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Grygorieva N, Tronko M, Kovalenko V, Komisarenko S, Tatarchuk T, Dedukh N, Veliky M, Strafun S, Komisarenko Y, Kalashnikov A, Orlenko V, Pankiv V, Shvets O, Gogunska I, Regeda S. Ukrainian Consensus on Diagnosis and Management of Vitamin D Deficiency in Adults. Nutrients 2024; 16:270. [PMID: 38257163 PMCID: PMC10820145 DOI: 10.3390/nu16020270] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2023] [Revised: 01/10/2024] [Accepted: 01/10/2024] [Indexed: 01/24/2024] Open
Abstract
Vitamin D deficiency (VDD) is a global problem, however, there were no Ukrainian guidelines devoted to its screening, prevention, and treatment, which became the reason for the Consensus creation. This article aimed to present the Consensus of Ukrainian experts devoted to VDD management. Following the creation of the multidisciplinary Consensus group, consent on the formation process, drafting and fine-tuning of key recommendations, and two rounds of voting, 14 final recommendations were successfully voted upon. Despite a recent decrease in VDD prevalence in Ukraine, we recommend raising awareness regarding VDD's importance and improving the strategies for its decline. We recommend screening the serum 25-hydroxyvitamin D (25(OH)D) level in risk groups while maintaining a target concentration of 75-125 nmol/L (30-50 ng/mL). We recommend prophylactic cholecalciferol supplementation (800-2000 IU/d for youthful healthy subjects, and 3000-5000 IU/d for subjects from the risk groups). For a VDD treatment, we recommend a short-term administration of increased doses of cholecalciferol (4000-10,000 IU/d) with 25(OH)D levels monitored after 4-12 weeks of treatment, followed by the use of maintenance doses. Additionally, we recommend assessing serum 25(OH)D levels before antiosteoporotic treatment and providing vitamin D and calcium supplementation throughout the full course of the antiosteoporotic therapy.
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Affiliation(s)
- Nataliia Grygorieva
- D.F. Chebotarev Institute of Gerontology, The National Academy of Medical Sciences of Ukraine, 04114 Kyiv, Ukraine
| | - Mykola Tronko
- V.P. Komisarenko Institute of Endocrinology and Metabolism, The National Academy of Medical Sciences of Ukraine, 04114 Kyiv, Ukraine
| | - Volodymir Kovalenko
- National Scientific Center «The M.D. Strazhesko Institute of Cardiology», Clinical and Regenerative Medicine, The National Academy of Medical Sciences of Ukraine, 03151 Kyiv, Ukraine
| | - Serhiy Komisarenko
- Palladin Institute of Biochemistry, The National Academy of Sciences of Ukraine, 02000 Kyiv, Ukraine
| | - Tetiana Tatarchuk
- Institute of Pediatrics, Obstetrics and Gynecology Named after Academician O.M. Lukyanova, The National Academy of Medical Sciences of Ukraine, 04050 Kyiv, Ukraine
| | - Ninel Dedukh
- D.F. Chebotarev Institute of Gerontology, The National Academy of Medical Sciences of Ukraine, 04114 Kyiv, Ukraine
| | - Mykola Veliky
- Palladin Institute of Biochemistry, The National Academy of Sciences of Ukraine, 02000 Kyiv, Ukraine
| | - Serhiy Strafun
- Institute of Traumatology and Orthopedics, The National Academy of Medical Sciences of Ukraine, 01601 Kyiv, Ukraine
| | - Yulia Komisarenko
- Department of Endocrinology, O.O. Bogomolets National Medical University, 01601 Kyiv, Ukraine
| | - Andrii Kalashnikov
- Institute of Traumatology and Orthopedics, The National Academy of Medical Sciences of Ukraine, 01601 Kyiv, Ukraine
| | - Valeria Orlenko
- V.P. Komisarenko Institute of Endocrinology and Metabolism, The National Academy of Medical Sciences of Ukraine, 04114 Kyiv, Ukraine
| | - Volodymyr Pankiv
- Ukrainian Scientific and Practical Centre for Endocrine Surgery, Transplantation of Endocrine Organs and Tissues, Health Ministry of Ukraine, 01021 Kyiv, Ukraine
| | - Oleg Shvets
- Department of Public Health and Nutrition, National University of Life and Environmental Sciences of Ukraine, 03041 Kyiv, Ukraine
| | - Inna Gogunska
- O.S. Kolomiychenko Institute of Otolaryngology, The National Academy of Medical Sciences of Ukraine, 03057 Kyiv, Ukraine
| | - Svitlana Regeda
- Center of Innovative Medical Technologies, The National Academy of Sciences of Ukraine, 04053 Kyiv, Ukraine
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Ozkanay H, Arslan FD, Narin F, Koseoglu MH. Biological variation of plasma 25-Hydroxyvitamin D 3, Serum vitamin B12, folate and ferritin in Turkish healthy subject. Scand J Clin Lab Invest 2023; 83:509-518. [PMID: 37961767 DOI: 10.1080/00365513.2023.2278537] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Accepted: 10/30/2023] [Indexed: 11/15/2023]
Abstract
Biological variation (BV) plays a crucial role in determining analytical performance specifications, assessing serial measurements of individuals, and establishing the use of population-based reference intervals. Our study aimed to calculate the BV and BV-based quality goals of 25-hydroxyvitamin D3 (25-OH D3), ferritin, folate and vitamin B12 tests. We included a total of 22 apparently healthy volunteers (9 women and 13 men) aged 18-55 years in the study that we conducted in Turkey. Blood samples were collected from the participants once a week for five weeks. Serum ferritin, folate and vitamin B12 levels were measured using immunochemical method, while plasma 25-OH D3 levels were determined using the high-performance liquid chromatography method. Analysis of variance (ANOVA) was used to estimate analytical variation(CVA), within-subject BV(CVI) and between-subject BV(CVG). The individuality index (II) and reference change value (RCV) were calculated based on these data. The CVI of 25-OH D3, ferritin, folate, and vitamin B12 were found to be 1.8% (0.6%-2.5%), 16.9% (14.4%-20.2%), 10.7% (9.2%-12.7%), and 8.6% (6.8%-10.5%), respectively. CVG were 44.2% (34.3%-69.9%), 132% (87.7%-238%), 19.4% (14.4%-28.8%), and 39.6% (29.8%-59.0%) for the same biomarkers, while CVA were 3.2% (2.81%-3.71%), 3.5% (3.1%-4.1%), 4.0% (3.5%-4.6%), and 7.5% (6.6%-8.6%), respectively. The II values for 25-OH D3, ferritin, folate, and vitamin B12 were calculated as 0.04, 0.13, 0.55, and 0.22, respectively. The RCV were 10.2%, 47.8%, 31.7%, and 31.6%, respectively. Because the tests analyzed in this study exhibit high individuality, RCV should be preferred rather than population-based reference ranges in clinical interpretation of results.
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Affiliation(s)
- Hayat Ozkanay
- Department of Medical Biochemistry, Katip Celebi University, Izmir, Turkey
| | | | - Figen Narin
- Department of Medical Biochemistry, Katip Celebi University, Izmir, Turkey
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Gong M, Wang K, Sun H, Wang K, Zhou Y, Cong Y, Deng X, Mao Y. Threshold of 25(OH)D and consequently adjusted parathyroid hormone reference intervals: data mining for relationship between vitamin D and parathyroid hormone. J Endocrinol Invest 2023; 46:2067-2077. [PMID: 36920734 PMCID: PMC10514164 DOI: 10.1007/s40618-023-02057-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Accepted: 03/02/2023] [Indexed: 03/16/2023]
Abstract
PURPOSE By recruiting reference population, we aimed to (1): estimate the 25(OH)D threshold that maximally inhibits the PTH, which can be defined as the cutoff value for vitamin D sufficiency; (2) establish the PTH reference interval (RI) in population with sufficient vitamin D. METHODS Study data were retrieved from LIS (Laboratory Information Management System) under literature suggested criteria, and outliers were excluded using Tukey fence method. Locally weighted regression (LOESS) and segmented regression (SR) were conducted to estimate the threshold of 25(OH)D. Multivariate linear regression was performed to evaluate the associations between PTH concentration and variables including 25(OH)D, gender, age, estimated glomerular filtration rate (EGFR), body mass index (BMI), albumin-adjusted serum calcium (aCa), serum phosphate(P), serum magnesium(Mg), and blood collection season. Z test was adopted to evaluate whether the reference interval should be stratified by determinants such as age and gender. RESULTS A total of 64,979 apparently healthy subjects were recruited in this study, with median (Q1, Q3) 25(OH)D of 45.33 (36.15, 57.50) nmol/L and median (Q1, Q3) PTH of 42.19 (34.24, 52.20) ng/L. The segmented regression determined the 25(OH)D threshold of 55 nmol/L above which PTH would somewhat plateau and of 22 nmol/L below which PTH would rise steeply. Multivariate linear regression suggested that gender, EGFR, and BMI were independently associated with PTH concentrations. The PTH RI was calculated as 22.17-72.72 ng/L for subjects with 25(OH)D ≥ 55 nmol/L with no necessity of stratification according to gender, age, menopausal status nor season. CONCLUSION This study reported 25(OH)D thresholds of vitamin D sufficiency at 55 nmol/L and vitamin D deficiency at 22 nmol/L, and consequently established PTH RIs in subjects with sufficient vitamin D for northern China population for the first time.
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Affiliation(s)
- M Gong
- Department of Laboratory Medicine, Second Medical Center of Chinese PLA General Hospital, National Clinical Research Center for Geriatric Diseases, Beijing, China
| | - K Wang
- Department of Laboratory Medicine, Second Medical Center of Chinese PLA General Hospital, National Clinical Research Center for Geriatric Diseases, Beijing, China
| | - H Sun
- Department of Laboratory Medicine, Second Medical Center of Chinese PLA General Hospital, National Clinical Research Center for Geriatric Diseases, Beijing, China
| | - K Wang
- Department of Laboratory Medicine, Second Medical Center of Chinese PLA General Hospital, National Clinical Research Center for Geriatric Diseases, Beijing, China
| | - Y Zhou
- Department of Laboratory Medicine, Second Medical Center of Chinese PLA General Hospital, National Clinical Research Center for Geriatric Diseases, Beijing, China
| | - Y Cong
- Department of Laboratory Medicine, Second Medical Center of Chinese PLA General Hospital, National Clinical Research Center for Geriatric Diseases, Beijing, China
| | - X Deng
- Department of Laboratory Medicine, Second Medical Center of Chinese PLA General Hospital, National Clinical Research Center for Geriatric Diseases, Beijing, China.
| | - Y Mao
- Department of Laboratory Medicine, Fifth Medical Center, Chinese PLA General Hospital, Beijing, China.
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Ekici Ö, Çelik S. The relationship of biochemical factors related to calcium metabolism with temporomandibular disorders. JOURNAL OF STOMATOLOGY, ORAL AND MAXILLOFACIAL SURGERY 2023; 124:101315. [PMID: 36280111 DOI: 10.1016/j.jormas.2022.10.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Revised: 10/14/2022] [Accepted: 10/19/2022] [Indexed: 12/13/2022]
Abstract
OBJECTIVE The aim of this study is to investigate the relationship between calcium metabolism-related biochemical factors (alkaline phosphatase, vitamin D, parathyroid hormone (PTH), calcium, phosphorus and magnesium), and temporomandibular joint (TMJ) disk displacement with reduction (DDWR). MATERIALS AND METHODS This prospective observational study included patients with temporomandibular disorders (TMDs) (n = 50) and healthy controls (n = 50) of similar age and sex. The diagnosis of TMJ DDWR was made using the diagnostic criteria for temporomandibular joint disorders (DC/TMD). Both groups were compared in terms of serum alkaline phosphatase, 25 (OH) vitamin D, PTH, calcium, magnesium, and phosphorus levels. P<0.005 was accepted as a significant difference. RESULTS There was no significant difference between the groups in terms of age, gender, and body mass index (BMI). Calcium levels of patients with TMD were statistically significantly lower than control patients (p<0.05). While there was no significant difference between the two groups in terms of mean VIT D, the number of people with severe Vit D deficiency (<10 ng) in the TMD group was significantly higher than in the control group (p<0.05). There was no statistically significant difference between the groups in terms of serum alkaline phosphatase, magnesium, phosphorus and PTH levels. CONCLUSION The differences in serum calcium and vitamin D levels seen in the study indicate that biochemical factors related to calcium metabolism may be associated with TMJ DDWR. These results suggest that calcium and vitamin D deficiency should be evaluated and corrected in patients with TMD.
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Affiliation(s)
- Ömer Ekici
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Afyonkarahisar Health Sciences University, Afyonkarahisar, 03030, Turkey.
| | - Sefa Çelik
- Department of Medical Biochemistry, Faculty of Medicine, Afyonkarahisar Health Sciences University, Afyonkarahisar, 03030, Turkey
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Jastrzębska J, Skalska M, Radzimiński Ł, Sánchez GFL, Weiss K, Knechtle B. The Level of Selected Blood Parameters in Young Soccer Players in Relation to the Concentration of 25(OH)D at the Beginning and End of Autumn. BIOLOGY 2023; 12:biology12010129. [PMID: 36671821 PMCID: PMC9855687 DOI: 10.3390/biology12010129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/25/2022] [Revised: 01/10/2023] [Accepted: 01/11/2023] [Indexed: 01/14/2023]
Abstract
This study aimed to demonstrate the changes of selected blood parameters in relation to 25(OH)D concentration during the autumn period in young soccer players. A total of 35 participants’ results (age: 17.5 ± 0.6 years, body mass 71.3 ± 6.9 kg) were tested twice: in mid-September and in mid-December and divided into subgroups with regard to two criteria. First, according to the initial level of the 25(OH)D concentration (optimal group—ODG, suboptimal group—SDG), second, according to drops in 25(OH)D concentration (high drop group—HDG, low drop group—LDG). A significant decrease (p < 0.001) in the 25(OH)D concentration was reported in the total group (TGr) and in all subgroups. Blood parameters such as white blood cells, red blood cells, haemoglobin and haematocrit increased significantly (p < 0.05) in TGr during the analysed period of time. The analysis of changes in the lipid profile did not expose significant differences except triglycerides. The asparagine amino transferase and creatine kinase activity decreased significantly after autumn in all analysed groups. The declining level of 25(OH)D concentration should be compensated (e.g., with vitamin D supplementation) during autumn. Applied training loads could also influence the blood parameters variability in young soccer players. Regular measurements of 25(OH)D concentration are helpful in identifying potential drops and allows for the preparation of individual supplementation plans for the players.
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Affiliation(s)
- Joanna Jastrzębska
- Department of Pediatrics, Diabetology and Endocrinology, Gdansk Medical University, 80-210 Gdansk, Poland
| | - Maria Skalska
- Department of Pediatrics, Diabetology and Endocrinology, Gdansk Medical University, 80-210 Gdansk, Poland
| | - Łukasz Radzimiński
- Department of Health and Natural Sciences, Gdansk University of Physical Education and Sport, 80-336 Gdansk, Poland
| | - Guillermo F. López Sánchez
- Division of Preventive Medicine and Public Health, Department of Public Health Sciences, School of Medicine, University of Murcia, 30120 Murcia, Spain
| | - Katja Weiss
- Institute of Primary Care, University Hospital Zurich, 8091 Zurich, Switzerland
- Medbase St. Gallen Am Vadianplatz, 9001 St. Gallen, Switzerland
| | - Beat Knechtle
- Institute of Primary Care, University Hospital Zurich, 8091 Zurich, Switzerland
- Medbase St. Gallen Am Vadianplatz, 9001 St. Gallen, Switzerland
- Correspondence:
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Rezaei OM, Sharifi F, Moodi M, Zarban A, Tahergorabi R, Tahergorabi Z. The Prevalence and Determinants of Vitamin D Status among Older Adults: Data from a Longitudinal Aging Study. Int J Prev Med 2023; 14:27. [PMID: 37033285 PMCID: PMC10080568 DOI: 10.4103/ijpvm.ijpvm_366_21] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2021] [Accepted: 10/27/2022] [Indexed: 04/11/2023] Open
Abstract
Background Aging is identified as a risk factor for vitamin D deficiency (VDD) therefore this investigation was designed to determine the prevalence of VDD and its determinants in a sample of older adults. Methods The data of this study were obtained from the baseline wave of the Longitudinal Aging Study (LAS). Demographic, past medical history, medication history, and smoking behavior were collected using an interview approach. The physical activity and nutritional status of the participants were assessed using a standard questionnaire. Anthropometric indices were measured according to a standard protocol then body mass index (BMI) was calculated. Serum vitamin D and calcium levels were measured by autoanalyzers. Univariate and multiple logistic regression models were applied to detect the associated factors with VDD. Results Mean age of the participants was 71.82 (SD = 7.63) years. A total of 1319 people participated in our study, and 51.16% (n = 688) were female. A total of 8.42% (n = 111) of the participants had VDD and 17.06% of them (n = 225) had insufficient vitamin D levels. In the multivariable logistic regression model, the age group of 70-79 years in comparison with the age group of 60-69 years had a 43% less chance of VDD. Furthermore, being overweight (OR = 0.36, P = 0.01) and obese (OR = 0.35, P = 0.02), and taking vitamin D supplements (OR = 0.31, P = 0.04) were significantly associated with VDD. Conclusions Our results showed that 25% of older adults had vitamin D deficiency or insufficiency. In addition, some modifiable lifestyle factors were associated with VDD. Given that, old age is considered a risk factor for VDD. Therefore, detection and improvement of VDD may be a preventive measure in at-risk subjects.
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Affiliation(s)
- Omolbanin Motamed Rezaei
- Instructor of Environmental Toxicology, Social Determinants of Health Research Center, Department of Occupational Health, School of Health, Birjand University of Medical Sciences, Birjand, Iran
| | - Farshad Sharifi
- Department of Geronoto-Epidemiology, Elderly Health Research Center, Endocrinology and Metabolism Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Mitra Moodi
- Social Determinants of Health Research Center, Birjand University of Medical Sciences, Birjand, Iran
| | - Asghar Zarban
- Department of Clinical Biochemistry, School of Medicine, Birjand University of Medical Sciences, Birjand, Iran
| | - Reza Tahergorabi
- Medical Toxicology and Drug Abuse Research Center, Birjand University of Medical Sciences, Birjand, Iran
| | - Zoya Tahergorabi
- North Carolina Agricultural and Technical State University, Greensboro, NC, USA
- Address for correspondence: Dr. Zoya Tahergorabi, Department of Physiology, School of Medicine, Birjand University of Medical Sciences, Ghafari Street, Birjand, Iran. E-mail:
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Welford AE, Darling AL, Allison SJ, Lanham-New SA, Greig CA. Lack of significant seasonal association between serum 25(OH)D concentration, muscle mass and strength in postmenopausal women from the D-FINES longitudinal study. J Nutr Sci 2022; 11:e107. [PMID: 36588541 PMCID: PMC9794962 DOI: 10.1017/jns.2022.106] [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] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Revised: 11/02/2022] [Accepted: 11/03/2022] [Indexed: 12/14/2022] Open
Abstract
The aim of the present study was to assess the seasonal relationship between serum 25(OH)D concentration, lean mass and muscle strength. This was a secondary data analysis of a subgroup of 102 postmenopausal women participating in the 2006-2007 D-FINES (Vitamin D, Food Intake, Nutrition and Exposure to Sunlight in Southern England) study. The cohort was assessed as two age subgroups: <65 years (n=80) and ≥65 years (n=22). Outcome measures included lean mass (DXA), muscle strength (handgrip dynamometry) and serum 25(OH)D concentration (enzymeimmunoassay). Derived outcomes included appendicular skeletal muscle mass (ASM) and relative appendicular skeletal muscle index (RASM). Sarcopenia status was assessed using the European Working Group on Sarcopenia in Older People 2018 criteria. Non-parametric partial correlation using BMI as a covariate was used to evaluate the study aims. There were no statistically significant associations between total lean mass, ASM or RASM and 25(OH)D in any group at any season. There was a trend for handgrip strength to be positively associated with serum 25(OH)D concentration. There was a trend showing a higher prevalence of sarcopenia in women ≥65 years. Sarcopenia status appeared transient for five women. In conclusion, the present study found no significant association between vitamin D status and functional indicators of musculoskeletal health, which were additionally not affected by season.
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Key Words
- 1,25(OH)2D, 1,25-dihydroxyvitamin D
- 25(OH)D, 25-hydroxyvitamin D
- ASM, appendicular skeletal mass
- BMI, body mass index
- D-FINES, Vitamin D
- DEQAS, vitamin D quality assurance scheme
- DXA, dual X-ray absorptiometry
- EWGSOP, European Working Group on Sarcopenia in Older People
- Food Intake, Nutrition and Exposure to Sunlight in Southern England
- GP, General Practitioner
- HGS, handgrip strength
- Longitudinal
- Muscle mass
- Muscle strength
- PAL, physical activity level
- RASM, relative appendicular skeletal mass
- SPSS, Statistical Package for Social Sciences
- Sarcopenia
- Seasonal variation
- UK, United Kingdom
- USA, United States of America
- VDR, vitamin D receptor
- Vitamin D
- kg, kilogram
- ng/ml, nanograms per millilitre
- nmol/l, nanomoles per litre
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Affiliation(s)
- Anneka E. Welford
- School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Edgbaston, Birmingham B15 2TT, UK
- Leicester Diabetes Centre, University of Leicester, Leicester General Hospital, Leicester LE5 4PW, UK
| | - Andrea L. Darling
- Nutrition, Food and Exercise Sciences Department, School of Biomedical Sciences, Faculty of Health and Medical Sciences, University of Surrey, Guildford GU2 7XH, UK
| | - Sarah J. Allison
- Nutrition, Food and Exercise Sciences Department, School of Biomedical Sciences, Faculty of Health and Medical Sciences, University of Surrey, Guildford GU2 7XH, UK
| | - Susan A. Lanham-New
- Nutrition, Food and Exercise Sciences Department, School of Biomedical Sciences, Faculty of Health and Medical Sciences, University of Surrey, Guildford GU2 7XH, UK
| | - Carolyn A. Greig
- School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Edgbaston, Birmingham B15 2TT, UK
- MRC-Versus Arthritis Centre for Musculoskeletal Ageing Research, University of Birmingham, Edgbaston, Birmingham B15 2TT, UK
- NIHR Birmingham Biomedical Research Centre, University Hospitals Birmingham NHS Foundation Trust & University of Birmingham, Birmingham, UK
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Guo H, Liu Q. Clinical Value of Growth Differentiation Factor 15 Detection in the Diagnosis of Early Liver Cancer Based on Data Mining. BIOMED RESEARCH INTERNATIONAL 2022; 2022:4448075. [PMID: 36440365 PMCID: PMC9691313 DOI: 10.1155/2022/4448075] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Revised: 08/12/2022] [Accepted: 09/06/2022] [Indexed: 07/22/2023]
Abstract
The incidence of liver cancer is increasing year by year, and how to effectively diagnose early-stage liver cancer and improve the survival rate of liver cancer patients has become one of the current research topics of concern. Aiming at this problem, it is of great significance for the diagnosis of early liver cancer. With the in-depth research on the diagnosis of early-stage liver cancer, the research on growth differentiation factor 15 is gradually carried out, and its performance advantages are of great significance to solve the problem of detection and diagnosis of early-stage liver cancer. This study can improve the accuracy of early diagnosis of liver cancer. The purpose of this paper is to study the application of data mining in the study of clinical value of growth and differentiation factor 15 detection and diagnosis of early liver cancer. In this paper, the data mining algorithm is analyzed, the performance of the algorithm is experimentally analyzed, and the relevant theoretical formulas are used to explain. The results showed that the expression level of GDF-15 was significant in early primary liver cancer (tumor diameter <2.5 cm). Different from normal liver tissue (P < 0.01), there was a significant difference (P < 0.01) compared with adjacent tissue (P < 0.01). Serum GDF-15 can be used as a tumor marker for predicting early stage liver cancer. The high expression of GDF-15 in early stage liver cancer is an independent risk factor affecting the prognosis of liver cancer patients.
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Affiliation(s)
- Hongyan Guo
- Center of Laboratory Test, Beijing YouAn Hospital, Capital Medical University, Beijing, China
| | - Qingfeng Liu
- Clinical Laboratory, Guang'anmen Hospital China Academy of Chinese Medical Sciences, Beijing 100053, China
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Abukhalil AD, Falana H, Hamayel R, Yasser F, Nasser A, Naseef H, Al-Shami N, Rabba A. Vitamin D Deficiency Association with Comorbid Diseases in Palestine: "A Cross-Sectional Observation Study". Int J Gen Med 2022; 15:8033-8042. [PMID: 36348976 PMCID: PMC9637367 DOI: 10.2147/ijgm.s389190] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Accepted: 10/27/2022] [Indexed: 01/24/2023] Open
Abstract
BACKGROUND Vitamin D deficiency (VDD) is a global health concern. This study aimed to determine the prevalence of vitamin D deficiency and its associated comorbidities in Palestine, such as diabetes mellitus, hypertension, hyperlipidemia, and cardiovascular and autoimmune diseases. METHODS A retrospective, descriptive study retrieved medical data from the Nat Health insurance processor database from 2014 to 2020. Patient information included age, sex, vitamin D laboratory order, symptoms, and comorbidities. This study included patients prescribed vitamin D at a dose of 50000IU for vitamin D deficiency confirmed by a serum vitamin D laboratory test. The collected data were analyzed using IBM SPSS. In addition, a chi-square test was conducted to assess the association between vitamin D deficiency, symptoms, and comorbidities. RESULTS Data of 3011 patients were collected; 639 patients were diagnosed with osteoporosis, and 39 patients prescribed vitamin D without a laboratory test were excluded. Approximately, 1837 (78%) participants had vitamin D deficiency. A total of 1330 women (81.3%) were significantly more likely to have vitamin D deficiency than males, 507 (72.7%; P < 0.001). Joint pain, back pain, and cervicalgia were significantly associated with vitamin D deficiency (P < 0.001). Asymptomatic participants (2.1%) were significantly less likely to have vitamin D deficiency than symptomatic participants (9.5%, p < 0.001). Hypothyroidism is significantly associated with vitamin D deficiency (p = 0.048). CONCLUSION In this retrospective study, the prevalence of vitamin D was high and alarming. There was a significant association between VDD, patients who presented with back pain, arthritis, and cervicalgia symptoms, and patients diagnosed with hypothyroidism. Therefore, health initiative programs are warranted to increase awareness regarding screening, prevention, and treatment. Further studies are needed to confirm the relationship between vitamin D supplementation and the reduced risk of comorbid diseases.
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Affiliation(s)
- Abdallah Damin Abukhalil
- Pharmacy Department, Faculty of Pharmacy, Nursing and Health Professions, Birzeit University, Birzeit, Palestine,Correspondence: Abdallah Damin Abukhalil; Hiba Falana, Pharmacy Department, Faculty of Pharmacy, Nursing and Health Professions, Birzeit University, Birzeit, Palestine, Email ;
| | - Hiba Falana
- Pharmacy Department, Faculty of Pharmacy, Nursing and Health Professions, Birzeit University, Birzeit, Palestine
| | - Rawan Hamayel
- Pharmacy Department, Faculty of Pharmacy, Nursing and Health Professions, Birzeit University, Birzeit, Palestine
| | - Fatima Yasser
- Pharmacy Department, Faculty of Pharmacy, Nursing and Health Professions, Birzeit University, Birzeit, Palestine
| | - Aleen Nasser
- Pharmacy Department, Faculty of Pharmacy, Nursing and Health Professions, Birzeit University, Birzeit, Palestine
| | - Hani Naseef
- Pharmacy Department, Faculty of Pharmacy, Nursing and Health Professions, Birzeit University, Birzeit, Palestine
| | - Ni’meh Al-Shami
- Pharmacy Department, Faculty of Pharmacy, Nursing and Health Professions, Birzeit University, Birzeit, Palestine
| | - Abdullah Rabba
- Pharmacy Department, Faculty of Pharmacy, Nursing and Health Professions, Birzeit University, Birzeit, Palestine
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Bhat GH, Guldin S, Khan MS, Yasir M, Prasad G. Vitamin D status in Psoriasis: impact and clinical correlations. BMC Nutr 2022; 8:115. [PMID: 36261848 PMCID: PMC9583481 DOI: 10.1186/s40795-022-00610-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Accepted: 09/26/2022] [Indexed: 11/18/2022] Open
Abstract
Psoriasis is a continuing, periodic, immune‑mediated, fiery skin disease branded by hyper proliferation of epidermal keratinocytes and accompanying with inflammatory cellular infiltrate in both dermis and epidermis. Immunomodulation could be an important effect of vitamin D in Psoriasis. This case-control study was designed to measure serum 25-hydroxy vitamin D levels in patients with psoriasis and healthy controls and to find out clinical correlation, if any. Six hundred two (n = 602) subjects (285 cases and 317 controls) were taken for the study. Cases and controls were frequency matched with respect to age and gender. Various demographic and clinical details were taken using a questionnaire. Chemiluminescence Micro Particle Immunoassay was used to estimate serum 25-hydroxy vitamin D levels. The vitamin D deficiency in psoriasis patients was 60.0% vs. 17.5% in controls (P < 0.001) with mean vitamin D levels of 28.3 ± 13.9 ng/ml in psoriasis patient’s vs. 37.9 ± 9.7 ng/ml in controls. Vitamin D deficiency was found to be associated with psoriasis independently of gender, age, smoking status, family history, hypertension, chronic medication, nail changes, duration of symptoms and severity of disease. Vitamin D levels were seven times lower in patients with Psoriasis as compared to controls. Reduced vitamin D levels are related to duration and clinical severity of the disease. Early detection of vitamin D deficiency and timely intervention could lead to better clinical outcome and improved quality of life in psoriasis patients.
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Affiliation(s)
- Ghulam Hassan Bhat
- Department of Biochemistry, Yenepoya Medical College Hospital, 575018, Mangalore, India.,Department of Microbiology, Yenepoya Medical College Hospital, 575018, Mangalore, India
| | - Sadaf Guldin
- Department of Microbiology, Yenepoya Medical College Hospital, 575018, Mangalore, India
| | - Mosin Saleem Khan
- Department of Biochemistry, Government Medical College Baramulla and Associated Hospitals, Kanth Bagh, 193101, Baramulla, J&K, India. .,Department of Plastic and Reconstructive Surgery, Sher-I-Kashmir Institute of Medical Sciences (SKIMS), Soura, 190011, Srinagar, J&K, India.
| | - Mir Yasir
- Department of Plastic and Reconstructive Surgery, Sher-I-Kashmir Institute of Medical Sciences (SKIMS), Soura, 190011, Srinagar, J&K, India
| | - Ganesh Prasad
- Department of Biochemistry, Yenepoya Medical College Hospital, 575018, Mangalore, India
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11
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The Construction and Effect Analysis of Nursing Safety Quality Management Based on Data Mining. COMPUTATIONAL INTELLIGENCE AND NEUROSCIENCE 2022; 2022:6560452. [PMID: 35694599 PMCID: PMC9184199 DOI: 10.1155/2022/6560452] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Revised: 04/19/2022] [Accepted: 04/25/2022] [Indexed: 11/23/2022]
Abstract
Data mining belongs to knowledge discovery, which is the process of revealing hidden, unknown, and valuable information from a large amount of fuzzy application data. The potential information revealed by data mining can help decision-makers adjust market strategies and reduce market risks. The information mined can be the discovery of a particular study and little known, which must be based on the principle of truth. Nursing safety means that during nursing work, the nursing staff must strictly follow the nursing system and operating procedures, accurately execute doctor's orders, implement nursing plans, and ensure that patients get physical and mental safety during treatment and recovery. This paper aims to explore the construction of nursing safety quality management system and its effect analysis based on data mining. It is hoped that improvements in hospital nursing processes will provide better nursing services for patients using data mining techniques. This paper uses the FP algorithm to mine the data set and generates frequent itemsets, proposes and implements the association rule mining algorithm, and obtains the association rules with practical reference value. This article analyzes the current status and existing problems of nursing management, and puts forward some problems existing in the current nursing management staff's own quality, nursing quality system standards, and nursing management system. The experimental results in this article show that there are 42 cases of poor nursing due to lack of basic medical knowledge, accounting for 52%; there are 12 cases of poor nursing due to their own diseases, accounting for 15%; there were 7 cases of poor nursing due to lack of communication, accounting for 9%; there were 15 cases of poor nursing caused by unreasonable use of restraint devices, accounting for 19%. From these data, it can be seen that patients need to have basic medical knowledge and act in strict accordance with doctors' orders. Family members also need to accompany the patients more and cooperate with all parties in order to maximize the effectiveness of care.
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12
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Application of Intelligent Archives Management Based on Data Mining in Hospital Archives Management. JOURNAL OF ELECTRICAL AND COMPUTER ENGINEERING 2022. [DOI: 10.1155/2022/6217328] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Data mining belongs to knowledge discovery, which is the process of revealing implicit, unknown, and valuable information from a large amount of fuzzy application data. The potential information revealed by data mining can help decision makers adjust market strategies and reduce market risks. The information excavated must be real and not universally known, and it can be the discovery of a specific problem. Data mining algorithms mainly include the neural network method, decision tree method, genetic algorithm, rough set method, fuzzy set method, association rule method, and so on. Archives management, also known as archive work, is the general term for various business works, in which archives directly manage archive entities and archive information and provide utilization services. It is also the most basic part of national archives. Hospital archives are an important part of hospital management, and hospital archives are the accumulation of work experience and one of the important elements for building a modern hospital. Hospital archives are documents, work records, charts, audio recordings, videos, photos, and other types of documents, audio-visual materials, and physical materials, such as certificates, trophies, and medals obtained by hospitals, departments, and individuals. The purpose of this paper is to study the application of intelligent archives management based on data mining in hospital archives management, expecting to use the existing data mining technology to improve the current hospital archives management. This paper investigates the age and educational background of hospital archives management workers and explores the relationship between them and the quality of archives management. Based on the decision number algorithm, on the basis of the database, the hospital data is classified and analyzed, and the hospital file data is classified and processed through the decision number algorithm to improve the system data processing capability. The experimental results of this paper show that among the staff working in the archives management department of the hospital, 20-to-30-year-olds account for 46.2% of the total group. According to the data, the staff in the archives management department of the hospital also tends to be younger. Among the staff under the age of 30, the file pass rate was 98.3% and the failure rate was 1.7%. Among the staff over 50 years old, the file pass rate was 99.9% and the failure rate was 0.1%. According to the data, the job is related to the experience of the employee.
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Wyld MLR, Mata NLDL, Viecelli A, Swaminathan R, O'Sullivan KM, O'Lone E, Rowlandson M, Francis A, Wyburn K, Webster AC. Sex-Based Differences in Risk Factors and Complications of Chronic Kidney Disease. Semin Nephrol 2022; 42:153-169. [PMID: 35718363 DOI: 10.1016/j.semnephrol.2022.04.006] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Globally, females are ∼30% more likely to have pre-dialysis chronic kidney disease (CKD) than males for reasons that are not fully understood. CKD is associated with numerous adverse health outcomes which makes understanding and working to eradicating sex based disparities in CKD prevalence essential. This review maps both what is known, and what is unknown, about the way sex and gender impacts (1) the epidemiology and risk factors for CKD including age, diabetes, hypertension, obesity, smoking, and cerebrovascular disease, and (2) the complications from CKD including kidney disease progression, cardiovascular disease, CKD mineral and bone disorders, anaemia, quality-of-life, cancer and mortality. This mapping can be used to guide future research.
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Affiliation(s)
- Melanie L R Wyld
- School of Public Health, Faculty of Medicine and Health, University of Sydney, Sydney, Australia; Department of Renal and Transplant Medicine, Westmead Hospital, Sydney, Australia.
| | - Nicole L De La Mata
- School of Public Health, Faculty of Medicine and Health, University of Sydney, Sydney, Australia
| | - Andrea Viecelli
- Department of Nephrology, Princess Alexandra Hospital, Brisbane, Queensland, Australia; Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia
| | - Ramyasuda Swaminathan
- Department of Nephrology, Fiona Stanley Hospital, Murdoch, Western Australia, Australia
| | - Kim M O'Sullivan
- Department of Medicine, Centre for Inflammatory Diseases, Monash University, Clayton, Victoria, Australia
| | - Emma O'Lone
- Department of Renal Medicine, Royal North Shore Hospital, Sydney, Australia
| | - Matthew Rowlandson
- Department of Renal and Transplant Medicine, Westmead Hospital, Sydney, Australia
| | - Anna Francis
- Child and Adolescent Renal Service, Queensland Children's Hospital, Brisbane, Queensland, Australia
| | - Kate Wyburn
- Department of Renal Medicine,Royal Prince Alfred Hospital, Sydney, Australia
| | - Angela C Webster
- School of Public Health, Faculty of Medicine and Health, University of Sydney, Sydney, Australia; Department of Renal and Transplant Medicine, Westmead Hospital, Sydney, Australia
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Bocheva G, Slominski RM, Slominski AT. The Impact of Vitamin D on Skin Aging. Int J Mol Sci 2021; 22:ijms22169097. [PMID: 34445803 PMCID: PMC8396468 DOI: 10.3390/ijms22169097] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Revised: 08/20/2021] [Accepted: 08/21/2021] [Indexed: 12/11/2022] Open
Abstract
The active metabolites of vitamin D3 (D3) and lumisterol (L3) exert a variety of antiaging and photoprotective effects on the skin. These are achieved through immunomodulation and include anti-inflammatory actions, regulation of keratinocytes proliferation, and differentiation programs to build the epidermal barrier necessary for maintaining skin homeostasis. In addition, they induce antioxidative responses, inhibit DNA damage and induce DNA repair mechanisms to attenuate premature skin aging and cancerogenesis. The mechanism of action would involve interaction with multiple nuclear receptors including VDR, AhR, LXR, reverse agonism on RORα and -γ, and nongenomic actions through 1,25D3-MARRS receptor and interaction with the nongenomic binding site of the VDR. Therefore, active forms of vitamin D3 including its canonical (1,25(OH)2D3) and noncanonical (CYP11A1-intitated) D3 derivatives as well as L3 derivatives are promising agents for the prevention, attenuation, or treatment of premature skin aging. They could be administrated orally and/or topically. Other forms of parenteral application of vitamin D3 precursor should be considered to avoid its predominant metabolism to 25(OH)D3 that is not recognized by CYP11A1 enzyme. The efficacy of topically applied vitamin D3 and L3 derivatives needs further clinical evaluation in future trials.
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Affiliation(s)
- Georgeta Bocheva
- Department of Pharmacology and Toxicology, Medical University of Sofia, 1431 Sofia, Bulgaria
- Correspondence: (G.B.); (A.T.S.)
| | - Radomir M. Slominski
- Department of Dermatology, University of Alabama at Birmingham, Birmingham, AL 35294, USA;
- Graduate Biomedical Sciences Program, University of Alabama at Birmingham, Birmingham, AL 35294, USA
| | - Andrzej T. Slominski
- Department of Dermatology, University of Alabama at Birmingham, Birmingham, AL 35294, USA;
- Comprehensive Cancer Center, Cancer Chemoprevention Program, University of Alabama at Birmingham, Birmingham, AL 35294, USA
- Veteran Administration Medical Center, Birmingham, AL 35294, USA
- Correspondence: (G.B.); (A.T.S.)
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15
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Vitamin D: Promises on the Horizon and Challenges Ahead for Fighting Pancreatic Cancer. Cancers (Basel) 2021; 13:cancers13112716. [PMID: 34072725 PMCID: PMC8198176 DOI: 10.3390/cancers13112716] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2021] [Revised: 05/21/2021] [Accepted: 05/27/2021] [Indexed: 12/12/2022] Open
Abstract
Simple Summary Pancreatic cancer is an almost universally lethal cancer, largely due to its late diagnosis, early metastasis, and therapeutic resistance. This highlights the need to develop novel and effective intervention strategies to improve the outcomes of patients with pancreatic cancer. Vitamin D is one of the hottest topics in cancer research and clinics because of its pleiotropic functions on the hallmarks of cancer. Here we critically review past and current efforts that define the effects of vitamin D on the risk, incidence, patient survival, and mortality of pancreatic cancer. We also provide overviews on the opportunities and challenges associated with vitamin D as an economic adjunct to improve the efficacy of immunotherapy and chemo- or radiotherapy for pancreatic cancer. Abstract Pancreatic cancer has a dismal prognosis, while its incidence is increasing. This is attributed, in part, to a profound desmoplastic and immunosuppressive tumor microenvironment associated with this cancer and resistance to current available therapies. Novel and effective intervention strategies are urgently needed to improve the outcomes of patients with pancreatic cancer. Vitamin D has pleiotropic functions beyond calcium–phosphate homeostasis and has been extensively studied both in the laboratory and clinic as a potential preventive agent or adjunct to standard therapies. Accumulating evidence from ecological, observational, and randomized controlled trials suggests that vitamin D has beneficial effects on risk, survival, and mortality in pancreatic cancer, although controversies still exist. Recent advances in demonstrating the important functions of vitamin D/vitamin D receptor (VDR) signaling in the regulation of stromal reprogramming, the microbiome, and immune response and the emergence of checkpoint immunotherapy provide opportunities for using vitamin D or its analogues as an adjunct for pancreatic cancer intervention. Many challenges lie ahead before the benefits of vitamin D can be fully realized in pancreatic cancer. These challenges include the need for randomized controlled trials of vitamin D to assess its impact on the risk and survival of pancreatic cancer, optimizing the timing and dosage of vitamin D or its analogues as an adjunct for pancreatic cancer intervention and elucidating the specific role of vitamin D/VDR signaling in the different stages of pancreatic cancer. Nevertheless, vitamin D holds great promise for reducing risk and improving outcomes of this disease.
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16
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Ding F, Nie X, Li X, He Y, Li G. Data mining: Biological and temporal factors associated with blood parathyroid hormone, vitamin D, and calcium concentrations in the Southwestern Chinese population. Clin Biochem 2021; 90:50-57. [PMID: 33539806 DOI: 10.1016/j.clinbiochem.2021.01.014] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2020] [Revised: 01/19/2021] [Accepted: 01/24/2021] [Indexed: 02/08/2023]
Abstract
BACKGROUND Parathyroid hormone (PTH) and vitamin D plays a major role in calcium (Ca) homeostasis and bone turnover. The purpose of this study was to assess which factors (sex, age, time of blood sampling, season of the year, temperature and sunshine hours (SHH)) had the greatest impact on plasma PTH, 25-OH-VitD, and Ca levels, and then whether these effects were clinically acceptable in a large number of Southwestern Chinese subjects. METHOD The data was from West China Hospital Health Examination Center, Sichuan University from April 1, 2018 to June 30, 2019. A total of 18,664 physical examination subjects were included. PTH and 25-OH-VitD were measured by a Roche Cobas e 601, and Ca was measured by a Roche Cobas 8000. Linear regression models were used to assess correlations between PTH, 25-OH-VitD, Ca and the above factors. RESULTS The concentrations of serum PTH in females were significantly higher than those in males, while the 25-OH-VitD and Ca were opposite. The concentration of PTH in data collection decreased in summer and increased in spring. The concentration of 25-OH-VitD decreases in spring and increases in autumn. PTH concentrations were negatively correlated with last month temperature and SHH, while 25-OH-VitD were opposite. Linear regression showed that season may be the main factor affecting serum PTH and 25-OH-VitD levels, and these effects were not clinically acceptable. CONCLUSION In order to avoid influencing clinicians' investigation of suspected hyperparathyroidism and hypovitaminosis, reference intervals for PTH, 25-OH-VitD, and Ca should be established, taking into account sex, age and the season.
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Affiliation(s)
- Fei Ding
- Department of Laboratory Medicine, West China Hospital, Sichuan University, Chengdu 610041, China
| | - Xin Nie
- Department of Laboratory Medicine, West China Hospital, Sichuan University, Chengdu 610041, China
| | - Xiaoling Li
- Department of Laboratory Medicine, West China Hospital, Sichuan University, Chengdu 610041, China
| | - Yong He
- Department of Laboratory Medicine, West China Hospital, Sichuan University, Chengdu 610041, China.
| | - Guixing Li
- Department of Laboratory Medicine, West China Hospital, Sichuan University, Chengdu 610041, China.
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17
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Di Luigi L, Antinozzi C, Piantanida E, Sgrò P. Vitamin D, sport and health: a still unresolved clinical issue. J Endocrinol Invest 2020; 43:1689-1702. [PMID: 32632904 DOI: 10.1007/s40618-020-01347-w] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2020] [Accepted: 06/25/2020] [Indexed: 02/07/2023]
Abstract
Vitamin D metabolites have a pleiotropic role in human physiology, both in static and dynamic conditions, and a lot of vitamin D-related biological effects could influence physical and sport performances in athletes. Probably due to different factors (e.g., drugs, doping, nutrition, ultraviolet B radiation exposure), in athletes a very high prevalence of vitamin D inadequacy (i.e., deficiency or insufficiency) has been observed. Vitamin D inadequacy in athletes could be associated with specific health risks and to alterations of functional capacities, potentially influencing the fine adjustment of physical performances during training and sport competitions. When risk factors for vitamin D inadequacy exist, a preventive vitamin D supplementation is indicated, and if a vitamin D inadequacy is diagnosed, its supplementation is recommended. Unfortunately, on these issues many concerns remain unresolved. Indeed, it is not clear if athletes should be classified as a special population at increased risk for vitamin D inadequacy; moreover, in comparison to the non-athletic population, it is still not clear if athletes should have different reference ranges and different optimal target levels for serum vitamin D, if they have additional health risks, and if they need different type of supplementations (doses) for prevention and/or replacement therapy. Moreover, in athletes also the abuse of vitamin D supplements for ergogenic purposes raise different ethical and safety concerns. In this review, the main physio-pathological, functional and clinical issues that relate vitamin D to the world of athletes are described.
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Affiliation(s)
- L Di Luigi
- Unit of Endocrinology, Department of Movement, Human and Health Sciences, Università Degli Studi Di Roma "Foro Italico", Piazza Lauro de Bosis, 6, 00135, Rome, Italy.
| | - C Antinozzi
- Unit of Endocrinology, Department of Movement, Human and Health Sciences, Università Degli Studi Di Roma "Foro Italico", Piazza Lauro de Bosis, 6, 00135, Rome, Italy
| | - E Piantanida
- Department of Medicine and Surgery, University of Insubria, Via Ravasi 2, 21100, Varese, Italy
| | - P Sgrò
- Unit of Endocrinology, Department of Movement, Human and Health Sciences, Università Degli Studi Di Roma "Foro Italico", Piazza Lauro de Bosis, 6, 00135, Rome, Italy
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18
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Fan H, Hui L, Yan X, Hou W, Bai E, Wang L, Yu X. Serum 25 hydroxyvitamin D levels and affecting factors among preconception fertile women. BMC WOMENS HEALTH 2020; 20:146. [PMID: 32677935 PMCID: PMC7367390 DOI: 10.1186/s12905-020-01018-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/11/2019] [Accepted: 07/12/2020] [Indexed: 12/14/2022]
Abstract
Background Recent study found that vitamin D before conception was considered as a potential additional determinant for achieving pregnancy and live births. The study aimed to evaluate the serum 25 hydroxyvitamin D (25(OH)D) levels and its affecting factors among preconception fertile women. Methods This cross-sectional study enrolled 410 women aged 22–44 years who attended a preconception genetic counseling clinic from January 2018 to May 2019. Sociodemographic characteristics and reproductive history of women were collected, and height and weight were measured. Serum 25(OH)D concentration was assayed with chemiluminescence immunoassay. Descriptive statistics were used to examine serum 25(OH)D concentration, and socio-demographic characteristics and reproductive history among preconception women. Determinants of vitamin D deficiency and its affecting factors were assessed using χ2 test and logistic regression. Results Findings showed 84.4% of women had serum 25(OH)D concentration below 20 ng/mL. Women working indoors as well as without a history of childbirth had significantly lower 25(OH)D levels compared with those non-working individuals and having delivered a previous child (both P < 0.05). The 25(OH)D levels were the lowest in winter among that in spring, summer, and autumn (all P < 0.001). Women in winter have significantly elevated OR of 5.00 (95%CI 1.75–14.25) to develop vitamin D deficiency. Seasonal variation in serum 25(OH)D levels was not present in non-working individuals and women aged 31–44 years. Conclusions Vitamin D deficiency is common among preconception women especially nulliparous women and working women, which propose to screen serum 25(OH)D on preconception evaluation and emphasize need vitamin D supplements and get sunshine exposure.
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Affiliation(s)
- Haiyan Fan
- Department of Obstetrics & Gynecology, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710061, China.,Department of General Medicine in Xi'an Jiaotong University, Xi'an, 710061, China
| | - Lingyun Hui
- Laboratory Department, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710061, China
| | - Xiaoting Yan
- Department of Obstetrics & Gynecology, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710061, China
| | - Wei Hou
- Department of Maternal Health Care, Maternal and Child Health Hospital of Shaanxi Province, Xi'an, 710002, China
| | - E Bai
- Department of Obstetrics & Gynecology, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710061, China
| | - Li Wang
- Department of Obstetrics & Gynecology, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710061, China
| | - Xuewen Yu
- Department of Obstetrics & Gynecology, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710061, China.
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Shen M, Li Z, Lv D, Yang G, Wu R, Pan J, Wang S, Li Y, Xu S. Seasonal variation and correlation analysis of vitamin D and parathyroid hormone in Hangzhou, Southeast China. J Cell Mol Med 2020; 24:7370-7377. [PMID: 32415728 PMCID: PMC7339220 DOI: 10.1111/jcmm.15330] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2019] [Revised: 02/29/2020] [Accepted: 03/06/2020] [Indexed: 11/28/2022] Open
Abstract
This study aimed to describe the 25‐hydroxyvitamin D (25(OH)D) and parathyroid hormone (PTH) status of Southeast Chinese individuals influenced by season. The secondary aim was to determine the cutoff for sufficient 25(OH)D in a four‐season region. From January 2011 to June 2014, a total of 17 646 individuals were evaluated in our study. The serum levels of PTH were detected simultaneously in 5579 cases. A total of 25(OH)D and intact PTH were measured by the electrochemiluminescent immunoassay. The distribution of the concentration, prevalence and seasonal variability of 25(OH)D and PTH were studied. The mean 25(OH)D concentration in our study was 43.00(30.40) nmol/L. The prevalence of insufficiency (25(OH)D < 50 nmol/L) was 62.87% and that of deficiency (<30 nmol/L) was 28.54%. Mean serum 25(OH)D levels revealed a limited sinusoidal profile throughout the year and were significantly higher in Autumn. On the other hand, PTH levels showed an opposite response to seasonal effects relative to 25(OH)D. Age, BMI and daylight were not significantly correlated with 25(OH)D and serum PTH reached a plateau at higher values of serum 25(OH)D of 42.86 nmol/L. This study demonstrated that Vitamin D insufficiency is highly prevalent in Southeast China. The concentration of 25(OH)D in the male group was generally higher than that in the female group. Seasonal variation was an important aspect of 25(OH)D and PTH concentration. This study revealed that the optimal serum threshold of 25(OH)D for bone health should be between 40 and 50 nmol/L for Southeast Chinese individuals.
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Affiliation(s)
- Miaoda Shen
- Department of Orthopedics, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
| | - Zhuoyang Li
- Department of Orthopedics, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
| | - Duo Lv
- Research Center of Clinical Pharmacy, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
| | - Ge Yang
- Department of Orthopedics, Hunan Children's Hospital, Changsha, China
| | - Ronghuan Wu
- Department of Orthopedics, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
| | - Jun Pan
- Department of Orthopedics, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
| | - Shuo Wang
- Department of Orthopedics, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
| | - Yifan Li
- Department of Orthopedics, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
| | - Sanzhong Xu
- Department of Orthopedics, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
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20
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Vitamin D's Effect on Immune Function. Nutrients 2020; 12:nu12051248. [PMID: 32353972 PMCID: PMC7281985 DOI: 10.3390/nu12051248] [Citation(s) in RCA: 193] [Impact Index Per Article: 48.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2020] [Revised: 04/24/2020] [Accepted: 04/26/2020] [Indexed: 02/06/2023] Open
Abstract
Ever since its discovery by Windhaus, the importance of the active metabolite of vitamin D (1,25-dihydroxyvitamin D3; 1,25-(OH)2D3) has been ever expanding. In this review, the attention is shifted towards the importance of the extra-skeletal effects of vitamin D, with special emphasis on the immune system. The first hint of the significant role of vitamin D on the immune system was made by the discovery of the presence of the vitamin D receptor on almost all cells of the immune system. In vitro, the overwhelming effect of supra-physiological doses of vitamin D on the individual components of the immune system is very clear. Despite these promising pre-clinical results, the translation of the in vitro observations to solid clinical effects has mostly failed. Nevertheless, the evidence of a link between vitamin D deficiency and adverse outcomes is overwhelming and clearly points towards avoidance of vitamin D deficiency especially in early life.
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The association of vitamin D with hepatitis B virus replication: Bystander rather than offender. J Formos Med Assoc 2020; 119:1634-1641. [PMID: 31932201 DOI: 10.1016/j.jfma.2019.12.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2019] [Revised: 11/10/2019] [Accepted: 12/16/2019] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND/PURPOSE Low vitamin D is frequent in hepatitis B virus (HBV)-infected patients and several studies show an inverse association of serum vitamin D level with HBV viral load. However, the causal relationship remains unclear. METHODS HBV carriers receiving regular 6-month surveillance without current antiviral treatment or cirrhosis were invited to participate into this trial. The markers of HBV replication included serum HBV DNA and quantitative HBsAg (qHBsAg) levels. Those with undetectable HBV DNA or sufficient vitamin D levels, cancer or electrolyte imbalance were excluded. The eligible subjects were randomized to receive either vitamin D supplement 2000 IU per day for 2 months (vitamin D group) or none (control group). RESULTS A total of 196 HBV carriers (93 males and 103 females; mean age 51.9 ± 10.0 years) were screened. Of them, 28 patients had undetectable serum HBV DNA levels, which is defined as spontaneous viral clearance. The vitamin D levels were not different between patients with detectable HBV DNA and those without (p = 0.18). After exclusion, 149 patients were randomized to two groups: 75 in vitamin D group and 74 in control group. After 2 months vitamin D supplement, the serum vitamin D levels were significantly higher in the vitamin D group than the control group (p < 0.001). However, the serum qHBsAg and HBV DNA levels were comparable between these two groups. CONCLUSION There is no causal relationship between vitamin D and HBV replication. The role of liver reserve on serum vitamin D levels in patients with chronic HBV infection needs further investigation.
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Censi S, Iacobone M, Simmini S, Manso J, Franceschet G, Plebani M, Frigo AC, Zaninotto M, Torresan F, De Silvestro G, Scaroni C, Mian C, Camozzi V. PTH: Redefining Reference Ranges in a Healthy Population-The Role of Interfering Factors and the Type of Laboratory Assay. Int J Endocrinol 2020; 2020:1053719. [PMID: 32148482 PMCID: PMC7054804 DOI: 10.1155/2020/1053719] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2019] [Accepted: 01/23/2020] [Indexed: 01/22/2023] Open
Abstract
UNLABELLED Introduction. Parathyroid hormone (PTH) is a linear peptide constituted by 84 amino acids and active in its 1-84 form, but a wide range of PTH forms produced by its post-transcriptional modifications are present in blood. Many assays with different specificities are commercially available. The aim of our study was to compare a 2nd and 3rd generation in healthy population in order to better define the reference range in the healthy population residing in our region. Materials and Methods. 108 subjects (53 females and 55 males) referring to the transfusion donor were enrolled in the study centre in April 2016 and underwent PTH levels measurements with a 3rd generation kit (chemiluminescent immunoassay DiaSorin Liaison) and with a 2nd generation kit (immunoradiometric assay Total Intact PTH Assay (Coated Tube), Scantibodies). Also calcium, phosphate, creatinine, and 25OHD3 were measured. A questionnaire on lifestyle and dietary habits was obtained. RESULTS The median PTH values obtained with the 2nd generation assay and the whole 3rd generation assay were 20.26 pg/ml and 23.11 pg/ml, respectively. Bland-Altman method showed substantial concordance between the two PTH assays, although with an overestimation of the 3rd generation method over the 2nd generation method. There was no correlation between 3rd generation PTH and 25OHD3 and creatinine. Calcium was negatively correlated with PTH only when measured with 3rd generation kit. CONCLUSIONS On the basis of our data, obtained from healthy subjects, we can conclude that the reference range used by our laboratory was too narrow and was necessary to reestablish normal ranges according to our population. This is useful to avoid hyperparathyroidism misdiagnosis.
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Affiliation(s)
- Simona Censi
- Endocrinology Unit, Department of Medicine (DIMED), University of Padua, Padua, Italy
| | - Maurizio Iacobone
- Endocrine Surgery Unit, Department of Surgery, Oncology and Gastroenterology (DiSCOG), University of Padua, Padua, Italy
| | - Stefano Simmini
- Endocrinology Unit, Department of Medicine (DIMED), University of Padua, Padua, Italy
| | - Jacopo Manso
- Endocrinology Unit, Department of Medicine (DIMED), University of Padua, Padua, Italy
| | - Giulio Franceschet
- Endocrinology Unit, Department of Medicine (DIMED), University of Padua, Padua, Italy
| | - Mario Plebani
- Laboratory Medicine, Department of Medicine (DIMED), University of Padua, Padua, Italy
| | - Anna Chiara Frigo
- Department of Cardiac, Thoracic and Vascular Sciences, Biostatistics, Epidemiology and Public Health Unit, University of Padua, Padua, Italy
| | - Martina Zaninotto
- Laboratory Medicine, Department of Medicine (DIMED), University of Padua, Padua, Italy
| | - Francesca Torresan
- Endocrine Surgery Unit, Department of Surgery, Oncology and Gastroenterology (DiSCOG), University of Padua, Padua, Italy
| | | | - Carla Scaroni
- Endocrinology Unit, Department of Medicine (DIMED), University of Padua, Padua, Italy
| | - Caterina Mian
- Endocrinology Unit, Department of Medicine (DIMED), University of Padua, Padua, Italy
| | - Valentina Camozzi
- Endocrinology Unit, Department of Medicine (DIMED), University of Padua, Padua, Italy
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Gannagé-Yared MH, Kallas-Chémaly MN, Sleilaty G. Parathormone Levels in a Middle-Eastern Healthy Population Using 2 nd and 3 rd Generation PTH Assays. Int J Endocrinol 2020; 2020:6302861. [PMID: 32148490 PMCID: PMC7054794 DOI: 10.1155/2020/6302861] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2019] [Revised: 12/15/2019] [Accepted: 01/23/2020] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND The purpose of the current study is to determine PTH reference values in vitamin-D-replete Lebanese adults using 2nd and 3rd generation PTH assays and to look at the factors that affect PTH variations. METHODS Fasting PTH was measured using 2nd and 3rd generation Diasorin PTH assays in 339 vitamin-D-replete healthy subjects aged 18 to 63 years (230 men and 109 women) who have normal calcium levels and an eGFR ≥60 ml/mn. 25-OH vitamin D (25(OH)D) was measured using the Diasorin assay. RESULTS For the 2nd PTH generation, median (IQR) levels were 48.9 (34.9-66.0) pg/ml, and its 2.5th-97.5th percentile values were 19.7-110.5 pg/ml for 25(OH)D values between 20 and 30 ng/ml, and 19.7-110.7 pg/ml for 25(OH)D values ≥30 ng/ml. For the 3rd PTH generation, the median (IQR) values were 23.9 (17.7-30.5) pg/ml, and its 2.5th-97.5th percentile values were, respectively, 9.2 and 50.2 pg/ml for 25(OH)D values between 20 and 30 ng/ml, and 8.4 and 45.4 pg/ml for 25(OH)D values ≥30 ng/ml. The median (IQR) serum 25(OH)D levels were 27.5 (23.8-32.7) ng/ml. 2nd and 3rd generation PTH values are strongly correlated (r = 0.96, p < 0.0001), but poorly concordant (Lin's concordance coefficient 0.365, 95% CI: 0.328-0.401) with observations beyond the 95% Bland-Altman limits of agreement. 2nd and 3rd generation PTH levels did not differ according to gender and were significantly correlated with age but not with 25(OH)D and serum calcium levels. CONCLUSION Lebanese adult healthy subjects have higher 2nd and 3rd generation PTH levels compared with the reference range provided by the manufacturer. The reference range was not influenced by changing the 25(OH)D cutoff. The clinical significance of the higher PTH levels in our population should be investigated.
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Affiliation(s)
| | | | - Ghassan Sleilaty
- Department of Biostatistics, Faculty of Medicine, Saint-Joseph University, Beirut, Lebanon
- Clinical Research Center, Faculty of Medicine, Saint-Joseph University, Beirut, Lebanon
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Vitamin D Levels of Outpatients Admitted to a University Hospital in the Marmara Region of Turkey Over 3 Years. J Med Biochem 2019; 38:181-187. [PMID: 30867646 PMCID: PMC6410998 DOI: 10.2478/jomb-2018-0027] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2018] [Accepted: 06/16/2018] [Indexed: 12/30/2022] Open
Abstract
Background Vitamin D regulates calcium and phosphorus metabolism, and it is essential for bone formation. Several factors can affect vitamin D levels in plasma. In present study we compare vitamin D levels of outpatients, who admit to Maltepe University Hospital between 2011 and 2013 and had vitamin D measurements regarding gender, age, and season. Methods Hospital records were evaluated to identify the outpatients with vitamin D levels and their gender, age, and vitamin D levels and the seasons of measurements were recorded. Results Data of 4860 subjects (74% female) were analyzed and 69.2% were between 18-64 years old. Vitamin D levels were as follows: 43.1% ≤ 10 ng/mL, 31.9% between 10 ng/mL and 20 ng/mL, 16.1% between 20 ng/mL and 30 ng/mL, and only 8.9% ≥ 30 ng/mL. The number of females with vitamin D levels < 10 ng/mL was significantly higher than that of males, while the number of males with vitamin D levels between 10 ng/mL and 20 ng/mL was significantly higher than that of females (P = 0.001) for each of the individuals, 6.2% and 11.1% had sufficient levels in winter and summer, respectively. Overall, it was observed that 6.6% of individuals between 18-44 years old, 8.2% of individuals between 45-64 years old and 10.3% of individuals over 65 years old had vitamin D levels > 30 ng/mL. Conclusions The prevalence of vitamin D deficiency in outpatients of Maltepe University Hospital in Marmara region was 75% (< 20 ng/mL).
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25
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Farhat KH, Arafa MA, Rabah DM, Amin HS, Ibrahim NK. Vitamin D status and its correlates in Saudi male population. BMC Public Health 2019; 19:211. [PMID: 30786876 PMCID: PMC6381691 DOI: 10.1186/s12889-019-6527-5] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2018] [Accepted: 02/11/2019] [Indexed: 11/20/2022] Open
Abstract
Background Vitamin-D deficiency is a universal health problem caused primarily by inadequate exposure to sunlight. This study aimed to assess the vitamin D status and investigate the factors affecting vitamin D distribution among Saudi males. Methods A cross-sectional study was conducted at the King Saud University Medical City from December 2015 to August 2016. Saudi males attending the outpatient primary health care clinics were invited to participate in the study. Data were collected on the current and past health status along with biochemical investigations for total 25-hydroxyvitamin D (25OHD), blood sugar, and cholesterol. Results Majority of the participants (76.1%) had vitamin D deficiency. Blood sugar level, age, and cholesterol level were the most significant factors associated with vitamin D status. The highest percentage of deficiency was observed in the youngest age group (30-40 years). With increasing age, the percentage of deficiency decreased significantly. Those with normal blood sugar and cholesterol level had higher serum vitamin D levels compared to those with diabetes and hypercholesterolemia. Conclusions Vitamin D deficiency is still endemic in Saudi Arabia, particularly among younger males and those with diabetes and hypercholesterolemia. Vitamin D screening, supplementations, and vitamin D-fortified foods should be provided especially for these groups. Electronic supplementary material The online version of this article (10.1186/s12889-019-6527-5) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Karim H Farhat
- Cancer Research Chair, College of Medicine, King Saud University, P.O.Box: 76047, Riyadh, 11922, Saudi Arabia. .,Laboratory of Molecular Immuno-Oncology, Faculty of Medicine of Monastir, Monastir, Tunisia.
| | - Mostafa A Arafa
- Cancer Research Chair, College of Medicine, King Saud University, P.O.Box: 76047, Riyadh, 11922, Saudi Arabia.,Family and Community Medicine Department College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Danny M Rabah
- Cancer Research Chair, College of Medicine, King Saud University, P.O.Box: 76047, Riyadh, 11922, Saudi Arabia.,Surgery Department, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Hussein S Amin
- Family and Community Medicine Department College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Nahla K Ibrahim
- Community Medicine Department, King Abdulaziz University, Jeddah, Saudi Arabia.,Epidemiology Department High Institute of Public health, Alexandria University, Alexandria, Egypt
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Abstract
OBJECTIVE To assess vitamin D, parathyroid hormone, calcitonin, calcium, phosphorus and magnesium levels in patients with versus without temporomandibular disorders (TMDs). METHODS This prospective observational study included patients with TMDs and age-matched healthy controls. TMDs were diagnosed via physical and radiologic examination, and serum levels of 25 (OH) vitamin D, parathyroid hormone, calcitonin, calcium, magnesium, and phosphorus were determined. The impact of age, sex and seasonal variations in serum 25 (OH) vitamin D levels was controlled by the inclusion of age, sex and date-matched control patients. RESULTS The study included 100 patients, comprising 50 patients with TMDs and 50 control patients. No statistically significant between-group differences were found regarding age or sex. No statistically significant between-group differences were found in terms of serum 25 (OH) vitamin D, calcitonin, calcium, magnesium or phosphorus levels. Parathyroid hormone levels were statistically significantly higher in patients with TMDs versus healthy control patients. CONCLUSION In patients with temporomandibular disorders, increased parathyroid hormone levels in response to vitamin D deficiency was significantly more prominent. These data suggest that, in patients with temporomandibular disorders, vitamin D deficiency should be assessed and corrected.
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Affiliation(s)
- Canser Yilmaz Demir
- Faculty of Medicine, Department of Plastic, Reconstructive and Aesthetic Surgery, Yuzuncu Yil University, Van, Turkey
| | - Muhammet Eren Ersoz
- Faculty of Medicine, Department of Plastic, Reconstructive and Aesthetic Surgery, Yuzuncu Yil University, Van, Turkey
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Cesareo R, Attanasio R, Caputo M, Castello R, Chiodini I, Falchetti A, Guglielmi R, Papini E, Santonati A, Scillitani A, Toscano V, Triggiani V, Vescini F, Zini M. Italian Association of Clinical Endocrinologists (AME) and Italian Chapter of the American Association of Clinical Endocrinologists (AACE) Position Statement: Clinical Management of Vitamin D Deficiency in Adults. Nutrients 2018; 10:nu10050546. [PMID: 29702603 PMCID: PMC5986426 DOI: 10.3390/nu10050546] [Citation(s) in RCA: 88] [Impact Index Per Article: 14.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2018] [Revised: 04/09/2018] [Accepted: 04/23/2018] [Indexed: 01/08/2023] Open
Abstract
Vitamin D deficiency is very common and prescriptions of both assay and supplementation are increasing more and more. Health expenditure is exponentially increasing, thus it is timely and appropriate to establish rules. The Italian Association of Clinical Endocrinologists appointed a task force to review literature about vitamin D deficiency in adults. Four topics were identified as worthy for the practicing clinicians. For each topic recommendations based on scientific evidence and clinical practice were issued according to the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) System. (1) What cut-off defines vitamin D deficiency: even though 20 ng/mL (50 nmol/L) can be considered appropriate in the general population, we recommend to maintain levels above 30 ng/mL (75 nmol/L) in categories at risk. (2) Whom, when, and how to perform screening for vitamin D deficiency: categories at risk (patients with bone, liver, kidney diseases, obesity, malabsorption, during pregnancy and lactation, some elderly) but not healthy people should be screened by the 25-hydroxy-vitamin D assay. (3) Whom and how to treat vitamin D deficiency: beyond healthy lifestyle (mostly sun exposure), we recommend oral vitamin D (vitamin D2 or vitamin D3) supplementation in patients treated with bone active drugs and in those with demonstrated deficiency. Dosages, molecules and modalities of administration can be profitably individually tailored. (4) How to monitor the efficacy of treatment with vitamin D: no routine monitoring is suggested during vitamin D treatment due to its large therapeutic index. In particular conditions, 25-hydroxy-vitamin D can be assayed after at least a 6-month treatment. We are confident that this document will help practicing clinicians in their daily clinical practice.
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Affiliation(s)
- Roberto Cesareo
- Department of Internal Medicine, "S. M. Goretti" Hospital, 04100 Latina, Italy.
| | - Roberto Attanasio
- Endocrinology Service, Galeazzi Institute IRCCS, 20161 Milan, Italy.
| | - Marco Caputo
- Ospedale Classificato Villa Salus, 30174 Venezia Mestre, Italy.
| | - Roberto Castello
- General Medicine and Endocrinology, University Hospital, 37126 Verona, Italy.
| | - Iacopo Chiodini
- Unit for Bone Metabolism Diseases and Diabetes & Lab of Endocrine and Metabolic Research, IRCCS Istituto Auxologico Italiano, 20149 Milan, Italy.
- Department of Clinical Sciences and Community Health, University of Milan, 20149 Milan, Italy.
| | - Alberto Falchetti
- Centro Hercolani and Villa Alba (GVM), 40123 Bologna and EndOsMet, Villa Donatello Private Hospital, 50132 Florence, Italy.
| | - Rinaldo Guglielmi
- Department of Endocrinology and Metabolic Diseases, Regina Apostolorum Hospital, Albano Laziale, 00041 Rome, Italy.
| | - Enrico Papini
- Department of Endocrinology and Metabolic Diseases, Regina Apostolorum Hospital, Albano Laziale, 00041 Rome, Italy.
| | - Assunta Santonati
- Department of Endocrinology, San Giovanni Addolorata Hospital, 00184 Rome, Italy.
| | - Alfredo Scillitani
- Endocrinology Unit, Department of Medical Science, Ospedale Casa Sollievo della Sofferenza IRCCS, 71013 San Giovanni Rotondo (FG), Italy.
| | - Vincenzo Toscano
- Endocrinology, Department of Clinical and Molecular Medicine, Sant'Andrea Hospital, Sapienza University of Rome, 00189 Roma, Italy.
| | - Vincenzo Triggiani
- Interdisciplinary Department of Medicine, Endocrinology and Metabolic Diseases, University of Bari "Aldo Moro", 70124 Bari, Italy.
| | - Fabio Vescini
- Department of Endocrinology and Diabetes, Santa Maria della Misericordia Hospital, 33010 Udine, Italy.
| | - Michele Zini
- Endocrinology Unit, Arcispedale S. Maria Nuova IRCCS, 42123 Reggio Emilia, Italy.
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Matana A, Brdar D, Torlak V, Boutin T, Popović M, Gunjača I, Kolčić I, Boraska Perica V, Punda A, Polašek O, Barbalić M, Hayward C, Zemunik T. Genome-wide meta-analysis identifies novel loci associated with parathyroid hormone level. Mol Med 2018; 24:15. [PMID: 30134803 PMCID: PMC6016867 DOI: 10.1186/s10020-018-0018-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2018] [Accepted: 04/02/2018] [Indexed: 02/08/2023] Open
Abstract
Background Parathyroid hormone (PTH) is one of the principal regulators of calcium homeostasis. Although serum PTH level is mostly accounted by genetic factors, genetic background underlying PTH level is insufficiently known. Therefore, the aim of this study was to identify novel genetic variants associated with PTH levels. Methods We performed GWAS meta-analysis within two genetically isolated Croatian populations followed by replication analysis in a Croatian mainland population and we also combined results across all three analyzed populations. The analyses included 2596 individuals. A total of 7,411,206 variants, imputed using the 1000 Genomes reference panel, were analysed for the association. In addition, a sex-specific GWAS meta-analyses were performed. Results Polymorphisms with the lowest P-values were located on chromosome 4 approximately 84 kb of the 5′ of RASGEF1B gene. The most significant SNP was rs11099476 (P = 1.15 × 10−8). Sex-specific analysis identified genome-wide significant association of the variant rs77178854, located within DPP10 gene in females only (P = 2.21 × 10− 9). There were no genome-wide significant findings in the meta-analysis of males. Conclusions We identified two biologically plausible novel loci associated with PTH levels, providing us with further insights into the genetics of this complex trait. Electronic supplementary material The online version of this article (10.1186/s10020-018-0018-5) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Antonela Matana
- Department of Medical Biology, University of Split, School of Medicine, Šoltanska 2, Split, Croatia
| | - Dubravka Brdar
- Department of Nuclear Medicine, University Hospital Split, Spinciceva 1, Split, Croatia
| | - Vesela Torlak
- Department of Nuclear Medicine, University Hospital Split, Spinciceva 1, Split, Croatia
| | - Thibaud Boutin
- MRC Human Genetics Unit, University of Edinburgh, Western General Hospital, Crewe Road, Edinburgh, UK
| | - Marijana Popović
- Department of Medical Biology, University of Split, School of Medicine, Šoltanska 2, Split, Croatia
| | - Ivana Gunjača
- Department of Medical Biology, University of Split, School of Medicine, Šoltanska 2, Split, Croatia
| | - Ivana Kolčić
- Department of Public Health, University of Split, School of Medicine Split, Šoltanska 2, Split, Croatia
| | - Vesna Boraska Perica
- Department of Medical Biology, University of Split, School of Medicine, Šoltanska 2, Split, Croatia
| | - Ante Punda
- Department of Nuclear Medicine, University Hospital Split, Spinciceva 1, Split, Croatia
| | - Ozren Polašek
- Department of Public Health, University of Split, School of Medicine Split, Šoltanska 2, Split, Croatia
| | - Maja Barbalić
- Department of Medical Biology, University of Split, School of Medicine, Šoltanska 2, Split, Croatia
| | - Caroline Hayward
- MRC Human Genetics Unit, University of Edinburgh, Western General Hospital, Crewe Road, Edinburgh, UK
| | - Tatijana Zemunik
- Department of Medical Biology, University of Split, School of Medicine, Šoltanska 2, Split, Croatia.
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Sahin ON, Serdar M, Serteser M, Unsal I, Ozpinar A. Vitamin D levels and parathyroid hormone variations of children living in a subtropical climate: a data mining study. Ital J Pediatr 2018; 44:40. [PMID: 29562938 PMCID: PMC5863369 DOI: 10.1186/s13052-018-0479-8] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2018] [Accepted: 03/12/2018] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Vitamin D and intact parathyroid hormone (iPTH) play a crucial role in calcium homeostasis and bone health of children. Serum level of 25-hydroxyvitamin D (25-OHD) is considered to be the most accurate marker for vitamin D status. However, there have only been a few studies, with limited number of subjects, investigating the relationship between 25-OHD and parathyroid hormone (PTH) in children. The aim of this study was to evaluate the seasonal 25-OHD levels and its associations with intact parathyroid hormone (iPTH) in Turkish children at all pediatric ages; and then to define a critical decision threshold level for 25-OHD deficiency in Turkish children. METHODS A retrospective record review of 90,042 children, was performed on serum 25-OHD and for 3525 iPTH levels. They were measured by mass spectrometry method and by electrochemiluminescence immunoassay simultaneously. RESULTS 25-OHD levels showed a sinusoidal fluctuation througout the year; being significantly higher in summer and autumn (p < 0,01). 25-OHD levels decreased with respect to age. The significant inverse relationship that was found between iPTH and 25-OHD suggests that the inflection point of serum 25-OHD level for maximal suppression of PTH is at 30 ng/ml. CONCLUSION As the rate of vitamin D deficiency decreases in the early years due to vitamin D supplementation, the recommendation should be set due to a clinical threshold level of 30 ng/ml for 25-OHD based on PTH levels in children of our population.
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Affiliation(s)
- Ozlem Naciye Sahin
- Department of Pediatrics, Acibadem Mehmet Ali Aydinlar University, School of Medicine, Icerenkoy mah. Kayısdagı cad. No.32, 34752 Istanbul, Atasehir Turkey
| | - Muhittin Serdar
- Department of Clinical Biochemistry, Acibadem Mehmet Ali Aydinlar University, School of Medicine, Istanbul, Turkey
| | - Mustafa Serteser
- Department of Clinical Biochemistry, Acibadem Mehmet Ali Aydinlar University, School of Medicine, Istanbul, Turkey
| | - Ibrahim Unsal
- Department of Clinical Biochemistry, Acibadem Mehmet Ali Aydinlar University, School of Medicine, Istanbul, Turkey
| | - Aysel Ozpinar
- Department of Clinical Biochemistry, Acibadem Mehmet Ali Aydinlar University, School of Medicine, Istanbul, Turkey
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30
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Wang Q, Zhu Z, Liu Y, Tu X, He J. Relationship between serum vitamin D levels and inflammatory markers in acute stroke patients. Brain Behav 2018; 8:e00885. [PMID: 29484258 PMCID: PMC5822590 DOI: 10.1002/brb3.885] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2017] [Revised: 10/13/2017] [Accepted: 11/01/2017] [Indexed: 02/06/2023] Open
Abstract
Introduction Low serum vitamin D levels are associated with the development of poststroke depression (PSD). Inflammatory markers play an important role in pathophysiology of PSD. The relationship between vitamin D levels and inflammatory markers has been discussed in nonstroke individuals. The purposes of this study were to explore the relationship between vitamin D levels and inflammatory markers in acute stroke patients and examine the effect of vitamin D and inflammatory markers on PSD. Methods A total of 152 acute stroke patients were recruited. Serum levels of 25-hydroxyvitamin D and inflammatory markers were measured by standardized laboratory methods. Depression symptoms were assessed with the 17-item Hamilton Depression Scale (HAMD-17). Patients with the HAMD-17 scores ≥7 were identified to have depression symptoms. Results Serum vitamin D levels were negatively correlated with serum levels of interleukin-6 and high-sensitivity C-reactive protein (hsCRP) (r = -.244, p = .002; r = -.231, p = .004). Multiple regression analysis showed that interleukin-6 and hsCRP levels were associated with vitamin D levels (B = -0.355, p = .003; B = -2.085, p = .006), whereas age, height, weight, leukocyte count, neutrophil ratio, and lymphocyte rate could be omitted without changing the results. In multivariate analyses, the serum levels of vitamin D and interleukin-6 were associated with the development of PSD after adjusted possible variables (OR = 0.976, 95% CI: 0.958-0.994, p = .009; OR = 1.029, 95% CI: 1.003-1.055, p = .027). Conclusions Serum vitamin D levels are inversely associated with the levels of interleukin-6 and hsCRP, suggesting a potential anti-inflammatory role for vitamin D in stroke individuals.
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Affiliation(s)
- Qiongzhang Wang
- Department of NeurologyThe First Affiliated Hospital of Wenzhou Medical UniversityWenzhouZhejiang ProvinceChina
| | - Zhuoying Zhu
- Department of NeurologyThe First Affiliated Hospital of Wenzhou Medical UniversityWenzhouZhejiang ProvinceChina
| | - Yuntao Liu
- Department of NeurologyThe First Affiliated Hospital of Wenzhou Medical UniversityWenzhouZhejiang ProvinceChina
| | - Xinjie Tu
- Department of NeurologyThe First Affiliated Hospital of Wenzhou Medical UniversityWenzhouZhejiang ProvinceChina
| | - Jincai He
- Department of NeurologyThe First Affiliated Hospital of Wenzhou Medical UniversityWenzhouZhejiang ProvinceChina
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Seasonal Variation in Vitamin D in Association with Age, Inflammatory Cytokines, Anthropometric Parameters, and Lifestyle Factors in Older Adults. Mediators Inflamm 2017; 2017:5719461. [PMID: 29104377 PMCID: PMC5618765 DOI: 10.1155/2017/5719461] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2017] [Accepted: 08/09/2017] [Indexed: 02/07/2023] Open
Abstract
Vitamin D deficiency is present even in sunny regions. Ageing decreases pre-vitamin D production in the skin and is associated with altered cytokine profile. We performed a multivariate analysis considering lifestyle factors, anthropometric, and inflammatory markers according to seasonal variation in Mexican healthy older adults. The same cohort was followed during 12 months. Vitamin D deficiency/insufficiency was found in 91.3% of the subjects despite living in appropriate latitude (25°40′0″N). 25(OH)D levels remained below <30 ng/mL through all seasons. Vitamin D deficiency did not correlate to sun exposure or dietary intake. Gender was the strongest associated factor, explaining a variance of 20%. Waist circumference (WC) greater than 88 cm was a risk factor for vitamin D deficiency. Age (>74 years) combined with WC (>88 cm) and BMI (>32.7) showed a high probability (90%) of vitamin D deficiency. Remarkably, an increase in one centimeter in WC decreased 25(OH)D by 0.176 ng/mL, while an increase in one point BMI decreased 25(OH)D by 0.534 ng/mL. A cutoff point of 74 years of age determined probability of vitamin D hipovitaminosis. Vitamin D deficiency was correlated with TNF-α serum levels, possibly increasing the susceptibility of older adults to a proinflammatory state and its related diseases.
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