scholarly journals Vitamin D – challenges in diagnosing and monitoring of hypovitaminosis D / Vitamin D – izazovi u dijagnozi i praćenju hipovitaminoze D

2012 ◽  
Vol 31 (4) ◽  
pp. 316-325
Author(s):  
Michael Vogeser ◽  
Christoph Seger

Summary During recent years, it has been recognized that sub-optimum vitamin D-status, often defined as decrease of PTH concentrations in response to supplementation of vitamin D, is a very widespread finding with potential health effects on a population level. As a consequence, there is a con tinuously increasing interest in the laboratory-based asses sment of the vitamin D status, with 25-hydroxyvitamin D as the most widely used analyte. However, there is a number of challenges in the characterization of the individual vitamin D status that are addressed in this article; they in clu - de analytical issues of 25-hydroxyvitamin D measurement; interpretation of results; development of guidelines for ratio - nal indication for laboratory testing; and evaluation of the role of 25-hydroxyvitamin D in the context of complementary markers of the vitamin D status.

Nutrients ◽  
2021 ◽  
Vol 13 (9) ◽  
pp. 3082
Author(s):  
Spyridon N. Karras ◽  
Erdinç Dursun ◽  
Merve Alaylıoğlu ◽  
Duygu Gezen-Ak ◽  
Cedric Annweiler ◽  
...  

Recent results indicate that dysregulation of vitamin D-binding protein (VDBP) could be involved in the development of hypovitaminosis D, and it comprises a risk factor for adverse fetal, maternal and neonatal outcomes. Until recently, there was a paucity of results regarding the effect of maternal and neonatal VDBP polymorphisms on vitamin D status during pregnancy in the Mediterranean region, with a high prevalence of hypovitaminosis D. We aimed to evaluate the combined effect of maternal and neonatal VDBP polymorphisms and different maternal and neonatal 25-hydroxyvitamin D (25(OH)D) cut-offs on maternal and neonatal vitamin D profile. Blood samples were obtained from a cohort of 66 mother–child pairs at birth. Our results revealed that: (i) Maternal VDBP polymorphisms do not affect neonatal vitamin D status at birth, in any given internationally adopted maternal or neonatal cut-off for 25(OH)D concentrations; (ii) neonatal VDBP polymorphisms are not implicated in the regulation of neonatal vitamin D status at birth; (iii) comparing the distributions of maternal VDBP polymorphisms and maternal 25(OH)D concentrations, with cut-offs at birth, revealed that mothers with a CC genotype for rs2298850 and a CC genotype for rs4588 tended to demonstrate higher 25(OH)D (≥75 nmol/L) during delivery (p = 0.05 and p = 0.04, respectively), after adjustments for biofactors that affect vitamin D equilibrium, including UVB, BMI and weeks of gestation. In conclusion, this study from Southern Europe indicates that maternal and neonatal VDBP polymorphisms do not affect neonatal vitamin D status at birth, whereas mothers with CC genotype for rs2298850 and CC genotype for rs4588 demonstrate higher 25(OH)D concentrations. Future larger studies are required to establish a causative effect of these specific polymorphisms in the attainment of an adequate (≥75 nmol/L) maternal vitamin D status during pregnancy.


2011 ◽  
Vol 106 (9) ◽  
pp. 1383-1389 ◽  
Author(s):  
R. K. Marwaha ◽  
N. Tandon ◽  
S. Chopra ◽  
N. Agarwal ◽  
M. K. Garg ◽  
...  

The present cross-sectional study was conducted to determine the vitamin D status of pregnant Indian women and their breast-fed infants. Subjects were recruited from the Department of Obstetrics, Armed Forces Clinic and Army Hospital (Research and Referral), Delhi. A total of 541 apparently healthy women with uncomplicated, single, intra-uterine gestation reporting in any trimester were consecutively recruited. Of these 541 women, 299 (first trimester, ninety-seven; second trimester, 125; third trimester, seventy-seven) were recruited in summer (April–October) and 242 (first trimester, fifty-nine, second trimester, ninety-three; third trimester, ninety) were recruited in winter (November–March) to study seasonal variations in vitamin D status. Clinical, dietary, biochemical and hormonal evaluations for the Ca–vitamin D–parathormone axis were performed. A subset of 342 mother–infant pairs was re-evaluated 6 weeks postpartum. Mean serum 25-hydroxyvitamin D (25(OH)D) of pregnant women was 23·2 (sd 12·2) nmol/l. Hypovitaminosis D (25(OH)D < 50 nmol/l) was observed in 96·3 % of the subjects. Serum 25(OH)D levels were significantly lower in winter in the second and third trimesters, while serum intact parathormone (iPTH) and alkaline phosphatase levels were significantly higher in winter in all three trimesters. A significant negative correlation was found between serum 25(OH)D and iPTH in mothers (r − 0·367, P = 0·0001) and infants (r − 0·56, P = 0·0001). A strong positive correlation was observed between 25(OH)D levels of mother–infant pairs (r 0·779, P = 0·0001). A high prevalence of hypovitaminosis D was observed in pregnancy, lactation and infancy with no significant inter-trimester differences in serum 25(OH)D levels.


2017 ◽  
Vol 118 (7) ◽  
pp. 550-558 ◽  
Author(s):  
Yannis Manios ◽  
George Moschonis ◽  
Toine Hulshof ◽  
Anne-Sophie Bourhis ◽  
George L. J. Hull ◽  
...  

AbstractThe current study was aiming to report the prevalence of suboptimal vitamin D status among schoolchildren in Greece and investigate the role of sex, urbanisation and seasonality on vitamin D status. A sample of 2386 schoolchildren (9–13 years old) from four distinct prefectures was examined. The prevalence of 25-hydroxyvitamin D (25(OH)D) concentration <30 and <50 nmol/l (vitamin D deficiency and insufficiency respectively) was 5·2 and 52·5 %, respectively. Girls had a higher prevalence of 25(OH)D<30 (7·2 v. 3·2 %) and 50 nmol/l (57·0 v. 48·0 %) than boys (P<0·001). The highest prevalence rates of 25(OH)D<30 and 50 nmol/l (9·1 and 73·1 %, respectively) were observed during spring (April to June), whereas the lowest (1·5 and 31·9 %, respectively) during autumn (October to December). The prevalence of 25(OH)D<50 nmol/l was higher in urban/semi-urban than rural regions, particularly during spring months (74·6 v. 47·2 %; P<0·001). Female sex, urban/semi-urban region of residence and spring months were found to increase the likelihood of vitamin D deficiency and insufficiency, with the highest OR observed for spring months (7·47; 95 % CI 3·23, 17·3 and 5·14; 95 % CI 3·84, 6·89 for 25(OH)D<30 and 50 nmol/l respectively). In conclusion, despite the southerly latitude, the prevalence of low vitamin D status among primary schoolchildren in Greece is comparable to or exceeds the prevalence reported among children and adolescents on a European level. Sub-populations at highest risk are girls in urban/semi-urban areas during spring months, thus indicating the need for effective initiatives to support adequate vitamin D status in these population groups.


2007 ◽  
Vol 99 (4) ◽  
pp. 876-882 ◽  
Author(s):  
Seema Puri ◽  
Raman K. Marwaha ◽  
Neha Agarwal ◽  
Nikhil Tandon ◽  
Rashmi Agarwal ◽  
...  

Forty to fifty per cent of skeletal mass, accumulated during childhood and adolescence, is influenced by sunlight exposure, physical activity, lifestyle, endocrine status, nutrition and gender. In view of scarce data on association of nutrition and lifestyle with hypovitaminosis D in Indian children and adolescents, an in-depth study on 3127 apparently healthy Delhi schoolgirls (6–18 years) from the lower (LSES, n 1477) and upper socioeconomic strata (USES, n 1650) was carried out. These girls were subjected to anthropometry and clinical examination for hypovitaminosis D. Girls randomly selected from the two strata (LSES, n 193; USES, n 211) underwent detailed lifestyle, dietary, biochemical and hormonal assessment. Clinical vitamin D deficiency was noted in 11·5 % girls (12·4 % LSES, 10·7 % USES). USES girls had significantly higher BMI than LSES counterparts. Prevalence of biochemical hypovitaminosis D (serum 25-hydroxyvitamin D < 50 nmol/l) was seen in 90·8 % of girls (89·6 % LSES, 91·9 % USES, NS). Mean intake of energy, protein, fat, Ca, vitamin D and milk/milk products was significantly higher in USES than LSES girls. Conversely, carbohydrate, fibre, phytate and cereal intakes were higher in LSES than USES girls. Physical activity and time spent outdoors was significantly higher in LSES girls (92·8 v. 64 %, P = 0·000). Significant correlation between serum 25-hydroxyvitamin D and estimated sun exposure (r 0·185, P = 0·001) and percentage body surface area exposed (r 0·146, P = 0·004) suggests that these lifestyle-related factors may contribute significantly to the vitamin D status of the apparently healthy schoolgirls. Hence, in the absence of vitamin D fortification of foods, diet alone appears to have an insignificant role.


2021 ◽  
Author(s):  
Simmi Kharb

Pathogenesis of preeclampsia involves immune dysfunction, placental implantation, abnormal angiogenesis, excessive inflammation, hypertension that may be affected by vitamin D. Human placenta expresses all the components for vitamin D signaling: Vitamin D receptor (VDR), retinoid X receptor (RXR), 1-alpha- hydroxylase (CYP27B1) and 24- hydroxylase (CYP24A1). Vitamin D binding protein plays a role in binding and transportation of 25 hydroxyvitamin D [25(OH)D] and 1,25(OH)2D3. Vitamin D is activated by 25-hydroxylase (CYP2R1) and 1-alpha -hydroxylase (CYP27B1) and is degraded by 24-hydroxylase (CYP24A1). Vitamin D supplementation is not recommended by WHO for pregnant women and allows recommended nutrient intake (RNI) of 200 IU (5 μg) per day. Further research requires serum 25(OH)D analysis and assessment of maternal and infant outcomes; pre-conceptional vitamin D status.


2015 ◽  
Vol 35 (1) ◽  
pp. 83-90 ◽  
Author(s):  
Boglárka Szabó ◽  
Ádám G. Tabák ◽  
Erzsébet Toldy ◽  
László Szekeres ◽  
Balázs Szili ◽  
...  

2006 ◽  
Vol 21 (3) ◽  
pp. 205-210 ◽  
Author(s):  
Polyxeni Nicolaidou ◽  
Helen Georgouli ◽  
Haralambos Kotsalis ◽  
Yiannis Matsinos ◽  
Anna Papadopoulou ◽  
...  

Reports of hypovitaminosis D associated with anticonvulsant drugs in pediatric patients are conflicting. The effects of carbamazepine or sodium valproate on vitamin D status were evaluated prospectively in 51 ambulatory epileptic children who were followed during the first year of the study and in 25 and 6 children during the second and third year, respectively. Serum 25-hydroxyvitamin D, parathyroid hormone, calcium, and phosphorus levels were determined before and every 3 months during anticonvulsant therapy. Our subjects were grouped into four classes (0, 1, 2, and 3 consisted of the patients before and during the first, second, and third years of the treatment, respectively). The control group consisted of 80 healthy children. Comparisons between controls and patients of class 0 for the means for each season of all variables showed no significant differences. A decreasing trend in serum 25-hydroxyvitamin D ( P < .03) and an increasing trend in serum parathyroid hormone ( P < .04) levels were noticed in all seasons from class 0 to class 3. Twenty-five patients (49%) acquired hypovitaminosis D during the study period. The effects of seasonality on serum 25-hydroxyvitamin D, parathyroid hormone, and calcium were noticed in our patients grouped in classes 0, 2 and 3, as well as in controls. Evidence is provided that carbamazepine or sodium valproate can cause hypovitaminosis D in children. ( J Child Neurol 2006; 21:205—209; DOI 10.2310/7010.2006.00050)


Nutrients ◽  
2022 ◽  
Vol 14 (2) ◽  
pp. 317
Author(s):  
Anna Regalia ◽  
Matteo Benedetti ◽  
Silvia Malvica ◽  
Carlo Alfieri ◽  
Mariarosaria Campise ◽  
...  

Background: Recently the protective role of 25-hydroxyvitamin D (25(OH)D) against viral infections has been hypothesized. We evaluated the association between vitamin D status and SARS-CoV-2 infection susceptibility and severity in a cohort of kidney transplanted patients (KTxp). Methods: A total of 61 KTxp with SARS-CoV-2 infection (COV+) were matched with 122 healthy KTxp controls (COV−). Main biochemical parameters at 1, 6, and 12 months before SARS-CoV-2 infection were recorded. Vitamin D status was considered as the mean of two 25(OH)D measures obtained 6 ± 2 months apart during the last year. The severity of SARS-CoV-2 infection was based on the need for hospitalization (HOSP+) and death (D+). Results: 25(OH)D levels were lower in COV+ than in controls [19(12–26) vs. 23(17–31) ng/mL, p = 0.01]. No differences among the other biochemical parameters were found. The SARS-CoV-2 infection discriminative power of 25(OH)D was evaluated by ROC-curve (AUC 0.61, 95% CI 0.5–0.7, p = 0.01). 25(OH)D was not significantly different between HOSP+ and HOSP− [17(8–25) vs. 20(15–26) ng/mL, p = 0.19] and between D+ and D− [14(6–23) vs. 20(14–26) ng/mL, p = 0.22] and had no significant correlation with disease length. Conclusions: During the year preceding the infection, 25(OH)D levels were lower in COV+ KTxp in comparison with controls matched for demographic features and comorbidities. No significant association between vitamin D status and SARS-CoV-2 infection related outcomes was found.


2020 ◽  
Vol 319 (2) ◽  
pp. G253-G260
Author(s):  
Carmen J. Reynolds ◽  
Nicholas J. Koszewski ◽  
Ronald L. Horst ◽  
Donald C. Beitz ◽  
Jesse P. Goff

We found that 25OHD-Gluc, an endogenously produced metabolite, is delivered to the colon via bile to induce vitamin D-mediated responses in the colon.


Nutrients ◽  
2021 ◽  
Vol 13 (2) ◽  
pp. 573
Author(s):  
Naoko Tsugawa ◽  
Mayu Nishino ◽  
Akiko Kuwabara ◽  
Honami Ogasawara ◽  
Maya Kamao ◽  
...  

Background: Breast milk is considered the optimal source of nutrition during infancy. Although the vitamin D concentration in human breast milk is generally considered poor for infants, vitamin D in breast milk is an important source for exclusively breastfed infants. Increases in vitamin D insufficiency and deficiency in lactating mothers may reduce vitamin D concentrations in breast milk. This study aimed to compare vitamin D and 25-hydroxyvitamin D (25OHD) concentrations in breast milk collected in 1989 and 2016–2017 and simultaneously analyze them with liquid chromatography-tandem mass spectrometry (LC-MS/MS); the association between the lifestyle of recent lactating mothers (2016–2017) and vitamin D status in human breast milk was also evaluated. Method: Lactating mothers were recruited from three regions of Japan in 1989 (n = 72) and 2016–2017 (n = 90), and milk from 3–4 months was collected in summer and winter. The samples were strictly sealed and stored at −80℃ until measurement. Breast milk vitamin D and 25OHD concentrations were analyzed by LC-MS/MS. Vitamin D intake, sun exposure, and sunscreen use of the lactating mothers in 2016–2017 were assessed. Results: Both vitamin D and 25OHD concentrations in breast milk were higher in the summer regardless of the survey year. Significantly lower vitamin D and 25OHD concentrations were observed in 2016–2017 compared with 1989 in summer, but no survey year difference was observed in winter. The stepwise multiple regression analyses identified season, daily outdoor activity, and suntan in the last 12 months as independent factors associated with vitamin D3 concentrations. Conclusion: The results suggest that low vitamin D status in recent lactating mothers may have decreased vitamin D and 25OHD concentrations in breast milk compared with the 1980s. These results are helpful for developing public health strategies to improve vitamin D status in lactating mothers and infants.


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