scholarly journals Vitamin D Status in Full-term Exclusively Breastfed Infants versus Full-term Breastfed Infants Receiving Vitamin D Supplementation in Thailand: A Randomized Controlled Trial

Author(s):  
Chayatat Ruangkit ◽  
Sukrit Suwannachat ◽  
Pornchanok Wantanakorn ◽  
Napapailin Sethaphanich ◽  
Surapat Assawawiroonhakarn ◽  
...  

Abstract Background: Many international medical organizations recommend vitamin D supplementation for infants, especially exclusively breastfed infants. In Thailand, however, data regarding the vitamin D status in Thai infants are lacking. Such data would help to support physician decisions and guide medical practice. Methods: Full-term, exclusively breastfed infants were randomized into two groups at 2 months of age to continue exclusive breastfeeding either without vitamin D supplementation (control group, n = 44) or with vitamin D3 supplementation at 400 IU/day (intervention group, n = 43) until 6 months of age. At 6 months, the serum vitamin D (25OHD) of the infants and their mothers, serum bone marker, and infants' growth parameters were compared between the two groups. Results: The infants' serum 25OHD concentration was lower in the control group than intervention group (20.57 ± 12.66 vs. 46.01 ± 16.42 ng/mL, p < 0.01). More infants had vitamin D sufficiency (25OHD of >20 ng/mL) in the intervention group than control group (93.0% vs. 43.2%, p < 0.01). Vitamin D supplementation in breastfed infants increased the mean serum 25OHD concentration by 25.66 ng/mL (95% confidence interval, 19.07–32.25; p < 0.001) and contributed to an 88.7% decrease in the prevalence of vitamin D insufficiency/deficiency (relative risk, 0.11; 95% confidence interval, 0.04–0.35; p < 0.01).Conclusions: Most full-term, exclusively breastfed Thai infants have serum vitamin D concentration below sufficiency level at 6 months of age. However, vitamin D supplementation (400 IU/day) improves their vitamin D status and prevents vitamin D deficiency.Trial registration: The study was pre-registered in the Thai Clinical Trials Registry (TCTR20190622001) on 22/06/2019.

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Chayatat Ruangkit ◽  
Sukrit Suwannachat ◽  
Pornchanok Wantanakorn ◽  
Napapailin Sethaphanich ◽  
Surapat Assawawiroonhakarn ◽  
...  

Abstract Background Many international medical organizations recommend vitamin D supplementation for infants, especially exclusively breastfed infants. In Thailand, however, data regarding the vitamin D status in Thai infants are lacking. Such data would help to support physician decisions and guide medical practice. Methods Full-term, exclusively breastfed infants were randomized into two groups at 2 months of age to continue exclusive breastfeeding either without vitamin D supplementation (control group, n = 44) or with vitamin D3 supplementation at 400 IU/day (intervention group, n = 43) until 6 months of age. At 6 months, the serum vitamin D (25OHD) of the infants and their mothers, serum bone marker, and infants’ growth parameters were compared between the two groups. Results The infants’ serum 25OHD concentration was lower in the control group than intervention group (20.57 ± 12.66 vs. 46.01 ± 16.42 ng/mL, p < 0.01). More infants had vitamin D sufficiency (25OHD of > 20 ng/mL) in the intervention group than control group (93.0% vs. 43.2%, p < 0.01). There were no significant differences in the maternal 25OHD concentrations between the control and intervention groups (25.08 ± 7.75 vs. 23.75 ± 7.64 ng/mL, p = 0.42). Serum calcium, phosphorus, intact parathyroid hormone, alkaline phosphatase, and infants’ growth parameters were comparable between the two groups. After adjustment for the confounding factors, 25OHD concentration in the intervention group was 25.66 ng/mL higher than the control group (95% confidence interval, 19.07–32.25; p < 0.001). Vitamin D supplement contributed to an 88.7% decrease in the prevalence of vitamin D insufficiency/deficiency (relative risk, 0.11; 95% confidence interval, 0.04–0.35; p < 0.01). Conclusions Most full-term, exclusively breastfed Thai infants have serum vitamin D concentration below sufficiency level at 6 months of age. However, vitamin D supplementation (400 IU/day) improves their vitamin D status and prevents vitamin D deficiency. Trial registration The study was pre-registered in the Thai Clinical Trials Registry (TCTR20190622001) on 22/06/2019.


2021 ◽  
Author(s):  
Leho Rips ◽  
Alar Toom ◽  
Rein Kuik ◽  
Ahti Varblane ◽  
Hanno Mölder ◽  
...  

Abstract BackgroundThere has been a growing interest in the role of vitamin D for the well-being and physical performance of humans; however, there is a lack of long-term supplementation studies performed on members of the young, physically active, male population.The hypothesis of the study was that vitamin D supplementation during wintertime will decrease the prevalence of critically low vitamin D blood serum levels and increase hand grip strength during the winter season among young male conscripts. Study DesignLongitudinal, triple-blinded, randomized, placebo-controlled trial. MethodsFifty-three male conscripts from the Estonian Army were randomized into two groups: 27 to an intervention group and 26 to a placebo group. The groups were comparable in terms of their demographics. The intervention group received 1200 IU (30 µg) capsules of vitamin D3 and the control group received placebo oil capsules once per day. The length of the follow-up was seven months, from October 2016 until April 2017. Blood serum vitamin D (25(OH)D), parathyroid hormone (PTH), calcium (Ca), ionized calcium (Ca-i), testosterone and cortisol values and hand grip strength were measured four times during the study period. ResultsThe mean 25(OH)D level decreased significantly in the control group to a critically low level during the study, with the lowest mean value of 22 nmol/l found in March 2017. At that time point, 65% in the control group vs 15% in the intervention group had 25(OH)D values of less than 25 nmol/l (p < 0.001). In the intervention group the levels of 25(OH)D did not change significantly during the study period. All other blood tests revealed no significant differences at any time point. The corresponding result was found for hand grip strength at all time points. ConclusionLong-term vitamin D supplementation during wintertime results in fewer conscripts in the Estonian Army with critically low serum vitamin D (25(OH)D) levels during the winter season. However, this did not influence their physical performance in the form of the hand grip strength test. Trial registrationClinicalTrials.gov Identifier: NCT04359524. Registered 20 April 2020 - Retrospectively registered. https://register.clinicaltrials.gov


Nutrients ◽  
2021 ◽  
Vol 13 (2) ◽  
pp. 564
Author(s):  
Agnieszka Radom ◽  
Andrzej Wędrychowicz ◽  
Stanisław Pieczarkowski ◽  
Szymon Skoczeń ◽  
Przemysław Tomasik

Maintaining an optimal vitamin D concentration reduces the risk of recurrence and extends survival time in patients after breast cancer treatment. Data on vitamin D deficiency among Polish women after breast cancer therapy are limited. Thus, the aim of the study was the analysis of vitamin D status in post-mastectomy patients, considering such factors as seasons, social habits, vitamin D supplementation and its measurements. The study involved 94 women after breast cancer treatment. Serum vitamin D concentration was measured, and a questionnaire, gathering demographic and clinical data regarding cancer, diet, exposure to sun radiation, and knowledge of recommendations on vitamin D supplementation, was delivered twice, in both winter and in summer. The control group consisted of 94 age-matched women with no oncological history. In women after breast cancer treatment, 25-hydroxyvitamin D (25(OH)D) deficiency was much more frequent than in the general population. Only about half of the patients supplemented vitamin D at the beginning of the study. After the first test and the issuing of recommendations on vitamin D supplementation, the percentage of vitamin D supplemented patients increased by about 30% in study groups. The average dose of supplement also increased. None of the women that were not supplementing vitamin D and were tested again in winter had optimal 25(OH)D concentration. It was concluded that vitamin deficiency is common in women treated for breast cancer. Medical advising about vitamin D supplementation and monitoring of 25(OH)D concentration should be improved.


Nutrients ◽  
2020 ◽  
Vol 12 (9) ◽  
pp. 2608
Author(s):  
Sara Tomei ◽  
Parul Singh ◽  
Rebecca Mathew ◽  
Valentina Mattei ◽  
Mathieu Garand ◽  
...  

Background. Vitamin D deficiency represents a major healthcare problem. Vitamin D status is influenced by genetic and environmental determinants. Several observational studies have evaluated the association of single-nucleotide polymorphisms (SNPs) in vitamin D-related genes and vitamin D levels. Nevertheless, little is known about the role of these SNPs in the response to vitamin D supplementation. We conducted an interventional study to define the association between SNPs in vitamin D-related genes and the response to vitamin D supplementation in 100 self-reported healthy women of Arab ancestry for the majority. Methods. A total of 100 healthy female subjects received a weekly oral dose of 50,000 IU vitamin D for 12 weeks. Serum vitamin D concentration and metabolic profiles were measured at baseline and 12 weeks post-vitamin D supplementation. The genotypes of 37 SNPs selected from previously reported vitamin D-related genes have been assessed by Fluidigm genotyping assay. Results. Rs731236 (VDR gene) and rs7116978 (CYP2R1 gene) showed a significant association with vitamin D status. The rs731236 GG genotype and the rs7116978 CC genotype were associated with a “vitamin D sufficiency” state. Rs731236 GG and rs7116978 CC genotypes showed a higher response to vitamin D supplementation. Transcription factor binding site prediction analysis showed altered binding sites for transcription factors according to the different rs7116978 alleles. Interestingly, the 37 SNPs previously established to play a role in vitamin D-related pathways explained very little of the response to vitamin D supplementation in our cohort, suggesting the existence of alternative loci whose number and effect size need to be investigated in future studies. Conclusion. In this paper, we present novel data on vitamin D-related SNPs and response to vitamin D supplementation demonstrating the feasibility of applying functional genomic approaches in interventional studies to assess individual-level responses to vitamin D supplementation.


Author(s):  
Sharmeen Mahmood ◽  
Hasna Hena Pervin ◽  
Shereen Yousuf

Background: This study was done to evaluate the association of serum vitamin D level with GDM (n=30) and without GDM (n=30). The age and body mass index of the participants along with their gestational age, gravidity and parity were harmonized. The serum vitamin D levels and blood glucose were investigated. The results revealed that, normal pregnant women had significantly higher vitamin D level than their GDM counterparts.Methods: This case-control study was conducted on healthy pregnant women attending routine antenatal care at Bangabandhu Sheikh Mujib medical university from January 2019 to December 2019 recruited at third trimester of gestation. We measured maternal serum vitamin D status (25[OH]D) in third trimester of pregnancy. GDM was diagnosed according to the American diabetes association. guidelines. Vitamin D status was defined as, vitamin D sufficiency (≥30 or ≥75 nmol/L), insufficiency (20-30 and 50-75 nmol/L), were used to categories participants according to their 25[OH]D concentrations. We calculated adjusted odds ratios and 95% confidence intervals (CIs) using logistic regression.Results: The mean serum vitamin D level was lower in case group case 23.4 (17.4±35.1) compared to that in control group 29.7 (15.4±39.8) and the difference between the 2 groups was statistically significant (p≤0.001). Sufficient level of vitamin D was more in control group (66.7%) than that of case group (26.1%). Insufficient level of vitamin D was higher in case (73.3%) group than that of control (33.3%) group. These findings were significant (p=0.021). Respondents with insufficient level of vitamin D have 3.1 times more chance to develop GDM.Conclusions: Serum vitamin D level is reduced in pregnant women having GDM.


2021 ◽  
pp. 1-3
Author(s):  
Manaswita Samanta ◽  
Shweta Pathak ◽  
Debarshi Jana

Introduction:Low vitamin D status, among other risk factors, is linked to the development of preeclampsia. Systematic reviews and metaanalyses have concluded that low serum vitamin D levels (25-hydroxyvitamin D [25OHD]) in pregnancy are associated with a higher risk of preeclampsia and suggest a preventive role of vitamin D supplementation. Aim:To examine the association between maternal serum 25-hydroxyvitamin D (25[OH]D) concentration in early pregnancy and the subsequent diagnosis of preeclampsia. Material and methods:This prospective case control study was carried out at Department of Obstetrics and Gynecology, College of medicine and JNM Hospital, Kalyani, Nadia. Duration of the study was one and half year study period from March 2018-August 2019. Total 100 cases attending regular antenatal OPD was included provided they full the inclusion criteria. Result:It was found that in preeclampsia, 4(66.7%) patients had Vitamin-D Deciency and 2(33.3%) patients had Insufciency Vitamin-D. Association of Vitamin-D vs. preeclampsia was not statistically signicant (p=0.3135). It was found that in preeclampsia, 6(100.0%) patients had no Previous Eclampsia. Association of Previous Eclampsia vs. preeclampsia was not statistically signicant (p=0.6991965055). Conclusion:We concluded that maternal vitamin D deciency may be an independent risk factor for preeclampsia. Vitamin D supplementation in early pregnancy should be explored for preventing preeclampsia.


2019 ◽  
Vol 99 (7) ◽  
pp. 460-463 ◽  
Author(s):  
Burçin Nalbantoğlu ◽  
Ayşin Nalbantoğlu

Background: Recurrent aphthous stomatitis is one of the most prevalent oral mucosa diseases and the etiology is unclear. As a potent anti-inflammatory and immunomodulating agent, vitamin D can significantly affect oral cavity homeostasis. However, to the best of our knowledge, no study has been conducted in pediatric population on the potential role of vitamin D in recurrent aphthous stomatitis to date. The aim of the present study is to determine the vitamin D status in recurrent aphthous stomatitis in children. Methods: This study is conducted retrospectively. Seventy-two patients with minor recurrent aphthous stomatitis and 70 age-matched healthy controls included in the study. 25-Hydroxyvitamin D levels were measured in all patients using enzyme immunoassay. Results: Serum vitamin D levels were 16.4 (8.6) ng/mL in patient group and 23.1 (11.5) ng/mL in healthy controls. There was a statistically significant difference between the groups in terms of serum vitamin D levels ( P = .002). There was no significant correlation between serum vitamin D levels and the severity of the recurrent aphthous stomatitis ( r = 0.54, P = .76). Conclusions: Our study showed a significant difference in vitamin D levels between patients with recurrent aphthous stomatitis and the healthy control group. We also found no correlation between vitamin D status and the severity of the disease.


PLoS ONE ◽  
2021 ◽  
Vol 16 (6) ◽  
pp. e0253689
Author(s):  
Thereza Were Piloya ◽  
Sabrina Bakeera–Kitaka ◽  
Grace Paul Kisitu ◽  
Richard Idro ◽  
Sarah E. Cusick

Background A high prevalence of suboptimal serum vitamin D has been reported among HIV infected children even in countries with high sunshine abundance throughout the year. Vitamin D is a potent immune modulator of innate and adaptive immune responses. Vitamin D regulates immune responses through the vitamin D receptor on CD4 cells. We aimed to determine the vitamin D status of HIV infected children and factors associated with suboptimal vitamin D. Methods This was a cross sectional study. We enrolled children aged between 6 months and 12 years attending an outpatient paediatric HIV clinic. Serum 25-hydroxyvitamin D (25(OH)D) was measured using the electrochemoluminisence method. Suboptimal vitamin D was defined as 25(OH)D <30 ng/ml, vitamin D insufficiency and deficiency were 21–29 ng/ml and <20 ng/ml respectively. Anthropometry, physical exam and medical history were documented. Logistic regression was performed. Results We enrolled 376 children with mean age (sd) 8.05 years (3.03), a median (IQR) duration of ART of 5.9 years (3.2–8.4). Majority of the children (64%) had been exposed to non nucleoside reverse transcriptase inhibitors (NNRTIs). A third were severely immunosuppressed (CD4% ≤15%) at ART initiation. At the time of the study, the majority (89%) were virologically suppressed (VL <1000 copies/ml). Prevalence of 25(OH)D <30 ng/ml was 49 (13%) of 375 participants and 11 (3%) had 25(OH)D <20 ng/ml. Lopinavir/ritonavir regimen was independently associated with 25(OH)D <30 ng/ml; OR 0.27 CI (0.13–0.57), p value-0.002. Serum 25(OH)D <20 ng/ml was associated with CD4 count ≤15% at ART initiation OR 6.55(1.30–32.9), p value—0.023 and use of NNRTIs; OR 10.9(1.22–96.2), p value—0.03. Conclusion We found a low prevalence of suboptimal vitamin D compared to earlier reports. Severe immunosuppression at ART initiation and use of NNRTIs increases odds of deficiency. Vitamin D supplementation should be considered in severely immunosuppressed children initiating ART.


2010 ◽  
Vol 104 (1) ◽  
pp. 108-117 ◽  
Author(s):  
Evelien R. Leffelaar ◽  
Tanja G. M. Vrijkotte ◽  
Manon van Eijsden

Low vitamin D levels during pregnancy may account for reduced fetal growth and for altered neonatal development. The present study explored the association between maternal vitamin D status measured early in pregnancy and birth weight, prevalence of small-for-gestational-age (SGA) infants and postnatal growth (weight and length), as well as the potential role of vitamin D status in explaining ethnic disparities in these outcomes. Data were derived from a large multi-ethnic cohort in The Netherlands (Amsterdam Born Children and their Development (ABCD) cohort), and included 3730 women with live-born singleton term deliveries. Maternal serum vitamin D was measured during early pregnancy (median 13 weeks, interquartile range: 12–14), and was labelled ‘deficient’ ( ≤ 29·9 nmol/l), ‘insufficient’ (30–49·9 nmol/l) or ‘adequate’ ( ≥ 50 nmol/l). Six ethnic groups were distinguished: Dutch, Surinamese, Turkish, Moroccan, other non-Western and other Western. Associations with neonatal outcomes were analysed using multivariate regression analyses. Results showed that compared with women with adequate vitamin D levels, women with deficient vitamin D levels had infants with lower birth weights ( − 114·4 g, 95 % CI − 151·2, − 77·6) and a higher risk of SGA (OR 2·4, 95 % CI 1·9, 3·2). Neonates born to mothers with a deficient vitamin D status showed accelerated growth in weight and length during the first year of life. Although a deficient vitamin D status influenced birth weight, SGA risk and neonatal growth, it played a limited role in explaining ethnic differences. Although vitamin D supplementation might be beneficial to those at risk of a deficient vitamin D status, more research is needed before a nationwide policy on the subject can be justified.


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