scholarly journals Vitamin D, A Predictor of Outcome in COVID-19 Patients

2021 ◽  
pp. 492-500
Author(s):  
Y. R. Lamture ◽  
Varsha P. Gajbhiye ◽  
Ranjit Ambad ◽  
Md. Jawed Akther ◽  
Rajesh Domakunti
Keyword(s):  
Diabetes Mellitus ◽  
Vitamin D ◽  
Vitamin D Deficiency ◽  
Severe Disease ◽  
Hypovitaminosis D ◽  
Medical Examination ◽  
Vitamin D Levels ◽  
Co Morbidity ◽  
High Flow Oxygen ◽  
Patient Reported

Introduction: Hypovitaminosis D is a commonly associated with increased prevalence of pulmonary  infections. High mortality rate of  COVID 19 infections is associated with immune dysfunction like cytokine storm. Many studies show important function of vitamin D in proper functioning of immune system.  Very few studies are available to associate vitamin D level and severity of Covid infection, Hence this study was undertaken  to find a relation of vitamin D levels and outcome of COVID-19. Methods: Study design is retrospective observational analytical case control. A study population  was hospital base cases and medical examination with clear definition of cases, medical examination, inclusion/ exclusion criteria, outcome and exposure. The Statistical analysis was done to  measure the  association  of outcome (the death or severe disease risk ) with exposure (low vitamin D) and that was determined by measuring  Odds ratio. Results: Most of the patients (45%) were in an age ranging from 40 to 59 years . Maximum number of the patients (68%) have one comorbidity. Diabetes mellitus and hypertension , both present in 28 % and other co morbidity in 40 % of patients and 32% of patient reported to have no comorbidities.  Present study reveals vitamin D deficiency in around for 74% of patients. Most of the patients were managed without supplementation of oxygen, but few needed high flow oxygen and even invasive ventilation. However prognosis was good. COVID-19 deaths occurred only in 2% of the cases.  All  dead patients and patients with a severe disease had vitamin D deficiency. This association of hypovitaminosis D was more significant than other co morbidities including hypertension and diabetes mellitus. Conclusions: Our study concluded that, two third of patients were having vitamin  D deficiency. Study clearly depicts severe vitamin D deficiency is associated with fatal cases,  therefore  vitamin D level can be used as a predictor of mortality.

scholarly journals Estimation of maternal serum vitamin D levels and its correlation with gestational diabetes mellitus

2018 ◽  
Vol 7 (8) ◽  
pp. 3348
Author(s):  
Anupriya Narain ◽  
Alka Goel ◽  
Parul Goyal
Keyword(s):  
Diabetes Mellitus ◽  
Vitamin D ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Vitamin D Deficiency ◽  
Serum Vitamin ◽  
Hypovitaminosis D ◽  
P Value ◽  
Serum Vitamin D ◽  
Vitamin D Levels

Background: Several studies in the past two decades have proved beyond doubt that there is a high prevalence of hypovitaminosis D worldwide including India which has almost taken the shape of a pandemic. The study aims to determine the prevalence of hypovitaminosis D in the pregnant population of Delhi and its correlation with gestational diabetes mellitus.Methods: This prospective cross sectional observational study was conducted at the Department of Obstetrics and Gynaecology, Postgraduate Institute of Medical Education and Research (PGIMER), Dr R.M.L Hospital, New Delhi over a period of 1 year and 4 months. Four hundred term patients were enrolled randomly from amongst the patients admitted in labor room or antenatal ward at PGIMER, Dr. Ram Manohar Lohia Hospital who fulfilled the inclusion and exclusion criteria. 3-4ml of fasting blood samples were collected of all the enrolled women and were analysed for total serum calcium levels and serum vitamin D levels. History of presence of gestational diabetes mellitus was noted along with any treatment history. The 25(OH)D levels for each subject was recorded and correlation of vitamin D levels with gestational diabetes mellitus was analysed. Statistical analysis was done using ANOVA/ Kruska Wallis test and Chi-Square test/ Fisher’s exact test. A p value of <0.05 was considered statistically significant.Results: The overall prevalence of vitamin D deficiency in the present study was 86.25%. The overall mean serum vitamin D level was 14.06±9.43 ng/ml. Thirty five out of 37 GDM patients had hypovitaminosis D i.e. 94.59%. The prevalence of hypovitaminosis D among non-GDM population was 85.40%. The association between GDM and Vitamin D deficiency was statistically non- significant in the present study with p value=0.186.Conclusions: There is a very high prevalence of hypovitaminosis D in pregnant females attending present institute i.e. 86.25%. Although 94.59 % of Gestational Diabetes Mellitus patients had vitamin D deficiency, there is no statistically significant association between Gestational diabetes mellitus and serum vitamin D levels.

Study on Vitamin D deficiency in patients of diabetes mellitus presenting with Acute Coronary syndrome in a tertiary care hospital in South India

2020 ◽  
Vol 11 (5) ◽  
pp. 49-53
Author(s):  
Archana Bhat ◽  
Arunachalam Ramachandran ◽  
Pradeep Periera ◽  
Akshatha Rao Aroor
Keyword(s):  
Diabetes Mellitus ◽  
Coronary Artery Disease ◽  
Vitamin D ◽  
Acute Coronary Syndrome ◽  
Coronary Artery ◽  
Vitamin D Deficiency ◽  
Coronary Syndrome ◽  
Vitamin D Levels ◽  
Luminal Stenosis ◽  
Artery Disease

Background: Vitamin D, a fat-soluble vitamin has its receptor present in myriad of tissues and it modulates multiple cellular processes. Vitamin D deficiency is reported to be associated with coronary artery disease. Cardiovascular disease is the leading cause of mortality worldwide. Aims and Objective: The primary outcome was to investigate if there is a correlation of 25-OH levels with the percentage of luminal stenosis, as measured with coronary angiogram. The secondary outcome was to determine the differences in angiographically proven luminal stenosis across categories of 25-OH vitamin D levels. Materials and Methods: Thirty patients with acute coronary syndrome with diabetes mellitus were included in this cross-sectional descriptive study. All patients were tested for fasting vitamin D levels, fasting blood sugar, HbA1C and serum creatinine. Detailed history of the patients was recorded. Data was analyzed by the statistical software SPSS version 19 and p value <0.05 was considered significant. Statistical tests like Chi- square, independent t test and log regression was used. Results: In this study 30 patients undergoing coronary angiography for acute coronary syndrome, Vitamin D levels showed severe deficiency in 6.7% (2) cases while mild deficiency was seen in 50% of the cases. Patients with single vessel disease on the coronary angiogram had lower mean HbA1C (9.18) levels in our study. Patients with triple vessel disease had poorly controlled mean HbA1C levels (10.42). Conclusion: In this study we did not find any significant difference between the serum Vitamin D deficiency levels with patients with angiographic severity of the coronary artery disease. Patients with poorly controlled diabetes mellitus had more severe angiographic proven coronary artery disease.

Prevalence of Vitamin-D Deficiency in Patients with Acute Coronary Syndrome in Syria

2016 ◽  
Vol 9 (6) ◽  
pp. 3544-3548
Author(s):  
Aya Hallak ◽  
Malhis Mahmoud ◽  
Yaser Abajy Mohammad
Keyword(s):  
Vitamin D ◽  
Acute Coronary Syndrome ◽  
Vitamin D Deficiency ◽  
Hypovitaminosis D ◽  
Control Group ◽  
Coronary Syndrome ◽  
Normal Individuals ◽  
Vitamin D Levels ◽  
25 Hydroxy Vitamin D ◽  
Coronary Syndromes

The objectives of this study were to estimate the prevalence of vitamin D deficiency in patients with acute coronary syndrome in comparison with normal individuals and study the correlation between these two conditions. We measured the plasma 25-hydroxy vitamin D (25-OH-D) levels in 60 patients with acute coronary syndromes (ACS) of both gender and in 30 age matched control individuals of both gender without any known cardiovascular or systemic diseases. The levels of 25-OH-D were measured by ELISA method and the results were statically analyzed to find out any possible correlation. We classified the cases according to their plasma 25(OH)D levels. 25(OH)D levels of ≥ 30 ng/ml were considered normal, levels < 30 and > 20 ng/ml were classified as insufficient, while levels of ≤ 20 ng/ml were classified as deficient. In the current study the prevalence of hypovitaminosis D in the patients group was much higher than it was in the control group. Vitamin D deficiency was observed in 80% and insufficiency in 13% of total patients of ACS, there by bringing the total count to 93%. Whereas only 7% of the patients had adequate vitamin D levels. Thus, these results indicate the existence of a significant correlation between the vitamin D deficiency and ACS in comparison to healthy controls

scholarly journals Hypovitaminosis D in pregnancy and its correlation with preeclampsia and gestational diabetes mellitus

2017 ◽  
Vol 6 (3) ◽  
pp. 890 ◽  
Author(s):  
Ankita Kumari ◽  
Shaila Mitra ◽  
Harish C Tiwari ◽  
Reena Srivastav
Keyword(s):  
Diabetes Mellitus ◽  
Vitamin D ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Vitamin D Deficiency ◽  
Serum Vitamin ◽  
Hypovitaminosis D ◽  
Health Concern ◽  
Control Group ◽  
The Impact

Background: Hypovitaminosis D has been associated with a number of adverse pregnancy outcomes, and has been recognised as a public health concern. The objective of this study was to determine the impact of Vitamin D deficiency on maternal complications like gestational diabetes mellitus (GDM) and preeclampsia (PE) among pregnant women.Methods: This was a case control study undertaken at antenatal clinics and indoor of BRD Medical College, Gorakhpur, Uttar Pradesh, India. Two maternal blood samples, one at <20 weeks and other at term along with cord blood at delivery were taken. Patients were classified into preeclampsia (n=60), gestational diabetes mellitus (n=35) and control group (n=180) after abstracting past medical records at delivery. Vitamin D was estimated by 25- Hydroxyvitamin D125 RIA kit and categorized according to ACOG criteria. Statistical analysis was done by using chi square test, binary logistic regression and Pearson’s correlation coefficient to compare between two variables. P<0.05 was considered statistically significant.Results: Out of 275 women included in the study, 78% of women were Vitamin D deficient. Mean serum vitamin D was significantly lower among preeclamptic women 11.53±6.22 ng/ml and GDM women 12.62±6.69 ng/ml as compared to controls 24.25±14.44 ng/ml (median=18.2 ng/ml) (P<0.05). Vitamin D deficiency was significantly higher in pregnant women GDM (94.28% vs 68.3%) and preeclampsia (96.67% vs 68.3%) when compared to uncomplicated group.Conclusions: Maternal vitamin D deficiency is highly prevalent in early pregnancy and is significantly associated with elevated risk for GDM and preeclampsia.

scholarly journals Vitamin D status and 3-month Glasgow Outcome Scale scores in patients in neurocritical care: prospective analysis of 497 patients

2018 ◽  
Vol 128 (6) ◽  
pp. 1635-1641 ◽  
Author(s):  
Jian Guan ◽  
Michael Karsy ◽  
Andrea A. Brock ◽  
Ilyas M. Eli ◽  
Gabrielle M. Manton ◽  
...  
Keyword(s):  
Vitamin D ◽  
Logistic Regression ◽  
Vitamin D Deficiency ◽  
Glasgow Outcome Scale ◽  
Neurocritical Care ◽  
Care Center ◽  
Hypovitaminosis D ◽  
Simplified Acute Physiology Score ◽  
Vitamin D Supplementation ◽  
Vitamin D Levels

OBJECTIVEVitamin D deficiency has been associated with a variety of negative outcomes in critically ill patients, but little focused study on the effects of hypovitaminosis D has been performed in the neurocritical care population. In this study, the authors examined the effect of vitamin D deficiency on 3-month outcomes after discharge from a neurocritical care unit (NCCU).METHODSThe authors prospectively analyzed 25-hydroxy vitamin D levels in patients admitted to the NCCU of a quaternary care center over a 6-month period. Glasgow Outcome Scale (GOS) scores were used to evaluate their 3-month outcome, and univariate and multivariate logistic regression was used to evaluate the effects of vitamin D deficiency.RESULTSFour hundred ninety-seven patients met the inclusion criteria. In the binomial logistic regression model, patients without vitamin D deficiency (> 20 ng/dl) were significantly more likely to have a 3-month GOS score of 4 or 5 than those who were vitamin D deficient (OR 1.768 [95% CI 1.095–2.852]). Patients with a higher Simplified Acute Physiology Score (SAPS II) (OR 0.925 [95% CI 0.910–0.940]) and those admitted for stroke (OR 0.409 [95% CI 0.209–0.803]) or those with an “other” diagnosis (OR 0.409 [95% CI 0.217–0.772]) were significantly more likely to have a 3-month GOS score of 3 or less.CONCLUSIONSVitamin D deficiency is associated with worse 3-month postdischarge GOS scores in patients admitted to an NCCU. Additional study is needed to determine the role of vitamin D supplementation in the NCCU population.

A prospective analysis of hypovitaminosis D and mortality in 400 patients in the neurocritical care setting

2017 ◽  
Vol 127 (1) ◽  
pp. 1-7 ◽  
Author(s):  
Jian Guan ◽  
Michael Karsy ◽  
Andrea A. Brock ◽  
Ilyas M. Eli ◽  
Holly K. Ledyard ◽  
...  
Keyword(s):  
Vitamin D ◽  
Critical Care ◽  
Hospital Mortality ◽  
Vitamin D Deficiency ◽  
Neurocritical Care ◽  
Care Center ◽  
Demographic Data ◽  
Hypovitaminosis D ◽  
Vitamin D Levels ◽  
The Impact

OBJECTIVEHypovitaminosis D is highly prevalent among the general population. Studies have shown an association between hypovitaminosis D and multiple negative outcomes in critical care patients, but there has been no prospective evaluation of vitamin D in the neurological critical care population. The authors examined the impact of vitamin D deficiency on in-hospital mortality and a variety of secondary outcomes.METHODSThe authors prospectively collected 25-hydroxy vitamin D levels of all patients admitted to the neurocritical care unit (NCCU) of a quaternary-care center over a 3-month period. Demographic data, illness acuity, in-hospital mortality, infection, and length of hospitalization were collected. Univariate and multivariable logistic regression were used to examine the effects of vitamin D deficiency.RESULTSFour hundred fifteen patients met the inclusion criteria. In-hospital mortality was slightly worse (9.3% vs 4.5%; p = 0.059) among patients with deficient vitamin D (≤ 20 ng/dl). There was also a higher rate of urinary tract infection in patients with vitamin D deficiency (12.4% vs 4.2%; p = 0.002). For patients admitted to the NCCU on an emergency basis (n = 285), higher Simplified Acute Physiology Score II (OR 13.8, 95% CI 1.7–110.8; p = 0.014), and vitamin D deficiency (OR 3.0, 95% CI 1.0–8.6; p = 0.042) were significantly associated with increased in-hospital mortality after adjusting for other factors.CONCLUSIONSIn the subset of patients admitted to the NCCU on an emergency basis, vitamin D deficiency is significantly associated with higher in-hospital mortality. Larger studies are needed to confirm these findings and to investigate the role of vitamin D supplementation in these patients.

scholarly journals Vitamin D Levels: Associations with Acute Pain Events and Self-Reported Pain in Children with Sickle Cell Disease

Blood ◽  
2021 ◽  
Vol 138 (Supplement 1) ◽  
pp. 3089-3089
Author(s):  
Latika Puri ◽  
Nicole M Alberts ◽  
Guolian Kang ◽  
Juan Ding ◽  
Jane S Hankins ◽  
...  
Keyword(s):  
Vitamin D ◽  
Sickle Cell Disease ◽  
Vitamin D Deficiency ◽  
Sickle Cell ◽  
Care Utilization ◽  
Cell Disease ◽  
Cross Sectional ◽  
Vitamin D Levels ◽  
Patient Reported ◽  
Deficient Group

Abstract Background/Aims: Individuals with sickle cell disease (SCD) are at high risk for vitamin D deficiency due to dark skin color, limited physical activity, poor nutrition, and renal dysfunction. In smaller retrospective studies, vitamin D deficiency in SCD was associated with increased frequency of acute pain events and higher opioid use, however the impact of vitamin D deficiency on pain related patient reported outcomes has not been described . Supplementation with high dose vitamin D is shown to be associated with fewer pain days per week and higher physical activity scores in patients with chronic pain. Thus, the objective of our study was to evaluate relationship between vitamin D levels, acute health care utilization and self-reported pain among children with SCD. We hypothesized that vitamin D deficiency is associated with increase health care utilization for pain and patient-reported outcomes for pain. Methods: Patients with SCD (1 to 18 years of age), enrolled in Sickle Cell Clinical Research and Intervention Program (SCCRIP), at St. Jude Children's Research Hospital were included in the study (Hankins et.al., Pediatric Blood and Cancer, 2018). Demographic, clinical and laboratory data were extracted from SCCRIP database. Prospective pain event leading to a hospital visit was analyzed. We analyzed pain-related hospitalizations in two ways: the number of pain-related hospitalizations within 2 years prior to and after vitamin D measurement in a cross-sectional design and longitudinally. Generalized linear regression model was used to examine associations between vitamin D and cross-sectional pain events with adjusting for hydroxyurea use. Generalized linear mixed effect model was used to assess the associations between vitamin D and longitudinal pain events, with adjusting for SCD genotype, sex, age, hydroxyurea use and interaction between age and hydroxyurea use. Pediatric Quality of Life Inventory™ Sickle Cell Disease Module (PedsQL™ SCD) was used to measure pain and pain interference using 1) Pain and Hurt and 2) Pain Impact scales. PedsQL™ SCD assessments include a Likert response scale. Items are reverse -scored and transformed to a 0-100 scale where higher scores indicate better health related quality of life in that scale. Two sample t-test or Wilcoxon rank sum test was used to compare mean scores between the two groups. Results: A total of 799 patients (females, n=398; males, n=401) were included in the study. Mean age (Standard Deviation [SD]), range at time of first vitamin D measurement for entire cohort was 8.7 (4.7), (0.8-18 years). Mean (SD) initial vitamin D level for entire cohort was 19.0 (9.4) ng/dl. Mean (SD) number of pain-related hospitalizations within two years of first vitamin D measurement was higher in the vitamin D deficient group as compared to non deficient group [0.81(1.97) vs 0.66 (1.2), (p=0.0034)]. Longitudinal data analyses showed vitamin D deficiency was associated with increased number of pain related hospitalizations (p=0.0091), after adjusting for covariates listed above (Figure 1a). Mean (SD) scores for Pain and Hurt in vitamin D deficient versus non deficient group were [74.5.7(18.2) versus 83.5(15.6), p &lt; 0.001]. Mean (SD) scores for Pain Impact in vitamin D deficient group as compared to non deficient group were [(66.7 (22.7) versus 75.5 (22.3), p &lt;0.001] (Figure 1b) Conclusion: Results indicated that low vitamin D levels predicted higher frequency of painful events leading to a hospital visit and were associated with higher prevalence of self-reported pain and pain interference. Further studies evaluating mechanisms by which vitamin D influences sickle cell pain are warranted and larger controlled trials can help evaluate the therapeutic efficacy of vitamin D for sickle cell pain. Figure 1 Figure 1. Disclosures Hankins: UpToDate: Consultancy; Bluebird Bio: Consultancy; Vindico Medical Education: Consultancy; Global Blood Therapeutics: Consultancy.

scholarly journals VITAMIN D STATUS IN A HEALTHY TUNISIAN POPULATION

2022 ◽  
Author(s):  
Asma KRIR ◽  
Afef BAHLOUS ◽  
Mehdi MRAD ◽  
BOUKSILA Mouna ◽  
KALAI Safa ◽  
...  
Keyword(s):  
Vitamin D ◽  
Vitamin D Deficiency ◽  
Rural Areas ◽  
Hypovitaminosis D ◽  
Vitamin D Supplementation ◽  
Tunisian Population ◽  
Diabetic Patients ◽  
Dietary Intakes ◽  
Vitamin D Status ◽  
Vitamin D Levels

Vitamin D deficiency is one of the most common medical conditions worldwide. In Tunisia, several studies evaluated Vitamin D status, but this was concerning specific populations (pregnant women, obese or diabetic patients and children with asthma). The only study that evaluated Vitamin D status in a healthy Tunisian population was conducted by Meddeb and al. in 2002. The update of data available, based on the currently recommended limits, is necessary. This study aimed to estimate the prevalence of hypovitaminosis D in a healthy Tunisian population, and correlate the values with potential risk factors. It was conducted on 209 Tunisian healthy subjects. Data collected included clinical characteristics and dietary intakes. We measured 25-hydroxyvitamin D (25(OH)D), parathyroid hormone (PTH), glycemia, creatinine, calcium, phosphorus, proteins and alkaline phosphatase levels. Hypovitaminosis D was retained for 25(OH)D concentrations <30ng/ml. Vitamin D deficiency was defined by 25(OH)D concentrations <10 ng/ml. The prevalence of hypovitaminosis D and vitamin D deficiency were respectively 92.3% and 47.6%. The main factors that were significantly associated with low vitamin D levels in our multivariate analysis were veiling, living in rural areas and sunscreen use. However, sex, age, socioeconomic level, phototype, solar exposure score, smoking and bone mass index, were not statistically associated with hypovitaminosis D. The study of relationship between vitamin D status and serum PTH levels showed a significative and negative correlation (p< 0.005). Given the high prevalence of vitamin D, an adapted health policy is essential. A widespread vitamin D supplementation and food fortification seems to be necessary in Tunisia.

scholarly journals Assessment of vitamin D status and its association with insulin resistance among type 2 diabetic subjects

2018 ◽  
Vol 6 (12) ◽  
pp. 3825
Author(s):  
Jaitra Bhattacharya
Keyword(s):  
Diabetes Mellitus ◽  
Insulin Resistance ◽  
Type 2 Diabetes ◽  
Vitamin D ◽  
Vitamin D Deficiency ◽  
Serum Vitamin ◽  
Serum Vitamin D ◽  
Vitamin D Levels ◽  
Type 2 Diabetic

Background: The 21st century has seen the rise of diabetes mellitus as one of the major metabolic issues as is vitamin D deficiency which has been found to be pandemic worldwide. The present study is an endeavor to study the status of serum vitamin D levels in relation to the glycemic and insulin resistance status in type 2 diabetes mellitus patients.Methods: The present is a cross-sectional study with a sample size of 100 type 2 diabetic subjects in the age group of 30-60 years. Serum vitamin D and Insulin levels were estimated using the ELISA technique. HbA1c levels were measured using immunoturbidimetric assays and plasma glucose levels were determined using glucose oxidase- peroxidase method.Results: The fasting plasma glucose, HbA1c and serum insulin levels were found to be significantly higher in those with vitamin D levels below the normal cut-off value of less than 30ng/ml (p value <0.01). Also, the insulin resistance calculated using HOMA-IR was found to be higher in those subjects having vitamin D deficiency or insufficiency.Conclusions: Hence, the study suggests that vitamin D deficiency contributes to further insulin resistance and poorer long-term diabetic control in type 2 diabetes mellitus subjects.

scholarly journals Severe hypovitaminosis D in pregnant refugees arriving in Europe: neonatal outcomes and importance of prenatal intervention

2021 ◽  
Author(s):  
Anna Liori ◽  
Damaskini Polychroni ◽  
Georgios K Markantes ◽  
Maria Stamou ◽  
Sarantis Livadas ◽  
...  
Keyword(s):  
Vitamin D ◽  
Pregnant Women ◽  
Vitamin D Deficiency ◽  
Hypovitaminosis D ◽  
Neonatal Health ◽  
Host Countries ◽  
Effective Interventions ◽  
Vitamin D Levels ◽  
High Prevalence ◽  
Prenatal Intervention

Adequate vitamin D levels are particularly important in pregnant women for both the maternal and neonatal health. Prior studies have shown a significantly high prevalence of vitamin D deficiency (VDD) among refugees. However, no study has addressed the prevalence of VDD in pregnant refugees and its effects on neonatal health. In this study, we examined the prevalence of VDD in refugee pregnant women living in Greece and compared our results with Greek pregnant inhabitants. Vitamin D deficiency was frequent in both groups but was significantly more common in refugees (92.2% vs 67.3% of Greek women, p=0.003) with 70.6% of refugees having severe hypovitaminosis D (<10 ng/ml). As a result, most newborns had Vitamin D deficiency, which affected refugee newborns to a greater extent. Our results suggest a need to screen newcomer children and pregnant women for vitamin D deficiency in all host countries around the world. Such a screen will appropriately guide early and effective interventions with the goal to prevent adverse neonatal and maternal outcomes.

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