scholarly journals Role of Vitamin D in Reducing the Frequency of Asthma Attacks in Patients with Frequent Exacerbation of Asthma

Author(s):  
Mubeen Ahmed Memon ◽  
Sheeba Faryal Ansari ◽  
Mumtaz Ali Lakho ◽  
Mukhtiar Hussain Jaffery ◽  
Syed Zulfiquar Ali Shah ◽  
...  

Introduction: Vitamin D deficiency is common among asthmatics with literature suggesting that its low levels in the body may trigger exacerbations and decrease the response to corticosteroid treatment. It has also shown to inhibit the production of cytokines, which in turn enhances the body’s response to corticosteroid treatment during an exacerbation. Therefore, maintenance of adequate levels of vitamin D in patients with asthma may reduce the risk of exacerbation and improve their general health. This study aims to explore the role of vitamin D supplementation in preventing asthma exacerbations. Methods: This single blind parallel arm interventional study was conducted in the pulmonology ward in a tertiary care hospital from June 2018 to April 2020. Two hundred (n= 200) participants with a history of frequent acute exacerbation of asthma were enrolled in the study via consecutive convenient non-probability technique. Participants were divided into two groups; the placebo and the interventional group that received 200,000 IU of vitamin D capsule. Results: Compared to day 0, mean episodes of exacerbation in the interventional group were significantly lower after 180 days (1.1 ± 0.4 vs. 0.61 ± 0.3; p-value <0.0001). Similarly, number of asthma attacks in past 7 days was significantly lower in intervention group after 180 days (4.4 ± 2.7 vs. 3.1 ± 1.5; p-value 0.0001) Conclusion: Vitamin D supplementation is a safe and cost-friendly approach to reducing asthma exacerbations. It may also help to improve the condition in severe asthmatics with low vitamin D levels.

2020 ◽  
Vol 7 (1A) ◽  
pp. 320-328
Author(s):  
Maria Mexitalia ◽  
Martvera Susilawati ◽  
Rina Pratiwi ◽  
JC Susanto

Latar Belakang : Paparan sinar matahari pada kulit merupakan cara terbaik untuk sintesis vitamin D. Kadar vitamin D yang adekuat dalam tubuh merupakan proteksi terhadap berbagai penyakit seperti penyakit degeneratif, kanker dan juga infeksi saluran napas. Beberapa penelitian menghubungkan kadar vitamin D yang rendah dengan morbiditas dan mortalitas COVID-19. Hal ini menyebabkan fenomena baru pada masyarakat yaitu kebiasaan berjemur. Tujuan : Artikel ini akan membahas tentang metabolisme vitamin D, peran sinar matahari dalam mengaktifkan vitamin D di dalam tubuh, dan peran vitamin D dalam berbagai penyakit, khususnya mekanisme imunitas untuk COVID-19. Diskusi : Vitamin D meningkatkan kekebalan alami seluler terutama dengan cara menginduksi peptida antimikroba, yang meliputi cathelicidin, LL-37, 1,25-dihdroxyvitamin D dan defensins. Selain itu vitamin D akan meningkatkan sekresi hidrogen peroksida pada sel monosit. Pemberian vitamin D dosis tinggi sebanyak 10.000 IU/hari selama beberapa minggu dilanjutkan 5000 IU/hari bermanfaat untuk mencegah COVID-19, walaupun hasilnya masih memerlukan penelitian lebih lanjut. Absorpsi sinar matahari ke dalam tubuh manusia dipengaruhi oleh warna kulit, penggunaan bahan pakaian dan tabir surya , dan luas pajanan. Paparan sinar matahari sebesar satu Minimal Erythemal Dose (MED) pada orang dewasa dapat meningkatkan konsentrasi vitamin D setara dengan suplementasi 10.000 – 25.000 IU. Penelitian pada bayi yang diberi paparan 3 kali seminggu @ 5 menit pada jam 10.00-14.00, dengan paparan 50% area tubuh selama 2 bulan, mendapatkan kenaikan 25(OH)D sebesar 8,9 ng/mL. Simpulan : Vitamin D yang diaktifkan oleh paparan sinar matahari sangat bermanfaat sebagai proteksi berbagai penyakit termasuk juga pada COVID-19, walaupun efektifitasnya masih memerlukan penelitian lebih lanjut. Kata Kunci : COVID-19, vitamin D, paparan sinar matahari   Background : The exposured of sunlight on the skin is the best way for vitamin D synthesis. Adequate vitamin D levels are protection against various diseases such as degenerative diseases, cancer and also respiratory infections. Several studies have linked between low vitamin D levels with COVID-19 morbidity and mortality. This causes a new phenomenon in the community, namely sunbathing. Purpose : This review rearticle will discuss about vitamin D metabolism, the role of sunlight in activating vitamin D in the body, and the role of vitamin D in various diseases, specifically the immune mechanism for COVID-19.Discussion : Vitamin D increases cellular innate immunity mainly by inducing antimicrobial peptides, which include cathelicidin, LL-37, 1,25-dihdroxyvitamin D and defensins, and also increase the secretion of hydrogen peroxide in monocyte cells. The administration of high-dose vitamin D of 10,000 IU / day for several weeks followed by 5000 IU / day is useful to prevent COVID-19, although the results still require further research. The sun exposure to activated vitamin D body is affected by skin color, using of clothing and sunscreen, and area of ??exposure. Sun exposure of one Minimum Erythemal Dose (MED) in adults can increase vitamin D concentrations equivalent to 10,000 - 25,000 IU vitamin D supplementation. Study on infants who were given exposure 3 times a week @ 5 minutes at 10:00 to 14:00, with exposure 50% of body surface area for 2 months, increased 25(OH)D of 8.9 ng/mL. Conclusion : Vitamin D which is activated by sun exposure is very useful as protection for various diseases including COVID-19, although its effectiveness still requires further research. Keywords : vitamin D, sun exposure, COVID-19.


Background: The risk factors for asthma exacerbations are well understood. However, the effect of vitamin D levels on number of asthma exacerbations per year is not clearly studied. The objective of the study was to find out the association of serum vitamin D levels and asthma risk factors on asthma exacerbations. Methods: In this study, ninety-nine subjects from 5 to 15 years of age were recruited at an episode of acute exacerbation. It was a cross sectional study and carried out from 2012 to 2015. Pulmonary function test was done by spirometry. Asthma exacerbation was labeled when forced expiratory volume/ forced vital capacity (FEV1/FVC) ratio was less than 80% (American Thoracic Society). Global Initiative for Asthma (GINA) guidelines were used to classify asthma into mild, moderate and severe persistent asthma. Serum vitamin D levels were measured by chemiluminescence method. Pearson Chi-square test was applied and p value (p<0.05) was considered as statistically significant. Results: Children who had exposure to animal dander had significantly lower asthma exacerbations per year (p-value <0.046). There was no significant association between vitamin D levels and number of exacerbations per years (p-value <0.099). Asthma was prevalent in girls of low socioeconomic status (SES) compared to males. However, there was no significant association between smoke, exercise, home environment, food allergies, weather, pollen and dust with asthma exacerbations. Conclusion: Low levels of vitamin D were not associated with increased number of asthma exacerbations per year. However, children exposed to animal dander had lesser number of exacerbations per year (p-value <0.046). Keywords: Asthma; Vitamin D; Children; Exacerbations, Risk factors.


Author(s):  
Maryam Mosavat ◽  
Aisling Smyth ◽  
Diana Arabiat ◽  
Lisa Whitehead

AbstractVitamin D contributes to numerous physiological processes within the body but primarily calcium and bone homeostasis. Emerging evidence highlights a novel role for vitamin D in maintaining and regulating optimal sleep. Sleep is a known regulator of bone health, highlighting the interconnectedness between vitamin D concentrations, sleep duration and bone metabolism. It is possible that the relationship between sleep length and vitamin D is bidirectional, with vitamin D playing a role in sleep health and conversely, sleep affecting vitamin D levels. Nevertheless, limited information on the direction of the interaction is available, and much remains to be learned concerning the complex relationship between insufficient sleep duration and vitamin D deficiency. Given the potential to implement interventions to improve sleep and vitamin D supplementation, understanding this relationship further could represent a novel way to support and improve health.


Author(s):  
Poonam Rani ◽  
Seema Gupta ◽  
Gaurav Gupta

Background: Deficiency of vitamin D is quite prevalent among elderly population or postmenopausal women worldwide and may affect various function of the body. The status of its deficiency with their relation with other variables are not well explored in perimenopausal women.Methods: 100 perimenopausal women from the department of obstetrics and gynaecology were selected without having known risk of thyroid disorder and cardiovascular disease. The age group criteria for these women were 40 to 50 years. Thyroid profile including TSH, T3, and T4 were estimated by using enzyme linked immunesorbent assay. Serum levels of 25(OH) D3 was estimated by using spectrophotometric method. Lipid profile including TC, TG and HDL-C were estimated CHOD-POD method, GPO-PAP method, and CHOD-POD/Phosphotungustate method. LDL-C was calculated by friedewald formula.Results: There 58 women were presented with insufficient amount of vitamin D. They were characterised with increased BMI, elevated thyrotropin alongwith lower concentrations of T3 and T4. Increased levels of TC, TG and LDL-cholesterol alongwith lower concentration of HDL-C were also observed in women with vitamin d deficiency. Women having vitamin D deficiency were presented with overweight (OR-18.0, p-value=<0.001) and dyslipidemia (OR-12.13, p-value≤0.001). Vitamin D was negatively correlated with variable i.e. BMI, TSH, TC, TG and LDL-C. This negative association was significant (<0.001) while HDL-C and T4 were positively correlated with vitamin D levels in this study population.Conclusions: Vitamin D deficiency frequently occurs in middle aged perimenopausal women. Negative correlation of it with BMI, TSH and lipid variables may suggest the development of cardiovascular disease and hypothyroidism in coming years. Vitamin D supplements or vitamin D containing diet and regular exposure to sun is highly recommended to perimenopausal women.


2017 ◽  
Vol 35 (15_suppl) ◽  
pp. e18251-e18251
Author(s):  
Aurora Mirabile ◽  
Erika Vecchio ◽  
Stefania Falvella ◽  
Lucia Barbarini ◽  
Chiara Butti ◽  
...  

e18251 Background: Metastatic colorectal cancer (mCRC) patients (pts) are at high risk of CTID influencing treatment outcome. The primary end-point of our study was the decrease of grade 3-4 (G3-4 from Common Terminology Criteria for Adverse Events 4.0) CTID incidence to 50% in respect to literature data. A predefined nutritional regimen was planned and administrated to each pts. In explorative analyses, we investigated the correlation between Vitamin D deficiency and CTID incidence and between dihydropyrimidine dehydrogenase (DpD) mutations and CTID. Methods: All mCRC pts undergoing chemotherapy (CT) with an expected G3-4 CTID incidence of about 17% were enrolled. During CT the nutritionist administered a predefined, slag free diet according to Italian Society of Human Nutrition indications and within World Cancer Research Found recommendations. Results: Fifty consecutive pts were enrolled within 11 months. Pts characteristics are summarized in the table. A significant decrease (p-value 0.00096; IC 95% 0.059) of G3-4 CTID incidence to 95% was obtained in respect to literature data. No CT modification or admissions/supportive care were needed. Due to strict diet adherence (96%) > 50% pts had no diarrhea and no one had G4 diarrhea. BMI improved in 35% over-weights and in 40% obese, no changes in normal-weights. The correlation analysis showed the decrease of CTID incidence with the increase of vitamin D levels, but did not reveal a relation between DpD mutations and diarrhea. Conclusions: The preliminary results suggest a possible role of the diet on CTID prevention and a correlation with vitamin D levels. [Table: see text]


2020 ◽  
Vol 10 (6) ◽  
pp. 7077-7084

Asthma is a chronic disease that affects the airways in the lungs and is common in many countries. Studies have shown that vitamin D levels are associated with the onset and exacerbation of asthma symptoms. Given the role of vitamin D in regulating immune responses and the importance of the two major cytokines IL-4 (an inflammatory cytokine) and IL-10 (an anti-inflammatory cytokine) in immunological processes, in this study, the relationship between vitamin D intake and the level of expression of these ILs in asthmatic mice was investigated. In the case-control study performed in three groups of mice, 10 experimental asthma mice, 10 asthmatic vitamin D-treated mice, and 10 healthy mice as the control group were studied. For analyses, after RNA extraction and cDNA synthesis, the expression level of two IL-4 and IL-10 genes was evaluated by real-time PCR. Finally, the results were analyzed by SPSS software. The results showed that in the control group, the expression level of IL-4 and IL-10 genes was 0.01 and 0.02, respectively. Accordingly, the expression level of the IL-4 gene in asthmatic mice and asthmatic mice treated with vitamin D was 0.6 and 0.2, respectively, while the expression level of the IL-10 in these groups was 1.2 and 2.8, respectively, which showed significant changes (p-value < 0.05) in treated mice compared to the asthmatic mice without treatment. Based on results, in asthmatic mice treated with vitamin D, a significant increase in IL-10 expression was observed (1.2 to 2.8), while IL-4 expression was decreased from 0.6 to 0.2. It appears that vitamin D supplementation in asthmatic patients by affecting T-cell maturation and increasing anti-inflammatory IL-10 and suppressing IL-4 may play a role in reducing the symptoms of asthma.


2020 ◽  
Vol 135 (1) ◽  
pp. 50-61
Author(s):  
Lorenzo Brambilla ◽  
Giuseppe Maria Peretti ◽  
Paolo Sirtori ◽  
Nicola Maffulli ◽  
Laura Mangiavini

Abstract Background Low levels of vitamin D are common in patients undergoing total hip arthroplasty (THA) and total knee arthroplasty (TKA), but it is still unclear whether the outcome of such surgery is related to vitamin D levels. Sources of data Publicly available electronic databases were systematically reviewed to update knowledge about the role of vitamin D in THA and TKA patients, and to appraise the correlation between vitamin D levels before surgery and post-surgical outcomes. Eight studies were included in our review: six employed prospective observational designs, two reported retrospective database interrogations. Six prospective observational studies and two retrospective database interrogations matched inclusion and exclusion criteria. Areas of agreement Patients undergoing THA and TKA have a high prevalence of hypovitaminosis D. Five of eight studies (62.5%) report a statistically significant association between low vitamin D status and worse outcomes after THA and TKA. Areas of controversy Different explanations have been proposed for vitamin D insufficiency, but some authors have questioned the correctness of the methods used to measure the vitamin D levels. Growing points A trial focusing on the role of vitamin D supplementation on safety and outcomes of patients undergoing THA and TKA with low vitamin D status is ongoing. Areas timely for developing research Further studies should explore the possible causal relationship between vitamin D status and outcomes of THA and TKA and verify the laboratory methods to analyse it.


2019 ◽  
Vol 7 (3_suppl) ◽  
pp. 2325967119S0013
Author(s):  
Kevin A. Williams ◽  
Michael Horan

Background: Vitamin D deficiency is a global issue, affecting adults and children of all ages, races and genders. Within the last decade, multiple studies have demonstrated the potential health benefits of vitamin D supplementation including improved bone health, reduced fracture risk, protection from autoimmune disease, and decreased cancer risk. Because of the prevalence of vitamin D deficiency in pediatric populations despite recent evidence of increased vitamin D supplementation in the US, our goal is to assess the knowledge of current vitamin D recommendations among Pediatric Society of North America (POSNA) members. It is our purpose to use the data to increase awareness and understanding of vitamin D amongst all pediatric providers. Methods: Our survey was distributed to 1316 POSNA members via a series of 2 email requests in which they were invited to participate in the survey on the Survey Monkey website. Their participation was entirely voluntary and they agreed to participate by responding positively on the first page of the survey. The data was depersonalized and analyzed via chi square and Fisher’s exact testing. Results: 395 responses were recorded. 9 participants opted out of the survey. 69% of participants rated their vitamin D knowledge as fair to good. 68% of participants have been in practice over ten years and represented most US geographic regions fairly equally. Most estimate that over 25% of their practice is vitamin D deficient with about a 50% compliance rate of supplementation. Over 30% of participants feel vitamin D management is mostly the role of the pediatrician, however 64% of participants discuss or check vitamin D levels in their practice for patients with repeat fractures, medical comorbidities, or nonunions most commonly. Conclusion: Survey participants demonstrated a wide variety of responses indicating their understanding of vitamin D testing and supplementation. Although providers estimate a high deficiency rate, many do not routinely check vitamin D. When they do check, there is no standard indication for testing or supplementation and many believe this to be the role of the pediatrician or endocrinologist. More studies are needed to provide a standardized protocol for vitamin D testing/supplementation in the pediatric orthopaedic literature.


Author(s):  
Rashmi Kumari ◽  
Usha Kumari ◽  
Krishna Sinha

Aim: to study the effects of teenage pregnancy on obstetrics and neonatal outcome. Materials and methods: The present prospective comparative interventional study was conducted in the Department of Obstetrics and Gynecology, Jawaharlal Nehru Medical College and Hospital, Bhagalpur, Bihar, India. Total 60 patients were divided in to two groups. Results: Majority of the patients (66.9%) were in the 18-20 years of age group. Pre-eclampsia was observed in 26.7% of the patients who didn’t receive vitamin D supplement whereas the group I which received supplementation showed on pre-eclampsia in   6.7% of the patients (p=0.001). Conclusion: This study concludes that there is significant role of vitamin D supplementation in pregnant women in prevention of pre-eclampsia. Keywords: pre-eclampsia, vitamin D, neonatal outcome, teenage


2021 ◽  
Vol 15 (6) ◽  
pp. 1231-1233
Author(s):  
A. W. Khan ◽  
H. T. Hussain ◽  
Z.U. Mustafa ◽  
M. A. Qamar ◽  
M. A. Qamar ◽  
...  

Aim: To determine the role of vitamin D in the management of COVID-19 patients regarding morbidity and mortality. Study Design: Prospective/Observational Place and Duration: Departments of Medicine & Pulmonology, Allama Iqbal Memorial Teaching Hospital, Sialkot and Department of Medicine, Sughra Shafi Medical Complex Narowal from 1st November 2020 to 30th April 2020. Methodology: One hundred and sixty patients of both genders diagnosed to have COVID-19, were enrolled. Patient’s ages were ranging from 17 to 70 years. The detailed demographics such as age, sex, and body mass index were recorded. 5 ml blood samples were taken from all the patients to check their vitamin D levels. Severe Vitamin D deficiency was defined as 25(OH)D <25 nmol/L (10 ng/dl). Association between mortality and morbidity was examined. Results: Ninety (56.25%) were males while 70 (43.75%) were females with mean age 40.15±17.37 years. Mean body mass index of patients was 24.16±7.26 kg/m2. Severe vitamin D deficiency was observed in 80 (50%) patients. Mortality found in 30 (18.75%) patients. Frequency of morbidity was among 66 (41.25%) patients. Patients with severe vitamin D deficiency had high rate of mortality 20 (25%) and morbidity 50 (62.5%) as compared to patients with no vitamin D deficiency had 10 (8%) mortality and 16 (20%) morbidity. A significant association was observed between severe vitamin D deficiency regarding morbidity and mortality among patients with covid-19 disease with p-value <0.05. Conclusion: The vitamin-D has strongest relationship among patients with covid-19 disease to reduce mortality and morbidity. Keywords: Morbidity, COVID-19, Vitamin D, Mortality


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