Vitamin D Deficiency in Tuberculosis and Diabetes Mellitus - A Cluster Analysis

Author(s):  
Chaya K Sindaghatta ◽  
Vishwa K Vijetha ◽  
Lokesh Sundararaja Komarla ◽  
Jayaraj Siddaiah Biligere ◽  
Sowmya Malamardi ◽  
...  

Background: Diabetes mellitus and tuberculosis are a dual burden of disease, and diabetes is associated with a threefold risk of developing tuberculosis. Though India is considered to have an abundance of sunlight, the prevalence of deficiency of vitamin D is high, which is shown to cause impairment in the macrophage-initiated immune response against Mycobacterium tuberculosis. Methods: Our study estimated the prevalence of mean levels and determinants of vitamin D deficiency in patients with tuberculosis or diabetes and those with both tuberculosis and diabetes. A cluster analysis was performed to identify whether these patients belong to distinct clusters and evaluate whether vitamin D levels were significantly different between clusters. Results: The study observed that the lowest vitamin D levels were observed among subjects with both pulmonary tuberculosis and diabetes. Multinomial logistic regression analysis observed that higher levels of vitamin D were protective against both diabetes and pulmonary tuberculosis and while higher body mass index lowered odds of pulmonary tuberculosis, it increased the odds of diabetes. The cluster analysis identified five distinct clusters with different characteristics of pulmonary tuberculosis, diabetes mellitus, sputum mycobacterial load, age distribution, body mass index, vitamin D, serum albumin and serum calcium. Conclusion: In South India, among patients with pulmonary tuberculosis and diabetes or either disease alone, hypovitaminosis D is a common phenomenon. The cluster analysis plays an important role in future research on biomarkers to identify specific phenotypes in patients with tuberculosis and diabetes.

2021 ◽  
Vol 15 (6) ◽  
pp. 1231-1233
Author(s):  
A. W. Khan ◽  
H. T. Hussain ◽  
Z.U. Mustafa ◽  
M. A. Qamar ◽  
M. A. Qamar ◽  
...  

Aim: To determine the role of vitamin D in the management of COVID-19 patients regarding morbidity and mortality. Study Design: Prospective/Observational Place and Duration: Departments of Medicine & Pulmonology, Allama Iqbal Memorial Teaching Hospital, Sialkot and Department of Medicine, Sughra Shafi Medical Complex Narowal from 1st November 2020 to 30th April 2020. Methodology: One hundred and sixty patients of both genders diagnosed to have COVID-19, were enrolled. Patient’s ages were ranging from 17 to 70 years. The detailed demographics such as age, sex, and body mass index were recorded. 5 ml blood samples were taken from all the patients to check their vitamin D levels. Severe Vitamin D deficiency was defined as 25(OH)D <25 nmol/L (10 ng/dl). Association between mortality and morbidity was examined. Results: Ninety (56.25%) were males while 70 (43.75%) were females with mean age 40.15±17.37 years. Mean body mass index of patients was 24.16±7.26 kg/m2. Severe vitamin D deficiency was observed in 80 (50%) patients. Mortality found in 30 (18.75%) patients. Frequency of morbidity was among 66 (41.25%) patients. Patients with severe vitamin D deficiency had high rate of mortality 20 (25%) and morbidity 50 (62.5%) as compared to patients with no vitamin D deficiency had 10 (8%) mortality and 16 (20%) morbidity. A significant association was observed between severe vitamin D deficiency regarding morbidity and mortality among patients with covid-19 disease with p-value <0.05. Conclusion: The vitamin-D has strongest relationship among patients with covid-19 disease to reduce mortality and morbidity. Keywords: Morbidity, COVID-19, Vitamin D, Mortality


Nutrients ◽  
2021 ◽  
Vol 14 (1) ◽  
pp. 102
Author(s):  
Nuria Agüero-Domenech ◽  
Silvia Jover ◽  
Ana Sarrión ◽  
Javier Baranda ◽  
José A. Quesada-Rico ◽  
...  

A relationship between vitamin D deficiency (VDD) and gestational diabetes mellitus (GDM) has been described. Considering that GDM prevalence depends on body mass index (BMI), our main objective was to determine if VDD is associated with GDM, independent of BMI. A cross-sectional study with 886 pregnant women was conducted in Elda (Spain) from September 2019 to June 2020. To assess the association, Poisson regression models with robust variance were used to estimate the prevalence ratio (PR). The observed GDM prevalence was 10.5%, while the VDD prevalence was 55.5%. In the crude model, both VDD and obesity were associated with GDM, but in the adjusted model, only VDD was statistically significant (PR = 1.635, p = 0.038). A secondary event analysis did not detect differences in VDD, but BMI yielded a higher frequency of births by cesarean section and newborns with a >90 percentile weight in the obesity group. In conclusion, VDD is associated with GDM, independent of BMI. Future longitudinal studies could provide information on causality.


2021 ◽  
Vol 71 (5) ◽  
pp. 1544-47
Author(s):  
Samina Rashid ◽  
Khuram Haq Nawaz ◽  
Amer Fakhr ◽  
Hammad Ather ◽  
Farzana Hakeem ◽  
...  

Objective: To determine frequency of vitamin D deficiency in patients presenting with fibromyalgia and its association with various factors. Study Design: Cross sectional study. Place and Duration of Study: Medicine department, Pak Emirates Military Hospital Rawalpindi, from Sep 2018 to Feb 2019. Methodology: Ninety patients of fibromyalgia were included in the study. Diagnosis of fibromyalgia was made by the consultant rheumatologist on the basis of American College of Rheumatology Criteria needed for fibromyalgia diagnosis and classification. Vitamin D levels <20ng/ml were considered as deficient. Age, education, marital status, menstrual abnormallities and body mass index were correlated with the presence of vitamin D deficiency among the patients suffering from fibromyalgia. Results: Out of 90 patients of fibromyalgia, 57 (63.3%) showed the presence of vitamin D deficiency while 33 (36.7%) had no deficiency of vitamin D. Among the study participants 88 (97.8%) patients were females and only 2 (2.2%) patients were males. Mean age of the patients was 39.4 ± 3.365 years. After applying the binary logistic regression, we found that presence of menstrual abnormalities and high body mass index had significant association with the presence of vitamin D deficiency among the patients of fibromyalgia (p-value<0.05). Conclusion: Vitamin D deficiency emerged as a common finding among the patients of fibromyalgia in a teaching hospital of Pakistan. Vitamin D deficiency should be screened at the rheumatology clinics and special attention should be paid to the patients who are overweight or obese and female patients with the menstrual abnormalities.


2020 ◽  
Author(s):  
Salma Ahi ◽  
Fatemeh Gholami ◽  
Naser Hatami ◽  
Fatemeh Golabi

Abstract Background: Vitamin D deficiency is one of the most prevalent disorders worldwide. Considering the magnitude of growth in adolescence, the aim of this study was to ascertain the prevalence of vitamin D deficiency and discover the association between anthropometric indices and vitamin D levels and the effect of vitamin D treatment on anthropometric indices in adolescent girls. Method: we performed this randomized clinical trial study (approved by Iranian Registry of Clinical Trials with code of IRCT20200615047785N2) conducting 313 high school girl students in a random cluster sampling from Jahrom city schools. Blood samples were collected from participants to determine the serum level (OH) D25. We divided vitamin D deficient patients into two groups: control who received placebo (n=150) and intervention group (n=150) who were prescribed one tablet of 50,000 units of vitamin D per week for eight weeks. Anthropometric indices of participants were measured before and after the intervention. Datas were analyzed by SPSS software version 19.Results: The prevalence of vitamin D deficiency was 95%. Body mass index had no significant difference before the intervention in both groups (P = 0.76). After intervention in the case group, body mass index increased significantly (P = 0.01), but there was no significant difference in the control group after treatment (P = 0.42). There was no significant difference in waist circumference, height and weight before and after the intervention in both groups (P > 0.05). There was also a weak but significant correlation between height, weight, and baseline 25OHD levels of participants.Conclusion: The results of this study showed that there is a reverse and significant relationship between height and weight index with 25OHD. Further monitoring and prolonged studies with extended follow ups might improve the anthropometric parameters after treatment.


2020 ◽  
Vol 11 (5) ◽  
pp. 49-53
Author(s):  
Archana Bhat ◽  
Arunachalam Ramachandran ◽  
Pradeep Periera ◽  
Akshatha Rao Aroor

Background: Vitamin D, a fat-soluble vitamin has its receptor present in myriad of tissues and it modulates multiple cellular processes. Vitamin D deficiency is reported to be associated with coronary artery disease. Cardiovascular disease is the leading cause of mortality worldwide. Aims and Objective: The primary outcome was to investigate if there is a correlation of 25-OH levels with the percentage of luminal stenosis, as measured with coronary angiogram. The secondary outcome was to determine the differences in angiographically proven luminal stenosis across categories of 25-OH vitamin D levels. Materials and Methods: Thirty patients with acute coronary syndrome with diabetes mellitus were included in this cross-sectional descriptive study. All patients were tested for fasting vitamin D levels, fasting blood sugar, HbA1C and serum creatinine. Detailed history of the patients was recorded. Data was analyzed by the statistical software SPSS version 19 and p value <0.05 was considered significant. Statistical tests like Chi- square, independent t test and log regression was used. Results: In this study 30 patients undergoing coronary angiography for acute coronary syndrome, Vitamin D levels showed severe deficiency in 6.7% (2) cases while mild deficiency was seen in 50% of the cases. Patients with single vessel disease on the coronary angiogram had lower mean HbA1C (9.18) levels in our study. Patients with triple vessel disease had poorly controlled mean HbA1C levels (10.42). Conclusion: In this study we did not find any significant difference between the serum Vitamin D deficiency levels with patients with angiographic severity of the coronary artery disease. Patients with poorly controlled diabetes mellitus had more severe angiographic proven coronary artery disease.


Author(s):  
Elham Nozari Mirarkolaei ◽  
Mahdi Gholami ◽  
Elham Rostami ◽  
Azita Aliakbarniya ◽  
Massoumeh Hotelchi ◽  
...  

Introduction: Body weight gain in children and teenagers is one of the major challenges that cause undesirable health outcomes. Simultaneously with the prevalence of overweight and obesity, children and adolescents are diagnosed with 25-hydroxyvitamin D (25(OH)D) deficiency in different sides of the world. The present study aimed to assess 25(OH)D status among Iranian volunteers aged 1-16 years and find the correlation between 25(OH)D status and body mass index (BMI) subjects.    Material and Methods: The total volunteers included 807 Iranian children aged 1 to 16 referred to the general and endocrinology clinics in Babol city, Mazandaran Province. A trained physician determined anthropometric characteristics. Serum levels of calcium (Ca), phosphate (P), creatinine (Cr), urea, thyroxine (T4), thyroid-stimulating hormone (TSH), and 25(OH)D were assessed in all children.      Results: 25.27% of the children were 25(OH)D deficient, and 59.1% were insufficient. There was no significant difference in serum 25(OH)D level between girls and boys (P=0.13). A significant negative correlation was found in serum 25(OH)D level with weight (P=0.000, r=-0.12), BMI (P=0.000, r=-0.13), and age (P=0.000, r=-0.13). Conclusion: These data displayed that 25(OH)D insufficiency is highly prevalent among children in the north of Iran. Serum 25(OH)D levels are affected by age and BMI value. Improving vitamin D deficiency helps to maintain the health of children and adolescents during this critical period.


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