Association Between Serum Vitamin A Levels and Recurrent Respiratory Tract Infections in Children

To evaluate the association between serum vitamin A levels and the prevalence of recurrent respiratory tract infections (RRTIs) in children and adolescents and to provide evidence that would help decrease the prevalence of respiratory tract infections (RTIs) in children. This cross-sectional study included 8034 children and adolescents in Beijing aged 6 months to 17 years. RRTI and RTI symptoms were diagnosed according to the Clinical Concept and Management of Recurrent Respiratory Tract Infections in Children. Multivariate logistic regression models were used to evaluate the association between serum vitamin A levels and RRTIs after adjusting for potential confounders. Among the included children, 721 (8.97%) were diagnosed with vitamin A deficiency, whereas 3,073 (38.25%) were diagnosed with subclinical vitamin A deficiency. Only 28.8% (208/721) of children with vitamin A deficiency and 53.1% (1,631/3,073) of children with subclinical vitamin A deficiency had no RRTI and RTI symptoms, respectively. Compared with children with normal vitamin A levels, those with vitamin A deficiency and subclinical vitamin A deficiency had a greater risk for RRTIs, with an odds ratio (OR) of 6.924 [95% confidence interval (CI): 5.433–8.824] and 2.140 (95% CI: 1.825–2.510), respectively]. Vitamin A levels were also positively associated with RTI symptoms, with those having vitamin A deficiency and subclinical vitamin A deficiency showing an OR of 1.126 (95% CI: 0.773–1.640) and 1.216 (95% CI: 1.036–1.427), respectively. The present cross-sectional study found that low serum vitamin A levels were significantly associated with RRTI or RTI prevalence in children and adolescents.

Co-administration of vitamin D3 and Lacticaseibacillus paracasei DG increase 25-hydroxyvitamin D serum levels in mice

Purpose Subclinical vitamin D (vitD) deficiency enhances the predisposition to a myriad of acute and chronic pathologies in many people worldwide. Due to the scarcity of vitD-rich foods, the consumption of supplements or fortified foods can be required to maintain healthy serum levels of 25-hydroxyvitamin D [25(OH)D], and the major circulating form of vitD that is commonly measured in serum to determine the vitD status. Since the vitD absorption seems to resemble that of lipids, improved emulsification in the gut could favor vitD permeation through the enterocyte membrane. Contextually, we hypothesized that a microorganism with cholecalciferol (vitD3)-solubilization properties may potentially result in enhanced serum vitD levels. Methods and results Six probiotic strains were screened for their ability to create a stable suspension of vitD3 in water: Lacticaseibacillus paracasei DG, L. paracasei LPC-S01, L. paracasei Shirota, L. rhamnosus GG, Limosilactobacillus reuteri DSM 17938, and Lactobacillus acidophilus LA5. The DG strain displayed the strongest vitD3 solubilization ability and, consequently, were used in an in vivo trial where a commercial preparation of vitD3 in refined olive oil was administered by gavage to CD-1 mice with or without the concurrent administration of L. paracasei DG. ELISA measurements showed that the DG strain significantly increased the serum levels of 25(OH) D when administered once a day for 1 week in association with the vitD3 supplement. Conclusion This preliminary pre-clinical study suggests that the combined administration of L. paracasei DG with an oil-based cholecalciferol supplement could contribute to the maintenance of the adequate 25(OH) D serum levels in people at risk of vitD deficiency.

Experimental Model of Subclinical Vitamin K Deficiency

Introduction: Vitamin K (VK) is a co-factor in the post-translational gamma glutamic carboxylation of Gla-proteins. VK-dependent coagulation factors are carboxylated in the liver by VK1. Osteocalcin and Matrix-Gla protein (MGP) are carboxylated in extrahepatic tissues by VK2. A model of VK deficiency would be suitable for studying extrahepatic Gla-proteins provided that severe bleeding is prevented. Aim: The aim of this work was to adapt an established protocol of vascular calcification by warfarin-induced inactivation of MGP as a calcification inhibitor, in an attempt to create a broader state of subclinical VK deficiency and to verify its safety. Materials and methods: Two consecutive experiments, each lasting 4 weeks, were required to modify the dosing schedule of warfa­rin and VK1 and to adapt it to the Wistar rats used. The original high doses of warfarin used initially had to be halved and the protective dose of VK1 to be doubled, in order to avoid treatment-induced hemorrhagic deaths. The second experiment aimed to confirm the efficacy and safety of the modified doses. To verify the VK deficiency, blood vessels were examined histologically for calcium deposits and serum osteocalcin levels were mea­sured. Results: The original dosing schedule induced VK deficiency, manifested by arterial calcifications and dramatic changes in carboxyl­ated and uncarboxylated osteocalcin. The modified dosing regimen caused similar vascular calcification and no bleeding. Conclusion: The modified protocol of carefully balanced warfarin and VK1 doses is an effective and safe way to induce subclinical VK deficiency that can be implemented to investigate VK-dependent proteins like osteocalcin.

Prevalence of Vitamin A Deficiency among Preschool Children in Ethiopia: A Systematic Review and Meta-Analysis

Background. Vitamin A deficiency is a major nutritional concern in lower-income countries. The aim of this systematic review and meta-analysis was to show the magnitude of vitamin A deficiency among preschoolers in Ethiopia. Objective. The present study was aimed at synthesizing qualitatively and quantitatively the existing literature on the prevalence of VAD in preschool children in Ethiopia. Methods. Studies were searched through the search engine of Google Scholar, Hinari, MEDLINE/PubMed, Cochrane Library, and Africa-Wide Information. Searching was made using the keywords/MeSH of vitamin A deficiency, xerophthalmia, night blindness, Bitot’s spot, retinol, children, and Ethiopia. Data were analyzed and compared with the WHO threshold criteria to declare a public health problem. Heterogeneity among studies was assessed using a Cochran Q test and I2 statistics. A random-effects model with 95% confidence interval was used for prevalence estimations. Results. Of the 13 studies included in clinical analysis, 12 of them reported the prevalence of night blindness and/or Bitot’s spot among preschool children in Ethiopia which was above WHO cutoff point for the public health problem 1% and 0.5%, respectively. The prevalence of night blindness significantly decreased from moderate public health problem 4.2% (95% CI: 2.8%-5.7%) in a period from 1990 to 2004 to mild public health problem 0.8% (95% CI: 0.6%-1.0%) in a period from 2005 to 2019. Furthermore, statistically insignificant reduction was observed in the prevalence of Bitot’s spot in a period from 1990 to 2004, 2.2% (95% CI: 1.3%-3.2%) to 1.8% (95% CI: 1.2%-2.3%) in a period from 2005 to 2019. Among 8 studies on subclinical vitamin A deficiency, 7 of them indicated a severe public health problem (>20%). The prevalence of subclinical vitamin A deficiency decreased from 55.7% (95% CI: 39.8%-71.6%) in a period from 1990 to 2004 to 28.3% (95% CI: 9.8%-46.7%) in a period from 2005 to 2019, but not statistically significant. Conclusions. Despite the reduced proportion of night blindness and Bitot’s spot, still both clinical and subclinical vitamin A deficiencies remain a public health problem in Ethiopia requiring strengthen intervention through the newly initiated health extension program.

Phylloquinone (vitamin K1) concentration, polymorphism of biotransformation genes, vitamin K-oxidoreductase in the population of Nenets ethnos in Arctic region of Russian Federation

Введение. Несмотря на то что выраженный дефицит витамина К встречается достаточно редко, клиническое значение данного нутриента значимо. Следует учитывать, что роль витамина К не ограничивается только процессами коагуляции крови это и регуляция обмена кальция, витамина Д, созревание белка костной ткани остеокальцина. Основной путь поступления филлохинона алиментарный. Отдельного внимания, на наш взгляд, заслуживает изучение данного вопроса в популяциях постоянно проживающих в труднодоступных регионах с алиментарным дефицитом данного нутриента. Цель исследования: анализ возможной зависимости концентрации витамина К1 в сыворотке крови от полиморфизма генов биотрансформации и витамин Коксидоредуктазы у коренного населения (ненцы) в условиях постоянного островного проживания в Арктическом регионе России. Материалы и методы. Проведено поперечное популяционное исследование коренного населения (ненцы), проживающего в Арктической зоне России на острове Вайгач (7001 с. ш. 5933 в. д.). Использованы методы молекулярногенетического исследования полиморфизма генов биотрансформации и витамин Коксидоредуктазы анализ концентрации витамина К1 проводили методом высокоэффективной жидкостной хроматографии с детектированием сигнала на тандемном массспектрометре. Результаты. Выявлен значимый субклинический дефицит витамина К1 (филлохинона) при отсутствии зависимости от полиморфизма генов биотрансформации и витамин Коксидоредуктазы. Заключение. Выявленный нами факт субклинического дефицита витамина К1 может иметь неблагоприятное влияние на развитие остеопороза детерминированным дополнительным присутствием гомозиготного аллеля VKORC1 1173Т, что требует дополнительного изучения. Introduction. Despite the fact that expressed vitamin K deficiency is quite rare, the clinical significance of this nutrient is important. Vitamin K (phylloquinone) is involved in blood coagulation, in regulation of calcium and vitamin D metabolism, in maturation of osteocalcin bone protein. The main route of phylloquinone intake is alimentary. Special mention should be made of alimentary deficiency of this nutrient in populations of permanently residing in difficulttoreach regions. Aim: to analyze the possible dependence of vitamin K1 concentration in serum from polymorphism of genes biotransformation and vitamin Koxidoreductase in indigenous population (Nenets) permanently living on an island in Russian Arctic region. Materials and methods. We conducted a crosspopulation study of the indigenous population (Nenets) living in Russian Arctic zone on Vaigach Island (7001 north latitude 5933 east longitude). We used the methods of molecular genetic studies of genes biotransformation polymorphism and vitamin Koxidoreductase vitamin K1 concentration was analyzed by highperformance liquid chromatography with detection of signal on a tandem mass spectrometer. Results. We revealed a significant subclinical deficiency of vitamin K1 (phylloquinone) with the absence of dependence from genes biotransformation polymorphism and vitamin Koxidoreductase. Conclusion. Revealed subclinical vitamin K1 deficiency may have an adverse effect on osteoporosis development by the deterministic additional presence of homozygous VKORC1 1173T allele that requires additional study.

Prevalence of vitamin D deficiency in exclusively breastfed infants

Background: Vitamin D deficiency in exclusively breast fed infants was increasing in young infants. Many studies were done previously but still the data on vitamin D status of healthy term infants are scanty. Hence the present study was done to determine the prevalence of subclinical vitamin D deficiency among exclusively breast fed babies by estimating the serum levels of relevant parameters.Methods: The present descriptive study included 40 babies that are exclusively breast fed healthy term babies with birth weight >2.5kg. After collection of complete demographic and antenatal data, serum was collected from all the babies to estimate serum levels of vitamin D (25OH-D3) and calcium, phosphate, and alkaline phosphatase.Results: Out of 40 babies, vitamin D deficiency was found in 33 (83%) babies. Of them, hypocalcaemia was seen in 13 (39.3%) infants. Raised ALP was noticed in all babies with a mean value of 464.97 IU/L. Phosphorus levels were normal in all babies with a mean value of 6.12 mg/ml. Serum 25 OH vitamin D3 levels were low (mean-10.02 ng/ml) and mean calcium was 8.81 mg/dl.Conclusions: Prevalence of vitamin D deficiency was found to be high in exclusively breastfed babies with hypocalcemia in 39% of babies and associated seizure in one baby in this study.

Vitamin K in Chronic Kidney Disease

Vitamin K is a composite term referring to a group of fat-soluble vitamins that function as a cofactor for the enzyme γ-glutamyl carboxylase (GGCX), which activates a number of vitamin K-dependent proteins (VKDPs) involved in haemostasis and vascular and bone health. Accumulating evidence demonstrates that chronic kidney disease (CKD) patients suffer from subclinical vitamin K deficiency, suggesting that this represents a population at risk for the biological consequences of poor vitamin K status. This deficiency might be caused by exhaustion of vitamin K due to its high requirements by vitamin K-dependent proteins to inhibit calcification.