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1.
Medicine (Baltimore) ; 99(8): e19034, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-32080077

RESUMO

BACKGROUND: Previous studies showed conflicting results for associations between vitamin D and prediabetes. The study aimed to make a systematic review and meta-analysis for the association between vitamin D and prediabetes. METHODS: We searched for articles identifying associations between vitamin D and prediabetes published in English until July 2019 in following databases (PubMed, Web of Science, EMBASE, Medline, Google Scholar, and Cochrane databases). Finally, we conducted these analyses (heterogeneities examination, meta-regression analyses, sensitivity analysis, and publication bias examination) using STATA 12.0 software (Stata Corporation, College Station, TX, USA). Q test and I were applied to examine heterogeneities between studies. RESULTS: Twelve studies were finally included in the present study. The study included 4 studies to explore the association between serum levels of 25-hydroxy (OH) vitamin D and risks of prediabetes (including 3094 participants). Additionally, the present study included 8 studies (including 865 individuals with prediabetes treated with vitamin D supplementation and 715 patients treated with placebo) to assess differences in therapeutic effects between individuals with prediabetes treated with vitamin D supplementation and those treated with placebo. The present study showed no significant associations between low serum levels of 25(OH) vitamin D and high risk of prediabetes. Additionally, the study showed no significant differences in changes of hemoglobin A1c (HbA1c), fasting plasma glucose (FPG), and homeostatic model assessment of insulin resistance (HOMA-IR) between individuals with prediabetes treated with vitamin D and those patients given placebo, whereas meta-analysis showed significantly greater changes in 2-hour oral glucose tolerance test (2HPG) in individuals with prediabetes treated with vitamin D, compared with individuals with prediabetes treated with placebo. CONCLUSION: The study supported that low serum levels of 25(OH) vitamin D increased the risk of prediabetes. In addition, vitamin D supplementation improves impaired glucose tolerance in prediabetes. However, more large-scale clinical trials are essential to explore the association between vitamin D and prediabetes.


Assuntos
Estado Pré-Diabético/sangue , Estado Pré-Diabético/tratamento farmacológico , Vitamina D/sangue , Vitaminas/sangue , Glicemia/efeitos dos fármacos , Jejum/sangue , Intolerância à Glucose/tratamento farmacológico , Teste de Tolerância a Glucose/métodos , Hemoglobina A Glicada/análise , Humanos , Resistência à Insulina/fisiologia , Placebos/administração & dosagem , Fatores de Risco , Vitamina D/uso terapêutico , Vitaminas/uso terapêutico
2.
Crit Care Resusc ; 21(4): 236-42, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31778629

RESUMO

OBJECTIVES: To study vitamin C pharmacokinetics in septic shock. DESIGN: Prospective pharmacokinetic study. SETTING: Two intensive care units. PARTICIPANTS: Twenty-one patients with septic shock enrolled in a randomised trial of high dose vitamin C therapy in septic shock. INTERVENTION: Patients received 1.5 g intravenous vitamin C every 6 hours. Plasma samples were obtained before and at 1, 4 and 6 hours after drug administration, and vitamin C concentrations were measured by high performance liquid chromatography. MAIN OUTCOME MEASURES: Clearance, volume of distribution, and half-life were calculated using noncompartmental analysis. Data are presented as median (interquartile range [IQR]). RESULTS: Of the 11 participants who had plasma collected before any intravenous vitamin C administration, two (18%) were deficient (concentrations < 11 µmol/L) and three (27%) had hypovitaminosis C (concentrations between 11 and 23 µmol/L), with a median concentration 28 µmol/L (IQR, 11-44 µmol/L). Volume of distribution was 23.3 L (IQR, 21.9-27.8 L), clearance 5.2 L/h (IQR, 3.3-5.4 L/h), and half-life 4.3 h (IQR, 2.6-7.5 h). For the participants who had received at least one dose of intravenous vitamin C before sampling, T0 concentration was 258 µmol/L (IQR, 162- 301 µmol/L). Pharmacokinetic parameters for subsequent doses were a median volume of distribution 39.9 L (IQR, 31.4-44.4 L), clearance 3.6 L/h (IQR, 2.6-6.5 L/h), and half-life 6.9 h (IQR, 5.7-8.5 h). CONCLUSION: Intravenous vitamin C (1.5 g every 6 hours) corrects vitamin C deficiency and hypovitaminosis C and provides an appropriate dosing schedule to achieve and maintain normal or elevated vitamin C levels in septic shock.


Assuntos
Deficiência de Ácido Ascórbico/tratamento farmacológico , Ácido Ascórbico/farmacocinética , Estado Terminal/terapia , Choque Séptico/tratamento farmacológico , Vitaminas/farmacocinética , Administração Intravenosa , Ácido Ascórbico/administração & dosagem , Ácido Ascórbico/sangue , Deficiência de Ácido Ascórbico/prevenção & controle , Biomarcadores/sangue , Cromatografia Líquida de Alta Pressão , Relação Dose-Resposta a Droga , Humanos , Estudos Prospectivos , Choque Séptico/sangue , Choque Séptico/metabolismo , Vitaminas/administração & dosagem , Vitaminas/sangue
4.
J Steroid Biochem Mol Biol ; 195: 105472, 2019 12.
Artigo em Inglês | MEDLINE | ID: mdl-31550504

RESUMO

Blood for determining 25-hydroxyvitamin D3 [25(OH)D3] is usually obtained through venipuncture although, as an alternative for serum, dried blood spot (DBS) can be considered. The aim of this proof-of-concept study was to investigate levels of agreement between measurements of 25(OH)D3 obtained with DBS compared with serum. 301 Chinese participants were included who completed 25(OH)D3 measurement from DBS and from simultaneously collected blood samples obtained by venipuncture. Measurements of both DBS and serum 25(OH)D3 were performed using liquid chromatography followed by tandem mass spectrometry. Agreement between the two methods was assessed with Passing and Bablok regression analysis and Bland-Altman plot. Measurements showed a good correlation (Pearson's correlation coefficient r = 0.929, P < 0.001) between the two methods. After recalculating for a 13% difference, a regression equation of DBS 25(OH)D3 = -1.91 + 1.00 serum 25(OH)D3 was found in Passing and Bablok regression analysis. Bland-Altman analysis showed a fixed bias of 1.7 nmol/L; upper and lower limit of agreement was 24.1 nmol/L and -20.7 nmol/L, respectively. Sensitivity of recalculated DBS for 25(OH)D3 concentrations <30 and <50 nmol/L was 87.8% and 91.1%, respectively, and specificity was 89.2% and 83.1%, respectively. In conclusion, a good agreement was found between the measurement of 25(OH)D3 obtained with DBS compared with serum. DBS may possibly be used in a future screening program, but it is less suitable for individualized vitamin D status assessment.


Assuntos
Calcifediol/sangue , Soro/química , Vitaminas/sangue , Adulto , Idoso , Grupo com Ancestrais do Continente Asiático , Cromatografia Líquida , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Países Baixos , Reprodutibilidade dos Testes , Espectrometria de Massas em Tandem
5.
Autoimmun Rev ; 18(11): 102392, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31520805

RESUMO

BACKGROUND: Systemic lupus erythematosus (SLE) is a systemic autoimmune disease where chronic inflammation and tissue or organ damage is observed. Due to various suspected causes, inadequate levels of vitamin D (a steroid hormone with immunomodulatory effects) has been reported in patients with SLE, however, contradictory. AIMS: The aim of this systematic review and meta-analysis was to evaluate the serum levels of vitamin D in patients with SLE in compared to healthy controls. METHODS: PubMed, SCOPUS, ScienceDirect and Google Scholar electronic databases were searched systematically without restricting the languages and year (up to March 2, 2019) and studies were selected based on the inclusion criteria. Mean difference (MD) along with 95% confidence intervals (CI) were used and the analyses were carried out by using a random-effects model. Different subgroup and sensitivity analyses were conducted. Study quality was assessed by the modified Newcastle-Ottawa Scale (NOS) and publication bias was evaluated by a contour-enhanced funnel plot, Begg's and Egger's tests. RESULTS: We included 34 case-control studies (2265 SLE patients and 1846 healthy controls) based on the inclusion criteria. Serum levels of vitamin D was detected significantly lower in the SLE patients than that in the healthy controls (MD: -10.44, 95% CI: -13.85 to -7.03; p < .00001). SLE patients from Asia (MD: -13.75, 95% CI: -21.45 to -6.05; p = .0005), South America (MD: -3.16, 95% CI: -4.62 to -1.70; p < .0001) and Africa (MD: -16.15, 95% CI: -23.73 to -8.56; p < .0001); patients residing below 37° latitude (MD: -11.75, 95% CI: -15.79 to -7.70; p < .00001); serum vitamin D during summer season (MD: -7.89, 95% CI: -11.70 to -4.09; p < .0001), patients without vitamin D supplementation (MD: -15.57, 95% CI: -19.99 to -11.14; p < .00001) or on medications like hydroxychloroquine, corticosteroids or immunosuppressants without vitamin D supplementation (MD: -16.46, 95% CI: -23.86 to -9.05; p < .0001) are in higher risk in presenting inadequate serum levels of vitamin D. The results remained statistically significant from different sensitivity analyses which represented the robustness of this meta-analysis. According to the NOS, 91.2% of the studies were considered as of high methodological quality (low risk of bias). No significant publication bias was detected from contour-enhanced and trim and fill funnel plots or Begg's test. CONCLUSION: Inadequate levels of serum vitamin D is significantly high in patients with SLE compared to healthy subjects, therefore, vitamin D supplementation with regular monitoring should be considered as part of their health management plans.


Assuntos
Lúpus Eritematoso Sistêmico/sangue , Vitamina D/sangue , Vitaminas/sangue , Estudos de Casos e Controles , Humanos
6.
Artigo em Inglês | MEDLINE | ID: mdl-31540105

RESUMO

The purpose of this study was to examine the associations of vitamin D status with athletic performance and blood-borne markers in adolescent athletes. This cross-sectional study included forty-seven Taekwondo athletes, aged 15-18 years old. Athletic performance was assessed using maximal oxygen consumption (VO2max), Wingate anaerobic power test, vertical jump, agility T-test, lower limb muscle strength, and fatigue resistance. Blood samples were collected to assess serum 25-hydroxyvitamin D [25(OH)D], free-testosterone, cortisol, creatine kinase, and urea. One-way ANOVAs were applied using Bonferroni adjusted alpha levels, which was 0.02 (i.e., 0.05/3). Multiple linear regressions analyses as well as Pearson and partial correlation analyses were used to examine the relationship among 25(OH)D concentration, athletic performance, and blood-borne markers. The participants 25(OH)D concentration were ranged from 16 to 73.25 nmol/L, indicating that 74.5% of the adolescent athletes have vitamin D insufficiency or deficiency. The vitamin D status did not show any significant effects on the performance factors or blood-borne markers. Serum 25(OH)D concentration was positively correlated with mean power output (r = 0.359, p < 0.05) and relative mean power output (r = 0.325, p < 0.05) after adjusting for bone age, height, weight, training experience, lean body mass, and fat mass. However, 25(OH)D concentration was not associated with other performance-related factors and blood-borne markers. In addition, multiple linear regressions analyses revealed that serum 25(OH)D concentration were not significant predictors of athletic performance in adolescent athletes. In conclusion, vitamin D status is weakly correlated with anaerobic capacity; moreover, the underlying mechanisms of how vitamin D influence anaerobic performance is unclear in the present study. Nevertheless, the importance of vitamin D on health benefits should not be underestimated, especially during growth periods.


Assuntos
Desempenho Atlético , Artes Marciais , Vitamina D/análogos & derivados , Vitaminas/sangue , Adolescente , Atletas , Biomarcadores/sangue , Creatina Quinase/sangue , Estudos Transversais , Humanos , Hidrocortisona/sangue , Masculino , Força Muscular , Consumo de Oxigênio , Testosterona/sangue , Ureia/sangue , Vitamina D/sangue
7.
J Pediatr Endocrinol Metab ; 32(9): 951-957, 2019 Sep 25.
Artigo em Inglês | MEDLINE | ID: mdl-31444965

RESUMO

Background Childhood obesity is a serious health condition with increasing rates worldwide. The aim of this study was to investigate the association between inflammation, oxidative stress, vitamin D, copper and zinc in pre-obese and obese children compared to controls. Methods The study involved 202 children aged 7-15 years (63.9% boys), randomly chosen from 10 elementary schools in Podgorica, Montenegro. Participants were divided into three groups according to their nutritional status (International Obesity Task Force [IOTF] criteria): normal-weight (42.1%), pre-obese (40.6%) and obese (17.3%). Serum biochemical analyses were performed (C-reactive protein [CRP], retinol-binding protein [RBP], total antioxidant status [TAS], total vitamin D [VD], copper and zinc). Results Serum TAS and CRP concentrations were higher in pre-obese and obese children compared to controls (p < 0.001). Serum VD concentrations were lower in pre-obese and obese children compared to their normal-weight peers (p = 0.027 and p = 0.054, respectively). Copper, zinc and RBP concentrations did not differ significantly among the groups (p > 0.05). In pre-obese and obese children, a positive correlation was found between CRP and copper (r = 0.305, p = 0.011 and r = 0.440, p = 0.013, respectively), and TAS and RBP (r = 0.528, p < 0.001 and r = 0.434, p = 0.015, respectively). Standard regression analyses showed that CRP and TAS increase (p < 0.001) whereas VD decreases (p = 0.011) with the body mass index (BMI). Conclusions We show that pre-obesity and obesity in childhood are positively associated with oxidative stress and inflammation, and inversely associated with VD status. Copper and zinc concentrations were not associated with excess fat in children.


Assuntos
Cobre/sangue , Inflamação/fisiopatologia , Estresse Oxidativo , Obesidade Pediátrica/epidemiologia , Deficiência de Vitamina D/fisiopatologia , Vitamina D/sangue , Zinco/sangue , Antioxidantes/metabolismo , Biomarcadores/sangue , Índice de Massa Corporal , Proteína C-Reativa/análise , Criança , Feminino , Seguimentos , Humanos , Masculino , Montenegro/epidemiologia , Obesidade Pediátrica/sangue , Obesidade Pediátrica/patologia , Prognóstico , Vitaminas/sangue
8.
Artigo em Inglês | MEDLINE | ID: mdl-31438516

RESUMO

Observational studies and randomised controlled studies suggest that vitamin D plays a role in the prevention of acute respiratory tract infection (ARTI); however, findings are inconsistent and the optimal serum 25-hydroxyvitamin D (25(OH)D) concentration remains unclear. To review the link between 25(OH)D concentration and ARTI, we searched PubMed and EMBASE databases to identify observational studies reporting the association between 25(OH)D concentration and risk or severity of ARTI. We used random-effects meta-analysis to pool findings across studies. Twenty-four studies were included in the review, 14 were included in the meta-analysis of ARTI risk and five in the meta-analysis of severity. Serum 25(OH)D concentration was inversely associated with risk and severity of ARTI; pooled odds ratios (95% confidence interval) were 1.83 (1.42-2.37) and 2.46 (1.65-3.66), respectively, comparing the lowest with the highest 25(OH)D category. For each 10 nmol/L decrease in 25(OH)D concentration, the odds of ARTI increased by 1.02 (0.97-1.07). This was a non-linear trend, with the sharpest increase in risk of ARTI occurring at 25(OH)D concentration < 37.5 nmol/L. In conclusion, there is an inverse non-linear association between 25(OH)D concentration and ARTI.


Assuntos
Infecções Respiratórias/sangue , Vitamina D/análogos & derivados , Vitaminas/sangue , Doença Aguda , Humanos , Estudos Observacionais como Assunto , Infecções Respiratórias/epidemiologia , Vitamina D/sangue
9.
Artigo em Inglês | MEDLINE | ID: mdl-31405087

RESUMO

Vitamin D deficiency (serum 25-hydroxyvitamin D (25(OH)D) concentrations <50 nmol/L) is a public health issue in Australia and internationally. Those with darker skin require a greater dose of ultraviolet B radiation from sunlight than those with paler skin to synthesise adequate amounts of vitamin D. Using data from the 2011-2013 Australian Health Survey, we investigated the prevalence and predictors of vitamin D deficiency in African immigrants aged ≥18 years living in Australia (n = 236). Serum 25(OH)D was measured using a liquid chromatography-tandem mass spectrometry method that is certified to international reference measurement procedures. Poisson regression was used to investigate independent predictors of vitamin D deficiency. A total of 36% of adults were vitamin D deficient (35% of men, 37% of women). The prevalence ratio (PR) of vitamin D deficiency decreased by 2% per year of age (PR 0.98; 95% CI (0.97, 0.99); p = 0.004) and was 1.6 times higher in those with low/sedentary, compared to moderate/high, physical activity levels (PR 1.64; 95% CI (1.12, 2.39); p = 0.011). The greatest risk was for those assessed during winter/spring compared with summer/autumn (PR 1.89; 95% CI (1.33, 2.64); p < 0.001). Culturally appropriate messaging on safe sun exposure and dietary vitamin D is warranted in order to promote vitamin D sufficiency in African immigrants living in Australia.


Assuntos
Grupo com Ancestrais do Continente Africano/estatística & dados numéricos , Emigrantes e Imigrantes/estatística & dados numéricos , Deficiência de Vitamina D/epidemiologia , Adulto , Austrália/epidemiologia , Exercício , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Estações do Ano , Vitamina D/análogos & derivados , Vitamina D/sangue , Deficiência de Vitamina D/sangue , Vitaminas/sangue
10.
Life Sci ; 233: 116744, 2019 Sep 15.
Artigo em Inglês | MEDLINE | ID: mdl-31401314

RESUMO

The prevalence of autoimmune diseases (ADs) has increased over the past few decades. Vitamin D deficiency is a common factor in many of these diseases, whose etiology remains poorly understood. The objective of this study was to review published data on the role of vitamin D in ADs. Vitamin D insufficiency has been described as an important factor in the development of some ADs, generally attributed to the key role of this vitamin in the immune system. Most studies show that adequate supplementation can prevent and improve the development of some of these diseases, although the optimal vitamin D dose remains controversial. We highlight the importance of measuring serum vitamin D levels of the population and developing strategies to improve and maintain levels with no health risks.


Assuntos
Doenças Autoimunes/prevenção & controle , Suplementos Nutricionais , Deficiência de Vitamina D/complicações , Vitamina D/sangue , Vitaminas/sangue , Doenças Autoimunes/etiologia , Humanos , Vitamina D/administração & dosagem , Vitaminas/administração & dosagem
12.
BMJ Case Rep ; 12(8)2019 Aug 26.
Artigo em Inglês | MEDLINE | ID: mdl-31451474

RESUMO

While scurvy is considered to be a rare disease in the modern era, the disease still presents in certain populations with nutritional deficiencies such as those with poor nutritional absorption secondary to gastrointestinal disorders and in patients with poor nutritional intake. We present a case of scurvy in a patient who had eosinophilic oesophagitis which limited his oral intake. He presented with the classic symptoms of scurvy including a perifollicular rash, arthralgia, gingivitis and anaemia. He was treated with intravenous vitamin C initially followed by an oral course after which he showed improvement. This case demonstrates that it is important to consider vitamin C deficiency in patients with who present with anaemia and bleeding stigmata specifically in those who have poor nutritional intake. Furthermore, additional consideration should be given to patients with malnutrition as part of the preoperative evaluation.


Assuntos
Anemia , Ácido Ascórbico , Esofagite Eosinofílica , Escorbuto , Administração Intravenosa , Anemia/sangue , Anemia/diagnóstico , Anemia/etiologia , Ácido Ascórbico/administração & dosagem , Ácido Ascórbico/sangue , Biópsia/métodos , Diagnóstico Diferencial , Esofagite Eosinofílica/complicações , Esofagite Eosinofílica/patologia , Esofagite Eosinofílica/fisiopatologia , Humanos , Ferro/sangue , Exame Físico/métodos , Escorbuto/diagnóstico , Escorbuto/etiologia , Escorbuto/fisiopatologia , Escorbuto/terapia , Índice de Gravidade de Doença , Pele/patologia , Resultado do Tratamento , Vitaminas/administração & dosagem , Vitaminas/sangue
13.
Iran J Kidney Dis ; 13(4): 269-276, 2019 07.
Artigo em Inglês | MEDLINE | ID: mdl-31422394

RESUMO

INTRODUCTION: Poor nutritional status is prevalent in peritonealdialysis (PD) patients and is related to morbidity and mortality.Therefore, the aim of the present study was to assess the dietaryintake and its related factors in PD patients in Tehran, Iran. METHODS: All eligible PD patients in Tehran peritoneal dialysiscenters were included in this cross-sectional study. Dietary intakeof PD patients was determined using a 3-day dietary recall. Also,a 4 mL blood sample was obtained from each patient to measureserum biochemical parameters. RESULTS: Intake of energy, protein, and fiber were lower thanrecommended values in 81%, 92%, and 100% of PD patients;respectively. The prevalence of inadequate energy intake in PDpatients with dialysis vintage ≤ 5 years was significantly higheras compared to those with dialysis vintage > 5 years (P < .05). Asignificant association was observed between inadequate energyintake and inadequate vitamin B3 intake (P < .05). There was amarginally (not) significant association between inadequate energyintake and inadequate vitamin B1 intake (P = 0.06). Intake of thevitamins B1, B2, B3, B6, folic acid, B12, E, C, and of the minerals,calcium, and zinc from both the diet and supplements were lowerthan recommended values in 15%, 38%, 23%, 39%, 52%, 32%, 47%,29%, 54%, and 50.5% of PD patients, respectively. CONCLUSION: Insufficient intake of energy and various nutrients arecommon in PD patients in Tehran, Iran; which may contribute tomorbidity and mortality in these patients.


Assuntos
Inquéritos sobre Dietas , Dieta , Ingestão de Energia , Diálise Peritoneal , Adolescente , Adulto , Idoso , Cálcio/sangue , Creatinina/sangue , Estudos Transversais , Proteínas na Dieta/administração & dosagem , Suplementos Nutricionais , Feminino , Humanos , Irã (Geográfico) , Masculino , Pessoa de Meia-Idade , Vitaminas/administração & dosagem , Vitaminas/sangue , Adulto Jovem , Zinco/sangue
14.
Diabetes Metab Syndr ; 13(5): 2813-2817, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31425941

RESUMO

BACKGROUND: The link between Vitamin-D deficiency and type 2 diabetes (T2D) is well-established. Since prediabetic obese populations have the greatest risk to develop to T2D, it was important in our study to examine serum 25(OH) D3 concentration among prediabetic obese patients and to evaluate the correlation between serum level of vitamin D and BMI, FBS, HOMA IR and HbA1c among prediabetes patients. METHODS: A multicenter case control study was carried out among 101 prediabetic persons & 50 controls, after obtaining consent from subjects and clearance from institutional ethics committee. Serum vitamin D level, Plasma levels of glycosylated hemoglobin (HbA1c) and fasting insulin levels were measured by ELISA in both groups enrolled in the study. RESULTS: The prevalence of vitamin-D deficiency/insufficiency was (73.3%) (n = 74) among 101 prediabetic obese individuals. Also, A significant inverse correlation was observed between vitamin D levels & body mass index(r = - 0.28, P = 0.004); fasting blood sugar (r = - 0.22, P = 0.002); HOMA insulin resistance (r = - 0.25 P = 0.01); HbA1C (r = - 0.2, P= 0.004). CONCLUSIONS: High prevalence of vitamin D deficiency exists among obese prediabetic individuals and there is significant inverse correlation between BMI, FBS, HOMA IR, HbA1c and vitamin D level.


Assuntos
Biomarcadores/análise , Resistência à Insulina , Obesidade/fisiopatologia , Estado Pré-Diabético/fisiopatologia , Deficiência de Vitamina D/epidemiologia , Vitamina D/sangue , Adulto , Glicemia/análise , Estudos de Casos e Controles , Estudos Transversais , Egito/epidemiologia , Feminino , Seguimentos , Hemoglobina A Glicada/análise , Humanos , Incidência , Masculino , Prognóstico , Deficiência de Vitamina D/sangue , Vitaminas/sangue
15.
Diabetes Metab Syndr ; 13(5): 2843-2847, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31425945

RESUMO

BACKGROUND: Vitamin D insufficiency (VDI) is one of impaired calcium absorption causes. It is associated with increased risk of several diseases. The aim of this study was to survey the prevalence and predictors of VDI in Yazd. METHOD AND MATERIAL: This cross sectional study was conducted on 700 participant aged between 20 and 70 years old on second phase of the Iranian Multi-Center Osteoporosis Study (IMOS) in Yazd province. All analyzes were performed with the SPSS 20 and Stata 14.1 software. Chi-squared test, Pearson correlation and binary logistic regression were used. A significance level was considered for all tests P ≤ 0.05. RESULTS: The prevalence of VDI was 55.1% (51.37-58.87%) in total participant of this study. Predictors of VDI including: age 31-45 years old (OR = 1.68, CI = 1.04-2.70), female (OR = 3.49, CI = 1.80-6.78), live in the apartment houses (OR = 2.15, CI = 1.06-4.35), inability of climbing of steps (OR = 2.59, CI = 1.17-5.69), serum Calcium (OR = 0.53, CI = 0.34-0.81) and serum PTH (OR = 1.04, CI = 1.02-1.06). CONCLUSIONS: The prevalence of VDI in Yazd is high. It is recommended to people that to be exposed to sunlight per day. And people should consumption vitamin D supplements under their physician.


Assuntos
Deficiência de Vitamina D/epidemiologia , Vitamina D/sangue , Vitaminas/sangue , Adulto , Idoso , Estudos Transversais , Feminino , Seguimentos , Humanos , Irã (Geográfico)/epidemiologia , Masculino , Pessoa de Meia-Idade , Prevalência , Prognóstico , Deficiência de Vitamina D/sangue , Adulto Jovem
16.
Int Immunopharmacol ; 75: 105811, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31422183

RESUMO

BACKGROUND: Vitamin D regulates the immune system and affects the outcome of allografts. We investigated the mechanisms underlying the preventative potential of vitamin D in acute cellular rejection (ACR) and infection, and determined its effects on the induction of both T cells and complement. METHODS: A total of 141 patients who received a liver allograft at our center between 2012 and 2016 were enrolled in the study and divided into a vitamin D supplementation group (case group, n = 71) and a non-vitamin D supplementation group (control group, n = 70). Serum was collected in the hours prior to transplantation and within the first month of transplantation. We evaluated the relationship between the serum levels of 25-hydroxyvitamin D ACR, infection, T cells, complement, and graft function. Follow-up was conducted until patient death or June 30, 2018. RESULTS: Vitamin D deficiency was an important independent risk factor for ACR. The incidence of ACR, and bacterial and fungal infection was reduced in patients with vitamin D supplementation. The frequency of Treg, Tmemory, T naïve cells and CD8 + CD28+ T cells (CTL) and the level of complement component 3 were related to ACR in the first month after transplantation. This study showed increased numbers of Treg cells and Tmemory cells and decreased numbers of Naïve cells and CTL in the case group. Vitamin D status was significantly associated with mortality. CONCLUSIONS: Vitamin D supplementation is associated with a lower risk of ACR and infection, suggesting that it may promote immune tolerance towards the liver allografts.


Assuntos
Infecções Bacterianas/prevenção & controle , Suplementos Nutricionais , Rejeição de Enxerto/prevenção & controle , Transplante de Fígado , Micoses/prevenção & controle , Deficiência de Vitamina D/tratamento farmacológico , Vitamina D/uso terapêutico , Vitaminas/uso terapêutico , Adulto , Aloenxertos , Complemento C3/imunologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Fatores de Risco , Linfócitos T/efeitos dos fármacos , Linfócitos T/imunologia , Vitamina D/sangue , Deficiência de Vitamina D/imunologia , Vitaminas/sangue
17.
J Steroid Biochem Mol Biol ; 193: 105419, 2019 10.
Artigo em Inglês | MEDLINE | ID: mdl-31255688

RESUMO

Innate immunity plays an important role in pathophysiology of tuberculosis which is influenced by various host factors. One such factor is vitamin D which, along with its associated molecule, can alter the host defense against Mycobacterium Tuberculosis (M.Tb.) via altered production of cathelicidin and nitric oxide, both having bactericidal effect. Therefore, assessment of vitamin D and its associated molecules in tuberculosis patients and household contacts as compared to healthy controls were done and the implication of these findings in susceptibility to tuberculosis (TB) was studied. 80 active TB patients, 75 household contacts and 70 healthy controls were included. Vitamin D receptor (VDR), vitamin D binding protein (VDBP) and inducible nitric oxide synthase (iNOS) mRNA levels were studied using quantitative PCR. Serum VDR, cathelicidin, and iNOS levels were measured using ELISA. Vitamin D and NO levels were measured in serum using chemiluminescence based immunoassay and greiss reaction based colorimetry kit respectively. Decreased serum levels of vitamin D were observed in active TB patients as compared to healthy controls (p < 0.001). VDR and iNOS mRNA levels were found to be significantly lower in active TB patients compared to household contacts and healthy controls (p < 0.0001 and 0.005 respectively). VDBP mRNA expression was found to be lower in active TB group as compared to household contacts and healthy controls however the difference was not found to be significant (p > 0.21). Although, mRNA expression of VDR, VDR protein and iNOS along with vitamin D levels were significantly (p < 0.05) higher in household contacts compared to active TB group. However, levels of iNOS, NO and cathelicidin were found to be higher in TB patients as compared to household contacts and healthy controls (p < 0.01, 0.05 and 0.01 respectively). Higher levels of Vitamin D along with VDR and iNOS expression in household contacts as compared to active TB patients suggest vitamin D might have a protective role against TB plausibly decreasing disease susceptibility. Low vitamin D levels in active TB patients warrants further studies to determine the role of vitamin D supplementation in prevention and treatment of TB.


Assuntos
Tuberculose Pulmonar/sangue , Vitamina D/sangue , Vitaminas/sangue , Adolescente , Adulto , Peptídeos Catiônicos Antimicrobianos/sangue , Estudos Transversais , Características da Família , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Óxido Nítrico/sangue , Óxido Nítrico Sintase Tipo II/sangue , Óxido Nítrico Sintase Tipo II/genética , Receptores de Calcitriol/sangue , Receptores de Calcitriol/genética , Tuberculose Pulmonar/genética , Proteína de Ligação a Vitamina D/genética , Adulto Jovem
18.
Reprod Health ; 16(1): 106, 2019 Jul 15.
Artigo em Inglês | MEDLINE | ID: mdl-31307482

RESUMO

BACKGROUND: Vitamin D deficiency has been associated with an increased risk of abnormal pregnancy implantation leading to obstetric complications such as pre-eclampsia and fetal growth restriction. However, the effect of vitamin D on reproductive treatment outcomes in couples undergoing assisted reproductive treatment is poorly understood. This study investigates the association between vitamin D and reproductive treatment outcomes in women undergoing assisted reproductive treatments? METHODS: A prospective cohort study conducted at a large tertiary teaching hospital, United Kingdom. Five hundred women undergoing assisted reproductive treatment were recruited between September 2013 and September 2015. All participants had their serum vitamin D measured and their reproductive treatment outcomes collated. Women were categorised in to three groups: vitamin D replete (> 75 nmol/L), insufficient (50-75 nmol/L) and deficient (< 50 nmol/L) according to Endocrine Society guidance. The primary outcome was live birth. Secondary outcomes included biochemical pregnancy, clinical pregnancy and pregnancy loss rates. RESULTS: Vitamin D deficiency was found in 53.2% (266/500) of participants and vitamin D insufficiency was found in 30.8% (154/500) of participants. Only 16% (80/500) of women were vitamin D replete. The live birth rates for vitamin D deficient, insufficient and replete women were 23.2% (57/246), 27.0% (38/141) and 37.7% (29/77) respectively (p = 0.04). The respective live birth rates for vitamin D deficient, insufficient and replete women were 24.3, 27.1, 34.4% after adjustment for key prognostic factors (p = 0.25). CONCLUSIONS: Vitamin D deficiency and insufficiency are common in women undergoing assisted reproductive treatments. The crude live birth rate achieved in women undergoing assisted reproductive treatments are associated with serum vitamin D, although statistical significance is lost when adjusting for important prognostic variables. Vitamin D deficiency could be an important condition to treat in women considering fertility treatment. A research trial to investigate the benefits of vitamin D deficiency treatment would test this hypothesis. TRIAL REGISTRATION: Clinicaltrials.gov - NCT02187146 .


Assuntos
Infertilidade Feminina/terapia , Nascimento Vivo , Técnicas de Reprodução Assistida , Deficiência de Vitamina D/terapia , Vitamina D/administração & dosagem , Vitamina D/sangue , Adulto , Implantação do Embrião , Feminino , Humanos , Infertilidade Feminina/sangue , Infertilidade Feminina/complicações , Gravidez , Resultado da Gravidez , Taxa de Gravidez , Estudos Prospectivos , Deficiência de Vitamina D/sangue , Deficiência de Vitamina D/complicações , Vitaminas/administração & dosagem , Vitaminas/sangue
19.
Diabetes Metab Syndr ; 13(2): 1087-1091, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31336449

RESUMO

BACKGROUND: Diabetic Peripheral neuropathy (DPN) is the most distressing complication of diabetic population leading to loss of sensation, pain, and amputation. Low-level laser therapy (LLLT) has been used to manage nerve injuries as it holds the potential to induce a biostimulatory effect with no side effects. Hence we planned to study the biochemical effect and therapeutic outcomes of LLLT on patients with painful diabetic peripheral neuropathy as a preliminary work. MATERIALS AND METHODS: Pre-posttest analysis was done on 40 patients diagnosed with DPN confirmed using 10 g Monofilament test and Michigan Neuropathy Screening Instrument (MNSI). Vibration sensation and pain measured by Vibration perception threshold (VPT) and Numeric pain rating scale (NPRS). All patients were given LLLT (3.1 J/cm2) on plantar and dorsal of the foot for 10 days. Serum samples were collected at baseline and 4 weeks after LLLT to estimate Vitamin D and Magnesium and compared the results. RESULTS: There was a significant increase in Vitamin D and Magnesium levels after LLLT. We observed a considerable improvement in the quality of life after LLLT demonstrated by a decrease in VPT and MNSI and a reduction in NPRS in DPN patients. CONCLUSION: In this study, we found that LLLT improved the QL and hence may be a useful therapeutic option in treating peripheral neuropathic pain in type 2 diabetic patients. The progress in the serum Magnesium and Vit. D levels were proportional to the QL and may be a good indicator of the prognosis of DPN after LLLT.


Assuntos
Biomarcadores/sangue , Diabetes Mellitus Tipo 2/complicações , Neuropatias Diabéticas/radioterapia , Terapia com Luz de Baixa Intensidade/métodos , Magnésio/sangue , Qualidade de Vida , Vitamina D/sangue , Adulto , Idoso , Neuropatias Diabéticas/sangue , Neuropatias Diabéticas/etiologia , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Projetos Piloto , Prognóstico , Estudos Prospectivos , Vitaminas/sangue
20.
Diabetes Metab Syndr ; 13(2): 1517-1521, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31336515

RESUMO

OBJECTIVE: To determine the burden of vitamin D deficiency and its determinants and to assess the relationship of 25 hydroxycholecalciferol (25-OHD) levels with biochemical parameters linked to health outcomes in women with Type 2 Diabetes Mellitus (T2DM). MATERIAL AND METHODS: This was a hospital based cross-sectional study in the diabetes out-patient department clinic of a major tertiary care hospital in Delhi, India. Adult women with T2DM on treatment for at least 6 months were included in this study. The women who have been given Vitamin D supplementation during the past 6 months were excluded. We assessed Serum 25-OHD, HbA1c, lipid profile and fasting plasma glucose in the patients through standardized laboratory methods. RESULTS: One hundred women with T2DM were enrolled of which 22 (22%) had good glycemic control (HbA1c < 7%). Vitamin D deficiency was seen among 77 (77%) and insufficiency among 16 (16%) of the recruited subjects. Younger age group (31-45 years) and illiteracy was significantly associated with vitamin D deficiency (p < 0.05). No association was found between Vitamin D deficiency and HbA1c levels. CONCLUSION: Vitamin D deficiency is highly prevalent among women with T2DM. Illiteracy and young age were major determinants of vitamin D deficiency indicating they need special attention and Vitamin D supplementation.


Assuntos
Biomarcadores/sangue , Diabetes Mellitus Tipo 2/sangue , Diabetes Mellitus Tipo 2/epidemiologia , Deficiência de Vitamina D/fisiopatologia , Vitamina D/sangue , Vitaminas/sangue , Adolescente , Adulto , Glicemia/análise , Estudos Transversais , Diabetes Mellitus Tipo 2/patologia , Feminino , Seguimentos , Hemoglobina A Glicada/análise , Humanos , Índia/epidemiologia , Masculino , Pessoa de Meia-Idade , Prevalência , Prognóstico , Adulto Jovem
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