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1.
J Assoc Physicians India ; 68(2): 18-22, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-32009356

RESUMO

Background: Rheumatoid arthritis (RA) is a chronic inflammatory connective tissue disorder with wide spectrum of presentation from polyarthritis to multisystem involvement. Apart from bones, muscles and other soft tissues, Vitamin D receptors have been found on many immune cells and tissues. The most vital function of Vitamin D is calcium and phosphorus absorption but it can also act as an immune-modulator hormone, which can affects both innate and adaptive immune responses leading to autoimmune diseases. Objectives: To study the relationship of vitamin D insufficiency with disease activity and functional disability in patients of Rheumatoid Arthritis. Material and Methods: The present study was an observational, cross sectional study done in a tertiary care hospital in New Delhi, India. The inclusion criteria comprised of patients attending the inpatient (IPD) and outpatient department (OPD), age above 18 years and fulfilling 1987 American college of Rheumatology (ACR) criteria for RA. The exclusion criteria was patients suffering from any other connective tissue disorder (CTD) and patients who were taking vitamin D supplements for past 6 months. Thirty patients were enrolled in the study after satisfying inclusion and exclusion criteria and appropriate clinical data and blood sample were collected after informed consent. Joint examination were performed and swollen joint count (SJC), tender joint count (TJC), patient global assessment (PGA) and evaluator global assessment (EGA) scores were recorded. Disease activity using DAS28ESR, DAS28CRP and CDAI were calculated and disability index was assessed using Short Fries Health Assessment Questionnaire. Results: In our study mean vitamin D level was 18.93 ng/ml (S.D. 6.64 ng/ml). Mean DAS28 ESR was 4.57±1.48. Mean Disability Index was 0.52±0.89. All the study population had low Vitamin D level (100%), while 50% patients had vitamin D level in deficiency range (<20ng/ml). On analysis by student t-test, statistically higher PGA (p value 0.024) and Disability Index (p value < 0.001) in vitamin D deficient patients, compared to vitamin D insufficient patient group was observed, however there was no significant difference in disease activity between the groups. Conclusion: Low Vitamin D levels are common in Indian rheumatoid arthritis patients. Mean PGA significantly increased, and disability index significantly increased in Vitamin D deficient group compared to insufficient group suggesting vitamin D deficient patients poor wellbeing and more disability.


Assuntos
Artrite Reumatoide/epidemiologia , Deficiência de Vitamina D/epidemiologia , Vitamina D/metabolismo , Artrite Reumatoide/metabolismo , Estudos Transversais , Humanos , Índia/epidemiologia , Índice de Gravidade de Doença
3.
N Engl J Med ; 381(26): 2529-2540, 2019 12 26.
Artigo em Inglês | MEDLINE | ID: mdl-31826336

RESUMO

BACKGROUND: Vitamin D deficiency is a common, potentially reversible contributor to morbidity and mortality among critically ill patients. The potential benefits of vitamin D supplementation in acute critical illness require further study. METHODS: We conducted a randomized, double-blind, placebo-controlled, phase 3 trial of early vitamin D3 supplementation in critically ill, vitamin D-deficient patients who were at high risk for death. Randomization occurred within 12 hours after the decision to admit the patient to an intensive care unit. Eligible patients received a single enteral dose of 540,000 IU of vitamin D3 or matched placebo. The primary end point was 90-day all-cause, all-location mortality. RESULTS: A total of 1360 patients were found to be vitamin D-deficient during point-of-care screening and underwent randomization. Of these patients, 1078 had baseline vitamin D deficiency (25-hydroxyvitamin D level, <20 ng per milliliter [50 nmol per liter]) confirmed by subsequent testing and were included in the primary analysis population. The mean day 3 level of 25-hydroxyvitamin D was 46.9±23.2 ng per milliliter (117±58 nmol per liter) in the vitamin D group and 11.4±5.6 ng per milliliter (28±14 nmol per liter) in the placebo group (difference, 35.5 ng per milliliter; 95% confidence interval [CI], 31.5 to 39.6). The 90-day mortality was 23.5% in the vitamin D group (125 of 531 patients) and 20.6% in the placebo group (109 of 528 patients) (difference, 2.9 percentage points; 95% CI, -2.1 to 7.9; P = 0.26). There were no clinically important differences between the groups with respect to secondary clinical, physiological, or safety end points. The severity of vitamin D deficiency at baseline did not affect the association between the treatment assignment and mortality. CONCLUSIONS: Early administration of high-dose enteral vitamin D3 did not provide an advantage over placebo with respect to 90-day mortality or other, nonfatal outcomes among critically ill, vitamin D-deficient patients. (Funded by the National Heart, Lung, and Blood Institute; VIOLET ClinicalTrials.gov number, NCT03096314.).


Assuntos
Colecalciferol/administração & dosagem , Estado Terminal/terapia , Deficiência de Vitamina D/tratamento farmacológico , Vitaminas/administração & dosagem , Adulto , Colecalciferol/efeitos adversos , Estado Terminal/mortalidade , Método Duplo-Cego , Feminino , Humanos , Estimativa de Kaplan-Meier , Tempo de Internação , Masculino , Pessoa de Meia-Idade , Escores de Disfunção Orgânica , Falha de Tratamento , Vitamina D/análogos & derivados , Vitamina D/sangue , Vitaminas/efeitos adversos
4.
BMC Infect Dis ; 19(1): 1020, 2019 Dec 02.
Artigo em Inglês | MEDLINE | ID: mdl-31791247

RESUMO

BACKGROUND: Vitamin D deficiency, determined by blood levels of 25-hydroxyvitamin D [25(OH) D, i.e. the major vitamin D form in blood], has been shown to associate with all-cause mortalities. We recently demonstrated that blood levels of 1,25-dihydroxyvitamin D [1,25(OH)2D, i.e. the active vitamin D] were significantly lower in non-survivors compared to survivors among sepsis patients. Unexpectedly, despite the well documented roles of 1,25(OH)2D in multiple biological functions such as regulation of immune responses, stimulation of antimicrobials, and maintenance of barrier function, 1,25(OH)2D supplementation failed to improve disease outcomes. These previous findings suggest that, in addition to 1,25(OH)2D deficiency, disorders leading to the 1,25(OH)2D deficiency also contribute to mortality among sepsis patients. Therefore, this study investigated the mechanisms leading to sepsis-associated 1,25(OH)2D deficiency. METHODS: We studied mechanisms known to regulate kidney 25-hydroxylvitamin D 1α-hydroxylase which physiologically catalyzes the conversion of 25(OH) D into 1,25(OH)2D. Such mechanisms included parathyroid hormone (PTH), insulin-like growth factor 1 (IGF-1), fibroblast growth factor 23 (FGF-23), and kidney function. RESULTS: We demonstrated in both human subjects and mice that sepsis-associated 1,25(OH)2D deficiency could not be overcome by increased production of PTH which stimulates 1α-hydroxylase. Further studies showed that this failure of PTH to maintain blood 1,25(OH)2D levels was associated with decreased blood levels of IGF-1, increased blood levels of FGF-23, and kidney failure. Since the increase in blood levels of FGF-23 is known to associate with kidney failure, we further investigated the mechanisms leading to sepsis-induced decrease in blood levels of IGF-1. Our data showed that blood levels of growth hormone, which stimulates IGF-1 production in liver, were increased but could not overcome the IGF-1 deficiency. Additionally, we found that the inability of growth hormone to restore the IGF-1 deficiency was associated with suppressed expression and signaling of growth hormone receptor in liver. CONCLUSIONS: Because FGF-23 and IGF-1 have multiple biological functions besides their role in regulating kidney 1α-hydroxylase, our data suggest that FGF-23 and IGF-1 are warranted for further investigation as potential agents for the correction of 1,25(OH)2D deficiency and for the improvement of survival among sepsis patients.


Assuntos
Sepse/sangue , Sepse/complicações , Deficiência de Vitamina D/etiologia , Vitamina D/análogos & derivados , Animais , Estudos de Casos e Controles , Modelos Animais de Doenças , Regulação para Baixo , Feminino , Fatores de Crescimento de Fibroblastos/sangue , Humanos , Fator de Crescimento Insulin-Like I , Rim/efeitos dos fármacos , Testes de Função Renal , Masculino , Camundongos , Camundongos Endogâmicos C57BL , Hormônio Paratireóideo/sangue , Sepse/fisiopatologia , Transdução de Sinais , Vitamina D/sangue , Vitamina D/metabolismo , Deficiência de Vitamina D/sangue , Deficiência de Vitamina D/fisiopatologia
5.
Wiad Lek ; 72(11 cz 2): 2202-2209, 2019.
Artigo em Polonês | MEDLINE | ID: mdl-31860837

RESUMO

OBJECTIVE: Introduction: Mineral homeostasis is achieved through a complex interplay of several feedback processes involving primarily the bone, intestine and kidney, regulated by different proteins acting on endocrine, paracrine or autocrine levels. The dysregulation of these processes in chronic renal failure, called kidney disease (CKD) - mineral and bone disorder (CKD-MBD), although apparent, is still poorly understood. The aim: The aim of the study was an analysis of potential relationships between selected biomarkers of CKD-MBD in maintenance hemodialysis (HD) patients. PATIENTS AND METHODS: Material and Methods: In the first part of this cross-sectional study, the 25(OH)D serum concentrations were measured in 115 HD vitamin D naïve patients from 5 dialysis units located in central Poland. Thereafter in 81 patients (49 men, 32 women, aged 67 ± 13 years) with vitamin deficiency (25(OH)D <20 ng/ml) serum concentrations of 25(OH)D, 1,25(OH)2D, intact parathyroid hormone (iPTH), intact FGF23, sclerostin (SCL), osteocalcin (OC), and C-terminal telopeptide of type I collagen (CTX1) were determined. RESULTS: Results: Serum levels of both 25(OH)D and 1,25(OH)2D were low (mean values 13.4±6.72 ng/ml and 12.9 ± 9.08 pmol/l, respectively). While serum 25(OH)D correlated only with a declared time spent outside (r= 0.411; p=0.000139), serum 1,25(OH)2D was related to diuresis (r= 0.289; p=0.009), and negatively to time on dialysis (r= -0.272; p=0.014) , serum phosphate (r= -0.393; p=0.000289), FGF23(r= -0.295; p=0.008), and SCL (r= -0.260; p=0.019). There was a marked dispersion of FGF-23 serum levels across the group (mean 823±5647, median 379 pg/ml) , and - as expected - they correlated highly with phosphate (r= 0.549, p=0.000), calcium (r= 0,328, p=0,003), OC (r=0.479; p=0.000), and negatively with z 1,25(OH)2D (r= -0.295, p=0.008). Mean serum SCL levels (89.2±46.7, median 81.9 pmol/l) were 3x higher than in general population, and correlated highly positively with dialysis vintage (r=0.402; p<0.001), age (r=0.356; p=0.001), as well as negatively with 1,25(OH)2D (r= -0.260; p=0.019) and CTX1 (r= -0.293; p=0.008). CONCLUSION: Conclusions: In our hemodialysis population, in addition to profoundly impaired 1,25(OH)2D synthesis, there is also a widespread prevalence of 25(OH)D deficiency. The patients have also markedly increased serum bone-secreted proteins, FGF23, and SCL, which regulate mineral and bone metabolism and are associated with the systemic side effects of uremia. All these hormones interact one with the other, creating a sophisticated cross-talk between the bone, intestine, and the kidney.


Assuntos
Deficiência de Vitamina D , Idoso , Idoso de 80 Anos ou mais , Biomarcadores , Remodelação Óssea , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Hormônio Paratireóideo , Polônia , Diálise Renal , Vitamina D
6.
Endocrinol. diabetes nutr. (Ed. impr.) ; 66(10): 628-638, dic. 2019. tab
Artigo em Inglês | IBECS | ID: ibc-184790

RESUMO

Background: Studies trying to find the association between vitamin D status and metabolic syndrome (MetS) have led to inconsistent results, and community-based data for individuals living in the Middle East are limited. Objectives: To find out if MetS and its components are associated with vitamin D status among female teachers residing in Yazd city during winter 2015. Materials and methods: A total of 276 female teachers (case group, n = 124 and control group, n = 152) aged 20-60 years were included. Weight, height, waist circumference, blood pressure, daily energy intake, physical activity, serum 25 hydroxy vitamin D (25(OH)D3), fasting blood glucose, triglycerides and high-density lipoprotein cholesterol (HDL-C) levels were assessed. Logistic regression was used to examine the odds ratio of MetS according to vitamin D status. Results: Mean serum 25(OH)D3 was 32.79 ± 18.62 ng/ml and 33.73 ± 20.20, in females with and without MetS, respectively (P > 0.142). Compared to those with 25(OH)D3of < 20 ng/ml, the odds ratio for MetS was 1.01 (95% CI: 0.48-2.13) and 0.95 (95% CI: 0.56-1.60) for those with serum 25(OH)D3 levels of 20-29 ng/ml and ≥ 30 ng/ml, respectively (P trend = 0.84). The association remained insignificant after adjusting for potential confounders. Furthermore, vitamin D status was not associated with MetS components (P > 0.05). Conclusion: Although several studies have claimed the association between vitamin D status and MetS, we could not find a similar connection in a sample of Iranian female teachers. Prospective studies are needed to determine the possible effect of vitamin D in the development of MetS, particularly in the Yazd province


Antecedentes: Los estudios en busca de una asociación entre el estado de vitamina D y el síndrome metabólico (SM) han dado resultados no concluyentes, y los datos sobre comunidades de personas residentes en Oriente Próximo son limitados. Objetivos: Averiguar si existe asociación entre el SM y sus componentes y el estado de vitamina D en profesoras residentes en la ciudad de Yazd durante el invierno de 2015. Materiales y métodos: Se incluyó a un total de 276 profesoras (grupos de casos, n = 124 y grupo de control, n = 152) de 20-60 años de edad. Se determinaron el peso, la talla, el perímetro de la cintura, la presión arterial, la ingesta diaria de energía, la actividad física y los niveles de 25-hidroxivitamina D (25(OH)D3), glucosa en ayunas, triglicéridos y colesterol de las proteínas de alta densidad (C-HDL). Se utilizó regresión logística para determinar la razón de probabilidades de SM en función del estado de vitamina D. Resultados: La concentración sérica media de 25(OH)D3 era de 32,79 ± 18,62 ng/ml y 33,73 ± 20,20 en las mujeres con y sin SM, respectivamente (P > 0,142). En comparación con las que tenían < 20 ng/ml de 25(OH)D3, la razón de probabilidades de SM era 1,01 (IC al 95%, 0,48-2,13) y 0,95 (IC al 95%, 0,56-1,60) en las que tenían valores de 20-29 ng/ml y ≥ 30 ng/ml, respectivamente (tendencia de P = 0,84). La asociación seguía siendo no significativa después del ajuste por posibles factores de confusión. Además, el estado de vitamina D no se asociaba con los componentes del SM (P > 0,05). Conclusión: Aunque varios estudios han informado de una asociación entre el estado de la vitamina D y el SM, no pudimos hallar una relación similar en una muestra de profesoras iraníes. Se necesitan estudios prospectivos para determinar el posible efecto de la vitamina D en el desarrollo del SM, especialmente en la provincia de Yazd


Assuntos
Humanos , Feminino , Adulto , Pessoa de Meia-Idade , Vitamina D/administração & dosagem , Síndrome Metabólica/tratamento farmacológico , Deficiência de Vitamina D/dietoterapia , Irã (Geográfico) , Modelos Logísticos , Peso-Estatura , Relação Cintura-Quadril , Pressão Arterial , Pressão Sanguínea , Exercício/fisiologia
7.
J Surg Orthop Adv ; 28(4): 257-259, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31886760

RESUMO

The objective of this study was to document the 25-hydroxyvitamin D status of patients with a confirmed diagnosis of spondylolysis to determine if these patients have increased rates of vitamin D deficiency. After confirming the diagnosis of spondylolysis, patients were prospectively enrolled in this study. A total of 39 patients (30 male, 9 female) with a mean age of 14.9 years and a mean BMI of 22.9 had vitamin D levels drawn after imaging confirmed the diagnosis of spondylolysis. The mean 25-hydroxyvitamin D level was 26 ng/ml. Only 9 patients (23.1%) were considered to have normal vitamin D levels > 32 ng/ml. An additional 22 patients (56.4%) had insufficient values of 20 to 32 ng/ml, and 8 patients (20.5%) had vitamin D deficiency with values <20 ng/ml. Pediatric patients presenting with spondylolysis, regardless of race or age, have high rates of 25-hydroxyvitamin D deficiency. (Journal of Surgical Orthopaedic Advances 28(4):257-259, 2019).


Assuntos
Espondilólise , Deficiência de Vitamina D , Adolescente , Feminino , Humanos , Masculino , Vitaminas
8.
Pan Afr Med J ; 34: 38, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31762905

RESUMO

Introduction: The prevalence of diabetes mellitus is rising at an alarming rate, calling for more insights into its pathogenetic mechanisms, and other factors involved in its progression. The prevalence of vitamin D deficiency is higher in diabetic compared to non-diabetic patients, and is associated with poor glycaemic control. This has not been documented among diabetic patients in Kenya. Aims: to determine the prevalence of hypovitaminosis D among type 2 diabetic patients at Kenyatta National Hospital in Nairobi, Kenya. Methods: We recruited type 2 diabetic patients on follow-up at Kenyatta National Hospital. Measurements of height, weight and waist/hip ratios were taken. We drew 6mls of peripheral blood to determine vitamin D, zinc and HbA1c levels. Results: A total of 151 participants were recruited, with 69.5% females and mean age of 58.2 years. Hypertension was found in 72.8% of the participants, and obesity in 37.7%. The mean HbA1c levels were 8.46%, and 62.9% had poor glycaemic control. The mean vitamin D level was 31.40ng/ml. Vitamin D deficiency and insufficiency was found in 38.4% and 21.9% of the participants respectively. We found a significant inverse correlation between vitamin D and glycaemic control (r = -0.09, p = 0.044) and vitamin D and BMI (r = - 0.145, p = 0.045). Conclusion: In this study population on long-term follow-up for diabetes, there was high prevalence of vitamin D deficiency. This forms a basis for further management of patients with poor glycaemic control. Further studies are needed to document the causal association between poor glycaemic control and vitamin D deficiency.


Assuntos
Glicemia , Diabetes Mellitus Tipo 2/epidemiologia , Deficiência de Vitamina D/epidemiologia , Idoso , Estudos Transversais , Diabetes Mellitus Tipo 2/patologia , Feminino , Seguimentos , Hemoglobina A Glicada/metabolismo , Humanos , Hipertensão/epidemiologia , Quênia , Masculino , Pessoa de Meia-Idade , Obesidade/epidemiologia , Prevalência
9.
Methodist Debakey Cardiovasc J ; 15(3): 207-213, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31687100

RESUMO

Vitamin D has traditionally been known as the "bone vitamin". However, a large body of observational data has also linked low concentrations of serum 25-hydroxyvitamin D (25[OH]D), the primary storage form of vitamin D, to an increased risk of incident cardiovascular disease (CVD) and mortality, garnering public excitement about the purported nonskeletal benefits of vitamin D. Despite this, more recent meta-analyses and randomized clinical trials have failed to find a beneficial effect of vitamin D supplements on CVD and cancer outcomes. These findings, along with the lack of consensus on optimal serum 25(OH)D concentrations, have dampened some of the initial enthusiasm for vitamin D supplements. Residual confounding or reverse causation may explain some of the discrepancy between the observational and trial results. At this time, vitamin D supplements should not be prescribed for the primary purpose of CVD prevention. Adding to this complexity is the fact that many adults take vitamin D and calcium supplements together for bone health, and there is some concern (albeit inconclusive) related to calcium use and increased CVD risk. In this light, it may be best to achieve the recommended daily allowances of calcium intake through food and reserve calcium supplementation only for those at risk for calcium intake deficiency, with the smallest dosage needed after dietary modifications have been exhausted. In this review, we discuss vitamin D and calcium supplementation and how they may affect cardiovascular health.


Assuntos
Cálcio/uso terapêutico , Doenças Cardiovasculares/prevenção & controle , Suplementos Nutricionais , Deficiência de Vitamina D/tratamento farmacológico , Vitamina D/uso terapêutico , Animais , Biomarcadores/sangue , Cálcio/efeitos adversos , Cálcio/deficiência , Cálcio na Dieta/sangue , Doenças Cardiovasculares/sangue , Doenças Cardiovasculares/diagnóstico , Doenças Cardiovasculares/epidemiologia , Suplementos Nutricionais/efeitos adversos , Humanos , Fatores de Proteção , Recomendações Nutricionais , Medição de Risco , Fatores de Risco , Resultado do Tratamento , Vitamina D/efeitos adversos , Vitamina D/análogos & derivados , Vitamina D/sangue , Deficiência de Vitamina D/sangue , Deficiência de Vitamina D/diagnóstico , Deficiência de Vitamina D/epidemiologia
10.
Georgian Med News ; (294): 88-91, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31687956

RESUMO

Plenty of studies demonstrated an association between a Vitamin D deficiency and several autoimmune disorders, such as diabetes mellitus, systemic lupus erythematosus (SLE), and rheumatoid arthritis (RA) in adult patients. This study was aimed to assess probable association between the 25-hydroxyvitamin D [25(OH)D] level and juvenile idiopathic arthritis (JIA) features and the possible relationship between serum vitamin D level and disease activity. 69 patients with JIA were examined and 15 healthy children were chosen as the control group. The mean age of patients was 10 years 8 months ±4 years 6 months (45 female, 24 male). 25 patients with oligoarthicular subtype of disease, 34 with poliarthicular sybtype and 10 patient with undifferentiated arthritis . The total duration of the disease was 4 years 1 month ± 1 year 1 month. Patients got methotrexate therapy (15mg/m2). Any of the patients were not treated by corticosteroids. The serum level of vitamin D was measured through blood test by chemiluminescence method. The relationship between the level of vitamin D and disease activity was analyzed based on juvenile arthritis disease activity score (JADAS27). The average level of vitamin D in serum was 22,69±7,8 ng/ml at the control group the vitamin D status was 28,67±5,06 ng/ml. In spite of the fact that a decrease in vitamin D status was observed in both groups, however in the group of healthy children it was significantly higher (p>0.05). Using the regression method, a significant relationship was established between the number of active joints and the age of patients, duration of disease, the level of vitamin D in serum, the number of injured joints, and disease activity (accordant to JADAS27 score) (number of active joints = - 1,144 + 0,005 x age of patients - 0,007x duration of disease + 0,292 x the number of injured joints + 0,033 x level of vitamin D + 0,077 x the number of points accordant to JADAS27). The monitoring of vitamin D level is advisable to carry out during observing the children with JIA. It can be useful for timely correction of vitamin D deficiency and preventions both skeleton and non-skeleton complications. That may improve the quality of life of patients and their families.


Assuntos
Artrite Juvenil , Deficiência de Vitamina D/sangue , Adulto , Artrite Juvenil/sangue , Artrite Juvenil/complicações , Artrite Juvenil/epidemiologia , Artrite Reumatoide , Estudos de Casos e Controles , Criança , Feminino , Humanos , Masculino , Qualidade de Vida , Ucrânia/epidemiologia , Vitamina D/sangue , Deficiência de Vitamina D/complicações , Deficiência de Vitamina D/epidemiologia
11.
Medicina (B Aires) ; 79(5): 345-348, 2019.
Artigo em Espanhol | MEDLINE | ID: mdl-31671383

RESUMO

Hypovitaminosis D is frequent worldwide. In Argentina, according to studies conducted between 1987 and 2015, prevalence was > 40% in the general population. In people living with HIV it may vary between 20 and 90%, but the prevalence in our environment is not known. Our objective was to determine the prevalence of hypovitaminosis D in a cohort of adults with HIV infection in the city of Buenos Aires. We analyzed retrospectively medical records of 814 HIV positive subjects older than 18 years with at least one determination of vitamin D. The median age was 44 years (interquartile range 21-80), 746 (91.6%) were men, and 813 (99.9%) were on antiretroviral treatment. Univariate and multivariate analyses were performed to determine the association of hypovitaminosis D with CD4 values, viral load for HIV, and antiretroviral therapy. The present study shows that, in our environment, hypovitaminosis D is very common in people with HIV infection. Although it does not reveal evidence of a relationship with viral load for HIV, immune status, or antiretroviral treatment, the systematic search for hypovitaminosis D is mandatory in this population, taking into account its high frequency and the increased risk of osteopenia, osteoporosis and fractures, as described in people with HIV.


Assuntos
Instituições de Assistência Ambulatorial/estatística & dados numéricos , Infecções por HIV/epidemiologia , Deficiência de Vitamina D/epidemiologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Antirreumáticos/uso terapêutico , Argentina/epidemiologia , Benzoxazinas/uso terapêutico , Contagem de Linfócito CD4 , Feminino , Infecções por HIV/tratamento farmacológico , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Estudos Retrospectivos , Inibidores da Transcriptase Reversa/uso terapêutico , Fatores de Risco , Carga Viral , Deficiência de Vitamina D/etiologia , Adulto Jovem
12.
Braz J Cardiovasc Surg ; 34(5): 605-609, 2019 12 01.
Artigo em Inglês | MEDLINE | ID: mdl-31719011

RESUMO

Atrial fibrillation is a common type of arrhythmia and is an important cause of stroke and heart failure. vitamin D is an emerging risk factor of AF, and is implicated in the pathophysiology of atrial fibrillation. It has been established that this vitamin is extensively involved in the regulation of both the renin angiotensin aldosterone system and the immune system. Epidemiological studies have not yet reached a consensus on the possible association between vitamin D deficiency and atrial fibrillation. Better research designs and methods can further clarify the relationship between the two.


Assuntos
Fibrilação Atrial/etiologia , Fibrilação Atrial/metabolismo , Deficiência de Vitamina D/complicações , Humanos , Sistema Renina-Angiotensina/fisiologia , Fatores de Risco
13.
Arq Gastroenterol ; 56(4): 425-430, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31721968

RESUMO

BACKGROUND: Vitamin D deficiency is being recognized as a pandemic due to the volume of people affected by the deficiency and the number of illnesses generated or stimulated by the deficiency. There is a lack of consensus in the literature on what is considered vitamin D deficiency [25(OH)D]. OBJECTIVE: This review brings together the most common levels of 25(OH)D found in healthy schoolchildren and what is considered deficient. METHODS: This systematic review was based on the literature accessed from the electronic databases: MEDLINE, EMBASE, LILACS, SCOPUS and WEB OF SCIENCE. The following descriptors were used in English, Portuguese and Spanish: "Vitamin D"; "Vitamin D deficiency"; "Nutritional Supplements" as well as all their synonyms. The meta-analysis was performed considering the random model. Inclusion criteria: healthy children aged 6 to 12 years, studies that had vitamin D levels, defined vitamin D deficiency. RESULTS: Of the 191 potentially eligible articles, only six articles were included, with 2618 students in total. The mean value of 25(OH)D was estimated at 18.11 ng/mL with 95% confidence interval. Among the articles found, three were considered deficiency levels below 20 ng/mL, one considered below 18 ng/mL, another below 15 ng/mL, and the latter below 11 ng/ mL. The prevalence of vitamin D deficiency among the articles was 48.6%, 7%, 98%, 64.63%, 19.5%, 28.4%, according to each classification used by the same. CONCLUSION: The most common definition in the literature of 25(OH)D deficiency in schoolchildren was at levels below 20 ng/mL. No side effects have been reported in studies that used fortification and/or vitamin D supplementation. Daily supplementation is more effective than seasonal supplementation. However, more studies are needed to define what can be considered as optimal levels of 25(OH)D in children.


Assuntos
Padrões de Referência , Estudantes , Deficiência de Vitamina D/diagnóstico , Criança , Humanos
14.
BMC Neurol ; 19(1): 284, 2019 Nov 13.
Artigo em Inglês | MEDLINE | ID: mdl-31722673

RESUMO

BACKGROUND: We aimed to comprehensively explore the associations between serum 25(OH)D deficiency and risk of dementia and Alzheimer's disease(AD). METHODS: We systematically searched Pubmed, the Cochrane Library, Embase and the reference lists of pertinent review articles for relevant articles published from database inception up until January 2019. Pooled hazard ratios (HRs) and 95% confidence intervals (CIs) were calculated with random effects models using the Stata 12.0 statistical software package. RESULTS: Twelve prospective cohort studies and four cross-sectional studies were included in this meta-analysis. The pooled HRs of dementia and AD, respectively, were 1.32 (95%CI: 1.16, 1.52) and 1.34 (95%CI: 1.13, 1.60) for vitamin D deficiency (< 20 ng/ml). In the subgroup analyses, the pooled HRs of dementia and AD, respectively, were 1.48 (95%CI: 1.19, 1.85) and 1.51 (95%CI: 1.04, 2.18) for moderate vitamin D deficiency (10-20 ng/ml) and 1.20 (95%CI: 0.99, 1.44) and 1.36 (95%CI: 1.01, 1.84) for severe vitamin D deficiency (< 10 ng/ml). CONCLUSION: There are significant associations between vitamin D deficiency and both dementia and AD. There are stronger associations between severe vitamin D deficiency (< 10 ng/ml) and both dementia and AD compared to moderate vitamin D deficiency (10-20 ng/ml).


Assuntos
Doença de Alzheimer/sangue , Demência/sangue , Deficiência de Vitamina D/complicações , Algoritmos , Estudos Transversais , Bases de Dados Factuais , Humanos , Modelos de Riscos Proporcionais , Estudos Prospectivos , Fatores de Risco , Vitamina D/sangue
15.
Medicine (Baltimore) ; 98(48): e18113, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31770235

RESUMO

The impact of vitamin D deficiency on the recovery of patients with malnutrition remains undefined. Our aim was to study the prevalence of vitamin D deficiency in a well-characterized cohort of patients with malnutrition and its association with outcomes.Within this secondary analysis of a randomized controlled trial, we examined the association of vitamin D deficiency and adverse clinical outcomes over a follow-up of 180 days in hospitalized patients at risk for malnutrition. We measured 25-hydroxyvitamin D levels upon admission and defined Vitamin D deficiency when levels were <50nmol/l. The primary endpoint was 180-day mortality.The prevalence of vitamin D deficiency in our cohort of 828 patients was 58.2% (n = 482). Patients with vitamin D deficiency had increased 180-day mortality rates from 23.1% to 29.9% (odds ratio 1.42, 95% confidence interval [CI] 1.03-1.94, P = .03). When adjusting the analysis for demographics, comorbidities, and randomization, this association remained significant for the subgroup of patients not receiving vitamin D treatment (adjusted odds ratio 1.63, 95% CI 1.01-2.62, P = .04). There was no significantly lower risk for mortality in the subgroup of vitamin D deficient patients receiving vitamin D treatment compared to not receiving treatment (adjusted odds ratio 0.74, 95% CI 0.48-1.13, P = .15).Vitamin D deficiency is highly prevalent in the population of malnourished inpatients and is negatively associated with long-term mortality particularly when patients are not receiving vitamin D treatment. Our findings suggest that malnourished patients might benefit from vitamin D screening and treatment in case of deficiency.


Assuntos
Idoso Fragilizado/estatística & dados numéricos , Fragilidade/mortalidade , Desnutrição/mortalidade , Deficiência de Vitamina D/mortalidade , Deficiência de Vitamina D/terapia , Idoso , Idoso de 80 Anos ou mais , Suplementos Nutricionais , Feminino , Fragilidade/sangue , Fragilidade/complicações , Humanos , Pacientes Internados/estatística & dados numéricos , Masculino , Desnutrição/sangue , Desnutrição/complicações , Prevalência , Estudos Prospectivos , Qualidade de Vida , Resultado do Tratamento , Vitamina D/análogos & derivados , Vitamina D/sangue , Vitamina D/uso terapêutico , Deficiência de Vitamina D/complicações , Vitaminas/uso terapêutico
16.
Medicine (Baltimore) ; 98(48): e18118, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31770239

RESUMO

BACKGROUND: Vitamin D is a fat-soluble vitamin that is related to the health of the human body and is an indispensable nutrient for human beings. Some studies indicated that type 2 diabetes mellitus (T2DM) with diabetic peripheral neuropathy (DPN) may be associated with vitamin D deficiency, but the current understanding of this point of view remains controversial. This study aimed to evaluate the correlation between serum 25-hydroxyl vitamin D (25 [OH] D) concentration and DPN in patients with T2DM by a meta-analysis, and to provide a reference for doctors. METHODS: Relevant studies were selected from the PubMed, Cochrane Library, China National Knowledge Infrastructure, VIP databases, and Wanfang Data Knowledge Service Platform databases dating from 2000 to December 2017. A total of 75 articles related to serum 25 (OH) D and DPN were selected from 2000 to December 2017. Based on the inclusion and exclusion criteria of the literature, a quality assessment was conducted using the Newcastle-Ottawa scale, and a meta-analysis was performed by RevMan5.3 statistical software. RESULTS: Thirteen studies that involved a total of 2814 type 2 diabetic patients were finally included into the meta-analysis. Meta-analysis results, heterogeneity test showed that, P < .000 01, I = 92%, calculation by random effect model revealed that, the serum concentration of 25 (OH) D in T2DM combined with DPN group was lower than that in the group without DPN (weighted mean difference = -0.74, 95% confidence interval: -1.03 to -0.46) CONCLUSIONS:: Vitamin D is associated with type 2 DPN (DPN), and vitamin D deficiency can lead to an increased risk of type 2 DPN. However, more high-quality research is needed.


Assuntos
Diabetes Mellitus Tipo 2/sangue , Neuropatias Diabéticas/sangue , Doenças do Sistema Nervoso Periférico/sangue , Deficiência de Vitamina D/etiologia , Vitamina D/análogos & derivados , Adulto , Idoso , Diabetes Mellitus Tipo 2/complicações , Neuropatias Diabéticas/etiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Doenças do Sistema Nervoso Periférico/etiologia , Fatores de Risco , Vitamina D/sangue , Deficiência de Vitamina D/sangue
17.
Zhonghua Wei Zhong Bing Ji Jiu Yi Xue ; 31(9): 1170-1173, 2019 Sep.
Artigo em Chinês | MEDLINE | ID: mdl-31657348

RESUMO

OBJECTIVE: Sepsis is a life-threatening organ dysfunction caused by the host's imbalance in response to infection, which is still the leading cause of death in critically ill patients. In recent years, studies have found that vitamin D deficiency or insufficiency is common in critically ill patients, especially sepsis. The relationship between vitamin D and sepsis has attracted more and more attention. The mechanism of vitamin D in sepsis is described from the aspects of immune regulation, inflammation regulation, endothelial cell protection, carbon monoxide regulation, and receptor gene polymorphism, by analyzing the related literatures of vitamin D and sepsis in recent years in order to provide new ideas for clinical diagnosis and treatment of sepsis.


Assuntos
Sepse/metabolismo , Deficiência de Vitamina D , Vitamina D/metabolismo , Estado Terminal , Humanos , Inflamação
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