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Abdo B, Abdullah M, AlShoaibi IA, Ahmed F, Alawdi R, Alzanen K, Algaadi K. Relationship Between Glycated Hemoglobin (HbA1c) and Vitamin D Levels in Type 2 Diabetes Patients: A Retrospective Cross-Sectional Study. Cureus 2024; 16:e62468. [PMID: 39015860 PMCID: PMC11250245 DOI: 10.7759/cureus.62468] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/16/2024] [Indexed: 07/18/2024] Open
Abstract
BACKGROUND Significant links between low serum levels of vitamin D3 and insufficient glycemic control in patients with type 2 diabetes mellitus (T2DM) have been reported previously in the literature. However, there is no exciting evidence on the association between glycated hemoglobin (HbA1c) and vitamin D levels in T2DM individuals in our nation (Yemen). This study aimed to investigate the relationship between HbA1c and vitamin D levels in T2DM patients in a resource-limited setting. METHOD A retrospective cross-sectional study was conducted at the Al-Raffa Center, Ibb, Yemen between June 2018 and September 2023 including 396 patients diagnosed with T2DM. The patient characteristics, comorbidities, HbA1c, and vitamin D levels were gathered from patients' medical profiles. Linear regression analysis was used to find the factors associated with vitamin D deficiency (serum 25(OH)D levels < 20 ng/mL) among T2DM patients. Subsequently, the correlation between HbA1c and vitamin D levels was examined using receiver operating characteristic (ROC) curve analysis. RESULTS The mean age was 44.6 ±14.6 years and most of them (n= 227, 57.3%) were female and from a rural area (n= 229, 57.8%). Comorbidities were hypertension, dyslipidemia disease, and cardiovascular disease in 176 (44.4%), 63 (15.9%), and 88 (22.2%) cases, respectively. The mean HbA1c was 8.1 ±2.5%. The mean vitamin D level was 26.9 ±16.5 ng/mL and low vitamin D was present in 260 (65.7%) (vitamin D deficiency in 160 (40.4%) and vitamin D insufficiency in 100 (25.3%) cases). In regression analysis, obesity (>30 kg/m2) (odds ratio (OR): 299.49; 95% confidence interval (CI): 72.66 - 1234.42, p <0.0001), higher HbA1c levels (OR: 1.61; 95% CI: 1.26 - 2.05, p =0.0001), and urban residence (OR: 23.98; 95% CI: 5.62 - 102.42, p <0.0001) were associated with vitamin D deficiency. There was a negative correlation between the vitamin D level and HbA1c which was statistically significant (correlation coefficient r: -0.5452; 95% CI: -0.6109 to -0.4720, p <0.0001). Using the ROC analysis, the serum vitamin D value of ≤18.42 ng/ml was the best cut-off point to predict hyperglycemia (area under the curve: 0.633, 95% CI: 0.672 to 0.770, sensitivity: 52%, specificity: 84.71 %, Yoden's index: 0.3671, p <0.001). Based on this cut-off, 39.4% of individuals (37.5% in the normoglycemic group and 90.9% in the hyperglycemic group) were vitamin D deficient. CONCLUSION In this study, low vitamin D was common among T2DM patients, especially those with poor glycemic control. We observed a link between HbA1c levels, urban residency, and BMI with vitamin D deficiency in T2DM patients. The association was distinguished by low vitamin D levels and elevated HbA1c. Additionally, we found that the serum vitamin D value of ≤18.42 ng/ml was the best cut-off point to predict hyperglycemia in T2DM patients with moderate agreement. To manage their disease, patients with T2DM should take their medications as prescribed and live a healthy lifestyle. This will increase their overall health, especially their vitamin D levels.
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Affiliation(s)
- Basheer Abdo
- Department of Internal Medicine, School of Medicine, Ibb University, Ibb, YEM
| | - Mohammed Abdullah
- Department of Internal Medicine, School of Medicine, Ibb University, Ibb, YEM
| | - Ismaeel A AlShoaibi
- Department of Internal Medicine, School of Medicine, Ibb University, Ibb, YEM
| | | | - Redwan Alawdi
- Department of Internal Medicine, School of Medicine, Ibb University, Ibb, YEM
| | - Khaled Alzanen
- Department of Internal Medicine, School of Medicine, Ibb University, Ibb, YEM
| | - Kamal Algaadi
- Department of Internal Medicine, School of Medicine, Ibb University, Ibb, YEM
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Qureshi G, Khemissa M, Amr G, Bhat R. The Non-conventional Effects of Hypovitaminosis D: A Pandemic Even in Sunlight-Rich Countries. Cureus 2024; 16:e59267. [PMID: 38813297 PMCID: PMC11135140 DOI: 10.7759/cureus.59267] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/29/2024] [Indexed: 05/31/2024] Open
Abstract
The synthesis and absorption of Vitamin D play crucial roles in numerous bodily functions, yet deficiencies persist due to factors like insufficient sunlight exposure and dietary inadequacy. Research underscores the significance of lifestyle elements such as diet, sun exposure, and physical activity in maintaining optimal Vitamin D levels. Strategies aimed at tackling deficiencies emphasize supplementation alongside lifestyle adjustments, especially in regions with abundant sunlight like the Middle East and North Africa (MENA). Despite the abundance of sunshine in the Arab world, there remains a prevalent issue of Vitamin D deficiency. This problem arises from various factors, including cultural practices such as traditional clothing covering most skin areas, which limit sun exposure, and environmental factors like air pollution that reduce UV penetration. Dietary habits and lifestyle choices also contribute to this deficiency. Dealing with the ongoing pandemic requires a focused effort to enhance awareness. While some individuals may recognize common diseases caused by Vitamin D deficiency, such as rickets and osteomalacia, many remain unaware of the broader health risks associated with the condition, including non-skeletal manifestations. Additionally, there is a lack of understanding regarding the numerous hidden benefits of this hormone. Therefore, prioritizing educational initiatives that delve into these aspects is essential to effectively combat the current health crisis. This literature review aims to report both skeletal and extraskeletal consequences of hypovitaminosis and briefly discuss the cause of paradoxical vitamin D deficiency in sunny regions like the MENA. This was done by reviewing pertinent articles published between January 2000 and January 2024, sourced from databases such as PubMed, UpToDate, Scopus, and CINAHL, focusing exclusively on English language literature and using keywords such as "Vitamin D deficiency" and "Extraskeletal manifestations."
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Affiliation(s)
- Ghania Qureshi
- Internal Medicine, Ras al Khaimah Medical and Health Sciences University, Ras Al Khaimah, ARE
| | - Madjda Khemissa
- Internal Medicine, Ras al Khaimah Medical and Health Sciences University, Ras Al Khaimah, ARE
| | - Ganna Amr
- Internal Medicine, Ras al Khaimah Medical and Health Sciences University, Ras Al Khaimah, ARE
| | - Raghavendra Bhat
- Internal Medicine, Ras al Khaimah Medical and Health Sciences University, Ras Al Khaima, ARE
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Zhang X, Chen Z, Xiang Y, Zhou Y, Tang M, Cai J, Xu X, Cui H, Feng Y, Xu R. The Association between Serum Level of Vitamin D and Inflammatory Biomarkers in Hospitalized Adult Patients: A Cross-Sectional Study Based on Real-World Data. Mediators Inflamm 2024; 2024:8360538. [PMID: 38549715 PMCID: PMC10978080 DOI: 10.1155/2024/8360538] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2023] [Revised: 02/16/2024] [Accepted: 03/11/2024] [Indexed: 04/02/2024] Open
Abstract
Objective The association between vitamin D status and inflammation remains unclear in hospitalized patients. Materials and Methods We performed the current study based on real-world data from two teaching hospitals. Serum level of vitamin D (assessed by 25-hydroxyvitamin D) was evaluated within 2 days after admission. All the patients were further classified into three groups: deficiency (<12 ng/mL), insufficiency (12-20 ng/mL), and adequate (≥20 ng/mL). White blood cell (WBC) count, serum level of C-reactive protein (CRP), and procalcitonin were also measured and used to evaluate inflammation. Other potential covariates were abstracted from medical records. Charlson comorbidity index (CCI) was calculated to assess the severity of disease. Results A total number of 35,528 hospitalized adult patients (21,171 men and 14,357 women) were included. The average age and BMI were 57.5 ± 16.2 years and 23.4 ± 3.7 kg/m2, respectively, while medium vitamin D level was 16.1 ng/mL (interquartile range: 11.4 ng/mL, 21.6 ng/mL) and median CCI was one point (interquartile range: 0 point, two points). The prevalence of deficiency and insufficiency was 28.0% and 40.5%. Multivariate linear regression model showed that serum level of vitamin D was significantly associated with WBC and CRP but not associated with procalcitonin. Each standard deviation (≈7.4 ng/mL) increase in vitamin D was associated with a decrease in WBC by 0.13 × 109/mL (95% CI: 0.2 × 109/mL, 0.06 × 109/mL) and 0.62 mg/L (95% CI: 0.88 mg/L, 0.37 mg/L) for CRP. Subgroup analysis and sensitivity analysis (excluding those whose eGFR <60 ml/min/1.73 m2, those whose daily calorie intake <1,000 kcal, and those who were recruited from Xin Hua hospital) generated similar results. Conclusions The deficiency and insufficiency of vitamin D in the hospitalized adult patients was very common. However, the results should be interpreted with caution for limited representation of the whole inpatients. Low level of vitamin D was associated with inflammatory biomarkers, which provide the evidences to early intervention for lower the risk of infection.
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Affiliation(s)
- Xiaomin Zhang
- Department of Clinical Nutrition, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200127, China
| | - Zhiqi Chen
- Department of Clinical Nutrition, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200127, China
| | - Yi Xiang
- Department of Clinical Nutrition Center, Xin Hua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200092, China
| | - Yiquan Zhou
- Department of Clinical Nutrition, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200127, China
| | - Molian Tang
- Department of Clinical Nutrition, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200127, China
| | - Jun Cai
- Department of Clinical Nutrition, Long Hua Hospital affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai 200031, China
| | - Xinyi Xu
- University of Michigan, LSA 500 S, State Street, Ann Arbor, MI 48109, USA
| | - Hongyuan Cui
- Department of General Surgery, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Science, Beijing 100730, China
| | - Yi Feng
- Department of Clinical Nutrition Center, Xin Hua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200092, China
| | - Renying Xu
- Department of Clinical Nutrition, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200127, China
- Department of Nutrition, College of Health Science and Technology, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
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Albai O, Braha A, Timar B, Golu I, Timar R. Vitamin D-A New Therapeutic Target in the Management of Type 2 Diabetes Patients. J Clin Med 2024; 13:1390. [PMID: 38592202 PMCID: PMC10931811 DOI: 10.3390/jcm13051390] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2024] [Revised: 02/25/2024] [Accepted: 02/27/2024] [Indexed: 04/10/2024] Open
Abstract
Background: Vitamin D is a fat-soluble vitamin that prevents cardiovascular diseases and diabetes mellitus (DM). The present research aimed to study the impact of 25-hydroxyvitamin D (25(OH)D) level on the health status of patients with type 2 DM (T2DM) hospitalized in the "Pius Brînzeu" Emergency Clinical County University Hospital in Timisoara, Romania. Methods: The study retrospectively included 160 patients with T2DM who were clinically and biologically evaluated during hospitalization. Results: 13.1% of patients had optimal, 23.1% insufficient, and 63.8% deficient 25(OH)D values. Patients with 25(OH)D deficiency presented poorer glycemic control and were older, with higher weight, but had altered renal function, anemia, and lower iron values. Also, patients with associated neoplasia, diabetic neuropathy, cardiovascular disease (CVD), dementia, and grade 3 arterial hypertension (HTN) had lower values of 25(OH)D. An age > 55 years (sensitivity 69.9, specificity 82.5, AUROC 0.786, p < 0.001) and an HbA1c > 7.7% (sensitivity 89.3, specificity 92.9, AUROC 0.938, p < 0.001) predict 25(OH)D deficiency in T2DM patients. Conclusions: Vitamin D influences almost every system and organ in the body, so it should be a routine test for all patients with DM to correct the deficiency and prevent other diseases and complications.
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Affiliation(s)
- Oana Albai
- Department of Second Internal Medicine—Diabetes, Nutrition, Metabolic Diseases, and Systemic Rheumatology, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania; (O.A.); (B.T.); (R.T.)
- Department of Diabetes, Nutrition and Metabolic Diseases Clinic, “Pius Brînzeu” Emergency Clinical County University Hospital, 300723 Timisoara, Romania
- Centre for Molecular Research in Nephrology and Vascular Disease/MOL-NEPHRO-VASC, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania
| | - Adina Braha
- Department of Second Internal Medicine—Diabetes, Nutrition, Metabolic Diseases, and Systemic Rheumatology, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania; (O.A.); (B.T.); (R.T.)
- Department of Diabetes, Nutrition and Metabolic Diseases Clinic, “Pius Brînzeu” Emergency Clinical County University Hospital, 300723 Timisoara, Romania
| | - Bogdan Timar
- Department of Second Internal Medicine—Diabetes, Nutrition, Metabolic Diseases, and Systemic Rheumatology, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania; (O.A.); (B.T.); (R.T.)
- Department of Diabetes, Nutrition and Metabolic Diseases Clinic, “Pius Brînzeu” Emergency Clinical County University Hospital, 300723 Timisoara, Romania
- Centre for Molecular Research in Nephrology and Vascular Disease/MOL-NEPHRO-VASC, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania
| | - Ioana Golu
- Department of Endocrinology, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania;
| | - Romulus Timar
- Department of Second Internal Medicine—Diabetes, Nutrition, Metabolic Diseases, and Systemic Rheumatology, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania; (O.A.); (B.T.); (R.T.)
- Department of Diabetes, Nutrition and Metabolic Diseases Clinic, “Pius Brînzeu” Emergency Clinical County University Hospital, 300723 Timisoara, Romania
- Centre for Molecular Research in Nephrology and Vascular Disease/MOL-NEPHRO-VASC, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania
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Majeed M, Siddiqui M, Lessan N. Vitamin D deficiency increases with age and adiposity in Emirati children and adolescents irrespective of type 1 diabetes mellitus: a case control study. BMC Endocr Disord 2023; 23:150. [PMID: 37452421 PMCID: PMC10347721 DOI: 10.1186/s12902-023-01405-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Accepted: 07/06/2023] [Indexed: 07/18/2023] Open
Abstract
BACKGROUND Association of vitamin D (25(OH)D) deficiency with obesity and diabetes has been well-established in paediatric and adult populations. This study aims to report the association of 25(OH)D deficiency with body composition and prevalence of 25(OH)D deficiency in Emirati children and adolescents, who attended a diabetes centre in the United Arab Emirates. METHODS Using Abu Dhabi Diabetes and Obesity Study cohort, type 1 diabetes (T1D) and normoglycaemic (NG) participants between 4-19 years of age were selected. WHO criteria were used to define 25(OH)D cut-offs: deficient (< 30 nmol/L), insufficient (30-50 nmol/L) and sufficient (> 50 nmol/L). Based on CDC recommendations, BMI percentile was categorised as underweight, normal weight, overweight and obesity. RESULTS After age and sex matching, 148 T1D cases and 296 NG controls were identified. 25(OH)D deficiency was observed in 22.3% (n = 33) T1D and 40.5% (n = 120) NG participants. 25(OH)D levels were lower in adolescents (15 - 19 years) than children (4 - 7 years) in both T1D and NG groups (p = 0.018 vs p < 0.001). Females were more likely to be 25(OH)D deficient in both groups. Children and adolescents with BMI ≥ 95th percentile were more likely to be 25(OH)D deficient than those with normal weight (OR: 2.69; 95% CI: 1.56, 4.64). Adiposity measures and 25(OH)D levels correlated negatively in both groups (T1D p < 0.01, NG p < 0.001). CONCLUSION Vitamin D 25(OH)D deficiency is notably prevalent in Emirati children and adolescents despite adequate sunlight throughout the year. The prevalence was lower in those with T1D which may be indicative of treatment compliance in this population. This study also confirms important negative association of serum 25(OH)D levels with body mass and obesity in this population.
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Affiliation(s)
- Maria Majeed
- Imperial College London Diabetes Centre, Khaleej Al Arabi Street, PO Box 48338, Abu Dhabi, UAE
| | - Mohsin Siddiqui
- Imperial College London Diabetes Centre, Khaleej Al Arabi Street, PO Box 48338, Abu Dhabi, UAE
| | - Nader Lessan
- Imperial College London Diabetes Centre, Khaleej Al Arabi Street, PO Box 48338, Abu Dhabi, UAE.
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Shatnawei A, AlNababteh AH, Govender RD, Al-Shamsi S, AlJarrah A, Al-Rifai RH. Mode of presentation and performance of serology assays for diagnosing celiac disease: A single-center study in the United Arab Emirates. Front Nutr 2023; 10:1107017. [PMID: 37090770 PMCID: PMC10113562 DOI: 10.3389/fnut.2023.1107017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2022] [Accepted: 03/21/2023] [Indexed: 04/09/2023] Open
Abstract
ObjectiveTo characterize patients with celiac disease (CD), examines the clinical spectrum of CD, and evaluate the performance of serologic tests used for CD screening, in the United Arab Emirates (UAE).MethodsMedical charts of patients received at the Digestive Diseases Institute of Cleveland Clinic Abu Dhabi from January 2015 to December 2020 were reviewed. Patients who were screened for four serologic biomarkers (anti-tissue transglutaminase IgA [Anti-tTG-IgA], anti-tissue transglutaminase IgG [Anti-TtG-IgG], anti-deamidated gliadin peptide IgG [Anti-DGP-IgG], and anti-deamidated gliadin peptide IgA [Anti-DGP-IgA]) were included. Histopathology was performed on patients with the seropositive test. Marsh score > 1 considered to confirm CD. Characteristics of the Anti-tTG-IgA seropositive patients were described and that correlated with histopathologically confirmed CD were explored.ResultsOf the 6,239 patients, 1.4, 2.9, 4.7, and 4.9%, were seropositive to Anti-tTG-IgG, Anti-TtG-IgA, Anti-DGP-IgA, and Anti-DGP-IgG, respectively. Overall, 7.7% were seropositive to either of the four biomarkers. Of the biopsy-screened 300 patients, 38.7% (1.9% of the total serologically screened) were confirmed with CD. The mean age of Anti-TtG-IgA seropositive patients was 32.1 ± 10.3 SD years, 72% of them were females, and 93.4% were Emirati. In those patients, overweight (28.7%) and obesity (24.7%) were common while 5.8% of patients were underweight. Anemia prevalence was 46.7%, 21.3% had Gastroesophageal reflux disease (GERD), 7.7% with autoimmune thyroid disease, 5.5% (type 1), and 3.3% (type 2) were diabetic. Vitamin D deficiency was observed in 47.8% of the Anti-TtG IgA seropositive patients. Twelve (10.3%) histopathologically confirmed CD patients were seronegative to Anti-TtG-IgA but seropositive to anti-DGP-IgA and/or Anti-DGP-IgG. Body mass index, GERD, autoimmune thyroid disease, type 1 diabetes, asthma, hemoglobin, and vitamin D concentration, were all correlated with biopsy-confirmed CD (P < 0.05). Compared to the gold-standard biopsy test, Anti-TtG-IgA had the highest sensitivity (89.7%) and specificity (83.7%).ConclusionThree and two of every 100 patients were serologically (anti-tTG-IgA positive) and histopathologically diagnosed with CD, respectively. Although Anti-TtG-IgA is the most sensitive, specific, and commonly used test, one of every ten histopathologically confirmed patients and Anti-tTG-IgA seronegative were seropositive to Anti-DGP. To avoid missing patients with CD, a comprehensive serological investigation covering DGP-IgG/IgA is warranted.
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Affiliation(s)
| | - Asma H. AlNababteh
- College of Medicine and Health Sciences, Institute of Public Health, United Arab Emirates University, Al Ain, United Arab Emirates
| | - Romona Devi Govender
- Department of Family Medicine, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates
| | - Saif Al-Shamsi
- Department of Internal Medicine, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates
| | - Ammar AlJarrah
- Clinical Medical Science, Faculty of Medicine, Yarmouk University, Irbid, Jordan
| | - Rami H. Al-Rifai
- College of Medicine and Health Sciences, Institute of Public Health, United Arab Emirates University, Al Ain, United Arab Emirates
- Zayed Center for Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates
- *Correspondence: Rami H. Al-Rifai,
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Grant WB, Al Anouti F, Boucher BJ, Fakhoury HMA, Moukayed M, Pilz S, Al-Daghri NM. Evidence That Increasing Serum 25(OH)D Concentrations to 30 ng/mL in the Kingdom of Saudi Arabia and the United Arab Emirates Could Greatly Improve Health Outcomes. Biomedicines 2023; 11:biomedicines11040994. [PMID: 37189612 DOI: 10.3390/biomedicines11040994] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Revised: 03/17/2023] [Accepted: 03/21/2023] [Indexed: 03/30/2023] Open
Abstract
Accumulating evidence supports the potential protective effects of vitamin D against chronic diseases such as Alzheimer’s disease, autoimmune diseases, cancers, cardiovascular disease (ischaemic heart disease and stroke), type 2 diabetes, hypertension, chronic kidney disease, stroke, and infectious diseases such as acute respiratory tract diseases, COVID-19, influenza, and pneumonia, as well as adverse pregnancy outcomes. The respective evidence is based on ecological and observational studies, randomized controlled trials, mechanistic studies, and Mendelian randomization studies. However, randomized controlled trials on vitamin D supplementation have largely failed to show benefits, probably due to poor design and analysis. In this work, we aim to use the best available evidence on the potential beneficial effects of vitamin D to estimate the expected reduction in incidence and mortality rates of vitamin D-related diseases in the Kingdom of Saudi Arabia and the United Arab Emirates if minimum serum 25(OH)D concentrations were to be raised to 30 ng/mL. Estimated reductions by 25% for myocardial infarction incidence, 35% for stroke incidence, 20 to 35% for cardiovascular disease mortality, and 35% for cancer mortality rates depicted a promising potential for raising serum 25(OH)D. Methods to increase serum 25(OH)D concentrations at the population level could include food fortification with vitamin D3, vitamin D supplementation, improved dietary vitamin D intake, and sensible sun exposure.
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Niakan Lahiji M, Moghaddam OM, Ameri F, Pournajafian A, Mirhosseini F. Relationship of Vitamin D level with insulin dosage required based on insulin therapy protocol. Eur J Transl Myol 2023. [PMID: 36786150 PMCID: PMC10388596 DOI: 10.4081/ejtm.2023.11017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Accepted: 12/11/2022] [Indexed: 02/05/2023] Open
Abstract
The deficiency of vitamin D amongst Iranian people is high and also is related on hyperglycemia. This study aims to evaluate the association of vitamin D levels with the required dose of insulin prescribed based on an insulin therapy protocol in critical condition patients admitted to intensive care unit (ICU), in an investigation based in Iran. This cross-sectional study was performed on patients who required insulin due to hyperglycemia. The relationship between serum vitamin D level and the required dose of insulin prescribed based on insulin therapy protocol in this group of patients was investigated. A total of 172 patients with a mean age of 46.93 ± 31.9 years were included in this study. Across the included participants, 78.8% of patients had vitamin D deficiency, 11.9% had insufficient vitamin D and 9.3% had normal vitamin D levels. There was a significant difference in mean blood sugar between the vitamin D deficiency group and the normal group. Vitamin D levels were also significantly higher in men than women. Furthermore, the HbA1C hemoglobin level in patients with Vitamin D deficiency was significantly higher compared to the group with normal levels of vitamin D. Our findings suggest that decreased vitamin D is associated with increased blood sugar and insulin requirements in patients admitted to ICU. Women are at a higher risk for vitamin D deficiency. We hope that these findings may help inform relevant treatment strategies.
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Affiliation(s)
- Mohammad Niakan Lahiji
- Trauma and Injury Research Center, Critical Care Department, School of Medicine, Iran university of Medical Sciences, Tehran.
| | - Omid Moradi Moghaddam
- Trauma and Injury Research Center, Critical Care Department, School of Medicine, Iran university of Medical Sciences, Tehran.
| | - Forough Ameri
- Department of Anesthesiology, Hazrat-e Rasool Hospital, School of Medicine, Iran University of Medical Sciences, Tehran.
| | - Alireza Pournajafian
- Department of Anesthesiology, Firoozgar Hospital, School of Medicine, Iran University of Medical Sciences, Tehran.
| | - Farnaz Mirhosseini
- Clinical Nutrition Department, Hazrat-e Rasool Hospital, School of Medicine, Iran University of Medical Sciences, Tehran.
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Gariballa S, Yasin J, Alessa A. A randomized, double-blind, placebo-controlled trial of vitamin D supplementation with or without calcium in community-dwelling vitamin D deficient subjects. BMC Musculoskelet Disord 2022; 23:415. [PMID: 35505326 PMCID: PMC9063133 DOI: 10.1186/s12891-022-05364-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Accepted: 04/26/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Although vitamin D deficiency is highly prevalent in the Middle East, very few studies have attempted to measure its health impact. AIMS We aimed to assess whether vitamin D3 and calcium, either alone or in combination, have health benefit. METHODS In a 2 × 2 factorial design double-blind, placebo-controlled trial, Community free living adults living in the city of Al Ain, UAE were randomly assigned to receive daily 2000 IU oral vitamin D3 alone, 600 mg calcium alone, oral vitamin D3 (2000 IU per day) combined with 600 mg calcium, or a placebo for 6 months. Primary outcomes were self-rated health and bone turnover markers. RESULTS Of the 545 randomized, 277 subjects completed 6 months follow up. 25(OH)D levels marginally increased in the two groups received vitamin D3 alone or combined with calcium compared to the decline seen in those who received calcium supplement alone or a placebo. Sub-group analysis revealed that parathyroid hormone (PTH) concentration decreased and Calcium/creatinine ratio increased significantly in the combined vitamin D and Calcium group compared to the vitamin D alone or Calcium alone in contrast to the increase seen in the placebo group [p < 0.05 for between group difference at 6 months]. There were no statistically significant differences between the supplement and placebo groups at the 6 months follow-up in body weight, body mass index (BMI), blood pressure, body pains and general health. CONCLUSION PTH concentration decreased and calcium/creatinine ratio increased in subjects who received vitamin D and Calcium together compared to those who received vitamin D alone. TRIAL REGISTRATION NCT02662491 , First registered on 25 January 2016 ( https://register. CLINICALTRIALS gov/prs/app/action/SelectProtocol?sid=S00060CE&selectaction=Edit&uid=U0001M6P&ts=3&cx=scu4cb , Last update: 05 August 2019.
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Affiliation(s)
- Salah Gariballa
- Internal Medicine, Faculty of Medicine & Health Sciences, United Arab Emirates University, PO Box 17666, Al Ain, United Arab Emirates.
| | - Javed Yasin
- Internal Medicine, Faculty of Medicine & Health Sciences, United Arab Emirates University, PO Box 17666, Al Ain, United Arab Emirates
| | - Awad Alessa
- Internal Medicine, Faculty of Medicine & Health Sciences, United Arab Emirates University, PO Box 17666, Al Ain, United Arab Emirates
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Anouti FA, Ahmed LA, Riaz A, Grant WB, Shah N, Ali R, Alkaabi J, Shah SM. Vitamin D Deficiency and Its Associated Factors among Female Migrants in the United Arab Emirates. Nutrients 2022; 14:nu14051074. [PMID: 35268048 PMCID: PMC8912400 DOI: 10.3390/nu14051074] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Revised: 02/21/2022] [Accepted: 02/22/2022] [Indexed: 01/14/2023] Open
Abstract
Vitamin D is important for bone health, and vitamin D deficiency could be linked to noncommunicable diseases, including cardiovascular disease. The purpose of this study was to determine the prevalence of vitamin D deficiency and its associated risk factors among female migrants from Philippines, Arab, and South Asian countries residing in the United Arab Emirates (UAE). We used a cross-sectional study to recruit a random sample (N = 550) of female migrants aged 18 years and over in the city of Al Ain, UAE. Vitamin D deficiency was defined as serum 25-hydroxyvitamin D concentrations ≤20 ng/mL (50 nmol/L). We used multivariable logistic regression analysis to identify risk factors associated with vitamin D deficiency. The mean age of participants was 35 years (SD ± 10). The overall prevalence rate of vitamin D deficiency was 67% (95% CI 60-73%), with the highest rate seen in Arabs (87%), followed by South Asians (83%) and the lowest in Filipinas (15%). Multivariate analyses showed that low physical activity (adjusted odds ratio (aOR) = 4.59; 95% CI 1.98, 10.63), having more than 5 years duration of residence in the UAE (aOR = 4.65; 95% CI: 1.31, 16.53) and being obese (aOR = 3.56; 95% CI 1.04, 12.20) were independently associated with vitamin D deficiency, after controlling for age and nationality. In summary, vitamin D deficiency was highly prevalent among female migrants, especially Arabs and South Asians. It is crucial that health professionals in the UAE become aware of this situation among this vulnerable subpopulation and provide intervention strategies aiming to rectify vitamin D deficiency by focusing more on sun exposure, physical activity, and supplementation.
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Affiliation(s)
- Fatme Al Anouti
- Department of Health Sciences, College of Natural and Health Sciences, Zayed University, Abu Dhabi 144534, United Arab Emirates;
| | - Luai A. Ahmed
- Institute of Public Health, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain 17666, United Arab Emirates;
| | - Azmat Riaz
- Department of Obstetrics and Gynecology, Ajman University, Ajman 20550, United Arab Emirates;
| | - William B. Grant
- Sunlight, Nutrition and Health Research Center, P.O. Box 641603, San Francisco, CA 94164-1603, USA;
| | - Nadir Shah
- Planning and Development Division, Government of Gilgit Baltistan, Gilgit 15100, Pakistan;
| | - Raghib Ali
- Public Health Research Center, New York University Abu Dhabi, Abu Dhabi 129188, United Arab Emirates;
| | - Juma Alkaabi
- Department of Internal Medicine, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain 17666, United Arab Emirates;
| | - Syed M. Shah
- Institute of Public Health, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain 17666, United Arab Emirates;
- Department of Family Medicine, Aga Khan University, Karachi 3500, Pakistan
- Correspondence: ; Tel.: +92-971-3-713-7458
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11
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Al Zarooni AAR, Nagelkerke N, Al Marzouqi FI, Al Darmaki SH. Risk factors for vitamin D deficiency in Abu Dhabi Emirati population. PLoS One 2022; 17:e0264064. [PMID: 35167624 PMCID: PMC8846532 DOI: 10.1371/journal.pone.0264064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2021] [Accepted: 02/02/2022] [Indexed: 11/18/2022] Open
Abstract
Objective
There have been concerns regarding the high prevalence of vitamin D deficiency in the United Arab Emirates and the association between this prevalence and cardiovascular risk. Vitamin D deficiency is a global public health problem, with a high prevalence in the Abu Dhabi national population. This cross-sectional retrospective observational study aimed to elucidate vitamin D deficiency symptoms and contributing factors in this context.
Method and sampling
Among 12346 participants presenting for their Weqaya population comprehensive cardiovascular risk factor screening, 700 were randomly selected and telephoned, among whom 400 completed a questionnaire that elicited information on dietary intake, sun exposure, clothing, physical activity, and symptoms related to vitamin D deficiency.
Results
Higher vitamin D levels were noted in participants who consumed extra servings of cod liver oil, tuna, salmon, and eggs; who wore clothes with their arms and legs exposed; and who performed daily physical activity. Symptoms of hypovitaminosis D (bone pain) were more frequently found in females. Fatigue is significantly associated with low vitamin D and younger participants. Strategies focusing on health promotion and lifestyle interventions should be implemented to address vitamin D deficiency.
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Affiliation(s)
| | - Nico Nagelkerke
- Community Medicine, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates
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12
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Bushnaq T, Algethami F, Qadhi A, Mustafa R, Ghafouri K, Azhar W, Malki AA. The Impact of Vitamin D Status on COVID-19 Severity among Hospitalized Patients in the Western Region of Saudi Arabia: A Retrospective Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19031901. [PMID: 35162923 PMCID: PMC8835555 DOI: 10.3390/ijerph19031901] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Revised: 01/21/2022] [Accepted: 02/05/2022] [Indexed: 02/01/2023]
Abstract
The coronaviruses disease 2019 (COVID-19) spreads continuously worldwide. The new vaccines and drugs have been approved. The prevention of disease is crucial, and some studies reveal the promising effect of alternative therapies such as vitamin D supplementations on COVID-19 prevention, but they still require sufficient evidence. Therefore, the current retrospective multicenter cross-sectional study aims to determine the primary association between the vitamin D status of hospitalized COVID-19 and its severity as well as mortality. A total of 197 COVID-19 were admitted at King Faisal Hospital, Al Noor Specialist Hospital in Makkah, and at Complex King Faisal Hospital in Taif in the Westering region of Saudi Arabia (SA) between June and August 2020. The demographic and clinical characteristics, laboratory tests included serum 25(OH)D and admission for intensive care unit (ICU), length of stay in the hospital, mechanical ventilation (MV) support, and mortality were recorded and analyzed. Vitamin D deficiency (25(OH)D < 20 ng/mL) was found in 73.10% of all study population. Multiple logistic regression was used after adjusted covariances such as age, gender, diabetes, hypertension, and chronic kidney disease (CKD). No statistically significant was shown for ICU admission [Odd Ratio, OR 1.25 (95% confidence interval, CI 0.41–3.88) p = 0.70], MV support [Odd Ratio, OR 3.12 (95% confidence interval, CI 0.74–13.21) p = 0.12] and mortality [Odd Ratio, OR 2.39 (95% confidence interval, CI 0.31–18.11), p = 0.40]. These data didn’t support the association between serum 25(OH)D and the severity of the disease among hospitalized COVID-19 patients.
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Affiliation(s)
- Taqwa Bushnaq
- Department of Food Science and Nutrition, College of Sciences, Taif University, P.O. Box 11099, Taif 21944, Saudi Arabia;
- Correspondence:
| | - Fadiyah Algethami
- Clinical Nutrition Department, College of Applied Medical Sciences, University of Umm Al-Qura, P.O. Box 7067, Makkah 21955, Saudi Arabia; (F.A.); (A.Q.); (R.M.); (K.G.); (W.A.)
| | - Alaa Qadhi
- Clinical Nutrition Department, College of Applied Medical Sciences, University of Umm Al-Qura, P.O. Box 7067, Makkah 21955, Saudi Arabia; (F.A.); (A.Q.); (R.M.); (K.G.); (W.A.)
| | - Reham Mustafa
- Clinical Nutrition Department, College of Applied Medical Sciences, University of Umm Al-Qura, P.O. Box 7067, Makkah 21955, Saudi Arabia; (F.A.); (A.Q.); (R.M.); (K.G.); (W.A.)
| | - Khloud Ghafouri
- Clinical Nutrition Department, College of Applied Medical Sciences, University of Umm Al-Qura, P.O. Box 7067, Makkah 21955, Saudi Arabia; (F.A.); (A.Q.); (R.M.); (K.G.); (W.A.)
| | - Wedad Azhar
- Clinical Nutrition Department, College of Applied Medical Sciences, University of Umm Al-Qura, P.O. Box 7067, Makkah 21955, Saudi Arabia; (F.A.); (A.Q.); (R.M.); (K.G.); (W.A.)
| | - Asma Al Malki
- Department of Food Science and Nutrition, College of Sciences, Taif University, P.O. Box 11099, Taif 21944, Saudi Arabia;
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13
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Chen KW, Chen CW, Yuan KC, Wang IT, Hung FM, Wang AY, Wang YC, Kuo YT, Lin YC, Shih MC, Kung YC, Ruan SY, Chiu CT, Chao A, Han YY, Kuo LK, Yeh YC. Prevalence of Vitamin D Deficiency and Associated Factors in Critically Ill Patients: A Multicenter Observational Study. Front Nutr 2021; 8:768804. [PMID: 34966771 PMCID: PMC8710763 DOI: 10.3389/fnut.2021.768804] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Accepted: 11/22/2021] [Indexed: 12/26/2022] Open
Abstract
Background: Vitamin D deficiency is common in the general population worldwide, and the prevalence and severity of vitamin D deficiency increase in critically ill patients. The prevalence of vitamin D deficiency in a community-based cohort in Northern Taiwan was 22.4%. This multicenter cohort study investigated the prevalence of vitamin D deficiency and associated factors in critically ill patients in Northern Taiwan. Methods: Critically ill patients were enrolled and divided into five groups according to their length of stay at intensive care units (ICUs) during enrolment as follows: group 1, <2 days with expected short ICU stay; group 2, <2 days with expected long ICU stay; group 3, 3-7 days; group 4, 8-14 days; and group 5, 15-28 days. Vitamin D deficiency was defined as a serum 25-hydroxyvitamin D (25(OH)D) level < 20 ng/ml, and severe vitamin D deficiency was defined as a 25(OH)D level < 12 ng/ml. The primary analysis was the prevalence of vitamin D deficiency. The exploratory analyses were serial follow-up vitamin D levels in group 2, associated factors for vitamin D deficiency, and the effect of vitamin D deficiency on clinical outcomes in critically ill patients. Results: The prevalence of vitamin D deficiency was 59% [95% confidence interval (CI) 55-62%], and the prevalence of severe vitamin D deficiency was 18% (95% CI 15-21%). The median vitamin D level for all enrolled critically ill patients was 18.3 (13.7-23.9) ng/ml. In group 2, the median vitamin D levels were <20 ng/ml during the serial follow-up. According to the multivariable analysis, young age, female gender, low albumin level, high parathyroid hormone (PTH) level, and high sequential organ failure assessment (SOFA) score were significantly associated risk factors for vitamin D deficiency. Patients with vitamin D deficiency had longer ventilator use duration and length of ICU stay. However, the 28- and 90-day mortality rate were not associated with vitamin D deficiency. Conclusions: This study demonstrated that the prevalence of vitamin D deficiency is high in critically ill patients. Age, gender, albumin level, PTH level, and SOFA score were significantly associated with vitamin D deficiency in these patients.
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Affiliation(s)
- Kuo-Wei Chen
- Department of Surgery, National Taiwan University Hospital Hsin-Chu Branch, Hsinchu, Taiwan
| | - Chung-Wei Chen
- Department of Surgical Intensive Care Unit, Far Eastern Memorial Hospital, New Taipei City, Taiwan
| | - Kuo-Ching Yuan
- Department of Critical Care Medicine, Taipei Medical University Hospital, Taipei, Taiwan
| | - I-Ting Wang
- Division of Critical Care Medicine, Mackay Memorial Hospital, Taipei, Taiwan
| | - Fang-Ming Hung
- Department of Surgical Intensive Care Unit, Far Eastern Memorial Hospital, New Taipei City, Taiwan
| | - An-Yi Wang
- Department of Critical Care Medicine, Taipei Medical University Hospital, Taipei, Taiwan.,Department of Emergency Medicine, School of Medicine, College of Medicine, Taipei Medical University Hospital, Taipei, Taiwan.,Graduate Institute of Injury Prevention and Control, College of Public Health, Taipei Medical University, Taipei, Taiwan
| | - Yin-Chin Wang
- Department of Anesthesiology, National Taiwan University Hospital, Taipei, Taiwan
| | - Yu-Ting Kuo
- Department of Anesthesiology, National Taiwan University Hospital, Taipei, Taiwan
| | - Yi-Che Lin
- Department of Environment and Occupational Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - Ming-Chieh Shih
- Department of Public Health, Institute of Epidemiology and Preventive Medicine, National Taiwan University, Taipei, Taiwan
| | - Yu-Chung Kung
- Division of Critical Care Medicine, Mackay Memorial Hospital, Taipei, Taiwan
| | - Sheng-Yuan Ruan
- Department of Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - Ching-Tang Chiu
- Department of Anesthesiology, National Taiwan University Hospital, Taipei, Taiwan
| | - Anne Chao
- Department of Anesthesiology, National Taiwan University Hospital, Taipei, Taiwan
| | - Yin-Yi Han
- Department of Traumatology, National Taiwan University Hospital, Taipei, Taiwan
| | - Li-Kuo Kuo
- Division of Critical Care Medicine, Mackay Memorial Hospital, Taipei, Taiwan.,Department of Medicine, Mackay Medical College, New Taipei City, Taiwan
| | - Yu-Chang Yeh
- Department of Anesthesiology, National Taiwan University Hospital, Taipei, Taiwan
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14
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Marzban M, Kalantarhormozi M, Mahmudpour M, Ostovar A, Keshmiri S, Darabi AH, Khajeian A, Bolkheir A, Amini A, Nabipour I. Prevalence of vitamin D deficiency and its associated risk factors among rural population of the northern part of the Persian Gulf. BMC Endocr Disord 2021; 21:219. [PMID: 34732181 PMCID: PMC8565643 DOI: 10.1186/s12902-021-00877-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2020] [Accepted: 10/18/2021] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Accumulating evidence indicates that vitamin D deficiency has been increased globally over the last two decades. However, the majority of these studies are concerned with cities and there is scant information regarding the prevalence of vitamin D in rural areas. The main aim of this study was to investigate the prevalence of vitamin D deficiency and its associated risk factors among the rural population in Bushehr province which shares the longest border with the Persian Gulf. METHODS The rural inhabitants of more than 25 years old from three mountainous, plain, and seashore areas of Bushehr province were selected through a stratified multi-cluster random sampling method. After obtaining the participants' demographic and anthropometric data and their past medical history, serum 25-hydroxyvitamin D [25(OH)D] was measured using ELISA. RESULTS A total of 1806 (means ±SD, 46± 14years old) rural subjects (35 % males and 65 % females) participated in this study. The prevalence of vitamin D deficiency, insufficiency, and sufficiency were 28 %, 50 %, and 22 %, respectively. The deficiency of vitamin D in women was higher than in men (OR=1.27, 95 % CI: 1.05 to 1.54, P=0.04). There was a positive significant correlation between age and serum vitamin D levels. Men with vitamin D deficiency had higher BMI (P=0.008); this association was not observed among women (P=0.7). There was no significant difference between the food item's consumption frequencies, and vitamin D status (P>0.05). The mountainous, and plain areas had the highest and lowest vitamin D levels, respectively. CONCLUSIONS Although, Bushehr province is located in a sunny part of Iran, the prevalence of vitamin D deficiency was high among its rural population. The shift of their lifestyle patterns and rapid industrialization in these rural areas may be responsible. Therefore, the enrichment of dietary sources with vitamin D and the use of vitamin D supplements are recommended to tackle the high prevalence of vitamin D deficiency in the rural population of the northern part of the Persian Gulf.
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Affiliation(s)
- Maryam Marzban
- The Persian Gulf Tropical Medicine Research Center, The Persian Gulf Biomedical Sciences Research Institute, Bushehr University of Medical Sciences, Bushehr, Iran
| | - Mohammadreza Kalantarhormozi
- Department of Endocrine and Metabolic Disease, the Persian Gulf Tropical Medicine Research Center, Bushehr University of Medical Sciences, Bushehr, Iran
| | - Mehdi Mahmudpour
- The Persian Gulf Tropical Medicine Research Center, The Persian Gulf Biomedical Sciences Research Institute, Bushehr University of Medical Sciences, Bushehr, Iran
| | - Afshin Ostovar
- Osteoporosis Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Saeed Keshmiri
- Faculty of Medicine, Bushehr University of Medical Sciences, Bushehr, Iran
| | - Amir Hossein Darabi
- The Persian Gulf Tropical Medicine Research Center, The Persian Gulf Biomedical Sciences Research Institute, Bushehr University of Medical Sciences, Bushehr, Iran
| | | | - Amirreza Bolkheir
- The Persian Gulf Tropical Medicine Research Center, The Persian Gulf Biomedical Sciences Research Institute, Bushehr University of Medical Sciences, Bushehr, Iran
| | - Azam Amini
- Department of Internal Medicine, Division of Rheumatology, School of Medicine, Bushehr University of Medical Sciences, Bushehr, Iran
| | - Iraj Nabipour
- The Persian Gulf Tropical Medicine Research Center, The Persian Gulf Biomedical Sciences Research Institute, Bushehr University of Medical Sciences, Bushehr, Iran
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15
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Al Ghali R, El-Mallah C, Obeid O, El-Saleh O, Smail L, Haroun D. Urinary minerals excretion among primary schoolchildren in Dubai-United Arab Emirates. PLoS One 2021; 16:e0255195. [PMID: 34351961 PMCID: PMC8341483 DOI: 10.1371/journal.pone.0255195] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Accepted: 07/10/2021] [Indexed: 11/18/2022] Open
Abstract
Introduction Urinary excretion of calcium (Ca), magnesium (Mg), phosphorus (P), iodine and fluoride is used to assess their statuses and/or the existence of metabolic abnormalities. In the United Arab Emirates (UAE), the urinary concentration of these minerals among children have not been documented. Materials and methods A cross-sectional study, including 593 subjects (232 boys and 361 girls), was conducted among healthy 6 to 11-year-old Emirati children living in Dubai. Non-fasting morning urine samples and anthropometrical measurements were collected and analyzed. Results were expressed as per mg of creatinine (Cr). Results On average, estimated Cr excretion was 17.88±3.12 mg/kg/d. Mean urinary Ca/Cr, Mg/Cr and P/Cr excretions were 0.08±0.07 mg/mg, 0.09±0.04 mg/mg, and 0.57±0.26 mg/mg respectively. Urinary excretion of Ca, Mg and P were found to decrease as age increased. Urinary excretion and predicted intake of fluoride were lower than 0.05 mg/kg body weight per day. Surprisingly, more than 50% of the children were found to have urinary iodine excretion level above adequate. Conclusion The Emirati schoolchildren had comparable levels of urinary Ca, Mg and P excretion to other countries. The 95% percentile allows the use of the current data as a reference value for the detection of mineral abnormalities. Fluoride excretion implies that Emirati children are at low risk of fluorosis. The level of urinary iodine excretion is slightly higher than recommended and requires close monitoring of the process of salt iodization to avoid the harmful impact of iodine overconsumption.
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Affiliation(s)
- Rola Al Ghali
- Department of Public Health and Nutrition, College of Natural and Health Sciences, Zayed University, Dubai, United Arab Emirates
| | - Carla El-Mallah
- Department of Nutrition and Food Science. Faculty of Agricultural and Food Sciences, American University of Beirut, Beirut, Lebanon
| | - Omar Obeid
- Department of Nutrition and Food Science. Faculty of Agricultural and Food Sciences, American University of Beirut, Beirut, Lebanon
| | - Ola El-Saleh
- Department of Medicine, School of Public Health, Imperial College London, London, United Kingdom
| | - Linda Smail
- Department of Mathematics and Statistics, College of Natural and Health Sciences, Zayed University, Dubai, United Arab Emirates
| | - Dalia Haroun
- Department of Public Health and Nutrition, College of Natural and Health Sciences, Zayed University, Dubai, United Arab Emirates
- * E-mail:
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16
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Saeed BQ, Jairoun AA, Ashraf Khamis A, Hatim Abdelrahim L, Abobakr Aljomhi A, Adrees AO, Saeed Fahady K, Saleh Al-Hajjaj M. Vitamin D Deficiency and Insufficiency Among University Students: Prevalence, Risk Factors, and the Association Between Vitamin D Deficiency and Episodes of Respiratory Tract Infections. Risk Manag Healthc Policy 2021; 14:2733-2741. [PMID: 34234589 PMCID: PMC8253923 DOI: 10.2147/rmhp.s308754] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2021] [Accepted: 05/17/2021] [Indexed: 12/30/2022] Open
Abstract
Background Vitamin D deficiency (VDD) and insufficiency (VDI) is a public health problem worldwide. Low blood levels of vitamin D have been associated with many illnesses, including respiratory tract infections (RTIs). This study aims to evaluate the prevalence of VDD and VDI among university students, assess the correlation with demographic and anthropometric factors, and determine the effect of VDD on the respiratory tract infection (RTI) incidence. Methods A cross-sectional and prospective design was used. Our sample consisted of 287 students aged 18–24 years from the University of Sharjah-UAE. Participants were tested for serum 25(hydroxyvitamin)D levels, Body mass index (BMI) was calculated, and the survey was completed. The association between VDD, VDI with the participant’s characteristics, and the incidents of RTIs were examined. Results VDD and VDI were highly prevalent among 85% of the students. The median serum 25(OH) D level was 15.8 ng/dl (19.5±11.6). The mean BMI was (24.32±6.3) kg/m. The results showed a significant positive correlation between VDI and VDD with gender and students who were previously diagnosed with VDD (P < 0.05); however, they were not statistically significant (P < 0.05) with other factors. The tonsillitis incidents were significantly associated with VDD (P = 0.027), while no significant correlation with other incidences of RTIs was found. Conclusion VDD and VDI represent a significant problem across the university students specifically with the female gender. VDD is associated with tonsillitis infection incidence. Both the health and higher education authorities’ attention is needed, exploring the causes of VDD and VDI, regular 25(OH)D serum level examination, and educational programs on VDD risks are required.
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Affiliation(s)
- Balsam Qubais Saeed
- Clinical Sciences Department, College of Medicine, University of Sharjah, Sharjah, United Arab Emirates.,Sharjah Institute for Medical Research, University of Sharjah, Sharjah, United Arab Emirates
| | - Ammar A Jairoun
- Health and Safety Department, Dubai, United Arab Emirates.,Discipline of Social And Administrative Pharmacy, School of Pharmaceutical Sciences, University Sains Malaysia, Penang, 11500, Malaysia
| | | | | | | | - Ahmed Omar Adrees
- College of Medicine, University of Sharjah, Sharjah, United Arab Emirates
| | - Kubais Saeed Fahady
- College of Humanities and Science, Ajman University, Ajman, United Arab Emirates
| | - Mohamed Saleh Al-Hajjaj
- Clinical Sciences Department, College of Medicine, University of Sharjah, Sharjah, United Arab Emirates
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17
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Sooriyaarachchi P, Jeyakumar DT, King N, Jayawardena R. Impact of vitamin D deficiency on COVID-19. Clin Nutr ESPEN 2021; 44:372-378. [PMID: 34330492 PMCID: PMC8164501 DOI: 10.1016/j.clnesp.2021.05.011] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Accepted: 05/14/2021] [Indexed: 02/02/2023]
Abstract
Background & aims COVID-19 has emerged as a global pandemic affecting millions of people. Vitamin D deficiency is one of the risk factors for increased susceptibility to COVID-19. This study aimed to examine the correlation between the prevalence of vitamin D deficiency and COVID-19 infection and mortality rates among the adult population in European and Asian continents. Methods Prevalence of vitamin D deficiency in each country was retrieved through literature searching on PubMed® database for the last ten years. As of December, 31st 2020, COVID-19 infections and mortalities per million population were extracted from the ‘real time’ statistics of the Worldometer website. The association between both vitamin D deficiency and COVID-19 infections and mortalities were explored. Results Forty seven countries were included in the analysis. The prevalence of vitamin D deficiency ranged from 6.9 to 81.8% in European countries and 2.0–87.5% in Asian countries. Significantly positive correlations were observed for both COVID-19 infection (r = 0.76; p < 0.001) and mortality rates (r = 0.75; p < 0.001) in the Asian continent. The correlation values for the infections and mortality rates in the European continent were (r = 0.37; p = 0.08) and (r = 0.43; p = 0.04) respectively. When both the continents were combined, the correlation results for both infection (r = 0.42; p = 0.003) and mortality (r = 0.35; p = 0.016) rates with vitamin D deficiency values remained significant. Conclusion Prevalence of vitamin D deficiency was significantly associated with the mortality rate of COVID-19 in Europe and Asia. The association between the infection rate and prevalence of vitamin D deficiency was significant for Asia only. Both the associations were significant when the two continents were combined in the analysis. Therefore we suggest that vitamin D supplementation could play a key role in the prevention and/or treatment of the COVID-19 patients.
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Affiliation(s)
- Piumika Sooriyaarachchi
- Queensland University of Technology, School of Exercise & Nutrition Sciences, Brisbane, Queensland, Australia; Health and Wellness Unit, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka
| | - Dhanushya T Jeyakumar
- Health and Wellness Unit, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka; Department of Biosystems Technology, Faculty of Technology, Sabaragamuwa University of Sri Lanka, Sri Lanka
| | - Neil King
- Queensland University of Technology, School of Exercise & Nutrition Sciences, Brisbane, Queensland, Australia
| | - Ranil Jayawardena
- Queensland University of Technology, School of Exercise & Nutrition Sciences, Brisbane, Queensland, Australia; Department of Physiology, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka.
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18
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Wyse J, Mangan R, Zgaga L. Power determination in vitamin D randomised control trials and characterising factors affecting it through a novel simulation-based tool. Sci Rep 2021; 11:10804. [PMID: 34031451 PMCID: PMC8144427 DOI: 10.1038/s41598-021-90019-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Accepted: 04/12/2021] [Indexed: 11/21/2022] Open
Abstract
Thousands of observational studies have linked vitamin D deficiency with numerous diseases, but randomised controlled trials (RCTs) often fail to show benefit of supplementation. Population characteristics and trial design have long been suspected to undermine power but were not systematically investigated. We propose a flexible generative model to characterise benefit of vitamin D supplementation at the individual level, and use this to quantify power in RCTs. The model can account for seasonality and population heterogeneity. In a simulated 1-year trial with 1000 participants per arm and assuming a 25-hydroxyvitamin D (25OHD) increase of 20 nmol/L due to the intervention, with baseline 25OHD in the population of 15, 35, 50, 60 and 75 nmol/L, the power to detect intervention effect was 77%, 99%, 95%, 68% and 19%, respectively. The number of participants required per arm to achieve 80% power according to baseline 25OHD of 15-60 nmol/L was 1200, 400, 600 and 1400, respectively. As expected, larger increases in 25OHD due to supplementation improved power in certain scenarios. For a population baseline of 50 nmol/L, with 1500 participants in each arm, there was 100% power to detect a 20 nmol/L 25OHD increase while it was 76% for a 10 nmol/L increase. Population characteristics and trial design, including temporal considerations, have a dramatic impact on power and required sample size in vitamin D RCTs.
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Affiliation(s)
- Jason Wyse
- Discipline of Statistics and Information Systems, School of Computer Science and Statistics, Trinity College Dublin, College Green, Dublin 2, Ireland.
| | - Rebecca Mangan
- Discipline of Statistics and Information Systems, School of Computer Science and Statistics, Trinity College Dublin, College Green, Dublin 2, Ireland
- Discipline of Public Health and Primary Care, Institute of Population Health, Trinity College Dublin, Tallaght Cross, Tallaght, Dublin 24, Ireland
| | - Lina Zgaga
- Discipline of Public Health and Primary Care, Institute of Population Health, Trinity College Dublin, Tallaght Cross, Tallaght, Dublin 24, Ireland.
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19
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Shamsi U, Azam I, Shamsi A, Shamsi D, Callen D. Frequency and determinants of vitamin D deficiency among premenopausal and postmenopausal women in Karachi Pakistan. BMC WOMENS HEALTH 2021; 21:194. [PMID: 33971882 PMCID: PMC8108729 DOI: 10.1186/s12905-021-01339-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Accepted: 04/27/2021] [Indexed: 01/02/2023]
Abstract
Background Vitamin D deficiency is becoming a serious public health problem, even in sun-drenched cities like Karachi, Pakistan. We investigated the prevalence of vitamin D deficiency and its association with sociodemographic characteristics, anthropometric measures, and lifestyle factors among premenopausal and postmenopausal women (n = 784). Methods Face-to-face interviews were conducted to collect information and serum concentrations of 25-hydroxyvitamin D were measured after the interviews. Results A total of 57% of women were vitamin D deficient with higher vitamin D deficiency found among premenopausal women (64.7%) compared to postmenopausal women (49%). The median serum concentrations of 25-hydroxyvitamin D (IQR) were 16.7 ng/ml (IQR 9.8–30.0). Factors associated with vitamin D deficiency were lower socioeconomic status (OR 2.00; 95% CI 1.15–3.48), younger age with highest vitamin D deficiency found in < 35 years of age group (OR 3.11; 95% CI 1.76–5.51), and winter season (OR 1.51, 95% CI 1.07–2.15) after adjusting for multiple confounders. The use of vitamin D supplement (OR 0.59, 95% CI 0.38–0.92) and vigorous exercise (OR 0.20, 95% CI 0.05–0.80) were protective against vitamin D deficiency.
Conclusions The study shows a high prevalence of vitamin D deficiency, with detrimental health effects, among younger women belonging to lower socioeconomic status and during the winter season. The use of vitamin D supplements and vigorous exercise were protective measures. Public health campaigns are needed for education and awareness about vitamin D deficiency to improve vitamin D status for younger women living in poor environments.
Supplementary Information The online version contains supplementary material available at 10.1186/s12905-021-01339-9.
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Affiliation(s)
- Uzma Shamsi
- School of Medicine, Adelaide Medical School, University of Adelaide, Adelaide, Australia.
| | - Iqbal Azam
- Department of Community Health Sciences, Aga Khan University, Karachi, Pakistan
| | - Azra Shamsi
- Department of Gynecology and Obstetrics, Combined Military Hospital, Karachi, Pakistan
| | - Dua Shamsi
- Division of Data Science, University of California, Berkeley, USA
| | - David Callen
- School of Medicine, Adelaide Medical School, University of Adelaide, Adelaide, Australia
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20
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Jayawardena R, Jeyakumar DT, Francis TV, Misra A. Impact of the vitamin D deficiency on COVID-19 infection and mortality in Asian countries. Diabetes Metab Syndr 2021; 15:757-764. [PMID: 33823331 PMCID: PMC7955807 DOI: 10.1016/j.dsx.2021.03.006] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2021] [Accepted: 03/08/2021] [Indexed: 12/25/2022]
Abstract
BACKGROUND AND AIMS COVID-19 is a pandemic that has affected beyond 100 million and caused nearly 3 million deaths globally. Vitamin D is a known risk factor for COVID-19. Therefore, we aimed to investigate the association of prevalence of vitamin D deficiency and mean vitamin D level with COVID-19 infection and mortality in Asia, predicting with other confounding factors such as median age, obesity, and diabetes. METHODS COVID-19 infections and mortalities among the Asian countries were retrieved from the Worldometer website. Information on prevalence of vitamin D deficiency and mean vitamin D values in each Asian country was retrieved through literature searching on PubMed® and Google scholar. The associations between COVID-19 infections and mortalities with prevalence of vitamin D deficiency and mean vitamin D level were explored with correlation coefficients. As a predictive analysis, multiple linear regression was carried out with all confounders. RESULTS Positive correlations were observed for prevalence of vitamin D deficiency with COVID-19 infections (r = 0.55; p = 0.01; R2 = 0.31) and mortalities (r = 0.50; p = 0.01; R2 = 0.25). Moreover, the associations for the COVID-19 infections and mortalities improved to r = 0.76 (p = 0.002; R2 = 0.58) and r = 0.65 (p = 0.03; R2 = 0.42), respectively, after predicting with confounding factors. Similarly, mean vitamin D level had a significant negative correlation with COVID-19 infections (r = -0.77; p = 0.04; R2 = 0.59) and mortalities (r = -0.80; p = 0.03; R2 = 0.63) when combining with confounders. CONCLUSION Prevalence of vitamin D deficiency is significantly positively associated whereas the mean vitamin D level is significantly negatively associated with both infection and mortality rate of COVID-19 among Asian countries upon predicting with all confounders.
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Affiliation(s)
- Ranil Jayawardena
- Department of Physiology, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka; School of Exercise & Nutrition Sciences, Queensland University of Technology, Brisbane, Queensland, Australia.
| | - Dhanushya T Jeyakumar
- Health and Wellness Unit, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka; Department of Biosystems Technology, Faculty of Technology, Sabaragamuwa University of Sri Lanka, Sri Lanka
| | - Tormalli V Francis
- Health and Wellness Unit, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka
| | - Anoop Misra
- Fortis-C-DOC Centre of Excellence for Diabetes, Metabolic Diseases and Endocrinology, Chirag Enclave, New Delhi, India
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21
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Li X, Yu J, Wen L, Li Q, Yan J, Tian J, Tong C, Tong Q, Qi H, Saffery R, Kilby MD, Baker PN. Vitamin D status in women with dichorionic twin pregnancies and their neonates: a pilot study in China. BMC Pregnancy Childbirth 2021; 21:279. [PMID: 33832462 PMCID: PMC8034067 DOI: 10.1186/s12884-021-03707-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Accepted: 03/10/2021] [Indexed: 01/16/2023] Open
Abstract
Background Vitamin D deficiency is a global public health issue in women and children and is associated with adverse impacts on child growth, such as rickets. However, prior studies have mainly focused on measuring vitamin D levels in singleton pregnant women and their offspring, and very limited studies have revealed the prevalence of vitamin D deficiency in twin pregnant women and their offspring. The aim of this study was to investigate vitamin D levels in twin-pregnant women and their neonates. We also explored the correlation of maternal vitamin D levels with neonatal outcomes and infant growth. Methods A prospective subcohort investigation was carried out among 72 dichorionic, diamniotic twin-pregnant mothers and their twin offspring from the Longitudinal Twin Study. Peripheral blood was collected from the mothers in the third trimester, and cord blood was collected from neonates at birth to identify 25[OH]D levels. Data on the characteristics of the mothers and neonates were collected. Infant growth data and food sensitivities were also collected. Results The average maternal 25[OH]D level was 31.78 ng/mL, with 19.4% being deficient and 20.8% insufficient, while the average neonatal 25[OH]D level was 15.37 ng/mL, with 99.3% being deficiency or insufficient. A positive correlation was found between maternal and neonatal 25[OH]D levels (beta-value: 0.43, 95% CI: 0.37, 0.49). Interestingly, the higher the maternal 25[OH]D level was, the smaller the cotwin birthweight discordance (beta-value: -2.67, 95% CI: − 5.11, − 0.23). In addition, the infants of mothers with vitamin D deficiency were more likely to be allergic to foods at 6 months than those of mothers with vitamin D sufficiency. Conclusions Twin neonates were at high risk of vitamin D deficiency, although their mothers’ vitamin D deficiency partially improved. Higher maternal vitamin D levels were associated with smaller discordance of cotwin birthweight. Trial registration Chinese Clinical Trial Registry ChiCTR-OOC-16008203, 1st April 2016. Supplementary Information The online version contains supplementary material available at 10.1186/s12884-021-03707-7.
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Affiliation(s)
- Xin Li
- Department of Obstetrics, The First Affiliated Hospital of Chongqing Medical University, 1 Youyi Road, Yuzhong District, Chongqing, 400016, China.,State Key Laboratory of Maternal and Fetal Medicine of Chongqing Municipality, Chongqing Medical University, Chongqing, 400016, China.,International Collaborative Laboratory of Reproduction and Development of Chinese Ministry of Education, Chongqing Medical University, Chongqing, 400016, China
| | - Jiaxiao Yu
- Department of Obstetrics, The First Affiliated Hospital of Chongqing Medical University, 1 Youyi Road, Yuzhong District, Chongqing, 400016, China.,State Key Laboratory of Maternal and Fetal Medicine of Chongqing Municipality, Chongqing Medical University, Chongqing, 400016, China.,International Collaborative Laboratory of Reproduction and Development of Chinese Ministry of Education, Chongqing Medical University, Chongqing, 400016, China
| | - Li Wen
- Department of Obstetrics, The First Affiliated Hospital of Chongqing Medical University, 1 Youyi Road, Yuzhong District, Chongqing, 400016, China.,State Key Laboratory of Maternal and Fetal Medicine of Chongqing Municipality, Chongqing Medical University, Chongqing, 400016, China.,International Collaborative Laboratory of Reproduction and Development of Chinese Ministry of Education, Chongqing Medical University, Chongqing, 400016, China
| | - Qingshu Li
- State Key Laboratory of Maternal and Fetal Medicine of Chongqing Municipality, Chongqing Medical University, Chongqing, 400016, China.,International Collaborative Laboratory of Reproduction and Development of Chinese Ministry of Education, Chongqing Medical University, Chongqing, 400016, China.,Department of Pathology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, China
| | - Jianying Yan
- Fujian Provincial Maternity and Children's Hospital, affiliated hospital of Fujian Medical University, Fuzhou, 350001, Fujian, China
| | - Jing Tian
- Department of Obstetrics and Gynecology, University-Town Hospital of Chongqing Medical University, Chongqing, 401331, China
| | - Chao Tong
- Department of Obstetrics, The First Affiliated Hospital of Chongqing Medical University, 1 Youyi Road, Yuzhong District, Chongqing, 400016, China. .,State Key Laboratory of Maternal and Fetal Medicine of Chongqing Municipality, Chongqing Medical University, Chongqing, 400016, China. .,International Collaborative Laboratory of Reproduction and Development of Chinese Ministry of Education, Chongqing Medical University, Chongqing, 400016, China. .,Chongqing Population and Family Planning Science and Technology Research Institute, 18 Honghuang Rd, Jiangbei District, Chongqing, 400020, China.
| | - Qi Tong
- Chongqing Population and Family Planning Science and Technology Research Institute, 18 Honghuang Rd, Jiangbei District, Chongqing, 400020, China.
| | - Hongbo Qi
- Department of Obstetrics, The First Affiliated Hospital of Chongqing Medical University, 1 Youyi Road, Yuzhong District, Chongqing, 400016, China. .,State Key Laboratory of Maternal and Fetal Medicine of Chongqing Municipality, Chongqing Medical University, Chongqing, 400016, China. .,International Collaborative Laboratory of Reproduction and Development of Chinese Ministry of Education, Chongqing Medical University, Chongqing, 400016, China. .,Department of Pathology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, China.
| | - Richard Saffery
- International Collaborative Laboratory of Reproduction and Development of Chinese Ministry of Education, Chongqing Medical University, Chongqing, 400016, China.,Cancer, Disease and Developmental Epigenetics, Murdoch Children's Research Institute, Parkville, Victoria, 3052, Australia
| | - Mark D Kilby
- Centre for Women's and Newborn Health, Institute of Metabolism and Systems Research, University of Birmingham, Birmingham, B15 2TT, UK.,Fetal Medicine Centre, Birmingham Women's & Children's Foundation Trust, Edgbaston, Birmingham, B15 2TG, UK
| | - Philip N Baker
- International Collaborative Laboratory of Reproduction and Development of Chinese Ministry of Education, Chongqing Medical University, Chongqing, 400016, China.,College of Life Sciences, University of Leicester, Leicester, LE1 7RH, UK
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22
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Garcia Carretero R, Vigil-Medina L, Barquero-Perez O, Mora-Jimenez I, Soguero-Ruiz C, Ramos-Lopez J. Machine learning approaches to constructing predictive models of vitamin D deficiency in a hypertensive population: a comparative study. Inform Health Soc Care 2021; 46:355-369. [PMID: 33792475 DOI: 10.1080/17538157.2021.1896524] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Objective: Given the association between vitamin D deficiency and risk for cardiovascular disease, we used machine learning approaches to establish a model to predict the probability of deficiency. Determination of serum levels of 25-hydroxy vitamin D (25(OH)D) provided the best assessment of vitamin D status, but such tests are not always widely available or feasible. Thus, our study established predictive models with high sensitivity to identify patients either unlikely to have vitamin D deficiency or who should undergo 25(OH)D testing.Methods: We collected data from 1002 hypertensive patients from a Spanish university hospital. The elastic net regularization approach was applied to reduce the dimensionality of the dataset. The issue of determining vitamin D status was addressed as a classification problem; thus, the following classifiers were applied: logistic regression, support vector machine (SVM), random forest, naive Bayes, and Extreme Gradient Boost methods. Classification accuracy, sensitivity, specificity, and predictive values were computed to assess the performance of each method.Results: The SVM-based method with radial kernel performed better than the other algorithms in terms of sensitivity (98%), negative predictive value (71%), and classification accuracy (73%).Conclusion: The combination of a feature-selection method such as elastic net regularization and a classification approach produced well-fitted models. The SVM approach yielded better predictions than the other algorithms. This combination approach allowed us to develop a predictive model with high sensitivity but low specificity, to identify the population that could benefit from laboratory determination of serum levels of 25(OH)D.
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Affiliation(s)
- Rafael Garcia Carretero
- Department of Internal Medicine, Mostoles University Hospital, Rey Juan Carlos University, Madrid, Spain
| | - Luis Vigil-Medina
- Department of Internal Medicine, Mostoles University Hospital, Fuenlabrada, Spain
| | - Oscar Barquero-Perez
- Department of Signal Theory and Communications and Telematics Systems and Computing, Rey Juan Carlos University, Spain
| | - Inmaculada Mora-Jimenez
- Department of Signal Theory and Communications and Telematics Systems and Computing, Rey Juan Carlos University, Spain
| | - Cristina Soguero-Ruiz
- Department of Signal Theory and Communications and Telematics Systems and Computing, Rey Juan Carlos University, Spain
| | - Javier Ramos-Lopez
- Department of Signal Theory and Communications and Telematics Systems and Computing, Rey Juan Carlos University, Spain
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23
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Abboud M, Rizk R, Papandreou D, Hijazi R, Al Emadi NE, Waszak PM. Evaluation of Self-Assessed State of Health and Vitamin D Knowledge in Emirati and International Female Students in United Arab Emirates (UAE). Front Psychol 2020; 11:1236. [PMID: 32595567 PMCID: PMC7303256 DOI: 10.3389/fpsyg.2020.01236] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Accepted: 05/12/2020] [Indexed: 01/18/2023] Open
Abstract
INTRODUCTION Globally, vitamin D deficiency is one of the most common deficiencies, affecting nearly half the world's population. The objective of this survey was to assess and compare the knowledge about vitamin D and the perceived state of health in Emirati and international tourist female students in Dubai, United Arab Emirates (UAE). METHODS This is a cross-sectional study that took place in universities in Dubai, United Arab Emirates. This survey consisted of 17 multiple choice questions and was adapted from a study recently conducted in Poland. The first part of the survey assessed levels of supplementation, diet and UV exposure. Another section evaluated the participants' self-assessed state of health in terms of vitamin D testing, symptoms related to vitamin D deficiency and general welbeing. The collected data were statistically analyzed using SPSS statistics for windows version 26.0 (SPSS Inc., Chicago, IL, United States). Statistical significance was set at P < 0.05. RESULTS 105 respondents were Emiratis and 65 were international students. The average age was 21, with an average BMI 23.3 kg/m2. Almost one-third of each group reported using Vitamin D supplements once weekly. The vast majority of both groups reported rarely getting tanned. Almost all participants in both groups reported regular consumption of Vitamin D rich foods. In both groups, more than half reported consuming milk and cheese regularly and up to one-third reported consuming fish in a regular manner. Although more than half of the students rated their health as good; more than two-thirds reported experiencing muscle pain; only half reported having their blood Vitamin D levels measured once; half reported experiencing problems with concentration and more than three-quarters reported experiencing bad mood in the past month. The prevalence of these symptoms was almost similar across different categories of vitamin D supplementation, tanning habits, dietary intake, or nationality. No statistically significant differences were noted between the Emirati and International tourist students regarding any of the studied variables. CONCLUSION Notably, more Emirati students were aware of the association between vitamin D and osteoporosis than International tourist students (40% vs. 21.9%, respectively; p < 0.05). On the other hand, both groups had lower knowledge about the relationship between vitamin D deficiency and depression, Rheumatoid Arthritis and Hypertension, and the optimal vitamin D level; however, no statistically significant differences were noted regarding this knowledge of Emiratis and international students.
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Affiliation(s)
- Myriam Abboud
- College of Natural and Health Sciences, Zayed University, Abu Dhabi, United Arab Emirates
| | - Rana Rizk
- Institut National de Santé Publique, d’Épidémiologie Clinique et de Toxicologie (INSPECT-LB), Beirut, Lebanon
| | - Dimitrios Papandreou
- College of Natural and Health Sciences, Zayed University, Abu Dhabi, United Arab Emirates
| | - Rafiq Hijazi
- College of Natural and Health Sciences, Zayed University, Abu Dhabi, United Arab Emirates
| | - Nada Edris Al Emadi
- College of Natural and Health Sciences, Zayed University, Abu Dhabi, United Arab Emirates
| | - Przemyslaw M. Waszak
- Department of Hygiene and Epidemiology, Department of Developmental Psychiatry, Psychotic and Geriatric Disorders, Medical University of Gdańsk, Gdańsk, Poland
- Department of Developmental Psychiatry, Psychotic and Geriatric Disorders, Medical University of Gdańsk, Gdańsk, Poland
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24
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Voo VTF, Stankovich J, O'Brien TJ, Butzkueven H, Monif M. Vitamin D status in an Australian patient population: a large retrospective case series focusing on factors associated with variations in serum 25(OH)D. BMJ Open 2020; 10:e032567. [PMID: 32139482 PMCID: PMC7059428 DOI: 10.1136/bmjopen-2019-032567] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
OBJECTIVES To investigate whether sex, age, medical specialty and seasonal variations in serum concentration of 25-hydroxy vitamin D (25(OH)D) are evident among an Australian patient population. DESIGN Retrospective study analysing the results of serum 25(OH)D lab tests and vitamin D supplementation from Royal Melbourne Hospital (RMH) between 2014 and 2017. SETTING Tertiary healthcare centre in Victoria, Australia. PARTICIPANTS 30 023 patients (inpatient and outpatient) who had their serum 25(OH)D levels measured at RMH between 2014 and 2017. MAIN OUTCOME MEASURES Serum 25(OH)D levels stratified according to patients' sex, age and medical specialty admitted to, as well as the season and year (2014 to 2017) 25(OH)D level was measured. RESULTS Mean serum 25(OH)D level of study population was 69.9 nmol/L (95% CI 69.5 to 70.2). Only 40.2% patients in this cohort were sufficient in vitamin D (>75 nmol/L). On average, 25(OH)D levels in male patients were 6.1 units (95% CI 5.4 to 6.9) lower than in females. Linear regression analysis found that 25(OH)D levels increased by 0.16 unit (95% CI 0.14 to 0.18) for every year increase in age. One-way analysis of variance showed patients from neurology had the highest average 25(OH)D level, 76.8 nmol/L (95% CI 74.2 to 79.3) compared with other medical specialties. Mean 25(OH)D level during winter, 64.9 nmol/L (95% CI 64.2 to 65.6) was significantly lower compared with other seasons despite supplementation. Average 25(OH)D level measured in 2014, 71.5 nmol/L (95 CI% 70.8 to 72.2) was significantly higher than levels measured in 2016-2017. CONCLUSIONS There is a sex, age, medical specialty, seasonal and yearly variation in vitamin D status in an Australian patient population. The association between low vitamin D status and winter despite supplementation suggests other interventions are required to boost serum 25(OH)D levels.
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Affiliation(s)
- Veronica Tsin Fong Voo
- Department of Physiology, University of Melbourne, Parkville, Victoria, Australia
- Department of Neuroscience, Monash Univeristy, Melbourne, Victoria, Australia
- Department of Neurology, Royal Melbourne Hospital, Parkville, Victoria, Australia
| | - Jim Stankovich
- Department of Neuroscience, Monash Univeristy, Melbourne, Victoria, Australia
| | - Terence J O'Brien
- Department of Neuroscience, Monash Univeristy, Melbourne, Victoria, Australia
- Department of Neurology, Royal Melbourne Hospital, Parkville, Victoria, Australia
| | - Helmut Butzkueven
- Department of Neuroscience, Monash Univeristy, Melbourne, Victoria, Australia
- Department of Neurology, Royal Melbourne Hospital, Parkville, Victoria, Australia
| | - Mastura Monif
- Department of Physiology, University of Melbourne, Parkville, Victoria, Australia
- Department of Neuroscience, Monash Univeristy, Melbourne, Victoria, Australia
- Department of Neurology, Royal Melbourne Hospital, Parkville, Victoria, Australia
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25
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Grant WB, Al Anouti F, Moukayed M. Targeted 25-hydroxyvitamin D concentration measurements and vitamin D 3 supplementation can have important patient and public health benefits. Eur J Clin Nutr 2020; 74:366-376. [PMID: 31996793 DOI: 10.1038/s41430-020-0564-0] [Citation(s) in RCA: 52] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2019] [Revised: 01/08/2020] [Accepted: 01/15/2020] [Indexed: 02/06/2023]
Abstract
Over the past two decades, many studies reported the benefits of higher 25-hydroxyvitamin D [25(OH)D] concentrations for nonskeletal effects. Researchers found significant benefits in reducing risk of acute respiratory tract infections, many types of cancer, type 2 diabetes mellitus, premature death, and adverse pregnancy and birth outcomes. In addition, 25(OH)D concentrations are low for various reasons in several categories of people, including the obese, those with dark skin living at higher latitudes, the elderly, and those who do not eat much eggs, fish, meat, or vitamin D fortified milk. Measuring 25(OH)D concentrations is one way to both increase the awareness of vitamin D's importance in maintaining good health and to encourage vitamin D supplementation or increased solar ultraviolet-B exposure to sustain well-being throughout life by reducing disease incidence. Although 20 ng/ml seems adequate to reduce risk of skeletal problems and acute respiratory tract infections, concentrations above 30 ng/ml have been associated with reduced risk of cancer, type 2 diabetes mellitus, and adverse pregnancy and birth outcomes. Thus, judicious testing of 25(OH)D concentrations could reduce disease incidence and make treatment expenditures more cost-effective.
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Affiliation(s)
- William B Grant
- Director, Sunlight, Nutrition and Health Research Center, P.O. Box 641603, San Francisco, CA, 94164-1603, USA.
| | - Fatme Al Anouti
- College of Natural and Health Sciences, Department of Public Health and Nutrition, Zayed University, P.O. Box 4783, Abu Dhabi, UAE
| | - Meis Moukayed
- School of Arts and Sciences, American University in Dubai, P.O. Box 28282, Dubai, UAE
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26
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Anwar M, El-Dahiyat F, Jairoun A, Raed R, Butt I, Abdel-Majid W, Abdelgadir H. The sunshine under our skin: public knowledge and practices about vitamin D deficiency in Al Ain, United Arab Emirates. Arch Osteoporos 2019; 14:111. [PMID: 31758340 DOI: 10.1007/s11657-019-0671-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2019] [Accepted: 11/08/2019] [Indexed: 02/03/2023]
Abstract
UNLABELLED This cross-sectional study among members of public showed that people generally had good knowledge and awareness about vitamin D. However, inconsistencies between awareness and attitudes were observed. Our findings reinforce the need of educating people to improve attitude and practices toward vitamin D consumption. INTRODUCTION Owing to its hot and dry climate, United Arab Emirates (UAE) is one of the top ranked vitamin D deficient countries. However, little is known about people's awareness surrounding this topic. METHODS A descriptive cross-sectional survey to assess people's knowledge, awareness, and attitude toward vitamin D deficiency was conducted in Al Ain city of UAE. A 25-item validated self-administered questionnaire was used for data collection. Differences among demographic groups were analyzed using chi-square test, and simple binary logistic regressions were used to investigate the association between vitamin D awareness and other significant risk factors. RESULTS More than 90% of the total 346 participants showed awareness toward vitamin D and its deficiency. Doctors were reported as the most common source of information. More than one-third of the participants claimed to have vitamin D deficiency with significantly more females than males. More than 70% of the sample considered sunlight as the best source of vitamin D and avoiding going out in sun as the major risk for vitamin D deficiency. Nearly half (43%) of the participants did not consume milk and only 24% claimed to be using vitamin D supplements. Females were found to be applying sunscreen and consuming vitamin supplements significantly more than their male counterparts. Participants aged 24-35 years, having bachelor degree and those who were tested for vitamin D, were found to score better for awareness questions. CONCLUSIONS Our findings demonstrate a mismatch between knowledge and awareness, and attitude implying the need of educating people to improve their attitude toward consuming vitamin D rich food and supplements.
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Affiliation(s)
- Mudassir Anwar
- School of Pharmacy, University of Otago, PO Box 56, Dunedin, New Zealand.
| | - Faris El-Dahiyat
- College of Pharmacy, Al Ain University, Al Ain, United Arab Emirates
| | - Ammar Jairoun
- Health and Safety Department, Dubai Municipality, Dubai, United Arab Emirates
| | - Ruba Raed
- College of Pharmacy, Al Ain University, Al Ain, United Arab Emirates
| | - Iqra Butt
- College of Pharmacy, Al Ain University, Al Ain, United Arab Emirates
| | - Wasan Abdel-Majid
- College of Pharmacy, Al Ain University, Al Ain, United Arab Emirates
| | - Hind Abdelgadir
- College of Pharmacy, Al Ain University, Al Ain, United Arab Emirates
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