[Scurvy, a serious and rare form of avitaminosis, easily diagnosed

and treated. Presentation of a case].

[Article in Spanish]
Gil Llano JR1, Grespo Rincn L, Ruiz Llano FC, Costo Campoamor A, Mateos Polo L, Gonzlez MA.

Author information

Servicios de Medicina Interna, Hospital San Pedro de Alcntara, Cceres.

Abstract
We report a 66 years-old man case that was admitted with abdominal wall hemorrhagic swelling
ecchymosis on inferior extremities and perifollicular purpura with hyperkeratosis of the follicles, which
gives it an appearance of palpable purpura, together with gingival hemorrhage and moderate anemia.
He was a well-nourished sick man but who made a peculiar diet, practically free from fruit and
vegetables which developed a pure and serious form of scurvy. We report this case because we
consider that the features which appear are illustrative to provide the immediate clinical diagnosis of
this uncommon disease, potentially mortal, but easy to diagnose, if we think about it in the adequate
clinical contexts, and which it is quickly curable with the administration of ascorbic acid.

Comment in

[Vitamin C deficiency: scurvy. Report of a case]. [An Med Interna. 1996]

Prevalence of Vitamin D Insufficiency and Deficiency among Young

Physicians at University District Hospital in San Juan, Puerto Rico.
Ramrez-Vick M1, Hernndez-Dvila L1, Rodrguez-Rivera N1, Lpez-Valentn M2, Haddock L1,
Rodrguez-Martnez R3, Gonzlez-Bossolo A3.

Author information

Endocrinology Division, Internal Medicine Department, School of Medicine, University

Hospital, University of Puerto Rico Medical Sciences Campus, San Juan, PR.
Puerto Rico Clinical and Translational Research Consortium, School of Medicine, University
of Puerto Rico Medical Sciences Campus, San Juan, PR.
Internal Medicine Department, School of Medicine, University Hospital, University of Puerto
Rico Medical Sciences Campus, San Juan, PR.

Abstract
Vitamin D has been attracting increased attention because of higher prevalences of vitamin D
insufficiency and deficiency than expected in areas with sufficient sun exposure. Even though sunlight
exposure and diet are the main determinants of vitamin D status, other factors, such as age, race, the
use (or not) of sunscreen, medications, and malabsorptive conditions, also affect vitamin D levels.
Recent studies have found high prevalences of vitamin D deficiency and insufficiency in different
populations. However, there are limited data regarding the prevalence of vitamin D deficiency and
insufficiency in Puerto Rico. To shed more light on the subject, we evaluated a sample of 51 internal
medicine residents and research fellows, aged from 25 to 39 years at the University District Hospital in
San Juan, Puerto Rico, doing so by means of a questionnaire that explored basic socio demographic

and lifestyle characteristics and collected anthropometric data; in addition, we obtained blood samples
in order to determine 25-hydroxyvitamin D levels. The median 25-hydroxyvitamin D level was 21
ng/mL (range, 7-38 ng/mL). Forty-five participants (88.2%) had 25-hydroxyvitamin D concentrations of
lower than 30 ng/mL. We found vitamin D deficiencies in 43.1% of the population and insufficiencies in
45.1%. Contributory factors to our findings include limited exposure to sunlight during periods of high
sun intensity, increased body mass index, and a limited area of the body being exposed to sunlight. A
relationship between reduced physical activity levels and hypovitaminosis D was also found. Both
calcium intake and vitamin D intake, which were markedly below recommended daily allowances,
were positively correlated with 25-hydroxy vitamin D levels, but with a weak association.
KEYWORDS:
25-Hydroxyvitamin D/calcium; Dietary/sunlight exposure/physical activity; Dietary/vitamin D

Clinical Trial of Vitamin D2 vs D3 Supplementation in Critically Ill

Pediatric Burn Patients.
Gottschlich MM1, Mayes T2, Khoury J3, Kagan RJ4.

Author information

Department of Research, Shriners Hospitals for Children, Cincinnati, Ohio Department of

Nutrition, Shriners Hospitals for Children, Cincinnati, Ohio Department of Surgery, University
of Cincinnati College of Medicine, Cincinnati, Ohio mgottschlich@shrinenet.org.
Department of Nutrition, Shriners Hospitals for Children, Cincinnati, Ohio Cincinnati Children's
Hospital Medical Center, Cincinnati, Ohio.
Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio.

Department of Surgery, University of Cincinnati College of Medicine, Cincinnati, Ohio

Department of Surgery, Shriners Hospitals for Children, Cincinnati, Ohio.

Abstract
BACKGROUND:
Hypovitaminosis D exists postburn. However, evidence-based guidelines for vitamin D repletion are
unknown. This investigation examined differences between D2 and D3 supplementation on outcome in
children with burn injuries.
METHODS:
Fifty patients with total body surface area burn of 55.7% 2.6% and full-thickness injury of 40.8%
3.8% were enrolled, ranging in age from 0.7-18.4 years. All participants received multivitamin
supplementation per standardized clinical protocol. In addition, 100 IU/kg D 2, D3, or placebo was
administered daily during hospitalization using a randomized, double-blinded study design. Assay of
total 25-hydroxyvitamin D (D25), 1,25-dihydroxyvitamin D (D1,25), 25-hydroxyvitamin D 2 (25-OH-D2),
25-hydroxyvitamin D3 (25-OH-D3), and parathyroid hormone (PTH) was performed at 4 preplanned
time intervals (baseline, midpoint, discharge, and 1 year postburn). Differences in vitamin D status
were compared over time and at each specific study interval.
RESULTS:
There were no significant differences in serum vitamin D levels between groups, but >10% of patients
had low D25 at discharge, and percent deficiency worsened by the 1-year follow up for the placebo
(75%), D2 (56%), and D3 (25%) groups. There were no statistical differences in PTH or clinical

outcomes between treatment groups, although vitamin D supplementation demonstrated

nonsignificant but clinically relevant decreases in exogenous insulin requirements, sepsis, and scar
formation.
CONCLUSIONS:
The high incidence of low serum D25 levels 1 year following serious thermal injury indicates prolonged
compromise. Continued treatment with vitamin D3 beyond the acute phase postburn is recommended
to counteract the trajectory of abnormal serum levels and associated morbidity.
2015 American Society for Parenteral and Enteral Nutrition.
KEYWORDS:
burn injury; pediatrics; vitamin D

Plasma vitamin D status in patients with type 2 diabetes with and

without retinopathy.
Reddy GB1, Sivaprasad M2, Shalini T2, Satyanarayana A2, Seshacharyulu M2, Balakrishna N2,
Viswanath K3, Sahay M4.

Author information

Biochemistry, National Institute of Nutrition, Hyderabad, India. Electronic address:

Geereddy@yahoo.com.
Biochemistry, National Institute of Nutrition, Hyderabad, India.
Pushpagiri Vitreo Retina Institute, Hyderabad, India.
Nephrology, Osmania Medical College & Hospital, Hyderabad, India.

Abstract
OBJECTIVE:
Diabetic retinopathy (DR) is a common cause of blindness. Although an association between
hypovitaminosis D and type 1 diabetes is known, the association between vitamin D (VD) and type 2
diabetes (T2D) and its complications such as DR has been unclear. The aim of this study was to
investigate the status of VD in T2D patients with and without DR.
METHODS:
A cross-sectional case-control study was conducted with 99 normal control (CN) participants and 164
patients with T2D, of which 82 had retinopathy (DR) and 82 did not (DNR). After a complete
ophthalmic examination, inclusive of fundus fluorescein angiography, the clinical profile and the
plasma levels of VD and calcium were analyzed.
RESULTS:
Although the mean plasma VD levels were significantly lower in the DNR and DR groups compared
with the CN group, no significant differences were observed between the groups with diabetes.
Although the mean levels of VD in all three groups were below the normal range, the prevalence of VD
deficiency (VDD) was higher in the DNR and DR groups (66% and 63%) than in the CN group (45%),
suggesting that the prevalence of VDD was higher in individuals with diabetes, regardless of the
presence or absence of retinopathy. However, there were no group differences in the plasma levels of

calcium. Additionally, VDD did not seem to be related to patient's age or body mass index, but was
related to the duration of diabetes.
CONCLUSION:
Results from this study suggest a possible association between VDD and T2D, but not specifically with
DR. Further investigations are warranted.
Copyright 2015 Elsevier Inc. All rights reserved.
KEYWORDS:
Calcium; Diabetic complications; Diabetic retinopathy; Type 2 diabetes; Vitamin D

Vitamin D and tuberculosis: a review on a hot topic.

Facchini L, Venturini E, Galli L, Martino Md, Chiappini E.

Abstract
The aim of this study is to critically summarize the available data on the correlation between vitamin D
level and tuberculosis (TB) infection. A literature search covering English language articles published
up to 20 October 2014 was conducted in MEDLINE database. Three hundred ninety-seven articles
were initially identified, of which 147 studies were initially selected, and other 13 pertinent studies were
included. A significant association between low vitamin D levels and susceptibility to TB infection has
been found.
KEYWORDS:
Children,; Hypovitaminosis D,; Immunity; Mycobacterium tuberculosis,; Tuberculosis,; Vitamin D,

[Is there vitamin D deficiency in children in a sunny Mediterranean

city?]
[Article in Spanish]
Togo A1, Espadas Maci D2, Blanes Segura S2, Siv Daz N2, Villalba Martnez C3.

Author information

Servicio de Pediatra, Hospital Clnico de Valencia, Valencia, Espaa. Electronic address:

togoandrea@yahoo.it.
Servicio de Pediatra, Hospital Clnico de Valencia, Valencia, Espaa.

Laboratorio de Bioqumica Clnica y Patologa Molecular, Hospital Clnico de Valencia,

Valencia, Espaa.

Abstract
INTRODUCTION:
Despite the increasing interest in vitamin D functions, new cases of deficiency have been reported in
sunny regions where optimal levels are expected. The aim of this study was to analyze 25hydroxivitamin D levels in children younger than 2 years admitted for acute mild diseases in a tertiary
hospital in Valencia and its relationship with factors that can be associated with its deficiency.

METHODS:
This one year prospective and observational study was conducted on 169 children admitted for acute
mild diseases. 25-hydroxivitamin D levels were analyzed. A standardized physical examination and
structured interviews to the parents were performed. Children were classified into two groups,
according to 25-hydroxivitamin D levels (cut-off 30ng/mL).
RESULTS:
A total of 169 children were included, with a median age of 9 months, being more prevalent
Caucasians (75.7%) and youger than one year old (79.3%). Almost one quarter (24.3%) of the children
had 25-hydroxivitamin D levels <30ng/mL, more frequently in winter/spring, and in children with higher
skin phototypes (P<.01). Levels >30ng/mL were associated with vitamin D prophylaxis during the first
year, in children of a Caucasian mother, and those who did not wear a hijab. No statistical differences
were found in diet characteristics (P=.65). Prophylaxis was given to 47% of the breastfed children
younger than one year.
CONCLUSIONS:
In Valencia, Spain, 25-hydroxivitamin D levels lower than 30ng/mL were found in a quarter of the
children younger than two years. Our results emphasize the importance of vitamin D prophylaxis
during the first year of life, even in sunny Mediterranean regions.
Copyright 2015 Asociacin Espaola de Pediatra. Published by Elsevier Espaa, S.L.U. All rights
reserved.
KEYWORDS:
Exposicin solar; Hipovitaminosis; Hypovitaminosis; Lactante; Profilaxis; Prophylaxis; Sun exposure;
Toddler; Vitamin D; Vitamina D

Impact of Vitamin D Replacement on Markers of Glucose

Metabolism and Cardio-Metabolic Risk in Women with Former
Gestational Diabetes-A Double-Blind, Randomized Controlled Trial.
Yeow TP1, Lim SL2, Hor CP3, Khir AS4, Wan Mohamud WN5, Pacini G6.

Author information

Department of Medicine, Penang Medical College, Penang, Malaysia; Steno Diabetes Centre,
Gentofte, Denmark.
Department of Medicine, Penang General Hospital, Penang, Malaysia.

Clinical Research Centre, Seberang Jaya Hospital, Seberang Jaya, Penang, Malaysia;
Kepala Batas Hospital, Kepala Batas, Penang, Malaysia.
Department of Medicine, Penang Medical College, Penang, Malaysia; Department of
Medicine, Penang General Hospital, Penang, Malaysia.
Cardiovascular, Diabetes and Nutrition Research Centre, Institute for Medical Research,
Kuala Lumpur, Malaysia.
Metabolic Unit, Institute of Biomedical Engineering, National Research Council, Padova, Italy.

Abstract

Gestational Diabetes Mellitus (GDM) and vitamin D deficiency are related to insulin resistance and
impaired beta cell function, with heightened risk for future development of diabetes. We evaluated the
impact of vitamin D supplementation on markers of glucose metabolism and cardio metabolic risk in
Asian women with former GDM and hypovitaminosis D. In this double blind, randomized controlled
trial, 26 participants were randomized to receive either daily 4000 IU vitamin D3 or placebo capsules.
75g Oral Glucose Tolerance Test (OGTT) and biochemistry profiles were performed at baseline and 6
month visits. Mathematical models, using serial glucose, insulin and C peptide measurements from
OGTT, were employed to calculate insulin sensitivity and beta cell function. Thirty three (76%) women
with former GDM screened had vitamin D level of <50 nmol/L at baseline. Supplementation, when
compared with placebo, resulted in increased vitamin D level (+51.1 nmol/L vs 0.2 nmol/L, p<0.001)
and increased fasting insulin (+20% vs 18%, p = 0.034). The vitamin D group also demonstrated a
30% improvement in disposition index and an absolute 0.2% (2 mmol/mol) reduction in HbA1c. There
was no clear change in insulin sensitivity or markers of cardio metabolic risk. This study highlighted
high prevalence of vitamin D deficiency among Asian women with former GDM. Six months
supplementation with 4000 IU of vitamin D3 safely restored the vitamin D level, improved basal
pancreatic beta-cell function and ameliorated the metabolic state. There was no effect on markers of
cardio metabolic risk. Further mechanistic studies exploring the role of vitamin D supplementation on
glucose homeostasis among different ethnicities may be needed to better inform future
recommendations for these women with former GDM at high risk of both hypovitaminosis D and future
diabetes.

Association of 25-hydroxy Vitamin D levels with indexes of general

and abdominal obesity in Iranian adolescents: The CASPIAN-III
study.
Jari M1, Qorbani M2, Moafi M3, Motlagh ME4, Keikha M1, Ardalan G5, Kelishadi R1.

Author information

Department of Pediatrics, Child Growth and Development Research Center, Research

Institute for Primordial Prevention of Non-Communicable Disease, Isfahan University of
Medical Sciences, Isfahan, Iran.
Department of Community Medicine, Alborz University of Medical Science, Karaj, Iran ;
Department of Epidemiology, Chronic Disease Research Center, Endocrinology and
Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran,
Iran.
Department of Laboratory Sciences, School of Para Veterinary Medicine, Bu-Ali Sina
University, Hamedan, Iran.
Department of Pediatrics, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran ;
School Health Office, Ministry of Health and Medical Education, Tehran, Iran.
School Health Office, Ministry of Health and Medical Education, Tehran, Iran.

Abstract
BACKGROUND:
This study aimed to determine the association of serum 25-hydroxy Vitamin D (25(OH)D) levels with
measures of general and abdominal obesity in Iranian adolescents.
MATERIALS AND METHODS:
This nationwide cross-sectional study was conducted among 1090 students, aged 10-18 years, living
in 27 provinces in Iran. Serum concentration of 25(OH)D was analyzed quantitatively by direct

competitive immunoassay chemiluminescence method. Body mass index (BMI) and waist-to-height
ratio (WHtR) were considered as measures of generalized and abdominal obesity, respectively.
RESULTS:
Study participants consisted of 1090 adolescents (51.9% boy and 67.1% urban residents) with mean
age, BMI, and waist circumference of 14.7 (2.6) years, 19.3 (4.2) kg/m(2), and 67.82 (12.23) cm,
respectively. The median serum 25(OH)D was 13.0 ng/mL (interquartile range: 20.6). Overall, 40% of
participants were Vitamin D deficient, and 39% were Vitamin D insufficient. Serum 25(OH)D level was
not associated with BMI and WHtR.
CONCLUSION:
We did not document any significant association between serum 25(OH)D level and anthropometric
measures in adolescents. This finding may be because of considerably high prevalence of
hypovitaminosis D in the study population.
KEYWORDS:
25-Hydroxy Vitamin D; adolescents; obesity

Vitamin D in addition to peg-interferon-alpha/ribavirin in chronic

hepatitis C virus infection: ANRS-HC25-VITAVIC study.
Terrier B1, Lapidus N1, Pol S1, Serfaty L1, Ratziu V1, Asselah T1, Thibault V1, Souberbielle JC1, Carrat F1,
Cacoub P1.

Author information

Benjamin Terrier, Patrice Cacoub, Inflammation-Immunopathology-Biotherapy Department

(DHU i2B), Sorbonne Universits, UPMC Univ Paris 06, UMR 7211, F-75005 Paris, France.
1

Abstract
AIM:
To investigate if correction of hypovitaminosis D before initiation of Peg-interferon-alpha/ribavirin
(PegIFN/RBV) therapy could improve the efficacy of PegIFN/RBV in previously null-responder patients
with chronic genotype 1 or 4 hepatitis C virus (HCV) infection.
METHODS:
Genotype 1 or 4 HCV-infected patients with null response to previous PegIFN/RBV treatment and with
hypovitaminosis D (< 30 ng/mL) prospectively received cholecalciferol 100000 IU per week for 4 wk
[from week -4 (W-4) to W0], followed by 100000 IU per month in combination with PegIFN/RBV for 12
mo (from W0 to W48). The primary outcome was the rate of early virological response defined by an
HCV RNA < 12 IU/mL after 12 wk PegIFN/RBV treatment.
RESULTS:
A total of 32 patients were included, 19 (59%) and 13 (41%) patients were HCV genotype 1 and 4,
respectively. The median baseline vitamin D level was 15 ng/mL (range: 7-28). In modified intention-totreat analysis, 29 patients who received at least one dose of PegIFN/RBV were included in the
analysis. All patients except one normalized their vitamin D serum levels. The rate of early virologic
response was 0/29 (0%). The rate of HCV RNA < 12 IU/mL after 24 wk of PegIFN/RBV was 1/27 (4%).
The safety profile was favorable.

CONCLUSION:
Addition of vitamin D to PegIFN/RBV does not improve the rate of early virologic response in
previously null-responders with chronic genotype 1 or 4 HCV infection.
KEYWORDS:
Chronic hepatitis; Hepatitis C virus; Pegylated interferon; Ribavirin; Vitamin D

Vitamin D Deficiency in HIV Infection: Not Only a Bone Disorder.

Mansueto P1, Seidita A1, Vitale G1, Gangemi S2, Iaria C3, Cascio A4.

Author information

Department of Internal Medicine and Biomedicine, University of Palermo, 90100 Palermo,

Italy.
Department of Human Pathology, University of Messina, 98125 Messina, Italy ; IFC CNR,
Messina Unit, 98100 Messina, Italy.
Infectious Diseases Unit, Papardo-Piemonte Hospital, 98125 Messina, Italy.

Department of Human Pathology, University of Messina, 98125 Messina, Italy ; AILMI-ONLUS

Italian Association for the Control of Infectious Diseases, University of Messina, 98125
Messina, Italy.

Abstract
Hypovitaminosis D is a worldwide disorder, with a high prevalence in the general population of both
Western and developing countries. In HIV patients, several studies have linked vitamin D status with
bone disease, neurocognitive impairment, depression, cardiovascular disease, high blood pressure,
metabolic syndrome, type 2 diabetes mellitus, infections, autoimmune diseases like type 1 diabetes
mellitus, and cancer. In this review, we focus on the most recent epidemiological and experimental
data dealing with the relationship between vitamin D deficiency and HIV infection. We analysed the
extent of the problem, pathogenic mechanisms, clinical implications, and potential benefits of vitamin
D supplementation in HIV-infected subjects.
PMID:
26000302
[PubMed - as supplied by publisher]
PMCID:
PMC4426898
Free PMC Article

Vitamin D: A Review on Its Effects on Muscle Strength, the Risk of

Fall, and Frailty.
Halfon M1, Phan O1, Teta D1.

Author information

Service of Nephrology, Department of Medicine, Centre Hospitalier Universitaire Vaudois

(CHUV), Lausanne, Switzerland.
1

Abstract

Vitamin D is the main hormone of bone metabolism. However, the ubiquitary nature of vitamin D
receptor (VDR) suggests potential for widespread effects, which has led to new research exploring the
effects of vitamin D on a variety of tissues, especially in the skeletal muscle. In vitro studies have
shown that the active form of vitamin D, calcitriol, acts in myocytes through genomic effects involving
VDR activation in the cell nucleus to drive cellular differentiation and proliferation. A putative
transmembrane receptor may be responsible for nongenomic effects leading to rapid influx of calcium
within muscle cells. Hypovitaminosis D is consistently associated with decrease in muscle function and
performance and increase in disability. On the contrary, vitamin D supplementation has been shown to
improve muscle strength and gait in different settings, especially in elderly patients. Despite some
controversies in the interpretation of meta-analysis, a reduced risk of falls has been attributed to
vitamin D supplementation due to direct effects on muscle cells. Finally, a low vitamin D status is
consistently associated with the frail phenotype. This is why many authorities recommend vitamin D
supplementation in the frail patient.

Is vitamin d deficiency related to accumulation of advanced

glycation end products, markers of inflammation, and oxidative
stress in diabetic subjects?
ebekov K1, Strmer M2, Fazeli G2, Bahner U3, Stb F4, Heidland A5.

Author information

Comenius University Medical Faculty, 811 07 Bratislava, Slovakia.

University of Wrzburg, 97080 Wrzburg, Germany.
KfH Nierenzentrum Wrzburg, 97080 Wrzburg, Germany.
Beiersdorf AG, Hamburg, Germany.

University of Wrzburg, 97080 Wrzburg, Germany ; KfH Nierenzentrum Wrzburg, 97080

Wrzburg, Germany.

Abstract
Objectives. In diabetes accumulated advanced glycation end products (AGEs) are involved in the
striking cardiovascular morbidity/mortality. We asked whether a hypovitaminosis D associates with an
increased formation and toxicity of AGEs in diabetes. Methods. In 276 diabetics (160 M/116 F, age:
65.0 13.4; 43 type 1,T1DM, and 233 type 2 patients, T2DM) and 121 nondiabetic controls (60 M/61
F; age: 58.6 15.5 years) routine biochemistry, levels of 25-hydroxyvitamin D3 (25-(OH)D), skin
autofluorescence (SAF), plasma AGE-associated fluorescence (AGE-FL), N () -(carboxymethyl)lysine
(CML), soluble receptor for AGEs (sRAGE), soluble vascular adhesion protein-1 (sVAP-1), high
sensitive C-reactive protein (hs-CRP), and renal function (eGFR) were determined. Results. In the
diabetics SAF and AGE-Fl were higher than those of the controls and correlated with age, duration of
diabetes, and degree of renal impairment. In T2DM patients but not in T1DM the age-dependent rise
of SAF directly correlated with hs-CRP and sVAP-1. 25-(OH)D levels in diabetics and nondiabetics
were lowered to a similar degree averaging 22.5ng/mL. No relationship between 25-(OH)D and
studied markers except for sVAP-1 was observed in the diabetics. Conclusion. In diabetics
hypovitaminosis D does not augment accumulation of AGEs and studied markers of microinflammation
and oxidative stress except for sVAP-1.

Hypovitaminosis D and its relation to demographic and laboratory

data among hepatitis C patients.
Melo-Villar L1, Lampe E1, de Almeida AJ1, de P Scalioni L1, Lewis-Ximenez LL1, Miguel JC1, Del Campo
JA2, Ranchal I2, Villela-Nogueira CA3, Romero-Gomez M2.

Author information

Laboratory of Viral Hepatitis, Oswaldo Cruz Institute, FIOCRUZ, Rio de Janeiro, Brazil.

Unit for the Clinical Management of Digestive Diseases and CIBERehd, Hospital Universitario
de Valme, Sevilla, Spain.
Hepatology Unit, Medical Clinic Department, Clementino Fraga Filho University Hospital,
UFRJ, Rio de Janeiro, Brazil.

Abstract
BACKGROUND:
The relationship between 25-hydroxyvitamin D [25(OH)D] serum levels and response to antiviral
therapy and laboratory data in HCV infection remains unclear. The aim of this study was to determine
pre-treatment 25(OH)D serum level among HCV infected individuals and to evaluate the association
between vitamin D status, virological response, and laboratory data.
MATERIAL AND METHODS:
Baseline serum 25(OH)D levels were measured in 237 chronic HCV infected patients (139 female,
age 53.7 11.2 years) using chemiluminescence immunoassay. Correlations between serum 25(OH)D
levels, virological and laboratory data regarding HCV infection as well as sustained virological
response (SVR) to antiviral therapy were evaluated.
RESULTS:
Mean serum values of 25(OH)D was 26.2 12 ng/mL and prevalence of vitamin D deficiency (< 30
ng/mL) was 66.2%. Advanced age (> 55 years), high mean values of LDL, total cholesterol, HDL and
low mean values of alkaline phosphatase and hemoglobin were statistically associated to vitamin D
deficiency. Antiviral treatment was underwent by 133 HCV patients and 44.3% of them achieved SVR.
Most of individuals that presented SVR also presented 25(OH)D level higher than 30ng/mL (55.9%).
SVR was associated to low mean values of LDL, total cholesterol and platelets; high mean values of
ALT, AST and low fibrosis grade.
CONCLUSIONS:
In conclusion, low vitamin D levels were observed among HCV infected patients and was associated
to laboratory findings, however baseline 25(OH)D level is not independently associa

Impact of Vitamin D Replacement on Markers of Glucose

Metabolism and Cardio-Metabolic Risk in Women with Former
Gestational Diabetes-A Double-Blind, Randomized Controlled Trial.
Yeow TP1, Lim SL2, Hor CP3, Khir AS4, Wan Mohamud WN5, Pacini G6.

Author information

Department of Medicine, Penang Medical College, Penang, Malaysia; Steno Diabetes Centre,
Gentofte, Denmark.
Department of Medicine, Penang General Hospital, Penang, Malaysia.

Clinical Research Centre, Seberang Jaya Hospital, Seberang Jaya, Penang, Malaysia;
Kepala Batas Hospital, Kepala Batas, Penang, Malaysia.

Department of Medicine, Penang Medical College, Penang, Malaysia; Department of

Medicine, Penang General Hospital, Penang, Malaysia.
Cardiovascular, Diabetes and Nutrition Research Centre, Institute for Medical Research,
Kuala Lumpur, Malaysia.
Metabolic Unit, Institute of Biomedical Engineering, National Research Council, Padova, Italy.

Abstract
Gestational Diabetes Mellitus (GDM) and vitamin D deficiency are related to insulin resistance and
impaired beta cell function, with heightened risk for future development of diabetes. We evaluated the
impact of vitamin D supplementation on markers of glucose metabolism and cardio metabolic risk in
Asian women with former GDM and hypovitaminosis D. In this double blind, randomized controlled
trial, 26 participants were randomized to receive either daily 4000 IU vitamin D3 or placebo capsules.
75g Oral Glucose Tolerance Test (OGTT) and biochemistry profiles were performed at baseline and 6
month visits. Mathematical models, using serial glucose, insulin and C peptide measurements from
OGTT, were employed to calculate insulin sensitivity and beta cell function. Thirty three (76%) women
with former GDM screened had vitamin D level of <50 nmol/L at baseline. Supplementation, when
compared with placebo, resulted in increased vitamin D level (+51.1 nmol/L vs 0.2 nmol/L, p<0.001)
and increased fasting insulin (+20% vs 18%, p = 0.034). The vitamin D group also demonstrated a
30% improvement in disposition index and an absolute 0.2% (2 mmol/mol) reduction in HbA1c. There
was no clear change in insulin sensitivity or markers of cardio metabolic risk. This study highlighted
high prevalence of vitamin D deficiency among Asian women with former GDM. Six months
supplementation with 4000 IU of vitamin D3 safely restored the vitamin D level, improved basal
pancreatic beta-cell function and ameliorated the metabolic state. There was no effect on markers of
cardio metabolic risk. Further mechanistic studies exploring the role of vitamin D supplementation on
glucose homeostasis among different ethnicities may be needed to better inform future
recommendations for these women with former GDM at high risk of both hypovitaminosis D and future
diabetes.

Mineral metabolism in heart disease.

Heine GH1.

Author information

Internal Medicine IV - Nephrology and Hypertension, Saarland University Medical Center,

Homburg, Germany.
1

Abstract
PURPOSE OF REVIEW:
Strong experimental and clinical evidence points towards a substantial contribution of mineral
metabolism disorders to the initiation and progression of cardiovascular disease. Vice versa, recent
work suggests that cardiovascular disease may also cause mineral metabolism alterations.
RECENT FINDINGS:
Experimental studies suggest that hyperphosphatemia, elevated plasma levels of phosphaturic
hormones - parathyroid hormone and fibroblast growth factor-23 (FGF-23) - and hypovitaminosis D
exert detrimental effects on vascular tissue and on the myocardium. Accordingly, in longitudinal clinical
cohort studies, individuals with high plasma levels of phosphate, parathyroid hormone and FGF-23,
and with low vitamin D levels, face worst cardiovascular prognosis.Notably, recent evidence suggests
that cardiovascular disease may not only follow but also induce mineral metabolism disorders: severe
derangements in mineral metabolism were observed in patients with acute heart failure, who face a
tremendous increase in plasma FGF-23. Unfortunately, few prospective studies have been completed

hitherto that specifically target components of the mineral metabolism for cardiovascular disease
prevention or treatment.
SUMMARY:
A bidirectional interaction exists between mineral metabolism disorders and cardiovascular disease.
However, clinical evidence for a cardiovascular benefit of therapeutic interventions into mineral
metabolism is outstanding.

Vitamin D Metabolites and Their Association with Calcium,

Phosphorus, and PTH Concentrations, Severity of Illness, and
Mortality in Hospitalized Equine Neonates.
Kamr AM1, Dembek KA2, Reed SM3, Slovis NM4, Zaghawa AA5, Rosol TJ2, Toribio RE2.

Author information

College of Veterinary Medicine, The Ohio State University, Columbus, Ohio, United States of
America; Faculty of Veterinary Medicine, University of Sadat City, Sadat City, Egypt.
College of Veterinary Medicine, The Ohio State University, Columbus, Ohio, United States of
America.
Rood and Riddle Equine Hospital, Lexington, Kentucky, United States of America.
Hagyard Equine Medical Institute, Lexington, Kentucky, United States of America.
Faculty of Veterinary Medicine, University of Sadat City, Sadat City, Egypt.

Abstract
BACKGROUND:
Hypocalcemia is a frequent abnormality that has been associated with disease severity and outcome
in hospitalized foals. However, the pathogenesis of equine neonatal hypocalcemia is poorly
understood. Hypovitaminosis D in critically ill people has been linked to hypocalcemia and mortality;
however, information on vitamin D metabolites and their association with clinical findings and outcome
in critically ill foals is lacking. The goal of this study was to determine the prevalence of vitamin D
deficiency (hypovitaminosis D) and its association with serum calcium, phosphorus, and parathyroid
hormone (PTH) concentrations, disease severity, and mortality in hospitalized newborn foals.
METHODS AND RESULTS:
One hundred newborn foals 72 hours old divided into hospitalized (n = 83; 59 septic, 24 sick nonseptic [SNS]) and healthy (n = 17) groups were included. Blood samples were collected on admission
to measure serum 25-hydroxyvitamin D3 [25(OH)D3], 1,25-dihydroxyvitamin D3 [1,25(OH) 2D3], and
PTH concentrations. Data were analyzed by nonparametric methods and univariate logistic
regression. The prevalence of hypovitaminosis D [defined as 25(OH)D3 <9.51 ng/mL] was 63% for
hospitalized, 64% for septic, and 63% for SNS foals. Serum 25(OH)D3 and 1,25(OH) 2D3
concentrations were significantly lower in septic and SNS compared to healthy foals (P<0.0001; P =
0.037). Septic foals had significantly lower calcium and higher phosphorus and PTH concentrations
than healthy and SNS foals (P<0.05). In hospitalized and septic foals, low 1,25(OH)2D3
concentrations were associated with increased PTH but not with calcium or phosphorus
concentrations. Septic foals with 25(OH)D3 <9.51 ng/mL and 1,25(OH) 2D3 <7.09 pmol/L were more
likely to die (OR=3.62; 95% CI = 1.1-12.40; OR = 5.41; 95% CI = 1.19-24.52, respectively).

CONCLUSIONS:
Low 25(OH)D3 and 1,25(OH)2D3 concentrations are associated with disease severity and mortality in
hospitalized foals. Vitamin D deficiency may contribute to a pro-inflammatory state in equine perinatal
diseases. Hypocalcemia and hyperphosphatemia together with decreased 1,25(OH)2D3 but increased
PTH concentrations in septic foals indicates that PTH resistance may be associated with the
development of these abnormalities.

Atraumatic bilateral femoral neck fractures in a premenopausal

female with hypovitaminosis D.
Paraliticci G, David Rodrguez-Quintana R, Dvila A, Otero-Lpez A.

Abstract
Bilateral femur neck fractures in young adult patients are very rare in atraumatic circumstances. We
report a young premenopausal female with osteomalacia secondary to vitamin D deficiency and
spontaneous bilateral femur neck fractures. Patients had no reported risk factors for osteomalacia but
hypovitaminosis D was noted on laboratory evaluation. Osteomalacia secondary to low serum levels of
vitamin D may lead to stress and fragility fractures. Identification and treatment of at risk patients may
decrease the incidence of stress fractures and its possible complications.

Mood disorders are associated with a more severe hypovitaminosis

D than schizophrenia.
Belzeaux R1, Boyer L2, Ibrahim EC3, Fron F4, Leboyer M5, Fond G6.

Author information

Department of Psychiatry, Sainte-Marguerite University Hospital, La Conception University

Hospital, Assistance Publique - Hpitaux de Marseille, France; Aix Marseille Universit,
CNRS, CRN2M UMR 7286, Marseille, France; Fondation FondaMental, Fondation de
coopration scientifique en sant mentale, Crteil, France.
Department of Public Health, EA 3279 Research Unit, La Timone University Hospital,
Assistance Publique - Hpitaux de Marseille, Marseille, France.
Aix Marseille Universit, CNRS, CRN2M UMR 7286, Marseille, France; Fondation
FondaMental, Fondation de coopration scientifique en sant mentale, Crteil, France.
Aix Marseille Universit, CNRS, NICN, UMR7259, 13344, Marseille, France.

Fondation FondaMental, Fondation de coopration scientifique en sant mentale, Crteil,

France; University Paris Est-Crteil, GHU Mondor, DHU Pe-Psy, INSERM U955, Eq 15,
Crteil, France.
Fondation FondaMental, Fondation de coopration scientifique en sant mentale, Crteil,
France; University Paris Est-Crteil, GHU Mondor, DHU Pe-Psy, INSERM U955, Eq 15,
Crteil, France. Electronic address: guillaume.fond@gmail.com.

Abstract
Patients with psychiatric disorders display high levels of hypovitaminosis D (<50nmol/L). It remains
unclear whether it is associated with specific diagnoses. To further explore vitamin D status in
psychiatric inpatients, 82 individuals with mood disorders or schizophrenia/schizoaffective disorders
were included. Hypovitaminosis D was significantly lower in patients with mood disorders than patients

with schizophrenia (standardized coefficient=0.385, p=0.007). Further studies are warranted to

determine specific causes of hypovitaminosis D and the interest of supplementation.
Copyright 2015 Elsevier Ireland Ltd. All rights reserved.
KEYWORDS:
Bipolar disorders; Dysthymia; Major depression; Schizophrenia; Vitamin D

Are Growing Pains Related to Vitamin D Deficiency? Efficacy of

Vitamin D Therapy for Resolution of Symptoms.
Vehapoglu A1, Turel O, Turkmen S, Inal BB, Aksoy T, Ozgurhan G, Ersoy M.

Author information

Department of Pediatrics, Bezmialem Vakf University School of Medicine, Istanbul, Turkey.

Abstract
OBJECTIVES:
The aim of this study was to investigate the 25-hydroxyvitamin D [25(OH)D] status of children with
growing pains and to evaluate the efficacy of vitamin D treatment on the resolution of pain symptoms.
SUBJECTS AND METHODS:
One hundred and twenty children with growing pains were included in a prospective cohort study.
Serum 25(OH)D and bone mineral levels were measured in all subjects at the time of enrollment. The
pain intensity of those with vitamin D deficiency was measured using a pain visual analog scale (VAS).
After a single oral dose of vitamin D, the pain intensity was remeasured by means of the VAS at 3
months. The 25(OH)D levels and VAS scores before and after oral vitamin D administration were
compared by means of a paired Student's t test.
RESULTS:
In the 120 children with growing pains, vitamin D insufficiency was noted in 104 (86.6%). Following
vitamin D supplementation, the mean 25(OH)D levels increased from 13.4 7.2 to 44.5 16.4 ng/ml,
the mean pain VAS score decreased from 6.8 1.9 to 2.9 2.5 cm (a mean reduction of -3.8 2.1, p
< 0.001) and the difference was statistically significant.
CONCLUSION:
Supplementation with oral vitamin D resulted in a significant reduction in pain intensity among these
children with growing pains who had hypovitaminosis D. 2015 S. Karger AG, Basel.
Article in Press
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Mood disorders are associated with a more severe

hypovitaminosis D than schizophrenia
Raoul Belzeaux
,
Laurent Boyer
,
El Chrif Ibrahim

,
Franois Fron
,
Marion Leboyer
,
Guillaume Fond

Received: June 4, 2014; Received in revised form: March 6, 2015; Accepted: April 20, 2015; Published Online: May 19, 2015
Publication stage: In Press Corrected Proof

[Hypercalcemia and acute renal failure: a case report of vitamin D

intoxication].
[Article in French]
Pirotte B, Stifkens F, Kaye O, Radermacher L, Putzeys V, Deflandre J, Vijverman A.

Abstract
Vitamin D (VTD) deficiency has become a topical issue leading to screening with frequent
supplementation. The latter can be dangerous and exceptionally causes overdoses. We report the
case of a 20 year old patient with abdominal pain in the setting of hypercalcemia due to intoxication by
VTD. This case offers the opportunity to describe the differential diagnosis of hypercalcemia and to
brownse through the literature in search of clinical practice recommendations for VTD supplementation

Hypervitaminosis-D, an uncommon reality!

Mansuri ZH, Kaji BC, Dumra S, Buch HN.

Abstract
Vitamin D deficiency is highly prevalent in India. This has set off a trend among medical practitioners
to prescribe vitamin D supplements empirically. Whilst this approach is generally safe, in predisposed
individuals it may lead to hypervitaminosis D. Here we present a case where empirical use of high
dose vitamin D supplementation had serious consequences highlighting the need to use vitamin D
therapy judiciously and to remain vigilant for side-effects in high-risk individuals.

Determinants of serum 25(OH)D concentration in young and middleaged adults. The Cardiovascular Risk in Young Finns Study.
Voipio AJ1, Pahkala KA, Viikari JS, Mikkil V, Magnussen CG, Hutri-Khnen N, Khnen M,
Lehtimki T, Mnnist S, Loo BM, Jula A, Marniemi J, Juonala M, Raitakari OT.

Author information

The Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku
, Turku , Finland.
1

Abstract
INTRODUCTION:
We studied prevalence of hypovitaminosis D, its determinants, and whether achievement of
recommended dietary vitamin D intake (10 g/d) is associated with absence of hypovitaminosis D in
adults.

METHODS:
The study is part of the Cardiovascular Risk in Young Finns Study. We collected serum samples of 25hydroxyvitamin D as part of the 27-year follow-up (994 men and 1,210 women aged 30-45 years).
Hypovitaminosis was defined as vitamin D concentration 50 nmol/L.
RESULTS:
Hypovitaminosis D was found in 38% of men and 34% of women. Dietary vitamin D intake (OR 0.90,
95% CI 0.86-0.93), use of vitamin-mineral supplements (0.66, 0.51-0.85), sunny holiday (0.55, 0.410.75), and oral contraceptive use in women (0.45, 0.27-0.75) were independently associated with
reduced odds of hypovitaminosis. Increase in body mass index (1.06, 1.03-1.09), being a smoker
(1.36, 0.97-1.92), investigation month (December versus other) (1.35, 1.12-1.61), and risk alleles in
genotypes rs12785878 (1.31, 1.00-1.70) and rs2282679 (2.08, 1.66-2.60) increased odds of
hypovitaminosis. Hypovitaminosis D was common also when recommended dietary intake was
obtained (men 29%, women 24%).
CONCLUSION:
Several factors were associated with hypovitaminosis D. The condition was common even when
recommended vitamin D intake was reported. The results support the importance of vitamin D
fortification and nutrient supplement use.
KEYWORDS:
25(OH)D; Young Finns Study; fortification; hypovitaminosis D; single nucleotide polymorphism; vitamin
D

Optimization of Vitamin D Status After Roux-en-Y Gastric Bypass

Surgery in Obese Patients Living in Northern Climate.
Chan LN1, Neilson CH, Kirk EA, Colovos TF, Javelli DR, Khandelwal S.

Author information

Department of Pharmacy, School of Pharmacy, University of Washington, 1959 NE Pacific

Street, Box 357630, Seattle, WA, 98195, USA, neander@u.washington.edu.
1

Abstract
BACKGROUND:
Patients who undergo bariatric surgery are at risk for micronutrient deficiencies. The aims of this study
were to determine the prevalence and predictors of vitamin D deficiency in obese patients residing in
the northern climate, and to evaluate the effectiveness of a daily maintenance dose of vitamin D
2000 IU in preventing hypovitaminosis D within 1 year after bariatric surgery.
METHODS:
A cohort study involving adult patients undergoing RYGB was conducted. Longitudinal changes in
serum vitamin D concentrations and clinical parameters were measured and collected.
RESULTS:
Data from 134 recipients of RYGB were analyzed. Hypovitaminosis D was identified in 86 patients
(64 %), and was significantly affected by seasonal change and the number of comorbidities. Follow-up
data were available in 60 patients. Vitamin D sufficiency was achieved in 62.5 % of those patients with
baseline vitamin D insufficiency. A dose-response relationship of vitamin D intake was observed, with
the most significant increase in 25(OH)D associated with daily vitamin D intakes 2000 IU.

CONCLUSIONS:
The prevalence of hypovitaminosis D before RYGB was comparable to patients living in the nonnorthern climate. Daily vitamin D intake meeting at least 2000 IU is associated with greater
improvement in serum vitamin D concentration.

Effect of vitamin D supplementation on insulin kinetics and

cardiovascular risk factors in polycystic ovarian syndrome: a pilot
study.
Garg G1, Kachhawa G1, Ramot R1, Khadgawat R2, Tandon N1, Sreenivas V1, Kriplani A1, Gupta N1.

Author information

Departments of EndocrinologyObstetrics and GynecologyBiostaticsAll India Institute of

Medical Sciences, Ansari Nagar, New Delhi, 110029, India.
Departments of EndocrinologyObstetrics and GynecologyBiostaticsAll India Institute of
Medical Sciences, Ansari Nagar, New Delhi, 110029, India rajeshkhadgawat@hotmail.com.

Abstract
To assess the effect of vitamin D supplementation on parameters of insulin sensitivity/resistance
(IS/IR) and insulin secretion in subjects with polycystic ovarian syndrome (PCOS). A prospective
double-blind randomized control trial was conducted to assess the effect of vitamin D on insulin
kinetics in women with PCOS. The trial was conducted in a tertiary care research hospital. A total of 36
subjects with PCOS, aged 18-35 years, were included in this study. Vitamin D3 4000IU/day

versus
placebo was given once a month for 6 months and both groups received metformin. IS (by whole-body
IS index or Matsuda index), IR (by homeostasis model assessment IR (HOMA-IR)), and insulin
secretion (by insulinogenic index; II30) were the main outcome measures. Secondary outcome
included blood pressure (BP), lipid profile, disposition index (DI), and vascular stiffness. Out of 36
subjects who consented, 32 completed the study. Subjects were randomized into two groups: group A
(n=15; metformin and vitamin D 4000IU/day)

or group B (n=17; metformin and placebo). Oral glucose

tolerance tests with 75g
glucose were carried out at baseline and 6 months after supplementation.
Hypovitaminosis D was observed in 93.8% of all subjects with mean serum 25 hydroxy vitamin D level
of 7.304.45ng/ml.

After 6 months of vitamin D supplementation, there was no significant difference in

any of the parameters of IS/IR (area under curve (AUC)-glucose, AUC-insulin, insulin:glucose ratio,
HOMA-IR, Matsuda index, insulinogenic index, and DI), II30, and cardiovascular risk factors between
the two groups. Supplementation of vitamin D, at a dose of 4000IU/day

for 6 months, did not have any

significant effect on parameters of IS/IR and insulin secretion in subjects with PCOS.
2015 The authors.
1

J Am Med Dir Assoc. 2015 Jun 1;16(6):536.e8-536.e19. doi: 10.1016/j.jamda.2015.03.008. Epub 2015
Apr 24.

Derivation and validation of a clinical diagnostic tool for the

identification of older community-dwellers with hypovitaminosis d.
Annweiler C1, Kabeshova A2, Legeay M3, Fantino B2, Beauchet O2.

Author information

Division of Geriatric Medicine and Memory Clinic, Department of Neuroscience, UPRES EA

4638, UNAM, Angers University Hospital, Angers, France; Department of Medical Biophysics,
Robarts Research Institute, Schulich School of Medicine and Dentistry, The University of
Western Ontario, London, Ontario, Canada. Electronic address: CeAnnweiler@chu-angers.fr.
Division of Geriatric Medicine and Memory Clinic, Department of Neuroscience, UPRES EA
4638, UNAM, Angers University Hospital, Angers, France.
School of Medicine, University of Angers, Angers, France.

Abstract
OBJECTIVES:
Hypovitaminosis D is highly prevalent among seniors. Although evidence is insufficient to recommend
routine vitamin D screening in seniors, universal vitamin D supplementation is not desirable either. To
rationalize vitamin D determination, our objective was to elaborate and test a clinical diagnostic tool for
the identification of seniors with hypovitaminosis D without using a blood test.
DESIGN:
Derivation of a clinical diagnostic tool using artificial neural networks (multilayer perceptron; MLP) in
randomized training subgroup of Prvention des Chutes, Rseau 4' cohort, and validation in
randomized testing subgroup.
SETTING:
Health Examination Centers of health insurance, Lyon, France.
PARTICIPANTS:
A total of 1924 community-dwellers aged 65 years without vitamin D supplements, consecutively
recruited between 2009 and 2012.
MEASUREMENTS:
Hypovitaminosis D defined as serum 25-hydroxyvitamin (25OHD) concentration 75 nmol/L,
50 nmol/L, or 25 nmol/L. A set of clinical variables (age, gender, living alone, individual deprivation,
body mass index, undernutrition, polymorbidity, number of drugs used daily, psychoactive drugs,
biphosphonates, strontium, calcium supplements, falls, fear of falling, vertebral fractures, Timed Up
and Go, walking aids, lower-limb proprioception, handgrip strength, visual acuity, wearing glasses,
cognitive disorders, sad mood) were recorded. Several MLPs, based on varying amounts of variables
according to their relative importance, were tested consecutively.
RESULTS:
A total of 1729 participants (89.9%) had 25OHD 75 nmol/L, 1288 (66.9%) had 25OHD 50 nmol/L,
and 525 (27.2%) had 25OHD 25 nmol/L. MLP using 16 clinical variables was able to diagnose
hypovitaminosis D 75 nmol/L with accuracy = 96.3%, area under curve (AUC) = 0.938, and = 79.3
indicating almost perfect agreement. It was also able to diagnose hypovitaminosis D 50 nmol/L with
accuracy = 81.5, AUC = 0.867, and = 57.8 (moderate agreement); and hypovitaminosis
D 25 nmol/L with accuracy = 82.5, AUC = 0.385, and = 55.0 (moderate agreement).
CONCLUSIONS:
We elaborated an algorithm able to identify, from 16 clinical variables, seniors with hypovitaminosis D.
Copyright 2015 AMDA The Society for Post-Acute and Long-Term Care Medicine. Published by
Elsevier Inc. All rights reserved.

KEYWORDS:
Screening; older adults; vitamin D; vitamin D deficiency
PMID:
25922119
[PubMed - in process]

Risk factors associated with hypovitaminosis D in HIV/aids-infected

adults.
[Article in English, Portuguese]
Canuto JM1, Canuto VM1, Lima MH1, Omena AL1, Morais TM1, Paiva AM2, Diniz ET3, Almeida DJ4,
Ferreira SM1.

Author information

Centro Universitrio Cesmac, Macei, AL, Brazil.

Universidade Federal de Alagoas, Macei, AL, Brazil.
Universidade Federal de Campina Grande, Campina Grande, PB, Brazil.
Instituto Federal de Alagoas, Macei, AL, Brazil.

Abstract
Objective To investigate risk factors associated with hypovitaminosis D in adult patients infected with
HIV/aids, at a referral hospital in Macei, Brazil. Subjects and methods This cross-sectional study
involved 125 patients evaluated from April to September 2013 by means of interviews, review of
medical records, physical examination, and laboratory tests. The data were analyzed using the
SPSS software, version 17.0; the prevalence of hypovitaminosis D and mean levels of vitamin D
were determined. The association between hypovitaminosis D and the independent variables was
assessed using the Chi-square or the Fisher's exact tests; mean vitamin D concentrations were
analyzed using Kolmogorov-Smirnov, Mann-Whitney, and Kruskal-Wallis tests. The level of
significance was set at 5% across tests. Results The prevalence of hypovitaminosis D was 24%, with
a significant association with higher household income (p < 0.05). Higher vitamin D levels were
associated with female gender (p < 0.001), no use of sunscreen (p < 0.05), and previous opportunistic
infections (p < 0.01). Lower values were associated with the use of antiretroviral medication (p < 0.05),
overweight and obesity (p < 0.01). Conclusion Lower vitamin D concentrations were significantly
associated with well-known risk factors for hypovitaminosis D: use of sunscreen, antiretroviral
medication, overweight, and obesity. The prevalence of hypovitaminosis D in this study, considering
values > 20 ng/mL or > 30 ng/mL as vitamin D sufficiency, was lower to that of previous studies with
HIV-infected patients, a fact that might be related to the low latitude and high intensity of solar
radiation of the location of the present study.

Vitamin D status and surgical outcomes: a systematic review.

Iglar PJ1, Hogan KJ2.

Author information

Department of Population Health Sciences, University of Wisconsin School of Medicine and

Public Health, 707 WARF Building, 610 North Walnut Street, Madison, WI 53726 USA.
1

Department of Anesthesiology, University of Wisconsin School of Medicine and Public Health,

600 Highland Avenue, B/6 319 Clinical Sciences Center, Madison, WI 53792-3272 USA.
2

Abstract
The importance of vitamin D for musculoskeletal health has long been recognized, and awareness of
significant extra-skeletal effects in health and disease is rapidly emerging. Although it has been
possible for many decades to quantify serum markers of vitamin D deficiency, and to correct deficiency
at low cost and with high safety, the influence of vitamin D status on post-surgical outcomes has only
recently been identified as a research topic of interest. To the present, these data have not been the
subject matter of formal review. Accordingly, we conducted a systematic review to assess the
association between perioperative vitamin D status and outcomes after surgery. The databases of
PubMed, Ovid MEDLINE, EMBASE, AMED, CINAHL (EBSCOHost), The Cochrane Databases of
Systematic Review, and PROSPERO were searched through December, 2014 for studies relating to
vitamin D and surgery. The initial search yielded 90 manuscripts. After applying exclusion criteria, 31
studies were eligible for inclusion. Fifteen studies employed prospective observational designs, 3 used
prospective randomized protocols, and 13 report retrospective database interrogations. The main
finding of the present review is that 26 of 31 studies (84%) report at least one statistically significant
worse outcome in patients with low vitamin D status. Five of 31 studies (16%) found no association. In
conclusion, this review supports the hypothesis that hypovitaminosis D is associated with adverse
outcomes after diverse surgical procedures. Future studies should focus on additional surgeries and
outcomes, and on the role of vitamin D supplementation in the improvement of patient safety in
participants with low vitamin D status at the time of surgery.
KEYWORDS:
1,25-dihydroxyvitamin D3 (calcitriol); 1,25-dihydroxyvitamin D3 (calcitriol) level; 25(OH)D (calcifediol);
25(OH)D (calcifediol) level; Postoperative complication; Postoperative outcome; Surgery complication;
Surgery outcome; Vitamin D

Vitamin D status and its associations with components of metabolic

syndrome in healthy children.
Mellati AA, Sharifi F, Faghihzade S, Mousaviviri SA, Chiti H, Kazemi SA.

Abstract
AIM:
High prevalence of vitamin D insufficiency/deficiency has been reported in populations of different
countries. The aim of this cross-sectional study was to determine the prevalence and association of
vitamin D status with components of metabolic syndrome.
METHODS:
Lipid profile indices, anthropometric indices [body mass index and waist circumference (WC)], insulin
resistance index (HOMA-IR), systolic blood pressure (SBP), diastolic blood pressure (DBP), C-reactive
protein, intact parathyroid hormone (iPTH), and serum 25-hydroxyvitamin D [25(OH)D] concentration
were evaluated in 297 healthy schoolchildren aged 7-11 years. Multivariate linear regression was used
to determine independent predictors associated with low serum 25(OH)D concentrations.
RESULTS:
The mean serum 25(OH)D concentration was 14.128.20 ng/mL (35.320.5 nmol/L); 96% of children
had low serum 25(OH)D levels, 31.0% were deficient, and 65.0% had insufficient levels of 25(OH)D.
Vitamin D deficiency was higher in girls (2=13.66; p=0.00); 25(OH)D level was negatively associated

with WC, HOMA-IR, SBP, DBP, and iPTH. In the multivariate model, WC, DBP, and HOMA-IR were
significant independent predictor of low 25(OH)D concentrations.
CONCLUSION:
The prevalence of low vitamin D level in the studied healthy children was high and it is correlated with
some components of metabolic syndrome. Outdoor activity for optimum sun exposure and additional
studies are needed to evaluate the underlying metabolic syndrome components and hypovitaminosis
D complications.

Hypovitaminosis D: a novel risk factor for coronary heart disease in

type 2 diabetes?
Muscogiuri G1, Nuzzo V, Gatti A, Zuccoli A, Savastano S, Di Somma C, Pivonello R, Orio F, Colao A.

Author information

Dipartimento di Medicina Clinica e Chirurgia, Universit di Napoli "Federico II", via S. Pansini
5, 80131, Naples, Italy, giovanna.muscogiuri@gmail.com.
1

Abstract
Vitamin D (25(OH)D) levels have been associated with cardiovascular disease. Thus, the aim of our
study was to investigate the association of 25(OH)D levels with coronary heart disease (CHD) in 698
consecutive type 2 diabetic outpatients. 698 consecutive type 2 diabetic outpatients (25.2 % men, age
66 9 years) and 100 (90 % men, age 65 13 years) age-matched non-diabetic volunteers were
enrolled. 25(OH)D assay and the main cardiovascular risk factors were explored. 25(OH)D
concentration was 22 10 ng/ml in control subjects and 18.23 10 ng/ml in diabetic patients
(p < 0.01). The prevalence of hypovitaminosis D was higher in diabetic patients than in control
subjects (90 vs. 83 %, p < 0.01). Diabetic subjects with hypovitaminosis D had higher prevalence of
high values of A1C (p < 0.01), BMI (p < 0.01), LDL cholesterol (p < 0.01), triglycerides (p < 0.01), and
glycemia (p < 0.01) than their vitamin D-sufficient counterparts. 25(OH)D and HDL cholesterol were
lower (p < 0.01), while BMI (p < 0.01), age (p < 0.01), systolic (p < 0.01) and diastolic blood pressure
(p < 0.01), diabetes duration (p < 0.01), A1C (p < 0.01), glycemia (p < 0.01), fibrinogen (p < 0.01),
triglycerides (p < 0.01), and total (p < 0.01) and LDL cholesterol (p < 0.01) were higher in diabetic
subjects with CHD than diabetic subjects without CHD. At the logistic regression analysis, the
association of vitamin D with CHD was lost, while sex (p = 0.026), diabetes duration (p = 0.023), and
age (p = 0.024) were the most powerful predictors of CHD. The current study demonstrates that
25(OH)D does not have a direct effect on CHD but may have an indirect effect mediated by
cardiovascular risk factors such as diabetes duration, age, and sex.

Lower levels of 25-hydroxyvitamin D3 are associated with a higher

prevalence of microvascular complications in patients with type 2
diabetes.
Zoppini G1, Galletti A1, Targher G1, Brangani C1, Pichiri I1, Trombetta M1, Negri C1, De Santi F1, Stoico
V1, Cacciatori V1, Bonora E1.

Author information

Department of Medicine, Section of Endocrinology, Diabetes and Metabolism , Azienda

Ospedaliera Universitaria Integrata, University of Verona , Verona , Italy.
1

Abstract

OBJECTIVE:
Low levels of serum 25-hydroxyvitamin D [25(OH)D] are commonly found in type 2 diabetes. We
examined whether there is an association between circulating 25(OH)D concentrations and the
presence of microvascular complications in people with type 2 diabetes.
RESEARCH DESIGN AND METHODS:
We studied 715 outpatients with type 2 diabetes who regularly attended our clinic. Participants were
evaluated for the presence of microvascular complications (namely retinopathy and/or nephropathy)
by clinical evaluation, fundus examination, urine examination and biochemical tests. Serum 25(OH)D
levels were also measured for each participant.
RESULTS:
Hypovitaminosis D (ie, a serum 25(OH)D level <30ng/mL) was found in 75.4%, while deficiency (ie, a
25(OH)D level <20ng/mL) was found in 36.6% of these patients. Serum 25(OH)D levels decreased
significantly in relation to the severity of either retinopathy or nephropathy or both. In multivariate
logistic regression analysis, lower 25(OH)D levels were independently associated with the presence of
microvascular complications (considered as a composite end point; OR 0.758; 95% CI 0.607 to 0.947,
p=0.015). Notably, this association remained significant even after excluding those with an estimated
glomerular filtration rate <60mL/min/1.73m(2).
CONCLUSIONS:
We found an inverse and independent relationship between circulating 25(OH)D levels and the
prevalence of microvascular complications in patients with type 2 diabetes. However, vitamin D may
be simply a marker and causality cannot be implied from our cross-sectional study. Whether vitamin D
supplementation in patients with type 2 diabetes may have beneficial effects on the risk of
microvascular complications remains to be investigated.
KEYWORDS:
Microangiopathy; Microvascular Complications; Vitamin D

Bronchial asthma and hypovitaminosis D in Saudi children.

Aldubi HM1, Alissa EM1, Kamfar HZ2, Gaber O1, Marzouki ZM1.

Author information

Department of Clinical Biochemistry, King AbdulAziz University, Jeddah 21483, Saudi Arabia.

Department of Paediatrics, Faculty of Medicine, King AbdulAziz University, Jeddah 21483,

Saudi Arabia.

Abstract
BACKGROUND:
Asthma, a common lung disease in children, is caused by excessive immune responses to
environmental antigens.
OBJECTIVE:
Given the immuno-modulatory properties of vitamin D, the aim of the current study was to investigate
the relationship between vitamin D levels and markers of asthma severity.

METHODS:
This was investigated in a 70 Saudi children with and without asthma and were recruited from the King
Abdul Aziz University Hospital, Jeddah, Saudi Arabia, over the period of 11 months (May 2011-April
2012). Childhood asthma control test instrument was employed to assess the level of asthma control
among asthmatic patients. Anthropometric measurements were taken and interviewer-administrated
questionnaire was completed for all study participants. Pulmonary function test was performed by
recording changes in the peak expiratory flow. Venous blood samples were withdrawn for
measurements of vitamin D, bone profile, cytokines profile (interleukin-10, tumor necrosis factor-alpha,
platelets derived growth factor), and atopy markers (IgE and eosinophil count).
RESULTS:
Hypovitaminosis D is highly prevalent among asthmatic children with highly significant increase in
several markers of allergy and asthma severity as compared with healthy control children. Significant
correlations between several inflammatory and immunological markers and vitamin D levels were also
found. Finally, lower 25-hydroxyvitamin D levels were associated with a higher asthma prevalence in
multivariable analysis.
CONCLUSION:
Our study showed that hypovitaminosis D is highly prevalent in the whole population in addition to a
highly significant increase in several markers of allergy and asthma severity among asthmatic children
as compared with healthy control children.
KEYWORDS:
Asthma; Child; Hypersensitivity; Saudi Arabia; Vitamin D

Serum 25-Hydroxyvitamin D Levels: Variability, Knowledge Gaps,

and the Concept of a Desirable Range.
El-Hajj Fuleihan G1, Bouillon R2, Clarke B3, Chakhtoura M1, Cooper C4, McClung M5, Singh RJ3.

Author information

Department of Internal Medicine, Calcium Metabolism and Osteoporosis Program, American

University of Beirut, Beirut, Lebanon.
Department of Endocrinology and Laboratory Medicine, Katholieke Universiteit Leuven,
Leuven, Belgium.
Division of Endocrinology, Diabetes, Metabolism, and Nutrition, Mayo Clinic Foundation,
Rochester, MN, USA.
MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK.
Oregon Osteoporosis Center, Portland, OR, USA.

Abstract
Hypovitaminosis D is prevalent worldwide but proportions vary widely between regions, depending on
genetic and lifestyle factors, the threshold to define deficiency, and accuracy of 25-hydroxyvitamin D
(25OHD) assays used. Latitude, pollution, concealing clothing, sun exposure, gender, dietary habits,
and lack of government regulation account for up to 50% in variations in serum 25OHD levels,
whereas genetic polymorphisms in the vitamin D pathway account for less than 5%.
Organizations/societies have developed guidelines for recommended desirable 25OHD levels and

vitamin D doses to reach them, but their applicability across age groups and populations are still
debated. This article and the accompanying online Supporting Information highlight sources of
variations in circulating 25OHD levels, uncertainties and knowledge gaps, and analytical problems
facing 25OHD assays, while keeping efficacy and safety data as the dominant factors when defining a
desirable range for 25OHD levels. We propose a desirable range of 20 to 40 ng/mL (50 to 100 nmol/L),
provided precise and accurate assays are used. Although slightly lower levels, 15 to 20 ng/mL, may be
sufficient for some infants and adults, higher levels, 40 to 60 ng/mL, may still be safe. This desirable
range allows physicians to tailor treatment while taking season, lifestyle, vitamin D intake, and other
sources of variation into account. We reserve 25OHD measurements for at-risk patients, defined by
disease or lifestyle, and the use of 25OHD assays calibrated against the recommended international
standards. Most target groups reach desirable target levels by a daily intake of 400 to 600 IU for
children and 800IU for adults. A total daily allowance of vitamin D of up to 1000 IU in the pediatric age
groups, and up to 2000IU in adults, tailored to an individual patient risk profile, is probably safe over
long durations. Additional data are needed to validate the proposed range and vitamin D doses,
especially in children, pregnant women, and non-white populations. 2015 American Society for Bone
and Mineral Research.

Effect of vitamin D supplementation alone on muscle function in

postmenopausal women: a randomized, double-blind, placebocontrolled clinical trial.
Cangussu LM1, Nahas-Neto J, Orsatti CL, Bueloni-Dias FN, Nahas EA.

Author information

Department of Obstetrics and Gynecology, Botucatu Medical School, Sao Paulo State
University-UNESP, Sao Paulo, Brazil, lucianacangussu@gmail.com.
1

Abstract
The present study investigates the effects of vitamin D on muscle function in postmenopausal women.
It has been shown that vitamin D supplementation in postmenopausal women with hypovitaminosis D
provides significant protective factor against sarcopenia, with significant increases in muscle strength
and control of progressive loss of lean mass.
INTRODUCTION:
We aimed to evaluate the effect of supplementation of vitamin D (VITD) alone on muscle function in
younger postmenopausal women.
METHODS:
In this double-blind, placebo-controlled clinical trial, 160 Brazilian postmenopausal women were
randomized into two groups: VITD group consisting of patients receiving vitamin D3 1000 IU/day orally
(n=80) or placebo group (n=80). Women with amenorrhea for more than 12 months and age 5065 years, with a history of falls (previous 12 months), were included. The intervention time was
9 months, with assessments at two points, start and end. Lean mass was estimated by total-body
dual-energy X-ray absorptiometry (DXA) and muscle strength by handgrip strength and chair rising
test. The plasma concentrations of 25-hydroxyvitamin D [25(OH)D] were measured by highperformance liquid chromatography (HPLC). Statistical analysis was by intention to treat (ITT), using
ANOVA, Student's t test, and Tukey's test.

RESULTS:
After 9 months, average values of 25(OH)D increased from 15.0 7.5 to 27.5 10.4 ng/ml (+45.4 %) in
the VITD group and decreased from 16.96.7 to 13.8 6.0 ng/ml (-18.5 %) in the placebo group (p<
0.001). In the VITD group, there was significant increase in muscle strength (+25.3 %) of the lower
limbs by chair rising test (p=0.036). In women in the placebo group, there was considerable loss (6.8 %) in the lean mass (p=0.030).
CONCLUSION:
The supplementation of vitamin D alone in postmenopausal women provided significant protective
factor against the occurrence of sarcopenia, with significant increases in muscle strength and control
of progressive loss of lean mass.

Vitamin D deficiency and adrenal function in critically ill children.

Korwutthikulrangsri M, Mahachoklertwattana P, Lertbunrian R, Chailurkit LO, Poomthavorn P.

Abstract
BACKGROUND:
Data on interrelationship between vitamin D deficiency (VDD) and adrenal insufficiency in critically ill
children are limited.
OBJECTIVE:
To determine vitamin D status in critically ill children and its relationship with adrenal function.
MATERIAL AND METHOD:
Thirty-two patients and 36 controls were included. Serum 25-hydroxyvitamin D (25-OHD) levels were
measured. Pediatric Risk of Mortality (PRISM) III score, outcome and adrenal function assessed by 1microgram adrenocorticotropic hormone test were collected.
RESULTS:
Median (IQR) serum 25-OHD of thepatients was less than that of the controls (16.6 (13.3-19.5) vs.
24.2 (21.0-27.9) ng/mnL, p < 0.001). Twenty-five (78%) patients and seven (19%) controls had VDD.
PRISM III score, proportions of patients with shock and vasopressive drug used, length of intensive
care unit stay and ventilator used, and adrenal function were not different between patients with and
without VDD. Patients with serum 25-OHD of less than 12 ng/mL had higher median (IQR) PRISM III
score (14 (6-20) vs. 5 (2-10), p = 0.033) and higher proportion of mortality than those with serum 25OHD of 12 ng/mL or greater.
CONCLUSION:
A greater proportion of VDD in critically ill children as compared with that of the controls was
demonstrated. Serum 25-OHD was not associated with adrenal function.

Highlights

Patients with psychiatric disorders display high levels of hypovitaminosis D.

Patients with mood disorder had lower vitamin D levels than patient with schizophrenia.

Further studies are warranted to determine the potential interest of vitamin D supplementation.

Abstract
Patients with psychiatric disorders display high levels of hypovitaminosis D (<50 nmol/L). It remains unclear whether it is associated with specifc diagnoses. To further explore vitamin D status in psychiatric
inpatients, 82 individuals with mood disorders or schizophrenia/schizoaffective disorders were included. Hypovitaminosis D was signifcantly lower in patients with mood disorders than patients with
schizophrenia (standardized coefficient=0.385, p=0.007). Further studies are warranted to determine specifc causes of hypovitaminosis D and the interest of supplementation.

Vitamin D3 levels and bone mineral density in patients with

psoriasis and/or psoriatic arthritis.
Kincse G1, Bhattoa PH2, Herdi E3, Varga J4, Szegedi A3, Kri J5, Gal J1,5.

Author information

Department of Rheumatology, "Kenzy Gyula" Hospital, Debrecen, Hungary.

Department of Laboratory Medicine, Faculty of Medicine, University of Debrecen, Debrecen,

Hungary.
Division of Dermatological Allergology, Department of Dermatology, Faculty of Medicine,
University of Debrecen, Debrecen, Hungary.
Department of Nuclear Medicine, Faculty of Medicine, University of Debrecen, Debrecen,
Hungary.
Division of Clinical Immunology, Department of Internal Medicine, Faculty of Medicine,
University of Debrecen, Debrecen, Hungary.

Abstract
Limited data are available on the vitamin D3 status and bone mineral density (BMD) of patients with
psoriasis or with psoriatic arthritis. Our study intended to explore possible correlations between vitamin
D status and BMD, as well as among these parameters and the features of the underlying disorder.
Seventy-two patients with psoriasis/or psoriatic arthritis (female : male ratio, 40:32; mean age,
58.5 11.6 years; mean duration of follow up, 142.7 147.7 months) participated in the study. We
evaluated the characteristic clinical features of the underlying disease, performed bone densitometry
of the lumbar spine and the hip region, measured the serum vitamin 25(OH)D 3 levels of the patients,
and undertook the statistical analysis of the relationships between the clinical and the laboratory
parameters. The proportion of patients with a low BMD value did not exceed that seen in the general
population. We found an inverse correlation between the serum level of vitamin 25(OH)D 3 and body
mass index, as well as between the former and the severity of skin involvement. Furthermore, the
activity of psoriatic arthritis was significantly higher in patients with inadequate vitamin D 3 status. In
patients with psoriatic arthritis, BMD significantly exceeded the values measured in patients suffering
from psoriatic skin lesions only. Our findings suggest the importance of evaluating the vitamin D 3
status and screening for comorbid conditions in patients with psoriasis or psoriatic arthritis. This
appears justified, in particular, due to the possible role of hypovitaminosis D3 in provoking the
development of skin lesions and joint symptoms.
2015 Japanese Dermatological Association.
KEYWORDS:
D vitamin level; bone mineral density; disease activity; psoriasis

Performance characteristics of the ARCHITECT Active-B12

(Holotranscobalamin) assay.

Merrigan SD, Owen WE, Straseski JA.

Abstract
BACKGROUND:
Vitamin B12 (cobalamin) is a necessary cofactor in methionine and succinyl-CoA metabolism. Studies
estimate the deficiency prevalence as high as 30% in the elderly population. Ten to thirty percent of
circulating cobalamin is bound to transcobalamin (holotranscobalamin, holoTC) which can readily
enter cells and is therefore considered the bioactive form. The objective of our study was to evaluate
the analytical performance of a high-throughput, automated holoTC assay (ARCHITECT i2000(SR)
Active-B12 (Holotranscobalamin)) and compare it to other available methods.
METHODS:
Manufacturer-specified limits of blank (LoB), detection (LoD), and quantitation (LoQ), imprecision,
interference, and linearity were evaluated for the ARCHITECT HoloTC assay. Residual de-identified
serum samples were used to compare the ARCHITECT HoloTC assay with the automated AxSYM
Active-B12 (Holotranscobalamin) assay (Abbott Diagnostics) and the manual Active-B12
(Holotranscobalamin) Enzyme Immunoassay (EIA) (Axis-Shield Diagnostics, Dundee, Scotland, UK).
RESULTS:
Manufacturer's claims of LoB, LoD, LoQ, imprecision, interference, and linearity to the highest point
tested (113.4 pmol/L) were verified for the ARCHITECT HoloTC assay. Method comparison of the
ARCHITECT HoloTC to the AxSYM HoloTC produced the following Deming regression statistics:
(ARCHITECT(HoloTc)) = 0.941 (AxSYM(HoloTC)) + 1.2 pmol/L, S(y/x) = 6.4, r = 0.947 (n = 98).
Comparison to the Active-B12 EIA produced: (ARCHITECT(HoloTC)) = 1.105 (EIA(Active-B12)) - 6.8
pmol/L, S(y/x) = 11.0, r = 0.950 (n = 221).
CONCLUSIONS:
This assay performed acceptably for LoB, LoD, LoQ, imprecision, interference, linearity and method
comparison to the predicate device (AxSYM). An additional comparison to a manual Active-B12 EIA
method performed similarly, with minor exceptions. This study determined that the ARCHITECT
HoloTC assay is suitable for routine clinical use, which provides a high-throughput alternative for
automated testing of this emerging marker of cobalamin deficiency.

Low Vitamin D Levels Are Associated with the Presence of Serum

Cryoglobulins in Patients with Chronic HCV Infection.
Gentile I1, Scarano F2, Celotti A2, DE Iuliis E3, Scarano R3, Granata V3, Pinchera B2, Meola M4, D'Ambra
A4, Piccirillo M3, DI Paola F3, Cavalcanti E3, Izzo F3, Scarpato N4, Borgia G2.

Author information

Department of Clinical Medicine and Surgery - Section of Infectious Diseases, Federico II,
University of Naples, Naples, Italy ivan.gentile@unina.it.
Department of Clinical Medicine and Surgery - Section of Infectious Diseases, Federico II,
University of Naples, Naples, Italy.
National Tumor Institute "Fondazione G. Pascale", Naples, Italy.

Department of Molecular Medicine and Medical Biotechnology, Federico II, University of

Naples, Naples, Italy.

Abstract
BACKGROUND/AIM:
Mixed Cryoglobulinemia (MC) represents the most frequent extrahepatic manifestation of chronic
Hepatitis C Virus (HCV) infection. Its pathogenic mechanisms involve HCV-induced chronic stimulation
of B-lymphocytes. We aimed to investigate the relationship between serum levels of vitamin D (a
regulator of immune response) and the presence of serum cryoglobulins in the setting of HCV
infection.
PATIENTS AND METHODS:
We evaluated the serum concentration of 25(OH)vitamin D and cryoglobulins in 106 patients with
chronic HCV infection.
RESULTS:
Thirty patients (28.3%) showed the presence of serum cryoglobulins. For the cohort overall, the
median serum 25(OH)vitamin D level was 10.95 ng/ml. Patients with serum cryoglobulins had
significantly lower levels of 25(OH)vitamin D (5.61 ng/ml) than those without (13.65 ng/ml, p=0.029). At
multivariate analysis, severe hypovitaminosis [i.e. 25(OH)vitamin D <13 ng/ml] was the only
independent predictor of cryoglobulinemia (odds ratio=3.108).
CONCLUSION:
Severe deficiency of vitamin D was independently associated with mixed cryoglobulinemia in patients
with HCV infection.
Copyright 2015 International Institute of Anticancer Research (Dr. John G. Delinassios), All rights
reserved.
KEYWORDS:
Hepatitis C; extrahepatic manifestation; immune regulation; low-antigen diet; lymphoma; metabolism
PMID:
25977388
[PubMed - as supplied by publisher]

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A study of the prevalence of osteoporosis and hypovitaminosis D in

patients with primary knee osteoarthritis.
Ghosh B1, Pal T2, Ganguly S3, Ghosh A4.

Author information

Associate Professor, Dept. of Rheumatology, IPGMER and SSKM Hospital, Kolkata, India.
Resident, Dept. of Medicine, Medical College, Kolkata, India.

Professor, Dept. of Medicine, Medical College, Kolkata, India.

Professor, Dept. of Rheumatology, IPGMER and SSKM Hospital, Kolkata, India.

Abstract
INTRODUCTION:
Osteoarthritis and Osteoporosis are highly prevalent disease, so is hypovitaminosis D. We tried to find
out prevalence of osteoporosis and hypovitaminosis D in patients suffering from primary knee
Osteoarthritis. We also compared the prevalence of oseotoporosis between general population and
patients of primary osteoarthritis.
METHODS:
Patients suffering from primary knee OA were taken from Rheumatology OPD of Medical College
Hospital and SSKM Hospital Kolkata, India. For each patient age and sex matched friend or relative of
same locality was taken in the study as controls. Hospital staffs that come from different part of state
was taken in the study as controls. The control population was the representative of general
population.
RESULTS:
Total number of participants in this study was 206. Out of which there were 98 cases and 108 controls.
BMD status correlates significantly with Primary OA. Serum Vitamin D3 status correlates significantly
with Osteoarthritis. Age of the patients correlated significantly with both BMD Status and Knee OA but
not with the vVitamin D level. There were significant correlation between the Serum Vitamin D3 status
and BMD of the subjects.
CONCLUSION:
Osteoporosis is prevalent both in general population and patients suffering from Knee Osteoarthritis
and may increase the disability. The matter is complicated by the fact hypovitaminosis D is also
prevalent in the population and positively correlated with both Osteoporosis and osteoarthrosis, though
we cannot comment on further pathogenesis because of cross sectional design of the study.
KEYWORDS:
Hypovitaminosis D; Knee osteoarthitis; Osteoporosis