Vitamin D and Platelets: A Menacing Duo in COVID-19 and Potential Relation to Bone Remodeling

Global data correlate severe vitamin D deficiency with COVID-19-associated coagulopathy, further suggesting the presence of a hypercoagulable state in severe COVID-19 patients, which could promote thrombosis in the lungs and in other organs. The feedback loop between COVID-19-associated coagulopathy and vitamin D also involves platelets (PLTs), since vitamin D deficiency stimulates PLT activation and aggregation and increases fibrinolysis and thrombosis. Vitamin D and PLTs share and play specific roles not only in coagulation and thrombosis but also during inflammation, endothelial dysfunction, and immune response. Additionally, another ‘fil rouge’ between vitamin D and PLTs is represented by their role in mineral metabolism and bone health, since vitamin D deficiency, low PLT count, and altered PLT-related parameters are linked to abnormal bone remodeling in certain pathological conditions, such as osteoporosis (OP). Hence, it is possible to speculate that severe COVID-19 patients are characterized by the presence of several predisposing factors to bone fragility and OP that may be monitored to avoid potential complications. Here, we hypothesize different pervasive actions of vitamin D and PLT association in COVID-19, also allowing for potential preliminary information on bone health status during COVID-19 infection.

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A Study of Vitamin D Deficiency in Patients of Epilepsy on Anti-Epileptic Drug

International Journal Of Medical Science And Clinical Invention ◽

10.18535/ijmsci/v6i8.05 ◽

2019 ◽

Vol 6 (08) ◽

pp. 4551-4553

Author(s):

Dr. Anuya Chauhan mam ◽

Dr.Gargi Pathak mam ◽

Dr.Devhuti Godhani

Keyword(s):

Vitamin D ◽

Vitamin D Deficiency ◽

Antiepileptic Drugs ◽

Bone Health ◽

Mineral Metabolism ◽

Hepatic Metabolism ◽

Vitamin D Levels ◽

Co Morbidity ◽

Wide Range ◽

The Impact

Medical literature has recently focused attention on the impact of vitamin D on various aspects of health. Besides its pivotal role in calcium homeostasis and bone mineral metabolism, it is now recognized to serve a wide range of fundamental biological functions. The association between vitamin D, antiepileptic drugs , and bone health in individuals with epilepsy has been recognized for more than 30 years . Seizures themselves pose a risk for injury, including fractures; and the added co-morbidity of poor bone health increase this risk, especially in children with who suffer from seizures with motor manifestations, as well as those with impaired motor function and coordination. Many AEDs are inducers of hepatic cytochrome P450 metabolism. It has been postulated that these AEDs result in increased hepatic metabolism of vitamin D, leading to low vitamin D levels. However, non-enzyme inducing AEDs have also been associated with low vitamin D levels and in turn with poor bone health. Therefore, although the newer AEDs are less-potent enzyme inducers than older AED, they are not necessarily inert in bone metabolism. Studies have reported variable changes in vitamin D levels in children taking AEDs. We aimed to describe the prevalence of and risk factors for vitamin D deficiency among children with epilepsy on antiepileptic drugs.

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Association of vitamin D and osteocalcin levels in post-menopausal women with osteoporosis

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20170936 ◽

2017 ◽

Vol 6 (4) ◽

pp. 1244

Author(s):

Yogiraj Vaijanathrao Chidre ◽

Amir Babansab Shaikh

Keyword(s):

Vitamin D ◽

Parathyroid Hormone ◽

Vitamin D Deficiency ◽

Fragility Fractures ◽

Bone Fragility ◽

Vitamin D Supplementation ◽

Mineral Density ◽

Age Related ◽

Calcium Phosphorus ◽

Post Menopausal

Background: Osteoporosis is a common age related problem especially in women, with a consequent increase in bone fragility and susceptibility to fracture. Apart from Calcium, another nutrient that plays an important role in the mineralization of skeleton in Vitamin D. Osteocalcin, which is produced primarily by osteoblasts during bone formation, is considered to be one of the markers for osteoporosis.Methods: 314 women above the age of 40 were included into the study. A thorough physical and clinical examination, assessment of vital parameters, anthropometry evaluation was done for all patients. Bone mineral density was calculated using central DXA osteodensitometer at lumbar spine L1-L4, hip and ultradistal radius (in some cases.). Blood samples were taken for the detection of ionized calcium, phosphorus, alkaline phosphatase, 25hydroxivitamin D (25 ODH) and serum parathyroid hormone (PTH) by chemiluminiscent assay. Bone markers such as osteocalcin were measured as required.Results: Out of the 314 women attending our OPD, 96 of them were diagnosed as having osteoporosis. 24 out of them had fragility fractures, mainly of the hip, and 82 had ostepenia. Elevated levels of calcium (8.96 mg/dl), parathyroid hormone (58.76 pg/ml) and osteocalcin (24.46 ng/ml) were observed. Vitamin D deficiency of ≤ 20 was seen in 59 (63%) of the cases, insufficient in 23 (24%) and only 12 (13%) of these women had normal Vitamin D levels.Conclusions: Osteocalcin is a promising marker for the detection of osteoporosis. There is a considerable Vitamin D deficiency among the women with osteoporosis, and it is under-treated. It is essential to provide Vitamin D supplementation to these women especially those who are at high risk for fragility fractures.

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Vitamin D supplementation for term breastfed infants to prevent vitamin D deficiency and improve bone health

Cochrane Database of Systematic Reviews ◽

10.1002/14651858.cd013046 ◽

2018 ◽

Cited By ~ 1

Author(s):

May Loong Tan ◽

Steven A Abrams ◽

David A Osborn

Keyword(s):

Vitamin D ◽

Vitamin D Deficiency ◽

Bone Health ◽

Vitamin D Supplementation ◽

Breastfed Infants

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2. Vitamin D deficiency and bone fragility in sickle cell disease

Handbook of nutrition and diet in therapy of bone diseases - Human Health Handbooks ◽

10.3920/978-90-8686-823-0_2 ◽

2016 ◽

pp. 53-66

Author(s):

J.-B. Arlet ◽

J. Pouchot

Keyword(s):

Vitamin D ◽

Sickle Cell Disease ◽

Vitamin D Deficiency ◽

Sickle Cell ◽

Bone Fragility ◽

Cell Disease

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Vitamin D deficiency, poor bone health and the risk of CVD in Caucasian and South Asian women: analysis from the D-FINES study

Proceedings of The Nutrition Society ◽

10.1017/s0029665111001406 ◽

2011 ◽

Vol 70 (OCE3) ◽

Author(s):

O. A. Hakim ◽

F. Shojaee-Moradie ◽

K. Hart ◽

J. L. Berry ◽

R. Eastell ◽

...

Keyword(s):

Vitamin D ◽

Vitamin D Deficiency ◽

South Asian ◽

Bone Health ◽

Asian Women ◽

South Asian Women

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Rickets treatment improves more than bone health in toddler with autism spectrum disorder: A brief report

SAGE Open Medical Case Reports ◽

10.1177/2050313x19870026 ◽

2019 ◽

Vol 7 ◽

pp. 2050313X1987002 ◽

Cited By ~ 1

Author(s):

Leah D Stalnaker ◽

Priya Prasher ◽

Susan Flesher

Keyword(s):

Autism Spectrum Disorder ◽

Vitamin D ◽

Case Report ◽

Effective Treatment ◽

Vitamin D Deficiency ◽

Developmental Delay ◽

Bone Health ◽

Children With Autism ◽

Autism Spectrum ◽

Spectrum Disorder

Children with autism spectrum disorder have been found to have lower levels of vitamin D than their peers. Our case report supports the hypothesis that vitamin D may be an effective treatment for developmental delay in autism. In addition, we review the literature surrounding vitamin D deficiency as a potential cause of autism spectrum disorder and the role that vitamin D may play in treatment.

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BONE REMODELING MARKERS AS PREDICTORS OF BONE METABOLIC CHANGES IN MALES WITH DIABETIC OSTEOPATHY

Rheumatology Science and Practice ◽

10.14412/1995-4484-2020-290-293 ◽

2020 ◽

Vol 58 (3) ◽

pp. 290-293

Author(s):

S. S. Safarova ◽

S. S. Safarova

Keyword(s):

Vitamin D ◽

Vitamin D Deficiency ◽

Bone Remodeling ◽

Control Group ◽

Mineral Density ◽

Amino Terminal ◽

Bone Remodeling Markers ◽

History Of ◽

Male Patients

Diabetic osteopathy is one of the little studied complications of diabetes mellitus (DM), which leads to common lowtrauma fractures and, as a consequence, disability and death. The level of insulin is connected with bone functional and morphological changes followed by decreased bone mineral density (BMD) in the early stages of diabetic osteopathy. Objective: to study bone morphofunctional properties in males with type 1 and 2 DM (T1DM and T2DM). Subjects and methods. Examinations were made in 41 male patients with T1DM and 52 male patients with T2DM without a history of fractures. Their age varied from 40 to 70 years (mean age, 55.8±0.7 years and 58.4±0.9 years, respectively). A control group consisted of 34 patients (mean age, 55.9±0.9 years) without a history of DM. Patients with other endocrine disorders, end-stage complications, or chronic liver and kidney diseases were excluded from the investigation. BMD was determined by dual-energy X-ray absorptiometry (DXA). Serum bone remodeling markers (procollagen type 1 amino-terminal propeptide and C-terminal telopeptide), as well as 25(OH)D, parathyrin, insulin, glycated hemoglobin (HbA1c), and electrolytes (Ca2+, P+) were evaluated. Results and discussion. An association of BMD with renal function, HbA1c, and body mass index was observed in patients with T2DM. In the T1MD group, BMD was closely related to insulin deficiency and was significantly lower than that in the control group. In patients with vitamin D deficiency, BMD was significantly lower than in those with normal vitamin D levels (p<0.05). The patients with T1DM displayed both a decrease in BMD (p<0.05) and a pronounced change in the levels of bone markers (p<0.05). Those with T2DM had impaired bone remodeling processes, which was determined by the level of these markers (p<0.05) and observed in the presence of normal BMD due to the complex pathophysiology of the underlying disease. Conclusion. Vitamin D deficiency, insufficient and decreased insulin sensitivity, hyperglycemia, and overweight are important causes of osteopathy in patients with DM. The markers of bone remodeling may become promising indicators for diagnosing osteopathy, but additional studies are needed to elaborate recommendations for their use in routine practice in order to predict and prevent this complication of DM.

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Bone loss and vitamin D deficiency post gastrectomy for gastro-esophageal malignancy.

Journal of Clinical Oncology ◽

10.1200/jco.2016.34.4_suppl.165 ◽

2016 ◽

Vol 34 (4_suppl) ◽

pp. 165-165 ◽

Cited By ~ 2

Author(s):

Kiran Virik ◽

Robert Wilson

Keyword(s):

Risk Factors ◽

Vitamin D ◽

Vitamin D Deficiency ◽

Bone Disease ◽

Bone Health ◽

Nutritional Supplementation ◽

Type I ◽

Mineral Density ◽

Post Surgery

165 Background: Metabolic bone disease is a known but incompletely understood consequence of gastrectomy. Post gastrectomy osteoporosis (OP) is multifactorial. Evidence suggests that patients who undergo this surgery require long term bone health assessment and nutritional support. Methods: 30 post gastrectomy patients (2000-2008) from a single centre in Australia were evaluated re bone health post surgery and post nutritional supplementation. Exploratory analysis included: age, gender, pathology, type of surgery, 25 OH-vitamin D, calcium, parathyroid hormone (PTH), bone mineral density (BMD), vertebral XRs, urinary calcium and N telopeptides of type I collagen. Other risk factors evaluated were: smoking, corticosteroid use, alcohol intake, hyperthyroidism, menopausal status, hyperparathyroidism (hPTH), pre-existing bone disease. Results: The median age of the cohort was 67.5 (range 53-83) of whom 22 (73%) were male. Histology showed 16 (53%) gastric adenocarcinoma, 6 (20%) esophageal adenocarcinoma, 2 (7%) GISTs, 5 (17%) gastric/duodenal lymphoma and 1 other category. Similar numbers of patients underwent total (12) and partial/distal gastrectomy (12), with 6 having a subtotal gastrectomy. 22 (73%) had a Roux-en-Y or BR II reconstruction and 8 had a BRI/other. Median time from surgery to first BMD was 54.5 months (range 12-360) with median correlative calcium level 2.24 (range 1.97-2.49), median vitamin D level 43 (range 11-82) and median PTH 6.4 (range 1.8-13.8). Osteoporosis was diagnosed in 14 (47%) of patients, osteopenia in 14 and 2 (7%) patients had a normal BMD. Low vitamin D was seen in 23 (77%) patients, low calcium levels in 5 (17%) and secondary hPTH in 12 (41%). Post nutritional supplementation preliminary results showed 2/23 (9%) had a low vitamin D level, 3/11 (27%) had secondary hPTH, 5/19 (26%) had osteoporosis, 12/19 (63%) had osteopenia and 2/19 had a normal BMD. Analysis of other risk factors is to follow. Conclusions: Poor bone health and vitamin D deficiency is a clinically significant problem post gastrectomy. Patients should undergo long term nutritional and bone health surveillance in addition to their oncological follow up post resection.

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