scholarly journals FRACTURES

2015 ◽  
Vol 22 (07) ◽  
pp. 954-958
Author(s):  
Nasir Zulfiqar ◽  
Hamid Mahmood ◽  
Ghazia Irfan ◽  
Ammara Waqar ◽  
Nadeem Iqbal

To find out the effect in increase in serum 25(OH) vitamin D levels aftersupplementation with 1000 IU/day of vitamin D in patients with low vitamin D levels and otherfactors which may affect the increase in vitamin D levels. Study Design: Retrospective study.Period: January 2013 and June 2014. Setting: Ch. Rehmat Ali Trust Teaching Hospital in theLahore. Methods: The study included patients > 50 years with a low-energy fracture and avitamin D level < 25 nmol/l. Results: 85 patients were included, mean basal 25(OH) vitamin Dlevel was 22 nmol/l. After a mean of 10 weeks, the mean increase in vitamin D was 49.5 nmol/l.Only 45.1% reached the target level of > 50 nmol/l. The increase was correlated with the basallevel of vitamin D (p < 0.05), and the time interval between the two vitamin D measurements(p < 0.05) and was inversely related to body weight (p < 0.05), but was not related to age,gender or renal function. Conclusions: We found that the generally recommended dosage of1000 IU of vitamin D per day resulted in suboptimal serum levels after ten weeks of treatment inmore than half of the patients. The increase in vitamin D levels was higher in patients with lowbody weight and in patients with very low basal vitamin D levels. These data suggest that thesepatients should initially be treated with higher dosages of vitamin D. If not possible, vitamin Dmeasurements should be performed after at least six months of supplementation with dosageadjustment.

2017 ◽  
Vol 75 (1) ◽  
pp. 3-8 ◽  
Author(s):  
Yara Dadalti Fragoso ◽  
Tarso Adoni ◽  
Soniza Vieira Alves-Leon ◽  
Samira L. Apostolos-Pereira ◽  
Walter Oleschko Arruda ◽  
...  

ABSTRACT Objective: Vitamin D has taken center stage in research and treatment of multiple sclerosis (MS). The objective of the present study was to assess the serum vitamin D levels of a large population of patients with MS and controls living in a restricted tropical area. Methods: Data from 535 patients with MS and 350 control subjects were obtained from 14 cities around the Tropic of Capricorn. Results: The mean serum 25-OH vitamin D level was 26.07 ± 10.27 ng/mL for the control subjects, and 28.03 ± 12.19 ng/mL for patients with MS. No correlation was observed between vitamin D levels and the disability of patients over the disease duration. Conclusion: At least for the region around the Tropic of Capricorn, serum levels of vitamin D typically are within the range of 20 to 30 ng/mL for controls and patients with MS.


2018 ◽  
Vol 6 (3) ◽  
pp. 488-492
Author(s):  
Imad R. Musa ◽  
Duria A. Rayis ◽  
Mohmamed A. Ahmed ◽  
Ammar H. Khamis ◽  
Abubakr M. Nasr ◽  
...  

AIM: A cross-sectional study was conducted at Saad Abualila Hospital (Khartoum, Sudan) to evaluate the vitamin D levels and thyroid function among pregnant Sudanese women (132) in early pregnancy.METHODS: A cross-sectional study was conducted at Saad Abualila hospital (Khartoum, Sudan) during the period from March to July 2015. Women who were in early pregnancy with a singleton pregnancy were approached to participate in the study after signing informed consent. A sample size of 132 participants was calculated guided by the normal interval of thyroid function in Sudanese women in the first trimester and not the level of 25(OH) vitamin D. The 25 - hydroxyvitamin D (25 (OH) vitamins levels were measured using an electrochemiluminescence immunoassay on an Elecsys 2010 Analyzer (Roche Diagnostics, Mannheim, Germany).RESULTS: The mean (SD) of age, gravidity and gestational age was 27.6 (5.5) years, 2.2 (1.6) and 10.4 (2.2) weeks, respectively. The mean (SD) of the body mass index (BMI) and haemoglobin was 27.1 (5.2) kg/m2 and 10.8 (1.1) g/dl, respectively. Median (interquartile) values of TSH, FT3, and FT4 were 1.164 IU/ml (0.079 -2.177 IU/ml), 4.639 nmol/l (3.843 - 6.562 nmol/l), and 16.86 pmol/l (13.02 - 31.48 pmol/l), respectively. There was no significant correlation between vitamin D levels and TSH, FT3 and FT4CONCLUSION: There is no correlation between 25 (OH) vitamin D levels and thyroid function during early pregnancy among Sudanese pregnant women, despite prevalent vitamin D deficiency among these women.


Blood ◽  
2008 ◽  
Vol 112 (11) ◽  
pp. 2139-2139
Author(s):  
Christine Duncan ◽  
Lynda Vrooman ◽  
Lori Bechard ◽  
Elly Barry ◽  
Leslie E. Lehmann

Abstract Children undergoing HSCT are at risk for vitamin D deficiency due to lack of sun exposure, the recommended use of sunscreen, dietary insufficiency, and the effects of medications such as glucocorticoids and calcineurin inhibitors. We assessed the prevalence of 25-hydroxyvitamin D (25-OH vitamin D) deficiency in pediatric post-HSCT patients in an outpatient oncology clinic during 4 weeks in May 2008. Patients found to have low 25-OH vitamin D levels were referred for dietary counseling and given supplementation or repletion as needed. 25-OH vitamin D and parathyroid hormone (PTH) levels were measured in 62 (88.6%) of 70 eligible patients. 83.8% of patients had a 25-OH vitamin D level less than the institutional lower limit of normal, 30 ng/mL. 29% of patients were 25-OH vitamin D insufficient with levels 20–29 ng/mL (range of 20–29). 54.8% of patients were 25-OH vitamin D deficient with levels &lt;20 ng/mL (range 5–19). The prevalence of insufficiency and deficiency was similar between male (87.8%; 57.6%) and female patients (57.6%; 55.2%).The mean duration of days following transplant was 532.6 days (median 251.5 days). The mean age at transplant was 3.7 years (median 3.5 years). 47% of patients were female. 75.8% were Caucasian. 90.3% received allogeneic transplants. The underlying diseases were as follows: ALL (27.4%), AML/MDS (24.2%), bone marrow failure (11.3%), nonmalignant hematologic diagnosis (8.1%), solid tumor (8.1%), immunodeficiency (6.5%), lymphoma (6.5%), and other diagnoses (8.1%). 8 patients regularly took either an over-the-counter multivitamin or vitamin D supplement and all 8 patients had 25-OH levels less than 30 ng/mL. There was a negative inverse correlation of (r= −0.3, p=0.029) between PTH and 25-OH vitamin D. There were no significant associations between 25-OH vitamin D level and any of the following: corticosteroid or calcineurin inhibitor use in the preceding year, time from transplant, age at transplant, current age, or graft-versus-host disease. 25-OH vitamin D insufficiency and deficiency are common following pediatric HSCT. We recommend vitamin D screening for all post-HSCT pediatric patients. Further investigation is needed to identify potential risk factors for vitamin D deficiency and the long-term effects of deficiency on bone health and development.


Blood ◽  
2013 ◽  
Vol 122 (21) ◽  
pp. 1819-1819 ◽  
Author(s):  
Joerg Thomas Bittenbring ◽  
Bettina Altmann ◽  
Frank Neumann ◽  
Marina Achenbach ◽  
Joerg Reichrath ◽  
...  

Abstract Background To investigate the impact and underlying mechanisms of vitamin-D-deficiency (VDD) on outcome of elderly (61 to 80 year-old) DLBCL patients. Methods Pretreatment 25-OH-vitamin-D serum levels from 359 patients treated in the prospective multicenter RICOVER-60 trial with 6 or 8 cycles of CHOP-14 with and without 8 cycles rituximab and 63 patients in the RICOVER-noRT study treated with 6xCHOP-14 + 8xR were determined determined by LIASION®, a commercially available chemoluminescent immunoassay. Results RICOVER-60 patients with VDD (defined as serum levels ≤8 ng/m l) and treated with rituximab had a 3-year event-free survival of 59% compared to 79% in patients with >8 ng/ml; 3-year overall survival was 70% and 82%, respectively. These differences were significant in a multivariable analysis adjusting for IPI risk factors with a hazard ratio of 2.1 [p=0.008] for event-free survival and 1.9 [p=0.040] for overall survival. In patients treated without rituximab 3-year EFS was not significantly different in patients with vitamin-D levels ≤8 and >8 ng/ml (HR 1.2; p=0.388). These results were confirmed in an independent validation set of 63 patients treated within the RICOVER-noRT study. Rituximab-mediated cellular toxicity (RMCC) against the CD20+ cell line Daudi as determined by LDH release assay increased significantly (p<0.005) in 5/5 vitamin-D-deficient individuals after vitamin-D substitution and normalization of their vitamin-D levels. Conclusions VDD is a significant risk factor for elderly DLBCL patients treated with rituximab. Our results show that VDD impairs RMCC and that RMCC can be improved by vitamin-D substitution. This together with the differential effect of VDD in patients treated with and without rituximab suggests that vitamin-D substitution might result in a better outcome of these patients when treated with CHOP plus rituximab. Supported by a grant from Deutsche Krebshilfe. Disclosures: No relevant conflicts of interest to declare.


2013 ◽  
Vol 31 (15_suppl) ◽  
pp. 8569-8569
Author(s):  
Joerg Thomas Bittenbring ◽  
Marina Achenbach ◽  
Bettina Altmann ◽  
Marita Ziepert ◽  
Joerg Reichrath ◽  
...  

8569 Background: Vitamin D deficiency was shown to be is associated with a worse outcome in patients with non-Hodgkin's lymphoma (Drake et al., 2010) To study whether this observation could be confirmed in patients with aggressive B-cell lymphomas treated uniformly within a prospective trial, we analyzed 25-OH vitamin D serum levels in patients treated within the RICOVER-60 trial of the DSHNHL. Methods: 25-OH Vitamin D serum levels were determined with a commercial chemoluminescence immunoassay in the serum from elderly patients of the RICOVER-60 trial which compared 6 or 8 cycles of CHOP, both with and without rituximab. Results: 193 of 359 pts (53.8%) had vitamin D deficiency (<10 ng/ml) and 165/359 patients (46.0%) had vitamin D insufficiency (10-30 ng/ml) according to current definitions. When treated with R-CHOP, patients with vitamin D levels ≤8 ng/ml had a 3-year EFS of 59% compared to 79% of patients with vitamin D serum levels >8 ng/ml; the respective figures for 3-year overall survival were 70% and 82%, respectively. In R-CHOP pts these differences were significant in a multivariable analysis adjusting for IPI risk factors with a hazard ratio (HR) of 2.1 (p=0.008) for EFS and a HR of 1.9 (p=0.040) for OS. In pts treated without R effects of vitamin D deficiency were significant only for OS (HR 1.8; p=0.025), but not with respect to EFS (HR 1.2; p=0.388). These results were confirmed in an independent validation set of 63 patients treated within the prospective RICOVER-noRx study. Conclusions: Vitamin D deficiency is a significant risk factor for patients with aggressive B-cell lymphomas treated with R-CHOP. The stronger adverse effect of vitamin D deficiency in patients receiving rituximab suggests that vitamin D deficiency interferes with the R mechanisms of this antibody. A prospective study evaluating the effects of vitamin D substitution on outcome of patients receiving R-CHOP is warranted. Supported by Deutsche Krebshilfe.


2020 ◽  
Vol 70 (12) ◽  
pp. 4332-4335

Vitamin D is essential for calcium absorption and for maintaining bone health in the pediatric population. We conducted a retrospective study to establish the profile of a child aged under 3 years old with vitamin D deficiency in the context of correct prophylaxis, on a cohort of 49 children from two general practitioner offices. From the study group 30.6% of children (15 cases) had low vitamin D levels. The mean serum 25(OH)D level was 41.5±16.6 ng/ml. Regarding nutrition in the first year of life, breastfeeding predominated (83.7% of patients), and only 8.16% of patients had clinical signs of rickets. So, low serum levels of vitamin D can also be found in children who have successfully received correct prophylaxis with vitamin D. Keywords: vitamin D, children, rickets


2017 ◽  
Vol 5 (2) ◽  
pp. 65-69
Author(s):  
Mohammad Rasoul Sharanjani ◽  
Ebrahim Nadi ◽  
Maryam Vasheghani ◽  
Mohammad Jafari ◽  
Jalal Poorolajal

Background: The prevalence of vitamin D deficiency is increasing due to changes in lifestyle and dietary habits. The aim of this study was to compare the serum levels of 25-hydroxy vitamin D between patients with bronchial asthma and the healthy control group. Patients and Methods: In this case-control study, 45 patients with asthma and 45 healthy subjects were enrolled and the level of serum 25 (OH) vitamin D was measured in both groups. In addition, a welltrained observer assessed airway reversibility, peak flowmetry and spirometry in the participants. The data were statistically analyzed using t test, one-way analysis of variance (ANOVA), and chi-square test with Stata software (version 11). Results: The mean age (±SD) of participants were 49.06 ±16.43 and 46.13 ±16.10 years in case and control groups, respectively (P=.394). The prevalence of vitamin D deficiency was high in both groups (69% in case and 65.5% in control groups). The mean (±SD) serum 25 (OH) vitamin D was 16.24 (±14.98) ng/ml in case group and 17.70 (±16.07) ng/mL in control group (P=.657). We found a positive correlation between the levels of vitamin D and the amount of FEV1 (r=0.2). Conclusions: According to the present study, the mean serum levels of vitamin D differences were not statistically significant between asthmatic patients and control group. However, the results of this study showed a positive relationship between forced expiratory volumes in first second (FEV1) and vitamin D levels


2021 ◽  
Author(s):  
Maryam Vasheghani ◽  
Nasrin Jannati ◽  
Parvaneh Baghaei ◽  
Mitra Rezaei ◽  
Majid Marjani

Abstract BackgroundCoronavirus disease 2019 (COVID-19) is a pandemic disease. Experiments with influenza and severe acute respiratory syndrome (SARS) have shown supplemental vitamin D can reduce the risk of infection and death.AimThis study was performed to evaluate the relationship between vitamin D levels and the severity and outcome of admitted patients with COVID-19.Material and MethodsThis cross-sectional study was performed on COVID-19 cases diagnosed by examining RT-PCR assay for SARS-CoV-2 or a set of symptoms and typical findings in lung CT scan. Based on clinical and radiologic characteristics, the patients were categorized as mild, moderate, severe, and critical. Calcium, phosphorus, albumin, creatinine, and serum 25 hydroxy vitamin D were measured and their correlation with the severity and outcome were analyzed.ResultsFrom May 1 to June 31, 2020, 508 patients ((442 patients in general wards and 66 patients in intensive care unit (ICU)) were included in this study. The participants were 56±17 years old (mean ±SD) (range from 14 to 95 years) and 52% were male. According to the past medical history, 190 (37.4%) of them had comorbidity. Concerning severity, 13.2%, 42.3%, 35.4%, and 9.1% had the mild, moderate, severe, and critical disease, respectively. The in-hospital mortality rate was 10.8%. In the multivariate regression analysis, age had a positive correlation and use of vitamin D supplement, serum level of 25 OH vitamin D, calcium, and albumin had a negative correlation with disease severity and admission to ICU. Poor outcome was inversely related to serum levels of vitamin D, calcium, albumin, and renal function. Vitamin D deficiency increased the rate of ICU admission by 2.7 times (95%CI=1.288-5.91, P=0.009).ConclusionIn patients who are hospitalized due to COVID-19, low 25-hydroxyvitamin D, hypocalcemia, and hypoalbuminemia are associated with severe disease, ICU admission, and an increase in mortality.


2019 ◽  
Vol 4 (4) ◽  
pp. 2473011419S0029
Author(s):  
Elizabeth L. McDonald ◽  
Kathleen Jarrell ◽  
Steven M. Raikin ◽  
Kristen Nicholson ◽  
Daniel Fuchs ◽  
...  

Category: Lesser Toes, Midfoot/Forefoot, Sports Introduction/Purpose: The incidence of stress injury in female runners is reported in up to 21% of competitive runners, with female runners at higher risk for stress injury than men. Bone metabolism is closely linked with vitamin D, which may play a role in the high prevalence of stress fractures in female runners. Although runners who train outdoors in the southeastern US have adequate vitamin D levels, no study to date has evaluated runners in northeastern US. The aim of the study was to prospectively evaluate the relationship between 25-OH vitamin D serum levels and the incidence of stress injury in a cohort of collegiate competitive long-distance runners. Methods: 101 female collegiate runners from 7 Northeastern US colleges competing in varsity cross country were enrolled. Surveys were collected from all the study participants at the start of the fall cross country season reviewing demographics, weekly mileage, and medical history, including previous stress fracture incidence. Additionally, baseline (“summer”) serum 25-hydroxy vitamin D levels were obtained. Subjects insufficient in vitamin D (<30ng/mL) were supplemented with cholecalciferol (D3) 50,000 units weekly for 8 weeks and 2,000 units daily for an additional 1 month. In subjects with vitamin D insufficiency, repeat labs were performed at 3 months and repeat surveys distributed. To account for variation in season and geographical location, all subjects underwent repeat vitamin D labs at 6 months (”winter”). Fisher’s exact test was used to determine whether vitamin D levels were correlated with incidence of stress fracture. Results: 91/101 (90%) subjects with mean BMI of 20.5 and average age of 20 years completed all study requirements. The mean summer and winter vitamin D serum levels were 64.0 ng/mL (SD 16.6; range 28.9-112.9) and 45.0 ng/mL (SD 13.8; range 20.1- 90.6), respectively. One subject (1%) in the summer and 9 subjects (10%) in the winter were supplemented for vitamin D insufficiency. 7/10 (70%) insufficient subjects and 28/81 (35%) vitamin D sufficient subjects reported a stress fracture during the study period. Patients that had an insufficient vitamin D result were significantly more likely to have a stress fracture during the study period (p=0.041; Table 1). The mean change in vitamin D level from summer to winter was -19.7 (SD 14.4; range -60.5- 60.7). Conclusion: The high rate of stress fractures in this cohort of collegiate female long-distance runners is greater than previously reported. Runners who are vitamin D insufficient are at a higher risk to incur a stress fracture. The results of the study also highlight the considerable seasonal variance in vitamin D levels amongst female collegiate long-distance runners in the northeastern US. Further study is needed to determine whether vitamin D supplementation reduces the risk of stress fractures.


2014 ◽  
Vol 41 (2) ◽  
pp. 12-19 ◽  
Author(s):  
D. Bakalov ◽  
M. Boyanov ◽  
A. Tsakova

Summary Data from different studies correlating the serum 25(OH)D levels with the metabolic and glycemic parameters in type 2 diabetes patients are still varying. The objective if this study was to describe the correlation between serum 25(OH)D levels and some metabolic parameters in Bulgarian type 2 diabetes patients on oral antidiabetic drugs. One hundred type 2 diabetes patients participated - 56 men and 44 women. The mean age and diabetes duration of the women was 59.0 and 9.8 years, of the men - 58.0 and 7.7 years respectively. Complete patient history was taken and physical examination was performed (body weight and height, waist circumference). Body composition was measured on a leg-to-leg body impedance analyzer (TBF-215, Tanita Corp., Tokyo, Japan). Serum levels of vitamin D were measured by electro-hemi-luminescent detection as 25-(ОН) D Total (ECLIA, Elecsys 2010, Roche Diagnostics, Switzerland). Glycated hemoglobin A1c was measured on a NycoCard reader (Alere™). Total, HDL-cholesterol (direct) and triglycerides were analyzed on a Cobas Integra 400+ analyzer. Correlation analysis was performed on a SPSS 13.0 for Windows platform and included 10 curves. The data were first analyzed for the group as a whole and then separately for men and women as well as in the different vitamin D tertiles. The mean serum 25-OH-vitamin D levels were 23.8 ± 12.1 nmol/l in women and 33.3 ± 20.0 nmol/l in men. We were unable to find any statistically significant correlation between serum 25(OH) vitaminand the serum lipids (cholesterol profile and triglycerides). On the contrary, there was a weak correlation with the glycated hemoglobin A1c (cubic model, R2 = 0.178, p = 0.05) and the BMI (inverse model, R2 = 0.101, p = 0.038). The sub-analyses (men versus women or according to tertiles of vitamin D) did not produce any additional information. The influence of vitamin D on the parameters of the metabolic control in type 2 diabetes is very weak on an individual level. It might be only demonstrated in large epidemiological surveys.


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