<strong>Background:</strong> 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 ...<strong>Background:</strong> 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. <strong>Study: </strong>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).<strong> Results:</strong> 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. <strong>Conclusion:</strong> 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.展开更多
Background: Pediatric patients with type 1 diabetes (T1D) have increased risk for low bone mineral density, which may be due in part to low 25-hydroxyvitamin D levels. Vitamin D levels are influenced by sunlight expos...Background: Pediatric patients with type 1 diabetes (T1D) have increased risk for low bone mineral density, which may be due in part to low 25-hydroxyvitamin D levels. Vitamin D levels are influenced by sunlight exposure and thus display geographical variation. We hypothesize that the prevalence of 25-hydroxyvitamin D deficiency (<20 ng/mL) and insufficiency (20 - 29 ng/mL) in children with T1D living in the United States is higher than in healthy children and that diabetes duration, HbA1c, and insulin dose/kg are inversely associated with 25-hydroxyvitamin D levels. Methods: Medical records of patients with T1D being followed in Tennessee were reviewed for demographics, medical information, and 25-hydroxyvitamin D levels during the previous 2 years. Control subjects were obtained from a de-identified database of healthy pediatric subjects living in a similar geographical area. Chi squared tests and multivariable linear regression were performed. Results: Children and adolescents with T1D (n = 276;median age 14 years) have a significantly higher percentage of vitamin D deficiency and insufficiency compared with healthy pediatric controls (n = 100;median age 11.2 years) (68% versus 44%;p < 0.001). The median 25-hydroxyvitamin D level is 24 ng/mL versus 31 ng/mL, respectively. After adjusting for age, race, gender, UV light exposure, BMI, and multivitamin supplementation, children and adolescents with T1D have a serum 25-hydroxyvitamin D level 6.7 ng/mL lower than the control population [CI(4.11, 9.21), p < 0.0001]. Within the T1D population, there is no clear association between diabetes?duration, HbA1c, or insulin dose/kg and 25-hydroxyvitamin D levels. Conclusions: There is an increased prevalence of 25-hydroxyvitamin D deficiency and insufficiency in US. children with T1D compared with geographically similar children without diabetes. Further research is needed to determine whether decreased serum 25-hydroxyvitamin D can be alleviated via dietary or behavioral modifications in this population.展开更多
This study explores the relationship of 25-hydroxylvitamin D blood levels in 106 randomly selected patient files with diagnosed type 2 Diabetes Mellitus (t2DM) who enrolled in a functional medicine diabetes reversal p...This study explores the relationship of 25-hydroxylvitamin D blood levels in 106 randomly selected patient files with diagnosed type 2 Diabetes Mellitus (t2DM) who enrolled in a functional medicine diabetes reversal program from a chiropractic clinic located in Annapolis, Maryland, USA. Using a conservative recommendation for normal serum 25-hydroxyvitamin D concentration of 32 ng/ml, insufficiency level of 20 - 30 ng/ml, and deficiency level < 20 ng/ml, 21% (22/106) of our population were normal, 39% (41/106) were insufficient, and alarmingly, 35% (37/106) were outright deficient. Clinically, 74% (78/ 106) of our entire sample had significantly low vitamin D levels. Ou et al. (2011) determined the optimal concentration of serum 25OHD to be 40 ng/ml in order to optimize insulin sensitivity. In our sample 100/ 106 (94%) had vitamin D levels at or below this optimal cut-off level. BMI was negatively correlated with vitamin D;that is, the greater the BMI of the patient the less their vitamin D level. Both obesity and hypovitaminosis D are each mutually exclusive predictors for t2DM. Obesity and vitamin D deficiency may work synergistically to propel an individual into the diseased state of t2DM. As this study demonstrates that the majority of people with t2DM suffer from inadequate amounts of vitamin D, vitamin D testing should be routine for all people at risk for t2DM, prediabetics and those currently suffering with t2DM in order to elevate levels sufficiently to improve insulin sensitivity and improve long-term outcomes.展开更多
目的分析3例严重维生素D缺乏继发甲状旁腺功能亢进症患者的临床特点及治疗策略。方法收集确诊为维生素D缺乏继发甲状旁腺功能亢进患者3例,对其进行详细的病史采集和体格检查,生物化学指标测定及影像学检查。结果患者1、2起病隐匿,临床...目的分析3例严重维生素D缺乏继发甲状旁腺功能亢进症患者的临床特点及治疗策略。方法收集确诊为维生素D缺乏继发甲状旁腺功能亢进患者3例,对其进行详细的病史采集和体格检查,生物化学指标测定及影像学检查。结果患者1、2起病隐匿,临床症状不典型;患者3有长期双下肢乏力,全身疼痛,进行性加重的活动障碍及身高变矮。实验室检查结果:血25羟维生素D (25 hydroxyvitamin D,25OHD)低于检测值下限(<8. 0μg/L),甲状旁腺素(parathyroid hormone,PTH)水平升高,碱性磷酸酶(alkaline phosohatase,ALP)及Ⅰ型胶原C端肽(C-terminal telopeptide of type 1 collagen,β-CTX)升高。双能X线吸收检测仪(dual energy X-ray absorptiometry,DXA)检测骨密度,提示骨密度显著降低。给予维生素D联合钙剂治疗3个月后,患者临床症状好转,随着25OHD水平升高,血PTH及骨转换标志物水平均下降,骨密度检查可见骨量增加。结论维生素D缺乏在人群中普遍存在,由于早期缺乏临床症状易被忽视,但当其引起继发性甲状旁腺功能亢进时,会对骨骼产生严重影响,导致骨转换增加,骨量流失加快,摔倒及骨折风险增加等。因此,应重视维生素D缺乏的早期防治,避免发生继发性甲状旁腺功能亢进。展开更多
文摘<strong>Background:</strong> 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. <strong>Study: </strong>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).<strong> Results:</strong> 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. <strong>Conclusion:</strong> 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.
文摘Background: Pediatric patients with type 1 diabetes (T1D) have increased risk for low bone mineral density, which may be due in part to low 25-hydroxyvitamin D levels. Vitamin D levels are influenced by sunlight exposure and thus display geographical variation. We hypothesize that the prevalence of 25-hydroxyvitamin D deficiency (<20 ng/mL) and insufficiency (20 - 29 ng/mL) in children with T1D living in the United States is higher than in healthy children and that diabetes duration, HbA1c, and insulin dose/kg are inversely associated with 25-hydroxyvitamin D levels. Methods: Medical records of patients with T1D being followed in Tennessee were reviewed for demographics, medical information, and 25-hydroxyvitamin D levels during the previous 2 years. Control subjects were obtained from a de-identified database of healthy pediatric subjects living in a similar geographical area. Chi squared tests and multivariable linear regression were performed. Results: Children and adolescents with T1D (n = 276;median age 14 years) have a significantly higher percentage of vitamin D deficiency and insufficiency compared with healthy pediatric controls (n = 100;median age 11.2 years) (68% versus 44%;p < 0.001). The median 25-hydroxyvitamin D level is 24 ng/mL versus 31 ng/mL, respectively. After adjusting for age, race, gender, UV light exposure, BMI, and multivitamin supplementation, children and adolescents with T1D have a serum 25-hydroxyvitamin D level 6.7 ng/mL lower than the control population [CI(4.11, 9.21), p < 0.0001]. Within the T1D population, there is no clear association between diabetes?duration, HbA1c, or insulin dose/kg and 25-hydroxyvitamin D levels. Conclusions: There is an increased prevalence of 25-hydroxyvitamin D deficiency and insufficiency in US. children with T1D compared with geographically similar children without diabetes. Further research is needed to determine whether decreased serum 25-hydroxyvitamin D can be alleviated via dietary or behavioral modifications in this population.
文摘This study explores the relationship of 25-hydroxylvitamin D blood levels in 106 randomly selected patient files with diagnosed type 2 Diabetes Mellitus (t2DM) who enrolled in a functional medicine diabetes reversal program from a chiropractic clinic located in Annapolis, Maryland, USA. Using a conservative recommendation for normal serum 25-hydroxyvitamin D concentration of 32 ng/ml, insufficiency level of 20 - 30 ng/ml, and deficiency level < 20 ng/ml, 21% (22/106) of our population were normal, 39% (41/106) were insufficient, and alarmingly, 35% (37/106) were outright deficient. Clinically, 74% (78/ 106) of our entire sample had significantly low vitamin D levels. Ou et al. (2011) determined the optimal concentration of serum 25OHD to be 40 ng/ml in order to optimize insulin sensitivity. In our sample 100/ 106 (94%) had vitamin D levels at or below this optimal cut-off level. BMI was negatively correlated with vitamin D;that is, the greater the BMI of the patient the less their vitamin D level. Both obesity and hypovitaminosis D are each mutually exclusive predictors for t2DM. Obesity and vitamin D deficiency may work synergistically to propel an individual into the diseased state of t2DM. As this study demonstrates that the majority of people with t2DM suffer from inadequate amounts of vitamin D, vitamin D testing should be routine for all people at risk for t2DM, prediabetics and those currently suffering with t2DM in order to elevate levels sufficiently to improve insulin sensitivity and improve long-term outcomes.
文摘目的分析3例严重维生素D缺乏继发甲状旁腺功能亢进症患者的临床特点及治疗策略。方法收集确诊为维生素D缺乏继发甲状旁腺功能亢进患者3例,对其进行详细的病史采集和体格检查,生物化学指标测定及影像学检查。结果患者1、2起病隐匿,临床症状不典型;患者3有长期双下肢乏力,全身疼痛,进行性加重的活动障碍及身高变矮。实验室检查结果:血25羟维生素D (25 hydroxyvitamin D,25OHD)低于检测值下限(<8. 0μg/L),甲状旁腺素(parathyroid hormone,PTH)水平升高,碱性磷酸酶(alkaline phosohatase,ALP)及Ⅰ型胶原C端肽(C-terminal telopeptide of type 1 collagen,β-CTX)升高。双能X线吸收检测仪(dual energy X-ray absorptiometry,DXA)检测骨密度,提示骨密度显著降低。给予维生素D联合钙剂治疗3个月后,患者临床症状好转,随着25OHD水平升高,血PTH及骨转换标志物水平均下降,骨密度检查可见骨量增加。结论维生素D缺乏在人群中普遍存在,由于早期缺乏临床症状易被忽视,但当其引起继发性甲状旁腺功能亢进时,会对骨骼产生严重影响,导致骨转换增加,骨量流失加快,摔倒及骨折风险增加等。因此,应重视维生素D缺乏的早期防治,避免发生继发性甲状旁腺功能亢进。
