Search Results (132)

Objective: Studies show a high prevalence of vitamin D deficiency in Greece and Cyprus despite an abundance of sunlight. We investigate the vitamin D status of Greeks and Cypriots living in the UK, where sunlight availability is more limited. Design: Cross-sectional study of serum 25-hydroxyvitamin D (25(OH)D) using the UK Biobank cohort. Setting: The UK Biobank is a study of over 500K UK dwelling participants, with baseline measurements from 2006–2010. Participants: A sample of 325 Greek/Cypriot and 4158 British/Irish participants (aged 40–69 years). Results: The Greeks/Cypriots had statistically significantly lower median serum 25-hydroxyvitamin D (25(OH)D) (40.3 nmol/L) compared to the British/Irish (47.6 nmol/L). Eleven percent of British/Irish and 22.8% of Greeks/Cypriots had serum 25(OH)D < 25 nmol/L. Being exposed to summer sunlight for >30 min/d, as well as having a blood draw in summer or autumn, was statistically significantly associated with lower odds of 25 (OH))D < 50 nmol/L. Living in Scotland, having a winter blood draw, and not using a vitamin D-containing supplement were associated with increased odds of 25(OH)D < 50 nmol/L. Ethnicity was not a predictor of 25(OH)D < 50 nmol/L after confounder adjustment (Greek/Cypriot OR = 1.18 (95% CI 0.85, 1.63; British/Irish OR = 1.0). Conclusions: UK dwelling Greeks/Cypriots have a higher prevalence of vitamin D deficiency (<25 nmol/L) compared to the British/Irish population, but evidence from the literature is mixed as to whether they have a higher prevalence than when living in their country of origin. Public health interventions are required to improve 25(OH)D status in UK ethnic minority groups. Full article

Vitamin D, long recognized for its essential role in calcium–phosphate balance and bone health, has increasingly been identified as a pleiotropic regulator of metabolic, cardiovascular, and renal function. Deficiency of vitamin D is widespread worldwide and has been linked to a higher risk of insulin resistance, type 2 diabetes, atherosclerosis, hypertension, and chronic kidney disease. Meta-analyses suggest that each 10 nmol/L (≈4 ng/mL) increase in serum 25-hydroxyvitamin D [25(OH)D] is associated with about a 4% lower risk of type 2 diabetes, whereas other analyses indicate an approximately 10% reduction in cardiovascular event risk per 10 ng/mL (≈25 nmol/L) increment in circulating 25(OH)D concentration. Clinical and epidemiological studies suggest that optimal 25(OH)D concentrations may protect against cardiometabolic and renal complications, though supplementation trials show heterogeneous outcomes depending on baseline vitamin D status, genetic background, and dosage. By synthesizing current knowledge, this work highlights vitamin D status as a potentially modifiable determinant of global disease burden and a target for preventive and therapeutic strategies. Full article

Background/Objectives: Vitamin D is involved in immune regulation, and deficiency may increase susceptibility to SARS-CoV-2 infection. This study assessed vitamin D status and examined associations between serum 25-hydroxyvitamin D (25(OH)D) concentrations and demographic, anthropometric, and clinical factors, including SARS-CoV-2 infection, in a diverse urban UK patient population. Methods: We analysed 25(OH)D concentrations in 17,619 pre-COVID-19 vaccine patients (62% female) whose samples were routinely processed between January and June 2020 at St Thomas’ Hospital, London, UK. SARS-CoV-2 RNA/IgG test results (March 2020–January 2021) were linked to these records. Associations were examined with age, BMI, sex, ethnicity, and laboratory data. Vitamin D deficiency was defined as 25(OH)D <25 nmol/L, and insufficiency as 25–50 nmol/L. Results: Vitamin D deficiency was observed in 25% of Black, 21% of Asian, and 17% of White patients; insufficiency was found in 36%, 34%, and 33%, respectively. Serum 25(OH)D concentrations differed by sex in Black and White patients but not in Asian patients. A total of 485 patients (2.8%) were SARS-CoV-2 positive, with a median 25(OH)D concentration of 42 nmol/L (IQR 25–66); 24.1% were deficient and 36.7% insufficient (60.8% total). Among deficient individuals, 38% were White (median age 67.5 years) and 35% Black (median age 52.0 years). Age and BMI were the most significant contributors to infection in White and Black patients, respectively. Conclusions: Vitamin D deficiency and insufficiency were common across all ethnic groups and associated with SARS-CoV-2 infection. Deficiency was most prevalent among Black patients. Vitamin D status should be monitored in patient populations, and deficiencies addressed to ensure adequacy of this nutrient for immune system regulation and possibly the reduction in respiratory infection risk, including COVID-19. Full article

Background/Objectives: Vitamin D deficiency is common in the Middle East, where it affects about 90% of the population. 25-hydroxyvitamin D [25(OH)D]. plays a key role in immune function and antimicrobial defense. Its deficiency has been implicated in surgical site infections (SSIs) also, which lead to increased healthcare costs and morbidity. Around 60% SSIs are preventable by addressing factors like 25(OH)D levels among others. In Qatar, 55.8% of the population is 25(OH)D deficient, but no direct link has been established between 25(OH)D deficiency and SSI risk. This study aims to investigate the relationship between deficient 25(OH)D levels and SSI development in surgical patients at Hamad Medical Corporation (HMC), Qatar. Methods: A retrospective chart review was conducted on adult patients who underwent surgery at HMC, Qatar, between January 2021 and December 2023, with known 25(OH)D levels measured within three months before surgery. A multivariate logistic regression analysis was conducted to evaluate the relationship between 25(OH)D levels and SSIs. Results: This retrospective chart review included 24,097 patients, with 3818 (15.8%) being 25(OH)D deficient. The mean age of the patients was 45 years, and 55% of them were female. The proportion of SSIs was highest in the 25(OH)D deficient group (2.7%) compared to the insufficient (1.8%) and sufficient (1.9%) groups, with a p-value of <0.01. The mean 25(OH)D level was 23 ng/mL in the SSI group, compared to 25 ng/mL in the no SSI group, with a p-value of <0.01. Multivariate logistic regression analysis identified several independent risk factors for SSIs, including 25(OH)D deficiency, male gender, intermediate and major case levels, longer operative times, lower preoperative serum albumin, and contaminated and dirty wounds, all with p-values of <0.05. Conclusions: Preoperative lower 25(OH)D levels increase the risk of SSIs. This study emphasizes the importance of optimizing 25(OH)D levels before surgery to reduce the occurrence of SSIs. Full article

Background/Objectives: Polymyalgia rheumatica (PMR) is a relatively common inflammatory rheumatic disease of the elderly. The role of vitamin D remains unclear in this condition. The endpoints of this study were to assess 25-hydroxyvitamin D [25(OH)D] serum concentrations in PMR patients with active disease compared to elderly controls and to determine if baseline levels or changes following supplementation [delta 25-hydroxyvitamin D, Δ25(OH)D] were associated with improved clinical outcomes. Methods: In this retrospective, case–control study, 29 PMR patients (55% males, 75.24 ± 9.6 years old, disease duration of 3.8 ± 3 months) were included, meeting the 2012 EULAR/ACR classification criteria, with 29 age- and sex-matched controls without systemic inflammatory rheumatic diseases. We assessed demographic, clinical and laboratory features for PMR patients, including baseline 25(OH)D serum concentrations, disease activity (polymyalgia rheumatica activity score), and serum inflammatory biomarkers. A subgroup of them (n = 25) was followed longitudinally, for an average period of 21.1 ± 17.7 months, to evaluate the association between Δ25(OH)D and clinical outcomes at follow-up using multivariate logistic regression. Results: Although lower than the normal reference values, baseline 25(OH)D concentrations did not differ significantly between PMR patients and controls (21.6 ± 9.2 vs. 22.7 ± 11.3 ng/mL, p = 0.66) and did not predict long-term clinical outcomes. However, after only 3 months of supplementation, the increase in 25(OH)D concentrations was significantly associated with a remission status, and patients in remission showed a significant increase in 25(OH)D compared to those with persistent disease activity (+22.02 vs. +1.33 ng/mL, respectively; p = 0.044). Notably, in the multivariate model, this Δ25(OH)D was the strongest independent predictor of remission (OR = 2.89; 95% CI [1.60–4.11]), an effect independent of prednisone dosage prescribed at first visit (p = 0.32) and glucocorticoid exposure at third month (p = 0.12). Conclusions: Individual’s response of PMR patients to supplementation of vitamin D seems to be a robust independent predictor of early clinical remission achievement. Interestingly, optimizing vitamin D supplementation based on individual responsiveness may represent a valuable adjunctive strategy in PMR management. Full article

Background and Objectives: Type 2 diabetes mellitus (T2DM) is associated with subclinical cardiovascular changes, such as increased arterial stiffness and myocardial dysfunction. Vitamin D deficiency has been recognized as a potential contributing factor to vascular disease; however, its impact on early cardiac changes associated with T2DM remains poorly understood. Our aim was to evaluate the association between serum levels of 25-hydroxyvitamin D3 [25(OH)D3], arterial stiffness, and left ventricular global longitudinal strain (LV GLS) in patients with T2DM who do not have a clinically evident cardiovascular disease. Material and methods: This cross-sectional study evaluated the carotid intima–media thickness (IMT), aortic pulse wave velocity (PWVao), LV GLS, and serum 25(OH)D3 levels in patients diagnosed with T2DM (n = 65) compared to healthy control subjects (n = 55). Independent predictors of arterial stiffness were identified by a multivariate logistic regression analysis. Results: Patients with T2DM showed a significant increase in IMT and PWVao, a reduction in LV GLS, and low levels of 25(OH)D3 compared to subjects in the control group (all p < 0.05). Both vitamin D deficiency and T2DM were found to be independently associated with an increased arterial stiffness, with odds ratios of 2.4 and 4.8, respectively. A significant inverse relationship was identified between 25(OH)D3 levels and markers of arterial stiffness, as well as LV GLS, suggesting a possible association between the vitamin D status and the early onset of cardiovascular dysfunction. Conclusions: Patients with T2DM show early signs of heart and blood vessel problems, even with an ejection fraction that remains within normal limits. There is a significant correlation between vitamin D deficiency and increased arterial stiffness, along with impaired LV GLS, indicating its possible involvement in cardiovascular complications associated with diabetes. These findings support the utility of integrating vascular, myocardial, and vitamin D assessments in early cardiovascular risk stratification for T2DM patients. Full article

Coronavirus disease 2019 (COVID-19) presents with various symptoms, and some patients develop post-COVID-19 condition (PCC). Vitamin D has shown therapeutic potential in COVID-19 and may offer benefits for PCC. The aim of this study was to evaluate the differences associated with two supplementation strategies (bolus and daily) on interleukin-6 (IL-6) levels, glutathione peroxidase (GPx) activity, and clinical outcomes in PCC patients, regardless of whether target 25 (OH) D levels reached the ideal range. We conducted a self-controlled study in which 54 participants with PCC were supplemented with vitamin D₃ (n = 28 bolus and n = 26 daily) for 2 months. Blood samples were collected to measure IL-6 levels and GPx activity using spectrophotometric methods. The Hospital Anxiety and Depression Scale (HADS) was used to assess mental function. Both bolus and daily vitamin D supplementation were significantly associated with increased GPx activity and decreased IL-6 levels. Daily supplementation was additionally associated with a significant reduction in anxiety and depression scores. However, neither regimen was associated with improvements in cough, dyspnea, or fatigue. These findings suggest a potential association between vitamin D supplementation and improvements in antioxidant and neuropsychiatric parameters in PCC, possibly mediated by its immunomodulatory and antioxidant properties. Further placebo-controlled trials are warranted to determine whether these observed associations reflect causal relationships. Full article

Suboptimal vitamin D status is commonly observed in primary hyperparathyroidism but is rarely considered in management decisions. The present study aimed to bring additional insights on vitamin D status in primary hyperparathyroidism patients, particularly those presenting with the normocalcemic phenotype. A retrospective study was conducted on 53 confirmed primary hyperparathyroidism patients, stratified into hypercalcemic and normocalcemic groups, hospitalized at the “Pius Brînzeu” Emergency Clinical Country Hospital in Timișoara, Romania. Patients presenting with the normocalcemic phenotype had similar target-organ involvement compared to their counterparts. In this subgroup, 25 hydroxyvitamin D showed an inverse correlation with serum calcium (p = 0.048), and regression analysis identified iPTH and 25OH vitamin D as significant predictors of calcium levels (p < 0.0001; $R^2$ = 0.571). Adenoma volume showed a significant negative correlation with 25OH vitamin D levels (p = 0.021; r = −0.61) but was later found as insignificant after confounder analysis. Postoperative measurements of 25OH vitamin D levels confirmed increasing levels after parathyroidectomy. Our findings highlight a complex relationship between PTH and vitamin D in primary hyperparathyroidism, especially in the often-underdiagnosed normocalcemic phenotype. The inverse correlation between vitamin D and calcium suggests altered homeostasis, rather than true deficiency. Full article

Background and Objectives: Regular exercise is known to induce cardiovascular adaptations collectively referred to as “athlete’s heart”. While previous research has explored the morphological and functional cardiac adaptations in athletes, the relationship between vitamin D (25-hydroxyvitamin D [25(OH)D]) levels and echocardiographic parameters remains underexplored. This study aims to assess the association between 25(OH)D levels and structural and functional cardiac parameters using electrocardiographic (ECG) and echocardiographic evaluations in athletes. Materials and Methods: This case–control study included 93 male athletes, categorized into professional (n = 68) and recreational (n = 25) groups. Professional athletes were further divided into football (n = 19), weightlifting (n = 22), and running (n = 27) subgroups. Serum 25(OH)D levels were measured using high-performance liquid chromatography–tandem mass spectrometry (LC-MS/MS). Standard 12-lead ECG and transthoracic echocardiography were performed to assess cardiac structure and function. Data were analyzed using statistical tests that were appropriate for normal and non-normal distributions, with a significance level set at p < 0.05. Results: Athletes exhibited higher left ventricular interventricular septum (IVS) thickness and left ventricular posterior wall thickness (LVPWd) compared to the control group. Significant differences in diastolic function parameters, including early (E) and late (A) diastolic filling velocities and the E/A ratio, were observed among athlete subgroups. The weightlifting group showed lower end-systolic diameter (ESD) values than the football group. However, no statistically significant relationship was found between 25(OH)D levels and echocardiographic diastolic parameters. While more than half of the athletes had insufficient 25(OH)D levels (<30 ng/mL), their average values were higher than those reported in previous studies. Conclusions: This study demonstrates that 25(OH)D levels do not significantly influence echocardiographic diastolic parameters in athletes. However, notable differences in structural and functional cardiac findings were observed among different sports disciplines. These findings contribute to the understanding of cardiac adaptations in athletes and suggest that 25(OH)D may not play a crucial role in diastolic function. Further research is needed to explore the long-term effects of vitamin D on athletic cardiac performance. Full article

Vitamin D offers numerous under-recognized health benefits beyond its well-known role in musculoskeletal health. It is vital for extra-renal tissues, prenatal health, brain function, immunity, pregnancy, cancer prevention, and cardiovascular health. Existing guidelines issued by governmental and health organizations are bone-centric and largely overlook the abovementioned extra-skeletal benefits and optimal thresholds for vitamin D. In addition, they rely on randomized controlled trials (RCTs), which seldom show benefits due to high baseline 25-hydroxyvitamin D [25(OH)D] concentrations, moderate supplementation doses, and flawed study designs. This review emphasizes the findings from prospective cohort studies showing that higher 25(OH)D concentrations reduce the risks of major diseases and mortality, including pregnancy and birth outcomes. Serum concentrations > 30 ng/mL (75 nmol/L) significantly lower disease and mortality risks compared to <20 ng/mL. With 25% of the U.S. population and 60% of Central Europeans having levels <20 ng/mL, concentrations should be raised above 30 ng/mL. This is achievable through daily supplementation with 2000 IU/day (50 mcg/day) of vitamin D₃, which prevent diseases and deaths. Furthermore, a daily dose between 4000 and 6000 IU of vitamin D₃ to achieve serum 25(OH)D levels between 40 and 70 ng/mL would provide greater protection against many adverse health outcomes. Future guidelines and recommendations should integrate the findings from observational prospective cohort studies and well-designed RCTs to improve public health and personalized care. Full article

Background: Falls are a major public health concern. Daily vitamin D supplementation is a proposed fall prevention strategy; however, safety concerns have arisen from some clinical trials showing increased fall risk when using higher vitamin D dosing methods. The relationship between vitamin D and falls may be influenced by factors, such as inflammation, which can alter the balance of essential nutrients like vitamin D and retinol, potentially affecting motor function. We use a genetic epidemiological approach to explore the association of inflammation, vitamin D, and fall risk. Methods: We included 307,082 UK Biobank participants and conducted observational and Mendelian randomization (MR) analyses to investigate associations between 25-hydroxyvitamin D [25(OH)D] and fall risk, with analyses including restriction to participants who had fallen and had inflammation as defined by CRP ≥ 5 mg/L. Results: In the observational analysis, CRP was associated with a higher (per 5 mg/L CRP increase OR = 1.06, 95% CI 1.05–1.07) and 25(OH)D with a lower odds of falls. The association between 25(OH)D concentrations and fall risk was non-linear (p < 0.001), reflecting a plateauing of the association at higher concentrations. There was an interaction between 25(OH)D and CRP on their association with the odds of falls (p = 0.009). In participants with CRP ≥ 5 mg/L, the association was U-shaped, and the fall risk was elevated for both 25(OH)D < 25 nmol/L and ≥ 100 nmol/L (p < 0.004). The association between high 25(OH)D and falls was most pronounced for participants with CRP ≥ 20 mg/L (≥ 100 nmol/L vs. 50–74.99 nmol/L: OR = 2.40, 95% CI, 1.50–3.86). Genetically predicted higher 25(OH)D was not associated with fall risk in the overall population, but a suggestive association with fall risk was seen in participants who had fallen and had CRP > 20 mg/L (926 cases; OR = 1.20, 95% CI, 1.00–1.44). Conclusions: Our study suggests that inflammation might modify the vitamin D and fall risk relationship. Both low and high 25(OH)D levels are associated with more falls in individuals with chronic inflammation, with supporting evidence seen in both observational and MR analyses. This may provide insight into the increased fall risk following high-dose vitamin D supplementation in clinical trials, warranting further research. Full article

Background/Objectives: To collect evidence from studies that explored the associations between serum vitamin D (25[OH]D) concentrations/status and the presence of depressive/anxiety symptoms in the ante- and/or postnatal periods (PROSPERO-CRD42023390895). Methods: Studies that assessed serum 25[OH]D concentrations in adult women during the ante/postnatal periods and those that used valid instruments to identify the experience/severity of depressive/anxiety symptoms were included. Independent researchers performed the identification/selection of studies, data extraction, risk of bias (RoB) assessment, and bibliometric analysis steps. Results: Of the total of 6769 eligible records, 15 cohort studies [high (n = 3), moderate (n = 7), and low (n = 5) RoB], nine cross-sectional studies [moderate (n = 3) and low (n = 6) RoB], and one case-control study [moderate RoB] were included (n = 25). Depression (n = 24) and anxiety (n = 4) symptoms were assessed. A significant difference in antenatal serum 25[OH]D concentrations between the groups of women with and without depression was identified (mean difference: −4.63 ng/mL; 95% confidence interval [95% CI]: −8.88; −0.38). Postnatal serum 25[OH]D concentrations were found to be, on average, −2.36 ng/mL (95% CI: −4.59; −0.14) lower in women with postnatal depression than in those without. Maternal antenatal anxiety was associated with significantly lower concentrations/deficiency of 25[OH]D in only one included study. Conclusions: Based on very low/low-quality evidence, it was observed that reduced serum 25[OH]D concentrations in the ante- and postnatal period are associated with the presence of ante- and postnatal depressive symptoms, respectively. Low/deficient antenatal serum 25[OH]D concentrations may not be related to the presence of anxiety symptoms before childbirth. Well-designed longitudinal studies are needed to explore the estimated pooled effect of these associations. Full article

Background/Objectives: Young women are often at risk of vitamin D deficiency, while fatty fish can provide significant amounts of it, which is especially important when no vitamin D skin synthesis is possible due to limited sunshine exposure. This study aimed to analyze the impact of increasing the intake of salmon in various forms (smoked salmon, salmon sausages) on vitamin D status of young women in autumn. Methods: The 8-week intervention involved 120 non-obese women, aged 20–25 years. Participants were randomly assigned to one of three groups: smoked salmon (25 g/day), salmon sausage (100 g/day), or a control group. Both intervention products provided approximately 5 µg of vitamin D daily. Serum concentrations of 25(OH)D as well as vitamin D intakes were assessed pre-, mid-, and post-intervention. Results: The median vitamin D intake at baseline was 2.7–3.4 µg/day and did not differ between the groups (p > 0.05), while during the intervention, it was highest in the smoked salmon group (p < 0.001) and amounted to 7.3 µg/day. While all groups experienced a decrease in 25(OH)D serum concentrations, the decrease was significantly smaller in the salmon sausage group compared to the control group (−4.3 vs. −15.0 nmol/L, p < 0.05), and no significant difference was observed between the smoked salmon and control group after 8 weeks (p > 0.05). Moreover, in the salmon sausage group, the intervention was more effective among participants with an inadequate vitamin D status at baseline (25(OH)D change after the intervention: −3.0 vs. −5.4 nmol/L, p < 0.05; inadequate vs. adequate baseline vitamin D status). Conclusions: Increasing the intake of salmon, and hence of vitamin D, was not enough to maintain the vitamin D status of young women in autumn. It seems that other, not-yet-fully-understood factors, may influence vitamin D absorption and/or metabolism, thereby affecting the outcomes of such interventions indicating that further research is needed. Nevertheless, it may be concluded that increasing salmon sausage intake might aid slow down the natural decline of 25(OH)D in young women in autumn. Full article

Introduction: Acute severe ulcerative colitis (ASUC) represents a life-threatening medical emergency. One-third of ASUC patients are steroid non-responders. Our study aimed to create a new ASUC algorithm to predict corticosteroid response in the early course of the disease. Materials and Methods: A cross-sectional study included 103 patients with ASUC (65 male, 38 female). We calculated the serum CRP to 25-hydroxy 25 OH vitamin D ratio at admission. Logistic regression determined patients’ response to glucocorticoids, depending on the CRP/25 OH vitamin D ratio value. Results and Discussion: Significant differences were observed in the CRP/25 OH vitamin D ratio at admission between glucocorticoid responders and non-responders (p = 0.001). A negative correlation was found between glucocorticoid response and CRP/25 OH vitamin D levels (Spearman’s rho = −0.338, p < 0.01). Logistic regression revealed a significant association (p = 0.003) with a model chi-square value of 11.131 (p = 0.001). ROC curve analysis showed an AUC of 0.696 (p = 0.001), indicating moderate discriminatory ability. To achieve 91% sensitivity, the CRP/25 OH vitamin D ratio must be less than 3.985 to predict a complete glucocorticoid response. Conclusions: The serum CRP to 25 OH vitamin D ratio on the first day of hospital admission can potentially determine the response to glucocorticoids in patients with ASUC and significantly affect the mortality of these patients. Full article

Background: Antiseizure medications (ASMs) are crucial for managing epilepsy in children. However, a well-documented side effect of ASMs is their impact on bone health, often due to interference with vitamin D metabolism. This can lead to vitamin D deficiency in children with epilepsy. This study aimed to determine if a daily dose of 400 IU or 1000 IU would maintain adequate vitamin D levels in children with epilepsy. Methods: A phase IV randomized controlled trial enrolled children aged 2–16 years with epilepsy and receiving antiseizure medications. Children were divided into two groups: the monotherapy group, which was defined as children on one antiseizure medication (ASM), and the polytherapy group, which was defined as children receiving two or more ASMs. Eligible children with levels above 75 nmol/L were randomized to receive a maintenance dose of either 400 IU/day or 1000 IU/day of cholecalciferol. Baseline and 6-month assessments included demographic data, anthropometric measurements, seizure type, medications, seizure control, and 25(OH)D level. Results: Out of 163 children, 90 were on monotherapy and 25 on polytherapy. After 6 months of vitamin D maintenance, the proportion of children with 25(OH)D concentration below 75 nmol/L was 75.0% in the 400 IU group and 54.8% in the 1000 IU group. In the monotherapy group, baseline seizure-free children increased from 69% to 83.6% after treating vitamin D deficiency. Conclusion: Daily vitamin D supplementation with 1000 IU may be beneficial for children with epilepsy, particularly those receiving monotherapy, to maintain sufficiency and potentially improve seizure control. Full article