Prevalence of vitamin D deficiency in exclusively breastfed infants at Charoenkrung Pracharak Hospital

BACKGROUND Vitamin D deficiency is a common problem in exclusively breastfed infants,with supplementation recommended by various international medical organizations.However,in Thailand,no advice for routine vitamin D supplementation is available.Thus,this study investigated the prevalence of vitamin D deficiency and its associated factors in exclusively breastfed infants in Bangkok,Thailand.AIM To investigated the prevalence of vitamin D deficiency and its associated factors in exclusively breastfed infants in Bangkok,Thailand.METHODS This descriptive observational cross-sectional study assessed 1094-month-old infants at Charoenkrung Pracharak Hospital from May 2020 to April 2021.The 25-OH vitamin D level of the infants was measured using an electrochemiluminescence binding assay.Vitamin D deficiency was defined as 25-OH level<20 ng/mL,with vitamin D insufficiency 20-30 ng/mL.The sun index and maternal vitamin D supplementation data were collected and analyzed using the independent t-test,univariate logistic regression,and multivariate logistic regression to identify the associated factors.RESULTS The prevalences of vitamin D deficiency and vitamin D insufficiency were 35.78%and 33.03%,respectively with mean serum 25-OH vitamin D levels in these two groups 14.37±3.36 and 24.44±3.29 ng/mL.Multivariate logistic regression showed that the main factors associated with vitamin D status were maternal vitamin D supplementation and birth weight,with crude odds ratios 0.26(0.08–0.82)and 0.08(0.01–0.45),respectively.The sun index showed no correlation with the 25-OH vitamin D level in exclusively breastfed infants(r=−0.002,P=0.984).CONCLUSION Two-thirds of healthy exclusively breastfed infants had hypovitaminosis D.Vitamin D supplementation prevented this condition and was recommended for both lactating women and their babies.

Maternal Vitamin D Deficiency and Risk of Development of Gestational Diabetes Mellitus: A Scoping Review

Background: Maternal vitamin D status is a critical determinant during pregnancy, because it plays an important role in the body not only in calcium homeostasis and bone remodeling, but also in the glucose metabolism. Vitamin D deficiency is associated with adverse pregnancy outcomes including gestational diabetes mellitus. Objective: To review evidence on the association between maternal vitamin D deficiency and incidence of gestational diabetes mellitus (GDM). Methods: PRISMA for scoping review guideline and scoping review guidelines of Arksey & O’Malley (2005) was followed in methodological process. A comprehensive search strategy was carried out across the Google Scholar and PubMed from January 2012 to December 2022, using the search terms of “gestational diabetes mellitus/pregnancy outcomes” combined with “vitamin D”, “cholecalciferol” or “25-hydroxyvitamin D” and/or “deficiency”. Articles were screened at the title and the abstract level and at full text by three co-investigators of the study independently with a fourth reviewer resolving discrepancies. Research studies published only in English language were selected. Research using pregnant mothers with multiple pregnancy and chronic diseases was excluded. Results: After screening 134 titles and abstracts, finally 55 original research articles were selected. It involved 48 observational studies and 7 Randomized Control Trials (RCT). Only 30 research articles had found an association between maternal vitamin D deficiency and GDM. Conclusion: As results of previous studies are mixed and inconclusive, further research including more RCTs is needed to clarify the exact mechanism of vitamin D on glucose metabolism during pregnancy.

The Association between Vitamin D Deficiency and Developing COVID-19 Related Serious Illnesses—A Systematic Review and Meta-Analysis

Background: Coronavirus is rapidly transmitted and highly infectious, and it is also associated with high morbidity and mortality but no drugs have been recognised as being effective;therefore, it is necessary to protect against serious illnesses with an intrinsic protection mechanism. In addition, Vitamin D enhances the intrinsic protection mechanism. Purpose: This study aims to systematically review and conduct a meta-analysis to determine if vitamin D deficiency is associated with the development of severe COVID-19 illness, providing crucial insights into the potential impact of vitamin D on disease outcomes. Methods: This study is conducted through systematic reviews and meta-analysis while following well-designed research questions. Literature searches are performed according to PRISMA guidelines with inclusion and exclusion criteria through the electronic database PubMed, CINAHL and Google Scholar. All data for meta-analysis were performed using RevMan 5.4. The software program was used for blending the statistical data and deriving the cumulative result of the intervention on concluding outcomes of interest. To analyze dichotomous data, the Mantel-Haenszel method was performed, and an odds ratio was conducted for outcome evaluation with 95% confidence interval. Results: The meta-analysis showed that there is statistically significant (P Conclusion: This study indicated that Vitamin D deficiency is associated with the development of COVID-19 related serious illnesses. Also, it is highly recommended to do more randomised control trials for the establishment of this topic strongly.

Vitamin D deficiency among outpatients and hospitalized patients with diabetic foot ulcers:A systematic review and meta-analysis

BACKGROUND The definition of diabetic foot syndrome(DFS)varies depending on the location and resources.Few classifications are available according to the indication.DF ulcers and vitamin D deficiency are common diseases among patients with diabetes.Previous literature has shown an association between DF ulcer(DFU)and vitamin D deficiency.However,the available meta-0analysis was limited by substantial bias.AIM To investigate the association between DFUs and vitamin D levels.METHODS We searched PubMed,MEDLINE,and Cochrane Library,EBSCO,and Google Scholar for studies comparing vitamin D levels and DF.The keywords DFU,DFS,diabetic septic foot,vitamin D level,25-hydroxy vitamin D,vitamin D status,and vitamin D deficiency were used.The search engine was set for articles published during the period from inception to October 2022.A predetermined table was used to collect the study information.RESULTS Vitamin D level was lower among patients with DFU compared to their counterparts[odds ratio(OR):-5.77;95%confidence interval(CI):-7.87 to-3.66;χ2 was 84.62,mean difference,9;I2 for heterogeneity,89%;P<0.001 and P for overall effect<0.001].The results remained robust for hospitalized patients(OR:-6.3295%CI:-11.66 to-0.97;χ2 was 19.39;mean difference,2;I2 for heterogeneity,90%;P=0.02).CONCLUSION Vitamin D was lower among outpatients and hospitalized patients with DFUs.Further larger randomized controlled trials are needed.

Association of Vitamin D Deficiency with Diabetic Retinopathy in Young People with Type 1 Diabetes Mellitus

Background: Diabetic retinopathy is among the most common diabetic complications, and is one of the leading causes of blindness in the world. Recent studies have linked vitamin D to the pathogenesis of diabetes and there is growing evidence that vitamin D can interfere with the mechanisms involved in diabetes and its complications. Despite improvements in treatment, diabetic retinopathy remains a significant complication of type 1 diabetes mellitus. Identification of early treatable predictors of diabetic retinopathy such as vitamin D deficiency, may allow more aggressive management of those at high risk. Purpose: To assess the association of vitamin D deficiency with diabetic retinopathy in young people with type 1 diabetes mellitus. Design: Observational study with case control design. Method: 60 young people with type 1 diabetes aged between 11 to 24 years were included in this study. Among them, 30-young people have diabetic retinopathy and 30-young people do not have diabetic retinopathy. Purposive sampling technique was applied as per inclusion criteria. Statistical analysis of the results was done by using computer-based software, SPSS version 26. P value of less than 0.05 was considered as statistically significant. Results: Vitamin D deficiency was present in 83% of the young people with diabetic retinopathy and in 53% without diabetic retinopathy. The mean vitamin D level in young people with and without diabetic retinopathy was 17.38 ± 3.77 ng/ml and 20.15 ± 5.06 ng/ml respectively and the difference was statistically significant (p = 0.019). Vitamin D deficiency was increased with the severity of diabetic retinopathy. Univariate and multivariate logistic regression showed vitamin D deficiency was independently associated with diabetic retinopathy with a crude odds ratio of 5.69 with a p value of 0.008 and adjusted odds ratio of 16.08 with a p value of 0.002 respectively. Conclusion: Result of the study revealed that vitamin D deficiency was strongly associated with diabetic retinopathy in young people with type 1 diabetes mellitus.

Vitamin D deficiency in cirrhosis relates to liver dysfunction rather than aetiology

AIM: To examine the vitamin D status in patients with alcoholic cirrhosis compared to those with primary biliary cirrhosis. METHODS: Our retrospective case series comprised 89 patients with alcoholic cirrhosis and 34 patients with primary biliary cirrhosis who visited our outpatient clinic in 2005 and underwent a serum vitamin D status assessment. RESULTS: Among the patients with alcoholic cirrhosis, 85% had serum vitamin D levels below 50 nmol/L and 55% had levels below 25 nmol/L, as compared to 60% and 16% of the patients with primary biliary cirrhosis, respectively (P < 0.001). In both groups, serum vitamin D levels decreased with increasing liver disease severity, as determined by the Child-Pugh score. CONCLUSION: Vitamin D deficiency in cirrhosis relates to liver dysfunction rather than aetiology, with lower levels of vitamin D in alcoholic cirrhosis than in primary biliary cirrhosis.

The impact of vitamin D deficiency on neurogenesis in the adult brain

There is increasing evidence from epidemiological studies indicating that vitamin D deficiency during adulthood is associated with adverse brain outcomes in humans（Ginde et al.,2009）and rodents（Groves et al.,2014）,however,a causal relationship has not yet been established.

Fatigue is not associated with vitamin D deficiency in inflammatory bowel disease patients

AIM To investigate if vitamin D deficiency is associated with fatigue in patients with inflammatory bowel disease(IBD).METHODS IBD patients were recruited from nine hospitals in the southeastern and western regions of Norway to participate in a multicenter cross-sectional study lasting from March 2013 to April 2014. Data were collected by interviews, from medical records and laboratory tests. The Fatigue Questionnaire(FQ) was used to measure fatigue. Linear and logistic regression models were applied to explore the possible association between vitamin D deficiency and total fatigue scores and chronic fatigue, respectively. The analyses were adjusted for age, gender, disease activity, depressive symptoms and sleep disturbance.RESULTS In total, 405 patients were included in the analyses, of which 227(56%) had Crohn's disease(CD) and 178(44%) had ulcerative colitis(UC). Vitamin D deficiency(< 50 nmol/L) was present in half(203/405) of the patients. Chronic fatigue was reported by 116(29%) of all included patients with substantial fatigue reported by 194(48%). Vitamin D levels were neither associated with total fatigue nor with chronic fatigue. Higher total fatigue scores and chronic fatigue were both associated with increased disease activity scores in patients with UC and CD, but not with increased CRP or fecal calprotectin. In UC patients, female gender was associated with fatigue in the univariate analysis, but no such difference was found when adjusted for elevated disease activity scores. Sleep disturbance and more depressive symptoms were associated with total fatigue scores in both UC and CD patients, but with chronic fatigue only in CD patients.CONCLUSION In this study, no significant association between fatigue and vitamin D deficiency in IBD patients was revealed.

Predictors of vitamin D deficiency in inflammatory bowel disease and health: A Mississippi perspective

AIMTo identify the predictors of vitamin D deficiency in patients with and without inflammatory bowel disease (IBD).METHODSPatients with ulcerative colitis (UC) or Crohn’s disease (CD) related diagnostic codes who received medical care at University of Mississippi Medical Center between July 2012 and 2015 were identified. After thorough chart review, we identified patients with biopsy proven IBD who had also been tested for serum 25-hydroxyvitamin D [25(OH)D] concentration. We compared these patients to a previously studied cohort of healthy controls who also had vitamin D concentration checked. Logistic regression analysis was performed to determine the association between vitamin d deficiency and UC, CD, race, age, gender and body mass index (BMI).RESULTSWe identified 237 patients with confirmed IBD. Of these, only 211 had a serum 25(OH)D concentrations available in the medical record. The group of healthy controls consisted of 98 individuals with available serum 25(OH)D concentration. 43% of IBD patients were African American (AA). Patients with CD were more likely to have vitamin D concentration checked. Bivariate analysis showed that AA (51% vs 21%, P = 0.00001), subjects with BMI >30 kg/m2 (39% vs 23% P = 0.01) and CD (40% vs 26%, P = 0.04) were more likely to be vitamin D deficient than vitamin D sufficient. Those with Age > 65 were more likely to be vitamin D sufficient (46% vs 15%, P = 0.04). Multiple regression showed that only BMI > 30 kg/m2 and AA race are associated with vitamin D deficiency.CONCLUSIONBMI > 30 kg/m2 and AA race are predictive of vitamin D deficiency. Gender, age and diagnosis of IBD are not predictive of vitamin D deficiency.

Vitamin D Deficiency and Insufficiency in Northeast Tennessee

Background: The role of vitamin D in population subgroups throughout the world continues to be a topic of interest among researchers. Current evidence demonstrates that treating vitamin D deficiency plays a significant role in improving mortality in hospitalized patients, reducing hospital length of stay, and boosting innate immune system. Vitamin D levels vary with age, gender, body mass index (BMI) and geographical area. The purpose of this study is to evaluate vitamin D levels in a cohort of patients in Northeast Tennessee. Study: This institutional review board-approved, retrospective study evaluated vitamin D levels of patients obtained from Mcleod Cancer and Blood Center. Vitamin D levels were collected over a 2-year period and classified as deficient (<20 ng/mL), insufficient (20 - 30 ng/mL), or replete (>30 ng/mL). Data were then stratified based on patient characteristics (age, gender, body mass index (BMI), race, seasons, and place of residence) and compounds of vitamin D (D2 and D3). Results: There were 2011 individuals included, with only 44.3% having replete levels and 21.4% with levels less than 20 ng/mL. Females with vitamin D deficiency are more likely to have levels below 20 ng/ml compared to males (18.6% vs. 23%, respectively, p = 0.003). Regarding BMI, the highest levels were reported in normal weight and overweight. With regards to age, advanced age (≥70) was associated with the highest levels and most replete patients. Winter months were associated with the lowest levels of vitamin D. Higher vitamin D levels were found in individuals over 70 years, normal weight and overweight category. Conclusion: Testing vitamin D levels in high-risk groups becomes of utmost importance in areas with longer winter months, obese and underweight patients. Vitamin D levels should be routinely tested and treated in vulnerable populations.

SARS-CoV-2 Infection Is Associated with Vitamin D Deficiency in Côte d’Ivoire

In 2019, the coronavirus pandemic broke out as a serious public health issue worldwide. In Côte d’Ivoire, the number of cases of COVID-19 has increased rapidly. The Severe Acute Respiratory Syndrome virus (SARS-CoV-2) binds to angiotensin converting enzyme 2 (ACE2) receptors in the respiratory tracts and enters the respiratory and alveolar cells of infected patients. Deficiency of fat-soluble vitamin D3 is associated with respiratory distress syndrome and pulmonary fibrosis by activation of the renin-angiotensin system. In Côte d’Ivoire, very little research is being done on SARS-CoV-2 and vitamin D. The objective of this study was to assess the vitamin D status of people infected and suffering from COVID-19 in order to contribute to their medical treatment. The study involved 100 adults infected with SARS-CoV-2 (24 women and 76 men). After confirmation of the patient’s SARS-CoV-2 status by RT-PCR, the 25 (OH) vitamin D assay was performed on the Cobas 6000 device and compared to control subjects, the non-COVID-19 positive. A significant decrease in 25-hydroxy vitamin D3 concentrations (44 ± 1.29 nmole/L) was observed in patients infected with SARS-CoV-2, compared to control (78 ± 0.68 nmole/L) (p < 0.0001). The 25-hydroxy vitamin D3 deficiency requires vitamin D supplementation in the management of hospitalized patients infected with SARS-CoV-2.

Vitamin D Deficiency and Its Relationship with Child-Pugh Class in Patients with Chronic Liver Disease

Background and Aims:Skeletal manifestation in liver dis-eases represents the minimally scrutinized part of the disease spectrum.Vitamin D deficiency has a central role in developing hepatic osteodystrophy in patients with chronic liver disease.This study aimed to investigate vitamin D levels and their relationship with disease advancement in these patients.Methods:Vitamin D levels were checked in 125 chronic liver disease patients.The patients were classified in three stages according to Child-Pugh score:A,B and C.The relationship of vitamin D levels with Child-Pugh score and other variables in the study was assessed by the contingency coefficient.Correlation and logistic regression analyses were also carried out to find additional predictors of low vitamin D levels.Results:Among the patients,88%had either insufficient or deficient stores of vitamin D,while only 12%had sufficient vitamin D levels(p>0.05).Vitamin D levels were notably related to Child-Pugh class(contingency coefficient=0.5,p<0.05).On univariate and multinomial regression analyses,age,female sex,MELD and Child-Pugh class were predictors of low vitamin D levels.Age,model of end-stage liver disease score and Child-Pugh score were negatively correlated to vitamin D levels(p<0.05).Conclusions:Vitamin D deficiency is notably re-lated to age,female sex and model of end-stage liver disease score,in addition to Child-Pugh class of liver cirrhosis.Vita-min D levels should be routinely checked in patients with ad-vanced liver cirrhosis(Child-Pugh class B and C)and this deficiency must be addressed in a timely manner to improve general well-being of cirrhotic patients.

Association of vitamin D receptor gene polymorphism(VDR)with vitamin D deficiency,metabolic and inflammatory markers in Egyptian obese women

Vitamin D deficiency might contribute to the pathogenesis of metabolic syndrome and could cause immune disturbance.The aim of this study is to analyze the associations between Vitamin D receptor(VDR)gene polymorphism,serum 25-hydroxy vitamin D,metabolic and inflammatory biomarkers in Egyptian obese women.The study included 201 obese women with vitamin D deficiency and 249 obese matched age healthy controls with sufficient vitamin D levels.Their age ranged between 25 and 35 years.Inflammatory biomarkers(interleukin-6 and C-reactive protein)and serum 25(OH)D were measured by enzyme-linked immunosorbent assay.Insulin resistance(IR)was determined by the homeostasis model assessment of insulin resistance(HOMA-IR).Vitamin D receptor(VDR)gene polymorphisms of FokI,ApaI,and TaqI were studied by PCR using the restriction fragment length polymorphism(RFLP)technique.Obese women with vitamin D deficiency had significant higher values of inflammatory and metabolic parameters compared to controls.Multivariable-logistic regression showed associations between 25(OH)D deficiency and metabolic components when comparing cases with controls.Moreover,cases carrying polymorphic alleles showed significant lower levels of serum 25(OH)D and higher HOMA-IR,blood pressure levels and lipid parameters compared to those with the wild type homozygote in obese cases with vitamin D deficiency.Vitamin D deficiency in Egyptian obese women with vitamin D deficiency is associated with abnormal metabolic components and abnormal inflammatory biomarkers.Moreover,VDR polymorphisms play important role in immune and inflammation status.

Identification and Evaluation of Vitamin D Levels in Urban Children & Adolescents in Dhaka City, Bangladesh through a Cross Sectional Study

Background: Vitamin D plays a pivotal role in supporting the immune system, helping to reduce the risk of infections and certain autoimmune diseases. Adequate vitamin D levels may be associated with a reduced risk of certain health conditions like pre-eclampsia, gestational diabetes, and postpartum depression. Brittle bones, osteoporosis in the elderly, and osteomalacia in young children are all symptoms of vitamin D insufficiency. Additionally, it contributes to problems linked to gum disease, including an increase in dental cavities, alveolar bone loss around the teeth, and other problems. It could lead to depression, tiredness, and a loss of appetite. In this study, urban children and adolescents in Dhaka city, Bangladesh are examined for vitamin D deficiency, insufficiency, and sufficiency. Methods: The Study was a cross-sectional study conducted under Dhaka National Medical College and Hospital, Dhaka and additionally included two other health centers Medinova Medical Services and Monoara General Hospital Service Golap bag, Dhaka from October 2020 to November 2021. The study location was at the 3 (Three) different hospitals which was located in Dhaka City. In this cross-sectional study, Participants will be selected purposively and conveniently based on the age categories from 0 - 19 years of age at the outdoor department of the hospital. The study included the secondary dataset of ambulatory individuals who came to the 3 (three) hospitals, randomly to evaluate serum vitamin D levels on referral from a general out-patient-department (OPD). They were examined for laboratory findings of serum 25 hydroxyvitamin D levels to determine vitamin D deficiency, insufficiency, and sufficiency among children and adolescent groups of both male and female Sex. Results: A total of 6394 individuals with a diverse age group were statistically examined for laboratory findings of serum vitamin D levels. Vitamin D deficiency was observed in 40.58% of individuals with a mean log of 1.01 ± 0.18 ng/ml serum vitamin D levels, vitamin D insufficiency in 30.93% of individuals with a mean log of 1.38 ± 0.05 ng/ml serum vitamin D levels and vitamin D sufficiency in 19.49% individuals with a mean log of 1.63 ± 0.12 ng/ml serum vitamin D levels. The highest percentage of individuals deficient in vitamin D were children and adolescents of age ranging between 15 to 19 years. Conclusion: The findings of vitamin D deficiency in children and adolescents direct higher authorities in the public health sector to take immediate steps to screen, intervene and educate high-risk populations incorporating vitamin D supplements to establish preventive and therapeutic measures.

The Effect of the Paleo Diet on People Suffering from Osteoporosis (Review Paper)

Osteoporosis is a disease that decreases bone mass and increases bone porosity, weakening bones. The Paleo diet is an eating plan that imitates the dietary patterns of the Stone Age. It excludes grains, dairy, and processed foods and emphasizes feeding on lean meats, fruits, vegetables, and nuts. Consumption of the Paleo diet has many positive sides, such as high protein intake and weight loss. Still, excluding dairy products risks calcium and vitamin D deficiencies, which are crucial for bone health. Statistics and simulations that have explored the relationship between the Paleo diet and bone health (especially for people suffering from low bone density) show mixed outcomes on bone health.). While the consumer does get lots of benefits from fruit and vegetable intake in a large sum due to them containing nutrients like magnesium, potassium, and vitamin K (which are also necessary for bone health), the lack of dairy products (gives the maximum amount of calcium and vitamin D) raises concerns about maintaining adequate bone mineral density (BMD). More information on this topic shows the negative impact of this diet on people suffering from osteoporosis due to a lack of nutrient intake that nourishes the bone. Although the Paleo diet can enhance overall health through nutrient-dense foods and reduced processed intake, it can’t be said the same for people suffering from osteoporosis.

Fitting logistic regression models to assess vitamin D deficiency with clinical parameters in chronic hepatitis B patients

Statistical models provide a quantitative structure with which clinicians can evaluate their hypotheses to explain patterns in observed data and generate forecasts.In contrast,vitamin D is an important immune modulator that plays an emerging role in liver diseases such as chronic hepatitis B(CHB).Therefore,we quantified 25(OH)D_(3) serum levels in 292 CHB patients tested for their association with clinical parameters.Of 292 patients,69(63%),95(47%),and 39(19%)had severe vitamin D deficiency(25(OH)D_(3)<10 ng/mL),vitamin D insufficiency(25(OH)D_(3)10 and<20 ng/mL),or adequate vitamin D serum levels(25(OH)D_(3)20 ng/mL),respectively.In both univariate and multivariate analyses,zinc serum level was a strong predictor of low 25(OH)D_(3) serum levels(P<0.001).Results of fitted models showed that lower vitamin D levels were significantly associated with:younger age,lower uric acid levels,HBeAg-positive status,lower calcium levels(p<0.05).Vitamin D deficiency(<20 ng/ml)or severe deficiency(<10 ng/ml)was observed more frequently among HBV patients(52%).Vitamin D deficiency was observed in most CHB patients.Generally,our results recommend that substitution of vitamin D can be a substitution method in the treatment of patients with HBV-associated disorders.

The presence of primary sclerosing cholangitis in patients with ileal pouch anal-anastomosis is associated with an additional risk for vitamin D deficiency

Objective:Vitamin D deficiency is common in patients with ileal pouch-anal anastomosis(IPAA)for ulcerative colitis(UC).Whether vitamin D levels are further lowered in patients with concomitant IPAA and primary sclerosing cholangitis(PSC)is not known.The aim of this study was to evaluate the presence of PSC as a risk factor for vitamin D deficiency in patients with UC and IPAA.Methods:In this case control study,74 patients with concurrent IPAA and PSC were included in the study group,and 79 patients with IPAA,but without PSC,served as controls.Forty-four variables were analyzed.Univariate analysis and multivariate analysis with stepwise logistic regression were performed.Results:A total 153 eligible patients were included,with 74(48.4%)in the study group and 79(51.6%)in the control group.Vitamin D level in the study group was 18.961.4 ng/dL compared with 30.361.7 ng/d in the control group(P=0.011).Vitamin D deficiency(≤20 ng/dL)was present in 65(42.5%)patients.PSC occurred in 49(75.4%)of the 65 patients with vitamin D deficiency.In the multivariate analysis,only the presence of PSC(odds ratio[OR]:7.56;95% confidence interval[CI]:2.39–24.08;P=0.001)and vitamin D supplementation(OR:2.58;95% CI:1.57–9.19;P=0.018)remained associated with vitamin D deficiency.Conclusion:The presence of PSC was found to be an independent risk factor for vitamin D deficiency in UC patients with IPAA.These patients should be routinely screened and closely monitored for vitamin D deficiency.

Effect of replenishment of vitamin D on survival in patients with decompensated liver cirrhosis:A prospective study

To assess the vitamin D (VD) deficiency as a prognostic factor and effect of replenishment of VD on mortality in decompensated cirrhosis. METHODSPatients with decompensated liver cirrhosis were screened for serum VD levels. A total of 101 VD deficient patients (< 20 ng/mL) were randomly enrolled in two groups: Treatment group (n = 51) and control group (n = 50). Treatment group received VD treatment in the form of intramuscular cholecalciferol 300000 IU as loading dose and 800 IU/d oral as maintenance dose along with 1000 mg oral calcium supplementation. The VD level, clinical parameters and survival of both the groups were compared for 6-mo. RESULTSPrevalence of vitamin D deficiency (VDD) in decompensated CLD was 84.31%. The mean (SD) age of the patients in the treatment group (M:F: 40:11) and control group (M:F: 37:13) were 46.2 (± 14.93) years and 43.28 (± 12.53) years, respectively. Baseline mean (CI) VD (ng/mL) in control group and treatment group were 9.15 (8.35-9.94) and 9.65 (8.63-10.7), respectively. Mean (CI) serum VD level (ng/mL) at 6-mo in control group and treatment group were 9.02 (6.88-11.17) and 29 (23-35), respectively. Over the period of time the VD, calcium and phosphorus level was improved in treatment group compared to control group. There was non-significant trend seen in greater survival (69% vs 64%; P > 0.05) and longer survival (155 d vs 141 d; P > 0.05) in treatment group compared to control group. VD level had no significant association with mortality (P > 0.05). In multivariate analysis, treatment with VD supplement was found significantly (P < 0.05; adjusted hazard ratio: 0.48) associated with survival of the patients over 6-mo. CONCLUSIONVD deficiency is very common in patients of decompensated CLD. Replenishment of VD may improve survival in patients with decompensated liver cirrhosis.

Impact of vitamin D on the hospitalization rate of Crohn's disease patients seen at a tertiary care center

AIM To study the association between vitamin D level and hospitalization rate in Crohn's disease(CD) patients.METHODS We designed a retrospective cohort study using adult patients(> 19 years) with CD followed for at least one year at our inflammatory bowel disease center. Vitamin D levels were divided into: low mean vitamin D level(< 30 ng/m L) vs appropriate mean vitamin D level(30-100 ng/m L). Generalized Poisson Regression Models(GPR) for Rate Data were used to estimate partially adjusted and fully adjusted incidence rate ratios(IRR) of hospitalization among CD patients. We also examined IRRs for vitamin D level as a continuous variable.RESULTS Of the 880 CD patients, 196 patients with vitamin D level during the observation period were included. Partially adjusted model demonstrated that CD patients with a low mean vitamin D level were almost twice more likely to be admitted(IRR = 1.76, 95%CI: 1.38-2.24) compared to those with an appropriate vitamin D level. The fully adjusted model confirmed this association(IRR = 1.44, 95%CI: 1.11-1.87). Partially adjusted model with vitamin D level as a continuous variable demonstrated,higher mean vitamin D level was associated with a 3% lower likelihood of admission with every unit(ng/m L) rise in mean vitamin D level(IRR = 0.97, 95%CI: 0.96-0.98). The fully adjusted model confirmed this association(IRR = 0.98, 95%CI: 0.97-0.99). CONCLUSION Normal or adequate vitamin D stores may be protective in the clinical course of CD. However, this role needs to be further characterized and understood.

Determination of vitamin D and analysis of risk factors for osteoporosis in patients with chronic pain

BACKGROUND Vitamin D deficiency is common in patients with chronic pain and healthy people,but the difference between the two has not been reported;thus,whether there is a relationship between vitamin D deficiency and chronic pain remains to be confirmed.Osteoporosis is a common disease in chronic pain disorders.Understanding the relationship between vitamin D and osteoporosis will provide a basis for the rational supplementation of vitamin D to prevent osteoporosis,and to understand the risk factors of bone mass change to provide a new treatment plan for early prevention of osteoporosis.AIM To determine 25 hydroxy vitamin D(25OHD)level in patients with chronic pain to clarify its clinical significance.The relationship between vitamin D and bone mineral density(BMD)and the risk factors for bone mass change were also evaluated.METHODS In this study,184 patients with chronic pain were included in the study group,and 104 healthy individuals who underwent routine health checkups during the same period were included in the control group.25OHD level was detected in both groups by enzyme-linked immunosorbent assay.According to the BMD test results,the patients in the study group were further classified into three subgroups:Normal BMD group,reduced BMD group,and osteoporosis group.Age,sex,ethnicity,living altitude,body mass index,25OHD level,parathyroid hormone(PTH),calcium(Ca)and phosphorus levels were analyzed statistically in both groups.RESULTS The vitamin D level in the study group was lower than that in the control group at 53.8%vs 57.7%,with no significant difference between the two groups.The proportion of patients with severe vitamin D deficiency in the study group was higher than that in the control group.The mean age was greater in the osteoporosis subgroup,and the youngest in the normal BMD subgroup.Vitamin D level in the osteoporosis subgroup was lower than that in the other two subgroups,and was not specific for the diagnosis of bone mass reduction and osteoporosis.The above results were analyzed statistically and showed significant differences(P<0.05).There was a positive correlation between age and BMD in patients with chronic pain(R=0.567,P<0.001).Age,PTH and Ca were risk factors for bone mass reduction,while age,ethnicity and altitude were risk factors for osteoporosis.CONCLUSION Vitamin D deficiency is a common phenomenon in patients with chronic pain,and severe vitamin D deficiency is not uncommon.Vitamin D level is not a risk factor for bone mass reduction and osteoporosis.Bone mass reduction is correlated with age,PTH and Ca,while osteoporosis is correlated with age,ethnicity and altitude.