Dependent and independent causes of hypercalcemia

Previous clinical studies show that the condition is significantly associated with mortality and increased cardiovascular morbidities. Accordingly, it is essential to conduct adequate diagnosis and evaluation to assess these cases properly. Studies show that different etiologies have been associated with hypercalcemia development with variable prevalence rates among different populations. Reduced PTH levels among patients with hypercalcemia indicate the presence of a non-PTH-dependant etiology for hypercalcemia. We have discussed various causes of hypercalcemia, including dependant and non-dependant causes. We found that malignancy-induced hypercalcemia is the commonest non-PTH-dependant etiology of hypercalcemia. Many malignancies were reported in the literature to attribute to the development of hypercalcemia. Vitamin D-mediated hypercalcemia was also reported as another common etiology for the condition. It might occur secondary to overdosing, immobilization, endocrine disorders, and granulomatous diseases. Other familial and congenital causes were also reported in the literature and discussed.

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Levels of vitamin D in patients with various endocrine disorders

Endocrine Abstracts ◽

10.1530/endoabs.35.p119 ◽

2014 ◽

Author(s):

Ekaterina Pigarova ◽

Larisa Dzeranova ◽

Liudmila Rozhinskaya ◽

Alexander Il'in ◽

Galina Melnichenko

Keyword(s):

Vitamin D ◽

Endocrine Disorders

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ASSOCIATION OF OVARIAN VITAMIN D AND HORMONE RECEPTORS EXPRESSION IN WOMEN WITH POLYCYSTIC OVARY SYNDROME

Crimea Journal of Experimental and Clinical Medicine ◽

10.37279/2224-6444-2020-10-4-36-42 ◽

2021 ◽

Vol 10 (4) ◽

pp. 36-42

Author(s):

S. T. Aigul ◽

G. A. Demyashkin ◽

M. R. Orazov ◽

S. Yu. Kalinchenko ◽

G. M. Shaimardanova ◽

...

Keyword(s):

Vitamin D ◽

Hormone Receptors ◽

Polycystic Ovary ◽

Married Couples ◽

Ovarian Cysts ◽

Control Group ◽

Endocrine Disorders ◽

Social Burden ◽

Metabolism Disorder ◽

Group I

Infertility is one of the most common diseases of the reproductive system, which carries a significant medical and social burden, affecting from 10 to 15% of married couples, and one of the causes of which is polycystic ovarian syndrome (PCOS), associated with menstrual and endocrine disorders. Changes in the concentration of key enzymes of the metabolic pathway of vitamin D in PCOS may affect the regulation of local tissue homeostasis. Mechanisms of inhibition of cell proliferation under the action of vitamin D have not been fully explored. The aim of the study is to investigate the expression of VDR and hormone receptors in the ovaries of women with PCOS. Material and methods. Patients were divided into main (I) and control groups (II), that included women (n=60) aged 18 to 44 years (mean age - 29.1±3.3 years), who at diagnostic laparoscopy due to infertility of unknown cause. Immunohistochemical (IHC) study of ovarian cysts was performed according to a standard protocol using antibodies to VDR, AR, ERß, PR. The expression of VRD, 1α-OH, 24-OH in samples of ovarian cysts was determined by polymerase chain reaction in real time (PCR-RT). Results. The following IHC expression of the studied markers was observed in the samples of the 1st group cysts of women with PCOS: VDR - 67.7±2.1%; AR - 51.7±1.3%; ERß - 23.1±1.2%; PR - 89.3±2.1%. According to PCR-RT data, the relative VDR expression in group I was 4,31±0,18 arb. u., vs 2,17±0,11 arb. u. in the control group. Conclusions. The key role in PCOS pathogenesis is played by complex metabolism disorder of vitamin D and androgen-estrogen balance as well as decrease of ERß and increase of PR expression level.

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DENTAL IMPLANTS IN MEDICALLY COMPROMISED PATIENTS

10.36106/ijar/6912181 ◽

2021 ◽

pp. 64-65

Author(s):

A.Bhagya Mathivanan ◽

Balakrishnan Balakrishnan

Keyword(s):

Literature Review ◽

Dental Implants ◽

Clinical Studies ◽

Meta Analysis ◽

Endocrine Disorders ◽

Oral Bisphosphonates ◽

Inclusion Criteria ◽

Vital Function ◽

The Status ◽

Compromised Patients

The present study was carried out with an aim and interest to evaluate the status of implant, its function, and durability which are placed in the medically compromised patient .The literature review was done in order to identify the medically compromised patients with implants and were on medication with oral bisphosphonates for the ossication to be formed around dental implants for its vital function. The articles published between the years2001 to 2010 were included in the study. The articles of clinical studies in which 7-8 patients were treated, consensus articles,review articles and meta analysis were included. The total of 34 articles was found in which 26 articles met the inclusion criteria. The systematic diseases/ medically compromised are those patients with cardiac, diabetic,endocrine disorders and who are also seems to treated with dental implant and its outcomes.

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Association of Vitamin D Pathway Gene CYP27B1 and CYP2R1 Polymorphisms with Autoimmune Endocrine Disorders: A Meta-Analysis

The Journal of Clinical Endocrinology & Metabolism ◽

10.1210/clinem/dgaa525 ◽

2020 ◽

Vol 105 (11) ◽

Author(s):

Xiaoxi Ma ◽

Zhiguo Xie ◽

Jiabi Qin ◽

Shuoming Luo ◽

Zhiguang Zhou

Keyword(s):

Vitamin D ◽

Type 1 Diabetes ◽

Meta Analysis ◽

Hashimoto Thyroiditis ◽

Minor Allele ◽

Graves Disease ◽

Endocrine Disorders ◽

Organ Specific ◽

Allele Model

Abstract Background Studies on organ-specific autoimmune endocrine disorders showed correlations between disease risks and vitamin D pathways gene variants, such as CYP27B1 rs10877012 and rs4646536, or CYP2R1 rs10741657 single nucleotide polymorphisms. However, previous works presented inconsistent conclusions. Our study aimed at assessing the association of CYP27B1 and CYP2R1 polymorphisms with autoimmune endocrine disorder susceptibility using the meta-analysis method. Methods Case-control studies of the subject of interest were identified from the databases Pubmed, Embase, Cochrane Library, and China National Knowledge Infrastructure. Studies that met inclusion and quality criteria were pooled. Observational outcomes were diagnosis of autoimmune Addison’s disease, Graves disease, Hashimoto thyroiditis, or type 1 diabetes mellitus. Statistical analysis was performed using software STATA 16.0. Results A total of 14 studies involving 12 929 patients (2243 autoimmune Addison disease, 1253 Graves disease, 612 Hashimoto thyroiditis, 8821 type 1 diabetes), and 12 907 healthy control subjects were pooled for meta-analysis. The rs10877012 minor allele A and its homozygote and heterozygote conferred low overall disease risk (OR [odds ratio] = 0.748, 95% CI [confidence interval] 0.620-0.902 in dominant model; OR = 0.709, 95% CI 0.571-0.879 in recessive model; OR = 0.777, 95% CI 0.674-0.895 in the allele model). The population carrying rs4646536 minor allele C and its homozygote and heterozygote showed decreased overall autoimmune endocrine disorders risk (OR = 0.849, 95% CI 0.748-0.963; OR = 0.868, 95% CI 0.790-0.955; OR = 0.915, 95% CI 0.875-0.957 in the dominant, recessive, and allele model, respectively). No significant genetic association was found for rs10741657. Conclusion Our study suggested CYP27B1 polymorphisms rs10877012 minor allele A and rs4646536 minor allele C were negatively related to susceptibilities of organ-specific autoimmune endocrine diseases.

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Vitamin D Immunomodulatory Potential in Multiple Sclerosis

Folia Medica ◽

10.2478/folmed-2013-0011 ◽

2013 ◽

Vol 55 (2) ◽

pp. 5-9 ◽

Cited By ~ 4

Author(s):

Georgi S. Slavov ◽

Anastasiya G. Trenova ◽

Mariya G. Manova ◽

Ivanka I. Kostadinova ◽

Tonka V. Vasileva ◽

...

Keyword(s):

Multiple Sclerosis ◽

Vitamin D ◽

Clinical Studies ◽

Short Interval ◽

Unknown Etiology ◽

Vitamin D Metabolism ◽

Social Burden ◽

25 Hydroxy Vitamin D ◽

The Central Nervous System ◽

Immunomodulatory Potential

ABSTRACT Multiple sclerosis (MS) is an autoimmune disease of unknown etiology whose treatment is of limited efficiency and therefore has a high social burden. As it has been suggested that myelin destruction model, the clinical manifestation and the potential of therapeutic response in MS are correlated, it is quite justifiable that we study various factors (genetic, hormonal, environmental) that take part in the autoimmune process in order to improve the control over the disrupted immune regulation. Results from epidemiological and clinical studies clearly suggest that changes in vitamin D serum concentrations are correlated with the magnitude of the risk of developing MS, the phases of relapse and remittance and with gender differences in vitamin D metabolism. Experimental and clinical studies also have established that 25-hydroxy vitamin D (25(OH)D) and 1,25-dihydroxy vitamin D (1,25(OH)2D) exert an immunomodulatory effect in the central nervous system and peripheral organs of the immune system. The standard reference range of vitamin D concentration in serum is 50-80 nmol/l - it provides normal calcium metabolism. Issues that are discussed include the vitamin D serum concentration needed to suppress the aberrant immune response in MS patients; a subgroup of MS patients suitable for vitamin D treatment, the vitamin D being applied in optimally effective and safe dosage. MS prevalence rate in Bulgaria has increased two-fold in 17 years but this is a rather short interval to be able to assume that the gene pool of the population changes. Thus further studies on possible interactions between different environmental factors and these factors’ role in the disease pathogenesis are justified and necessary.

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Influence of Vitamin D Binding Protein on Accuracy of 25-Hydroxyvitamin D Measurement Using the ADVIA Centaur Vitamin D Total Assay

International Journal of Endocrinology ◽

10.1155/2014/691679 ◽

2014 ◽

Vol 2014 ◽

pp. 1-12

Author(s):

James Freeman ◽

Kimberly Wilson ◽

Ryan Spears ◽

Victoria Shalhoub ◽

Paul Sibley

Keyword(s):

Vitamin D ◽

Healthy Subjects ◽

Binding Protein ◽

Reference Method ◽

Total Serum ◽

Vitamin D Binding Protein ◽

Hydroxyvitamin D ◽

Liquid Chromatography Tandem Mass ◽

25 Hydroxyvitamin D ◽

Different Populations

Vitamin D status in different populations relies on accurate measurement of total serum 25-hydroxyvitamin D [25(OH)D] concentrations [i.e., 25(OH)D3and 25(OH)D2]. This study evaluated agreement between the ADVIA Centaur Vitamin D Total assay for 25(OH)D testing (traceable to the NIST-Ghent reference method procedure) and a liquid chromatography tandem mass spectrometry (LC-MS/MS) method for various populations with different levels of vitamin D binding protein (DBP). Total serum 25(OH)D concentrations were measured for 36 pregnant women, 40 hemodialysis patients, and 30 samples (DBP-spiked or not) from healthy subjects. ELISA measured DBP levels. The mean serum DBP concentrations were higher for pregnancy (415 μg/mL) and lower for hemodialysis subjects (198 μg/mL) than for healthy subjects and were highest for spiked serum (545 μg/mL). The average bias between the ADVIA Centaur assay and the LC-MS/MS method was −1.4% (healthy), −6.1% (pregnancy), and 4.4% (hemodialysis). The slightly greater bias for samples from some pregnancy and hemodialysis subjects with serum DBP levels outside of the normal healthy range fell within a clinically acceptable range—reflected by analysis of their low-range (≤136 μg/mL), medium-range (137–559 μg/mL), and high-range (≥560 μg/mL) DBP groups. Thus, the ADVIA Centaur Vitamin D Total assay demonstrates acceptable performance compared with an LC-MS/MS method for populations containing different amounts of DBP.

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Vitamin D and Chronic Lung Disease: A Review of Molecular Mechanisms and Clinical Studies

Advances in Nutrition ◽

10.3945/an.111.000398 ◽

2011 ◽

Vol 2 (3) ◽

pp. 244-253 ◽

Cited By ~ 66

Author(s):

James D. Finklea ◽

Ruth E. Grossmann ◽

Vin Tangpricha

Keyword(s):

Vitamin D ◽

Lung Disease ◽

Chronic Lung Disease ◽

Clinical Studies ◽

Molecular Mechanisms

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Hypercalcemia: A Metabolic Complication of an AIDS-Defining Illness

Journal of the Endocrine Society ◽

10.1210/jendso/bvab048.403 ◽

2021 ◽

Vol 5 (Supplement_1) ◽

pp. A198-A199

Author(s):

Dorothy E Bennett ◽

Ruba Riachy ◽

Lucas S Blanton ◽

L Maria Belalcazar

Keyword(s):

Vitamin D ◽

Immune Reconstitution ◽

Kidney Injury ◽

Thyroid Stimulating Hormone ◽

High Serum ◽

Hiv Viral Load ◽

Dihydroxyvitamin D ◽

Metabolic Complication ◽

Granulomatous Diseases ◽

Hiv 1

Abstract Background: Hypercalcemia may result from the activation of macrophages in granulomatous diseases with increased production of 1,25 dihydroxyvitamin D/calcitriol. Its occurrence in patients with human immunodeficiency virus-1 (HIV-1) infection may be atypical and signal major changes in immune status. We report on a patient with acquired immunodeficiency syndrome (AIDS) presenting with new-onset hypercalcemia after months of treatment for mycobacterium avium complex (MAC) infection and normal calcitriol levels. Clinical Case: A 37-year-old man on treatment for HIV-1 and disseminated MAC infection presented to the hospital 6 months after initial diagnosis with worsening headache, cough, and abdominal pain. On arrival he was afebrile and without palpable lymphadenopathy. He was found to have a high serum calcium (13.4 mg/dL, n 8.6–10.6 mg/dL) and acute kidney injury (AKI) (creatinine 4 mg/dL, n 0.6–1.25 mg/dL). His CD4 count had increased from 24 at time of diagnosis to 162 cells/μL (n 410–1,590 cells/μL); his HIV viral load was undetectable. Workup for hypercalcemia revealed an elevated phosphorus (5.2 mg/dL, n 2.5–5.0 mg/dL), low 25-OH vitamin D level (<13 ng/mL, n 25–80 ng/dL), low PTH (4.8 pg/mL, n 12–88 pg/mL), and calcitriol level of 31.4 pg/mL, n 19.9–73.3 pg/mL). Additional tests, including serum electrophoresis, thyroid stimulating hormone, and parathyroid hormone-related peptide levels, were unremarkable. The patient was diagnosed with hypercalcemia secondary to dysregulated calcitriol production in the setting of disseminated MAC and possible immune reconstitution. Hypercalcemia resolved with hydration and prednisone 20 mg daily. Patient was discharged with an 8-day prednisone taper, but readmitted to the hospital 3 weeks later with recurrent hypercalcemia (13.8 mg/dL) and AKI. Urine calcium was found to be elevated (484 mg/24 hours, n100-300 mg/24 hours) and repeat calcitriol was 53.6 pg/ml. Patient was restarted on prednisone 40 mg daily with normalization of calcium within 5 days (calcium 10.3 mg/dL). Conclusion: Hypercalcemia due to increased calcitriol production in the setting of MAC infection, an AIDS-defining illness, may occur months after initiation of effective antibiotic and antiviral therapy and could represent a manifestation of immune reconstitution. The deleterious effects of excess calcitriol may be present even in patients with chronic vitamin D deficiency and a calcitriol level that inappropriately remains within the normal range.

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About antiviral effects of vitamin D

Medical Council ◽

10.21518/2079-701x-2020-3-152-158 ◽

2020 ◽

pp. 152-158

Author(s):

O. A. Gromova ◽

I. Yu. Torshin ◽

D. E. Frolova ◽

N. P. Lapochkina ◽

O. A. Limanova

Keyword(s):

Vitamin D ◽

Human Papillomavirus ◽

Viral Hepatitis ◽

Vitamin D Deficiency ◽

Clinical Studies ◽

Respiratory Infections ◽

Antiviral Immunity ◽

Antiviral Action ◽

Epstein Barr ◽

Based Medicine

Preventing infectious diseases is very important in obstetric and gynaecological practice. Vitamin D is a complex regulator of innate and adaptive immunity. It is known that lack of vitamin D reduces antibacterial and antiviral immunity, stimulates the development of pathologies associated with chronic systemic inflammation. Evidence from evidence-based medicine indicates the importance of using vitamin D preparations to support immunity. The results of fundamental and clinical studies have shown that chronic inflammation and congenital immunity disorders resulting from vitamin D deficiency significantly reduce the body’s resistance not only to tuberculosis, but also to viral hepatitis, acute respiratory infections, papillomavirus and herpesvirus. In addition to a pronounced antibacterial effect, vitamin D is also characterized by its antiviral action. By increasing the expression of interferon-alpha, cathecidine, defensin and antiviral microRNA, vitamin D activates various mechanisms of congenital antiviral immunity. Studies show the need to compensate for vitamin D deficiency for successful therapy of viral hepatitis, respiratory infections, human papillomavirus (HPV) and herpesvirus. In the present article the molecular fundamentals of antiviral action of vitamin D are sequentially considered, as well as the results of fundamental and clinical studies indicating the action of vitamin D against the viruses of hepatitis, herpes, RSV, Epstein-Barr, human papillomavirus, the possibility of using vitamin D in the treatment of these and other viral pathologies is considered. The authors analyzed data on the effect of vitamin D on immunity functions and antiviral protection of the human body.

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Vitamin D and Coronavirus Disease (COVID-19); Is Deficiency and Maintenance Supplementation Therapy Necessary?

Journal of Nutrition and Food Security ◽

10.18502/jnfs.v5i3.3790 ◽

2020 ◽

Author(s):

Seyedeh Mahdieh Namayandeh

Keyword(s):

Vitamin D ◽

Vitamin D3 ◽

Bone Structure ◽

Antimicrobial Activities ◽

Gram Negative Bacteria ◽

Enveloped Viruses ◽

The People ◽

General Metabolism ◽

Immune System Regulation ◽

Different Populations

Vitamin D is a fat soluble vitamin with a well-known general metabolism and actions in bone structure and immune system regulation. Vitamin D exhibits direct antimicrobial activities against a spectrum of microbes, including Gram-positive and Gram-negative bacteria, enveloped and non-enveloped viruses, as well as fungi. An observational study showed that concentrations of 38 ng/ml or more were associated with a significant more than twofold reduction in the risk of developing acute respiratory syndrome (17% vs. 45%). Some clinical trials on vitamin D showed a decrease in incidence and severity of the Coronavirus Disease 2019 (COVID-19). To achieve the optimum vitamin D3 levels, approximately half of the population should take at least 2000–5000 iu/d of vitamin D3. Various loading doses were proposed for achieving a 25(OH)D concentration of 30 ng/ml. A study reported that to achieve the concentration of 40–60 ng/ml a weekly or fort nightly dose totaling 100,000–200,000 iu over 8 weeks (1800 or 3600 iu/d) as loading should be prescribed. Approximately about half the people, using 5000 iu/d of vitamin D3 or 30,000–35,000 iu/wk would increase 25(OH)D concentration to 40 ng/ml and 6235–7248 iu/d can ensure that 97.5% of the people have concentrations > 20 ng/ml. Well-designed human clinical studies over the dosage and combination of micronutrients such as vitamin C and D and Zinc in different populations are required to substantiate the benefits of micronutrient supplementation against infection.

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