scholarly journals Monitored Supplementation of Vitamin D in Preterm Infants: A Randomized Controlled Trial

Nutrients ◽  
2021 ◽  
Vol 13 (10) ◽  
pp. 3442
Author(s):  
Alicja Kołodziejczyk-Nowotarska ◽  
Renata Bokiniec ◽  
Joanna Seliga-Siwecka

Appropriate supplementation of vitamin D can affect infections, allergy, and mental and behavioral development. This study aimed to assess the effectiveness of monitored vitamin D supplementation in a population of preterm infants. 109 preterm infants (24 0/7–32 6/7 weeks of gestation) were randomized to receive 500 IU vitamin D standard therapy (n = 55; approximately 800–1000 IU from combined sources) or monitored therapy (n = 54; with an option of dose modification). 25-hydroxyvitamin D [25(OH)D] concentrations were measured at birth, 4 weeks of age, and 35, 40, and 52 ± 2 weeks of post-conceptional age (PCA). Vitamin D supplementation was discontinued in 23% of infants subjected to standard treatment due to increased potentially toxic 25(OH)D concentrations (>90 ng/mL) at 40 weeks of PCA. A significantly higher infants’ percentage in the monitored group had safe vitamin D levels (20−80 ng/mL) at 52 weeks of PCA (p = 0.017). We observed increased vitamin D levels and abnormal ultrasound findings in five infants. Biochemical markers of vitamin D toxicity were observed in two patients at 52 weeks of PCA in the control group. Inadequate and excessive amounts of vitamin D can lead to serious health problems. Supplementation with 800–1000 IU of vitamin D prevents deficiency and should be monitored to avoid overdose.

Author(s):  
Alicja Kołodziejczyk-Nowotarska ◽  
Renata Bokiniec ◽  
Joanna Seliga-Siwecka

Appropriate supplementation of vitamin D can affect infections, allergy, and mental and behavioral development. This study aimed to assess the effectiveness of monitored vitamin D supplementation in a population of preterm infants. 109 preterm infants (24 0/7–32 6/7 weeks of gestation) were randomized to receive 500 IU vitamin D standard therapy (n=55; approximately 800-1000 IU from combined sources) or monitored therapy (n=54; with an option of dose modification). 25(OH)D concentrations were measured at birth, 4 weeks of age, and 35, 40, and 52±2 weeks of post-conceptional age (PCA). Vitamin D supplementation was discontinued in 23% of infants subjected to standard treatment due to increased potentially toxic 25(OH)D concentrations (>90 ng/mL) at 40 weeks of PCA. A significantly higher infants’ percentage in the monitored group had safe vitamin D levels (20–80 ng/mL) at 52 weeks of PCA (p=0.017). We observed increased vitamin D levels and abnormal ultrasound findings in five infants. Biochemical markers of vitamin D toxicity were observed in two patients at 52 weeks of PCA in the control group. Inadequate and excessive amounts of vitamin D can lead to serious health problems. Supplementation with 800–1000 IU of vitamin D prevents deficiency and should be monitored to avoid overdose.


2005 ◽  
Vol 11 (3) ◽  
pp. 266-271 ◽  
Author(s):  
M Soilu-Hänninen ◽  
L Airas ◽  
I Mononen ◽  
A Heikkilä ◽  
M Viljanen ◽  
...  

Past sun exposure and vitamin D supplementation have been associated with a reduction in the risk of MS. We measured the serum concentration of 25-hydroxyvitamin D (25[OH]D) at the time of MS diagnosis in 40 MS patients and 40 controls. We found no difference in the serum levels of 25(OH)D between MS patients and controls when all samples or samples obtained during winter months were compared, but MS patients had significantly lower serum 25(OH)D concentrations in June to September than the controls. The vitamin D stores were adequate for bone metabolism (> 37 nmol/L) in 70% of MS patients throughout the year and within the hypovitaminosis level (< 37 nmol/L) in 30% of MS patients at some time of the year. During MS-relapses, 25(OH)D levels were lower than in remission, but mostly within the reference range observed in relation with normal bone metabolism. We conclude that the vitamin D stores in most MS patients are adequate for their normal bone metabolism. However, lower vitamin D levels during MS relapses than in remission suggest that vitamin D could be involved in the regulation of the clinical disease activity of MS. The optimal serum levels of vitamin D for the regulation of immune responses remain to be determined.


2016 ◽  
Vol 174 (4) ◽  
pp. 445-452 ◽  
Author(s):  
Stina T Sollid ◽  
Moira Y S Hutchinson ◽  
Vivian Berg ◽  
Ole M Fuskevåg ◽  
Yngve Figenschau ◽  
...  

ObjectiveTo determine the relationship between serum total 25-hydroxyvitamin D (25(OH)D), directly measured free 25(OH)D and calculated free 25(OH)D with regard to vitamin D-binding protein (DBP) phenotypes, sex, BMI, age and season, and their interrelationship to vitamin D supplementation.Design, patients and interventionsA randomized controlled trial with 20 000 IU of vitamin D3per week or placebo for 12 months was designed. A total of 472 subjects, 236 in each of the intervention groups, were included in the analyses.Main outcome measuresBaseline serum concentrations and increases in serum total 25(OH)D, directly measured free 25(OH)D, calculated free 25(OH)D and DBP.ResultsSerum total 25(OH)D and DBP concentrations were significantly lower in subjects with the phenotype Gc2/Gc2 compared to phenotypes with the Gc1S allele, and lower in males compared to females. When using directly measured free 25(OH)D, the differences related to DBP phenotypes and sexes were clearly diminished. All calculated free 25(OH)D concentrations were overestimated compared to the directly measured free 25(OH)D. Serum parathyroid hormone showed an inverse correlation with all vitamin D parameters analyzed. The increases after 12 months of vitamin D supplementation were not significantly different for any of the vitamin D parameters regardless of DBP phenotype, sex or age. Supplementation with vitamin D did not affect serum DBP.ConclusionDirect measurements of free 25(OH)D reduce the differences seen in total 25(OH)D between DBP phenotype groups and sexes, probably caused by differences in DBP concentrations. With conditions affecting serum DBP concentrations, direct measurements of free 25(OH)D should be considered.


Author(s):  
Anna Grzegory ◽  
Lech Pomorski ◽  
Konrad Pagacz ◽  
Karol Sieniawski ◽  
Krzysztof Kaczka

IntroductionHypocalcaemia remains the most common postoperative complication after total thyroidectomy. The purpose of the study was to evaluate the clinical usefulness of routine preoperative oral calcium and vitamin D supplementation in the prevention of hypocalcaemia after total thyroidectomy.Material and methodsOne hundred fifty-three consecutive patients with nontoxic multinodular goitre were randomly assigned to routinely receive (group B) or not to receive (group A) calcium carbonate (3 g/d) and alfacalcidol (1 µg/d) on the day before surgery and calcium carbonate (1 g/d) and alfacalcidol (1 µg/d) taken once in the morning on the day of operation. Their preoperative 25-hydroxyvitamin D (25-OHD) levels, hypocalcemic symptoms, serum calcium and parathyroid hormone (iPTH) levels were determined 6 and 24 hour postoperatively and 6 weeks after surgery.ResultsSymptomatic hypocalcaemia was observed in 41/153(26.79%) patients. The incidence of symptomatic hypocalcaemia was significantly lower in the supplemented group than in the group not receiving supplementation: 10 of 77 participants (12.99%) versus 31 of 76 patients (40.79%) (p<0.05). The rates of laboratory and severe hypocalcaemia (corrected calcium <2.0 mmol/l) were 67.11% and 28.95% in group A and 50.65% and 9.09% in group B, respectively (p=0.04, p<0.05). There were no significant differences between groups A and B in corrected calcium levels after surgery and postoperative decreases in corrected calcium levels (p=0.06). 112(73.20%) participants had 25-OHD<20 ng/ml. Vitamin D levels did not influence corrected calcium level changes (p=0.98).ConclusionsOral supplementation of calcium and alfacalcidol may help in the prevention of postthyroidectomy hypocalcaemia. Vitamin D deficiency was widespread among operated patients.


2014 ◽  
Vol 2014 ◽  
pp. 1-6 ◽  
Author(s):  
Devi Dayal ◽  
Suresh Kumar ◽  
Naresh Sachdeva ◽  
Rakesh Kumar ◽  
Meenu Singh ◽  
...  

Plasma levels of 25-hydroxyvitamin D [25(OH)D] were measured by competitive Electrochemiluminescence Immunoassay (ECLIA) in 92 children (67 boys, 25 girls) aged 3 months to 12 years at admission to hospital (timepoint 1, T1) and at discharge (timepoint 2, T2). There was a significant fall in the mean 25(OH)D from T1 (71.87 ± 27.25 nmol/L) to T2 (49.03 ± 22.25 nmol/L) (mean change = 22.84 nmol/L,Pvalue = 0.0004). Proportion of patients having VDD (levels <50 nmol/L) at admission (25%, 23/92) increased significantly at the time of discharge (51.09%, 47/92) (P=0.0004). There was a trend towards longer duration of hospital stay, requirement of ventilation and inotropes, development of healthcare-associated infection, and mortality in vitamin D deficient as compared to nondeficient patients though the difference was statistically insignificant. In conclusion, vitamin D levels fall significantly and should be monitored during hospital stay in children. Large clinical studies are needed to prospectively evaluate the effect of vitamin D supplementation in vitamin D deficient hospitalized children on various disease outcome parameters.


2020 ◽  
Vol 29 (Sup7) ◽  
pp. S24-S30 ◽  
Author(s):  
Karen Smith ◽  
Susan Hewlings

Objective: Hard-to-heal wounds are a major biological, psychological, social and financial burden on both individual patients and the broader health system. They are associated with a variety of comorbidities and have a complex aetiology, but are typically associated with nutritional deficiencies, such as low vitamin D levels. This systematic literature review evaluates the current research regarding the connection between inadequate vitamin D status and wound healing. Method: PubMed and EBSCO databases were searched following PRISMA guidelines for primary research studies relating to pressure ulcers, diabetic ulcers or venous ulcers and vitamin D status. Results: A total of 10 studies, involving 2359 participants, met the inclusion criteria. There was a strong correlation between low levels of 25-hydroxyvitamin D and the presence of all three types of hard-to-heal wounds. Conclusion: Research suggests a correlation between low vitamin D levels and hard-to-heal wounds. However, it is not clear if the relationship is causal or only correlational. There is also emerging evidence on the use of vitamin D supplementation for the treatment of hard-to-heal wounds. More research is needed to understand the correlation between vitamin D and hard-to-heal wounds.


2017 ◽  
Vol 20 (10) ◽  
pp. 1816-1824 ◽  
Author(s):  
Jessica A Omand ◽  
Teresa To ◽  
Deborah L O’Connor ◽  
Patricia C Parkin ◽  
Catherine S Birken ◽  
...  

AbstractObjectiveUpper respiratory tract infections (URTI) are the most common and costly condition of childhood. Low vitamin D levels have been hypothesized as a risk factor for URTI. The primary objective was to determine if serum vitamin D levels were associated with health-service utilization (HSU) for URTI including hospital admission, emergency department visits and outpatient sick visits. The secondary objectives were to determine whether oral vitamin D supplementation in pregnancy or childhood was associated with HSU for URTI.DesignCohort study. HSU was determined by linking each child’s provincial health insurance number to health administrative databases. Multivariable quasi Poisson regression was used to evaluate the association between 25-hydroxyvitamin D, vitamin D supplementation and HSU for URTI.SettingToronto, Canada.SubjectsChildren participating in the TARGet Kids! network between 2008 and 2013.ResultsHealthy children aged 0–5 years (n 4962) were included; 52 % were male and mean 25-hydroxyvitamin D was 84 nmol/l (range 11–355 nmol/l). There were 105 (2 %), 721 (15 %) and 3218 (65 %) children with at least one hospital admission, emergency department visit or outpatient sick visit for URTI, respectively. There were no statistically significant associations between 25-hydroxyvitamin D or vitamin D supplementation and HSU for URTI.ConclusionsA clinically meaningful association between vitamin D (continuously and dichotomized at <50 and <75 nmol/l) and HSU for URTI was not identified. While vitamin D may have other benefits for health, reducing HSU for URTI does not appear to be one of them.


Nutrients ◽  
2016 ◽  
Vol 8 (5) ◽  
pp. 278 ◽  
Author(s):  
Stefan Pilz ◽  
Csilla Putz-Bankuti ◽  
Martin Gaksch ◽  
Walter Spindelboeck ◽  
Marius Haselberger ◽  
...  

2021 ◽  
pp. 135245852199548 ◽  
Author(s):  
Adil Harroud ◽  
Despoina Manousaki ◽  
Guillaume Butler-Laporte ◽  
Ruth E Mitchell ◽  
George Davey Smith ◽  
...  

Background: Obesity is associated with increased risk of multiple sclerosis (MS); however, the underlying mechanisms remain unclear. Objective: To determine the extent to which decreased vitamin D bioavailability and altered levels of adiponectin and leptin mediate the association between obesity and MS. Methods: We performed Mendelian randomization (MR) analyses to estimate the effects on MS of body mass index (BMI), 25-hydroxyvitamin D (25OHD), adiponectin, and leptin levels in a cohort of 14,802 MS cases and 26,703 controls. We then estimated the proportion of the effect of obesity on MS explained by these potential mediators. Results: Genetic predisposition to higher BMI was associated with increased MS risk (odds ratio (OR) = 1.33 per standard deviation (SD), 95% confidence interval (CI) = 1.09–1.63), while higher 25OHD levels reduced odds of MS (OR = 0.72 per SD, 95% CI = 0.60–0.87). In contrast, we observed no effect of adiponectin or leptin. In MR mediation analysis, 5.2% of the association between BMI and MS was attributed to obesity lowering 25OHD levels (95% CI = 0.3%–31.0%). Conclusions: This study found that a minority of the increased risk of MS conferred by obesity is mediated by lowered vitamin D levels, while leptin and adiponectin had no effect. Consequently, vitamin D supplementation would only modestly reverse the effect of obesity on MS.


2020 ◽  
Vol 9 (3) ◽  
pp. 123-130
Author(s):  
Burcu Kayılı ◽  
Muhammet Ali Oruç ◽  
Yasemin Alan ◽  
Murat Alan ◽  
Deniz Can Öztekin

Aim: The aim of this study was to compare vitamin D levels between pregnant women with hyperemesis gravidarum before 12 weeks of gestation and healthy pregnant women at similar ages. Methods: Sixty pregnancies with hyperemesis gravidarum and 60 age compatible healthy pregnancies applied to our facility were included in the study. Demographic characteristics, maternal thyroid function tests and 25-Hydroxyvitamin D levels were evaluated. Student t test was used for the variables with normal distribution and Mann-Whitney U test was used to analyze the variables without normal distribution. Results: Only one pregnant woman had normal vitamin D levels (>30ng/ml), whereas 71 patients had deficiency (10-30 ng/ml), and 48 had severe deficiency (<10 ng/ml). The mean vitamin D level of the total 120 pregnancies was 11.9±5.00 ng/ml (9.92±3.67 ng/ml in case group, 13.88±5.38 ng/ml in control group). The mean value of vitamin D was found to be significantly lower in hyperemesis gravidarum. 45% (n=27) of the pregnant women had vitamin D deficiency, whereas 55% (n=33) of them had severe deficiency. Free T3 and T4 levels were significantly higher than the control group, and thyroid-stimulating hormone level was significantly lower. Conclusion: Vitamin D levels of pregnant women with hyperemesis gravidarum were significantly lower. Vitamin D deficiency should be considered in patients with hyperemesis gravidarum. Keywords: pregnancy, hyperemesis gravidarum, Vitamin D deficiency


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