Zinc, Magnesium and Vitamin K Supplementation in Vitamin D Deficiency: Pathophysiological Background and Implications for Clinical Practice.

Zinc, magnesium, and vitamin K are important nutrients for humans. There are various factors that contribute to the development of their deficiency, which might result in or exacerbate various diseases. These nutrients can also interact with vitamin D metabolism and activity. This review discusses the main aspects of zinc, magnesium and vitamin K metabolism and action in the body, their clinical significance, and the "crosstalk" with vitamin D, as well as providing general suggestions for clinical practice when supplementation with these nutrients might be useful, in addition to vitamin D supplementation.

Guidelines for Preventing and Treating Vitamin D Deficiency: A 2023 Update in Poland.

Introduction: All epidemiological studies suggest that vitamin D deficiency is prevalent among the Polish general population. Since vitamin D deficiency was shown to be among the risk factors for many diseases and for all-cause mortality, concern about this problem led us to update the previous Polish recommendations. Methods: After reviewing the epidemiological evidence, case-control studies and randomized control trials (RCTs), a Polish multidisciplinary group formulated questions on the recommendations for prophylaxis and treatment of vitamin D deficiency both for the general population and for the risk groups of patients. The scientific evidence of pleiotropic effects of vitamin D as well as the results of panelists' voting were reviewed and discussed. Thirty-four authors representing different areas of expertise prepared position statements. The consensus group, representing eight Polish/international medical societies and eight national specialist consultants, prepared the final Polish recommendations. Results: Based on networking discussions, the ranges of total serum 25-hydroxyvitamin D concentration indicating vitamin D deficiency [<20 ng/mL (<50 nmol/L)], suboptimal status [20-30 ng/mL (50-75 nmol/L)], and optimal concentration [30-50 ng/mL (75-125 nmol/L)] were confirmed. Practical guidelines for cholecalciferol (vitamin D3) as the first choice for prophylaxis and treatment of vitamin D deficiency were developed. Calcifediol dosing as the second choice for preventing and treating vitamin D deficiency was introduced. Conclusions: Improving the vitamin D status of the general population and treatment of risk groups of patients must be again announced as healthcare policy to reduce a risk of spectrum of diseases. This paper offers consensus statements on prophylaxis and treatment strategies for vitamin D deficiency in Poland.

Vitamin D Dosing: Basic Principles and a Brief Algorithm (2021 Update).

Nowadays, in modern societies, many people can be at high risk to have low vitamin D levels. Therefore, testing of serum 25-hydroxy-vitamin D (25OH-D) levels should be performed before prescribing them vitamin D supplementation. However, in some cases the 25OH-D level assessment is not available at the right moment, e.g., due to mandatory quarantine of COVID-19 outpatients. Therefore, such patients could be advised to start taking moderate vitamin D doses (e.g., 4000 IU/day for adults), and their 25-OH-D levels could be checked later. The proposed algorithm also comprises vitamin D dosing principles when baseline 25OH-D levels are known.

Vitamin D and COVID-19: It is time to act.

Vitamin D (VitD) deficiency is considered a global problem and might be associated with increased susceptibility to COVID-19 illness. In the light of COVID-19 pandemic, VitD might be a promising agent for fighting the SARS-CoV-2, since VitD is involved in various pathophysiological mechanisms that occur during COVID-19 infection. High-dose VitD supplementation, particularly for risk groups, could be recommended to achieve and maintain optimal (range 40-60 ng/mL) serum 25-hydroxy vitamin D levels (marker of VitD status) both for COVID-19 prevention and treatment.

Vitamin D Levels of Out-Patients in Lithuania: Deficiency and Hypervitaminosis.

Aim: Data on the prevalence of vitamin D deficiency in Lithuania are scarce. The aim was to assess the reserves of vitamin D in different age groups of out-patients, regarding the season of the year. Methods: Data on serum 25-hydroxyvitamin D (25(OH)D) levels from blood tests made in 2012⁻2014 were obtained from one laboratory, and a retrospective cross-sectional analysis was performed. Results: A total of 9581 subjects were included. The mean age of the participants was 33 ± 23 years. The mean levels of vitamin D were higher in males than in females (p < 0.001). The highest mean 25(OH)D levels were in 0⁻9-year-old group, the lowest were in the 10⁻19-year-old group and in the group of participants that were 70 years and older (p < 0.001). The lowest vitamin D status was found in January, February, March, and April. The highest status was found in August and September. Overall, vitamin D deficiency, sufficiency, and hypervitaminosis were detected in 67%, 21%, and 12% of cases, respectively. Most cases with hypervitaminosis were in the group of children up to 2 years of age. Conclusion: Vitamin D status demonstrated clear seasonality. Significant sex-related differences of vitamin D statuses were also determined. Vitamin D deficiency was very prevalent in almost all age groups. Young children (aged up to 2 years) are of special interest for further research involving other types of 25(OH)D assays, such as those based on high-performance liquid chromatography (HPLC), since the real prevalence of "true" vitamin D hypervitaminosis in Lithuania's children is still to be determined.

Could both vitamin D and geomagnetic activity impact serum levels of soluble cell adhesion molecules in young men?

Vitamin D might have a role in diminishing endothelial dysfunction (ED). The initial aim was to test the hypothesis of reciprocity between levels of 25-hydroxyvitamin D (25(OH)D) and levels of soluble endothelial cell adhesion molecules (CAMs) that could serve as biomarkers of ED. Randomly selected men of age 20-39 were examined at February or March (cold season) and reexamined at August or September (warm season). Some lifestyle and anthropometrical data were recorded. Laboratory measurements, including those for serum levels of soluble CAMs-sICAM-1, sVCAM-1, sE-selectin and sP-selectin-were also performed. As some of the results were rather unexpected, indices of geomagnetic activity (GMA), obtained from the online database, were included in further analysis as a confounder. In 2012-2013, 130 men were examined in cold season, and 125 of them were reexamined in warm season. 25(OH)D levels were found to be significantly negatively associated with sVCAM-1 levels (ß = -0.15, p = 0.043 in warm season; ß = -0.19, p = 0.007 for changes). Levels of sVCAM-1 and sICAM-1 from the same seasons were notably different between years and have changed in an opposite manner. Soluble P-selectin levels were higher at warm season in both years. GMA was positively associated with sVCAM-1 (ß = 0.17, p = 0.039 in cold season; ß = 0.22, p = 0.002 for changes) and negatively with sICAM-1 (ß = -0.30. p < 0.001 in cold season) levels. Vitamin D might play a role in diminishing sVCAM-1 levels. Levels of sVCAM-1 and sICAM-1 were associated with the GMA; this implies a need for further research.