scholarly journals Oral versus intramuscular cholecalciferol replacement in hemodialysis patients with vitamin D deficiency

2021 ◽  
Vol 11 (1) ◽  
pp. e7-e7
Author(s):  
Maha A. Behairy ◽  
Reem M. Elsharabasy ◽  
Abdel Bassit El Shaarawy ◽  
Walid Anwar ◽  
Zeinab Ahmed Mahmoud ◽  
...  
Keyword(s):  
Vitamin D ◽  
Alkaline Phosphatase ◽  
Vitamin D Deficiency ◽  
Serum Calcium ◽  
Phosphate Binders ◽  
Mineral Density ◽  
Ipth Level ◽  
Group I ◽  
The Mean ◽  
Group Ii

Introduction: Low 25-hydroxyvitamin D (25(OH)D) level in hemodialysis (HD) patients is associated with high bone turnover, secondary hyperparathyroidism, and decreased bone mineral density (BMD). Objective: To investigate the efficacy of equivalent doses of pulse oral cholecalciferol versus intramuscular (IM) cholecalciferol in correcting serum 25(OH)D levels in HD patients with vitamin D deficiency. Patients and Methods: In a prospective randomized open-label clinical trial, 80 HD patients with 25(OH)D level <20 ng/mL and serum intact parathyroid hormone (iPTH) level >100 pg/mL were enrolled in the study. Patients were divided into two groups. Group I: 40 HD patients received oral cholecalciferol 25 000 IU weekly for 12 weeks. Group II: 40 HD patients received a single dose of IM cholecalciferol 300 000 IU. Patients were maintained on their regular medications as alfacalcidol or phosphate binders. Serum calcium, phosphorus, 25(OH)D, alkaline phosphatase and iPTH were monitored at 0, 6th, and 12th week of intervention. Results: Significant increase in serum 25(OH)D level in group II patients who received IM (intramuscular) cholecalciferol, with delta mean a change of vitamin D level was 2.92 ±7.29 ng/mL over three months in comparison to the insignificant change in oral cholecalciferol group. Additionally there was a significant increase in the mean of serum calcium in comparison to oral cholecalciferol group, while we found a statistically significant decrease in alkaline phosphatase level in both groups too (P<0.05). The mean of iPTH levels was reduced significantly with IM cholecalciferol dose (1064.00 ± 787.60 to 609.9 ± 551.41 pg/mL; P<0.05). Conclusion: Intramuscular cholecalciferol dose is more effective at increasing 25(OH) D levels in dialysis patients than oral supplementation, achieves more increase in serum calcium and reduce iPTH levels. However, the longer duration of treatment is required to achieve recommended levels of vitamin D and suppress high iPTH levels.

P1413EFFECT OF PULSE ORAL VERSUS INTRAMUSCULAR VITAMIN D REPLACEMENT IN HEMODIALYSIS PATIENTS WITH VITAMIN D DEFECIENCY

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Abdelbassit Shaarawy ◽  
Waleed Anwar ◽  
Maha Abdelmoneim Behairy Said ◽  
Lina Khedr ◽  
Reem Elsharabasy ◽  
...  
Keyword(s):  
Vitamin D ◽  
Single Dose ◽  
Parathyroid Hormone ◽  
Vitamin D Deficiency ◽  
Serum Calcium ◽  
Hemodialysis Patients ◽  
Ipth Level ◽  
Insignificant Change ◽  
Group I ◽  
The Mean

Abstract Background and Aims Low 25-hydroxyvitamin D (25(OH)D) level is common in patients with chronic kidney disease and hemodialysis (HD) patients . It has been associated with high bone turnover, secondary hyperparathyroidism (SHPT), and decreased bone mineral density (BMD). We aimed to investigate the efficacy of equivalent doses of pulse oral cholecalciferol (25,000 IU weekly for 12 weeks) versus single intramuscular cholecalciferol (300,000 IU) in correcting serum 25 (OH) D levels in HD patients. Method Prospective randomized open label Clinical trial. 40 prevalent HD patients with vitamin D deficiency were enrolled. Serum 25 hydroxy-vitamin D (25 (OH) D) level &lt; 20 ng/m and Serum parathyroid hormone level ( iPTH) &gt;100 pg/ml. Exclusion Criteria were serum calcium &gt; 10 .5mg/dl, Calcium phosphorus product ≥ 55, tertiary hyperparathyroidism and Parathyroidectomy among others. Patients were randomized equally into two groups. 36 patients were compliant and completed the study. Group I :17 HD patients received oral cholecalciferol 25000 IU weekly of (Vidrop® 2800 IU/ml ) for 12 weeks. Group II: 19 HD patients received a single intramuscular injection (IM) of cholecalciferol 300,000 IU (Devarol® 200000 IU/ ampoule). Vitamin D supplements were stopped if serum calcium &gt;10.5mg/dl or 25(OH) D level &gt; 100 ng /ml (toxic level) during study. Serum calcium (albumin-adjusted), phosphorus, 25(OH) D by ELISA, Alkaline phosphatase (ALP) and intact parathyroid hormone (iPTH) were monitored at baseline, 6 and 12 weeks of intervention. Both groups were maintained on their regular medications used to control mineral bone disorder as: alfacalcidol, sevelamer or a calcium-based chelator. Results Significant increase in serum 25(OH) D level in group II patients who received single dose IM Cholecalciferol after 12 w. Means of 25 (OH)D levels basal and 12 w of study were (10.54±5.14 and 13.45 ±5.72) ng/ml respectively. There was a significant increase in the mean of serum calcium basal and at 12 w (8.19±0.69 and 8.42 ±0.54) mg/dl respectively. No significant reduction in the iPTH level or any significant change in the serum phosphorus level was noticed. compared to group I with oral vitamin D, there was an insignificant change in the mean of serum 25(OH) D basal and at 12 w were (11.91±6.13 and 9.30±5.29) ng/ml respectively, associated with insignificant increase in serum calcium and an insignificant change in either the level of phosphorus or iPTH level. Conclusion Cholecalciferol 300,000 IU IM single dose showed better response on serum 25 (OH) D and calcium levels as a treatment of hemodialysis patients with Vitamin D deficiency compared to weekly oral dose for 3 months.

Bone mineral density and spongiosa architecture in correlation to vertebral body insufficiency fractures

1998 ◽  
Vol 39 (5) ◽  
pp. 538-542 ◽  
Author(s):  
R. Andresen ◽  
S. Radmer ◽  
D. Banzer
Keyword(s):  
Bone Mineral Density ◽  
Bone Mineral ◽  
Vertebral Body ◽  
Unknown Etiology ◽  
Insufficiency Fractures ◽  
Mineral Density ◽  
Group Iii ◽  
Group I ◽  
The Mean ◽  
Group Ii

Objective: the clinical value of spinal quantitative CT (sQCT) and the structural patterns of the vertebral bone were studied Material and Methods: sQCT was performed on 246 patients with a mean age of 57 years for whom conventional lateral radiographies of the thoracic and lumbar spine were available. All patients were suffering from back pain of unknown etiology. the bone mineral density (BMD) of the midvertebral section of 3 lumbar vertebral bodies was determined by means of single-energy-(SE)-weighted QCT (85 kV). Spongiosa architecture and density profile analyses were made in the axial images. This was contrasted to BMD values ascertained in SE QCT. the mean BMD was compared to the number of fractures and the patients were divided into three groups: group I — no fracture; group II — one fracture; and group III 1 fracture Results: the mean BMD was: 134.3 (74.1–187.5) mg hydroxyapatite (HA)/ml in group I; 79.6 (58.6–114.3) mg HA/ml in group II; and 52.4 (13.1–79.1)mg HA/ml in group III. A significant deterioration in spongiosa structure was found with increasing demineralization: strongly rarefied patterns predominated in the fracture groups II and III Conclusion: sQCT provides a good risk assessment of the occurrence of vertebral body insufficiency fractures

scholarly journals Role of Vitamin D Supplements in Prevention of Hungry Bone Syndrome after Successful Parathyroidectomy for Primary Hyperparathyroidism: A Prospective Study

2020 ◽  
pp. 145749692096260
Author(s):  
M. A. Salman ◽  
A. Rabiee ◽  
A. Salman ◽  
A. Youssef ◽  
H. E.-D. Shaaban ◽  
...  
Keyword(s):  
Vitamin D ◽  
Primary Hyperparathyroidism ◽  
Vitamin D Deficiency ◽  
Statistical Significance ◽  
Mineral Density ◽  
Hydroxyvitamin D ◽  
Group I ◽  
Vitamin D Levels ◽  
25 Hydroxyvitamin D ◽  
Vitamin D Supplements

Background: We postulated that the preoperative correction of vitamin D levels can significantly reduce the incidence of hunger bone syndrome among patients undergoing parathyroidectomy for primary hyperparathyroidism. Methods: We performed a prospective, randomized, open-label study on 102 patients with primary hyperparathyroidism and coexisting vitamin D deficiency who were scheduled to undergo parathyroidectomy. Patients were divided into the following two groups: group I which included 52 patients who did not receive preoperative vitamin D supplementation; and group II which included 50 patients who received cholecalciferol 1000–2000 IU daily or 50000 IU weekly until they achieve vitamin D levels >20 ng/mL (group IIa = 25 patients) or vitamin D levels >30 ng/mL (group IIb = 25 patients). Results: The incidence of hunger bone syndrome in group IIb was lower than group I and group IIa (8% versus 16% versus 23%, respectively); however, this difference did not reach the level of statistical significance (p = 0.22). Patients with hunger bone syndrome were significantly younger and had higher serum phosphorus, alkaline phosphatase, magnesium, and bone mineral density at baseline than patients without hunger bone syndrome. On the other hand, patients with hunger bone syndrome had significantly lower 25-hydroxyvitamin D at baseline than patients without hunger bone syndrome (p = 0.001). The ROC curve showed that the baseline level of serum 25-hydroxyvitamin D was not an independent discriminator of hunger bone syndrome (area under curve = 0.21 (95% CI: 0.06–0.34); p = 0.011). Conclusion: Preoperative course of vitamin D supplements has no preventive role on the postoperative incidence of hunger bone syndrome among patients with primary hyperparathyroidism and coexisting vitamin D deficiency undergoing parathyroidectomy.

Interleukin 37 Levels in Relation to Serum Vitamin D Levels Among Ain Shams University Medical Students

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Randa Reda Mabrouk ◽  
Afaf Abdelalim Mostafa ◽  
Dina Aly Mohamed Aly Ragab ◽  
Fouad Mohamed Fouad zaki
Keyword(s):  
Vitamin D ◽  
Medical Students ◽  
Vitamin D Deficiency ◽  
Negative Correlation ◽  
Serum Levels ◽  
Significant Negative Correlation ◽  
Group I ◽  
Vitamin D Levels ◽  
Significant Difference ◽  
Group Ii

Abstract Background The extraskeletal role of vitamin D is being increasingly recognized. This has important clinical implications, as vitamin D deficiency has reached epidemic proportions worldwide. Vitamin D has proposed anti-inflammatory properties as recent data suggests that low vitamin D concentrations are associated with increased levels of inflammatory markers. Interleukin-37(IL-37) is an IL1 family cytokine discovered in recent years and has 5 different isoforms. As an immunosuppressive factor, IL-37 can suppress excessive immune response .IL37 plays a role in protecting the body against endotoxin shock, ischemia reperfusion injury, autoimmune diseases, and cardiovascular diseases. In addition, IL-37 has a potential antitumor effect. IL-37 and its receptors may serve as novel targets for the study, diagnosis, and treatment of immune-related diseases and tumors. Aim of the Work The aim of this study is to determine the relation between the level of interleukin-37 and 25-hydroxy Vitamin D among Ain Shams University medical students. Subjects and Methods The study was conducted at Clinical Pathology Department, Ain Shams University Hospitals. Ninety individuals, from medical students of Ain Shams University who participated in the Nutritional Assessment of Ain Shams University Medical Students (NAMESASU) Project, were selected to be in the study. The study included 2 groups: Group I: included 45 subjects selected from the NAMES-ASU project with deficient vitamin D serum levels. Group II: included 45 subjects selected from the NAMES-ASU project with sufficient vitamin D serum levels. Results There was a highly significant difference between the two groups regarding vitamin D levels. Serum IL-37 levels were significantly higher in group I subjects compared to group II subjects. No significant difference was observed between group I and group II regarding BMI, BFM, PBF and hsCRP. No significant difference was observed between the two subgroups regarding IL-37 levels and hsCRP levels. A highly significant negative correlation was observed between vitamin D levels and IL-37. A significant negative correlation was observed between hsCRP and vitamin D levels. However, no correlation was observed between hsCRP and IL-37 levels. Conclusion Data from our study showed that present study denote that in case of vitamin D deficiency, irrespective of BMI, a subclinical state of inflammation may be present as reflected by the increased hsCRP levels and this state of inflammation might induce an increase in IL-37, an anti-inflammatory cytokine, in an attempt to reduce the inflammation.

Effect of Sunlight - UV Rays on the Vitamin D Status of Girls (18 to 22 years)

2018 ◽  
Vol 55 (4) ◽  
pp. 463
Author(s):  
Annu Francis ◽  
R. Balasasirekha
Keyword(s):  
Vitamin D ◽  
Nutrition Education ◽  
Calcium Level ◽  
Control Group ◽  
Vitamin D Status ◽  
Group I ◽  
Before And After ◽  
The Mean ◽  
Group Ii ◽  
Experimental Group

The study was aimed to evaluate the effect of sunlight on vitamin D and calcium status among the college girls, aged 18 – 22 years. One hundred and fifty girls were selected out of which 45 with vitamin D deficiency were considered for experiment. The participants were divided into three groups of 15 each: Experimental I - curd supplementation, exposure to sunlight and nutrition education; Experimental II - exposure to sunlight and nutrition education and Control group with no intervention. Anthropometric measurements, blood haemoglobin, serum vitamin D and calcium were analysed before and after supplementation for 50 days. In the experimental group I, there was a mean increase of 3.22 ng/ml of vitamin D and was significant at 1% level and in the experimental group II the increase was 1.03 ng/ml (significant at 5% level). There was a mean difference of 1.57 ng/ml in the control group which was not significant. The mean initial calcium level in the experimental group I was 9.33 mg/dl and the final value is 9.67 mg/dl and the increase was significant at 1% level. The experimental group II had a mean initial calcium level of 9.36 mg/dl and the mean final value of 9.56 ml g/dl. The mean difference of 0.05 mg/dl was noted in serum calcium before and after supplementation in the control group. The experimental group I showed a positive correlation of 0.035 between vitamin D and sunlight whereas in experimental group II and control group there was a negative correlation of 0.045 and 0.072 respectively. It can be concluded that sunlight had an effect on vitamin D status and the calcium level of the participants further highlighting that sunlight exposure is an effective method of improving the vitamin D status.

scholarly journals The association of vitamin D deficiency with iron deficiency anemia in Turkish children aged between 4 months to 5 years old

2021 ◽  
Author(s):  
Emine Çelik ◽  
Rukiye Saç ◽  
Nermin Dindar Badem ◽  
Yıldız Dallar Bilge ◽  
Bulent Alioglu
Keyword(s):  
Vitamin D ◽  
Iron Deficiency ◽  
Vitamin D Deficiency ◽  
Iron Deficiency Anemia ◽  
Deficiency Anemia ◽  
Turkish Children ◽  
Group I ◽  
Vitamin D Levels ◽  
Group Ii ◽  
25 Oh Vitamin D

Objectives: Iron deficiency anemia (IDA) is most frequent in children under five years old. Many studies have shown a high prevalence of vitamin D deficiency (VDD) in similar age group. An association between IDA and VDD was reported. The objective of our study was to determine whether there is an association of VDD with IDA in Turkish children under 5 years old. Methods: Children, ages between four months-five years were included in a case–control study. Two groups were constituted: children with IDA (group I) and healthy control children without IDA (group II). Serum 25(OH) vitamin D levels lower than 20 ng/mL were considered as deficiency. Results: Mean age of group I (n=211, 24.8±17.5 months, 45% males) and group II (n=149, 26.4±17.7 months, 44% males) were comparable (p>0.05). Median vitamin D level in group I (22.5 ng/ml) was lower than group II (32.3 ng/mL) (p=0.001). The frequency of VDD was 38.5% in group I and 14.5% in group II (p<0.001). Sixteen children had subclinical rickets signs (All <36 months old); 14 of these were in group I (p=0.034). Conclusions: VDD is more frequent in small children with IDA than healthy controls. Most of the children presenting subclinical rickets signs had concurrent IDA. Physicians should note that VDD or even subclinical rickets may associate to IDA in children younger than 36 months old.

scholarly journals Hypocalcemia in a 15 Year Old With New Onset Type 2 Diabetes Mellitus

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. A200-A200
Author(s):  
Carlos C Becerril Romero ◽  
Rebecca Schneider Aguirre ◽  
Erik Allen Imel ◽  
Linda A DiMeglio ◽  
Anisha Gohil
Keyword(s):  
Type 2 Diabetes ◽  
Vitamin D ◽  
Alkaline Phosphatase ◽  
Vitamin D Deficiency ◽  
Serum Calcium ◽  
Calcium Gluconate ◽  
25 Oh Vitamin D ◽  
Intravenous Calcium ◽  
New Onset

Abstract Background: Diabetic ketoacidosis and significant hyperglycemia are associated with known electrolyte derangements in sodium, potassium, and phosphorus. Hypocalcemia and hypoparathyroidism occurring in uncontrolled diabetes are rare. We present a case of new-onset diabetes with severe hypocalcemia. Case: A 15-year-old obese Caucasian male with ADHD and autism presented to the Emergency room due to hyperglycemia found on laboratory evaluation for hypertension. Serum glucose was 563 mg/dL, serum bicarbonate 24 meq/L (21 - 31 meq/L), and HgbA1C 11.4% (4.0 - 5.6%). He was admitted to initiate insulin and for diabetes education. On admission, hypocalcemia was noted: serum calcium 6.6 mg/dL (8.5 - 10.5 mg/dL), alkaline phosphatase 352 units/L (48 - 277 units/L), and albumin 4.6 g/dL (3.5 - 5.0 g/dL). Repeat testing revealed serum calcium 5.1 mg/dL, phosphorus 4.3 mg/dL (2.5 - 4.5 mg/dL), and magnesium 1.7 mg/dL (1.6 - 2.9 mg/dL). He endorsed a 2 month history of tetany, paresthesia, and muscle weakness. Due to food aversions, his dietary intake of calcium and vitamin D was minimal. He had limited sun exposure. Subsequent PTH was 40 pg/mL (10 - 65 pg/mL) with concurrent serum calcium of 6.5 mg/dL. QTc was prolonged [529 msec (&lt;440 msec)], prompting transfer to the intensive care unit for telemetry, intravenous calcium gluconate, and regular calcium monitoring. Treatment was commenced with cholecalciferol 2000 international units daily and oral calcium carbonate (50 mg elemental calcium/kg/day) in divided doses for presumed Vitamin D deficiency. After several intravenous calcium gluconate doses over 24 hours, the patient’s QTc and ionized calcium normalized. At discharge, calcium was 8.5 mg/dL. He was discharged on the above regimen of calcium and cholecalciferol, and basal and bolus insulin. After discharge, laboratory results returned indicating negative diabetes autoantibodies (GAD 65, Insulin, IA-2) and 25-OH Vitamin D &lt;10 ng/mL (30 - 100ng/mL). Two days after discharge, calcium was 7.3 mg/dL. Two weeks later, labs were: 25-OH Vitamin D 11.3 ng/mL, PTH 10.4 pg/mL, and calcium 9.6 mg/dL. Conclusion: This teen presented with new-onset type 2 diabetes and symptomatic hypocalcemia, an atypical feature of new-onset diabetes. This patient’s hypocalcemia was likely due to both vitamin D deficiency and hypoparathyroidism. He had a low vitamin D level and poor calcium intake with elevated alkaline phosphatase; however, his high normal serum phosphorus and inappropriately normal PTH (instead of elevated in the setting of severe hypocalcemia) indicated a component of hypoparathyroidism. Calcium normalized with detectable 25-OH Vitamin D levels but PTH remained low. Our case highlights the importance of recognizing both that electrolyte abnormalities at diabetes onset may not be directly attributable to diabetes/hyperglycemia and that vitamin D deficiency and hypoparathyroidism may co-exist.

scholarly journals Comparison of Vitamin D Level among Vaccinated and Non Vaccinated Pregnant Women with Covid-19

2021 ◽  
Vol 15 (10) ◽  
pp. 3500-3502
Author(s):  
Saeeda Safi ◽  
Umme habiba ◽  
Shandana Mustafa Jadoon ◽  
Umbreen Idrees ◽  
Ayesha Aftab ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Vitamin D ◽  
Pregnant Women ◽  
Vitamin D Deficiency ◽  
Body Mass ◽  
Gestational Age ◽  
Serum Vitamin ◽  
Serum Vitamin D ◽  
Group I ◽  
Group Ii

Objective: The aim of this study is to compare the vitamin D level among vaccinated and non-vaccinated pregnant women with COVID-19. Study Design: Observational/comparative study Place and Duration: The study was conducted at the department of Gynae and Obs Quaid-e-Azam International Hospital, Islamabad and Qazi Hussain Ahmad Medical Complex, Nowshera for Duration of six months from October 2020 to March 2021. Methods: Total 120pregnant women had coronavirus disease were presented. Informed written consent was taken for details demographics age, gestational age, parity and body mass index. 18-45years was the women ages. Patients were categorized into 2-groups. Group I had 60 vaccinated patients and in group II 60 non-vaccinated pregnant women. Blood sample of all the patients were taken for the level of serum 25-hydroxy vitaminD3 [25 (OH) D3]. Vitamin D deficiency was calculated and compared among both groups. Sufficient serum vitamin D level was considered >30ng/ml. SPSS 23.0 version was used to analyze complete data. Results: In group I age was 28.4±8.55 years with mean BMI 24.08±1.18 kg/m2 and in group II age was 27.41±6.37 years with mean body mass index 23.12±4.42 kg/m2. Mean gestation age in group I was 33.12±9.42 weeks and in group II mean gestational age was 34.07±5.63 weeks. Mean parity in group I was 3.88±7.27 and in group II 4.01±4.14 was mean parity. We found 28 (46.7%) primigravida cases in I-group and 30 (50%) primigravida females in II-group. In group I 51(85%) patients had vitamin D deficiency and in group II 54 (90%) had deficiency of vitamin D. Among 51 deficient women of group I, number of severe deficiency (<10ng/ml) women were 8 (13.3%), deficiency (10-20ng/ml) were 13 (21.7%) and not-sufficient (20-30ng/ml) were 30 (50%) and in group II prevalence of severity (<10ng/ml) patients were 10 (16.7%), deficient cases (10-20ng/ml) were 15 (25%) and not-sufficient cases (20-30ng/ml) were 29 (48.3%). Deficient vitamin D serum levels were 15.01±1.22 in group I and 14.34±4.12 in group II. Conclusion: In this study we concluded that prevalence of vitamin D deficiency was highly among pregnant women and most probably in non-vaccinated pregnant patients but did not find any significantly difference among both groups. Keywords: Pregnancy, COVID-19, Vitamin D, Vaccination

scholarly journals Assessment of Correlation of Vitamin D Level with Coronary Artery Disease

2020 ◽  
Vol 3 (1) ◽  
pp. 70-73
Author(s):  
Reddi Basha Saheb Shaik ◽  
Rondla Madhumitha
Keyword(s):  
Risk Factors ◽  
Coronary Artery Disease ◽  
Vitamin D ◽  
Coronary Artery ◽  
Smoking Habit ◽  
Type Ii Diabetes Mellitus ◽  
Group I ◽  
The Mean ◽  
Group Ii ◽  
Artery Disease

Background: Cardiovascular disease (CVD) is the leading cause of death in the developed world. The present study was conducted to assess correlation of plasma 25-Hydroxy-Vitamin D level with angiographic severity in coronary artery disease. Subjects and Methods: The present study was conducted on 120 patients of CAD. Group I were cases and group II were control. Hypertension, type II diabetes mellitus status, smoking etc. was recorded. 2 ml of blood sample was taken from all patients and measurement of 25(OH) vit D levels was performed. Results: The mean BMI in group I was 24.6 kg/m2 and 24.8 kg/m2 in group II, smoking habit was seen in 78 in group I and 34 in group II, hypertension was seen in 65 in group I and 26 in group II, diabetes was seen in 52 in group I and 30 in group II, alcoholism in 36 in group I and 10 in group II, dyslipidemia was seen in 48 in group I and 15 in group II. The mean 25 (OH) vitamin D in group I was 15.1 ng/ml and 19.6 ng/ml in group. The difference was significant (P< 0.05). Maximum dyslipidemia (80.5%) patients had low vitamin D level followed by DM, smoking, BMI, alcoholism and alcoholism. There was no correlation between risk factors and vitamin D deficiency (P> 0.05). Conclusion: Authors found that in cases, vitamin D level was lowered as compared to control, however, there was no correlation between risk factors and CAD.

The Effect of Low Dose Oral Vitamin D on Bone Mineral Density Changes in HIV Patients: 36 Months Follow Up

2020 ◽  
Vol 20 (5) ◽  
pp. 651-658
Author(s):  
Jasreen Dhother ◽  
Shyamalie Bopitiya ◽  
Huda Taha ◽  
Satyajit Das
Keyword(s):  
Bone Mineral Density ◽  
Vitamin D ◽  
Alkaline Phosphatase ◽  
Vitamin D Deficiency ◽  
Bone Mineral ◽  
Low Dose ◽  
Mineral Density ◽  
Oral Vitamin ◽  
Pth Level

Background:: A high incidence of vitamin-D deficiency and abnormal bone mineral density (BMD) is reported among Human Immunodeficiency Virus (HIV) infected patients. The study highlighted the effect of oral low dose vitamin-D replacement in patients with a known vitamin- D deficiency on the levels of vitamin-D [25 (OH)D], parathyroid hormone (PTH) and Bone Mineral Density (BMD) of hip and spine. Methods:: Patients took a daily low dose of 800IU of vitamin-D. The following details were collected on all patients: demographics, CD-4 cell count, viral load, fracture risk factors, treatment history, corrected calcium, alkaline phosphatase (ALP), Parathyroid Hormone (PTH) (intact PTH), vitamin D 25(OH)D, inorganic phosphate and BMD of hip and spine at baseline, 12 and 36 months. Results:: Our Cohort consisted of 86 patients. Patient details included: mean age 42.8 (+/-7.7) years, 48 (55%) females 64, (74%) black African, CD-4 count 440.7 (+/-180.8) cells/dL, plasma VL 1.6 log (+/-2.3) copies/mL, duration of illness 80.9 (34.1) months, duration of exposure to antiretroviral 65.2 (+/-27.9) months. At baseline, no difference in BMD of hip or spine was observed, however, a higher PTH (0.001) in patients taking Tenofivir and a lower vitamin-D was noticed in patients taking Efavirenz. : After 36 months, patients on vitamin D replacement (n=44) had a significant increase in vitamin- D level (15.4 +/-10.4 vs 104.1+/-29.1 p=0.0001), lower PTH (6.3 +/-3.4 vs 4.4 +/-1.4 p=0.0001) ALP (108.9+/-78.8 vs 90.6+/-45.8 p=0.05) but no change in corrected calcium (2.13 +/-0.1 vs 2.16 +/-0.34 p=0.5) and BMD of spine (1.039+/-0.226 vs.1.027+/-0.211, p=0.77), and BMD of hip (1.020 +/- 0.205 vs. 1.039, p=0.61). In a multivariate logistic regression analysis that included all significant variables, vitamin-D replacement independently was associated with increase in vitamin- D level (OR 2.08, CI 1.03, 4.12, p=0.005), decrease in PTH level (OR 0.53, CI 0.35, 0.82, p=0.04), but not with change in corrected calcium, alkaline phosphatase, BMD of hip or spine. Conclusion:: After 36 months of follow up, the replacement of low dose once daily oral vitamin-D in the treatment experienced HIV infected patients with vitamin-D deficiency can increase vitamin- D level, reduce PTH level without any change in BMD of spine and hip.

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