Factors Associated with Hypovitaminosis D in People Living with HIV/AIDS (PLWHA) Followed up in Porto-Novo in 2019

Background: Vitamin D deficiency is very common among PLWHA compared to the general population and is promoted by several factors. Aim: To identify the factors associated with hypovitaminosis D in people living with HIV/AIDS (PLWHA) followed up in Porto-Novo in 2019. Methods: This was a cross-sectional, descriptive and analytical study. PLWHA who were monitored on an outpatient basis and who gave their consent were included in this work. Subjects unable to answer questions or under ongoing vitamin D supplementation or suffering from chronic liver diseases were not included. Hypovitaminosis D was defined by a blood level of 25 hydroxy-vitamin D less than 30 ng/mL. Results: A total of 270 PLWHA were included in the study. The mean age of the patients was 39.51 ± 6.85 years with a female predominance (73.3%). The frequency of hypovitaminosis D was 56%. Hypertension, low protein intake, anemia and low glomerular filtration rate were associated with vitamin D deficiency. Conclusion: Vitamin D deficiency is common among PLWHA, which justifies routine screening, especially among those at risk.

Risk Factors Predicting Hypovitaminosis D in Children in South-East Region of Bangladesh

Background: Hypovitaminosis D (serum concentration of 25(OH)D Methods: This was a cross sectional observational study having conducted at a paediatric clinic in Chittagong Metropolitan City from July, 2012 to December, 2017 including 524 children of 0 - 18 years by convenient sampling. The relevant data were assessed using standard case record form and lab parameter of 25(OH)D assay. Serum level of 25(OH)D of Results: The prevalence of Hypovitaminosis D was 50.57%. Compared with the infancy age group the odds of Hypovitaminosis D is 1.36 times more likely in >5 yrs children. The odds of association (odds ratio or OR = 0.19) of rural population with Hypovitaminosis D is lower than urban population. The formula fed children had less chance of association (OR = 0.32) of developing hypovitaminosis D in comparison to exclusively breastfed babies. Occasional Sun exposed group was 1.40 times more likely to develop hypovitaminosis D in comparison to daily sun exposure group. The odds of Hypovitaminosis D were 1.9 times more in winter season than summer season. School going children had double the chance of Hypovitaminosis D than children with no education. Subjects with high weight for age were 3.65 times increased risk of suffering from hypovitaminosis D compared with normal weight for age. Girls had a little bit more chance of hypovitaminosis D than boys. Children coming from family with monthly Income > 10,000 BDT are associated with more Hypovitaminosis D. Among clinical variables only wheeze has significant association (OR = 1.83). Conclusion: Hypovitaminosis D (<20 ng/ml) prevails significantly among Infants and children of South-East region of Bangladesh. Age, area of residence, feeding pattern, sun exposure practice, seasons, schooling pattern, weight for age have strong association with Hypovitaminosis D.

High Prevalent Hypovitaminosis D Is Associated with Dysregulation of Calcium-parathyroid Hormone-vitamin D Axis in Patients with Chronic Liver Diseases

Background and Aims:Although hypovitaminosis D is common among patients with chronic liver disease(CLD),the data are inconsistent on its prevalence and its relationship with CLD.This study aimed to estimate the prevalence of hypovitaminosis D among patients with CLD and to determine the relationship between hypovitaminosis D and severity of liver dysfunction,and calcium(Ca),phosphate(PO4)and parathyroid hormone(PTH)levels in CLD.Methods:The study included 236 CLD patients attending the Department of Hepatology,Rajiv Gandhi Government General Hospital(Chennai,India).Serum levels of 25-hydroxyvitamin D(25(OH)D),PTH,Ca,and PO4 were estimated.Severity of liver dysfunction was graded using the Child-Turcotte-Pugh(CTP)score.Results:The first report from our population showed that 162 of 236(68.6%)CLD patients had hypovitaminosis D(25(OH)D levels of<30 ng/mL),with higher frequency(124/162)76.5%among CTP B,C patients.Significant negative correlation(r=-0.288,p=0.0001)between 25(OH)D and CTP scores was noted in hypovitaminosis D conditions.Level of 25(OH)D was correlated negatively with PTH(r=-0.537,p=0.0001),positively with Ca(r=0.657,p=0.0001),and positively with PO4(r=0.477,p=0.0001)in sufficient vitamin D conditions.Conclusions:Hypovitaminosis D is associated with higher CTP scores and is strongly associated with dysregulation of the Ca-PTH-vitamin D axis in CLD.Timely measurement of vitamin D levels is essential,along with levels of PTH,Ca and PO4,to manage CLD patients.

Valproic acid therapy decreases serum 25-hydroxyvitamin D level in female infants and toddlers with epilepsy-a pilot longitudinal study

To evaluate if valproic acid(VPA)therapy is associated with vitamin D deficiency among infants and toddlers with epilepsy,a cross-sectional clinical study was conducted in 25 children with epilepsy taking VPA.Blood levels of calcium,phosphorus,alkaline phosphatase,and 25-hydroxy vitamin D[25(OH)D]and plasma VPA level were measured at 1-to 3-month intervals.At the initial and final measurements,vitamin D deficiency or insufficiency was recognized in 8(32%)and 12(42%),respectively.In girls,a decreasing trend in serum25(OH)D levels(P<0.05)was observed.Polytherapy had a significant negative effect on the longitudinal change of 25(OH)D(P<0.05)in girls.In conclusion,our study indicates that a high proportion of girls after VPA therapy had hypovitaminosis D.

Vitamin D Deficiency and Pseudofractures in Child-Bearing Egyptian Women: Successful Medical Treatment Helps to Avoid Fractures and Surgical Interference

Background: Recent evidence for the effects of vitamin D and recognition of the high prevalence of its deficiency has increased the interest in it. Vitamin D-sub nutrition may contribute to the risk of a wide range of disorders. Methods: The females in the child-bearing period attending the endocrinology and orthopedic out-patient clinics complaining of pain and/or tenderness at the groin were evaluated. Patients with chronic metabolic or skeletal illness, primary hyperparathyroidism, and patients receiving drugs that interfere with bone mineral metabolisms were excluded. One hundred accepted and consented to participation in the study. All the participants were subjected to full history taking, clinical evaluation, laboratory investigations including serum Ca, Ph, PTH, ALP, TSH, F T4, F T3, Cortisol level, and 25(OH)D level. Plain X-ray was done for the regions of bony tenderness. The subjects were divided into 2 groups based on the presence or absence of pseudo-fractures (looser zones). They were treated and followed up till normalization of the laboratory parameters and healing of the looser zones. Results: The mean age for patients was 30.45 ± 5.8, their mean 25(OH) vitamin D level was 14.7 ± 5.9 ng/ml, the mean PTH was 195.7 ± 162.6, and looser zones were evident in the X-rays of 34 patients. The serum 25(OH)D showed significant negative correlations with veiling, parity, localized hip pain, and tenderness, ALP, PTH, but, a significant positive correlation with sun exposure, dairy products consumption, vitamin D supplementation, and serum calcium levels. The independent factors associated with hypovitaminosis D were the lack of sun exposure, lack of vitamin D supplementation, and the presence of pseudo- fracture (p ≤ 0.009, 0.038, and 0.001 respectively). No surgery was required in any of our patients. Conclusions: Vitamin D deficiency is common in our region. The main risk factors are decreased sun exposure, low dairy products consumption, and lack of vitamin D supplementation. Successful medical treatment may be helpful to satisfy the patient, avoid true fracture and further major surgical treatments.