is photosynthesized in skin in amounts ranging from 10,000 (250 mcg) to 25,000 (625 mcg) International Units (IU) from 7-dehydrocholesterol after whole-body exposure to one minimal erythemal dose (MED) of ultraviolet B (UVB) radiation, and is impacted by many factors including geographic localities, seasonal changes and skin pigmentation. We and others have reported extended daily oral dosing with these amounts of vitamin D3 safe. We routinely observe serum 25(OH)D concentrations below 20ng/ml on new admissions, which have been reported insufficient to sustain AMP production. In contrast serum 25(OH)D concentrations above 100ng/ml have been reported after serial UVB treatments for psoriasis. Little vitamin D naturally occurs in food, and insufficient sun exposure may be causing worldwide deficiency. We review evidence suggesting that higher daily intakes of vitamin D3 than the currently recommended 600 (15 mcg) IU/day may be necessary to sustain AMP production in the face of an overwhelming infection, particularly in non-Hispanic blacks, a high risk population suffering the worst outcomes from COVID-19. We propose that increased vitamin D supplementation could provide a safe and cost-effective way to protect all populations from infections, in particular those from pandemic COVID-19.

scholarly journals Vitamin D for the Immune System in Cystic Fibrosis (DISC): a double-blind, multicenter, randomized, placebo-controlled clinical trial

2019 ◽  
Vol 109 (3) ◽  
pp. 544-553 ◽  
Author(s):  
Vin Tangpricha ◽  
Joshua Lukemire ◽  
Yuqing Chen ◽  
José Nilo G Binongo ◽  
Suzanne E Judd ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Cystic Fibrosis ◽  
Vitamin D ◽  
Lung Function ◽  
Vitamin D Deficiency ◽  
Vitamin D3 ◽  
Pulmonary Exacerbation ◽  
Double Blind ◽  
Increased Risk ◽  
Pulmonary Exacerbations

ABSTRACT Background Patients with cystic fibrosis (CF) have increased risk of vitamin D deficiency owing to fat malabsorption and other factors. Vitamin D deficiency has been associated with increased risk of pulmonary exacerbations of CF. Objectives The primary objective of this study was to examine the impact of a single high-dose bolus of vitamin D3 followed by maintenance treatment given to adults with CF during an acute pulmonary exacerbation on future recurrence of pulmonary exacerbations. Methods This was a multicenter, double-blind, placebo-controlled, intent-to-treat clinical trial. Subjects with CF were randomly assigned to oral vitamin D3 given as a single dose of 250,000 International Units (IU) or to placebo within 72 h of hospital admission for an acute pulmonary exacerbation, followed by 50,000 IU of vitamin D3 or an identically matched placebo pill taken orally every other week starting at 3 mo after random assignment. The primary outcome was the composite endpoint of the time to next pulmonary exacerbation or death within 1 y. The secondary outcomes included circulating concentrations of the antimicrobial peptide cathelicidin and recovery of lung function as assessed by the percentage of predicted forced expiratory volume in 1 s (FEV1%). Results A total of 91 subjects were enrolled in the study. There were no differences between the vitamin D3 and placebo groups in time to next pulmonary exacerbation or death at 1 y. In addition, there were no differences in serial recovery of lung function after pulmonary exacerbation by FEV1% or in serial concentrations of plasma cathelicidin. Conclusions Vitamin D3 initially given at the time of pulmonary exacerbation of CF did not alter the time to the next pulmonary exacerbation, 12-mo mortality, serial lung function, or serial plasma cathelicidin concentrations. This trial was registered at clinicaltrials.gov as NCT01426256.

scholarly journals The Effect of Supplementation of Vitamin D in Neurocritical Care Patients With Hypovitaminosis D: A Randomized Controlled Clinical Trial

Neurosurgery ◽  
2019 ◽  
Vol 66 (Supplement_1) ◽  
Author(s):  
Andrea Archambault Brock ◽  
Michael Karsy ◽  
Jian Guan ◽  
Ilyas Eli ◽  
Sarah Tamara Menacho ◽  
...  
Keyword(s):  
Patient Outcome ◽  
Clinical Trial ◽  
Vitamin D ◽  
Vitamin D Deficiency ◽  
Vitamin D3 ◽  
Neurocritical Care ◽  
Hypovitaminosis D ◽  
Mean Difference ◽  
Saps Ii ◽  
Saps Ii Score

Abstract INTRODUCTION Hypovitaminosis D is prevalent in neurocritical care patients, but the potential to improve patient outcome by replenishing vitamin D has not been investigated. This single-center, double-blinded, placebo-controlled, randomized (1:1) clinical trial was designed to assess the effect on patient outcome of vitamin D supplementation in neurocritical care patients with hypovitaminosis D (NCT02881957). METHODS From October 2016 to April 2018, emergently admitted neurocritical care patients with vitamin D deficiency (=20 ng/ml) were randomized to receive vitamin D3 (cholecalciferol, 540 000 IU) (n = 134) or placebo (n = 133). Hospital length of stay (LOS) was the primary outcome; secondary outcomes included intensive care unit (ICU) LOS, repeat vitamin D levels, patient complications, and patient disposition. Exploratory analysis evaluated specific subgroups of patients by LOS, Glasgow Coma Scale (GCS), and Simplified Acute Physiology Score (SAPS II). RESULTS A total of 274 patients were randomized (intent-to-treat) and 267 were administered treatment within 48 hr (as-treated; 61.2% of planned recruitment) and monitored. The mean age of as-treated patients was 54.0 ± 17·2 yr (56.9% male, 77.2% White). After interim analysis suggested a low conditional power for outcome difference (predictive power: 0.12), the trial was halted. For as-treated patients, no significant difference in hospital (10.4 ± 14.5 vs 9.1 ± 7.9 d, P = .4; mean difference = 1.3, 95% CI = −1.5, 4.1) or ICU (ICU: 5.8 ± 7.5 vs 5.4 ± 6.4 d, P = .4; mean difference = .4, 95% CI = −1.3, 2.1) LOS was seen between vitamin D3 and placebo groups. Vitamin D3 supplementation significantly improved repeat serum levels compared with placebo (20.8 ± 9.3 vs 12.8 ± 4.8 ng/ml, P < .001) without adverse side effects. No subgroups were identified by exclusion of LOS outliers or segregation by GCS score, SAPS II score, or severe vitamin D deficiency (=10 ng/ml). CONCLUSION Despite studies showing vitamin D can predict prognosis, supplementation in vitamin D deficient neurocritical care patients did not result in appreciable improvement in outcomes and likely does not play a role in acute clinical recovery.

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