scholarly journals Assessment of Vitamin D Metabolism in Patients with Cushing’s Disease in Response to 150,000 IU Cholecalciferol Treatment

Nutrients ◽  
2021 ◽  
Vol 13 (12) ◽  
pp. 4329
Author(s):  
Alexandra Povaliaeva ◽  
Viktor Bogdanov ◽  
Ekaterina Pigarova ◽  
Artem Zhukov ◽  
Larisa Dzeranova ◽  
...  
Keyword(s):  
Vitamin D ◽  
Cushing’S Disease ◽  
Serum Vitamin ◽  
Urinary Free Cortisol ◽  
Cushing's Disease ◽  
Control Group ◽  
Vitamin D Metabolites ◽  
Vitamin D Metabolism ◽  
Serum Vitamin D ◽  
Free Cortisol

In this study we aimed to assess vitamin D metabolism in patients with Cushing’s disease (CD) compared to healthy individuals in the setting of bolus cholecalciferol treatment. The study group included 30 adults with active CD and the control group included 30 apparently healthy adults with similar age, sex and BMI. All participants received a single dose (150,000 IU) of cholecalciferol aqueous solution orally. Laboratory assessments including serum vitamin D metabolites (25(OH)D3, 25(OH)D2, 1,25(OH)2D3, 3-epi-25(OH)D3 and 24,25(OH)2D3), free 25(OH)D, vitamin D-binding protein (DBP) and parathyroid hormone (PTH) as well as serum and urine biochemical parameters were performed before the intake and on Days 1, 3 and 7 after the administration. All data were analyzed with non-parametric statistics. Patients with CD had similar to healthy controls 25(OH)D3 levels (p > 0.05) and higher 25(OH)D3/24,25(OH)2D3 ratios (p < 0.05) throughout the study. They also had lower baseline free 25(OH)D levels (p < 0.05) despite similar DBP levels (p > 0.05) and lower albumin levels (p < 0.05); 24-h urinary free cortisol showed significant correlation with baseline 25(OH)D3/24,25(OH)2D3 ratio (r = 0.36, p < 0.05). The increase in 25(OH)D3 after cholecalciferol intake was similar in obese and non-obese states and lacked correlation with BMI (p > 0.05) among patients with CD, as opposed to the control group. Overall, patients with CD have a consistently lower 25(OH)D3/24,25(OH)2D3 ratio, which is indicative of a decrease in 24-hydroxylase activity. This altered activity of the principal vitamin D catabolism might influence the effectiveness of cholecalciferol treatment. The observed difference in baseline free 25(OH)D levels is not entirely clear and requires further study.

scholarly journals SUN-305 Hair Cortisol Measurement: An Innovative Method for Diagnosis and Follow-Up in Patients with Cushing’s Disease

2020 ◽  
Vol 4 (Supplement_1) ◽  
Author(s):  
Natalia Gabriela Deligiannis ◽  
Soledad Sosa ◽  
Diego Gonzalez ◽  
Carolina Ibar ◽  
Dario Gustavo Jacobsen ◽  
...  
Keyword(s):  
Cushing’S Disease ◽  
Reference Interval ◽  
Urinary Free Cortisol ◽  
Cushing's Disease ◽  
Control Group ◽  
Hair Cortisol ◽  
Kappa Index ◽  
Free Cortisol ◽  
Pituitary Lesion

Abstract Diagnosis of endogenous Cushing’s syndrome entails corticotropic autonomy, lack of circadian rhythm and/or hypercortisolism, evaluated through 24h urinary free cortisol (UFC). Hair cortisol measurement (HCM) has been described as an alternative marker of cortisol exposure over the preceding three months. OBJECTIVES To evaluate HCM in Cushing’s disease (CD). To analyze the correlation between HCM and UFC. To compare HCM values in CD vs controls. PATIENTS AND METHODS 3 cm hair from posterior vertex in CD and in controls age- and gender-matched between May 2017 and May 2019. Controls were low level stressed individuals (Holmes-Rahe’s scale) without adrenal disease. Normal reference interval of HCM was defined (40-128 pg/mg hair). Measurement: Siemens Immulite 2000 (Gwynedd, UK) automated chemoluminiscent immunoassay (CLIA) UFC values within the 3 months previous to hair collection were considered. Controlled CD defined as UFC ≤1 upper normal limit (UNL) with or without treatment, remission as UFC ≤1 without pituitary lesion. Results are presented as median (m) and range. Kruskal-Wallis ANOVA used for median difference evaluation and Kappa index for concordance determination. Chi2 test for comparison of recategorized UFC and HCM. Statistical analysis performed with SPSS 23.0 RESULTS 23 CD patients recruited, median age 42 ± 11 years; 91% (n=21) female; 10 samples collected at diagnosis and 13 during follow-up. Control group composed of 50 individuals 45% (n=10) had controlled CD (mUFC 0.42 UNL, range 0.1-0.9) and a mHCM of 134.5 pg/mg (62-334) and 55% (n=12) did not have control (mUFC 2.2, 1.1-6) and a mHCM of 150.5 (75-459). After recategorization of UFC (&gt; o ≤ 1 UNL) and HCM (&gt; o ≤ 128 pg/mg), determinations were associated (Chi2, p= 0.18), however, the concordance was acceptable (Kappa index = 0.276). After dividing CD patients according to HCM, 35% (n=8) had normal HCM: mHCM 113.5 (62-126) and mUFC 0.45 (0.1- 4.4). Among them, 63% (n=5) had controlled CD (mHCM 110, 62-121; mUFC 0.39, 0.1-0.85); 25% (n=2) had active CD (mUFC 2.7, 1.1-4.4; mHCM 121, 75-126). 65% had high HCM (n=15): mHCM 167 (132-459) and mUFC 1.36 (0.1-6). Most of them had active CD (n=11, 73%): mHCM 160 (132-459) and mUFC 2.2 (1.1-6). Four patients with elevated HCM (m 248, 148-334) had normal UFC (m 0.61, 0.12-0.92): 2 were in remission, 1 had normal postsurgical UFC with active disease in the follow-up and 1 had normal UFC under medical treatment. Controls (n=50) had mHCM 62.5 (40-126), significantly different from CD. CONCLUSIONS We evaluated HCM in CD, proposing this method as an additional diagnostic test for hypercortisolism. The acceptable concordance between UFC and HCM is possibly due to the different duration of the evaluated periods. The difference in the HCM values observed between controlled or active CD patients and controls permits the consideration of the method as an alternative in the diagnosis and/or follow-up of CD.

scholarly journals Evaluation of Serum Vitamin D Levels in Adolescents with Pubertal Gynecomastia

Breast Care ◽  
2016 ◽  
Vol 11 (5) ◽  
pp. 333-337 ◽  
Author(s):  
Melis Pehlivantürk Kızılkan ◽  
Sinem Akgül ◽  
Filiz Akbıyık ◽  
Orhan Derman ◽  
Nuray Kanbur
Keyword(s):  
Vitamin D ◽  
Serum Vitamin ◽  
Serum Levels ◽  
Mammary Tissue ◽  
Control Group ◽  
Contributing Factors ◽  
Vitamin D Metabolism ◽  
Serum Vitamin D ◽  
Vitamin D Levels ◽  
Pubertal Gynecomastia

Background: Since vitamin D has an inhibitory function on ductal morphogenesis of the pubertal mammary gland, it may have a role in the development of gynecomastia. The aim of this study was to determine the effect of vitamin D deficiency on the development of pubertal gynecomastia. Methods: Serum 25-hydroxyvitamin D (25D) levels in 50 adolescents with pubertal gynecomastia and 54 healthy controls between the ages of 11 and 17 years were compared. Results: Mean 25D level was 14.03 ± 6.38 (5.0-32.5) ng/ml in the pubertal gynecomastia group and 15.19 ± 6.49 (5.0-33.2) ng/ml in the control group (p = 0.361). According to the vitamin D status classification of the American Academy of Pediatrics, 66% of the pubertal gynecomastia group was found to be deficient and 14% were insufficient. In the control group these values were 53.7% and 29.6%, respectively (p = 0.158). Conclusion: From our results we hypothesize that, rather than low serum levels of 25D, a dysregulation of the vitamin D signal pathway, vitamin D metabolism or vitamin D storage within the mammary tissue might be the contributing factors to the development of gynecomastia.

scholarly journals Fasting and Exercise Induce Changes in Serum Vitamin D Metabolites in Healthy Men

Nutrients ◽  
2021 ◽  
Vol 13 (6) ◽  
pp. 1963
Author(s):  
Małgorzata Żychowska ◽  
Rafał Rola ◽  
Andżelika Borkowska ◽  
Maja Tomczyk ◽  
Jakub Kortas ◽  
...  
Keyword(s):  
Vitamin D ◽  
Repeated Measures ◽  
Serum Vitamin ◽  
The Body ◽  
Vitamin D Metabolites ◽  
Serum Samples ◽  
Vitamin D Metabolism ◽  
Serum Vitamin D ◽  
Repeated Measures Design ◽  
Before And After

Background: Vitamin D plays pleiotropic roles in the body and hence, changes in its metabolism and distribution during starvation could play an important role in the adaptive response to famine. We aimed to identify the responses of some vitamin D metabolites to 8 d of fasting and exercise. Methods: A repeated-measures design was implemented, in which 14 male volunteers fasted for 8 d and performed an exercise test before and after fasting. Serum samples were collected on day 1 after night fasting and after 8 d of complete food restriction, before and 1 h and 3 h after exercise. Results: After 8 d of fasting, compared with baseline values, serum 24,25(OH)2D3 and 3-epi-25(OH)D3 levels significantly increased; those of 25(OH)D3 and 1,25(OH)2D3 were unaffected; and those of 25(OH)D2 decreased. Exercise on the first day of fasting induced an increase in serum 3-epi-25(OH)D3 levels, while exercise performed after 8 d of fasting induced an increase in 25(OH)D3, 24,25(OH)2D3, 25(OH)D2, and 3-epi-25(OH)D3 levels. Conclusion: Increases in 24,25(OH)2D3 and 3-epi-25(OH)D3 levels imply that fasting stimulates vitamin D metabolism. The effects of exercise on serum vitamin D metabolites, which are most pronounced after fasting and in subjects with serum 25(OH)D3 above 25 ng/mL, support the notion that fasting and exercise augment vitamin D metabolism.

Association of Vitamin D Deficiency in Newly Diagnosed Pulmonary Tuberculosis

2021 ◽  
Vol 15 (10) ◽  
pp. 2572-2573
Author(s):  
Khalil Ullah ◽  
Sajid Ur Rehman ◽  
Ramsha Nadeem ◽  
Muhammad Abubakar ◽  
Qasim Raza
Keyword(s):  
Vitamin D ◽  
Pulmonary Tuberculosis ◽  
Vitamin D Deficiency ◽  
Serum Vitamin ◽  
Sampling Technique ◽  
Hypovitaminosis D ◽  
Control Group ◽  
Sputum Smear ◽  
Study Group ◽  
Serum Vitamin D

Aim: Relationship between Vitamin D deficiency and pulmonary tuberculosis. Methodology: Study duration: November 2020 to April 2021 Sampling technique: A case-control study Setting: Hayatabad Medical Complex, Peshawar It included 30 adult newly identified sputum-quality pulmonary tuberculosis patients and 30 age and sex matched healthy cases as controls. All cases had undergone a thorough medical examination and repeated laboratory tests, including vitamin D, calcium, and sputum for AFB and X-ray chest. Results: Majority were males (88%). In the Study group, BMI decreased significantly i.e. 19.0 vs 23.5. Serum vitamin D concentrations were significantly lower in the tuberculosis group i.e. 17.9ng/dl than in the control group 24.8ng/dl. Mean of serum albumin in the control group was 3.9 ng/dl whereas 2.9 ng/dl in the study group. Conclusion: Hypovitaminosis D was associated with more severe medical symptoms, increased sputum smear positivity and large lesions on chest radiographs in patients with pulmonary tuberculosis. Keywords: Vitamin D, Pulmonary Tuberculosis, Sputum

Assessment of 25 Hydroxy Cholecalceferol Level in Autistic Children; is there a role for it in Treatment of Autism Spectrum Disorder?

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Martina Alfred Youssef Nakhla ◽  
Eman Ahmed Zaky ◽  
Enas Samir Nabeh ◽  
Asmaa Wafeeq Abd El Aziz
Keyword(s):  
Vitamin D ◽  
Serum Vitamin ◽  
Autism Spectrum ◽  
Laboratory Evaluation ◽  
Control Group ◽  
Autistic Children ◽  
Serum Vitamin D ◽  
Group I ◽  
Egyptian Children ◽  
Therapeutic Doses

Abstract Background Autism is a group of neurodevelopmental disabilities with various genetic and environmental risk factors. Vitamin D is an important neurosteroid hormone which can affect brain development and function, but research on its use in treating autism has been limited. Objectives The current study aimed at assessing the level of 25 OH vit D3level in a group of autistic infants and children compared to controls and correlating it with the severity of autistic manifestations and evaluation of the role of therapeutic doses of vitamin D on the severity of autistic manifestations. Methodology Thirty autistic Egyptian children (group I) and 30 clinically healthy age and sex matched controls were enrolled (group II). Therapeutic doses of vitamin D were given for autistic children who showed insufficient levels of 25 OH cholecalceferol for a period of 4-6 weeks followed by maintenance doses for another 6 weeks. Psychometric and laboratory evaluation for this group was done thrice: at the onset of study, at 6 week after enrollment in the study, and at 12 weeks after that enrollment. Results Serum vitamin D level was substantially reduced in patients with ASD in comparison to control group, and on the other hand, 25 (OH) vitamin D level was significantly negatively correlated with ATEC score and Total CARS score. Autistic children who received vitamin D3 treatment had significant improvement of CARS and ATEC scores. Conclusion vitamin D supplementation significantly improved the outcome of enrolled autistic children. It is recommended to follow up our studied sample to check the consolidation of improvement for how long it will be needed.

scholarly journals Long-Term Control of Urinary Free Cortisol With Osilodrostat in Patients With Cushing’s Disease: Final Results From the LINC 2 Study

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. A521-A522
Author(s):  
Maria Fleseriu ◽  
Beverly M K Biller ◽  
Jerome Bertherat ◽  
Jacques Young ◽  
Giorgio Arnaldi ◽  
...  
Keyword(s):  
Adrenal Insufficiency ◽  
Cushing’S Disease ◽  
Clinical Signs ◽  
Urinary Free Cortisol ◽  
Cushing's Disease ◽  
Efficacy And Safety ◽  
Entire Treatment Period ◽  
Free Cortisol ◽  
Long Term Treatment

Abstract Introduction: During the 22-week core LINC 2 study, the oral 11β-hydroxylase inhibitor osilodrostat normalized mean urinary free cortisol (mUFC) in 79% (15/19) of patients with Cushing’s disease. This report describes long-term LINC 2 efficacy and safety results following an optional extension. Methods: Patients receiving clinical benefit at week 22 could enter the extension (that ran until Oct 22, 2019), continuing the same osilodrostat dose; dose adjustments were permitted based on efficacy and safety. Response rate (mUFC ≤ULN [controlled] or mUFC &gt;ULN but ≥50% decrease from baseline [BL; partially controlled]) was assessed over time. Efficacy/safety were assessed for all patients from core BL until study end. Results: Of 19 enrolled patients (female:male 14:5; mean [SD] age 36.8 years [8.4]), 16 entered the optional extension and 8 of them remained on treatment until study end. Median (range) osilodrostat exposure was 282 weeks (2-351). Mean mUFC decreased from BL (9.9 x ULN) to ≤ULN by week 4 and remained stable throughout the study. All 19 patients achieved mUFC ≤ULN at least once during the study. At each assessment up to month 70 of the extension phase, 50-88% of ongoing patients were controlled, and up to 18% were partially controlled. Mean percentage change in clinical signs from BL (mean [SD]) to last assessment were: fasting plasma glucose, -10.8% (22.1) (from BL: 105.6 mg/dL [49.2]); HbA1c, -2.1% (9.0) (from BL: 5.7% [0.7]); systolic BP, -3.3% (12.6) (from BL: 132.6 mmHg [11.6]); diastolic BP, -2.0% (10.4) (from BL: 85.0 mmHg [6.5]); BMI, -5.9% (8.8) (from BL: 30.7 kg/m2 [7.0]). Overall, 9 patients discontinued treatment (n=2 core and n=7 extension), mostly because of AEs or no longer requiring treatment (n=3 each). The most common AEs during the entire treatment period were nausea (n=10), adrenal insufficiency, and headache (both n=9). AEs related to hypocortisolism and adrenal hormone precursor accumulation occurred in 11 (mostly adrenal insufficiency, n=9) and 12 patients (mostly hypertension, n=4), respectively; most were grade 1/2 and managed with dose adjustment/interruption and/or concomitant medication. Mean (SD) plasma ACTH increased from 1.8 x ULN (0.9) at BL to 7.1 x ULN (12.3) at week 22 and 6.9 x ULN (12.6) at last assessment. Mean (SD) 11-deoxycortisol increased from 1.2 x ULN (1.3) at BL to 13.6 x ULN (12.2) at week 22 and 3.6 x ULN (4.2) at last assessment. In females, mean (SD) testosterone increased from 0.8 x ULN (0.4) at BL to 2.4 x ULN (2.1) at week 22 and 1.0 x ULN (0.9) at last assessment. Two patients, both female, reported an AE of hirsutism. Conclusions: Rapid reductions in mUFC were sustained for up to 6 years of osilodrostat treatment and were accompanied by improvements in clinical signs of hypercortisolism. Osilodrostat was well tolerated, with no new safety signals during long-term treatment.

scholarly journals Oral Vitamin D3 Supplementation for Femtosecond LASIK–Associated Dry Eye

2021 ◽  
Author(s):  
Ying Lin ◽  
Huanjun Su ◽  
Jianbin Wu ◽  
Muzhi Yuan ◽  
Yong Zhang
Keyword(s):  
Vitamin D ◽  
Dry Eye ◽  
Vitamin D3 ◽  
Serum Vitamin ◽  
Control Group ◽  
Oral Vitamin ◽  
Serum Vitamin D ◽  
The Mean ◽  
Experimental Group ◽  
Schirmer I Test

Abstract Purpose: To assess the effect of oral vitamin D3 supplementation in dry eye after femtosecond laser-assisted in situ keratomileusis (FS-LASIK).Setting: Liuzhou Worker’s Hospital.Design: This prospective study included 90 patients selected between January and December in 2019, who underwent fs-lasik operation in our hospital and had obvious symptoms indicating dry eyes one month after operation. The subjects were randomly divided into two groups: the experimental group (n = 45) received vitamin D3 2000 IU / D continuously for 12 weeks; the control group (n = 45) did not take vitamin D3 orally. Ocular surface disease index（OSDI）, tear breakup time（TBUT）and Schirmer’s Test I were evaluated pre-medication and 1,3,6 months after treatment. Serum vitamin D level, and the mean concentration of cytokine IL-6, IL-17, IL-23 in tears were also measured. Results: One month after treatment, the mean OSDI score of the experimental group (11.67 ± 8.53) was significantly lower than that of the control group (23.82 ± 13.22) (P = 0.007). TBUT (10.71±1.02s) and Schirmer I (9.36±0.40mm) of the experimental group were higher than those of the control group (7.49±1.29 s and 7.51±0.44 mm). The OSDI (10.25 ± 5.49), TBUT (10.75±1.09 seconds) and Schirmer I test value (11.34±0.39 mm) of the experimental group were significantly lower than those of the control group (20.22±6.23, 8.36±1.23， 8.12±0.50) at 3 months after treatment. There were significant differences in OSDI, TBUT (P ＜ 0.05) and Schirmer I test value between the two groups at 6 months after treatment. Serum vitamin D3 level was negatively correlated with OSDI score (r=-0.90；P=0.00), and positively correlated with Schirmer I test (r=0.88；P=0.00), TBUT score (r=0.89；P=0.00) and TMH (r=0.80；P=0.00). IL-17 level was shown to be significantly correlated with TBUT (r=-0.25, P=0.014) and Schirmer I test (r=-0.21, P=0.018). IL-6 level was significantly correlated with OSDI (R=0.18, P = 0.020) and TBUT (R=0.20, P = 0.019).

scholarly journals Correlation of psoriasis and serum vitamin D

2021 ◽  
Vol 7 (4) ◽  
pp. 320-323
Author(s):  
Ritika Gujrati ◽  
Krishnendra Varma ◽  
Ujjwal Kumar
Keyword(s):  
Vitamin D ◽  
Vitamin D Deficiency ◽  
Psoriasis Vulgaris ◽  
Systemic Disease ◽  
Serum Vitamin ◽  
Psoriatic Skin ◽  
Control Group ◽  
P Value ◽  
Serum Vitamin D ◽  
Vitamin D Levels

Psoriasis is an immuno-mediated chronic systemic disease involving cytokines of helper Th1 pathway. Vitamin D has an effect on keratinocyte proliferation, differentiation and immune modulation of immune system especially Th1 pathway, which is altered in psoriatic skin suggesting that Vitamin D may have a role in pathogenesis of psoriasis. To study correlation between psoriasis vulgaris and serum vitamin D. To evaluate serum vitamin D level in psoriasis cases and in control group and correlating vitamin D level with severity and duration of the psoriasis. 57 cases (&#62;15years of age) with psoriasis and 57 healthy subjects were recruited. Psoriasis was clinically diagnosed and severity evaluated by PASI scale. Vitamin D was analysed by enhanced chemilumine scence on vitrus Eci autoanalyzer of Orth clinical diagnostic. Vitamin D deficiency defined as &#60;20ng/ml, insufficiency 20-30ng/ml and sufficient 30-100ng/ml. Vitamin D deficiency in the study was 22.8% in patients and 14% in control group. Vitamin D insufficiency was found in 42.1% of cases and 19.3% of control. According to chi-square the p-value is 0.003 showing significant association. There was a tendency towards decrease in vitamin D level with increase in disease duration. There was negative correlation between vitamin D and PASI score. The study found a significant relationship between vitamin D and psoriasis. Further metanalysis involving larger study population will be required to establish whether vitamin D levels benefits patient with psoriasis vulgaris.

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