Expert-analytical approach to assessing activity of vitamin D based on determination of vitamin D associated links by indicators of water-electrolyte metabolism

2021 ◽  
Vol 1 (30) ◽  
pp. 24-29
Author(s):  
A. V. Solomennikov ◽  
S. L. Bogdanova ◽  
A. I. Tyukavin ◽  
N. A. Arsenyev
Keyword(s):  
Vitamin D ◽  
Structural Changes ◽  
Laboratory Data ◽  
Statistical Processing ◽  
Individual Case ◽  
Bone Diseases ◽  
Electrolyte Metabolism ◽  
Functional Connections ◽  
Plasma Electrolyte ◽  
Analytical System

The authors used the proposed method of mathematical and statistical processing of laboratory data (indicators of electrolyte metabolism and osteomarkers) of archived data of 82 patients with various bone diseases aged 9.90 ± 0.55 years compared the structural changes in the panel of ratios of individual electrolytes and the influence of individual indicators on them in personalized data, on the basis of which a conclusion was made about a single mechanism of coinciding influences in the exchange of bone tissue. At the same time, it was found that the complex of associated links detected by the vitamin influence on the panel of electrolyte ratios may differ signifcantly in some cases from each other. These differences consisted in highly pronounced differences in the activity of vitamin D in relation to various components of osteosynthesis and osteolysis, which are described in the modern literature. On this basis, the authors conclude that the used method (analytical system) allows to identify the functional connections of the dynamics of the indicator of vitamin D in individual cases with the dynamics of other indicators of bone, which signifcantly expands the informativeness of the results of laboratory examination of the patient in determining the leading systems the implementation of functional activity of the vitamin. The presented results justify the possibility of creating and describing different images of vitamin D-related changes in the plasma electrolyte composition, followed by their use in the identifcation of certain disorders of calcium metabolism and/or evaluating the effectiveness of the therapy used in each individual case.

Calcium and Vitamin D Supplementation. Myths and Realities with Regard to Cardiovascular Risk

2019 ◽  
Vol 17 (6) ◽  
pp. 610-617 ◽  
Author(s):  
Giovanna Muscogiuri ◽  
Luigi Barrea ◽  
Barbara Altieri ◽  
Carolina Di Somma ◽  
Harjit pal Bhattoa ◽  
...  
Keyword(s):  
Vitamin D ◽  
Side Effects ◽  
Secondary Hyperparathyroidism ◽  
Calcium Supplementation ◽  
Physiological Role ◽  
Bone Diseases ◽  
Current Evidence ◽  
Bone Homeostasis ◽  
Mineral Density ◽  
Muscle Health

Vitamin D and calcium are considered crucial for the treatment of bone diseases. Both vitamin D and calcium contribute to bone homeostasis but also preserve muscle health by reducing the risk of falls and fractures. Low vitamin D concentrations result in secondary hyperparathyroidism and contribute to bone loss, although the development of secondary hyperparathyroidism varies, even in patients with severe vitamin D deficiency. Findings from observational studies have shown controversial results regarding the association between bone mineral density and vitamin D/calcium status, thus sparking a debate regarding optimum concentrations of 25-hydroxyvitamin D and calcium for the best possible skeletal health. Although most of the intervention studies reported a positive effect of supplementation with calcium and vitamin D on bone in patients with osteoporosis, this therapeutic approach has been a matter of debate regarding potential side effects on the cardiovascular (CV) system. Thus, the aim of this review is to consider the current evidence on the physiological role of vitamin D and calcium on bone and muscle health. Moreover, we provide an overview on observational and interventional studies that investigate the effect of vitamin D and calcium supplementation on bone health, also taking into account the possible CV side-effects. We also provide molecular insights on the effect of calcium plus vitamin D on the CV system.

scholarly journals 556. Evaluation of Hydroxychloroquine-based Combination Therapies for the Treatment of COVID-19

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S343-S343
Author(s):  
Andrew David Berti ◽  
Pramodini Kale-Pradhan ◽  
Christopher Giuliano ◽  
Bianca Aprilliano ◽  
Christopher R Miller ◽  
...  
Keyword(s):  
Vitamin D ◽  
Sofa Score ◽  
Laboratory Data ◽  
Organ Damage ◽  
Secondary Outcome ◽  
Mortality Data ◽  
Observational Cohort ◽  
Comorbidity Index ◽  
Significant Change ◽  
Investigational Agents

Abstract Background During the early COVID-19 pandemic a large number of investigational agents were utilized due to lack of therapeutic options. We evaluate the utility of commonly-used investigational agents combined with hydroxychloroquine (HCQ). Methods This multicenter observational cohort study included patients admitted with COVID-19 between March - May 2020 in Detroit, Michigan who received at least 2 doses of HCQ. Our primary outcome was the change in Sequential Organ Failure Assessment (SOFA) score from presentation to day 5 of HCQ therapy with a secondary outcome of in-hospital mortality. Data collected included demographics, Charlson Comorbidity index (CCI), daily SOFA score, laboratory data and COVID-directed therapies. Multiple linear regressions were performed to control for potential confounders between different therapies and change in SOFA score. Results Three hundred thirty-five patients receiving HCQ were included. Patients were 62 ± 14.8 years of age, male (54%) and African-American (82%) with a mean CCI of 1.7 ± 1.9. In our cohort, 32% were admitted to the intensive care unit and 35% expired. Therapies received by more than 20% of patients in addition to HCQ included azithromycin (80%), zinc (76%) and vitamin D (29%). In our unadjusted analysis, a significant improvement in SOFA score was observed with zinc (0.76) while no significant change was observed with azithromycin (-0.46) or vitamin D (0.05). However, there was no significant change in SOFA score after adjusting for confounders for azithromycin, zinc and vitamin D. No difference in mortality was observed between the groups. Conclusion Overall, no benefit in end-organ damage or mortality was observed with the addition of azithromycin, zinc or vitamin D to HCQ. Further studies are needed to confirm this observation. Disclosures All Authors: No reported disclosures

scholarly journals Ligand-Specific Structural Changes in the Vitamin D Receptor in Solution

Biochemistry ◽  
2011 ◽  
Vol 50 (51) ◽  
pp. 11025-11033 ◽  
Author(s):  
Kiran K. Singarapu ◽  
Jinge Zhu ◽  
Marco Tonelli ◽  
Hongyu Rao ◽  
Fariba M. Assadi-Porter ◽  
...  
Keyword(s):  
Vitamin D ◽  
Vitamin D Receptor ◽  
Structural Changes

scholarly journals Vision Loss in Patients with Giant Cell Arteritis Treated with Tocilizumab

2020 ◽  
Author(s):  
Jennifer Amsler ◽  
Iveta Kysela ◽  
Christoph Tappeiner ◽  
Luca Seitz ◽  
Lisa Christ ◽  
...  
Keyword(s):  
Giant Cell Arteritis ◽  
Giant Cell ◽  
Structural Changes ◽  
Vision Loss ◽  
Treated Patient ◽  
Laboratory Data ◽  
Reactive Protein ◽  
American College Of Rheumatology ◽  
Low Incidence ◽  
Initiation Of Therapy

Abstract Objectives: Giant cell arteritis (GCA) may lead to vision loss. To what extent tocilizumab (TCZ) is able to prevent vision loss is unknown. The aim was to analyze the occurrence of vision loss in a large GCA cohort treated with TCZ.Methods: In this observational monocentric study, GCA patients treated with TCZ between the years 2010 and 2018 were studied. Demographic, clinical and laboratory data were analyzed. Results: A total of 186 patients were included (62% female); 109 (59%) fulfilled the American College of Rheumatology (ACR) criteria, in 123 (66%) patients, large vessel vasculitis was diagnosed in magnetic resonance-angiography (MRA). Cumulative duration of TCZ treatment was 224 years, median treatment duration was 11.1 (IQR 5.6-17.9) months. Glucocorticoids (GC) were tapered over a median of 5.8 (IQR 3.0-8.5) months. At baseline, visual symptoms were present in 70 (38%) and vision loss in 21 (11%) patients. Patients with vision loss at baseline were older (p=0.032), had a lower C-reactive protein (p=0.002), more often cranial symptoms (p<0.001) or jaw claudication (p=0.031) and showed a negative association with MRA of the aorta (p=0.006). Two patients (1.1%) developed vision loss, both at initiation of TCZ treatment.Conclusion: Our data show a very low incidence of vision loss in TCZ-treated patient. The two cases of AION occurred at initiation of therapy, they support the hypothesis that advanced, and established structural changes of arteries are key factors for this accident. Whether shorter duration of concomitant GC treatment is risky regarding vision loss needs to be studied.

scholarly journals Osteomalacia in practice of endocrinologist: etiology, pathogenesis, differential diagnosis with osteoporosis

2020 ◽  
Vol 22 (2) ◽  
pp. 23-31
Author(s):  
Olga O. Golounina ◽  
Gyuzel E. Runova ◽  
Valentin V. Fadeyev
Keyword(s):  
Vitamin D ◽  
Differential Diagnosis ◽  
Vitamin D Deficiency ◽  
Clinical Symptoms ◽  
Fibroblast Growth Factor 23 ◽  
Bone Matrix ◽  
Bone Diseases ◽  
Mineral Density ◽  
Bone Formation Rate ◽  
Metabolic Bone Diseases

Osteoporosis is the most common cause of low bone mineral density (BMD) and low-traumatic fractures in adults. However, differential diagnosis should also consider other causes of decreased BMD, including osteomalacia, as treatment for these conditions vary significantly. Osteomalacia is a systemic disorder characterized by decrease in bone strength due to of excessive accumulation of non-mineralized osteoid and uncoupling between bone matrix formation and mineralization. Osteomalacia in adults mostly develops due to severe vitamin D deficiency of any etiology, less often along with kidney pathology, mesenchymal tumors secreting fibroblast growth factor 23 or hereditary metabolic bone diseases. Clinical symptoms of osteomalacia are nonspecific and mostly manifest by generalized diffuse bone pain, muscle weakness, skeletal deformities and often go unnoticed at initial stage of the disease. Histomorphometric examination is the most accurate method of the diagnosis, which allows assessment of bone formation rate and calcification. The utmost priority of the treatment of osteomalacia of any etiology is the elimination of vitamin D deficiency, hypocalcemia, hypophosphatemia and prevention of bone deformities progression and muscle hypotension.

Electrolyte Metabolism in Pyridoxine, Riboflavin and Pantothenic Acid-Deficient Rats

1957 ◽  
Vol 191 (1) ◽  
pp. 108-112 ◽  
Author(s):  
E. J. Diamant ◽  
K. Guggenheim
Keyword(s):  
Potassium Concentration ◽  
Pantothenic Acid ◽  
Chloride Content ◽  
Tubular Reabsorption ◽  
Electrolyte Metabolism ◽  
Experimental Conditions ◽  
Plasma Electrolyte ◽  
Full Diet ◽  
Plasma Chloride ◽  
Riboflavin Deficient

Muscle and plasma electrolyte concentrations were determined in rats suffering from pyridoxine, riboflavin and pantothenic acid deficiencies. Muscle of deficient rats contained more sodium and chloride than that of normal animals. There was also an increase in the plasma chloride content in pyridoxine and riboflavin-deficient rats. A decrease was observed in the potassium content of muscle in pyridoxine, and of the sodium level in plasma of riboflavin deficient animals. Cortisone, when administered to pyridoxine-deficient animals, reduced muscle sodium and chloride, and increased its potassium concentration. No such effect is found when cortisone is injected into normal or adrenalectomized rats maintained on a full diet. A saline load was imposed on pyridoxine-deficient rats. They responded with a diminished excretion of water, sodium and chloride. Cortisone, which under our experimental conditions had no effect upon the excretion of these substances in normal rats, increased however, excretion of water, sodium and chloride, when given to pyridoxine deficient rats. The retention of sodium and chloride in our deficient rats and their increased excretion following treatment with cortisone is interpreted as a consequence of either the decreased glomerular filtration found in pyridoxine, riboflavin and pantothenic acid deficiencies, and/or of the increased tubular reabsorption resulting from adrenal insufficiency, which both can be restored to normal again by administration of cortisone.

scholarly journals Pathology of Vitamin D Deficiency in Growing Turkeys

1986 ◽  
Vol 23 (4) ◽  
pp. 485-498 ◽  
Author(s):  
O. R. Hedstrom ◽  
N. F. Cheville ◽  
R. L. Horst
Keyword(s):  
Vitamin D ◽  
Structural Changes ◽  
Clinical Signs ◽  
Femoral Bone ◽  
Deficient Diet ◽  
Hypertrophic Chondrocyte ◽  
Turkey Poults ◽  
Bone Ash ◽  
Calcium Phosphorus ◽  
Plasma Alkaline Phosphatase

Turkey poults were fed a vitamin D-deficient diet and examined for clinical signs and structural changes of bone and parathyroid glands. Vitamin D-deficient poults developed ricketic changes during days 10 to 14. Control poults (deficient diet plus vitamin D) did not develop rickets. In deficient poults, lengths of proliferating-prehypertrophied zones of growth plates increased significantly in the proximal tibiotarsus but were only slightly elongated in the distal tibiotarsus. Unmineralized hypertrophic chondrocyte zones increased in length rapidly in conjunction with a decrease in the length of mineralized hypertrophic degenerative zones; this occurred more rapidly in proximal than in distal tibiotarsus. Other ricketic changes included decreases in bone ash, total femoral bone ash (calcium, phosphorus, magnesium), bone length, and body weight. Plasma alkaline phosphatase was increased, calcium was normal, and phosphorus was normal or elevated. Parathyroids were hyperplastic and had foci of degeneration. Vitamin D3 metabolites 25OHD3, 1,25(OH)2D3, and 24,25(OH)2D3 were rapidly depleted. Increase in bone ash Ca/P ratios in deficient poults suggests that phosphorus may be selectively released from ricketic bone. Low 25OHD3 and 1,25(OH)2D3 of control poults early in the experiment suggests that 1,400 IU of vitamin D3/kg of feed may not be an adequate level of vitamin D3 for growing turkey poults.

Prevalence and risk factors of vitamin D insufficiency in cancer

2009 ◽  
Vol 27 (15_suppl) ◽  
pp. 9581-9581
Author(s):  
K. A. Hauser ◽  
M. Karafa ◽  
D. Seyidova-Khoshknabi ◽  
M. P. Davis ◽  
D. Walsh
Keyword(s):  
Vitamin D ◽  
African American ◽  
Laboratory Data ◽  
Cleveland Clinic ◽  
Vitamin D Insufficiency ◽  
Cancer Site ◽  
Stepwise Logistic Regression ◽  
Cancer Type ◽  
Chi Square ◽  
25 Hydroxy Vitamin D

9581 Background: Low vitamin D has been linked to increased cancer incidence and reduced prognosis. Little is known about prevalence and risks of insufficiency in cancer. Methods: Electronic medical records of all adult solid tumor patients treated at The Cleveland Clinic in 2006–2007 were reviewed. Data extracted: demographics (age, gender, race), cancer site (primary and metastatic, ICD-9 codes) and first 25 hydroxy vitamin D level [25OHD] during the study period. Laboratory data (calcium, hepatic and renal function), medications prescribed (anticonvulsants, antineoplastic, corticosteroids, vitamin D) and treatment procedures (chemotherapy and radiotherapy) in 2 months preceding vitamin D were recorded. Clinical factors were compared between those tested for 25OHD vs not, and those insufficient (25OH D ≤30ng/ml) vs not (25OH D >31ng/ml) by Chi square or T-tests. Stepwise logistic regression identified independent predictors of vitamin D insufficiency. Results: n=39,254. 19,030 (48%) were female, mean age 63 (± 14), 86% Caucasian. Most common cancers: breast (19%), prostate (18%), skin (13%). 2,100 (5%) had vitamin D tested. They were more likely female (66% vs 47%), and to have breast, hepatobiliary, skin or thyroid cancer, than those not tested (both p<0.001). 1446 (69%) were insufficient, and 200 (10%) were frankly deficient (25OHD ≤12ng/ml). Insufficiency was associated with male gender, race (African American), month of test (Feb-Apr, Oct), cancer type (hepatobiliary, genitourinary, pancreas, upper gastrointestinal), metastatic disease, low albumin, high bilirubin and AST, and lack of antineoplastic or vitamin D medication (all p<0.01). Multivariable predictors were cancer type, test month, African American race, low albumin, and lack of antineoplastic or vitamin D medication (all p<0.01). Conclusions: Vitamin D insufficiency is highly prevalent among cancer patients tested. This study is limited by selection bias but indicates need for prospective vitamin D evaluation in cancer. No significant financial relationships to disclose.

scholarly journals Role of Vitamin D in Cardiometabolic Diseases

2013 ◽  
Vol 2013 ◽  
pp. 1-10 ◽  
Author(s):  
Chaoxun Wang
Keyword(s):  
Metabolic Syndrome ◽  
Vitamin D ◽  
Vitamin D Deficiency ◽  
Vascular Inflammation ◽  
Left Ventricular ◽  
Bone Diseases ◽  
The Body ◽  
Cvd Risk ◽  
Increased Risk ◽  
Vitamin D Levels

Vitamin D deficiency is a highly prevalent condition. Low vitamin D levels have long been associated with bone diseases, such as rickets in children and osteomalacia and osteoporosis in adults. However, it has become apparent in recent years that adequate vitamin D levels are also important for optimal functioning of many organs and tissues throughout the body, including the cardiovascular system. Evolving data indicate that vitamin D deficiency is associated with an increased risk of cardiovascular disease (CVD). Studies have shown that low vitamin D levels are associated with hypertension, diabetes, metabolic syndrome, left ventricular hypertrophy, and chronic vascular inflammation, all of which are risk factors for CVD. This paper reviews the definition and pathophysiology of vitamin D deficiency, clinical evidence linking vitamin D and CVD risk, diabetes and its complications, and metabolic syndrome.

scholarly journals Relationship between anemia and biochemical parameters of mineral bone disorders in chronic kidney disease stages 3-5 pre-dialysis patients

2020 ◽  
Vol 10 (3) ◽  
pp. 187-191
Author(s):  
Shudhanshu Kumar Saha ◽  
Rafi Nazrul Islam ◽  
Muhammad Abdur Rahim ◽  
Sarwar Iqbal
Keyword(s):  
Chronic Kidney Disease ◽  
Vitamin D ◽  
Alkaline Phosphatase ◽  
Kidney Disease ◽  
Biochemical Parameters ◽  
Bone Diseases ◽  
Dialysis Patients ◽  
Bone Disorders ◽  
Metabolic Bone Diseases ◽  
Ckd Stage

Background: Anemia and mineral bone disorders (MBD) accompany chronic kidney disease (CKD) and worsen as CKD progresses. Different biochemical parameters of CKD-MBD have been associated with anemia of CKD but are less well evaluated in low resource settings. In this study, we evaluated the role CKD-MBD disorders as a cause of anemia in CKD non-dialysis patients. Methods: This cross-sectional study recruited 115 patients with CKD who attended outpatient department (OPD) of Nephrology in BIRDEM General Hospital between January and June 2019. Patients, who were on iron, erythropoietin, calcium or vitamin D therapy in any form within the preceding 3 months and patients with known parathyroid disorders, metabolic bone diseases or anemia with definite etiology were excluded. Each patient’s demographic, clinical and biochemical parameters were recorded. Associations between anemia and serum levels of calcium (corrected), phosphate, parathyroid hormone (PTH), 25-hydroxy vitamin D [25(OH)D] and alkaline phosphatase were evaluated. Results: Total patients were 115 including 71 (61.7%) females. Mean age was 57.8 years. Most patients were in CKD stage 4 (43, 37.4%) and 5 (45, 39.1%). Mean duration of diabetes and hypertension were 12.7 and 7.2 years respectively. Mean serum creatinine (mg/dL), hemoglobin (gm/dL), calcium (mg/dL), albumin (gm/L), phosphate (mg/dL), alkaline phosphatase (U/L), PTH (pg/mL) and 25(OH)D (ng/mL) were 3.1, 10.5, 8.7, 37.9, 4.0, 119.1, 211.1 and 15.1 respectively. Hemoglobin in CKD stages 3-5 pre-dialysis patients had positive correlation with calcium and 25(OH)D and negative correlation with phosphate, alkaline phosphatase and PTH. Among these parameters of CKD-MBD, correlation with alkaline phosphatase was significant (r=-0.352, p=0.001) Conclusion: Anemia in CKD patients is multifactorial and this study concludes that CKD-MBD is yet another entity contributing to anemia in such pre-dialysis patients. Birdem Med J 2020; 10(3): 187-191

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