Your browser doesn't support javascript.
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 4.249
Filtrar
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
2.
Medicine (Baltimore) ; 99(8): e19293, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-32080146

RESUMO

It is well known that vitamin D (VitD) plays an important role in bone and calcium metabolism in the human body. VitD has additional roles in the body including modulation of cell growth, neurogenesis, neuroprotection, detoxification, immune function, and reduction of inflammation. Recent studies reveal insufficiency of VitD as a risk factor for cognitive decline or dementia. VitD has a role in normal brain function; insufficiency of VitD may lead to decreased memory and cognitive function.Using 2 years of baseline data from Korean frailty and aging cohort study, 2990 subjects (1415 men and 1575 women) were recruited. A short form of Korean version of the consortium to establish a registry for Alzheimer disease (CERAD-K), an assessment of cognitive status in patients with dementia was used. Among CERAD-K tests, we included word list memory/recall/recognition, digit span (forward, backward), trail making test (TMT) A, and mini-mental state examination in the Korean version of the CERAD assessment packet (MMSE-KC). Serum samples were collected and 25-hydroxyvitamin D (25(OH)D) was measured. Serum 25(OH)D concentrations were classified into clinically relevant categories as: deficient (<10 nmol/L), insufficient (10-30 nmol/L), and sufficient (≥30 nmol/L).The mean age of participants was 76.5 ±â€Š3.9 years, and 52.7% were women. Among 2990 participants, 119 (4.0%) were classified as 25(OH)D deficient and 2253 (75.3%) as insufficient. Only 618 (20.7%) participants were sufficient for 25(OH)D. Among them performance in MMSE-KC, TMT A, and digit span tests was better in sufficient, insufficient, and deficient groups, which was statistically significant (P < .05). However, in multivariable regression analysis after adjusting for age, sex, body mass index, education, center, seasonality, physical activity, and alcohol use, association between 25(OH)D and cognitive function was not statistically significant.Although, when comparing VitD levels, there were differences in cognitive tests among the groups, fully adjusted analysis did not show any association. This result suggests that cognition was not affected by VitD levels alone but also population and sociological variables. In a fully adjusted model, there was no statistically significant association between VitD and cognitive function in the elderly Koreans in logistic regression analysis.


Assuntos
Cognição , Deficiência de Vitamina D/epidemiologia , Idoso , Estudos de Coortes , Feminino , Humanos , Modelos Logísticos , Masculino , Testes Neuropsicológicos , República da Coreia/epidemiologia , Vitamina D/análogos & derivados , Vitamina D/sangue
3.
PLoS One ; 15(1): e0225402, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31967989

RESUMO

BACKGROUND: The prevalence of vitamin D inadequacy and breast cancer are both high among women living in Karachi, Pakistan. METHODS: A matched case control study was conducted in two hospitals of Karachi, Pakistan to evaluate the association of vitamin D (serum 25-hydroxyvitamin D) concentrations, vitamin D supplementation and sun exposure with breast cancer among Pakistani women. A total of 411 newly diagnosed histologically confirmed primary breast cancer cases were enrolled and 784 controls, free of breast and any other cancers, were matched by age (year of birth ± 5 years), residence in the same geographic area and study site. Information was collected on sociodemographic history, history of vitamin D supplementation, past medical and obstetrical history, family history of breast cancer, sun exposure history, histopathology reports and anthropometric measurement and venous blood was collected to measure serum 25-hydroxyvitamin D (25(OH)D) concentration. RESULTS: Compared to patients with sufficient serum vitamin D (>30 ng/ml), women with serum vitamin D deficiency (<20ng/ml), had a higher risk of breast cancer (OR = 1.65, 95%CI: 1.10, 2.50). Women with history of vitamin D supplementation one year prior to enrollment, had significant protective effect against breast cancer (OR = 0.32, 95% CI: 0.24, 0.43). CONCLUSIONS AND RECOMMENDATION: Serum vitamin D deficiency was associated with increased risk of breast cancer, while vitamin D supplementation was associated with decreased risk of breast cancer. In Pakistani women, where vitamin D deficiency is common, raising and maintaining serum vitamin D at population level is a safe and affordable strategy. It may play a role in reducing the incidence of both vitamin D deficiency and breast cancer, particularly among poor women where the breast cancer mortality is highest due to limited resources for early detection, diagnosis, and treatment. The effects of vitamin D with regard to breast cancer risk in Karachi Pakistan should be further evaluated.


Assuntos
Neoplasias da Mama/genética , Predisposição Genética para Doença , Deficiência de Vitamina D/genética , Vitamina D/genética , Adulto , Neoplasias da Mama/sangue , Neoplasias da Mama/patologia , Estudos de Casos e Controles , Suplementos Nutricionais , Feminino , Humanos , Pessoa de Meia-Idade , Paquistão/epidemiologia , Luz Solar , Vitamina D/análogos & derivados , Vitamina D/sangue , Deficiência de Vitamina D/sangue , Deficiência de Vitamina D/epidemiologia , Deficiência de Vitamina D/patologia
4.
Maturitas ; 132: 30-34, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31883660

RESUMO

OBJECTIVES: 25-hydroxyvitamin D [25(OH)D] deficiency is related to an increase in cardiovascular risk but the association between low 25(OH)D and hospitalization and mortality in heart failure (HF) patients remains unclear. The objective of this study was therefore to determine whether 25(OH)D deficiency is associated with a higher risk of all-cause hospitalizations and mortality in veterans with HF, as well as the differential effect of frailty. STUDY DESIGN: A retrospective cohort study of veterans with HF. MAIN OUTCOME: Association between 25(OH)D deficiency and risk of hospitalization and mortality. MEASURES: 25(OH)D status was dichotomized as deficiency (<30 ng/mL) and non-deficiency (≥30 ng/mL). A 44-item Frailty Index (FI) was constructed and used to categorize patients as non-frail (FI < .21) or frail (FI ≥ .21). The association of 25(OH)D deficiency with recurrent hospitalization was analyzed through an Andersen-Gill model and the association with mortality using Cox regression. RESULTS: We identified 284 patients, of whom 141 (50 %) exhibited 25(OH)D deficiency (67.3 ±â€¯10.5 years of age). The mean 25(OH)D levels in the deficiency and non-deficiency groups were 21.3±5.9 ng/mL and 40.9 ±â€¯10.9 ng/mL, respectively. Over a median follow-up of 1136 days (IQR = 691), there were 617 hospitalizations (68 % in those with 25(OH)D deficiency) and 131 deaths (40 % in those with 25(OH)D deficiency). A significantly higher risk of hospitalization was found in patients with 25(OH)D deficiency: hazard ratio (HR) = 1.8 (95 % CI:1.3-2.5),p < 0.001. Frail veterans had a greater risk of hospitalization than non-frail veterans: HR = 1.7 (95 % CI:1.2-2.7),p < 0.05. Mortality did not show any significant association with 25(OH)D deficiency. CONCLUSIONS: 25(OH)D deficiency was an independent risk factor for hospitalization in patients with HF and the effect persisted in those with frailty.


Assuntos
Fragilidade/epidemiologia , Insuficiência Cardíaca/mortalidade , Hospitalização/estatística & dados numéricos , Deficiência de Vitamina D/epidemiologia , Vitamina D/análogos & derivados , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Fatores de Risco , Estados Unidos/epidemiologia , Veteranos/estatística & dados numéricos , Vitamina D/sangue , Deficiência de Vitamina D/sangue
5.
NeuroRehabilitation ; 45(4): 513-517, 2019 Dec 18.
Artigo em Inglês | MEDLINE | ID: mdl-31868688

RESUMO

OBJECTIVE: To determine the prevalence of vitamin D deficiency among individuals with traumatic brain injury (TBI) undergoing acute inpatient rehabilitation. SETTING: Inpatient rehabilitation. PARTICIPANTS: Participants were admitted from November 1st, 2010 through June 30th, 2015 with diagnosis of mild-severe TBI and had serum 25 OH vitamin D levels checked upon admission. 369 out of 845 met inclusion. DESIGN: Retrospective cohort. MAIN MEASURES: 25 OH vitamin D, vitamin D treatment. RESULTS: The majority of patients were male (67%), Caucasian (89%) with private insurance (61%) and a mean age of 43.5±21.0 years. 25 OH vitamin D levels were categorized: deficient (<20 ng/mL), insufficient (20-29.9 ng/mL), and sufficient (≥30 ng/mL). There were 95 (26%) patients that were deficient, 131 (36%) that were insufficient, and 143 (39%) that were sufficient. Race/ethnicity was found to be significant (p = 0.0145) with the largest percentage of Hispanics found in the insufficient and deficient categories, and the largest percentage of Blacks in the deficient category. Most patients with deficient or insufficient vitamin D levels were prescribed vitamin D replacement during their rehab stay (p < 0.0001). CONCLUSION: The majority of patients undergoing acute inpatient rehabilitation were found to have insufficient or deficient vitamin D levels, therefore it should be routinely screened and treated as indicated.


Assuntos
Lesões Encefálicas Traumáticas/complicações , Deficiência de Vitamina D/epidemiologia , Adulto , Lesões Encefálicas Traumáticas/epidemiologia , Lesões Encefálicas Traumáticas/reabilitação , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Reabilitação Neurológica/estatística & dados numéricos , Prevalência
6.
PLoS One ; 14(12): e0226673, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31856242

RESUMO

BACKGROUND: Postpartum infections are a common cause of morbidity after childbirth. Vitamin D deficiency has been shown to increase the risk for several infections in a non-pregnant population. Vitamin D deficiency has been described as common in pregnant women. OBJECTIVE: To investigate whether vitamin D deficiency in pregnant women in labor was associated with an increased risk of overall postpartum infectious morbidity within eight weeks of delivery. A secondary aim was to estimate the prevalence of vitamin D deficiency among pregnant women in Linköping, Sweden at the time of delivery. MATERIAL AND METHODS: Serum vitamin D levels in labor were analyzed for 1397 women. Vitamin D deficiency was defined as serum levels <50 nmol/L. All ICD-10 codes given to the women eight weeks postpartum were reviewed and postpartum infections were defined as the presence of an ICD-10 code suggestive of infection. The prevalence of postpartum infections among women with sufficient vitamin D levels was compared with women with vitamin D deficiency. Adjusted Odds Ratios and 95% confidence intervals for postpartum infections were calculated using multivariate logistic regression analysis. RESULTS: Fifty eight per cent of the women had serum vitamin D levels <50 nmol/L. The proportion of women with vitamin D deficiency varied, as expected, with season. No association between vitamin D deficiency and postpartum infections was found. For vitamin D 25-50 nmol/L the adjusted Odds Ratio was 0.85 (95% confidence interval 0.56-1.29) and for vitamin D <25 nmol/L the adjusted Odds Ratio was 1.15 (95% confidence interval 0.66-2.03). Women who smoked or who had a cesarean section had an increased risk of postpartum infections. CONCLUSIONS: Vitamin D deficiency was more common than previously reported in Swedish pregnant women. No association between vitamin D deficiency and postpartum infections was found. Other well-known risk factors for postpartum infection were identified.


Assuntos
Infecção Puerperal/epidemiologia , Deficiência de Vitamina D/epidemiologia , Adulto , Feminino , Humanos , Gravidez , Infecção Puerperal/sangue , Suécia , Vitamina D/sangue , Deficiência de Vitamina D/sangue
7.
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
8.
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
9.
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
10.
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
11.
Clin Interv Aging ; 14: 1751-1761, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31686797

RESUMO

Purpose: Maintaining skeletal muscle function throughout life is a crucial component of successful ageing. Adequate vitamin D status may be important in preserving muscle function. We aimed to determine the association between impaired muscle function and serum vitamin D status in community-dwelling older adults. Falls were explored as a secondary aim. Methods: Data were analyzed from adults aged ≥60 years, from Wave 6 of the English Longitudinal Study of Aging (ELSA). Handgrip strength (HGS) and the short physical performance battery (SPPB) were employed as measures of muscle strength and physical function, respectively. Serum 25-hydroxyvitamin D [25(OH)D] was assessed with concentration <30 nmol/L classed as vitamin D deficient. Results: The study comprised 4157 community-dwelling adults with a mean age of 69.8 (SD 6.9). Overall, 30.6% had low HGS and 12.7% had low SPPB (≤6). Participants with the lowest serum 25(OH)D (<30 nmol/L) had the highest prevalence of impaired muscle strength and performance (40.4% and 25.2%) compared with participants with levels ≥50 nmol/L (21.6% and 7.9%). Consistent with this, vitamin D deficiency (<30 nmol/L) was a significant determinant of low HGS (OR 1.44 [1.22, 1.71], p<0.001) and poor physical performance (OR 1.65 [1.31, 2.09], p<0.001) in the logistic regression models. Older adults partaking in regular moderate physical activity had significantly lower odds of impaired muscle strength (OR 0.65 [0.58, 0.79]) and physical function (OR 0.30 [0.24, 0.38]), p <0.001, respectively. Single or multiple falls (15.8% and 10.5% in past year) were not associated with vitamin D status. Conclusion: Vitamin D deficiency was associated with impaired muscle strength and performance in a large study of community-dwelling older people. It is generally accepted that vitamin D deficiency at the <30 nmol/L cut-off should be reversed to prevent bone disease, a strategy that may also protect skeletal muscle function in ageing.


Assuntos
Força Muscular/fisiologia , Deficiência de Vitamina D/diagnóstico , Vitamina D/análogos & derivados , Acidentes por Quedas/prevenção & controle , Idoso , Idoso de 80 Anos ou mais , Calcifediol , Exercício/fisiologia , Feminino , Humanos , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Desempenho Físico Funcional , Vitamina D/sangue , Deficiência de Vitamina D/epidemiologia , Deficiência de Vitamina D/fisiopatologia
12.
S Afr Med J ; 109(10): 807-813, 2019 Sep 30.
Artigo em Inglês | MEDLINE | ID: mdl-31635580

RESUMO

BACKGROUND: Vitamin D deficiency (VDD) in pregnant women has been associated with adverse pregnancy and neonatal outcomes. 25-hydroxyvitamin D (25(OH)D) levels are affected by numerous factors, including vitamin D intake, skin pigmentation, latitude and season of the year; they therefore vary by race and country. Vitamin D status in pregnant women and their offspring in South Africa (SA) is not well established. OBJECTIVES: To assess vitamin D status by measuring serum 25(OH)D in pregnant black SA women and their offspring in Johannesburg (latitude 26°S) and to assess whether vitamin D status is affected by maternal HIV infection. METHODS: We prospectively enrolled pregnant women and their healthy neonates, and measured 25(OH)D in maternal and cord blood at delivery. Pregnant women were stratified by their HIV status. Predictors of maternal and neonatal VDD (levels <30 nmol/L) were assessed using multiple logistic regression analysis. RESULTS: A total of 291 pregnant women and their healthy neonates were enrolled over a 21-month period. Mean (standard deviation) maternal and cord blood 25(OH)D levels were 57.0 (29.7) and 41.9 (21.0) nmol/L and the prevalence of VDD was 15.9% and 32.8%, respectively. On average, concentrations of 25(OH)D in cord blood were ~80% of those in the mother. There was no association between cord 25(OH)D and gestational age, but levels were associated with birth weight (p<0.001). There were no differences in maternal or cord blood 25(OH)D levels between those HIV-infected or uninfected. The predictor of VDD in mothers was giving birth in winter (odds ratio (OR) 2.87, 95% confidence interval (CI) 1.47 - 5.61), and in neonates the predictors were maternal age (OR 16.5, 95% CI 1.82 - 149), being born in winter (OR 3.68, 95% CI 2.05 - 6.61), being born by caesarean section (OR 4.92, 95% CI 1.56 - 15.57) and being of low birth weight (OR 1.99, 95% CI 1.13 - 3.50). CONCLUSIONS: Among black SA women delivering in Johannesburg, about one in six mothers and one in three neonates have 25(OH)D levels indicative of VDD. Maternal HIV status appears not to affect levels of 25(OH)D in either the mother or her neonate. Research on the effects of VDD on the outcomes of pregnancy and the best methods to combat the high prevalence of VDD in women of childbearing age in the SA context is required.


Assuntos
Grupo com Ancestrais do Continente Africano/estatística & dados numéricos , Infecções por HIV/epidemiologia , Estado Nutricional , Complicações na Gravidez/epidemiologia , Deficiência de Vitamina D/epidemiologia , Adulto , Peso ao Nascer , Cesárea/estatística & dados numéricos , Estudos de Coortes , Feminino , Sangue Fetal/química , Humanos , Recém-Nascido , Gravidez , Estudos Prospectivos , Estações do Ano , África do Sul/epidemiologia , Vitamina D/análogos & derivados , Vitamina D/sangue , Adulto Jovem
13.
Nutr Metab Cardiovasc Dis ; 29(12): 1261-1272, 2019 12.
Artigo em Inglês | MEDLINE | ID: mdl-31653512

RESUMO

BACKGROUND AND AIMS: Atherogenesis and endothelial dysfunction contribute to cardiovascular risk and vitamin D has been implemented in endothelial repair. This systematic review, meta-analysis and meta-regression aims to establish the effect of vitamin D supplementation on endothelial function. METHODS AND RESULTS: To conduct the systematic review we searched the Cochrane Library of Controlled Trials, PubMed, ProQuest and EMBASE for randomized controlled trials that investigated the effects of vitamin D supplementation on flow-mediated dilation (FMD%), pulse wave velocity (PWV), and central augmentation index (AIx). Meta-analysis was based on a random effects model and inverse-variance methods to calculate either mean difference (MD) or standardized mean difference (SMD) as effects sizes. This was followed by meta-regression investigating the effect of baseline vitamin D concentrations, vitamin D dosing and study duration. Risk of bias was assessed using the JADAD scale and funnel plots. We identified 1056 studies of which 26 studies met inclusion criteria for quantitative analysis. Forty-two percent of the 2808 participants had either deficient or insufficient levels of vitamin D. FMD% (MD 1.17% (95% CI -0.20, 2.54), p = 0.095), PWV (SMD -0.09 m/s (95% CI -0.24, 0.07), p = 0.275) and AIx (SMD 0.05% (95% CI -0.1, 0.19), p = 0.52) showed no improvement with vitamin D supplementation. Sub-analysis and meta-regression revealed a tendency for AIx and FMD% to increase as weekly vitamin doses increased; no other significant relationships were identified. CONCLUSIONS: Vitamin D supplementation showed no improvement in endothelial function. More evidence is required before recommendations for management of endothelial dysfunction can be made.


Assuntos
Aterosclerose/tratamento farmacológico , Suplementos Nutricionais , Endotélio Vascular/efeitos dos fármacos , Vasodilatação/efeitos dos fármacos , Deficiência de Vitamina D/tratamento farmacológico , Vitamina D/uso terapêutico , Adulto , Idoso , Aterosclerose/epidemiologia , Aterosclerose/fisiopatologia , Suplementos Nutricionais/efeitos adversos , Endotélio Vascular/fisiopatologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Ensaios Clínicos Controlados Aleatórios como Assunto , Recuperação de Função Fisiológica , Fatores de Risco , Resultado do Tratamento , Vitamina D/efeitos adversos , Deficiência de Vitamina D/epidemiologia , Deficiência de Vitamina D/fisiopatologia
15.
Nutr. hosp ; 36(5): 1067-1073, sept.-oct. 2019. tab, graf
Artigo em Espanhol | IBECS | ID: ibc-184628

RESUMO

Introducción: la hipovitaminosis D tiene una prevalencia del 50,4% en personas mayores, población en aumento a nivel mundial, en la cual la deficiencia de vitamina D (< 30 mg/dl) podría ser un factor de riesgo para disminuir la sobrevida de esta población. Objetivo: determinar si niveles séricos de vitamina D menores a 30 ng/ml tienen impacto en la sobrevida, medida a través de la mortalidad general y por causas específicas, considerando un periodo de seguimiento de nueve años en personas mayores autovalentes con capacidades cognitivas adecuadas. Método: corresponde a un estudio retrospectivo longitudinal, con un seguimiento de nueve años. Se realizó el seguimiento a 418 personas mayores de la comuna de Santiago, los cuales fueron incorporados el año 2004 para participar en un estudio referente a la suplementación de vitamina D y fuerza muscular. Resultados: niveles de vitamina D bajo 30 ng/dl aumentan en casi tres veces la probabilidad de fallecer (OR = 2,77; IC = 1,81-3,85), mientras que igual nivel de vitamina D se asocia a un doble riesgo de morir por causas cardiovasculares (OR = 1,78; IC = 1,21-2,09) en el modelo no ajustado. Para la mortalidad por cáncer y por caídas no se obtuvo ningún resultado significativo. La vitamina D no actuaría como factor protector ante la mortalidad. Conclusión: el poseer niveles de vitamina D bajo 30 ng/dl podría ser un factor de riesgo de mortalidad general


Background: hypovitaminosis D has a prevalence of 50,4% in older persons. This population has grown globally in an impressive way during the last 20 years. In addition, the deficiency of vitamin D (< 30 ng/ml) could raise the risk of mortality in this population. Objectives: to know whether vitamin D levels less than 30 ng/ml have an impact on mortality for overall causes, cardiovascular causes, cancer or injuries (falls) in a follow-up period of nine years in elderly subjects. Methods: a retrospective longitudinal study with nine years period of observation; 418 elderly subjects were followed, and they were recruited in 2004 to participate in a study about vitamin D supplementation and muscle strength. Results: vitamin D levels below 30 ng/dl increase by almost three times the probability of dying (OR = 2.77, IC = 1.81-3.85), while the same level of vitamin D is associated with a double risk of dying from cardiovascular causes (OR = 1.78, CI = 1.21-2.09) in the unadjusted model. For cancer mortality and falls, no significant results were obtained. Vitamin D would not act as a protective factor against mortality. Conclusions: vitamin D levels less than 30 ng/ml could be a risk factor for general mortality


Assuntos
Humanos , Composição Corporal/efeitos dos fármacos , Deficiência de Vitamina D/epidemiologia , Sarcopenia/epidemiologia , Sobrevida , Fatores de Risco , Estado Nutricional , Deficiência de Vitamina D/complicações , Deficiência de Vitamina D/dietoterapia , Estudos Retrospectivos , Densitometria , Índice de Massa Corporal , Estudos Longitudinais , Causas de Morte , Deficiência de Vitaminas/epidemiologia , Chile/epidemiologia
16.
PLoS Med ; 16(9): e1002907, 2019 09.
Artigo em Inglês | MEDLINE | ID: mdl-31509529

RESUMO

BACKGROUND: Few studies have evaluated the association between preexisting vitamin D deficiency and incident tuberculosis (TB). We assessed the impact of baseline vitamins D levels on TB disease risk. METHODS AND FINDINGS: We assessed the association between baseline vitamin D and incident TB in a prospective cohort of 6,751 HIV-negative household contacts of TB patients enrolled between September 1, 2009, and August 29, 2012, in Lima, Peru. We screened for TB disease at 2, 6, and 12 months after enrollment. We defined cases as household contacts who developed TB disease at least 15 days after enrollment of the index patient. For each case, we randomly selected four controls from among contacts who did not develop TB disease, matching on gender and year of age. We also conducted a one-stage individual-participant data (IPD) meta-analysis searching PubMed and Embase to identify prospective studies of vitamin D and TB disease until June 8, 2019. We included studies that assessed vitamin D before TB diagnosis. In the primary analysis, we defined vitamin D deficiency as 25-(OH)D < 50 nmol/L, insufficiency as 50-75 nmol/L, and sufficiency as >75nmol/L. We estimated the association between baseline vitamin D status and incident TB using conditional logistic regression in the Lima cohort and generalized linear mixed models in the meta-analysis. We further defined severe vitamin D deficiency as 25-(OH)D < 25 nmol/L and performed stratified analyses by HIV status in the IPD meta-analysis. In the Lima cohort, we analyzed 180 cases and 709 matched controls. The adjusted odds ratio (aOR) for TB risk among participants with baseline vitamin D deficiency compared to sufficient vitamin D was 1.63 (95% CI 0.75-3.52; p = 0.22). We included seven published studies in the meta-analysis and analyzed 3,544 participants. In the pooled analysis, the aOR was 1.48 (95% CI 1.04-2.10; p = 0.03). The aOR for severe vitamin D deficiency was 2.05 (95% CI 0.87-4.87; p trend for decreasing 25-(OH)D levels from sufficient vitamin D to severe deficiency = 0.02). Among 1,576 HIV-positive patients, vitamin D deficiency conferred a 2-fold (aOR 2.18, 95% CI 1.22-3.90; p = 0.01) increased risk of TB, and the aOR for severe vitamin D deficiency compared to sufficient vitamin D was 4.28 (95% CI 0.85-21.45; p = 0.08). Our Lima cohort study is limited by the short duration of follow-up, and the IPD meta-analysis is limited by the number of possible confounding covariates available across all studies. CONCLUSION: Our findings suggest vitamin D predicts TB disease risk in a dose-dependent manner and that the risk of TB disease is highest among HIV-positive individuals with severe vitamin D deficiency. Randomized control trials are needed to evaluate the possible role of vitamin D supplementation on reducing TB disease risk.


Assuntos
Tuberculose/epidemiologia , Deficiência de Vitamina D/epidemiologia , Vitamina D/análogos & derivados , Adolescente , Adulto , Biomarcadores/sangue , Estudos de Casos e Controles , Criança , Pré-Escolar , Feminino , Humanos , Incidência , Lactente , Recém-Nascido , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Peru/epidemiologia , Estudos Prospectivos , Medição de Risco , Fatores de Risco , Tuberculose/diagnóstico , Tuberculose/microbiologia , Vitamina D/sangue , Deficiência de Vitamina D/sangue , Deficiência de Vitamina D/diagnóstico , Adulto Jovem
17.
J Ayub Med Coll Abbottabad ; 31(3): 432-435, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31535522

RESUMO

BACKGROUND: Vitamin D has been the focus of attention in the recent past owing to its multitude of effects on various organ systems including immune system, endocrine, cardiovascular etc. Diabetes mellitus and obesity are widely prevalent in our region. The present study was designed with an objective to determine the vitamin D status in relation to diabetes mellitus and obesity in our area. METHODS: This cross-sectional study was conducted at the Medical C Unit of Department of Medicine, Ayub Teaching Hospital from January to December 2017. Approval of ethical committee was taken. A total of 117 patients were enrolled in this study of which 109 were finalized for analysis owing to incomplete data in 8 cases. Patients' characteristics were recorded on a structured proforma. Type 2 diabetes was confirmed using HbA1C Levels. Using ADA 2016 criteria. Vitamin D status was assessed using 25-OH-Vit D levels from the same laboratory. Height and weight of the patients were recorded to obtain BMI. Data was entered and analysed using SPSS version 20. RESULTS: Of the total sample, 69 (63.3%) were females and 40 (36.7%) were males. Mean age of the participants was 44.13±15.777. Mean vitamin D levels were 26.35±18.72. A total of 83 (76.14%) patients were either vitamin D deficient 66 (60.6%) or insufficient 17 (15.6%) while 26 (23.9%) were sufficient in vitamin D. There was statistically significant difference in vitamin D status in diabetic versus non diabetic patients (p=0.015). As regards BMI and vitamin D status, the difference was also statistically significant (p=0.018). CONCLUSIONS: Vitamin D deficiency is widely prevalent in our region. There is also a high prevalence of obesity and diabetes mellitus and they are inversely related to low vitamin D levels.


Assuntos
Diabetes Mellitus Tipo 2 , Obesidade , Deficiência de Vitamina D , Adulto , Estudos Transversais , Diabetes Mellitus Tipo 2/complicações , Diabetes Mellitus Tipo 2/epidemiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Obesidade/complicações , Obesidade/epidemiologia , Paquistão/epidemiologia , Deficiência de Vitamina D/complicações , Deficiência de Vitamina D/epidemiologia
18.
J Steroid Biochem Mol Biol ; 195: 105480, 2019 12.
Artigo em Inglês | MEDLINE | ID: mdl-31541727

RESUMO

BACKGROUND: There is increasing evidence that vitamin D supplementation may only be beneficial in people with vitamin D deficiency, and the lack of sufficient people with very low vitamin D levels could explain the lack of protection against cardiovascular disease (CVD) reported in recent clinical trials of vitamin D supplementation. The aim of this study was to assess associations of low to moderate circulating concentrations of 25-hydroxyvitamin D (25(OH)D with risk of incident CVD and all-cause mortality, as well as the risk of ischaemic heart disease (IHD), cerebrovascular disease, and heart failure separately. METHODS AND RESULTS: Longitudinal analysis of electronic health records in The Health Improvement Network (THIN), a UK primary care database. The analysis included 180,263 patients age 18 years and older without a history of CVD and with circulating concentrations of 25(OH)D. After a mean follow-up of 2.2 (SD 1.7) years, there were 3747 patients diagnosed with CVD and 3912 patients died. Compared to patients in the highest quintile of 25(OHD) (≥ 67.5 nmol/L), those in the lowest 25(OH)D quintile (<23.1 nmol/L) had a hazard ratio (HR) of 1.24 (95% CI 1.12-1.38, P <  0.001) for CVD and 1.71 (1.55-1.88, P <  0.001) for mortality. The HR for both outcomes associated with 25(OH)D concentration was non-linear, being significantly increased in patients with 25(OH)D <35 nmol/L, and highest in those with 25(OH)D <25 nmol/L, although increased for mortality at 25(OH)D ≥100 nmol/L. The increased CVD HR in the lowest 25(OH)D quintile was more from IHD (1.35, 95% CI 1.13-1.60) and heart failure (1.38, 95% CI 1.08-1.77), than from cerebrovascular disease (1.13, 95% CI 0.97-1.31). CONCLUSION: Low 25(OH)D are associated with highest risk of CVD and mortality, and are consistent with accumulating evidence that increased risk of these diseases occurs primarily in people with vitamin D deficiency.


Assuntos
Doenças Cardiovasculares/epidemiologia , Mortalidade , Deficiência de Vitamina D/epidemiologia , Vitamina D/análogos & derivados , Adulto , Idoso , Doenças Cardiovasculares/sangue , Estudos de Coortes , Bases de Dados Factuais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Fatores de Risco , Reino Unido/epidemiologia , Vitamina D/sangue , Deficiência de Vitamina D/sangue
19.
Zhonghua Yu Fang Yi Xue Za Zhi ; 53(9): 947-950, 2019 09 06.
Artigo em Chinês | MEDLINE | ID: mdl-31474080

RESUMO

From March 2015 to February 2018, 4 728 women aged 18 to 45 years old with single-pregnancy at the gestational age of 13 to 27 weeks in Hefei were recruited to analyze the trend of vitamin D status. The average levels of serum 25(OH)D in 2015, 2016 and 2017 were (43.22±18.41) nmol/L, (39.3±15.1) nmol/L and (36.6±17.0) nmol/L, and the prevalence of vitamin D deficiency were 69.5%, 77.6% and 81.4%, respectively. Compared with 2015, the levels of serum 25(OH)D in pregnant women in 2016 and 2017 decreased by 5.23 (95%CI: 4.10-6.35) nmol/L and 7.98 (95%CI: 6.77-9.19) nmol/L. The OR (95%CI) values for the risk of vitamin D deficiency were 1.88 (95%CI: 1.57-2.24) and 2.41 (95%CI: 1.98-2.93).


Assuntos
Complicações na Gravidez , Deficiência de Vitamina D , Vitamina D , Adolescente , Adulto , Feminino , Idade Gestacional , Humanos , Pessoa de Meia-Idade , Gravidez , Complicações na Gravidez/sangue , Complicações na Gravidez/epidemiologia , Prevalência , Fatores de Risco , Vitamina D/sangue , Deficiência de Vitamina D/sangue , Deficiência de Vitamina D/epidemiologia , Adulto Jovem
20.
J Nutr Sci Vitaminol (Tokyo) ; 65(4): 303-308, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31474679

RESUMO

The relationship between vitamin D levels and non-alcoholic fatty liver disease (NAFLD) remains unestablished. In this study, we aimed to explore the relationship between vitamin D levels and NAFLD based on population survey data. This cross-sectional study was conducted based on data from the National Health and Nutrition Examination Survey. Liver steatosis was diagnosed by ultrasonography. Binary logistic regression analyses were performed to determine the relationship between vitamin D status and NAFLD. A total of 9,782 participants were identified in this analysis, with 46.8% male and an average age of 44.41±0.16 y old. Among them, 6,047 (61.8%) cases were without NAFLD, 1,357 (13.9%) had mild NAFLD, 1,594 (16.3%) had moderate and 784 (8.0%) had severe NAFLD. Compared to those with non-NAFLD or mild NAFLD, patients in the moderate to severe NAFLD group had higher vitamin D deficiency or insufficiency rates (12.4% vs 11.5% and 36.8% vs 33.2%, respectively). After adjustment for male gender, older age, race, BMI, history of diabetes and vitamin D intake, vitamin D levels were independently associated with the severity of NAFLD (vitamin D deficiency group OR: 1.314, 95% CI: 1.129 to 1.529, vitamin D insufficiency group OR: 1.203, 95% CI: 1.090 to 1.328). Besides that, cold season was also found to be an independent factor for NAFLD (OR: 0.896, 95% CI: 0.820 to 0.979). Lower vitamin D level is an independent risk factor for NAFLD. Vitamin D levels are inversely associated with the severity of NAFLD. Cold season increases the risk of NAFLD independently.


Assuntos
Hepatopatia Gordurosa não Alcoólica/epidemiologia , Deficiência de Vitamina D/epidemiologia , Adulto , Índice de Massa Corporal , Temperatura Baixa , Estudos Transversais , Diabetes Mellitus , Dieta , Grupos Étnicos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Hepatopatia Gordurosa não Alcoólica/diagnóstico por imagem , Inquéritos Nutricionais , Fatores de Risco , Estações do Ano , Ultrassonografia , Vitamina D/administração & dosagem , Vitamina D/sangue , Deficiência de Vitamina D/complicações
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA