Search Results (657)

Background: Diabetic kidney disease (DKD) is the most important cause of end-stage renal failure. The aim of this study is to investigate whether there is an association between supplementation of vitamin D and DKD or not. Methods: The study was designed prospectively and initiated with a total of 81 patients with a history of type 2 diabetes mellitus (DM) and diagnosed with stage 3 or 4 diabetic nephropathy (DN), who applied to Ankara University Faculty of Medicine between July 2011 and February 2013. It was completed with a total of 63 patients, 38 female (60.3%) and 25 male (39.7%), during the six-month follow-up period. The inclusion criteria were as follows: microalbumin ≥ 30 mg/day in 24 h urine, for which at least two measurements were obtained; age ≥ 18; HbA1c ≤ 8%; eGFR (estimated glomerular filtration rate) ≥ 30 mL/min; and, in addition, type 2 DM diagnosis. Patients with microalbumin levels of 30–299 mg/24 h were included in the microalbuminuria group, whereas patients with ≥300 mg were included in the macroalbuminuria group. An oral dose of 300,000 IU vitamin D3 replacement was given to patients with vitamin D deficiency and insufficiency. Results: In both groups, a significant increase in vitamin D levels at six months compared to baseline was observed, while a significant decrease in 24 h urine microalbumin and protein levels was observed at six months. Considering these results, vitamin D was considered to have a positive effect on 24 h urine microalbumin and protein levels. Conclusions: In both groups, a significant increase in vitamin D levels and a significant decrease in microalbumin and protein levels were detected at the sixth month via 24 h urine tests. Therefore, vitamin D replacement is thought to be beneficial for DKD treatment because of its antiproteinuric effect. Full article

Background: Vitamin D (VD) plays a central role in calcium homeostasis during pregnancy and has been implicated in redox-related biological processes. While VD deficiency (VDD) has been consistently associated with adverse pregnancy outcomes, the relationships between VD insufficiency (VDI), maternal antioxidant-related biomarkers, and neonatal outcomes remain incompletely characterized, particularly during the third trimester. Objective: To determines the prevalence of VDI in third-trimester pregnant women and to examine its associations with antioxidant-related markers and selected neonatal outcomes. Methods: A cross-sectional study was conducted among pregnant women in the third trimester attending a tertiary referral hospital in Mexico City. Maternal serum 25-hydroxyvitamin D (25-OHD) concentrations were measured, along with a panel of redox-related markers, including 2,2-diphenyl-2-2picrylhydrazyl (DPPH) radical scavenging activity, reduced glutathione (GSH), glutathione S-transferase (GST), glutathione peroxidase (GPx), and oxygen radical absorbance capacity (ORAC). Neonatal anthropometric parameters were recorded at birth. Associations between maternal VD status, redox-related markers, environmental factors, and neonatal outcomes were evaluated using appropriate statistical analyses. Results: A high prevalence of VDI was observed in the study population. Maternal VDI was associated with lower activities of GSH, GST, and GPx. Passive exposure to tobacco smoke and season of sampling were also associated with lower VD concentrations. Neonates born to women with VDI had higher birth weight compared with those born to women with sufficient VD concentrations. Maternal serum 25-OHD concentrations correlated positively with selected antioxidant enzyme activities. Conclusions: In this cohort of third-trimester pregnant women, VDI co-occurred with environmental factors, differences in maternal redox-related markers, and selected neonatal outcomes. These findings support an associative framework in which suboptimal VD status during the third trimester is accompanied by variations in redox-related markers. Longitudinal and mechanistic studies are needed to clarify the temporal sequence and biological relevance of these associations. Full article

Background/Objectives: The literature indicates that decreased vitamin D levels are frequently observed in individuals with severe psychiatric disorders. However, the scarcity of studies investigating this association in non-psychiatric populations, such as working women, limits the generalizability of these findings. Therefore, this study aimed to investigate the association between common mental disorders (CMDs) and vitamin D deficiency/insufficiency among female workers in southern Brazil. Methods: A cross-sectional study was conducted with a sample of 304 female workers from an industrial group in southern Brazil. Vitamin D deficiency/insufficiency was defined as a serum 25(OH)D concentration of <30 ng/mL. CMDs were assessed using the Self-Reporting Questionnaire (SRQ-20), with a cutoff score of ≥8. The association between CMDs and vitamin D deficiency/insufficiency was estimated using prevalence ratios (PRs) obtained through Poisson regression models adjusted for potential confounders. All analyses were stratified by age group (≤40 years and >40 years). Results: The ≤40-year group included 212 women (69.7%; mean age: 30.1 ± 6.3 years), and the >40-year group included 92 women (30.3%; mean age: 47.5 ± 5.6 years). The prevalence of vitamin D deficiency/insufficiency was 75.0% (95% confidence interval [CI]: 69.1–80.9) in women aged ≤40 years and 77.2% (95% CI: 68.4–85.9) in those aged >40 years. After adjustment for potential confounding variables, among women older than 40 years, those with CMDs had a 25% higher probability of presenting vitamin D deficiency/insufficiency compared to those without CMDs (PR = 1.25; 95% CI: 1.00–1.56; p = 0.044). Among women aged ≤40 years, no significant association was observed between CMDs and vitamin D deficiency/insufficiency (PR = 1.10; 95% CI: 0.94–1.30; p = 0.226). Conclusions: The findings of this study indicate a significant association between common mental disorders and vitamin D deficiency/insufficiency among female workers, particularly in those aged 40 years or older. Full article

Background/Objectives: Atypical femoral fractures (AFFs) are rare and classically linked to long-term bisphosphonate therapy, but many occur without such exposure. We aimed to characterize atypical femoral fractures without bisphosphonate exposure (AFFwB) in older adults and to explore biochemical patterns using principal component analysis (PCA). Methods: We conducted a retrospective study of patients ≥65 years admitted with femoral fractures (January 2019–September 2024). AFFs were identified from ICD-9 codes and confirmed according to 2014 ASBMR criteria by two blinded reviewers. Demographic, clinical, densitometric, and metabolic data were collected. Correlations between biochemical variables were assessed, and PCA was applied to PTH, vitamin D, BMD, ALP, calcium, and creatinine. Results: Among 932 femoral fractures, 36 met AFF criteria, including 21 AFFwB cases. AFFwB patients were mostly women, and fractures were predominantly diaphyseal. Vitamin D insufficiency/deficiency and osteoporosis were observed in 77% and 66.7% of cases, respectively. Strong correlations were found between PTH and vitamin D and between PTH and ALP. PCA identified four components explaining 88.2% of variance, corresponding to endocrine–mineral regulation, bone turnover, renal function, and BMD as an independent domain. Exploratory comparison with bisphosphonate-exposed AFF suggested higher vitamin D levels and lower ALP in treated patients. Conclusions: In this cohort, AFFs occurred both in patients without bisphosphonate exposure and in those receiving antiresorptive therapy, indicating that AFFs may arise through different pathways. These findings suggest that both insufficient bone quality and excessive remodeling suppression can ultimately lead to atypical fractures. Further studies are needed to clarify these findings. Full article

Background/Objective: Diabetic nephropathy (DN), a key microvascular complication of type 2 diabetes (T2DM), drives significant morbidity, mortality, and healthcare costs. Vitamin D deficiency has been linked to renal dysfunction, but its role in DN remains unclear. This study assessed the association between vitamin D status and DN versus T2DM without nephropathy. Methods: This cross-sectional hospital-based study included 399 participants (299 DN, 100 T2DM without nephropathy) at a tertiary endocrine clinic. Demographic, clinical, and biochemical data, including serum 25(OH)D, were collected. Chi-square and Mann–Whitney compared categorical and continuous variables, respectively, and multinomial logistic regression assessed the association between vitamin D status and DN (p < 0.05). Results: Patients with DN were older (58.2 ± 7.95 vs. 51.4 ± 9.94 years, p < 0.001), had more advanced CKD (stages 2–3b: 84.6% vs. 20.0%, p < 0.001), and higher albuminuria (moderate: 80.3% vs. 19.0%; severe: 18.4% vs. 0%, p < 0.001). They also showed poorer glycemic control, elevated urea and creatinine, lower serum albumin, dyslipidemia, elevated liver enzymes, and higher uric acid (all p < 0.05). Vitamin D deficiency was more prevalent in DN (37.7% vs. 8.0%, p < 0.001). Unadjusted multinomial regression indicated that T2DM patients without nephropathy had a 91% lower risk of vitamin D deficiency (RRR 0.09; 95% CI 0.04–0.19, p < 0.001) and an 87% lower risk of insufficiency (RRR 0.13; 95% CI 0.05–0.26, p < 0.001) compared with DN patients. After adjusting for age, HbA1c, creatinine, duration of diabetes and eGFR, the reduced risk of deficiency remained significant (RRR 0.04; 95% CI 0.01–0.16, p < 0.001), while the association with insufficiency was no longer significant (p = 0.310). Conclusions: This study shows a significant association between vitamin D deficiency and diabetic nephropathy, though its cross-sectional design precludes causal inference. Reverse causality and residual confounding cannot be excluded. Patients with DN had poorer glycemic control, dyslipidemia, and renal function, along with more frequent vitamin D deficiency. Routine vitamin D monitoring may support early detection and risk stratification in T2DM. Full article

Background/aim: Vitamin D (VitD) has been implicated in neuroprotection, yet its role in Parkinson’s disease (PD) remains unclear. This systematic review and meta-analysis aimed to evaluate the association between VitD status, supplementation, and vitamin D receptor (VDR) gene polymorphisms with PD risk and outcomes. Methodology: Following PRISMA guidelines, we searched PubMed, Scopus, and Google Scholar through August 2025 for observational studies, clinical trials, and genetic association studies. Primary outcomes included serum VitD levels in PD versus healthy controls (HCs), prevalence of VitD insufficiency/deficiency, and effects of VitD supplementation on motor symptoms. Secondary outcomes assessed associations between VDR polymorphisms and PD susceptibility. Data were synthesized using random- and fixed-effects models, with heterogeneity and publication bias evaluated. PROSPERO (CRD420251133875). Results: Sixty-three studies (n ≈ 10,700 participants) met inclusion criteria. PD patients exhibited significantly lower VitD levels (SMD = −0.46; 95% CI: −0.51 to −0.41) and higher odds of insufficiency (OR = 1.52) and deficiency (OR = 2.20) compared to HC. Cohort data suggested sufficient VitD may reduce PD risk (HR = 0.83). Supplementation yielded modest, non-significant improvements in motor outcomes. Among 20 genetic studies, FokI (rs2228570) was most consistently associated with PD, while other VDR SNPs showed variable or null associations. Conclusions: VitD deficiency is common in PD and may influence disease risk and motor function. Current evidence indicates limited benefit of supplementation for motor outcomes, and genetic associations remain inconsistent. Full article

Background: Vitamin D (VD) insufficiency is present in chronic pancreatitis (CP), leading to increased cardiovascular risk, bone complications, impaired quality of life, and increased mortality. This study aimed to determine the prevalence of VD deficiency in patients with CP and to assess its relationship to CP progression and associated cardiovascular complications. Methods: Seventy patients were enrolled and evaluated for pancreatic exocrine insufficiency by fecal elastase-1, CP severity by M-ANNHEIM classification, cardiovascular risk by 10-year risk mortality scores (SCORE and FRS), and for arterial stiffness using pulse wave velocity (PWV) at a. carotis and a. femoralis. Determination of 25-hydroxyvitamin D was performed by an LC-MS/MS method. Resting energy expenditure was calculated using the Harris–Benedict formula. Results: Mean VD levels were 37.86 ± 24.36 nmol/L (range 3.854–99.874 nmol/L); only five patients were in sufficiency status. VD levels correlated significantly with body mass index (BMI) and resting energy expenditure. In patients with severe structural changes, we observed lower VD levels regardless of etiology (p < 0.01). VD levels were lower in patients with pancreatic exocrine insufficiency (PEI), p < 0.05. Patients with mild CP by M-ANNHEIM had lower levels of VD compared to moderate and advanced CP, p < 0.05. At a cut-off of VD 11.95 nmol/L, we verified pancreatic lithiasis with 89.4% sensitivity, 83.3% specificity, and AUC of 0.826 ± 0.113 (95% CI, 0.61–1). VD status worsened with the increase in the 10-year risk mortality by both SCORE and FRS and PWV, p < 0.05. Conclusions: Most of our patients with CP were VD insufficient. Monitoring of nutritional status in patients with CP is mandatory to prevent the development of malnutrition complications and the associated morbidity and mortality. Full article

Background and Objectives: Osteoporosis risk in real-world, outpatient settings is shaped by intersecting socio-demographic, environmental, and clinical factors. We evaluated predictors of fracture risk status among adults seeking care in community pharmacies in Lahore, Pakistan. Materials and Methods: We conducted a cross-sectional study across urban and suburban pharmacies using a validated questionnaire aligned with international guidelines. Participants were classified as lower risk (osteopenia/osteoporosis without fragility fracture) or high risk (≥1 fragility fracture with clinical osteoporosis). Associations between candidate factors and risk status were examined using univariate and multivariable logistic regression analyses. Results: Of 286 participants, 53.1% were classified as lower risk. After adjustment, most sociodemographic characteristics were not independently associated with fracture risk status, except monthly income. Strong associations were observed for diabetes (AOR = 0.005, 95% CI 0.0007–0.040; p < 0.001), short-term glucocorticoid use (AOR = 32.33; p = 0.004), current smoking (AOR = 14.23; p = 0.002), ex-smoking (AOR = 4.95; p = 0.042), and lack of sunlight exposure (AOR = 7.09; p = 0.019). CKD, rheumatoid arthritis, and vitamin D insufficiency demonstrated borderline non-significant trends. Multivariable modeling did not include “not tested” categories or sparse variables. Conclusions: In Lahore’s community pharmacies, diabetes, CKD, RA, glucocorticoid exposure, smoking, and sunlight/vitamin D-related factors were the dominant correlates of osteoporosis fracture risk status, whereas most socio-demographic factors exerted limited independent effects. Pharmacy-anchored screening and counseling focused on these high-yield clinical indicators alongside timely BMD referral and guideline-concordant therapy may help identify individuals at elevated fracture risk. Full article

Background/Objectives: Air-polishing has become, in recent years, a very popular additional tool to subgingival debridement for treating periodontal disease. Vitamin D₃ plays a crucial role in bone metabolism and calcium-phosphate homeostasis. The aim of our retrospective study was to determine the additional effect of subgingival air-polishing with two types of powders (glycine and erythritol) on patients with different stages of periodontitis and low serum levels of Vitamin D₃. Methods: We collected and analysed the data of 62 patients (demographics, vitamin D₃ levels, plaque index, periodontal probing depth, bleeding on probing, clinical attachment loss, periodontitis stage and type of air-polishing powder) used during periodontal therapy. Results: We did not observe a significant correlation between periodontal status and vitamin D₃ levels/status (mean Vitamin D₃ levels: Stage I—20.19 ± 4.413 ng/mL; Stage II—19.482 ± 3.814 ng/mL; Stage III—17.681 ± 5.869 ng/mL; Stage IV—17.578 ± 5.94 ng/mL; and p = 0.539), nor did we find any significant differences in clinical outcomes when using glycine or erythritol in addition to scaling and root planning (SRP) at 3 months after treatment (all p > 0.05). Conclusions: The discrete association between lower levels of vitamin D₃ and more advanced stages of periodontitis could suggest a possible influence of vitamin D₃ insufficiency on periodontal disease progression. Although safe, easy to use and comfortable for patients, glycine and erythritol showed no differences in periodontal clinical parameters when compared as an addition to SRP. Full article

Background/Objectives: Big data analysis has revolutionized medical research, making it possible to analyze vast amounts of data and gain valuable insights that were previously impossible to obtain. Our knowledge of the characteristics of vitamin D sufficiency is primarily based on data from a limited number of observations, generally spanning a few years at most. Methods: Here at the Medical Faculty of the University of Debrecen, the big data approach has allowed us to analyze trends in vitamin D status using nearly 60,000 25-hydroxyvitamin D (25(OH)D) concentration results from 2000 onwards. Results: Apart from analyzing the well-known phenomenon of seasonality in 25(OH)D concentration, we observed a trend in test requests, which increased from a few hundred in 2000 to almost 10,000 in 2020. Of particular interest is the change in the gender gap in test requests. In previous years, test requests were primarily from women, but by the end of the analysis period, a significant number of requests were from men as well. Since the data set includes all age groups, we analyzed 25(OH)D concentration for incremental age sets of five years, from a few months to 100 years old. The prevalence of vitamin D insufficiency (<75 nmol/L) was clearly demarcated among various years of observation, age groups, sexes, and seasons. Our data was particularly valuable for analyzing the effect of the methodology used for 25(OH)D determination. Three different methodologies were used during the study period, and clear, statistically significant bias was observed. Conclusions: Our results clearly demonstrate the effect of the methodology used to determine 25(OH)D concentrations on vitamin D status, explicitly highlighting the urgent need to standardize the various platforms used to measure this important analyte and its consequences for public health. Full article

Background/Objectives: Osteoporosis represents a major yet underdiagnosed public health concern in developing countries, including Tunisia. Limited awareness, delayed diagnosis, and suboptimal adoption of preventive strategies contribute to increased risk of fragility fractures in aging populations. This study aimed to assess post-pandemic knowledge, attitudes, and preventive practices regarding osteoporosis in the Tunisian general population. Methods: A cross-sectional survey was conducted between February and April 2024 in six randomly selected community pharmacies in Tunis. Adults ≥ 40 years old completed a validated 31-item questionnaire assessing socio-demographic factors, osteoporosis knowledge, risk factors, screening practices, and preventive behaviors. A total of 160 fully completed questionnaires were analyzed using SPSS v22. Results: Only 60.6% of respondents reported awareness of osteoporosis. Knowledge levels were significantly higher in men (8.37 vs. 7.40; p = 0.043), urban residents (8.22 vs. 7.21; p = 0.036), participants with higher education (8.73 vs. 7.00; p < 0.001), those with a family history (8.58 vs. 7.49; p = 0.033), and individuals already diagnosed (9.19 vs. 7.63; p = 0.025). Screening rates were low: only 11.3% had ever undergone DXA testing, despite 18.8% reporting prior fractures. Preventive behaviors were inadequate: 80% did not supplement calcium, 88.1% did not use vitamin D, and 58.8% did not engage in <30 min of daily activity. Osteoporosis was reported by 13.1% of participants and 95.2% of diagnosed cases received treatment, predominantly bisphosphonates (75%). Comorbidities were significantly associated with osteoporosis (24.5% vs. 7.5%; p = 0.003). Conclusions: This study reveals suboptimal awareness, limited access to screening, and insufficient preventive behaviors regarding osteoporosis in Tunisia. Targeted educational initiatives, expansion of DXA availability, adoption of national osteoporosis guidelines, and multidisciplinary stakeholder involvement are critical to improve early detection, prevention, and management in the aging Tunisian population. Furthermore, promoting balanced nutrition that includes calcium- and vitamin D-rich foods, along with appropriate dietary supplementation when needed, is an essential preventive strategy to support optimal bone health and reduce osteoporosis risk in the general population. Full article

Falls are a major cause of morbidity in aging populations; this study examined physical, psychological, and lifestyle correlates of falls among older Korean adults. Using 2022 KNHANES data, we conducted a cross-sectional analysis of adults aged ≥65 years (n = 612). Fall in the past year was the outcome; multivariable logistic regression and ROC analyses evaluated candidate predictors. Lower weekly working hours (<12) (OR = 3.11, 95% CI 1.23–7.88), insufficient physical activity (<150 min/week) (2.49, 1.03–5.99), reduced grip strength (<15 kg) (2.23, 1.14–4.35), low diastolic blood pressure (<69 mmHg) (2.06, 1.09–3.89), elevated LDL cholesterol (≥150 mg/dL) (3.06, 1.49–6.28), and depressive symptoms (PHQ-9 ≥ 3) (3.02, 1.52–6.00) were independently associated with higher fall odds. Age ≥ 75 years, alcohol use, anxiety (GAD-7 ≥ 3), vitamin D ≤ 3 ng/mL, and vitamin E ≤ 7 mg/L were not significant in adjusted models. Discrimination was modest across individual markers (AUCs 0.55–0.65); model fit was acceptable (Nagelkerke R² = 0.262; Hosmer–Lemeshow p = 0.318). These findings suggest that screening for low muscle strength, depressive symptoms, hypotension, and high LDL cholesterol—alongside promoting physical activity and social engagement through work—may help identify and manage fall risk in community-dwelling older adults. Causal inference is not supported due to the cross-sectional design. Full article

Background/Objectives: Non-restorative sleep (NRS)—a subjective feeling of unrefreshing/insufficient rest despite adequate sleep duration—an important sleep-quality indicator is associated with depression and mortality. We examined whether insoluble dietary fiber intake is associated with NRS in Japanese adults, after adjusting for socioeconomic, lifestyle, and dietary factors. Methods: Using cross-sectional data from 5034 adult (≥20 years) respondents of the National Health and Nutrition Surveys (2014 and 2018), Japan, self-assessed NRS (coded as 1, absence as 0) was analyzed with insoluble fiber intake (g/1000 kcal) modeled as a continuous variable; logistic regression analyses with progressive adjustments included Model 1, adjusted for sex, age, and body mass index; Model 2, comprising socioeconomic and lifestyle factors; Model 3, adjusted for sleep duration; and Model 4, which included dietary energy, protein, fat, vitamin D, and magnesium. Results: Among 19.3% of participants with NRS, the median (interquartile range) insoluble dietary fiber intake was 5.45 (4.10–6.97) g/1000 kcal, with higher NRS prevalence among younger adults (<60 years), non-drinkers (no habitual alcohol consumption), and individuals with short sleep (<6 h). Higher insoluble dietary fiber intake was consistently associated with a lower NRS likelihood, before and after adjustment for potential confounders. In the fully adjusted model, younger age (<60 years), no habitual alcohol consumption, and short sleep (<6 h) were independently associated with greater odds of NRS. Conclusions: Higher insoluble dietary fiber density correlated with lower odds of NRS, indicating a significant association, rather than causation, that warrants longitudinal clarification of the temporal relationship between dietary fiber intake and perceived sleep restorativeness. Full article

During pregnancy, the fetus is entirely dependent on maternal sources of vitamin D, which also regulates placental function. Vitamin D deficiency during pregnancy has been associated with intrauterine growth restriction (IUGR). This study aims to provide a narrative review of the potential influence of vitamin D deficiency on the pathogenesis of IUGR, and the potential benefits of vitamin D supplementation during pregnancy on fetal anthropometry. This review highlights the high prevalence of vitamin D deficiency among pregnant women and newborns worldwide, even in sunny countries. Most studies support that fetal vitamin D levels are directly related to maternal vitamin D levels. There is extensive literature confirming the relation between maternal vitamin D status and fetal growth patterns throughout pregnancy (both early and late). However, there is currently insufficient evidence to establish recommendations on optimal prenatal vitamin D supplementation in women to reduce the risk of IUGR. Full article

Background: The Body Roundness Index (BRI) is an emerging anthropometric measure that reflects central adiposity, particularly relevant in ageing populations where body composition and nutritional status undergo significant changes. This study aims to explore patterns linking BRI values, age, energy intake, and micronutrient adequacy using cluster analysis, with a focus on implications for older adults. Methods: Data from 1504 community-dwelling older adults (mean age 74.4 ± 10.8 years) in Poland participating in the PolSenior project were analyzed. K-means cluster analysis was applied to standardized variables (BRI, age, energy intake, and micronutrient adequacy) to identify major participant profiles. Results: The data indicate that older adults, particularly those over 75 years old, are at an elevated risk of inadequate micronutrient intake, especially for essential nutrients such as calcium, magnesium, folate and vitamin D. Three distinct clusters were identified: Cluster 1 (n = 495, 33%): oldest participants, lowest BRI, and insufficient energy and micronutrient intake, indicating a high risk of undernutrition; Cluster 2 (n = 557, 37%): average age, moderate BRI, and highest energy and micronutrient intake, suggesting a potentially excessive energy balance. Cluster 3 (n = 452, 30%): the youngest group with the highest BRI and the lowest energy and micronutrient intake, indicating early-onset central adiposity and poor dietary quality. Conclusions: Three clusters were identified that differed significantly in BRI, age, and adequacy of energy and micronutrient intake. BRI combined with dietary indicators effectively distinguishes nutritional risk profiles among older adults. A low BRI may indicate a risk of undernutrition in advanced age, whereas a higher BRI with low nutrient adequacy suggests poor diet quality, even within the older population. Age-specific and nutrition-sensitive interventions are needed to support healthy ageing. Full article