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In our study, the toxic effects of cigarette smoke exposure on central nervous system and the protective role of Omega 3 and Vitamin D against these toxic effects were investigated at biochemical and histological level.

In view of research suggesting a possible beneficial impact of vitamin D on systemic inflammatory response, the authors decided to investigate an influence of vitamin D supplementation on serum levels of certain inflammatory markers in obese patients. The current study included such biomarkers as interleukin-6 (IL-6), pituitary adenylate cyclase-activating peptide (PACAP), advanced oxidation protein products (AOPP), C-X3-C Motif Chemokine Ligand 1 (CX3CL1), monocyte chemoattractant protein-1 (MCP-1), and nitric oxide (NO). The measurements were performed with the ELISA method before and after 3-month-long supplementation of 2000 IU of vitamin D orally. The results showed that the therapy did not induce any statistically significant changes in serum levels of MCP-1, IL-6, CX3CL1, and PACAP. The supplementation was related to a significant increase in measurements of NO and AOPP levels, although the correlation analysis between vitamin D concentration after its supplementation and the concentration of the molecular parameters did not show significant relation. In conclusion, our study seems to contradict certain aspects of findings available in the literature regarding the vitamin D’s impact.

Background: vitamin D has an important influence on the host’s immune system by modulating both innate and adaptive immunity and regulating the inflammatory cascade. Vitamin D deficiency may be related with reduced immunomodulation, specifically in preventing the occurrence of chronic tonsillitis. Objective: to identify the association between vitamin D deficiency with chronic tonsillitis in pediatric patients. Methods: the search was conducted with advanced searching on PubMed® and Cochrane® according to the clinical question. The screening of title and abstract using inclusion and exclusion criteria, double filter, and reading full text led to six useful articles. The selected studies were critically appraised for validity, importance, and applicability. Results: three original articles were eligible for this evidence-based case report. All studies were considered to have good validity. All three studies reported an increased risk of chronic tonsillitis with the vitamin D deficiency and/or insufficiency. Conclusion: Vitamin D deficiency may be associated with the increased risk of chronic or recurrent tonsillitis in children.

Introduction. Dengue fever is a vector-borne disease associated with a significant public health impact. The clinical picture ranges from undifferentiated fever to more severe forms such as dengue hemorrhagic fever (DHF) and dengue shock syndrome (DSS). Compared to healthy controls, we explored the likelihood of having vitamin D deficiency (VDD) among children with severe dengue infection. Methods. This case-control study compared hospitalized children (2 months to 12 years) with DHF and DSS with radiologically confirmed plasma leak with age-matched healthy controls. The association of 25-hydroxy vitamin D [25(OH)D] level, age, sex, and socioeconomic status with DHF/DSS was assessed using univariate and multivariate logistic regression. Results. Forty children with DHF/DSS were compared with 52 healthy controls. Mean (SD) age was 8.8 (2.9) years and 7.9 (3.7) years among cases and controls, respectively. Most (n = 28, 70%) had DHF. In multivariate logistic regression, the likelihood of having VDD [25(OH)D p = 0.006 ). When serum 25(OH)D was used as a continuous independent variable, the strength of the association between DHF/DSS and serum 25(OH)D was weak but statistically significant; the likelihood of having DHF/DSS is 0.94 times less with 1 ng/mL increase in serum 25(OH)D (OR: 0.940, 95% CI: 0.887, 0.995, p = 0.03 ). Conclusion. The present study suggests that the likelihood of having VDD among children with DHF/DSS is higher than that in their healthy counterparts. Thus, further studies are critical in confirming whether vitamin D repletion is beneficial in preventing severe forms of dengue in the quest to reduce the morbidity and mortality associated with dengue infection.

Background Markers of bone metabolism (MBM) play an important role in fracture evaluation, and changes have been associated with increased fracture risk. The purpose of the present study was to describe changes in MBM in premenopausal women with distal radial fractures. Methods Premenopausal women with distal radial fractures (n = 34) and without fractures (controls) (n = 39) were recruited. Serum MBM in patients with distal radial fractures were obtained at the time of the initial presentation, 6 weeks, and 3, 6, and 12 months. MBM included 25(OH) vitamin D, PTH, osteocalcin, P1NP, BSAP, CTX, sclerostin, DKK1, periostin, and TRAP5b. Areal bone mineral density (aBMD) was assessed with dual x-ray absorptiometry, and the bone material strength index (BMSi) was assessed with microindentation. Results Most MBM reached peak levels at 6 weeks after the injury, including osteocalcin (+17.7%), sclerostin (+23.5%), and DKK1 (12.6%). Sclerostin was lower (-27.4%) and DKK1 was higher (+22.2%) at 1 year after the fracture. CTX declined below baseline levels at 6 and 12 months, whereas TRAP5b, BSAP, and periostin did not significantly change. At 12 months, sclerostin was lower (p = 0.003) and DKK1 was higher (p = 0.03) in the distal radial fracture group than in the control group. Greater fracture severity was associated with greater increases in P1NP and BSAP. aBMD and BMSi were not associated with fracture. Conclusions Distal radial fractures caused increases in several MBM, which typically peaked at 6 weeks after injury and gradually decreased over 6 months. Sclerostin and DKK1 remained below and above baseline at 1 year, respectively. Increasing fracture severity resulted in larger changes in MBM. aBMD and BMSi did not discriminate between patients with distal radial fractures and controls. Continued efforts to identify markers of skeletal fragility in young women are warranted to mitigate future fracture risk. Level of evidence Prognostic Level II. See Instructions for Authors for a complete description of levels of evidence.

MicroRNAs (miRNAs) are important epigenetic regulators in head and neck squamous cell carcinoma (HNSCC), with miR-31 being considered an oncomir and miR-375, a tumor suppressor miR, which are up- and down-regulated in HNSCC, respectively. Nutrients are known to influence miRNA expression; however, this association is poorly explored in HNSCC. This work aimed to identify associations between dietary intake and the expression of miR-31 and miR-375 in patients newly diagnosed with HNSCC. The expression of miR-31 was positively associated with the consumption of iron (β = 16.65) and vitamin C (β = 0.37), and inversely associated with total sugar (β = -0.88), cholesterol (β= -0.23), vitamin B9 (β= -0.37) and zinc (β = -5.66) intake. The expression of miR-375 was positively associated with the consumption of selenium (β = 1.52), vitamin C (β = 0.17) and vitamin D (β = 13.01), and inversely associated with the consumption of added sugar (β = -0.49), phosphorus (β= -0.27) and vitamin B12 (β = -10.80). Our findings showed important associations between dietary intake and miR-31 and miR-375 expression in HNSCC, offering possible directions for further studies investigating how nutrients interfere with carcinogenesis.Supplemental data for this article is available online at https://doi.org/10.1080/01635581.2021.1990972 .

Using a matched case control design conducted at MRC Gambia in 2015, we measured vitamin D levels in pairs of asymptomatic children with discordant tuberculin skin test status despite the same sleeping proximity to the same adult TB index case. Median ages of groups (infected; 10.0 years, uninfected 8.8 years) were not significantly different (p = 0.13). Mean vitamin D levels were 2.05 ng/mL (95% CI − 0.288 to 4.38) higher in 24 highly TB-exposed uninfected children compared with 24 matched highly TB-exposed infected children (p = 0.08). The findings warrant further investigation in larger studies to understand the implications and significance. Conclusion: Vitamin D levels were higher in TB-uninfected children compared with TB-infected despite equal high exposure to a TB case. What is Known:• Paediatrics TB represents one of the leading causes of child death globally.• Current literature shows an inconsistent relationship between vitamin D deficiency and increased risk of TB disease however a large Phase 3 trial of vitamin D supplementation in (largely vitamin D deficient) Mongolian children did not find any association with TB infection rates. What is New:• This study adds to the literature in a vitamin D sufficient paediatric population whereby children with equal exposure to a household TB case with no evidence of TB infection have higher levels of vitamin D compared with matched children with TB infection.

Background Primary hyperparathyroidism (PHPT) is a common endocrine disorder with a wide range of adverse effects, such as osteoporosis. Many women are not diagnosed due to asymptomatic disease or vague symptoms but are still at risk of severe adverse effects. Early identification of patients with PHPT is therefore of importance. The aim of this study was to determine PHPT prevalence among postmenopausal women with a distal forearm fracture. Methods Recruitment was conducted in conjunction with the occurrence of a distal forearm fracture at Karolinska University Hospital. In total, 161 postmenopausal women were included in a cross-sectional study with repeated evaluations. Analyzes of serum calcium, ionized calcium, phosphate, parathyroid hormone (PTH), and vitamin D were performed. Diagnosis of PHPT was based on clinical evaluations and biochemical definitions of serum calcium and PTH in coherence with previous population prevalence reports. Results Mean age was 64.7 (9.5) years, serum calcium 2.33 (0.10) mmol/L, ionized calcium 1.25 (0.05) mmol/L and PTH 54 (26) ng/L. PTH was elevated in 32 (20%) women. In total, 11 (6.8%) women were diagnosed with PHPT; 6 with classical PHPT and 5 with mild PHPT. The prevalence of PHPT was significantly increased compared to the population prevalence of 3.4% (p = 0.022). Conclusion Screening postmenopausal women in conjunction with low-energy distal forearm fracture revealed a large number of women with parathyroid disturbance. Evaluation of parathyroid hormone and calcium status in this group of patients seems beneficial.

Chronic stress increases the production of pro-inflammatory cytokines and oxidative stress in the brain, which underlay cognitive and psychological problems. In addition to the anti-depressants, vitamin D is known to act as an anti-inflammatory and anti-oxidative agent. This study investigates the specific effects of vitamin D in protecting hippocampus and pre-frontal cortex (PFC) against chronic mild stress (CMS)-induced activation of pro-inflammatory cytokines IL-6 and TNF-α and decreasing the activation of anti-oxidative enzymes super oxide dismutase (SOD) and glutathione peroxidase (GPx). Rats were exposed to CMS for 3 weeks. Two groups of rats received vitamin D (5 and 10 μg/kg) and another received fluoxetine (5 mg/kg) along with CMS. Control groups were not exposed to CMS, but received treatments similar to CMS groups. Serum corticosterone and IL-6, TNF-α and SOD and GPx levels in the hippocampus and PFC were measured at the end of three weeks. CMS significantly increased corticosterone, IL-6, TNF-α and decreased SOD and GPx levels (P

Background In Europe, the rate of 25(OH)D deficiency is considered high. Thus, it seems necessary to conduct population-based studies to fully assess vitamin D deficiency in various groups of patients. Objectives To evaluate serum 25(OH)D levels and the frequency of deficiency in women in Poland with endocrine and osteoporotic disorders. The influences of diet, use of vitamin/mineral supplementation and exposure to ultraviolet (UVB) radiation on vitamin D status in women with metabolic disorders were also examined. Material and methods The patient group consisted of 223 women aged 19-81 years diagnosed with endocrine and/or osteoporotic disorders. The control group consisted of 108 clinically healthy women aged 26-72 years. Serum 25(OH)D concentration was assessed using a chemiluminescent immunoassay (CLIA). An ad hoc questionnaire was used to assess the participants' exposure to UVB radiation. Food intake was assessed using a three-day 24-hour questionnaire interview. Results The following groups showed significantly higher 25(OH)D levels: women taking vitamin D supplements compared to women not taking vitamin D supplements (29.3 ±3.2 compared to 19.5 ±3.7 ng/mL, p = 0.0024); premenopausal women compared to postmenopausal women (28.9 ±5.2 compared to 21.5 ±4.5 ng/mL, p = 0.0021); women who visited sunny countries in the last 6 months compared to women who did not (28.1 ±3.1 ng/mL compared to 24.5 ±5.3 ng/mL, p = 0.0031); and normal weight or overweight women (according to body mass index (BMI)) compared to obese women (27.4 ±4.5 ng/mL compared to 22.3 ±4.7 ng/mL, p = 0.0431). In addition, 25(OH)D concentration correlated with total dietary vitamin D intake in the patient group (R = 0.17, p = 0.0021). Of all examined food groups, fish consumption affected serum 25(OH)D levels in patients (R = 0.20, p = 0.0421) and controls (R = 0.29, p = 0.0002). Consumption of fish products contributed to statistical differences between the patient group (R = 0.17, p = 0.0072) and healthy subjects (R = 0.19, p = 0.0032). Conclusions The most crucial factors influencing vitamin D status in the studied women were regular fish consumption, spending holidays in sunny destinations and regular intake of vitamin D preparations.

Cutaneous warts, common in children and immunocompromised patients, can be painful and socially and functionally restricting. Caused by several human papillomavirus types, they may resolve spontaneously or respond to traditional treatments. If not, pharmacological options for difficult-to-treat warts include intralesional and/or topical immunological and antiviral agents, with clearance of all warts achieved in many patients. Vaccines, Candida albicans antigen, vitamin D analogues, cidofovir, imiquimod and chemotherapeutics are worth considering.

Over the latest years different studies have investigated the possible relationship between D deficiency and occurrence of orthostatic hypotension (OH), often reaching controversial results. We perform an update meta-analysis providing an update overview on the association between hypovitaminosis D and orthostatic hypotension (OH) in older adults. Data extraction was independently performed by two authors and based upon predefined criteria. The meta-analysis was performed using a random-effects model. Statistical heterogeneity between groups was measured using the Higgins I2 statistic. Eight investigations enrolling 16.326 patients (mean age 75.5 years) met the inclusion criteria and were considered for the analysis. Patients with vitamin D deficiency were more likely to have OH compared to those without (OR: 1.36, 95% CI 1.14–1.63, p = 0.0001, I2 = 43.6%). A further sub-analysis, based on three studies, estimating the risk of OH in patients with hypovitaminosis D receiving antihypertensive treatment, did not reach the statistical significance (OR: 1.40, 95% CI 0.61–3.18, p = 0.418, I2 = 53.3%). Meta-regression performed using age (p = 0.12), BMI (p = 0.73) and gender (p = 0.62) as moderators did not reveal any statistical significance in influencing OH. Conversely, physical activity, Vitamin D supplementation and use of radioimmunoassay for the measurement of vitamin D serum levels showed a significant inverse relationship towards the risk of OH (Coeff.—0.09, p = 0.002, Coeff. − 0.12, p

There is controversy in ophthalmic research as to whether vitamin D deficiency is an independent factor in the progression of myopia.

Periodic Fever, Aphthous Ulcers, Pharyngitis and Adenitis (PFAPA) Syndrome’s etiology is not well understood. The objective of this study is to explore the association between vitamin D level and PFAPA syndrome. A systematic review of all publications addressing the association between vitamin D level and PFAPA syndrome prior to May 2019 was conducted. Data were collected from online medical databases namely, PubMed, Ovid Medline, Embase, Cochrane Library, Google Scholar, and Scopus. The review adhered to the PRISMA statement and was performed in 3 main phases; an initial screening review of abstracts was performed, followed by a detailed review of full articles based on inclusion and exclusion criteria, and lastly a final review to extract data from selected articles. 3 prospective review-based and one case report articles were included with a total of 281 patients, 98 of whom were cases of PFAPA, while 183 were controls. Vitamin D levels were deficient in 27% of PFAPA group as compared with the control. Vitamin D supplementation was given as an initial treatment in 25/98 of the patients. Only 1 patient received it as a second treatment. After vitamin D supplementation, a marked reduction of the number of febrile episodes and modification of the mean duration were recognized. There may be an association between Vitamin D deficiency and a higher frequency of PFAPA episodes. Vitamin D supplementation in children with PFAPA may reduce the frequency of episodes and help manage the condition.

Background: In the midst of the COVID-19 pandemic, there has been an information overload of health data (both accurate and inaccurate) available to the public. With vitamins and supplements being readily accessible, many have turned to using them in an effort to combat the virus. The purpose of this review was to analyse clinical trials regarding vitamins and supplements for the treatment of COVID-19 infections. Methods: Articles were identified through a literature search utilizing online databases and bibliographic review. Results: A total of seven articles were identified for review. All articles evaluated the use of vitamins and supplements for the treatment of COVID-19. Drug therapies included oral vitamin D, intravenous and oral vitamin C, oral vitamin D/magnesium/vitamin B12, oral zinc, oral combination zinc/ascorbic acid, and intravenous alpha-lipoic acid. The end points of each study varied, including the Sequential Organ Failure Assessment score, mortality, rate of intensive care unit (ICU) admissions, negativity of COVID-19 tests, oxygen requirements, and symptom burden. Conclusion: Of the vitamins and supplements that were studied, vitamin D presented the most promising data demonstrating significant decreases in oxygen requirements, need for ICU treatment, SARS-CoV-2 RNA test positivity, and mortality. All of these benefits were exhibited in hospitalized patients. Other vitamins and supplements that were evaluated in studies did not demonstrate any statistically significant benefits. Common shortcomings of the articles included generally small sample sizes, varying sites of study (which could determine the virus variant), a lack of standard of care as background therapy, and utilization of doses that were higher than standard.

In-vitro evidence suggests that the lipid component of foods alters vitamin D absorption. This single-blinded, cross-over postprandial study examined the effect of changing the lipid component of a 20 µg vitamin D3 fortified dairy drink on postprandial 25(OH)D concentrations. Participants consumed one dairy drink per visit: a non-lipid, a pre-formed oleic acid micelle, an olive oil and a fish oil dairy drink. There was a significant time*drink*baseline status effect on 25(OH)D concentrations (p = 0.039). There were no time*drink, time or drink effects on 25(OH)D in vitamin D sufficient participants (>50nmol/L). However, there was an effect of time on changes in 25(OH)D concentrations after the olive oil dairy drink (p = 0.034) in vitamin D insufficient participants (

AIM: The aim of this study was to determine the 25(OH)D status in patients with genital endometriosis compared to the control group and to analyze the clinical efficacy of cholecalciferol implication as a combined targeted therapy of the disease. MATERIALS AND METHODS: The main group included 440 patients with genital endometriosis (mean age 33.75.8 years) with various degrees of disease prevalence. The control group consisted of 30 women with the normal ovulatory menstrual cycle (mean age 26.33.1 years) in whom gynecological pathology was not revealed. Peripheral blood (PB) 25(OH)D level was assessed in all the participants included into the study. In 49 women from the main group, the level of 25(OH)D in the peritoneal fluid (PF) was determined. Comparative evaluation of the clinical efficacy of cholecalciferol intake in combination with gonadotropin-releasing hormone agonist (aGnRH) 3.75 mg injections or with dienogest 2 mg oral administration, as well as monotherapy in comparison with standard hormone-modulating treatment was carried out. Prior to the start of treatment, the patients had pain syndrome of varying severity, which was evaluated using the McGill Pain Questionnaire with the Visual Analogue Scale for pain. The psycho-emotional status was assessed using the Hospital Anxiety and Depression Scale. The Excel, Statistica 10, and Jamovi software programs were used to process the obtained data. RESULTS: The level of 25(OH)D in PB of patients with endometriosis was significantly lower compared to the control group (p 0.001). Women with Grades III and IV genital endometriosis were characterized by lower PB 25(OH)D levels compared to the patients with Grades I and II of the disease, but the difference was not statistically significant. Relationships were revealed between 25(OH)D levels in the PB and PF (p 0.001), as well as PF 25(OH)D level and the disease prevalence (p = 0.004). Significantly more pronounced pain reduction and stabilization of the psycho-emotional status were observed in patients receiving combined therapy with cholecalciferol. CONCLUSIONS: Insufficient level of vitamin D and vitamin D deficiency can be considered as factors that play a role in the progression of genital endometriosis. The use of cholecalciferol in combination with aGnRH 3.75 mg or dienogest 2 mg may more effectively reduce the severity of pain and stabilize the psycho-emotional status in patients with genital endometriosis compared to standard hormone-modulating therapy.

The coronavirus disease 2019 (COVID-19) pandemic has disrupted the normal activities of various settings, including clinics, laboratories, and libraries. As the world deals with the fast-mutating causative virus, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), apart from the search for the best vaccine candidate, efforts towards repurposing existing molecules to save lives must continue. Considerable interest has centered around the implications of vitamin D deficiency and its supplementation on the outcomes in patients with COVID-19. We hypothesize that vitamin D supplementation has the potential to confer protection against SARS-CoV-2 infection and a severe COVID-19 course. Various animal, human observational as well as interventional studies have shown a protective role of vitamin D in COVID-19. More robustly designed studies where vitamin D is supplemented prophylactically and administered to those already infected are needed to determine the precise contribution of this supplementation in preventing SARS-CoV-2 infection and modifying the course of COVID-19.

1

AIM: The aim of this study was to analyze the association between the vitamin D receptor gene polymorphism and the risk of developing genital endometriosis and type 1 diabetes mellitus. MATERIALS AND METHODS: The frequency of allelic variants of the VDR gene was studied by PCR-RFLP analysis in 282 women, including 129 patients with genital endometriosis (stages I–IV), 71 patients with type 1 diabetes mellitus, and 82 women of the control group represented by the population sample. RESULTS: It was found that the frequency of the allele G polymorphic variant of rs1544410 (BsmI) in the VDR gene was significantly higher in the group of patients with genital endometriosis compared to the population sample ( p = 0.048). Significant differences for the G / G genotype in patients with genital endometriosis relative to the control group ( p < 0.05) and the group of patients with type 1 diabetes mellitus ( p < 0.05) were revealed. According to the odds ratio, the risk of developing genital endometriosis was 1.9 times higher for this genotype (OR = 1.93 CI = 1.082–3.450; OR = 1.892 CI = 1.022–3.430). The combination of the A / A and G / A genotypes was significantly more common in patients with type 1 diabetes mellitus ( p = 0.040) and in the population ( p = 0.025), when compared to the patients with genital endometriosis. A significant increase in the t allele of the rs731236 polymorphism (TaqI) of the VDR gene was found in the group of patients with type 1 diabetes mellitus ( p < 0.05). The combination of the T / t and t / t genotypes of the rs731236 polymorphism (TaqI) of the VDR gene in patients with type 1 diabetes mellitus were significantly more common than in the group of patients with genital endometriosis ( p = 0.017). CONCLUSIONS: The data obtained may be important for risk assessment of genital endometriosis and type 1 diabetes mellitus development and for developing new strategies for the prevention and treatment of these diseases.

Purpose of review This review summarizes recent studies that assessed whether nutritional supplementation enhances the efficacy of exercise training in older adults, focusing on the benefits for physical/functional performance of protein, vitamin D, or multi-ingredient supplementation. Recent findings Studies applying long-term exercise training strongly support the benefits of different exercise regimens for muscle strength and function but most studies do not provide direct evidence for protein, vitamin D, or multi-ingredient supplementation to further augment such improvements in older adults. Several methodological limitations are addressed that likely limited the reliability to convincingly establish or refute any additive effects of supplementation. Only when specifically tailored to the population under study, ensuring proper intensity, duration, and adherence to exercise, and aiming for a daily intake of similar to 1.5 g protein per kg body mass, and similar to 800 IU of vitamin D supplementation, there appears to be some potential to augment the efficacy of long-term exercise training in older adults, with potentially greater benefits in compromised older subpopulations. There is some support for the efficacy of nutritional supplementation to further augment the beneficial effects of prolonged exercise training in older adults but any intervention needs tailoring of both the exercise and the nutritional intervention towards the intended (sub)population.

Background: Chronic rhino-sinusitis with nasal polyps [CRSwNP] is a prevalent disease that has an important influence on patient quality of life. Vitamin D3 [VD3] has been shown to suppress the proliferation of fibroblasts generated from nasal polyps.Aim of the work: The aim of this work is to evaluate the safety and efficacy of vitamin D3 in decreasing the severity and size of sino-nasal polyps in patients with vitamin D3 insufficiency.Methods: This study is a prospective cohort study conducted on 46 patients with chronic rhino-sinusitis with nasal polyps with vitamin D3 insufficiency [low levels of vitamin D3 < 30 ng/ml]. Included patients were divided into 2 groups, the first group were 22 patients given vitamin D3 [200,000 IU] intramuscular [IM], and the other control group included 20 patients were given placebo in the same manner as the first group. The two groups were assessed before vitamin D3 and placebo supplementation and after 3 months with endoscopic Meltzer grading score and CT scan.Results: Based on endoscopic Meltzer scores, there was improvement among 68.3% of vitamin D3 group vs. 20% of the placebo group; the severity of sino-nasal polyps was observed to be considerably reduced in vitamin D3 group in comparison to placebo group. CT finding reported 40.9% of vitamin D3 group improved vs. 10% of placebo group], the improvement of CT was changing of the affected sinuses from complete to partial opacification.Conclusion: Vitamin D3 has an effective way in lowering the severity of nasal polyps and alleviating their manifestations.

Abstract. Some epidemiological evidence suggests an inverse correlation between non-alcoholic fatty liver disease (NAFLD) frequency and vitamin D levels. Likewise, a beneficial effect of vitamin D on diabetes mellitus (DM) and insulin resistance has been observed, but this is an unsolved issue. Thus, we aimed to investigate the prevalence of hypovitaminosis D in a NAFLD Brazilian population and its association with disease severity and presence of comorbidities. In a cross-sectional study, the clinical, biochemical and histological parameters of 139 NAFLD patients were evaluated according to two different cut-off points of serum 25-hydroxyvitamin D levels (20 ng/mL and 30 ng/mL). The mean age of the population was 56 ± 16 years, most patients were female (83%), 72% had hypertension, 88% dyslipidemia, 46% DM, 98% central obesity, and 82% metabolic syndrome. Serum vitamin D levels were

Background/Aim: Heart failure is an important health problem with an increasing incidence in the world and poor prognosis. Galectin-3 is associated with progressive fibrosis, an underlying pathology of heart failure, just as vitamin D deficiency. We examined the relationship between the stage of heart failure and galectin-3 and 25-OH vitamin D levels.Methods: Sixty patients with heart failure and 30 healthy volunteers were included in this prospective case-control study. Demographic data, comorbid diseases and laboratory data were examined, and 25-OH vitamin D and galectin-3 levels were compared between the patients with CHF and the control group.Results: Galectin-3 levels were high in patients with heart failure (P

Polycystic ovary syndrome (PCOS) is considered the commonest endocrinological disorder in childbearing age women with an incidence of 10%. Vitamin D has been shown in several studies to have a positive impact on female reproductive diseases, as well as PCOS. The diagnosis of PCOS, clinical symptoms, pathophysiology, hypovitaminosis D, insulin resistance, and the various methods for vitamin D and insulin assessment are all covered in this study. Androgen hypersecretion, oligo-ovulation, and/or ovarian morphologic features are used to diagnose this condition. Androgen excess, neuroendocrine causes, and insulin resistance are all part of the pathophysiology. Some female genital organs have been found to contain vitamin D receptors. Insulin regulates steroid biosynthesis in the ovaries and follicular maturation, so vitamin D is essential.

RESUMEN El objetivo de esta revisión narrativa fue analizar los resultados de la literatura recientemente publicada sobre el rol de la vitamina D y su posible asociación con los mecanismos de acción sobre el COVID-19 en niños, niñas y adolescentes para lo cual se consultaron las bases de datos: Medline/Pubmed, CENTRAL, Scopus, SciELO y el motor de búsqueda Google Académico en abril del 2021. La estrategia de búsqueda se realizó combinando el uso de los operadores booleano AND y OR, utilizando las siguientes palabras: COVID-19; SARS-CoV-2; Vitamin; Vitamin D; Deficiency; Pediatrics. Child; Adolescent. Las recomendaciones de diversas organizaciones sugieren una suplementación de entre 400 a 1.000 UI/día para mantener u obtener un nivel sérico suficiente (>30 ng/ml) en niños, niñas y adolescentes, sugiriendo la evidencia una posible relación entre los estados de insuficiencia (

Parathyroid hormone and vitamin D are essential endocrine regulators primarily responsible for maintaining calcium and phosphate homeostasis. Parathyroid hormone is responsible for the activation of vitamin D and forms a self-regulating negative feedback loop in response to changes in calcium and phosphate serum concentrations. This review discusses the synthesis, mechanisms of action the cellular and genomic targets of parathyroid hormone and vitamin D in both ‘calcaemic’ and ‘non-calcaemic’ scenarios. It will also discuss the clinical ramifications of disorders of the parathyroid hormone and vitamin D axis and the main considerations the orthopaedic surgeon should appreciate when treating their patients.

OBJECTIVE: To determine the association between vitamin D levels in the male partner and fertility outcomes in couples with mild male factor infertility. DESIGN: Secondary analysis of a randomized, controlled trial SETTING: Nine fertility centers in the United States PATIENT(S): Males (N = 154) with sperm concentration between 5 M/mL and 15 M/mL, motility ≤ 40%, or normal morphology ≤ 4% were eligible. Female partners were ovulatory, ≤ 40 years old, and had documented tubal patency. INTERVENTION(S): Men provided semen and blood at baseline for semen analysis and 25-hydroxyvitamin D (250HD) levels. They were randomly assigned to receive a vitamin formulation including Vitamin D 2000 IU daily or placebo for up to 6 months. Couples attempted to conceive naturally during the first 3 months and with clomiphene citrate with intrauterine insemination of the female partner in months 4 through 6. MAIN OUTCOME MEASURE(S): Primary: sperm concentration, motility, morphology, and DNA fragmentation at baseline; Secondary: cumulative pregnancy, miscarriage, and live birth rates RESULT(S): Semen parameters and sperm DNA fragmentation were not statistically significantly different in males with vitamin D deficiency compared to males with 25OHD levels ≥ 20 ng/mL. Clinical pregnancy and live birth rates were also similar. Male 25OHD level < 20 ng/mL was associated with a higher pregnancy loss rate [adjusted OR 9.0 (95% CI 1.3 to 61.3), p = 0.024] CONCLUSION(S): Vitamin D deficiency in the male partner did not significantly impact semen parameters or treatment outcomes. Further study is warranted to better characterize the rate of miscarriage in couples with male vitamin D deficiency.

Background: Vitamin D is a vital component of bone metabolism and calcium homeostasis, and its deficiency is known to cause rickets, osteomalacia and hypocalcemia. Objective: The aim of this study was to evaluate vitamin D level in patients with nephrotic syndrome and its relation to calcium. Patients and methods: This study was a case-control study carried out at Pediatric Nephrology Unit Pediatric Department, Faculty of Medicine, Zagazig University Hospitals from June 2020 to December 2020. It included 108 patients divided into 2 groups; each group included 54 patients.1st group was patients with nephrotic syndrome and 2nd group was healthy children as control group. A detailed history and clinical examination including anthropometry was taken for cases of Nephrotic syndrome admitted to the hospital. The patients underwent the following investigations: serum albumin, serum cholesterol, C3, C4, alkaline phosphatase, total calcium, ionized calcium, 25(OH) vitamin D, CBC, renal function test, urine analysis urine albumin/creatinine ratio, 24hr urine protein and X-ray bone. Results: There was statistically significant relation between vitamin D level and steroid response where steroid-resistant patient had lower vitamin level followed by steroid-dependent then steroid-sensitive patients. There was non-significant correlation between vitamin D and occurrence of relapse. Conclusion: Vitamin D and calcium supplementation should be considered in nephrotic patients.

Background. The threatened miscarriage is the most common pregnancy complication that occurs in 15–20 % of cases of ongoing pregnancy. The aim of this work was to study the features of electrolyte status and level of vitamin 25(OH)D in pregnant women with threatened miscarriage in I and II trimesters, living in the Luhansk region and having the status of internally displaced persons (IDP), to improve treatment and preventive measures and prevent obstetric and perinatal complications in such women. Materials and me­thods. The study included 27 pregnant women who had IDP status and were hospitalized for threatened miscarriage to the hospitals, located in the Luhansk region (group I). The control group consisted of 30 pregnant women with no relevant past medical history and with physiological course of pregnancy with similar gestation period (group II). Clinical and obstetric examinations were carried out, the content of vitamin 25(OH)D and the concentration of trace elements such as Na+, K+, Cl+, Ca2+, P, Mg, Zn in the blood serum were determined. Results. It was found that in pregnant women of group I, the concentrations of magnesium (0.74 (0.73–0.78)) and vitamin 25(OH)D (26.85 (23.38–29.04)) were significantly lower compared with the control group (0.79 (0.75–0.83) and 28.21 (25.85–29.15), respectively). In group I, a statistically significant positive correlation was found between the concentrations of vitamin 25(OH)D and ionized calcium (r = 0.445, p = 0.02), between the content of phosphorus and the body mass index (r = 0.456, p = 0.017). Conclusions. Antenatal study of electrolyte and vitamin 25(OH)D content in the blood serum of pregnant women with symptoms of threa­tened miscarriage and IDP status will allow us to individualize the approach to the management of pregnancy and to develop timely, if necessary, corrective and rehabilitation measures that will contribute to a successful pregnancy outcome and influence the health of the mother and her offspring.

Background. The purpose was to determine the risk factors for reducing the provision of vitamin D (VD) in patients with juvenile idiopathic arthritis (JIA) and to develop a questionnaire for the rapid identification of children who require monitoring the concentration of 25OHD in the blood. Materials and methods. Clinical and laboratory examination of 78 children aged 2–17 years with JIA was performed. General clinical, biochemical, statistical methods and standardized criterion testing were used. Results. The most unfavorable risk factors for reducing VD provision in children with JIA have been identified, a questionnaire has been developed that can be used to identify people at high VD deficiency. Risk factors are evaluated in points. When questioning individuals with JIA, the total number of points obtained by each patient was determined. In children, who have received more than 264 points, VD insufficiency or deficiency is confirmed laboratorially. The electronic version of the questionnaire is created in the online service for remote testing with the ability to view results for each respondent separately and to identify patients at high risk of vitamin D deficiency. The questionnaire also allows separating groups of patients at risk of VD insufficiency for further monito­ring of 25OHD concentrations in the blood serum, which is useful in clinical practice of children’s rheumatologist, pediatrician and family physician. Conclusions. In patients with JIA, it is necessary to determine the risk factors for reducing VD provision in the body to identify individuals who require the evaluation of its concentration in the blood with subsequent monitoring. A questionnaire has been developed that allows us to collect information on the risks of developing VD insufficiency, assess them and determine the basic cohort of patients for laboratory studies and deciding whether to prescribe vitamin D preparations to them., Мета: визначити фактори ризику зниження забезпеченості вітаміном D (ВD) у хворих на ювенільний ідіопатичний артрит (ЮІА) і розробити опитувальник для швидкої ідентифікації дітей, які потребують моніторування концентрації 25OHD у крові. Матеріали та методи. Проведено клініко-лабораторне обстеження 78 дітей віком 2–17 років з ЮІА. Застосовані загальноклінічні, біохімічні, статистичні методи та стандартизований критеріальний метод тестування. Результати. Установлені найбільш несприятливі фактори ризику зниження забезпеченості організму ВD у дітей з ЮІА, розроблений опитувальник, за допомогою якого можливо виявляти осіб, які мають високий дефіцит вD. Фактори ризику оцінено в балах. При анкетуванні хворих на ЮІА визначена загальна кількість балів, отриманих кожним пацієнтом. У дітей, які під час тестування отримали більше ніж 264 бали, лабораторно підтверджені недостатність або дефіцит ВD. Створено електронну версію опитувальника в онлайн-сервісі для проведення дистанційного тестування з можливістю переглядати результати по кожному респонденту окремо та визначати пацієнтів із високим ризиком дефіциту вітаміну D. Опитувальник також дозволяє відокремити групи пацієнтів із ризиком недостатності ВD для подальшого моніторування концентрації 25OHD у сироватці крові, що є корисним у клінічній практиці дитячого ревматолога, педіатра та сімейного лікаря. Висновки. У пацієнтів з ЮІА необхідним є визначення факторів ризику зниження забезпеченості організму ВD для ідентифікації індивідуумів, які потребують встановлення його концентрації в крові з подальшим моніторуванням. Розроблений опитувальник дозволяє зібрати інформацію про ризики розвитку недостатності ВD, оцінити їх та визначити базову когорту пацієнтів для проведення лабораторних досліджень і вирішення питання про доцільність призначення їм препаратів вітаміну D.

Low serum 1,25-dihydroxyvitamin D (1,25(OH)2D) in end-stage renal disease (ESRD) is considered a consequence of elevated fibroblast growth factor 23 (FGF23) and concomitant reduced activity of renal 1α-hydroxylase (CYP27B1). Current ESRD treatment strategies to increase serum calcium and suppress secondary hyperparathyroidism involve supplementation with vitamin D analogues that circumvent 1α-hydroxylase. This overlooks the potential importance of 25-hydroxyvitamin D (25(OH)D) deficiency as a contributor to low serum 1,25(OH)2D. We investigated the effects of vitamin D (cholecalciferol) supplementation (40,000 IU for 12 weeks and maintenance dose of 20,000 IU fortnightly), on multiple serum vitamin D metabolites (25(OH)D, 1,25(OH)2D3 and 24,25(OH)2D3) in 55 haemodialysis patients. Baseline and 12 month data were compared using related-samples Wilcoxon signed rank test. All patients remained on active vitamin D analogues as part of routine ESRD care. 1,25(OH)2D3 levels were low at baseline (normal range: 60–120 pmol/L). Cholecalciferol supplementation normalised both serum 25(OH)D and 1,25(OH)2D3. Median serum 25(OH)D increased from 35.1 nmol/L (IQR: 23.0–47.5 nmol/L) to 119.9 nmol/L (IQR: 99.5–143.3 nmol/L) (P < 0.001). Median serum 1,25(OH)2D3 and 24,25(OH)2D3 increased from 48.3 pmol/L (IQR: 35.9–57.9 pmol/L) and 3.8 nmol/L (IQR: 2.3–6.0 nmol/L) to 96.2 pmol/L (IQR: 77.1–130.6 pmol/L) and 12.3 nmol/L (IQR: 9–16.4 nmol/L), respectively (P < 0.001). A non-significant reduction in daily active vitamin D analogue dose occurred, 0.94 µmcg at baseline to 0.77 µmcg at 12 months (P = 0.73). The ability to synthesise 1,25(OH)2D3 in ESRD is maintained but is substrate dependent, and serum 25(OH)D was a limiting factor at baseline. Therefore, 1,25(OH)2D3 deficiency in ESRD is partly a consequence of 25(OH)D deficiency, rather than solely due to reduced 1α-hydroxylase activity as suggested by current treatment strategies.

Background: Vitamin D is a hormone that affects a wide range of functions within the body. Neonatal hypoxic ischemic encephalopathy (HIE) is a serious disease that may lead to permanent brain injury. Objective: The present study aimed to study vitamin D status in hypoxic ischemic in encephalopathy. Patients and methods: A case control study carried out in newborn intensive care unit (NICU) of Zagazig University Children Hospitals. Total number of cases that met the inclusion and exclusion criteria was 49 full term neonates with HIE divided according to Sarnat stages: stage I; 20 full term neonates, stage II; 15 full term neonates and stage III; 14 full term neonates. Cases were compared to 16 healthy controls. Results: There was a statistical significant increase in Apgar score 1, 5, 10 in control group compared to all cases groups. There were no statistical significant differences between the studied groups in relation to CBC results. There was a statistical significant difference between the different stages of HIE in CRP and pH.There was a statistical significant increase in frequency of hypoxic change in stage III compared to stage II and I. All stages of HIE showed statistical significant increase in frequency of vitamin D deficiency compared to control group. Stage III had statistical significant increase in frequency of vitamin D deficiency compared to stage I and II. Conclusion: Serum 25(OH) vitamin D insufficiency is present in the majority of term HIE neonates. 25 (OH) vitamin D was significantly deficient in stage III more than stage I and II.

Aim To investigate whether three-month oral vitamin D supplementation (800 IU in drops) reduces the risk of in - fluenza infection in elderly nursing home residents vacci - nated against influenza. Methods This cross-sectional observational study enrolled 97 participants (73.2% women) who received one dose of seasonal trivalent 2016-2017 influenza vaccine. The patients were randomized into an experimental group, which re - ceived vitamin D supplementation for three months start - ing on the day of vaccination, and a control group, which did not receive vitamin D supplementation. The primary outcome was the number of influenza infections labora - tory-confirmed using a rapid point-of-care test based on nasal swabs collected during vitamin D supplementation. The secondary outcome was serum 25-hydroxyvitamin D level at the end of the study. Results The mean age ±standard deviation was 78.5± 8.8 years. All participants had vitamin D deficiency at baseline. Twenty-three participants who developed signs of respira - tory infections during the study were tested for influenza virus. Although the number of influenza-positive partici - pants was lower in the group receiving vitamin D supple - mentation as compared with the control group (5 vs 12), this difference was not significant. Vitamin D supplemen - tation failed to increase 25(OH)D levels after three months of supplementation. Conclusion Elderly nursing home residents in Zagreb County have a significant vitamin D deficiency. The recom - mended national supplementation of 800 IU daily failed to lead to vitamin D sufficiency and did not reduce the risk of influenza infection among the vaccinated elderly.

Aim: The aim of the study was todetermine the factors associated with Obstructıve Sleep Apnea Syndrome (OSAS) severity and vitamin D deficiency by examining routine laboratory parameters in patients with OSAS without comorbidities. We also aimed to see whether theseverity of OSAS increased with decreasing levels ofvitamin D. Material and Method: Patients who presented to Adana City Training and Research Hospital, Ear Nose Throat Clinic with the symptoms of snoring and sleep apnea and who underwent PSG in the sleep laboratory of the Otorhinolaryngology Clinic were included in the study. Blood results were analyzed retrospectively from the hospital information system. The patients were divided into groups according to their Apnea hypopnea Index (AHI) values ​​as simple snoring, mild OSAS, moderate OSAS, and severe OSAS. According to the vitamin D values, the patients; Cathogarized as sufficient> 30 ng / ml, insufficient 20-30 ng / ml and deficient Results: Out of the 777 patients examined 482 patients fulfilling the inclusion criteria were analysed for the study. It was seen that severity of OSAS increased concomitantly with decreasing Vitamin D levels. Conclusion: Vitamin D deficiency is observed in patients with OSAS and is related to the severity of the disease. We think that vitamin D therapy may be beneficial in reducing the severity of the disease. &nbsp

Background: Rheumatoid arthritis (RA) is a chronic, systemic, destructive joint disease. Vitamin D initiates biological responses via binding to the vitamin D receptor (VDR), which is a member of the steroid hormone receptor superfamily located on chromosome 12 (12q12-q14) that regulates gene expression in a ligand-dependent manner. The receptor (VDR) is active in almost all tissues that are necessary for the effects of vitamin D. Objective: The present work aimed to detect vitamin D receptor FokI gene polymorphism in rheumatoid arthritis patients, to assess its role as a risk factor of the disease. Patients and Methods: A case-control study was conducted on 44 subjects (22 RA patients and 22 apparently normal volunteers age and sex-matched with patients) at the Clinical Pathology, Rheumatology and Rehabilitation Departments, Faculty of Medicine, Zagazig University. Results: Serum vitamin D level was found to be significantly lower among RA patients compared to healthy controls. There was a significant difference between the studied groups regarding VDR FOK1 gene polymorphism and its alleles. There was a non-significant difference between the different genotypes regarding age, however, the difference between them was significant regarding sex as it was noticed that FF and ff homozygous genotypes were found only in females compared to their male counterparts while Ff heterozygous genotype was found equally among both males and females. Conclusion: Vitamin D receptor gene FokI polymorphism could be considered as genetic risk markers of RA susceptibility, associated with vitamin D level deficiency which was found to be significantly lower among FF genotype compared to other genotypes. Having FF and Ff genotypes have almost a higher risk than having ff genotype to be RA patient.

Aim: of the work to determine serum levels of vitamin D and Milk fat globule-epidermal growth factor 8 (MFG-E8) in rheumatoid arthritis (RA) and primary knee osteoarthritis (OA) compared to healthy controls and their possible associations. Patients and methods: The study included 30 RA and 30 primary knee OA patients as well as 25 control. The disease activity was measured by disease activity score 28 (DAS28) in RA. The functional status was estimated by Western Ontario and McMaster Universities index (WOMAC index) in OA. While the assessment of pain was measured by the visual analog scale (VAS) in both RA and OA. Serum vitamin D and MFG-E8 levels were measured using enzyme-linked immunosorbent assay (ELISA). Results: The mean age of RA patients was 41.1 ± 9.2 years; 25 females and 5 males (F:M 5:1) and a disease duration of 6.9 ± 4.6 years. The mean age of OA patients was 48.7 ± 8.3 years; 28 females and 2 males (F:M 14:1) and disease duration was 5.4 ± 3.3 years. The mean vitamin D was significantly lower in RA (9.7 ± 5.04 ng/ml) than OA (16.4 ± 4 ng/ml) and controls (17.7 ± 3.4 ng/ml), p

Arto Yuwono Soeroto,1 Dadan Setiawan,2 Nabila Nauli Asriputri,3 Guntur Darmawan,4 Geraldo Laurus,3 Prayudi Santoso1 1Division of Respiratory and Critical Illness, Department of Internal Medicine, Faculty of Medicine Universitas Padjadjaran, Hasan Sadikin General Hospital, Bandung, Indonesia; 2Department of Internal Medicine, Occupational Health General Hospital, Bandung, West Java, Indonesia; 3Department of Internal Medicine, Faculty of Medicine Universitas Padjadjaran, Hasan Sadikin General Hospital, Bandung, Indonesia; 4Department of Internal Medicine, Faculty of Medicine, Krida Wacana Christian University, Jakarta, IndonesiaCorrespondence: Arto Yuwono Soeroto Tel +62 811 246 930Email aysoeroto@yahoo.co.idPurpose: This study aimed to assess the association between vitamin D levels and forced expiratory volume in one second (FEV1), number of exacerbations, and symptoms based on COPD assessment test (CAT) scores in stable COPD patients in Indonesia.Patients and Methods: An observational cross-sectional study was conducted. Subjects were stable COPD patients who were treated at a pulmonary clinic in a tertiary referral hospital in West Java from March to June 2018.Results: Thirty subjects were recruited this study with an average age 62± 8 years. The mean vitamin D level was 20.17± 8.91 ng/mL. Half of the patients had low vitamin D level (< 20ng/mL) (50%). The mean FEV1 (%) predicted value was 37.2± 14. The median exacerbation per year was 1 (0– 5) and symptoms based on CAT score was 14 (3– 34). No correlation was found between vitamin D levels and FEV1 (%) predicted value (r=0.126, p=0.253). Vitamin D level was inversely correlated with number of exacerbations (r=− 0.639, p< 0.001) and CAT (r= − 0.802, p< 0.001).Conclusion: Low level of vitamin D was associated with more frequent exacerbation and higher CAT scores but was not associated with FEV1 (%) predicted.Keywords: COPD, vitamin D, FEV1, CAT score

Objectives This study compared effects of vitamin D, fish oil and exercise on cardiovascular parameters in ovariectomized rats. Materials and methods This is an experimental study conducted with 45 female Wistar Albino rats; consisted of one sham (n=8) and four intervention (n=37) groups. Rats (n=37) were oophorectomized and, randomly divided into four groups at the end of the first week following wound healing. Interventions were applied to the groups of oophorectomize+Dvit, oophorectomize+fish oil and oophorectomize+exercise for 12 weeks. In analyzing the data, ANOVA and Tamhane’s T2 tests were used (p Results The levels of total-cholesterol (66.7 ± 7.6 mg/dL), HDL-cholesterol (33.8 ± 2.1 mg/dL), TOS (7.3 ± 1.2 μmol H2O2 Eq/L), TAS (4.0 ± 0.5 mmol Trolox Eq/L), OSI (0.2 ± 0.1) and total-cholesterol/HDL-cholesterol (2.0 ± 0.3) were obtained significant in exercising oophorectomized rats according to the oophorectomized rats (p Conclusions It was concluded that exercising oophorectomized rats had a lower risk of cardiovascular disease. In this context, exercise/physical activity should be recommended and must be supported for practicing in order to protect the cardiovascular health of postmenopausal women.

Summary Introduction Although prevalent and associated with worsened outcomes, vitamin D severe deficiency is not systematically searched among intensive care unit (ICU) admissions and waiting time for measurement results range from hours to few days. Hence, we developed and internally validated a simple nomogram for predicting severe vitamin D deficiency at ICU admission. Patients and methods Data of 3338 ICU admissions from an observational prospective cohort registered between January 2017 and December 2019 were analyzed. Demographic data as well as severity scores and season of admission were obtained. After splitting the population into training and test sets, a least absolute shrinkage (LASSO) regression model was used to select factors and construct the nomogram. Calibration and discrimination were used to assess the nomogram performance. Clinical use was evaluated by a decision curve analysis. Results Age, gender, Sequential Organ Failure Assessment (SOFA), Simplified Acute Physiology Score III (SAPS3) and season of admission were identified by the LASSO regression analysis as significant predictors of vitamin D severe deficiency at ICU admission. The nomogram model showed good discrimination with a 1000 bootstrap analysis and good calibration with a C-index of 0.64. The decision curve analysis showed that at a threshold probability between 30% and 50%, using the nomogram adds more benefit that considering that all patients are severely deficient or non-severely deficient. Conclusions This easy-to-use dynamic nomogram can help physicians to select patients that could benefit the most from vitamin D supplementation at ICU admission. External validation is needed to verify the generalizability of this nomogram.

Non-alcoholic fatty liver disease (NAFLD) represents a growing cause of liver morbidity and mortality globally with no proven effective therapy yet. The aim of this research is to investigate the effect of vitamin D treatment on choline deficient (CD) diet-induced nonalcoholic fatty liver disease (NAFLD) like lesions in rats, with the possible involvement of irisin in this effect. Thirty-two rats were divided into 4 equal groups; control group, vitamin D group, CD diet group, CD diet+ vitamin D group. It was found that CD diet led to significant elevations in liver weight and index, serum liver enzymes, hepatic triglycerides (TG), malondialdehyde (MDA), inflammatory markers with significant decreases in serum 25-(OH) D3, irisin, hepatic antioxidants and peroxisome proliferator–activated receptor alpha (PPAR–α). Administration of vitamin D caused a significant improvement in all previous parameters, these results were supported by histopathological examination. It seems that vitamin D supplementation significantly reduced NAFLD induced by CD diet even in part due to irisin.

Background: Although the burden of bronchiectasis is recognized globally, pediatric data are limited, particularly on trends over the years. Also, no published data exists regarding whether vitamin D deficiency or insufficiency and human T-cell lymphotropic virus type 1 (HTLV-1) infection, both found to be related to severe bronchiectasis in First Nations adults, also are important in children with bronchiectasis. Research Question: Among children with bronchiectasis, (1) have the clinical and BAL profiles changed between two 5-year periods (period 1, 2007-2011; period 2, 2012-2016) and (b) are vitamin D deficiency or insufficiency, HTLV-1 infection, or both associated with radiologic severity of bronchiectasis? Study Design and Methods: We analyzed the data from children with bronchiectasis prospectively enrolled at Royal Darwin Hospital, Australia, at the first diagnosis; that is, no child was included in both periods. Data collected include demographics, BAL, routine investigation bloods, and high-resolution CT scan of the chest evaluated using the Bhalla and modified Bhalla scores. Results: The median age of the 299 children was 2.2 years (interquartile range, 1.5-3.7 years). One hundred sixty-eight (56%) were male and most were First Nations (92%). Overall, bronchiectasis was high over time, particularly among First Nations children. In the later period, numbers of non-First Nations children more than tripled, but did not reach statistical significance. In period 2 compared with period 1, fewer First Nations children demonstrated chronic cough (period 1, 61%; period 2, 47%; P =.03), and were younger, First Nations children were less likely to have received azithromycin (period 1, 42%; period 2, 21%; P

Background This study was performed to reveal the relationships between the cross-sectional areas (CSAs) of the paraspinal muscles and the severity of low back pain (LBP), including the level of disability. Methods This single-center cross-sectional study was conducted on 164 patients with chronic LBP. The effects of demographic characteristics, posture, level of physical activity, disc herniation type, and sarcopenia risk on the CSAs of paraspinal muscles were evaluated along with the relationship between the CSAs and severity of pain and disability in all patients. The CSAs of paraspinal muscles were evaluated using the software program Image J 1.53. Results A negative significant correlation was found between age and the paraspinal muscle’s CSA (P < 0.05), whereas a positive correlation was present between the level of physical activity and the CSA of the paraspinal muscle at the L2-3 and L3-4 levels. The CSAs of paraspinal muscles in patients with sarcopenia risk was significantly lower than those in patients without sarcopenia risk (P < 0.05). The CSAs of paraspinal muscles at the L2-3 and L3-4 levels in obese patients were significantly higher than those in overweight patients (P = 0.028, P = 0.026, respectively). There was no relationship between the CSAs of paraspinal muscles and pain intensity or disability. Conclusions Although this study did not find a relationship between paraspinal CSAs and pain or disability, treatment regimens for preventing paraspinal muscles from atrophy may aid pain physicians in relieving pain, restoring function, and preventing recurrence in patients with chronic LBP.

BACKGROUND AND AIMS Vitamin D (VD) deficiency is considered an important risk factor for the development of atherosclerosis and aortic aneurysms. The deficiency is claimed to enhance degeneration and remodeling of collagen and elastin fibers in the artery wall, leading to its weakening and progressive dilatation. This study aimed to assess vitamin D status, in outpatients with abdominal aneurysms (AAA) and peripheral artery disease (PAD) not treated with VD, and factors affecting serum 25-OH-D levels. METHODS AND RESULTS This cross-sectional study involved 59 outpatients with AAA and 150 with PAD. AAA was defined as local dilation of the aorta diameter >30 mm in imaging. None of the patients was prescribed VD containing medicines. Serum 25-OH, iPTH, phosphorus and calcium levels were assessed in all study participants. VD status was categorized according to commonly used cut-offs for serum 25-OH-D (

Hypocalcemia (HCa) is one of the main water-electrolyte disturbances in clinical practice. An acute decrease in serum calcium levels can lead to seizures, ventricular arrhythmias, bronchospasm and laryngospasm. Chronic HCa can result in disorientation and confusion. To prevent these complications, the risk factors for low calcium levels must be carefully evaluated. One of these factors is drugs, in which case we are talking about drug-induced (DI) HCa. The list of drugs-inducers of DI HCa is quite extensive, but the leading role in this disorder is played by drugs for the treatment of osteoporosis, antineoplastic and antiepileptic drugs, as well as drugs for anti-tuberculosis therapy. When taking zoledronic acid, DI HCa is observed with a frequency of up to 39%. When taking imatinib, a targeted anticancer drug, a decrease in calcium levels was observed in 40% of cases. The pathophysiological mechanisms of DI HCa can be a decrease in bone resorption, a decrease in the concentration of vitamin D, inhibition of the action of parathyroid hormone and impaired calcium absorption. Risk factors in most cases of DI HCa are vitamin D deficiency and hypomagnesemia. An acute decrease in calcium levels leads to symptoms of neuromuscular excitability, abnormalities on the electrocardiogram (ECG) and electroencephalogram (EEG). The basis for the treatment of DI HCa is the drug withdrawal and the appointment of calcium. It is also necessary to prescribe vitamin D. The main methods of prevention of DI HCa are to determine the level of calcium and vitamin D before starting therapy with culprit medication, and to correct its level. It is also important to prescribe additional amounts of calcium and vitamin D during therapy with such drugs. Awareness of the attending physicians about the problem of DI HCa, a thorough assessment of its risk factors and the prophylactic administration of calcium and vitamin D preparations will help to effectively prevent those serious complications resulting from a decrease in calcium levels in clinical practice.

Background: Systemic lupus erythematosus (SLE) is a systemic autoimmune disease where chronic inflammation and organ damage is observed due to various suspected causes e.g. inadequate levels of vitamin D (a steroid hormone with immunomodulatory effects). Objective: To assess vitamin D (VD) levels in serum of patients with lupus nephritis (LN) in comparison with patients with extra-renal lupus and healthy controls, and to assess the relation between VD levels and the various clinical and laboratory disease parameters. Patients and Methods: This was a case-control study that was held in Zagazig University Hospitals between June 2019 and July 2020. The study included 40 patients admitted with systemic lupus erythematosus (SLE) with and without lupus nephritis (LN), and 20 age-matched healthy subjects. Laboratory investigations such as complete blood count, electrolytes, PTH, acute phase reactant, complements, Ads DNA and 25(OH) D levels of the subjects were measured. Results: Patients with SLE with lupus nephritis were significantly lower regarding vitamin D with no significant difference between patients with SLE without LN and control group. Conclusions: Our study revealed a high frequency of Vit D deficiency and insufficiency among patients with SLE with LN compared to SLE without LN and healthy controls. Keywords

Background: hypocalcemia is a common metabolic problem in neonates and infants that can be life threatening. The incidence of hypocalcemia leads to complications and developmental disorders in children. Case presentations: A 1 month-old boy with hypovitaminosis D and a history of recurrent hypocalcemia since one week of age. The patient had repeated seizures at the age of 7 days without fever and hypoglycemia, the overall physical examination was within normal, the results of the lumbar puncture were within normal limits. Laboratory examinations at that time showed low of serum calcium, urinary calcium, calcium ion and vitamin D levels, while magnesium, phosphorus and parathyroid hormone (PTH) levels were within normal limits. The patient was diagnosed with late onset hypocalcemia caused by hypovitaminosis D. The patient was given vitamin D therapy, calcium lactate, and intravena calcium correction was performed. Conclusion: late onset hypocalcemia occurring after the first 7 days of life was associated with hyperparathyroidism, high phosphate formula administration, DiGeorge syndrome, hypomagnesemia, and vitamin D deficiency.

Background: Coronavirus disease 2019 (COVID-19) has killed millions of individuals and has led to the largest economic contraction since the Great Depression. The antiviral effects of vitamin D can hinder viral replication directly, and also be effective in an anti-inflammatory and immunomodulatory way. Objective: This study aimed to estimate the serum levels of free 25 hydroxycholecalciferol (25(OH)-D) in patients with COVID-19 infection in correlation to clinical manifestations and severity in multicenter tertiary-care hospitals, Egypt. Subject and Methods: This cross-sectional study included 150 confirmed patients with COVID-19 by using RT-PCR for detection of the viral RNA. The COVID-19 patients were classified into four groups of mild (n=40) moderate (n=40), severe (n=40), and critical (n=30) based on disease severity. Serum concentrations of 25(OH)-D were tested using enzyme-linked immunosorbent assay (ELISA). Results According to the current study results, all included patients (n=150) had a low level of serum levels of 25(OH)- D (11.46±4.47) in COVID -19 patients compared to normal levels. Interestingly, the levels of serum 25(OH)-D were significantly low in severe (9.5±2.71) and critical (6.26±2.58) groups compared to mild (16.37±2.62) and moderate (12.3±2.62) groups. Also, there was a significant positive correlation between serum 25(OH)-D levels and hemoglobin, platelets, albumin, and SPO2 values. On the other hand, there was a significant negative correlation between serum 25(OH)-D levels and LDH, C reactive protein, D dimer, and ferritin levels. Conclusions: Patients with COVID-19 in particular patients with severe and critical COVID -19 had a significantly low level of serum 25(OH)-D compared to mild and moderate cases, in addition, PSO2 and D dimer were independently correlated with serum 25(OH)-D, thus low serum 25(OH)-D level could be a predictor of severe and critical COVID - 19. [ABSTRACT FROM AUTHOR] Copyright of Egyptian Journal of Hospital Medicine is the property of Egyptian Journal of Hospital Medicine and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Vitamin D concentrations are a function of sunlight exposure and dietary intake. However, current dietary vitamin D recommendations do not consider differences in country-specific sunlight availability or spontaneous individual exposure.We aimed to investigate the effects of vitamin D supplementation and sunlight exposure on vitamin D concentrations in Brazilian women living in high compared with low latitudes.In 2 parallel, double-blind, randomized placebo-controlled trials, Brazilian women living in England (51°N) composed "without ultraviolet B (UVB) exposure" groups and those living in Brazil (16°S) composed the "with UVB exposure" groups (mean age, 31.39 ± 8.7 years). Participants received 15 μg cholecalciferol or placebo daily for 12 weeks during wintertime. Serum 25-hydroxyvitamin D [25(OH)D] concentrations, the primary outcome, were assessed by HPLC-MS/MS, vitamin D intakes were assessed by 4-day diet diaries, and sunlight exposure was assessed by UVB dosimeters. The effects of supplementation and UVB exposure were tested by the intention to treat with a linear mixed model.The 25(OH)D concentrations increased in both supplemented groups [from 75.1 ± 22.0 to 84.8 ± 21.0 nmol/L (P = 0.004) in the group with UVB exposure; from 38.1 ± 15.9 to 55.1 ± 12.2 nmol/L (P 0.001) in the group without UVB exposure], with no significant changes in either placebo group. Concentrations in both supplemented groups were higher than those in the placebo group without UVB exposure (P = 0.0002 in the group with UVB exposure; P = 0.0035 in the group without UVB exposure). Postintervention 25(OH)D concentrations were significantly affected by serum 25(OH)D concentrations at baseline (P 0.0001) and by intervention (placebo or supplement; P 0.0001), with a large effect size (Cohen's D = 0.768), but were not affected by UVB exposure (with or without; P = 0.1386), nor by the interaction between the intervention (placebo or supplement) and UVB exposure (with or without; P = 0.9845).Moderate supplementation of 15 ug/d cholecalciferol, in accordance with current recommendations, supports an adequate vitamin D status in adult women, irrespective of latitude, and might concomitantly prevent an increase in parathyroid hormone. The Interaction Between Vitamin D Supplementation and Sunlight Exposure in Women Living in Opposite Latitudes (D-SOL) study was registered at clinicaltrials.gov as NCT03318029.

Objective This article summarizes the research progress on the association of vitamin D and food allergy in infants and children. Background In recent years, food allergy seriously has affected the quality of life of children and adults. Vitamin D is known to be involved in calcium and phosphorus metabolism, and recent research has demonstrated that vitamin D can also affect the immune regulation of food allergy. Methods The present study summarizes the research progress on the association of vitamin D and food allergy in infants and children. We searched the PubMed database to identify studies on the association of vitamin D and food allergy published between January 2003 and August 2021. Conclusions Vitamin D in the body through a number of steps into the final formation of biological effects. The implications of postnatal vitamin D levels for food allergy may be even greater. Vitamin D can prevent the intestinal immune system from being exposed to allergens by maintaining the integrity of the mucosal barrier. Many clinical studies believe that vitamin D supplementation can improve infants' and children's food allergy, however, some show negative results or opposite results. A lot of laboratory studies have confirmed that vitamin D is involved in the immune regulation of food allergy. Evidence indicates there may be a nonlinear relationship between vitamin D and food allergy. Further researches need to be launched.