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1.
PLoS One ; 15(9): e0239252, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32941512

RESUMO

Until treatment and vaccine for coronavirus disease-2019 (COVID-19) becomes widely available, other methods of reducing infection rates should be explored. This study used a retrospective, observational analysis of deidentified tests performed at a national clinical laboratory to determine if circulating 25-hydroxyvitamin D (25(OH)D) levels are associated with severe acute respiratory disease coronavirus 2 (SARS-CoV-2) positivity rates. Over 190,000 patients from all 50 states with SARS-CoV-2 results performed mid-March through mid-June, 2020 and matching 25(OH)D results from the preceding 12 months were included. Residential zip code data was required to match with US Census data and perform analyses of race/ethnicity proportions and latitude. A total of 191,779 patients were included (median age, 54 years [interquartile range 40.4-64.7]; 68% female. The SARS-CoV-2 positivity rate was 9.3% (95% C.I. 9.2-9.5%) and the mean seasonally adjusted 25(OH)D was 31.7 (SD 11.7). The SARS-CoV-2 positivity rate was higher in the 39,190 patients with "deficient" 25(OH)D values (<20 ng/mL) (12.5%, 95% C.I. 12.2-12.8%) than in the 27,870 patients with "adequate" values (30-34 ng/mL) (8.1%, 95% C.I. 7.8-8.4%) and the 12,321 patients with values ≥55 ng/mL (5.9%, 95% C.I. 5.5-6.4%). The association between 25(OH)D levels and SARS-CoV-2 positivity was best fitted by the weighted second-order polynomial regression, which indicated strong correlation in the total population (R2 = 0.96) and in analyses stratified by all studied demographic factors. The association between lower SARS-CoV-2 positivity rates and higher circulating 25(OH)D levels remained significant in a multivariable logistic model adjusting for all included demographic factors (adjusted odds ratio 0.984 per ng/mL increment, 95% C.I. 0.983-0.986; p<0.001). SARS-CoV-2 positivity is strongly and inversely associated with circulating 25(OH)D levels, a relationship that persists across latitudes, races/ethnicities, both sexes, and age ranges. Our findings provide impetus to explore the role of vitamin D supplementation in reducing the risk for SARS-CoV-2 infection and COVID-19 disease.


Assuntos
Betacoronavirus/isolamento & purificação , Infecções por Coronavirus/sangue , Pandemias , Pneumonia Viral/sangue , RNA Viral/sangue , Deficiência de Vitamina D/sangue , Vitamina D/análogos & derivados , Adulto , Comorbidade , Grupos de Populações Continentais , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/virologia , Grupos Étnicos , Feminino , Geografia Médica , Saúde Global , Humanos , Masculino , Pessoa de Meia-Idade , Técnicas de Amplificação de Ácido Nucleico , Razão de Chances , Pneumonia Viral/epidemiologia , Pneumonia Viral/virologia , Análise de Regressão , Estudos Retrospectivos , Estações do Ano , Vitamina D/sangue , Deficiência de Vitamina D/epidemiologia
2.
Maturitas ; 140: 24-26, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32972631

RESUMO

Using Hill's methodology for exploring causality, we aimed to determine in early May 2020 whether evidence supports vitamin D as a biological determinant of COVID-19 outcomes. Vitamin D is a secosteroid hormone theoretically able to reduce COVID-19 risk through regulation of (i) the renin-angiotensin system, (ii) cellular innate and adaptive immunity, and (iii) physical barriers. Inverse associations were found between 25-hydroxyvitamin D concentrations and COVID-19 incidence and mortality. Randomized controlled trials testing vitamin D supplementation in the treatment of COVID-19 are in progress. Positive results in such studies would encourage the use of vitamin D supplements as an adjuvant treatment in COVID-19.


Assuntos
Infecções por Coronavirus/sangue , Pneumonia Viral/sangue , Deficiência de Vitamina D/sangue , Vitamina D/análogos & derivados , Betacoronavirus , Causalidade , Infecções por Coronavirus/tratamento farmacológico , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/mortalidade , Suplementos Nutricionais , Humanos , Pandemias , Pneumonia Viral/tratamento farmacológico , Pneumonia Viral/epidemiologia , Pneumonia Viral/mortalidade , Prognóstico , Vitamina D/sangue , Vitamina D/uso terapêutico , Deficiência de Vitamina D/epidemiologia , Vitaminas/uso terapêutico
3.
JAMA Netw Open ; 3(9): e2019722, 2020 09 01.
Artigo em Inglês | MEDLINE | ID: mdl-32880651

RESUMO

Importance: Vitamin D treatment has been found to decrease the incidence of viral respiratory tract infection, especially in patients with vitamin D deficiency. Whether vitamin D is associated with coronavirus disease 2019 (COVID-19) incidence is unknown. Objective: To examine whether the last vitamin D status before COVID-19 testing is associated with COVID-19 test results. Design, Setting, and Participants: This retrospective cohort study at an urban academic medical center included patients with a 25-hydroxycholecalciferol or 1,25-dihydroxycholecalciferol level measured within 1 year before being tested for COVID-19 from March 3 to April 10, 2020. Exposures: Vitamin D deficiency was defined by the last measurement of 25-hydroxycholecalciferol less than 20 ng/mL or 1,25-dihydroxycholecalciferol less than 18 pg/mL before COVID-19 testing. Treatment changes were defined by changes in vitamin D type and dose between the date of the last vitamin D level measurement and the date of COVID-19 testing. Vitamin D deficiency and treatment changes were combined to categorize the most recent vitamin D status before COVID-19 testing as likely deficient (last level deficient and treatment not increased), likely sufficient (last level not deficient and treatment not decreased), and 2 groups with uncertain deficiency (last level deficient and treatment increased, and last level not deficient and treatment decreased). Main Outcomes and Measures: The outcome was a positive COVID-19 polymerase chain reaction test result. Multivariable analysis tested whether vitamin D status before COVID-19 testing was associated with testing positive for COVID-19, controlling for demographic and comorbidity indicators. Results: A total of 489 patients (mean [SD] age, 49.2 [18.4] years; 366 [75%] women; and 331 [68%] race other than White) had a vitamin D level measured in the year before COVID-19 testing. Vitamin D status before COVID-19 testing was categorized as likely deficient for 124 participants (25%), likely sufficient for 287 (59%), and uncertain for 78 (16%). Overall, 71 participants (15%) tested positive for COVID-19. In multivariate analysis, testing positive for COVID-19 was associated with increasing age up to age 50 years (relative risk, 1.06; 95% CI, 1.01-1.09; P = .02); non-White race (relative risk, 2.54; 95% CI, 1.26-5.12; P = .009), and likely deficient vitamin D status (relative risk, 1.77; 95% CI, 1.12-2.81; P = .02) compared with likely sufficient vitamin D status. Predicted COVID-19 rates in the deficient group were 21.6% (95% CI, 14.0%-29.2%) vs 12.2%(95% CI, 8.9%-15.4%) in the sufficient group. Conclusions and Relevance: In this single-center, retrospective cohort study, likely deficient vitamin D status was associated with increased COVID-19 risk, a finding that suggests that randomized trials may be needed to determine whether vitamin D affects COVID-19 risk.


Assuntos
Infecções por Coronavirus , Pandemias , Pneumonia Viral , Deficiência de Vitamina D , Vitamina D/uso terapêutico , Betacoronavirus/isolamento & purificação , Calcifediol/sangue , Calcitriol/sangue , Técnicas de Laboratório Clínico/métodos , Infecções por Coronavirus/sangue , Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/epidemiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Pneumonia Viral/sangue , Pneumonia Viral/diagnóstico , Pneumonia Viral/epidemiologia , Estudos Retrospectivos , Fatores de Risco , Estados Unidos/epidemiologia , Deficiência de Vitamina D/sangue , Deficiência de Vitamina D/epidemiologia , Deficiência de Vitamina D/terapia , Vitaminas/uso terapêutico
4.
Nutrients ; 12(9)2020 Sep 10.
Artigo em Inglês | MEDLINE | ID: mdl-32927735

RESUMO

Infection with the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) poses an enormous challenge to health care systems throughout the world. Without causal treatment, identification of modifiable prognostic factors may help to improve outcomes. To explore possible associations of vitamin D (VitD) status with disease severity and survival, we studied 185 patients diagnosed with coronavirus disease 2019 (COVID-19) and treated at our center. VitD status at first presentation was assessed retrospectively using accredited laboratory methods. VitD deficiency was defined as serum total 25-hydroxyvitamin D level < 12 ng/mL (<30 nM). Primary endpoint was severe course of disease (i.e., need for invasive mechanical ventilation and/or death, IMV/D). Within a median observation period of 66 days (range 2-92), 23 patients required IMV. A total of 28 patients had IMV/D, including 16 deaths. Ninety-three (50%) patients required hospitalization (inpatient subgroup). A total of 41 (22%) patients were VitD deficient. When adjusted for age, gender, and comorbidities, VitD deficiency was associated with higher risk of IMV/D and death (HR 6.12, 95% CI 2.79-13.42, p < 0.001 and HR 14.73, 95% CI 4.16-52.19, p < 0.001, respectively). Similar correlations were observed in the inpatient subgroup. Our study demonstrates an association between VitD deficiency and severity/mortality of COVID-19, highlighting the need for interventional studies on VitD supplementation in SARS-CoV-2 infected individuals.


Assuntos
Betacoronavirus , Infecções por Coronavirus/mortalidade , Pneumonia Viral/mortalidade , Deficiência de Vitamina D/mortalidade , Idoso , Infecções por Coronavirus/sangue , Infecções por Coronavirus/virologia , Feminino , Alemanha/epidemiologia , Hospitalização/estatística & dados numéricos , Humanos , Masculino , Pessoa de Meia-Idade , Estado Nutricional , Pandemias , Pneumonia Viral/sangue , Pneumonia Viral/virologia , Prognóstico , Estudos Prospectivos , Estudos Retrospectivos , Índice de Gravidade de Doença , Vitamina D/análogos & derivados , Vitamina D/sangue , Deficiência de Vitamina D/sangue , Deficiência de Vitamina D/virologia
5.
Nutrients ; 12(9)2020 Sep 11.
Artigo em Inglês | MEDLINE | ID: mdl-32932831

RESUMO

The novel Coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2) is a global health concern. Vitamin D (VITD) deficiency has been suggested to alter SARS-CoV-2 susceptibility and the course of disease. Thus, we aimed to investigate associations of VITD status to disease presentation within the CovILD registry. This prospective, multicenter, observational study on long-term sequelae includes patients with COVID-19 after hospitalization or outpatients with persistent symptoms. Eight weeks after PCR confirmed diagnosis, a detailed questionnaire, a clinical examination, and laboratory testing, including VITD status, were evaluated. Furthermore, available laboratory specimens close to hospital admission were used to retrospectively analyze 25-hydroxyvitamin D levels at disease onset. A total of 109 patients were included in the analysis (60% males, 40% females), aged 58 ± 14 years. Eight weeks after the onset of COVID-19, a high proportion of patients presented with impaired VITD metabolism and elevated parathyroid hormone (PTH) levels. PTH concentrations were increased in patients who needed intensive care unit (ICU) treatment, while VITD levels were not significantly different between disease severity groups. Low VITD levels at disease onset or at eight-week follow-up were not related to persistent symptom burden, lung function impairment, ongoing inflammation, or more severe CT abnormalities. VITD deficiency is frequent among COVID-19 patients but not associated with disease outcomes. However, individuals with severe disease display a disturbed parathyroid-vitamin-D axis within their recovery phase. The proposed significance of VITD supplementation in the clinical management of COVID-19 remains elusive.


Assuntos
Betacoronavirus , Infecções por Coronavirus/sangue , Pneumonia Viral/sangue , Deficiência de Vitamina D/virologia , Vitamina D/análogos & derivados , Idoso , Infecções por Coronavirus/complicações , Infecções por Coronavirus/virologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estado Nutricional , Pandemias , Hormônio Paratireóideo/sangue , Pneumonia Viral/complicações , Pneumonia Viral/virologia , Estudos Prospectivos , Sistema de Registros , Fatores de Risco , Índice de Gravidade de Doença , Vitamina D/sangue , Deficiência de Vitamina D/sangue , Deficiência de Vitamina D/epidemiologia
6.
Neurology ; 95(9): e1117-e1125, 2020 09 01.
Artigo em Inglês | MEDLINE | ID: mdl-32759193

RESUMO

OBJECTIVE: To assess the effect of vitamin D and calcium supplementation in preventing recurrences of benign paroxysmal positional vertigo (BPPV). METHODS: We performed an investigator-initiated, blinded-outcome assessor, parallel, multicenter, randomized controlled trial in 8 hospitals between December 2013 and May 2017. Patients with confirmed BPPV were randomly assigned to the intervention (n = 518) or the observation (n = 532) group after successful treatment with canalith repositioning maneuvers. The primary outcome was the annual recurrence rate (ARR). Patients in the intervention group had taken vitamin D 400 IU and 500 mg of calcium carbonate twice a day for 1 year when serum vitamin D level was lower than 20 ng/mL. Patients in the observation group were assigned to follow-ups without further vitamin D evaluation or supplementation. RESULTS: The intervention group showed a reduction in the ARR (0.83 [95% confidence interval (CI), 0.74-0.92] vs 1.10 [95% CI, 1.00-1.19] recurrences per 1 person-year) with an incidence rate ratio of 0.76 (95% CI, 0.66-0.87, p < 0.001) and an absolute rate ratio of -0.27 (-0.40 to -0.14) from intention-to-treat analysis. The number needed to treat was 3.70 (95% CI, 2.50-7.14). The proportion of patients with recurrence was also lower in the intervention than in the observation group (37.8 vs 46.7%, p = 0.005). CONCLUSIONS: Supplementation of vitamin D and calcium may be considered in patients with frequent attacks of BPPV, especially when serum vitamin D is subnormal. CLASSIFICATION OF EVIDENCE: This study provides Class III evidence that for patients with BPPV, vitamin D and calcium supplementation reduces recurrences of BPPV.


Assuntos
Vertigem Posicional Paroxística Benigna/prevenção & controle , Carbonato de Cálcio/uso terapêutico , Deficiência de Vitamina D/tratamento farmacológico , Vitamina D/uso terapêutico , Vitaminas/uso terapêutico , Acidentes por Quedas/estatística & dados numéricos , Idoso , Vertigem Posicional Paroxística Benigna/sangue , Vertigem Posicional Paroxística Benigna/complicações , Vertigem Posicional Paroxística Benigna/terapia , Cálcio/sangue , Suplementos Nutricionais , Feminino , Fraturas Ósseas/epidemiologia , Humanos , Masculino , Pessoa de Meia-Idade , Membrana dos Otólitos , Hormônio Paratireóideo/sangue , Posicionamento do Paciente , Fósforo/sangue , Recidiva , Prevenção Secundária , Vitamina D/análogos & derivados , Vitamina D/sangue , Deficiência de Vitamina D/sangue , Deficiência de Vitamina D/complicações
7.
PLoS One ; 15(8): e0236510, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32790765

RESUMO

BACKGROUND: Poor vitamin D status is a global health problem and common in patients with human immunodeficiency virus (HIV) in high-income countries. There is less evidence on prevalence of vitamin D deficiency and nutrition and growth in HIV-infected and -exposed children in low- and middle-income countries. OBJECTIVES: To determine the vitamin D status in Batswana HIV-infected mothers and their children, differences among HIV-infected mothers and between HIV-exposed and -infected infants and children, and associations between vitamin D and disease-related outcomes, nutrition, and growth. METHODS: This was a cross-sectional study of HIV+ mothers and HIV-exposed infants and unrelated children (1-7.9 years). Serum 25-hydroxyvitamin D (25(OH)D) was measured, among other nutritional indicators, for mothers, infants and children. Vitamin D status for HIV-infected mothers and children, and an immune panel was assessed. History of HIV anti-retroviral medications and breastfeeding were obtained. Data were collected prior to universal combination antiretroviral therapy in pregnancy. RESULTS: Mothers (n = 36) had a mean serum 25(OH)D of 37.2±12.4ng/mL; 11% had insufficient (<20ng/mL), 17% moderately low (20.0-29.9ng/mL) and 72% sufficient (≥30ng/mL) concentrations. No infants (n = 36) or children (n = 48) were vitamin D insufficient; 22% of HIV- and no HIV+ infants had moderately low concentrations and 78% of HIV- and 100% of HIV+ infants had sufficient status, 8% of HIV- and no HIV+ children had moderately low concentrations and 92% of HIV- and 100% HIV+ children had sufficient concentrations. HIV+ children had significantly lower length/height Z scores compared to HIV- children. Length/height Z score was positively correlated with serum 25(OH)D in all children (r = 0.33, p = 0.023), with a stronger correlation in the HIV+ children (r = 0.47 p = 0.021). In mothers, serum 25(OH)D was positively associated with CD4% (r = 0.40, p = 0.016). CONCLUSIONS: Results showed a low prevalence of vitamin D insufficiency in Botswana. Growth was positively correlated with vitamin D status in HIV-exposed children, and HIV+ children had poorer linear growth than HIV- children.


Assuntos
Infecções por HIV/epidemiologia , Deficiência de Vitamina D/epidemiologia , Adulto , Botsuana/epidemiologia , Criança , Desenvolvimento Infantil , Saúde da Criança , Pré-Escolar , Estudos Transversais , Feminino , Infecções por HIV/sangue , Infecções por HIV/complicações , Humanos , Lactente , Mães , Estado Nutricional , Gravidez , Complicações Infecciosas na Gravidez/sangue , Complicações Infecciosas na Gravidez/epidemiologia , Efeitos Tardios da Exposição Pré-Natal/sangue , Efeitos Tardios da Exposição Pré-Natal/epidemiologia , Vitamina D/análogos & derivados , Vitamina D/sangue , Deficiência de Vitamina D/sangue , Deficiência de Vitamina D/complicações , Adulto Jovem
8.
Ann Hematol ; 99(10): 2377-2384, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32728938

RESUMO

This study investigated the prognostic value of 25-hydroxy vitamin D (25-(OH)D) deficiency and the association between 25-(OH)D deficiency and c-Myc positivity in 208 newly diagnosed diffuse large B cell lymphoma (DLBCL) patients. 25-(OH)D deficiency was defined as serum 25-(OH)D level lower than 52.5 nmol/L. Using cutoff values of 40%, positive tumor cells for c-Myc expression was established. One hundred forty-two patients had 25-(OH)D deficiency and 70 had c-Myc positivity with a median follow-up of 29 months (range, 16 to 49 months) in this cohort. Multivariate Cox regression analysis showed that 25-(OH)D deficiency was an independent prognostic predictor for inferior progression-free survival (PFS) (P = 0.001) and overall survival (OS) (P = 0.006), and c-Myc positivity was an unfavorable prognostic factor for PFS (P = 0.004). In addition, c-Myc positivity was more frequent in patients with 25-(OH)D deficiency (P = 0.027). Moreover, we found that the presence of c-Myc positivity could aggravate the adverse effects of 25-(OH)D deficiency for PFS time (P = 0.0045). 25-(OH)D deficiency together with IPI (IPI-D) improved the prognostic capacity compared with only IPI in predicting the risk of DLBCL which was assessed by the calculation of receiver operator characteristic (ROC) curves and the areas under the curve (AUC). Noteworthy, c-Myc positivity combined with IPI-D was better than IPI-D in predicting PFS time. In summary, 25-(OH)D deficiency was a strong prognostic factor in DLBCL. Further multi-center prospective studies are needed to confirm the results and better understand the underlying mechanisms.


Assuntos
Genes myc , Linfoma Difuso de Grandes Células B/epidemiologia , Proteínas de Neoplasias/biossíntese , Proteínas Proto-Oncogênicas c-myc/biossíntese , Deficiência de Vitamina D/epidemiologia , Vitamina D/análogos & derivados , Adulto , Idoso , Idoso de 80 Anos ou mais , Protocolos de Quimioterapia Combinada Antineoplásica/administração & dosagem , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Área Sob a Curva , China/epidemiologia , Comorbidade , Ciclofosfamida/administração & dosagem , Progressão da Doença , Doxorrubicina/administração & dosagem , Feminino , Seguimentos , Humanos , Estimativa de Kaplan-Meier , Linfoma Difuso de Grandes Células B/sangue , Linfoma Difuso de Grandes Células B/tratamento farmacológico , Linfoma Difuso de Grandes Células B/genética , Masculino , Pessoa de Meia-Idade , Proteínas de Neoplasias/genética , Prednisona/administração & dosagem , Modelos de Riscos Proporcionais , Proteínas Proto-Oncogênicas c-myc/genética , Curva ROC , Vincristina/administração & dosagem , Vitamina D/sangue , Deficiência de Vitamina D/sangue , Adulto Jovem
9.
Nutrients ; 12(7)2020 Jul 15.
Artigo em Inglês | MEDLINE | ID: mdl-32679784

RESUMO

Vitamin D is responsible for regulation of calcium and phosphate metabolism and maintaining a healthy mineralized skeleton. It is also known as an immunomodulatory hormone. Experimental studies have shown that 1,25-dihydroxyvitamin D, the active form of vitamin D, exerts immunologic activities on multiple components of the innate and adaptive immune system as well as endothelial membrane stability. Association between low levels of serum 25-hydroxyvitamin D and increased risk of developing several immune-related diseases and disorders, including psoriasis, type 1 diabetes, multiple sclerosis, rheumatoid arthritis, tuberculosis, sepsis, respiratory infection, and COVID-19, has been observed. Accordingly, a number of clinical trials aiming to determine the efficacy of administration of vitamin D and its metabolites for treatment of these diseases have been conducted with variable outcomes. Interestingly, recent evidence suggests that some individuals might benefit from vitamin D more or less than others as high inter-individual difference in broad gene expression in human peripheral blood mononuclear cells in response to vitamin D supplementation has been observed. Although it is still debatable what level of serum 25-hydroxyvitamin D is optimal, it is advisable to increase vitamin D intake and have sensible sunlight exposure to maintain serum 25-hydroxyvitamin D at least 30 ng/mL (75 nmol/L), and preferably at 40-60 ng/mL (100-150 nmol/L) to achieve the optimal overall health benefits of vitamin D.


Assuntos
Suplementos Nutricionais , Deficiência de Vitamina D/imunologia , Vitamina D/análogos & derivados , Vitamina D/imunologia , Vitaminas/imunologia , Betacoronavirus/imunologia , Infecções por Coronavirus/sangue , Infecções por Coronavirus/imunologia , Humanos , Leucócitos Mononucleares/imunologia , Estado Nutricional , Pandemias , Pneumonia Viral/sangue , Pneumonia Viral/imunologia , Vitamina D/administração & dosagem , Vitamina D/sangue , Deficiência de Vitamina D/sangue , Vitaminas/administração & dosagem
11.
J Med Life ; 13(2): 260-264, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32728404

RESUMO

Several etiologies have been proposed as a basis and evolution theory for the development of adolescent idiopathic scoliosis, but limited data were published until now that link vitamin D and calcium deficiency to this condition. The present study aims to evaluate the relationship between 25-OH-Vitamin D, total calcium, and the following data: Cobb angle, age, and patient sex. The seasonal variation for vitamin D will also be taken into consideration. A total of 101 patients with a mean age of 11.61 ± 2.33 years had vitamin D and calcium levels tested. The mean Cobb angle was 26.21o ± 12.37. The level of vitamin D was, on average, 24 ng/mL ± 9.64. Calcium values were within the normal range, with an average of 9.82 mg/dL ± 0.42. The male group showed lower levels of vitamin D compared to the female group (19.6 vs. 25.45 ng/mL) (p = 0.02). Seasonal variations showed significant differences for vitamin D (p=.0001). Vitamin D level was positively correlated with the calcium level (p=0.01, r=0.973), but also with the patient's age (p <0.001, r=0.158). The Cobb angle was negatively correlated with serum vitamin D levels (p<0.01, r=-0.472). Patients included in this study had low vitamin D levels, significant differences being observed between boys and girls, boys being more affected. The positive correlation between vitamin D and calcium, together with the negative correlation with the Cobb angle, is yet another proof that patients with idiopathic scoliosis should be investigated regularly for these pathologies.


Assuntos
Calcifediol/deficiência , Cálcio/deficiência , Escoliose/epidemiologia , Deficiência de Vitamina D/epidemiologia , Adolescente , Calcifediol/sangue , Cálcio/sangue , Criança , Feminino , Humanos , Masculino , Prevalência , Escoliose/sangue , Estações do Ano , Deficiência de Vitamina D/sangue
12.
PLoS One ; 15(7): e0235332, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32628705

RESUMO

Neonatal vitamin D deficiency is common and is associated with development of pulmonary disease in children and adults. While the role of vitamin D in normal lung development is well established, the association between vitamin D deficiency and bronchopulmonary dysplasia (BPD) remains unclear. The present meta-analysis was conducted to evaluate the relationship between vitamin D and BPD. We identified relevant studies (n = 8) using the PubMed, EMBASE, Cochrane Library, and KoreaMed databases and applied the Newcastle-Ottawa Scale to assess the methodological components of each study, and used I2 statistic to evaluate heterogeneity. Comprehensive Meta-Analysis software version 3.3 was used for the statistical analysis. A total of 909 infants were included, of whom 251 (27.6%) were diagnosed with BPD. We found that both vitamin D deficiency at birth (four studies; OR 2.405; 95% CI 1.269 to 4.560; p = 0.007) and low levels of vitamin D at birth (four studies; standardized mean difference -1.463; 95% CI -2.900 to -0.027; p = 0.046) were associated with BPD. The compiled data suggest that antenatal vitamin D deficiency and low vitamin D levels are associated with neonatal BPD.


Assuntos
Displasia Broncopulmonar/epidemiologia , Deficiência de Vitamina D/epidemiologia , Vitamina D/sangue , Displasia Broncopulmonar/etiologia , Humanos , Incidência , Lactente , Recém-Nascido , Razão de Chances , Fatores de Risco , Deficiência de Vitamina D/sangue , Deficiência de Vitamina D/complicações , Deficiência de Vitamina D/diagnóstico
13.
PLoS One ; 15(6): e0234333, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32525921

RESUMO

In most cases, multiple sclerosis (MS) patients reduce physical activity with disease progression and many patients are found to be vitamin D deficient. The aim of this study was to explore correlations between daily physical activity in everyday life and 25-hydroxyvitamin-D3 (25(OH)D3) serum levels in mildly disabled patients with an Expanded Disability Status Scale (EDSS) ≤ 4. We analyzed serum 25(OH)D3 levels and recorded daily physical activity (activity duration, number of steps, distance, energy expenditure) using an activity tracker for 14-days in 25 women and 15 men. Participants recorded their daily sunlight exposure time by diary during the study period. We found a positive correlation between physical activity and 25(OH)D3 levels in both, Pearson correlation (r = 0.221) and multivariate regression analysis (ß = 0.236), which was stronger than correlation with sunlight exposure time (ß = -0.081). EDSS and physical activity were weakly correlated (r = -0.228), but no correlation between EDSS and 25(OH)D3 levels was found (r = -0.077). There were no relevant differences in physical activity (p = 0.803) and 25(OH)D3 concentrations (p = 0.385) between the EDSS groups 0 - 1.5 and 2.0 - 4.0. In conclusion, physical activity has an effect on vitamin D levels independent of sunlight exposure time in people with MS (pwMS) with low-grade disability.


Assuntos
Calcifediol/sangue , Exercício Físico/fisiologia , Esclerose Múltipla/sangue , Esclerose Múltipla/fisiopatologia , Adulto , Avaliação da Deficiência , Progressão da Doença , Feminino , Monitores de Aptidão Física , Humanos , Masculino , Pessoa de Meia-Idade , Esclerose Múltipla/complicações , Análise Multivariada , Estudos Prospectivos , Análise de Regressão , Luz Solar , Deficiência de Vitamina D/sangue , Deficiência de Vitamina D/complicações , Adulto Jovem
14.
PLoS One ; 15(6): e0233890, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32542014

RESUMO

BACKGROUND: Allergic conditions and respiratory tract infections (RTIs) are common causes of morbidity and mortality in childhood. The relationship between vitamin D status in pregnancy (mothers), early life (infants) and health outcomes such as allergies and RTIs in infancy is unclear. To date, studies have shown conflicting results. OBJECTIVE: This systematic review aims to gather and appraise existing evidence on the associations between serum vitamin D concentrations during pregnancy and at birth and the development of eczema, wheezing, and RTIs in infants. DATA SOURCES: PubMed, MEDLINE, ProQuest, Scopus, CINAHL, Cochrane Library and Academic Search Premier databases were searched systematically using specified search terms and keywords. STUDY SELECTION: Articles on the associations between serum vitamin D concentrations during pregnancy and at birth and eczema, wheezing, and RTIs among infants (1-year-old and younger) published up to 31 March 2019 were identified, screened and retrieved. RESULTS: From the initial 2678 articles screened, ten met the inclusion criteria and were included in the final analysis. There were mixed and conflicting results with regards to the relationship between maternal and cord blood vitamin D concentrations and the three health outcomes-eczema, wheezing and RTIs-in infants. CONCLUSION: Current findings revealed no robust and consistent associations between vitamin D status in early life and the risk of developing eczema, wheezing and RTIs in infants. PROSPERO registration no. CRD42018093039.


Assuntos
Eczema/epidemiologia , Hipersensibilidade/epidemiologia , Complicações na Gravidez/epidemiologia , Sons Respiratórios , Infecções Respiratórias/epidemiologia , Deficiência de Vitamina D/epidemiologia , Vitamina D/sangue , Adulto , Estudos de Coortes , Bases de Dados como Assunto , Feminino , Humanos , Lactente , Recém-Nascido , Morbidade , Gravidez , Complicações na Gravidez/sangue , Deficiência de Vitamina D/sangue
15.
Rev Assoc Med Bras (1992) ; 66(3): 268-274, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-32520144

RESUMO

OBJECTIVE: To investigate the association between low serum vitamin D levels and peripheral arterial disease (PAD). METHODS: A cross-sectional study with a consecutive sample of 133 individuals from Caxias do Sul, Brasil. We considered PAD patients those with an ankle-brachial index (ABI) ≤ 0.90 or with arterial revascularization. Vitamin D serum level was categorized as sufficient (≥30 ng/mL), insufficient (>20 to 29 ng/mL), and deficient (<20 ng/mL). Prevalence ratios (RP) were calculated through Poisson regression. RESULTS: The prevalence of PAD was 50.7% (95% CI 42-59). After adjustment for potential PAD risk factors, RP were 1.08 (95% CI 0.66-1.76) for insufficient serum level and 1.57 (95% CI 0.96-2.57) for deficient vitamin D serum level; (p for trend = 0.020). CONCLUSION: Vitamin D serum levels showed an inverse and significant dose-response relationship with PAD.


Assuntos
Doença Arterial Periférica/sangue , Doença Arterial Periférica/etiologia , Deficiência de Vitamina D/complicações , Vitamina D/sangue , Adulto , Índice Tornozelo-Braço , Brasil/epidemiologia , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Doença Arterial Periférica/epidemiologia , Prevalência , Fatores de Risco , Vitamina D/uso terapêutico , Deficiência de Vitamina D/sangue
16.
Arch Gynecol Obstet ; 302(1): 141-152, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-32430755

RESUMO

PURPOSE: No consensus exists on the relationship between vitamin D status and endometriosis. The chief aim of our study was to evaluate the association between serum vitamin D levels and endometriosis. METHODS: We searched for MEDLINE, EMBASE, and China National Knowledge Infrastructure (CNKI) databases for studies elucidated the circulating vitamin D levels in endometriosis. The standardized mean differences (SMDs) or odds ratios (ORs) with their 95% confidence interval (CIs) were calculated to evaluate the association between vitamin D levels and endometriosis. RESULTS: Nine studies were included in this meta-analysis. The pooled results indicated that women with endometriosis had lower vitamin D status than that in controls (SMD - 0.97 ng/mL, 95% CI - 1.80 to - 0.14; p = 0.02), and vitamin D status had a negative correlation with the severity of the disease (stage III-IV vs stage I-II: SMD - 1.33 ng/mL, 95% CI - 2.54 to - 0.12; p = 0.03). Although it was not statistically significantly different, hypovitaminosis D had a tendency to be associated with endometriosis (OR 2.77, 95% CI 0.85-6.08, p = 0.10). Heterogeneity was high among included studies. Subgroup analyses revealed that women with no hormone use had lower vitamin D status when compared with controls (SMD - 1.38 ng/mL, 95% CI - 2.59 to - 0.18; p = 0.02). For studies which sample size < 100, serum vitamin D levels were significantly lower in patients than that in controls (SMD - 0.65 ng/mL, 95% CI - 1.19 to - 0.11; p = 0.02). CONCLUSIONS: Women with endometriosis had lower vitamin D status when compared with controls, and a negative relationship between vitamin D levels and severity of endometriosis was observed. In addition, hypovitaminosis D was a potential risk factor for endometriosis.


Assuntos
Endometriose/complicações , Deficiência de Vitamina D/sangue , Vitamina D/sangue , Estudos de Casos e Controles , Feminino , Humanos , Garantia da Qualidade dos Cuidados de Saúde , Fatores de Risco
17.
Cardiovasc Ther ; 2020: 4940673, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32426036

RESUMO

Background: Hypertension is regarded as a major and independent risk factor of cardiovascular diseases, and numerous studies observed an inverse correlation between vitamin C intake and blood pressure. Aim: Our aim is to investigate the relationship between serum vitamin C and blood pressure, including the concentration differences and the correlation strength. Method: Two independent researchers searched and screened articles from the National Library of Medicine, Cochrane Library, Web of Science, China National Knowledge Infrastructure, VIP databases, and WANFANG databases. A total of 18 eligible studies were analyzed in the Reviewer Manager 5.3 software, including 14 English articles and 4 Chinese articles. Results: In the evaluation of serum vitamin C levels, the concentration in hypertensive subjects is 15.13 µmol/L lower than the normotensive ones (mean difference = -15.13, 95% CI [-24.19, -6.06], and P = 0.001). Serum vitamin C has a significant inverse relation with both systolic blood pressure (Fisher's Z = -0.17, 95% CI [-0.20, -0.15], P < 0.00001) and diastolic blood pressure (Fisher's Z = -0.15, 95% CI [-0.20, -0.10], P < 0.00001). Conclusions: People with hypertension have a relatively low serum vitamin C, and vitamin C is inversely associated with both systolic blood pressure and diastolic blood pressure.


Assuntos
Ácido Ascórbico/sangue , Pressão Sanguínea , Hipertensão/fisiopatologia , Deficiência de Vitamina D/sangue , Adulto , Idoso , Idoso de 80 Anos ou mais , Biomarcadores/sangue , Feminino , Humanos , Hipertensão/diagnóstico , Hipertensão/epidemiologia , Masculino , Pessoa de Meia-Idade , Estudos Observacionais como Assunto , Medição de Risco , Fatores de Risco , Deficiência de Vitamina D/diagnóstico , Deficiência de Vitamina D/epidemiologia , Adulto Jovem
18.
Thromb Haemost ; 120(5): 768-775, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-32369848

RESUMO

BACKGROUND: Cardiovascular events are associated with low circulating vitamin D concentrations, although the underlying mechanisms are poorly understood. This study investigated associations between 25-hydroxyvitamin D concentrations, platelet function, and single-nucleotide polymorphisms (SNPs) in genes influencing vitamin D biology in the 500 Functional Genomics (500FG) cohort. METHODS: In this observational study, platelet activation and function were measured by flow cytometry by binding of fibrinogen to the activated fibrinogen receptor integrin αIIbß3 and expression of P-selectin, markers of platelet aggregation and degranulation, respectively. These parameters were correlated to serum 25-hydroxyvitamin D and genotyping was performed to investigate SNPs in genes important for vitamin D biology. RESULTS: Circulating 25-hydroxyvitamin D concentrations correlated inversely with baseline platelet binding of fibrinogen to integrin αIIbß3 (Pearson's r= -0.172, p = 0.002) and platelet responses to platelet agonist cross-linked collagen-related peptide (CRP-XL) (Pearson's r= -0.196,p = 0.002). This effect was due to circulating vitamin D levels ≤50nmol/L, since no differences in platelet fibrinogen binding were observed between subjects with normal 25-hydroxyvitamin D concentrations (>75nmol/L) and a 25-hydroxyvitamin D insufficiency (50-75 nmol/L). No correlations between 25-hydroxyvitamin D concentrations and platelet P-selectin expression were found. Several SNPs in the GC region of the vitamin D binding proteingene were associated with platelet responses to CRP-XL. CONCLUSION: Low circulating vitamin D concentrations are associated with increased platelet fibrinogen binding to integrin αIIbß3 in unstimulated samples and after stimulation with CRP-XL. These findings may contribute to the increased incidence of cardiovascular events in vitamin D deficient adults and its seasonal variation. Further studies are needed to investigate causality.


Assuntos
Plaquetas/metabolismo , Ativação Plaquetária , Complexo Glicoproteico GPIIb-IIIa de Plaquetas/metabolismo , Deficiência de Vitamina D/sangue , Adolescente , Adulto , Biomarcadores/sangue , Degranulação Celular , Feminino , Fibrinogênio/metabolismo , Voluntários Saudáveis , Humanos , Masculino , Selectina-P/sangue , Agregação Plaquetária , Polimorfismo de Nucleotídeo Único , Receptores de Calcitriol/genética , Receptores de Calcitriol/metabolismo , Transdução de Sinais , Vitamina D/análogos & derivados , Vitamina D/sangue , Deficiência de Vitamina D/diagnóstico , Deficiência de Vitamina D/genética , Adulto Jovem
19.
Am J Med Sci ; 360(2): 146-152, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32466854

RESUMO

BACKGROUND: Transient hypocalcemia due to parathyroid gland or vessel manipulation is a common complication following thyroidectomy. Considering the role of 25-hydroxyvitamin D (25(OH)D) in calcium hemostasis, this study aimed to evaluate the effect of preoperative vitamin D supplementation on hypocalcemia incidence in thyroidectomy patients. METHODS: In this randomized clinical trial, 100 patients scheduled for total thyroidectomy and suffering from preoperative moderate or severe vitamin D deficiency were enrolled. Patients were randomly allocated to either study or control groups using the sealed envelope method. Patients in the study group received vitamin D3 50,000-unit pearl weekly for 4 weeks prior to the operation. The control group received placebo. Total and ionized serum calcium levels were checked before surgery, the day after surgery, and 2 weeks postoperatively. RESULTS: No significant difference was observed in terms of demographic data. During serial total calcium checks (5 episodes), total calcium levels changed significantly in patients who had received vitamin D supplements compared to the control group (P = 0.043). Symptomatic hypocalcemia incidence was significantly lower in patients supplemented with 25-hydroxyvitamin D (25(OH)D) (P = 0.04). Also, the requirement for intravenous calcium administration in order to treat the hypocalcemia symptoms was significantly lower in the study in comparison to the control group (P = 0.03). CONCLUSIONS: Vitamin D supplementation in patients with vitamin D deficiency might lead to a lower incidence of early-onset symptomatic hypocalcemia; hence, requiring less calcium supplementation for the management of hypocalcemia.


Assuntos
Colecalciferol/uso terapêutico , Hipocalcemia/epidemiologia , Complicações Pós-Operatórias/epidemiologia , Cuidados Pré-Operatórios/métodos , Doenças da Glândula Tireoide/cirurgia , Tireoidectomia , Deficiência de Vitamina D/tratamento farmacológico , Vitaminas/uso terapêutico , Adenocarcinoma Folicular/cirurgia , Adulto , Cálcio/sangue , Feminino , Bócio Nodular/cirurgia , Humanos , Hipocalcemia/sangue , Hipocalcemia/fisiopatologia , Masculino , Complicações Pós-Operatórias/fisiopatologia , Câncer Papilífero da Tireoide/cirurgia , Neoplasias da Glândula Tireoide/cirurgia , Vitamina D/análogos & derivados , Vitamina D/sangue , Deficiência de Vitamina D/sangue , Deficiência de Vitamina D/diagnóstico
20.
Nutr Metab Cardiovasc Dis ; 30(7): 1152-1160, 2020 06 25.
Artigo em Inglês | MEDLINE | ID: mdl-32456946

RESUMO

BACKGROUND AND AIMS: We determined the association between left atrial (LA) thrombus occurrence and a non-classic risk marker, plasma levels of vitamin D, in atrial fibrillation (AF) patients on continuous non-vitamin K antagonist oral anticoagulant (NOAC) therapy for ≥4 weeks. Low levels of plasma 25-hydroxy vitamin D (25-OHD) are predictive of fatal stroke. Vitamin D has anticoagulant effects on the coagulation cascade, which are indirectly targeted by NOAC therapy. The impact of plasma levels of vitamin D on the rate of LA thrombus detected by transesophageal echocardiography (TEE) in AF patients is unknown. METHODS AND RESULTS: We enrolled 201 (133 female) AF patients who were using continuous NOAC therapy for ≥4 weeks. All patients underwent transthoracic and TEE examination. Serum concentrations of 25-OHD, C-reactive protein (CRP) levels, CHA2DS2-VASc scores and parameters, LA size, and left ventricle ejection fraction (LVEF) were examined before the TEE procedure. LA thrombus occurrence was independently associated with serum levels of 25-OHD (OR: 0.884; 95% CI: 0.839-0.932; P < 0.001), LA diameter (OR: 1.120; 95% CI: 1.038-1.209; P = 0.003), and LVEF(OR: 0.944; 95% CI: 0.896-0.995; P = 0.032). Dense spontaneous echo contrast (SEC) presence was also inversely associated with 25-OHD concentrations. CONCLUSIONS: Low 25-OHD levels, as a non-classic risk factor, were independently and significantly associated with dense SEC and LA thrombus occurrence in AF patients under NOAC therapy, as well as LA enlargement and decreased LVEF. Further large-scale studies are needed to explain the role of vitamin D deficiency, or efficacy of replacement, on LA thrombus occurrence.


Assuntos
Fibrilação Atrial/tratamento farmacológico , Inibidores do Fator Xa/administração & dosagem , Acidente Vascular Cerebral/prevenção & controle , Trombose/prevenção & controle , Deficiência de Vitamina D/sangue , Vitamina D/análogos & derivados , Administração Oral , Idoso , Fibrilação Atrial/diagnóstico , Fibrilação Atrial/epidemiologia , Biomarcadores/sangue , Esquema de Medicação , Ecocardiografia Transesofagiana , Inibidores do Fator Xa/efeitos adversos , Feminino , Humanos , Masculino , Prevalência , Estudos Prospectivos , Medição de Risco , Fatores de Risco , Acidente Vascular Cerebral/diagnóstico , Acidente Vascular Cerebral/epidemiologia , Trombose/diagnóstico por imagem , Trombose/epidemiologia , Fatores de Tempo , Resultado do Tratamento , Turquia/epidemiologia , Vitamina D/sangue , Deficiência de Vitamina D/diagnóstico , Deficiência de Vitamina D/epidemiologia
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