scholarly journals Role of Vitamin D3 in fracture union in adults

2021 ◽  
Vol 7 (1) ◽  
pp. 38-41
Author(s):  
Arunabh Arora ◽  
Amrit Kumar Singh

Fractures play an important role in morbidity and often premature mobility among the elderly population. Because inactivity as a result of a fracture is harmful both to bone healing and health, it appears early or rapid fracture healing would be highly recommendable for returning fracture patients to come back to normal as soon as possible with minimal side effects. The literature remains unclear regarding supplementation required for promoting bone healing in fracture cases. Hereby we evaluated the advantages and disadvantages of vitamin D3 supplementation in fracture cases along with the quantitative analysis of vitamin D3 at the time of fracture and after fracture union.: A total of 200 patients were assessed clinically, biochemically (serum alkaline phosphatase, serum vitamin D3, and serum parathormone), and radiologically. All patients who satisfy inclusion criteria are followed up and vitamin D3 levels were measured up within 1 day of fracture and at the interval of 6 months after the orthopaedic intervention. The outcomes were monitored by the 5 points radiographic scoring system by Warden et al. With the majority of patients falling under the vitamin insufficiency group i.e. 53% of all patients were found to be vitamin insufficient at the time of fracture. 33% of patients found to be vitamin D deficient while 14% found to be insufficient stage. No patient was found to be in a toxicity state. According to Warden’s scoring., 50% of patients were in grade 3, 15% in grade 4, 33% in grade 2, and only 2% in grade 1. Regarding the prevalence of vitamin D deficiency or insufficiency in the general population, this study shows an alarming rate of vitamin D insufficient patients in a group of 200 patients, which indicates the need for attention towards vitamin D status not only for bone-related issues but for other issues related to vitamin D deficiency.

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
Y Lu ◽  
R Chou ◽  
Y Tsai ◽  
P Huang

Abstract Background Vitamin D deficiency had been suggested to be the risk factor of cardiovascular diseases and metabolic disorders. However, current evidence about the association between vitamin D deficiency and atherosclerosis are conflicted and inconclusive. Purpose We tried to investigate the relationship between serum vitamin D concentrations and subclinical atherosclerosis in the elderly Asian population. Methods The I-Lan longitudinal study (ILAS), 1798 community-dwelling adults older than 50 years old were enrolled and divided into two groups according to serum vitamin D level (sufficient, ≥20 ng/mL, and deficient <20 ng/mL). The concentrations of serum vitamin D3 was measured by chemiluminescence immunoassay and demographic data recorded from chart review. The carotid intima-media thickness (cIMT) was measured at bilateral common carotid arteries. Subclinical atherosclerosis was defined as mean cIMT more than 0.81mm, which had been proved to be associated with an increased risk of stroke and coronary events. Results Subjects with vitamin D deficiency (n=604, 33.6%) were younger, composed of more woman, smoker, with a higher incidence of hypertension, dyslipidemia, and metabolic syndrome. Compared with subjects without vitamin D sufficiency, patients with vitamin D deficiency were associated with lower risk of subclinical atherosclerosis (crude OR: 0.63, 95% CI: 0.50–0.81, p<0.001) in the univariate analysis. However, after adjusting gender and age, vitamin D deficiency was no more associated with risk of subclinical atherosclerosis. Risk of vitD3 and cIMT Subclinical Atherosclerosis (cIMT >0.8mm) Odds Ratio 95% Confidence Interval p-value Model 1   Vit D3 normal (≥20) Reference – –   Vit D3 deficiency (<20) 0.63 0.50–0.81 <0.001 Model 2   Vit D3 normal (≥20) Reference – –   Vit D3 deficiency (<20) 0.81 0.62–1.06 0.127 Model 3   Vit D3 normal (≥20) Reference – –   Vit D3 deficiency (<20) 0.93 0.69–1.24 0.599 Model 1: adjust for vit D3 (univariate); Model 2: adjusted for age, vit D3, Gender; Model 3: adjusted multivariate significantly in univariate analysis. Conclusion Vitamin D deficiency was not an independent risk factor for subclinical atherosclerosis in the elderly Asian population. The association observed in the univariate analysis may be confounded by gender difference or comorbidities.


Author(s):  
Sanjeeva Kumar Goud T ◽  
Rahul Kunkulol

The present study was aimed to study the effect of Sublingual Vitamin D3 on Serum Vitamin D level in Vitamin D deficiency patients. This was a cross-sectional and interventional study. All the Vitamin D deficiency patients of age 18-60years and either gender, willing to participate in the study were included. Patients who had greater than 20 ng/ml were excluded from the study. The total number of participants in our study was 200, out of these 111 males and 89 females, the mean age in our study was 51.07 ± 7.39Yrs. All volunteers were given sublingual vitamin D3 (60,000IU) in six doses every fifteen days of follow up for 3 months. The subject’s serum 25(OH)D levels were estimated before and after the treatment of sublingual vitamin D3. There was a statistically significant difference in serum vitamin D3 level before 16.61±6.71 ng/ml and after 35.80±7.80 ng/ml after treatment with Sublingual Vitamin D3. Six doses of 60,000IU of Vitamin D3 sublingual route having improved the role of serum 25(OH)D levels in the treatment of Vitamin D3 deficiency patients.Keywords: Vitamin D3; Sublingual route


Author(s):  
Cora M Best ◽  
Leila R Zelnick ◽  
Kenneth E Thummel ◽  
Simon Hsu ◽  
Christine Limonte ◽  
...  

Abstract Context The effect of daily vitamin D supplementation on the serum concentration of vitamin D (the parent compound) may offer insight into vitamin D disposition. Objective To assess the total serum vitamin D response to vitamin D3 supplementation and whether it varies according to participant characteristics. To compare results with corresponding results for total serum 25-hydroxyvitamin D (25(OH)D), which is used clinically and measured in supplementation trials. Design Exploratory study within a randomized trial. Intervention 2,000 International Units of vitamin D3 per day (or matching placebo). Setting Community-based. Participants 161 adults (mean ± SD age 70 ± 6 years; 66% males) with type 2 diabetes. Main Outcome Measures Changes in total serum vitamin D and total serum 25(OH)D concentrations from baseline to year 2. Results At baseline, there was a positive, nonlinear relation between total serum vitamin D and total serum 25(OH)D concentrations. Adjusted effects of supplementation were a 29.2 (95% CI: 24.3, 34.1) nmol/L increase in serum vitamin D and a 33.4 (95% CI: 27.7, 39.2) nmol/L increase in serum 25(OH)D. Among those with baseline 25(OH)D &lt; 50 compared with ≥ 50 nmol/L, the serum vitamin D response to supplementation was attenuated (15.7 vs 31.2 nmol/L; interaction p-value = 0.02), whereas the serum 25(OH)D response was augmented (47.9 vs 30.7 nmol/L; interaction p-value = 0.05). Conclusions Vitamin D3 supplementation increases total serum vitamin D and 25(OH)D concentrations with variation according to baseline 25(OH)D, which suggests that 25-hydroxylation of vitamin D3 is more efficient when serum 25(OH)D concentration is low.


2021 ◽  
Vol 10 (44) ◽  
pp. 3730-3735
Author(s):  
Rohit Kumar Agrawal ◽  
Preeti Sharma ◽  
Pradeep Kumar ◽  
Mehek Jaggi ◽  
Rachna Sharma

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


2016 ◽  
Vol 102 (1) ◽  
pp. 100-110 ◽  
Author(s):  
Pang Yao ◽  
Liang Sun ◽  
Ling Lu ◽  
Hong Ding ◽  
Xiafei Chen ◽  
...  

Abstract Context: Little is known about how genetic and nongenetic factors modify responses of vitamin D supplementation in nonwhite populations. Objective: To investigate factors modifying 25-hydroxyvitamin D [25(OH)D] and bioavailable 25(OH)D [25(OH)DBio] responses after vitamin D3 supplementation. Design, Setting, Participants, and Intervention: In this 20-week, randomized, double-blinded, placebo-controlled trial, 448 Chinese with vitamin D deficiency received 2000 IU/d vitamin D3 or placebo. Main Outcome Measures: Serum 25(OH)D, vitamin D-binding protein (VDBP), parathyroid hormone (PTH) and calcium were measured, and 25(OH)DBio was calculated based on VDBP levels. Six common polymorphisms in vitamin D metabolism genes were genotyped. Results: Between-arm net changes were +30.6 ± 1.7 nmol/L for 25(OH)D, +2.7 ± 0.2 nmol/L for 25(OH)DBio, and −5.2 ± 1.2 pg/mL for PTH, corresponding to 70% [95% confidence interval (CI), 62.8% to 77.2%] net reversion rate for vitamin D deficiency at week 20 (P &lt; 0.001). Only 25(OH)DBio change was positively associated with calcium change (P &lt; 0.001). Genetic factors (GC-rs4588/GC-rs7041, VDR-rs2228570, and CYP2R1-rs10741657; P ≤ 0.04) showed stronger influences on 25(OH)D or 25(OH)DBio responses than nongenetic factors, including baseline value, body mass index, and sex. An inverse association of PTH-25(OH)D was demonstrated only at 25(OH)D of &lt;50.8 (95% CI, 43.6 to 59.0) nmol/L. Conclusions: Supplemented 2000 IU/d vitamin D3 raised 25(OH)D and 25(OH)DBio but was unable to correct deficiency in 25% of Chinese participants, which might be partially attributed to the effect of genetic modification. More studies are needed to elucidate appropriate vitamin D recommendations for Asians and the potential clinical implications of 25(OH)DBio.


Author(s):  
Abdulrahman Hefdhallah Amer ◽  
Kaushik Chaudhari ◽  
Riyaben Trivedi ◽  
Riddhi Patel

Background Vitamin D deficiency is a global health problem, and its role as an immune modulator has been recently tightened. The main role of vitamin D is to maintain calcium and phosphorus homeostasis, thus maintaining bone health. Recent evidence has shown that vitamin D may play a role in a variety disorders such as endocrine diseases, adrenal diseases, polycystic ovary syndrome and particular type 1 diabetes, type 2 diabetes. We evaluated the association between thyroid disorders (subclinical or overt hypothyroidism and subclinical or overt hyperthyroidism) and serum vitamin D3 level in the Indian population and its association with ionized calcium. Methods The cross-sectional study, included patients who visited Shree Krishna Hospital, Karamsad for thyroid evaluation or follow-up. We conducted this study involving a total of 84 individuals with normal thyroid function, were recorded as control. The cases group included 75 patients with hypothyroidism (overt or subclinical) and 10 patients with hyperthyroidism (overt or subclinical). Serum levels of vitamin D3, thyroid function and calcium ionized were measured in all adult subjects. Deficiency of vitamin D is defined as the level of vitamin D3 in the serum less than 50 nmol/L. Vitamin D insufficiency is defined as serum vitamin D3 level between 50 - 75 nmol/L. Vitamin D sufficiency is defined as serum Vit D3 level >75 nmol/L. Result The prevalence of vitamin D deficiency in subclinical and clinical hypothyroidism cases (36 of 40, 90%) was significantly higher than that observed in healthy individuals (0 of 40, 0%). The prevalence of vitamin D deficiency in subclinical and clinical hyperthyroidism cases (4 of 40, 10%). The prevalence of vitamin D insufficiency in subclinical and clinical hypothyroidism cases (24 of 62, 38.7%) was significantly lower than that observed in healthy individuals (controls) (35 of 62, 56.5%).The prevalence of vitamin D insufficiency in subclinical and clinical hyperthyroidism cases (3 of 62, 4.8%).  The prevalence of vitamin D sufficiency in subclinical and clinical hypothyroidism cases (15 of 67, 22.4%) was significantly lower than that observed in healthy individuals (controls) (49 of 67, 73.1 %). The prevalence of vitamin D sufficiency in subclinical and clinical hyperthyroidism cases (3 of 67, 4.5%). Conclusion Vitamin D deficiency was associated with hypothyroidism especially clinical hypothyroidism. Low serum levels of vitamin D3 were associated with high serum TSH levels. Keyword: Vitamin D3, calcium ionized, hypothyroidism and hyperthyroidism.


2020 ◽  
Author(s):  
Danial Alebouyeh ◽  
Nasrin Khalessi ◽  
Maryam Saboute ◽  
Maryam Alizadeh Chamkhaleh ◽  
Mandana Kashaki

Abstract Introduction. Vitamin D status is a key determinant of bone health and growth during childhood and adolescence. Therefore, we design a study to find out the association between the levels of serum vitamin D and need to consumption of vitamin D supplement.Method and materials. In this cross sectional study infants under 20 months referred to Ali Asghar Children's Hospital were included. Infants with maternal diseases and congenital malformations were excluded. All infants used vitamin D3 supplementation 400 IU per day from day fifth of birth. The level of 25-hydroxy vitamin D at the age of 1 years (month 12) were measured. Level of 25-hydroxy vitamin D in mothers were checked, too. Furthermore, we defined sufficient level of 25-hydroxy vitamin D ≥30ng/ml.Results. In this study, 68 infants under 20 months were examined. Half of them were boy. Mean age of infants was 16±3 months and mothers was 33±3 years old. In addition, the mean level of serum 25-hydroxy vitamin D in the infants were 40.99±13.86 ng/ml and in mothers were 31.39±13.14 ng/ml. 62.1% of mothers were in sufficient group and also 83% of infants had sufficient vitamin D level (25-hydroxy vitamin D ≥ 30ng/ml). There was not any significant correlation between vitamin D level in infants and mothers (P value=0.965). The mean level of serum vitamin D3 in boys was 39.55±3.79 ng/ml (12-51) and girls was 35.32±3.67 ng/ml (13.4-50). Similarly, significant relationship was not shown between gender and vitamin D of infants (P value = 0.437). Level of vitamin D in second children was significantly higher than first children (P value=0.011). The correlation between gestational age and vitamin D3 deficiency was also insignificant (P value=0.087). Head circumference (r= -0.404, P value=0.014) and age of mothers (r= 0.344, P value=0.04) correlated with vitamin D.Conclusion. In summary, we demonstrated most of the infants had sufficient vitamin D level at the age of 1 year. So it is recommended to continue vitamin D3 supplementation consumption.


1997 ◽  
Vol 34 (9) ◽  
pp. 733-738
Author(s):  
Kiyoshi Nakatsuka ◽  
Hidetoshi Kosaka ◽  
Kiichiro Sekiya ◽  
Shoshi Takamoto ◽  
Toshio Onishi ◽  
...  

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