scholarly journals Vitamin D and mineral metabolism after childbirth with the use of preventive doses of cholecalciferol

2019 ◽  
Vol 68 (5) ◽  
pp. 45-53
Author(s):  
Tatyana V. Novikova ◽  
Irina E. Zazerskaya ◽  
Lyubov V. Kuznetsova ◽  
Ekaterina S. Shelepova ◽  
Elena L. Khazova

Hypothesis/aims of study. According to the literature, the prevalence of vitamin D deficiency and its deficiency in pregnant women reaches 6080%, which is a significant factor in reducing bone mineral density (BMD), osteopenia, and the risk of fractures after childbirth. Hormone-mediated changes in calcium-phosphorus metabolism during lactation are an independent factor in the reduction of BMD. Therefore, the study of the relationship between vitamin D deficiency and insufficiency after childbirth and the possibility of correction is relevant. The aim of this study was to evaluate the effect of prophylactic doses of cholecalciferol and calcium carbonate over time on calcium-phosphorus metabolism indicators after childbirth. Study design, materials and methods. A randomized controlled trial was conducted based on V.A. Almazov National Medical Research Center, Saint Petersburg. 64 puerperas, who lived in St. Petersburg from 2013 to 2014, were surveyed on the 35th day after childbirth. The age of women ranged from 20 to 35 years. Blood serum levels of calcium, phosphorus, magnesium, 25-hydroxycalciferol (25(OH)D), and parathyroid hormone (PTH) were determined for all the puerpera. Using the blind envelope method, the postpartum women were randomized into groups: group I received cholecalciferol 400 IU and calcium carbonate 1000 mg after delivery for 6 months; group II received cholecalciferol 900 IU and calcium carbonate 1000 mg after delivery for 6 months. Blood sampling was performed over time to assess the levels of 25(OH)D, PTH, calcium, phosphorus, and magnesium. Results. In group I after childbirth, the initial level of 25(OH)D in the blood serum was 22.46 4.35 ng/ml, which corresponds to vitamin D insufficiency. An increase in 25(OH)D level by 3.56 ng/ml was observed after 3 months from the start of taking cholecalciferol 400 IU. After 6 months, the level of 25(OH)D reached normal values in 20% of women (p = 0.0001). In group II after childbirth, the initial level of 25(OH)D in the blood serum was 20.64 5.37 ng/ml, which corresponds to vitamin D insufficiency. An increase in 25(OH)D level by 7.60 ng/ml was observed after 3 months from the start of taking cholecalciferol 900 IU. After 6 months, the level of 25(OH)D reached normal values in 56% of women, while the average level of 25(OH)D in these women corresponded to its normally low values. The levels of PTH, calcium, phosphorus, and magnesium remained within the reference values in both groups; however, there was an increase in PTH concentration 6 months after delivery, which may indicate that the cholecalciferol dose is insufficient to stabilize PTH. Conclusion. Vitamin D deficiency and insufficiency occurred in 80-97 % of those examined after delivery. The use of prophylactic doses of cholecalciferol has a positive effect on calcium-phosphorus metabolism; however, they are not sufficient to stabilize PTH level. The cholecalciferol dose of 400 IU is insufficient to normalize the level of 25(OH)D within 6 months of administration. The cholecalciferol dose of 900 IU leads to normally low values of 25(OH)D in 56 % of women after 6 months of administration, but this does not stabilize PTH level either.

2013 ◽  
Vol 32 ◽  
pp. S121
Author(s):  
M. Cayón ◽  
C. García-Figueras ◽  
P. Bancalero ◽  
A. Terrón ◽  
S. Pérez

2015 ◽  
Vol 96 (5) ◽  
pp. 752-756
Author(s):  
E R Bikmetova ◽  
I V Golovatskikh ◽  
E V Kuznetsova ◽  
V N Kozlov ◽  
V G Ivanov

Aim. Estimation of vitamin D level and calcium-phosphorus metabolism in urban and rural school children of 8-9 years old, living in the south of Bashkortostan. Methods. The study included two groups of 2-3 class pupils: 87 children living in Meleuz and 93 children of Meleuz Region (Zirgan village). The average age was 8.3±0.66 years. The following parameters were analyzed: serum levels of 25-hydroxyvitamin D, phosphorus, total calcium level, urine calcium level, and daily calcium intake. Results. 72.4% of children from Meleuz and 30.1% of rural children had vitamin D deficiency, subclinical vitamin D-deficiency was detected in 27.6 and 63% of primary school children, respectively. The average serum calcium level in schoolchildren living in town was somewhat lower than in rural residents (p=0.0012), and was close to the lower limit of the reference values. Serum phosphorus levels and urine calcium levels were within the physiological range in the examined children no matter of where they lived. The leading causes of calcium-phosphorus metabolism alterations are reduced calcium intake and vitamin D deficiency. Conclusion. The vast majority of primary school children on the south of Bashkortostan had vitamin D-deficiency or subclinical vitamin D-deficiency. Dietary calcium intake is 60 to 70% of the age norm, which is characterized as a moderate deficit.


2020 ◽  
Vol 39 (7) ◽  
pp. 426-429
Author(s):  
Anna Agrusti ◽  
Sarah Contorno ◽  
Irene Bruno ◽  
Giulia Gortani ◽  
Egidio Barbi

Mouhamed, a 7-year-old boy of African origin, presented with progressive fatigue and difficulty in walking. He was never treated with vitamin D supplementation. The evaluation of his calcium-phosphorus metabolism revealed a myopathy related to severe rickets. Therefore, he was treated with high-dose vitamin D3 and myopathy and fatigue progressively resolved. Vitamin D plays a crucial role in the calcium-phosphorus metabolism, by acting on enterocytes, osteoclasts and renal tubule. Vitamin D deficiency is defined when the 25OHD value is less than 20 ng/ml. In order to guarantee the assumption of the minimum daily dose of vitamin D, it is recommended to start vitamin D3 supplementation in all newborns and infants in their first year of life, regardless of the feeding modality. Exposure to the sun is essential for the activation of vitamin D, so dark-skinned children and mothers or those little exposed to the sun should start vitamin D3 supplementation. Vitamin D3 should also be supplemented in children with cerebral palsy and in patients treated with anti-epileptic drugs. Other conditions at risk of vitamin D deficiency are inflammatory bowel disease, celiac disease, cystic fibrosis, obesity, liver failure, cholestasis and vegetarian or vegan diets. Classic signs of rickets are the rickety rosary, the widening of the wrist and the arching of the tibia. Severe hypocalcaemia secondary to vitamin D deficiency can occur with dilated cardiomyopathy or convulsions, especially in dark-skinned infants. Vitamin D deficiency should be considered in children with progressive myopathy or muscular weakness, especially in dark-skinned ones or in those poorly exposed to the sun for cultural or religious reasons.


2014 ◽  
Vol 17 (3) ◽  
pp. 31-33
Author(s):  
L A Scheplyagina

Well known that the lack of vitamin D in mother leads to its deficiency in the fetus. Vitamin D deficiency in the fetus significantly increases the risk of disorders of calcium/phosphorus metabolism, decreases of size of ante - and postnatal skeleton of the child, and affects the child ’s growth, bone mineral density and increases the risk of fractures in working age.


Author(s):  
Timur Minasov ◽  
Radik Nurlygayanov ◽  
Angela Vershinina ◽  
Yulia Soboleva ◽  
Damir Akhmeldinov ◽  
...  

The results of a study of the concentration of vitamin D in blood serum of 3455 residents of Ufa are presented. Physiological values of 25(OH)D were observed in 34.9 % (274) of men and 31.7 % (847) of women, which is 32.4 % (1121) of all examined. Vitamin D deficiency was detected in 67.1 % of the examined. The level of 25(OH)D in the blood serum of residents is on average 75 nmol/L, which is the upper limit of vitamin D deficiency. Vitamin D deficiency is extremely common among residents of this region of the Russian Federation (67.1 %).


2018 ◽  
Vol 3 (1) ◽  
pp. 381-384
Author(s):  
Hem Sagar Rimal ◽  
Shripad J Walavalkar

Introduction: Vitamin D is an important micronutrient having crucial role in calcium and phosphate homeostasis but there is emerging evidence to suggest its role in prevention of infectious, inflammatory and neoplastic diseases. The vitamin D insufficiency/deficiency is a widely recognized problem among children in developed as well as developing countries.Objective: To find out the prevalence of vitamin D deficiency/insufficiency among children aged 2 months to 13 yrs and its correlation with serum calcium, phosphate and demographic factors.Methodology: Prospective, cross sectional, hospital based study conducted at Birat Medical College Teaching Hospital for a period of one year among children presented to pediatric OPD in whom pediatrician had a suspicion of Vitamin D Insufficiency /Deficiency. Venous blood Samples were taken for the estimation of 25(OH) Vitamin D, Calcium and Phosphate. Statistical analysis was done using SPSS software version 16. Results Among 174 children aged 2 months to 13 years, the prevalence of vitamin D insufficiency at the cutoff of <30ng/ml was 82.75% where as no cases of vitamin D deficiency was noted at cut off level of < 10 ng/ml. Children residing in urban area, samples taken in the winter season had higher prevalence of vitamin D insufficiency (p value <0.05). Serum calcium and phosphate level were found positively correlated with Vitamin D level (p<.05). However the relationship was very strong between Vitamin D and Calcium (r=0.402, p-value <0.001) and weak positive correlation was noted with phosphate(r=0.155, p value <0.05).Conclusion: There is very high prevalence of Vitamin D insufficiency among children. The vitamin D insufficiency was significantly higher in winter season as compared to summer. Children living in the urban area are more prone to Vitamin D insufficiency. Moderately strong positive correlation was observed between Vitamin D level and calcium but weak correlation existed with phosphate. BJHS 2018;3(1)5 : 381-384


1936 ◽  
Vol 26 (1) ◽  
pp. 85-100 ◽  
Author(s):  
R. H. Common

1. Where heavy phosphorus excretion accompanies egg laying in the pullet the excretion of ammonia nitrogen is simultaneously increased. It is probable that this indicates an excretion of excess phosphate in the urine as ammonium phosphate.2. It is shown that heavy phosphorus excretion does not accompany egg laying provided the calcium carbonate intake is sufficiently high.3. The origin of the excess of phosphorus excretion is discussed in relation to calcium-phosphorus metabolism.4. Pullets on a ration containing 5 per cent, calcium carbonate laid eggs containing a higher percentage of P2O5 than pullets receiving a similar ration but from which the calcium carbonate supplement was omitted.5. Some evidence is put forward in support of the view that current standards pitch the requirements of digestible protein for egg production at too high a level.


Author(s):  
Yogiraj Vaijanathrao Chidre ◽  
Amir Babansab Shaikh

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.


2008 ◽  
Vol 93 (5) ◽  
pp. 1784-1788 ◽  
Author(s):  
Junko Yorifuji ◽  
Tohru Yorifuji ◽  
Kenji Tachibana ◽  
Shizuyo Nagai ◽  
Masahiko Kawai ◽  
...  

Abstract Context: Craniotabes in otherwise normal neonates has been regarded as physiological and left untreated. Objective: Our objective was to investigate the role of vitamin D deficiency in the development of craniotabes in normal neonates. Design and Setting: Newborn screening of craniotabes was conducted at the single largest obstetrical facility in Kyoto, Japan. Follow-up study at 1 month was conducted at Kyoto University Hospital. Subjects: A total of 1120 consecutive normal Japanese neonates born in May, 2006, through April, 2007, were included in the study. Main Outcome Measures: The incidence of craniotabes was scored each month. Neonates with craniotabes were followed up at 1 month with measurements of serum calcium, phosphorus, alkaline phosphatase (ALP), intact PTH, 25-OH vitamin D (25-OHD), urinary calcium, phosphorus, creatinine, and hand x-rays. Results: Craniotabes was present in 246 (22.0%) neonates, and the incidence had obvious seasonal variations, highest in April-May and lowest in November. At 1 month, infants with craniotabes had significantly higher serum ALP compared with normal neonates; 6.9% of them had elevated intact PTH over 60 pg/ml, and 37.3% had 25-OHD less than 10 ng/ml. When separately analyzed according to the method of feeding, 56.9% of breast-fed infants showed 25-OHD less than 10 ng/ml, whereas none of formula/mixed-fed infants did, and breast-fed infants had significantly higher serum PTH and ALP compared with formula/mixed-fed infants. Summary: These results suggest that craniotabes in normal neonates is associated with vitamin D deficiency in utero, and the deficiency persists at 1 month in many of them, especially when breast-fed.


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