Vitamin D status in Mexican women at reproductive age, Ensanut 2018-19 / Estado de vitamina D en mujeres en edad reproductiva, Ensanut 2018-19

Abstract Objective: To describe the prevalence of deficiency (VDD) and insufficiency (VDI) of vitamin D (VD), by sociodemographic factors, obesity and physical activity in a probabilistic sample of Mexican women participating in Ensanut 2018-19. Materials and methods: In 1 262 women aged 20 to 49 years, the prevalence of VDD/IVD was estimated and the factors associated with it were evaluated with a multinomial regression model. Results: The prevalence of VDI was 46.1% and of VDD was 31.6%. The probability of presenting VDI and VDD was higher for residents of urban areas, in tertiles 2 and 3 of socioeconomic status, and with obesity, while was lower in women with moderate physical activity. Conclusión: The prevalence of vitamin D in Mexican women continues to be a public health problem in Mexico despite the high availability of sunlight in the country. It is necessary to promote healthy sun exposure in the population and consider fortifying foods with vitamin D.

Resumen Objetivo: Describir la prevalencia de deficiencia (VDD) e insuficiencia (VDI) de vitamina D (VD) por factores sociodemográficos, obesidad y actividad física, en una muestra probabilística de mujeres mexicanas participantes de la Encuesta Nacional de Salud y Nutrición 2018-19. Material y métodos: En 1 262 mujeres se estimó la prevalencia de VDD y VDI y se evaluaron los factores asociados con ellas con un modelo de regresión multinomial. Resultados: La prevalencia de VDI fue de 46.1% y de VDD fue 31.6%. La probabilidad de presentar VDI y VDD fue mayor en residentes de áreas urbanas, en terciles más altos de nivel socioeconómico y con obesidad, mientras que fue menor en mujeres con actividad física moderada. Conclusión: La prevalencia de VDI y VDD en mujeres mexicanas continúa siendo un problema de salud pública en México a pesar de la alta disponibilidad de luz solar en el país. Es necesario fomentar en la población una saludable exposición solar y considerar la fortificación de alimentos con vitamina D.

Prevalence of vitamin D deficiency in exclusively breastfed infants at a tertiary healthcare facility in Nairobi, Kenya.

OBJECTIVE: To determine the prevalence of vitamin D deficiency (VDD) in exclusively breastfed infants at the Aga Khan University Hospital Nairobi, Kenya (AKUHN). The relationships between 25-hydroxyvitamin D; 25OHD, parathyroid hormone (PTH), maternal vitamin D supplementation, and sunlight exposure were also determined. METHODS: Blood from 98 infants was assayed for 25OHD, calcium, phosphate, and PTH. Socio-demographic and clinical characteristics were analyzed using descriptive statistics and inferential analysis (p < 0.05). RESULTS: The prevalence of VDD (25OHD <12 ng/mL), vitamin D insufficiency (VDI, 25OHD 12-20 ng/mL) and vitamin D sufficiency (VDS, 25OHD >20 ng/mL) was 11.2% (95% CI 8.0%-14.4%), 12.2% (95% CI 8.9%-15.5%), and 76.5% (95% CI 72.3%-80.8%) respectively. There was no difference in the mean age, head circumference, length, or weight of infants in VDD, VDI, and VDS groups. PTH was elevated when 25OHD was <12 ng/mL and normal when 25OHD was between 12-20 ng/mL. 25OHD and PTH were normal in infants whose mothers received vitamin D supplements. Infants who received <30 minutes/day of exposure to sunlight were 5 times more likely to have VDI than infants who received ≥30 minutes/day (p = 0.042). CONCLUSION: The prevalence of VDD in exclusively breastfed infants at AKUHN is low. The current national policy that recommends exclusive breastfeeding of infants in the first 6 months of life appears to be effective in staving off vitamin D deficiency but those infants with < 30 minutes sunlight exposure may benefit from low dose supplemental vitamin D during times of low sunlight exposure.

Prevalence of vitamin D deficiency in exclusively breastfed infants at a tertiary healthcare facility in Nairobi, Kenya

ABSTRACT Objective: To determine the prevalence of vitamin D deficiency (VDD) in exclusively breastfed infants at the Aga Khan University Hospital Nairobi, Kenya (AKUHN). The relationships between 25-hydroxyvitamin D; 25OHD, parathyroid hormone (PTH), maternal vitamin D supplementation, and sunlight exposure were also determined. Subjects and methods: Blood from 98 infants was assayed for 25OHD, calcium, phosphate, and PTH. Socio-demographic and clinical characteristics were analyzed using descriptive statistics and inferential analysis (p < 0.05). Results: The prevalence of VDD (25OHD <12 ng/mL), vitamin D insufficiency (VDI, 25OHD 12-20 ng/mL) and vitamin D sufficiency (VDS, 25OHD >20 ng/mL) was 11.2% (95% CI 8.0%-14.4%), 12.2% (95% CI 8.9%-15.5%), and 76.5% (95% CI 72.3%-80.8%) respectively. There was no difference in the mean age, head circumference, length, or weight of infants in VDD, VDI, and VDS groups. PTH was elevated when 25OHD was <12 ng/mL and normal when 25OHD was between 12-20 ng/mL. 25OHD and PTH were normal in infants whose mothers received vitamin D supplements. Infants who received <30 minutes/day of exposure to sunlight were 5 times more likely to have VDI than infants who received ≥30 minutes/day (p = 0.042). Conclusions: The prevalence of VDD in exclusively breastfed infants at AKUHN is low. The current national policy that recommends exclusive breastfeeding of infants in the first 6 months of life appears to be effective in staving off vitamin D deficiency but those infants with < 30 minutes sunlight exposure may benefit from low dose supplemental vitamin D during times of low sunlight exposure.

The prevalence rate of vitamin D insufficiency in a random sample of individuals visiting the orthopedic unit in Al-Diwanyah Teaching Hospital, Iraq

Vitamin d deficiency state is a global public health issue that has been linked in addition to bone problems to a number of disordes affecting the cardiovascular syste, the development of neoplastic disords and autoimmune diseases. However, the prevalence rate of vitamin D deficiency in daily clinical practice in our province in the Mid-Euphrates region of Iraq is poorly defined. The current study was planned and conducted, taking into consideration the aim of estimating a hospital base prevalence rate of vitamin D and relate vitamin D insufficiency state to a number of demographic factors. The current crosssectionalk study was carried out in the orthopedic unit at Al-Diwaniyah Teaching Hospital, Mid Euphrates rgion, Iraq. The study included a random sample of 141 individuals from the pool of patientes daily visiting the orthopedic unit. The study started in January 2018 and ended on June 2019. Serum estimation of vitamin D was carried out to all particpants in addition to the inclusion of the fowling variables in the questionnaire form: age gender, residency, occupation, education level, and economic status. The results of the current study revealed that the serum level of vitamin D ranged from 4.80 to 70.00 ng/dl and it averaged 18.57±11.59 ng/dl; its median and inter-quartile range level was 15.83 (14.40) ng/dl. According to a cutoffvalue of < 20 ng/dl defining the vitamin D deficiency status according to some literature, the prevalence rate was 64.5%. Whereas, considering the cutoff value to be < 30 ng/dl, the prevalence rate of vitamin deficiency was 87.9%. Serum vitain D level was not significantly correlated to any of the demographic characteristics included in the study. In view of the available data from the current study and previous reports, vitamin D deficiency is a common health issue in daily clinical practice and strategies ust be adipted by our health institutes to overcome this health problem and associated disorders (AU)

Vitamin D Insufficiency and Asthma in a US Nationwide Study.

BACKGROUND: Vitamin D insufficiency (a serum 25-hydroxy vitamin D level of <30 ng/mL) has been associated with asthma morbidity. OBJECTIVE: To examine vitamin D insufficiency, asthma, and lung function among US children and adults. METHODS: Using data from the National Health and Nutrition Examination Survey from 2001 to 2010, we examined vitamin D insufficiency and (1) current asthma or wheeze in 10,860 children (6-17 years) and 24,115 adults (18-79 years) and (2) lung function in a subset of participants. Logistic or linear regression was used for the multivariable analysis, adjusting for age, sex, race/ethnicity, income, body mass index, smoking, and C-reactive protein level. RESULTS: Vitamin D insufficiency was associated with current asthma (odds ratio, 1.35; 95% CI, 1.11-1.64) and current wheeze in children, as well as with current wheeze in adults (odds ratio, 1.17; 95% CI, 1.04-1.31). After stratifying the analysis by race/ethnicity and (in adults) current smoking, vitamin D insufficiency was associated with current asthma and wheeze in non-Hispanic white children only; in adults, vitamin D insufficiency was associated with current wheeze in non-Hispanic whites and blacks. Vitamin D insufficiency was also associated with lower FEV1 and forced vital capacity in children and adults. When analyzing each National Health and Nutrition Examination Survey wave separately, vitamin D insufficiency prevalence was 72% to 76% from 2001 to 2006, and then decreased from 2007 to 2010 (64%-65%); interestingly, asthma prevalence decreased for the first time from the period 2007 to 2008 (8.2%) to the period 2009 to 2010 (7.4%). CONCLUSIONS: We show racial/ethnic-specific associations between vitamin D insufficiency and current asthma or wheeze in children and adults. Moreover, we report parallel recent decrements in the prevalence of vitamin D insufficiency and asthma.

Differences in the prevalence of vitamin D deficiency and hip fractures in nursing home residents and independently living elderly

ABSTRACT Objective To compare the prevalence of vitamin D deficiency and fracture history in nursing home residents and community-dwelling elderly subjects and to explore the association of vitamin D levels with various characteristics. Materials and methods Sixty-six nursing home residents and 139 community-dwelling elderly subjects participated. Marital status, medical history, medication including vitamin D supplements, smoking, past fractures were assessed. Weight and height were measured and body mass index calculated. Serum 25-hydroxyvitamin D (25-OHD), PTH, Ca, phosphate, creatinine and eGFR were determined. Results In the nursing home residents 25-OHD was lower (17.8 nmol/l, [9.4-28.6] vs. 36.7 nmol/l, [26.9-50], p < 0.001), PTH was higher (5.6 pmol/l, [3.9-8.9] vs. 4.7 pmol/l [3.6-5.8], P = 0.003) and 25-OHD deficiency was more prevalent (65.2% [53.7-76.7] vs. 22.3% [15.4-29.2], p < 0.001) as was elevated PTH (23% [12.8-33] vs. 5.8% [2-10], p = 0.001). 25-OHD correlated negatively with PTH (institutionalized r = -0.28, p = 0.025 and community-dwelling r = -0.36, p < 0.001). Hip fractures were reported by 8% of the residents and 2% of the independent elderly. The only predictor for hip fracture was elevated PTH (OR = 7.6 (1.5-36.9), p = 0.013). Conclusion The prevalence of vitamin D deficiency and secondary hyperparathyroidism was high in the institutionalized subjects. Hip fracture risk was associated with elevated PTH and not directly with vitamin D levels or the residency status.

Profile of oxidative stress markers is dependent on vitamin D levels in patients with chronic hepatitis C.

OBJECTIVES: Although vitamin D deficiency can change liver injury progression in patients with hepatitis C virus (HCV), the main molecular mechanisms involved are largely unknown. The first aim of this study was to evaluate the association between oxidative stress and hypovitaminosis D in patients with HCV. The second aim was to verify whether oxidative stress is involved in the molecular mechanisms related to liver injury. METHODS: The study included 147 participants: 89 controls and 58 patients with HCV (vitamin D < 30, n = 32; vitamin D > 30, n = 26). RESULTS: Patients with HCV and hypovitaminosis D presented significantly higher aminotransferase-to-platelet ratio index (APRI; P = 0.0464) and viral load (P = 0.0426) levels than patients with HCV without hypovitaminosis D. Regarding oxidative stress, HCV patients with hypovitaminosis D had higher advanced oxidation protein products (P = 0.0409), nitric oxide metabolites (P = 0.0206) levels, and oxidative stress index (P = 0.0196), whereas total radical-trapping antioxidant parameter (P = 0.0446) levels were significantly lower than HCV patients without hypovitaminosis D. Vitamin D in patients with HCV showed inverse correlations with levels of iron (r = -0.407, P = 0.0285), ferritin (r = -0.383, P = 0.0444), APRI (r = -0.453, P = 0.0154) and plasma lipid hydroperoxides levels (r = -0.426, P = 0.0189). CONCLUSION: Vitamin D insufficiency contributes to the inflammatory process and oxidative stress imbalance in patients with HCV. The profile of oxidative stress markers in these patients depends on vitamin D levels, which probably change intracellular signalling pathways and increase inflammation and liver injury.

Vitamina D: infecciones, atopia y asma / Vitamin D: infections, atopy and asthma

Data on vitamin D insufficiency are expanding to include evidence on its role in asthma, allergic disorders, and atopic dermatitis, vitamin D is now recognized as an immunomodulator. In addition epidemiologic studies have identified a link between inadequate vitamin D concentrations and infectious disease. Furthermore, their contribution in host defense against infection has been elucidated. Vitamin D plays an important role in innate and adaptive immune response. Several clinical studies exist supporting a relationship between vitamin D status and atopic dermatitis, asthma, asthma exacerbations, pulmonary function. The effect of vitamin D supplementation is still being studied and may be a promise.

La información sobre la deficiencia de vitamina D y su rol en el asma, desordenes alérgicos y dermatitis atópica, está en aumento. Además estudios epidemiológicos han identificado la relación entre concentraciones inadecuadas de vitamina D y enfermedades infecciosas. Su contribución a la inmunidad ha sido aclarada. La vitamina D juega un importante rol en la inmunidad innata y adaptativa y se le reconoce una acción inmunomoduladora. Varios estudios clínicos confirman que su status se relaciona con Dermatitis Atópica, Asma, exacerbaciones asmáticas y función pulmonar. El efecto de la suplementación con vitamina D esta aun en investigación y constituye una promesa.

Prevalência de deficiência e insuficiência de vitamina D e sua correlação com PTH, marcadores de remodelação óssea e densidade mineral óssea, em pacientes ambulatoriais / Prevalence of vitamin D deficiency and its correlation with PTH, biochemical bone turnover markers and bone mineral density, among patients from ambulatories

A deficiência de vitamina D (VD) leva ao raquitismo e à osteomalacia e sua insuficiência, caracterizada pelo hiperparatireoidismo secundário, pode resultar osteoporose. Apesar de amplamente prevalente, a insuficiência de VD ainda é pouco reconhecida e subtratada. Os autores estudaram 180 pacientes atendidos em ambulatório de endocrinologia em Belo Horizonte, que tiveram os níveis de 25(OH)VD mensurados, correlacionando-os com paratormônio (PTH), marcadores de remodelação óssea e densidade mineral óssea. Para caracterização de níveis insuficientes de VD, foram correlacionados os níveis de 25(OH)VD com os de PTH, definindo-se, nesta série, ponto de corte de 25(OH)VD de 32 ng/ml. Foi encontrada correlação inversa e significativa entre 25(OH)VD e PTH e entre 25(OH)VD e C-telopeptídeo. A prevalência de insuficiência de VD na população estudada foi de 42,4 por cento. Conclui-se que a insuficiência de VD tem alta prevalência entre pacientes que freqüentam nossos consultórios, alertando para a importância da sua investigação na prática clínica e na instituição de políticas para sua prevenção.

Consequences of VD deficiency include rickets and osteomalacia. However, marginal concentrations of 25-hydroxyvitamin D (25(OH)VD) are associated with secondary hyperparathyroidism and osteoporosis. In this context, levels of 25(OH)VD capable to elevate parathyroid hormone (PTH) could be considered as insufficient. The VD insufficiency, although widely prevalent, is still under-recognized and under-treated. The authors have studied 180 patients followed in a endocrinology clinic in Belo Horizonte, who had 25(OH)VD measured, correlating it with PTH, biochemical bone turnover markers and bone mineral density. To determine the sufficiency of VD, 25(OH)VD was correlated with PTH and the cutoff found was of 32ng/ml. CTX-1 and PTH were significantly negative correlated to 25(OH)VD and the prevalence of VD insufficiency was 42 percent. One concludes that the VD insufficiency is widely prevalent among patients who frequently come to our offices, alerting us for the importance to assess VD status more often and to practice politics for prevention of VD insufficiency.