Could vitamin D concentration be a marker of a long hospital stay in older adults patients?

Background and aims: Vitamin D plays a pleiotropic role in the human body. Some studies have suggested that hypovitaminosis D may serve as a marker of comorbidity severity and length of hospital stay. Hospitalized older adults patients with a higher comorbidity burden tend to have lower vitamin D status, which negatively impacts the length of their hospital stay. Vitamin D deficiency has been identified as a significant risk factor for a prolonged hospital stay. This study aimed to investigate the link between vitamin D status and prolonged hospital stays, focusing on geriatric patients, and to assess the variation in hospitalization duration among geriatric patients with different vitamin D statuses. Methods: The study sample comprised of 422 patients aged over 60 years admitted to the geriatric department. Blood samples were collected in the morning on the day of admission. According to the diagnostic threshold defining serum 25(OH)D concentration approved for Central Europe, patients were divided into two groups (deficiency group and suboptimal group). Patients were divided into two groups based on hospitalization duration: the first, "shorter hospitalization," included stays up to 11 days, whereas the second, "longer hospitalization," encompassed stays of 12 days and above. Results: In total, 242 Caucasian patients, primarily women (172 women and 70 men), were recruited in the study. Patients with vitamin D deficiency had extended hospital stays compared with those with vitamin D levels below 49.92 nmol/L: 10.0 (8.00-13.00) days vs. 9.00 (8.00-11.00) days, P = 0.044. Hospitalization length (in days) had a negative correlation with vitamin D blood status (nmol/L) (P = 0.0005; R = -0.2243). ROC analysis indicated that patients with vitamin D levels below 31.2 nmol/L had a 47% higher chance of extended hospitalization, whereas those with levels above 31.2 nmol/L had a 77% higher chance of avoiding it. A significant majority of patients with suboptimal 25(OH)D levels experienced shorter hospital stays (≤11 days) than those with vitamin D deficiency (64.6%), P = 0.045. Conclusion: The study findings indicate that lower serum levels of 25(OH)D in hospitalized patients within the geriatric department are linked to extended hospital stays. Vitamin D holds potential as a predictor of hospitalization duration in geriatric patients. Nonetheless, further research is imperative to account for additional factors affecting health status and hospitalization duration in older adults individuals.

Metabolic Deregulations in Patients with Polycystic Ovary Syndrome.

Polycystic ovary syndrome (PCOS) contributes to endocrine and metabolic complications for women worldwide. The aim of this study was to establish the usefulness of new anthropometric indices and atherogenic indices in the evaluation of metabolic disorders, in particular, glucose and insulin abnormalities in the profiles of women with polycystic ovary syndrome (PCOS). In the study, a total of 49 women with PCOS aged between 18 and 39 years were recruited. All patients were tested for fasting glucose and insulin, lipid parameters, oral-glucose administration, and biochemical parameters. All of them underwent anthropometric measurements, such as BMI (body mass index), WHR (waist-to-hip ratio), WHtR (waist-to-height ratio), BAI (body adiposity index), VAI (visceral adiposity index), LAP (lipid accumulation product), BRI (body roundness index), ABSI (A body shape index), AIP (atherogenic risk of plasma), AC (atherogenic coefficient), Castelli risk index-I, Castelli risk index-II and (LCI) lipoprotein combine index, TG/HDL-C ratio, METS-IR (The metabolic score of insulin resistance), triglyceride glucose index (TyG index), triglyceride glucose-body mass index (TyG-BMI index) and triglyceride glucose-waist circumference index (TyG-WC index) were calculated. The analyzed anthropometric measurements/indices and atherogenic indices demonstrated significant correlations in PCOS women. T A strong relationship was found between fasting glucose, fasting insulin, glucose after 60 min, HOMA-IR index in the patients with PCOS. There was no significant relationship between HbA1c and other analyzed parameters and indices. Most of the analyzed anthropometric and atherogenic indices may be useful tools in evaluating metabolic disorders, and, in particular, glucose and insulin abnormalities in PCOS women.

Fetuin-A and Its Association with Anthropometric, Atherogenic, and Biochemical Parameters and Indices among Women with Polycystic Ovary Syndrome.

BACKGROUND: Polycystic ovary syndrome (PCOS) contributes to metabolic and endocrine complications for women of reproductive age. We set out to assess the relationship between fetuin-A and anthropometric parameters, anthropometric indices, body composition, and atherogenic indices, as well as carbohydrate and lipid profile in women with polycystic ovary syndrome (PCOS). METHODS: The study included 49 women with PCOS, aged between 18 and 39 years. All patients were tested for fetuin-A, fasting glucose and insulin, and lipid parameters, after oral-glucose administration were done. All of them underwent anthropometric measurements and body composition analyses such as BMI (Body Mass Index), WHR (Waist to Hip Ratio), WHtR (Waist to Height Ratio), BAI (Body Adiposity Index), VAI (Visceral Adiposity Index), LAP (Lipid Accumulation Product), BRI (Body Roundness Index), ABSI (A Body Shape Index), ABSI z-core (ABSI with added mortality risk in correlation with age and gender), AIP (Atherogenic Risk of Plasma), AC (Atherogenic Coefficient), Castelli risk index-I, and Castelli risk index-II. RESULTS: Obesity was diagnosed in 18 patients (36.7%) based on BMI index and 7 patients (14.3%) based on BAI index. Significantly increased risk of metabolic complications was observed among 26 patients (53.1%) based on waist circumferences. Based on VAI index, risk of metabolic disease was observed among 17 women (34.7%). Dyslipidemia such as hypercholesterolemia, hypertriglyceridemia, and mixed hyperlipidemia was detected among 14 patients (28.6%), and insulin resistance was observed among 29 (59.2%). There was a positive correlation between fetuin-A and total cholesterol (r = 0.30, p = 0.0034). There was no statistically significant correlation between fetuin-A and all of the anthropometric measurements and anthropometric indices, atherogenic indices, and other biochemical parameters. CONCLUSION: Fetuin-A correlates with hypercholesterolemia. It is necessary to conduct further research regarding the relationship between fetuin-A concentrations and body composition, anthropometric indices, and metabolic disorders in women with PCOS. Surprisingly, the effects of concentration of fetuin-A and anthropometric indices (BAI, VAI, LAP, ABSI, ABSI z-core) in woman with PCOS have not been closely examined. Future studies that take these variables into account will need to be undertaken. More information on the relationship between fetuin-A concentrations and anthropometric indices would aid us in establishing a greater degree of accuracy on this matter.

Diet, Probiotics and Their Impact on the Gut Microbiota during the COVID-19 Pandemic.

SARS-CoV-2 infection is associated with diverse clinical manifestations, immune dysfunction, and gut microbiota alterations. The nutritional and biochemical quality of one's diet can influence the intestinal microbiota, which may play a role in the defense mechanisms against potential pathogens, by promoting a wide variety of immune-host interactions. In the COVID-19 pandemic, besides the development of pharmacological therapies, a healthy balanced diet, rich with food-derived antioxidants, may be a useful strategy. Many studies demonstrated that vitamins and probiotic therapies have positive effects on the treatment and prevention of oxidative stress and inflammation in COVID-19. The ecology of the gut microbiota in the digestive tract has been linked to the transport function of the host receptor known as angiotensin converting enzyme 2 (ACE2), suggesting that COVID-19 may be related to the gut microbiota. The angiotensin converting enzyme (ACE), and its receptor (ACE2), play central roles in modulating the renin-angiotensin system (RAS). In addition, ACE2 has functions that act independently of the RAS. ACE2 is the receptor for the SARS coronavirus, and ACE2 is essential for the expression of neutral amino acid transporters in the gut. In this context, ACE2 modulates innate immunity and influences the composition of the gut microbiota. Malnutrition is one of the leading underlying causes of morbidity and mortality worldwide and, including comorbidities, may be a major cause of worse outcomes and higher mortality among COVID-19 patients. This paper reviews the research on dietary components, with particular emphasis on vitamins, antioxidants, and probiotic therapies, and their impacts on the intestinal microbiota's diversity during the SARS-CoV-2 pandemic.

Microbiota and Its Impact on the Immune System in COVID-19-A Narrative Review.

The microbiota is of interest for the development of a therapeutic strategy against SARS-CoV-2 coronavirus disease 2019 (COVID-19) due to its impact on the host immune system. Proven communications of the gut microbiota with the pulmonary microbiota (gut-lung axis) and the pathway of neural connections between the gut and brain (gut-brain axis) may be important in the face of the pandemic. SARS-CoV-2 was shown to affect almost all organs because of the presence of a host receptor known as angiotensin converting enzyme 2 (ACE2). The ACE2 receptor is mainly present in the brush border of intestinal enterocytes, ciliary cells, and type II alveolar epithelial cells in the lungs. The transport function of ACE2 has been linked to the ecology of gut microbes in the digestive tract, suggesting that COVID-19 may be related to the gut microbiota. The severity of COVID-19 may be associated with a number of comorbidities, such as hypertension, diabetes, obesity, and/or old age; therefore, attention is also paid to multiple morbidities and the modulation of microbiota through comorbidities and medications. This paper reviews the research in the context of the state of the intestinal microbiota and its impact on the cells of the immune system during the SARS-CoV-2 pandemic.

Curcumin in Metabolic Health and Disease.

In recent years, epidemiological studies have suggested that metabolic disorders are nutritionally dependent. A healthy diet that is rich in polyphenols may be beneficial in the treatment of metabolic diseases such as polycystic ovary syndrome, metabolic syndrome, non-alcoholic fatty liver disease, cardiovascular disease, and, in particular, atherosclerosis. Curcumin is a polyphenol found in turmeric and has been reported to have antioxidant, anti-inflammatory, hepatoprotective, anti-atherosclerotic, and antidiabetic properties, among others. This review summarizes the influence of supplementation with curcumin on metabolic parameters in selected metabolic disorders.

Curcumin and Its Potential Impact on Microbiota.

Curcumin is one of the most frequently researched herbal substances; however, it has been reported to have a poor bioavailability and fast metabolism, which has led to doubts about its effectiveness. Curcumin has antioxidant and anti-inflammatory effects, and has demonstrated favorable health effects. Nevertheless, well-reported in vivo pharmacological activities of curcumin are limited by its poor solubility, bioavailability, and pharmacokinetic profile. The bidirectional interactions between curcumin and gut microbiota play key roles in understanding the ambiguity between the bioavailability and biological activity of curcumin, including its wider health impact.