scholarly journals Vitamin D and Diabetic Foot

2021 ◽  
Author(s):  
Antony Macido
Keyword(s):  
Vitamin D ◽  
Diabetic Foot ◽  
Large Scale ◽  
Negative Relationship ◽  
Hydroxyvitamin D ◽  
Diabetic Foot Infections ◽  
Randomized Controlled Studies ◽  
Patients With Diabetes ◽  
The Status ◽  
25 Hydroxyvitamin D

Approximately 15% of patients with diabetes mellitus (DM) are prone to developing diabetic foot ulcers (DFU) in their lifetime. The term vitamin D status or 25-hydroxyvitamin D [25(OH)D] levels are used interchangeably to represent the status of vitamin D in individuals throughout this paper. Evidence suggests a relationship between 25(OH)D levels and DFU. However, very minimal data is available on the association between DFU and vitamin D deficiency. After a careful review of the literature, it was inferred that vitamin D could be associated with DFU and diabetic foot infections. Available evidence on vitamin D and DFU suggests a negative correlation between 25(OH)D levels and the presence of DFU. Evidence also supports a negative relationship between 25(OH)D levels and diabetic foot infections. Further large-scale randomized controlled studies need to be done to confirm the relationship between 25(OH)D levels and DFU including the use of vitamin D in the management of DFU and diabetic foot infections.

scholarly journals Diabetic Foot Ulcers and Vitamin D Status: A Literature Review

2018 ◽  
Vol 4 ◽  
pp. 237796081878902 ◽  
Author(s):  
Antony Macido
Keyword(s):  
Vitamin D ◽  
Diabetic Foot ◽  
Large Scale ◽  
Negative Relationship ◽  
Foot Ulcers ◽  
Diabetic Foot Ulcers ◽  
Vitamin D Status ◽  
Hydroxyvitamin D ◽  
Diabetic Foot Infections ◽  
Randomized Controlled Studies

Approximately 15% of patients with diabetes mellitus (DM) are prone to developing diabetic foot ulcers (DFU) in their lifetime. The term vitamin D status or 25-hydroxyvitamin D (25(OH)D) levels is used interchangeably to represent the status of vitamin D in individuals throughout this article. Evidence suggests a relationship between 25(OH)D levels and DFU. However, very minimal data are available on the association between DFU and vitamin D deficiency. After a careful review of the literature, it was inferred that vitamin D could be associated with DFU and diabetic foot infections. Available evidence on vitamin D and DFU suggests a negative correlation between 25(OH)D levels and the presence of DFU. Evidence also supports a negative relationship between 25(OH)D levels and diabetic foot infections. Further large-scale randomized controlled studies need to be done to confirm the relationship between 25(OH)D levels and DFU including the use of vitamin D in the management of DFU and diabetic foot infections.

scholarly journals Vitamin K & D Deficiency Are Independently Associated With Covid-19 Disease Severity

2021 ◽  
Author(s):  
Ankita P Desai ◽  
Sahera Dirajlal-Fargo ◽  
Jared C Durieux ◽  
Heather Tribout ◽  
Danielle Labbato ◽  
...  
Keyword(s):  
Vitamin D ◽  
Disease Severity ◽  
Vitamin K ◽  
Matrix Gla Protein ◽  
Vitamin D Status ◽  
Hydroxyvitamin D ◽  
Moderate Disease ◽  
Unit Increase ◽  
The Status ◽  
25 Hydroxyvitamin D

Abstract Background We investigated the status of vitamin K and vitamin D and association to COVID-19 outcomes. Methods Levels of inactive vitamin K-dependent dephosphorylated uncarboxylated matrix Gla protein (dp-ucMGP; marker of vitamin K status) and 25-hydroxyvitamin D levels (25(OH)D; vitamin D status) were measured in plasma samples from participants with confirmed acute COVID-19 and were age and sex matched to healthy controls. Unadjusted (UOR) and adjusted odds ratios (AOR) with 95% confidence intervals (CI) were computed using cumulative logistic regression. Results 150 subjects were included, 100 COVID-19+ and 50 controls. Median agewas 55 (IQR: 48, 63), 50% were females. 34% had mild COVID-19 disease, 51% moderate disease, and 15% severe. Dp-ucMGP levels were higher (i.e. worse K status) in COVID-19+ vs controls (776.5 ng/mL vs 549.8 ng/mL, p <0.0001) with similar 25(OH)D between groups (25.8 vs 21.9 ng/mL, p=0.09). Participants who were vitamin D deficient (<20ng/mL) had the worse vitamin K status (dp-ucMGP >780ng/mL) and experienced the most severe COVID-19 outcomes. In adjusted models, every one-unit increase in the log2 dp-ucMGP nearly doubled the odds of acute critical disease or death [AOR 95%CI: 1.84 (1.01, 3.45)] and every one-unit decrease in the natural log 25(OH)D was associated with more than three times the likelihood of COVID-19 disease severity [AOR 95%CI: 0.29 (0.11, 0.67)]. Conclusion Early in acute COVID-19, both vitamin K and vitamin D deficiency were independently associated with worse COVID-19 disease severity, suggesting a potential synergistic interplay between these two vitamins in COVID-19.

scholarly journals Vitamin D deficiency is associated with inflammatory cytokine concentrations in patients with diabetic foot infection

2014 ◽  
Vol 112 (12) ◽  
pp. 1938-1943 ◽  
Author(s):  
Shalbha Tiwari ◽  
Daliparthy Devi Pratyush ◽  
Sanjeev Kumar Gupta ◽  
Surya Kumar Singh
Keyword(s):  
Vitamin D ◽  
Vitamin D Deficiency ◽  
Diabetic Foot ◽  
Inflammatory Cytokine ◽  
Diabetic Foot Infection ◽  
Hydroxyvitamin D ◽  
Severe Vitamin ◽  
Tnf Α ◽  
25 Hydroxyvitamin D ◽  
Ifn Γ

Vitamin D has been recognised as a potent immunomodulator and its deficiency is common in different population groups including patients with diabetic foot infection. Diabetic foot infection reflects the altered immune status of the host. As cytokine regulation plays a significant role in infection and wound-healing processes, the present study aimed to evaluate the association between vitamin D status and inflammatory cytokine profiles in patients with diabetic foot infection. The serum concentrations of vitamin D (25-hydroxyvitamin D), IL-1β, IL-6, TNF-α and interferon-γ (IFN-γ) were measured in 112 diabetic foot infection cases and 109 diabetic controls. Severe vitamin D deficiency (25-hydroxyvitamin D concentration < 25 nmol/l) was more common in cases than in controls (48·2v.20·5 %). Although age, duration of diabetes, HbA1C(glycosylated Hb) concentration and BMI were similar, cases had significantly higher concentrations of IL-6 (P≤ 0·001), IL-1β (P≤ 0·02) and TNF-α (P≤ 0·006) than controls. A significant negative correlation was also observed between 25-hydroxyvitamin D concentration and circulating concentrations of IL-1β (r− 0·323;P≤ 0·001) as well as IL-6 (r− 0·154;P≤ 0·04), but not between 25-hydroxyvitamin D and TNF-α and IFN-γ concentrations. Furthermore, a significant difference in IL-1β (P≤ 0·007) and IL-6 (P≤ 0·02) concentrations was observed in patients with severe 25-hydroxyvitamin D deficiency compared with patients with 25-hydroxyvitamin D concentration ≥ 25 nmol/l, and this difference was remarkable for TNF-α. In conclusion, severe vitamin D deficiency is associated with elevated inflammatory cytokine concentrations in diabetic patients, particularly in those with foot infection. A 25-hydroxyvitamin D concentration value < 25 nmol/l is suggested as the ‘cut-off’ for such immunological alterations in patients with diabetes mellitus.

scholarly journals Prevalence and severity of vitamin D deficiency in patients with diabetic foot infection

2012 ◽  
Vol 109 (1) ◽  
pp. 99-102 ◽  
Author(s):  
Shalbha Tiwari ◽  
Daliparthy D. Pratyush ◽  
Balram Gupta ◽  
Awanindra Dwivedi ◽  
Sandeep Chaudhary ◽  
...  
Keyword(s):  
Vitamin D ◽  
Vitamin D Deficiency ◽  
Diabetic Foot ◽  
Vitamin D Supplementation ◽  
Diabetic Patients ◽  
Similar Data ◽  
Diabetic Foot Infection ◽  
Hydroxyvitamin D ◽  
Severe Vitamin ◽  
Diabetic Foot Infections

The aim of the present research was to study the prevalence and severity of vitamin D deficiency in patients with diabetic foot infection. Patients were enrolled in two groups: diabetic patients with foot infection (n 125) as cases and diabetic patients without the infection as controls (n 164). Serum 25-hydroxyvitamin D (25(OH)D) was measured by RIA. Data were presented as means and standard deviations unless otherwise indicated and were analysed by SPSS. Results revealed that 25(OH)D (nmol/l) was significantly lower (40·25 (sd 38·35) v. 50·75 (sd 33·00); P < 0·001) in cases than in controls. Vitamin D inadequacy (25(OH)D < 75 nmol/l) was equally common in cases and controls (OR 1·45, 95 % CI 0·8, 3·0; P = 0·32), but cases had a greater risk of vitamin D deficiency (25(OH)D < 50 nmol/l) than controls (OR 1·8, 95 % CI 1·1, 3·0; P = 0·02). Risk of severe vitamin D deficiency (25(OH)D < 25 nmol/l) was significantly higher in cases than in controls (OR 4·0, 95 % CI 2·4, 6·9; P < 0·0001). Age, duration of diabetes and HbA1c were significantly higher in cases than in controls and therefore adjusted to nullify the effect of these variables, if any, on study outcome. The study concluded that vitamin D deficiency was more prevalent and severe in patients with diabetic foot infection. This study opens up the issue of recognising severe vitamin D deficiency ( < 25 nmol/l) as a possible risk factor for diabetic foot infections and the need for vitamin D supplementation in such patients for a better clinical outcome. This could be substantiated by similar data from future studies.

scholarly journals The Role of Skeletal Muscle in Maintaining Vitamin D Status in Winter

2019 ◽  
Vol 3 (10) ◽  
Author(s):  
Rebecca S Mason ◽  
Mark S Rybchyn ◽  
Myriam Abboud ◽  
Tara C Brennan-Speranza ◽  
David R Fraser
Keyword(s):  
Skeletal Muscle ◽  
Vitamin D ◽  
Uv Light ◽  
Muscle Cells ◽  
Cell Uptake ◽  
Vitamin D Status ◽  
Hydroxyvitamin D ◽  
The Status ◽  
25 Hydroxyvitamin D ◽  
Repeated Passage

ABSTRACT The status of vitamin D is determined mainly by its formation in skin by the photochemical action of solar UVB light (wavelength 290–320 nm) on the precursor 7-dehydrocholesterol. Because of seasonal variation in intensity of solar UV light, vitamin D status falls in winter and rises in summer. It has been presumed that there is no functional store of vitamin D. Thus, to avoid deficiency, a nutritional supply would be required in winter. However, there is now evidence that the main circulating metabolite of vitamin D, 25-hydroxyvitamin D, accumulates in skeletal muscle cells, which provide a functional store during the winter months. The mechanism is mediated by muscle cell uptake of circulating vitamin D–binding protein (DBP) through a megalin-cubilin membrane transport process. DBP then binds to cytoplasmic actin to provide an array of high-affinity binding sites for 25-hydroxyvitamin D [25(OH)D]. The repeated passage of 25(OH)D into and out of muscle cells would account for its long residence time in blood.

Vitamin D Status and Its Determinants in Healthy Slovenian Pregnant Women

2015 ◽  
Vol 67 (2) ◽  
pp. 96-103 ◽  
Author(s):  
Aneta Soltirovska Salamon ◽  
Evgen Benedik ◽  
Borut Bratanič ◽  
Manca Velkavrh ◽  
Irena Rogelj ◽  
...  
Keyword(s):  
Vitamin D ◽  
Pregnant Women ◽  
Vitamin D Deficiency ◽  
Sun Exposure ◽  
Physical Activities ◽  
Dietary Intakes ◽  
Hydroxyvitamin D ◽  
Day Range ◽  
The Status ◽  
25 Hydroxyvitamin D

Background/Aims: Vitamin D deficiency is a common underdiagnosed condition. The aim of this was to analyze the status of vitamin D and its determinants in healthy Slovenian pregnant women. Methods: A total of 132 volunteer pregnant women completed a questionnaire including baseline demographics, food frequency, physical activities; anthropometrical measurements, body mass index and levels of 25-(OH)D in serum were performed during the third trimester, and dietary intakes were assessed during the 27-28th week of gestation. Results: Vitamin D deficiency was present in 14% while insufficiency was present in 41% of women. The risk for inadequacy was higher in women older than 30 years (p = 0.01), in those with less frequent outdoor physical activity (p = 0.01) and in pregnancies during the low sun exposure season (p = 0.04). Insufficiency was not significantly more frequent in less educated women, unemployed and in those living in urban area. The median value of vitamin D from habitual dietary intake was 1.5 µg/day (range 0.1-13.4) and did not influence 25-hydroxyvitamin D level (p = 0.91). Conclusions: The prevalence of vitamin D inadequacy was 55% and was dependent on age, season and outdoor physical activities. The results suggest a discrepancy between vitamin D intake through habitual diet and the reference needs.

scholarly journals Evidence Regarding Vitamin D and Risk of COVID-19 and Its Severity

Nutrients ◽  
2020 ◽  
Vol 12 (11) ◽  
pp. 3361 ◽  
Author(s):  
Joseph Mercola ◽  
William B. Grant ◽  
Carol L. Wagner
Keyword(s):  
Vitamin D ◽  
Vitamin D Deficiency ◽  
Skin Color ◽  
Large Scale ◽  
Therapeutic Window ◽  
Hydroxyvitamin D ◽  
25 Hydroxyvitamin D ◽  
Vitamin D Supplements ◽  
Tract Infections ◽  
Endothelial Integrity

Vitamin D deficiency co-exists in patients with COVID-19. At this time, dark skin color, increased age, the presence of pre-existing illnesses and vitamin D deficiency are features of severe COVID disease. Of these, only vitamin D deficiency is modifiable. Through its interactions with a multitude of cells, vitamin D may have several ways to reduce the risk of acute respiratory tract infections and COVID-19: reducing the survival and replication of viruses, reducing risk of inflammatory cytokine production, increasing angiotensin-converting enzyme 2 concentrations, and maintaining endothelial integrity. Fourteen observational studies offer evidence that serum 25-hydroxyvitamin D concentrations are inversely correlated with the incidence or severity of COVID-19. The evidence to date generally satisfies Hill’s criteria for causality in a biological system, namely, strength of association, consistency, temporality, biological gradient, plausibility (e.g., mechanisms), and coherence, although experimental verification is lacking. Thus, the evidence seems strong enough that people and physicians can use or recommend vitamin D supplements to prevent or treat COVID-19 in light of their safety and wide therapeutic window. In view of public health policy, however, results of large-scale vitamin D randomized controlled trials are required and are currently in progress.

scholarly journals Association of serum 25-hydroxyvitamin D concentrations with risk of dementia among individuals with type 2 diabetes: A cohort study in the UK Biobank

PLoS Medicine ◽  
2022 ◽  
Vol 19 (1) ◽  
pp. e1003906
Author(s):  
Tingting Geng ◽  
Qi Lu ◽  
Zhenzhen Wan ◽  
Jingyu Guo ◽  
Liegang Liu ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Vitamin D ◽  
Lower Risk ◽  
Uk Biobank ◽  
Hydroxyvitamin D ◽  
Patients With Diabetes ◽  
25 Hydroxyvitamin D ◽  
The Uk

Background Several epidemiological studies have suggested that vitamin D status is associated with risk of dementia in general populations. However, due to the synergistic effect between diabetic pathology and neuroinflammation, and the prothrombotic profile in patients with diabetes, whether vitamin D is associated with risk of dementia among patients with diabetes is unclear. This study aimed to investigate the associations of circulating vitamin D levels with risks of all-cause dementia, Alzheimer disease (AD), and vascular dementia (VD) among adults with type 2 diabetes (T2D). Methods and findings This study included 13,486 individuals (≥60 years) with T2D and free of dementia at recruitment (2006–2010) from the UK Biobank study. Serum 25-hydroxyvitamin D (25[OH]D) concentrations were measured using the chemiluminescent immunoassay method at recruitment. Serum 25(OH)D ≥ 75 nmol/L was considered sufficient, according to the Endocrine Society Clinical Practice Guidelines. Incidence of all-cause dementia, AD, and VD cases was ascertained using electronic health records (EHRs). Each participant’s person-years at risk were calculated from the date of recruitment to the date that dementia was reported, date of death, date of loss to follow-up, or 28 February 2018, whichever occurred first. Among the 13,486 individuals with T2D (mean age, 64.6 years; men, 64.3%), 38.3% had vitamin D ≥ 50 nmol/L and only 9.1% had vitamin D ≥ 75 nmol/L. During a mean follow-up of 8.5 years, we observed 283 cases of all-cause dementia, including 101 AD and 97 VD cases. Restricted cubic spline analysis demonstrated a nonlinear relationship between serum 25(OH)D and risk of all-cause dementia (Pnonlinearity < 0.001) and VD (Pnonlinearity = 0.007), and the nonlinear association reached borderline significance for AD (Pnonlinearity = 0.06), with a threshold at around a serum 25(OH)D value of 50 nmol/L for all the outcomes. Higher serum levels of 25(OH)D were significantly associated with a lower risk of all-cause dementia, AD, and VD. The multivariate hazard ratios and 95% confidence intervals for participants who had serum 25(OH)D ≥ 50 nmol/L, compared with those who were severely deficient (25[OH]D < 25 nmol/L), were 0.41 (0.29–0.60) for all-cause dementia (Ptrend < 0.001), 0.50 (0.27–0.92) for AD (Ptrend = 0.06), and 0.41 (0.22–0.77) for VD (Ptrend = 0.01). The main limitation of the current analysis was the potential underreporting of dementia cases, as the cases were identified via EHRs. Conclusions In this study, we observed that higher concentrations of serum 25(OH)D were significantly associated with a lower risk of all-cause dementia, AD, and VD among individuals with T2D. Our findings, if confirmed by replication, may have relevance for dementia prevention strategies that target improving or maintaining serum vitamin D concentrations among patients with T2D.

Abstract P173: Serum 25-hydroxyvitamin D and Mortality in Middle-aged Men and Women: Results from the MONICA/KORA Augsburg Study

Circulation ◽  
2012 ◽  
Vol 125 (suppl_10) ◽  
Author(s):  
Barbara Thorand ◽  
Astrid Zierer ◽  
Andrea Schneider ◽  
Cornelia Huth ◽  
Christine S Autenrieth ◽  
...  
Keyword(s):  
Vitamin D ◽  
Large Scale ◽  
Inverse Association ◽  
Vitamin D Status ◽  
Hydroxyvitamin D ◽  
Markers Of Inflammation ◽  
Vitamin D Levels ◽  
All Cause Mortality ◽  
25 Hydroxyvitamin D ◽  
Cvd Mortality

Background: Recent studies found an inverse association between vitamin D status and both morbidity and mortality from major chronic diseases such as cardiovascular diseases (CVD) and cancer. In contrast, some studies have suggested adverse health effects such as increased all-cause mortality at the high end of vitamin D levels. Therefore, the aim of the present study was to further elucidate the relationship between 25-hydroxyvitamin D (25[OH]D) and all-cause as well as CVD and non-CVD mortality. Methods: Our study population comprised 851 men and 774 women aged 35-74 years at baseline selected randomly, stratifying by sex and survey out of 9,531 subjects with available blood samples. All had participated in at least one of the three population-based MONICA/KORA Augsburg surveys between 1984-1995. Participants were followed-up for a mean of 16.8 ± 5.4 years. During this period 197 persons died from CVD (ICD9 390-459, 798) and 226 from non-cardiovascular causes. For three participants the cause of death was missing. 25[OH]D was measured in serum samples collected at baseline using an enzyme immunoassay from IDS, Frankfurt. Results: After adjustment for age, sex, survey, and season of blood sampling we observed a significant inverse association between serum 25[OH]D and all-cause mortality. The hazard ratio (HR) and 95% confidence interval (CI) comparing subjects with levels >75 nmol/l to those with levels ≤25 nmol/l was 0.59 (0.38-0.93); P trend =0.007 across the following four categories: ≤25 nmol/l; >25-≤50 nmol/l; >50-≤75 nmol/l; >75 nmol/l, assigning the median value within each category to the respective category. Further adjustment for BMI, education and lifestyle factors attenuated the association and it became non-significant (HR [95% CI]: 0.78 [0.48-1.27]; P trend =0.205). For CVD mortality, we also observed an inverse association which persisted after adjustment for the above mentioned confounders (HR [95% CI]: 0.49 [0.21-1.11]; P trend =0.012). After further multivariable adjustment including potential intermediate risk factors such as systolic blood pressure, total cholesterol/HDL-cholesterol, diabetes and markers of inflammation the association became non-significant (HR [95% CI]: 0.63 [0.26-1.51]; P trend =0.122). We did not observe any significant association between 25[OH]D and non-CVD mortality regardless of the degree of adjustment. However, there was a trend towards increased non-CVD mortality in women with 25[OH]D >75 nmol/l compared to those with concentrations ≤25 nmol/l (HR [95% CI]: 2.87 [0.99-8.33]; P trend =0.111 for the fully adjusted model). Conclusions: Our data indicate that vitamin D status is inversely related to CVD mortality. However, before large scale measures to improve vitamin D status should be initiated, further studies should evaluate potentially harmful effects of very high levels of 25[OH]D on other outcomes especially among women.

scholarly journals Independent and Interactive Influences of Environmental UVR, Vitamin D Levels, and Folate Variant MTHFD1-rs2236225 on Homocysteine Levels

Nutrients ◽  
2020 ◽  
Vol 12 (5) ◽  
pp. 1455
Author(s):  
Patrice Jones ◽  
Mark Lucock ◽  
Charlotte Martin ◽  
Rohith Thota ◽  
Manohar Garg ◽  
...  
Keyword(s):  
Vitamin D ◽  
Genetic Variants ◽  
Vascular Diseases ◽  
Hydroxyvitamin D ◽  
Gene Environment ◽  
Vitamin D Levels ◽  
The Status ◽  
Nutrient Environment ◽  
Australian Cohort ◽  
25 Hydroxyvitamin D

Elevated homocysteine (Hcy) levels are a risk factor for vascular diseases. Recently, increases in ultraviolet radiation (UVR) have been linked to decreased Hcy levels. This relationship may be mediated by the status of UVR-responsive vitamins, vitamin D and folate, and/or genetic variants influencing their levels; however, this has yet to be examined. Therefore, the independent and interactive influences of environmental UVR, vitamin D and folate levels and related genetic variants on Hcy levels were examined in an elderly Australian cohort (n = 619). Red blood cell folate, 25-hydroxyvitamin D (25(OH)D), and plasma Hcy levels were determined, and genotyping for 21 folate and vitamin D-related variants was performed. Erythemal dose rate accumulated over six-weeks (6W-EDR) and four-months (4M-EDR) prior to clinics were calculated as a measure of environmental UVR. Multivariate analyses found interactions between 6W-EDR and 25(OH)D levels (pinteraction = 0.002), and 4M-EDR and MTHFD1-rs2236225 (pinteraction = 0.006) in predicting Hcy levels. The association between 6W-EDR and Hcy levels was found only in subjects within lower 25(OH)D quartiles (<33.26 ng/mL), with the association between 4M-EDR and Hcy occurring only in subjects carrying the MTHFD1-rs2236225 variant. 4M-EDR, 6W-EDR, and MTHFD1-rs2236225 were also independent predictors of Hcy. Findings highlight nutrient–environment and gene–environment interactions that could influence the risk of Hcy-related outcomes.

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