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Sample records for pseudo-vitamin d-deficiency rickets

  1. Rickets-vitamin D deficiency and dependency

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    Manisha Sahay

    2012-01-01

    Full Text Available Rickets is an important problem even in countries with adequate sun exposure. The causes of rickets/osteomalacia are varied and include nutritional deficiency, especially poor dietary intake of vitamin D and calcium. Non-nutritional causes include hypophosphatemic rickets primarily due to renal phosphate losses and rickets due to renal tubular acidosis. In addition, some varieties are due to inherited defects in vitamin D metabolism and are called vitamin D dependent rickets. This chapter highlights rickets/osteomalacia related to vitamin D deficiency or to inherited defects in vitamin D metabolism. Hypophosphatemic rickets and rickets due to renal tubular acidosis are discussed in other sections of the journal.

  2. [Diagnostic criteria for vitamin D-deficient rickets and hypocalcemia-].

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    Ozono, Keiichi

    2016-02-01

    Vitamin D deficiency causes rickets or osteomalacia, which is associated with hypomineralization of bone and chondrocytes, and/or hypocalcemia. Accumulating evidence indicates increase in frequency of vitamin D deficiency due to insufficient intake of vitamin D and calcium and decrease in sunshine. It is necessary for clinician to diagnose vitamin D deficiency accurately and treat patients with vitamin D deficiency adequately. For the purpose, clinical guideline or expert opinion on vitamin D deficiency has been reported.

  3. Rickets and vitamin D deficiency in Alaska native children.

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    Singleton, Rosalyn; Lescher, Rachel; Gessner, Bradford D; Benson, Matthew; Bulkow, Lisa; Rosenfeld, John; Thomas, Timothy; Holman, Robert C; Haberling, Dana; Bruce, Michael; Bartholomew, Michael; Tiesinga, James

    2015-07-01

    Rickets and vitamin D deficiency appeared to increase in Alaskan children starting in the 1990s. We evaluated the epidemiology of rickets and vitamin D deficiency in Alaska native (AN) children in 2001-2010. We analyzed 2001-2010 visits with rickets or vitamin D deficiency diagnosis for AN and American Indian children and the general US population aged rickets/vitamin D deficient cases and age- and region-matched controls. In AN children, annual rickets-associated hospitalization rate (2.23/100,000 children/year) was higher than the general US rate (1.23; 95% CI 1.08-1.39). Rickets incidence increased with latitude. Rickets/vitamin D deficiency cases were more likely to have malnutrition (OR 38.1; 95% CI 4.9-294), had similar breast-feeding prevalence, and were less likely to have received vitamin D supplementation (OR 0.23; 95% CI 0.1-0.87) than controls. Our findings highlight the importance of latitude, malnutrition, and lack of vitamin D supplementation as risk factors for rickets.

  4. Infantile Galactosialidosis Associated With Vitamin D Deficiency Rickets

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    BODUROĞLU, Koray

    2014-01-01

    Galactosialidosis is an autosomal recessive disease with combined deficiency of two lysosomal enzymes due to the lack of a protective protein. We report on a boy with infantile galactosialidosis who has an intermediate phenotype and vitamin D deficiency rickets. Due to the possible role of vitamin D deficiency in the pathogenesis of dysostosis multiplex we recommend that patients with lysosomal storage disease should be supplemented with vitamin D.

  5. Vitamin D deficiency rickets: socio-demographic and clinical risk ...

    African Journals Online (AJOL)

    Objective: To test the association between vitamin D deficiency rickets and protein energy malnutrition in Ethiopian children. Setting: Ethio-Swedish Children's Hospital, a tertiary health facility catering for children coming from Addis Ababa and the surrounding districts. Design: A case-control study. Subjects: One hundred ...

  6. Vitamin D-deficiency rickets among children in Canada.

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    Ward, Leanne M; Gaboury, Isabelle; Ladhani, Moyez; Zlotkin, Stanley

    2007-07-17

    Based on regional and anecdotal reports, there is concern that vitamin D-deficiency rickets is persistent in Canada despite guidelines for its prevention. We sought to determine the incidence and clinical characteristics of vitamin D-deficiency rickets among children living in Canada. A total of 2325 Canadian pediatricians were surveyed monthly from July 1, 2002, to June 30, 2004, through the Canadian Paediatric Surveillance Program to determine the incidence, geographic distribution and clinical profiles of confirmed cases of vitamin D-deficiency rickets. We calculated incidence rates based on the number of confirmed cases over the product of the length of the study period (2 years) and the estimates of the population by age group. There were 104 confirmed cases of vitamin D- deficiency rickets during the study period. The overall annual incidence rate was 2.9 cases per 100,000. The incidence rates were highest among children residing in the the north (Yukon Territory, Northwest Territories and Nunavut). The mean age at diagnosis was 1.4 years (standard deviation [SD] 0.9, min-max 2 weeks-6.3 years). Sixty-eight children (65%) had lived in urban areas most of their lives, and 57 (55%) of the cases were identified in Ontario. Ninety-two (89%) of the children had intermediate or darker skin. Ninety-eight (94%) had been breast-fed, and 3 children (2.9%) had been fed standard infant formula. None of the breast-fed infants had received vitamin D supplementation according to current guidelines (400 IU/d). Maternal risk factors included limited sun exposure and a lack of vitamin D from diet or supplements during pregnancy and lactation. The majority of children showed clinically important morbidity at diagnosis, including hypocalcemic seizures (20 cases, 19%). Vitamin D-deficiency rickets is persistent in Canada, particularly among children who reside in the north and among infants with darker skin who are breast-fed without appropriate vitamin D supplementation. Since

  7. Vitamin D deficiency rickets presenting as pseudotumor cerebri

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    Syed Ahmed Zaki

    2013-01-01

    Full Text Available Pseudotumor cerebri is a condition of elevated intracranial pressure in the absence of clinical, laboratory or radiological evidence of an intracranial space-occupying lesion. Various associations with pseudotumor cerebri have been made in literature. We report the case of a five-month-old female infant with vitamin D deficiency rickets, who presented with pseudotumor cerebri. Her cerebrospinal fluid examination was normal, with a high opening pressure of 330 mmH 2 O. Her computed tomography scan was normal. After lumbar puncture the anterior fontanelle came at level. Her investigations revealed vitamin D deficiency. She was started on acetazolamide, calcitriol sachets, and calcium supplements. She became asymptomatic in three days and was discharged. Through this case we wish to highlight this unusual presentation of vitamin D deficiency rickets appearing as pseudotumor cerebri.

  8. [Vitamin D deficiency rickets complicating Dorfman-Chanarin syndrome].

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    Barraud, C; Cano, A; Boulay, C; Milh, M; Bollini, G; Chabrol, B

    2015-04-01

    Vitamin D deficiency rickets remains a public health issue in many parts of the world. In France, this diagnosis has almost disappeared since 1992 with routine vitamin D supplementation for children. Therefore, it is more difficult for doctors to identify risk factors and early signs of this disease. In this article, we report a rickets diagnosis acquired by vitamin D deficiency in a child who presented with the onset of a genu valgum and difficulty walking at the age of 9½ years. This patient was a Comorian child followed up from his birth for Dorfman-Chanarin syndrome. Dorfman-Chanarin syndrome is a rare disease, with about 80 cases reported in the literature. It belongs to the group of neutral lipid storage diseases (NLSD) characterized especially on the skin by ichthyosis. This child presented risk factors for vitamin D deficiency (dark skin color, prolonged and exclusive breastfeeding, premature end of supplementation, and particularly severe ichthyosis) that should have alerted us to the risk of vitamin D deficiency and the need for supplementation. This case highlights the importance of vitamin D, especially if there are risk factors such as ichthyosis, and the need to remain watchful in monitoring all chronic diseases. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

  9. Clinical characteristics of vitamin D deficiency rickets in infants and preschool children

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    Kyoung Huh

    2010-02-01

    Full Text Available Purpose : Vitamin D deficiency rickets is a significant public health problem that results from insufficient exposure to sunlight and inadequate vitamin D supplementation. The purpose of this study is to identify the clinical characteristics of vitamin D deficiency rickets in infants. Methods : Data of 35 infants diagnosed as vitamin D deficiency rickets at Sanggye-Paik Hospital, Seoul, Korea, from March 2007 to May 2009 were reviewed. Children with plasma 25-hydroxyvitamin D levels<15 ng/mL and 15-30 ng/mL were considered to have vitamin D deficiency and vitamin D insufficiency, respectively. Results : Thirty-five infants (22 boys, 13 girls were diagnosed with rickets. Mean age at diagnosis was 7.4¡?#?.1 ;months (range: 0.1-29.8 months. Eighteen infants (51% were vitamin D deficient and seventeen infants (49% were insufficient. Twenty-eight of all (80% diagnosed as subclinical rickets. Twenty-nine infants (83% were below the age of 12months. Twenty infants (57% had breastfed and ten infants (29% had iron deficiency anemia. Nine of breastfed infants (45% were vitamin D deficient and ten of their mothers were vitamin D insufficient. Overall, radiographic evidence of rickets was present in 93% of the cases. Radiographic sign of rickets was evident even in vitamin D insufficient state. Conclusion : It is important for the clinician to screen for subclinical vitamin D deficiency rickets in inadequately supplemented infants by pairing 25-hydroxyvitamin D levels with wrist radiographs. A nationwide epidemiological study of vitamin D deficiency rickets must be conducted and evidence-based national guidelines must be defined to prevent rickets.

  10. Nutritional rickets and vitamin D deficiency in infants, children and adolescents.

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    Unuvar, Tolga; Buyukgebiz, Atilla

    2010-01-01

    Nutritional rickets continues to be a public health problem in many countries despite the presence of cheap and effective means of preventing the disease. Deficiency of vitamin D is associated with rickets in growing children and osteomalacia in adults. Vitamin D deficiency is attributed to a variety of causes including diet, atmospheric pollution, religious practices that restrict sunlight exposure (clothing), geographic latitude and altitude, season, and time of the day. The clinical findings of rickets can vary among stages of the disease. It is recommended that healthy infants, children and adolescents take at least 400 IU vitamin D per day to prevent rickets and vitamin D deficiency. Pediatricians and other healthcare professionals should try to ensure that children and adolescents receive daily vitamin D requirements appropriate for their risk factors, traditions, and customs. Additionally, it is important to use every opportunity to ensure that effective preventive strategies are put in practice.

  11. Prevalence of Vitamin D Deficiency and Rickets in Children with Cholestasis in Iran

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    Mohammad Eshagh Roze

    2012-07-01

    Full Text Available This study was aimed to determine prevalence of Vitamin D deficiency and rickets in children with cholestatic liver diseases. Forty eight children with established cholestatic liver disease who referred to gastrointestinal clinic of Children Medical Center (Tehran, Iran between April 2010 and March 2011 were enrolled in a cross-sectional study. Laboratory analysis including calcium, phosphate, albumin, total and direct bilirubin, aminotransferases, alkalinephosphatase (ALP, prothrombin time (PT, parathyroid hormone (PTH, total protein determined by routine laboratory techniques. Mean age of participants was 299.1 ± 676.8 days (range 2-3600 days whereas twenty one were female (43.8% and 27 (56.3% were male. Twenty two (45.8% had evidences of rickets in X-ray evaluation. Three children with rickets and two with normal X-ray had Vitamin D deficiency while ten in rickets group and 16 in normal group had Vitamin D insufficiency. The main underlying diseases were anatomical biliary atresia in cases with rickets and idiopathic in other group. Rickets and Vitamin D deficiency should be considered in chronic cholestatic children.

  12. Prevalence of vitamin D deficiency and rickets in children with cholestasis in Iran.

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    Mohammadi, Bahram; Najafi, Mehri; Farahmand, Fateme; Motamed, Farzaneh; Ghajarzadeh, Mahsa; Mohammadi, Jamshid; Eshagh Roze, Mohammad

    2012-01-01

    This study was aimed to determine prevalence of vitamin D deficiency and rickets in children with cholestatic liver diseases. Forty eight children with established cholestatic liver disease who referred to gastrointestinal clinic of Children Medical Center (Tehran, Iran) between April 2010 and March 2011 were enrolled in a cross-sectional study. Laboratory analysis including calcium, phosphate, albumin, total and direct bilirubin, aminotransferases, alkalinephosphatase (ALP), prothrombin time (PT), parathyroid hormone (PTH), total protein determined by routine laboratory techniques. Mean age of participants was 299.1 ± 676.8 days (range 2-3600 days) whereas twenty one were female (43.8%) and 27 (56.3%) were male. Twenty two (45.8%) had evidences of rickets in X-ray evaluation. Three children with rickets and two with normal X-ray had vitamin D deficiency while ten in rickets group and 16 in normal group had vitamin D insufficiency. The main underlying diseases were anatomical biliary atresia in cases with rickets and idiopathic in other group. Rickets and vitamin D deficiency should be considered in chronic cholestatic children.

  13. Incidence of vitamin D deficiency rickets among Australian children: an Australian Paediatric Surveillance Unit study.

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    Munns, Craig F; Simm, Peter J; Rodda, Christine P; Garnett, Sarah P; Zacharin, Margaret R; Ward, Leanne M; Geddes, Janet; Cherian, Sarah; Zurynski, Yvonne; Cowell, Christopher T

    2012-04-16

    To determine the incidence of and factors associated with vitamin D deficiency rickets in Australian children. 18-month questionnaire-based prospective observational study, using Australian Paediatric Surveillance Unit (APSU) data. Australian paediatricians and child health workers, January 2006 - July 2007. Children aged ≤ 15 years with vitamin D deficiency rickets (25-hydroxyvitamin D [25OHD] ≤ 50 nmol/L, and elevated alkaline phosphatase levels [> 229 IU/L] and/or radiological rickets). Incidence of vitamin D deficiency rickets. Description of demographics, clinical presentation, identification and further analysis of overrepresented groups, and treatment regimens compared with best-practice guidelines. We identified 398 children with vitamin D deficiency (55% male; median age, 6.3 years [range, 0.2-15 years]). The overall incidence in children ≤ 15 years of age in Australia was 4.9/100 000/year. All had a low 25OHD level (median, 28 nmol/L [range, 5-50 nmol]) and an elevated alkaline phosphatase level (median, 407 IU/L [range, 229-5443 IU/L]), and 48 (12%) were hypocalcaemic. Ninety-five children had wrist x-rays, of whom 67 (71%) had rachitic changes. Most (98%) had dark or intermediate skin colour and 18% of girls were partially or completely veiled. Most children were born in Africa (252; 63%) and 75% of children were refugees. Duration of exclusive breastfeeding was inversely related to serum vitamin D levels in children children before diagnosis. Vitamin D deficiency rickets is a significant problem in Australia among known high-risk groups. Public health campaigns to prevent, identify and tre@vitamin D deficiency, especially in high-risk groups, are essential.

  14. Incidence and characteristics of vitamin D deficiency rickets in New Zealand children: a New Zealand Paediatric Surveillance Unit study.

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    Wheeler, Benjamin J; Dickson, Nigel P; Houghton, Lisa A; Ward, Leanne M; Taylor, Barry J

    2015-08-01

    To investigate the incidence and characteristics of vitamin D deficiency rickets in New Zealand (NZ). Prospective surveillance among paediatricians of Vitamin D Deficiency Rickets was conducted by the New Zealand Paediatric Surveillance Unit (NZPSU) for 36 months, from July 2010 to June 2013, inclusive. Inclusion criteria were: children and adolescents rickets (defined by low serum 25-hydroxyvitamin D and elevated alkaline phosphatase levels, and/or radiological rickets). Fifty-eight children with confirmed vitamin D deficiency rickets were identified. Median age was 1.4 (range 0.3-11) years, 47% were male, and 95% of the children were born in NZ; however, the majority of the mothers (68%) were born outside NZ. Overall annual incidence of rickets in children aged children. Key risk factors identified were: darker skin pigment, Indian and African ethnicity, age rickets remains a problem for NZ children. Key risk factors remain similar to those identified in the international literature. Preventative targeted vitamin D supplementation, as per existing national guidelines, was lacking in all cases reported. Vitamin D deficiency rickets is the most significant manifestation of vitamin D deficiency in growing children. To reduce the incidence of this disease among those at high risk, increasing awareness and implementation of current public health policies for targeted maternal, infant and child supplementation are required. © 2015 Public Health Association of Australia.

  15. [Correlation between vitamin D receptor genetic polymorphism and 25-hydroxyvitamin D3 in vitamin D deficiency rickets].

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    Gong, Yi-Gu; Li, Yu-Ning; Zhang, Wei-Hua; Liu, Li-Jun; Kang, Xi-Guang

    2010-07-01

    To study the correlation between vitamin D receptor genetic polymorphism Fokand vitamin D deficiency rickets in children between 1 to 3 years old, and to explore the significance of hereditary factors in the development of vitamin D deficiency rickets. Sixty-two children with vitamin D deficiency rickets and 60 healthy children as a control group were enrolled. Serum levels of 25-hydroxyvitamin D3 were measured using ELISA. Polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) genetic analysis method was used. A restriction fragment length polymorphism in the vitamin D receptor genetic polymorphism Fok I was tested. The frequencies of the vitamin D receptor genotype and allele were compared between the two groups. Serum 25-hydroxyvitamin D3 levels in the rickets group were significantly lower than those in the control group ( 9.1+/-4.1 ng/mL vs 16.1+/-6.9 ng/mL; Ppolymorphism Fok I was more common in the rickets group than in the control group (53% vs 25%; Ppolymorphism Fok I and vitamin D deficiency rickets. This suggests that vitamin D receptor genetic polymorphism might play an important role in determining susceptibility to development of vitamin D deficiency rickets.

  16. Serum fibroblast growth factor 23 is a useful marker to distinguish vitamin D-deficient rickets from hypophosphatemic rickets.

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    Kubota, Takuo; Kitaoka, Taichi; Miura, Kohji; Fujiwara, Makoto; Ohata, Yasuhisa; Miyoshi, Yoko; Yamamoto, Keiko; Takeyari, Shinji; Yamamoto, Takehisa; Namba, Noriyuki; Ozono, Keiichi

    2014-01-01

    Vitamin D-deficient rickets (DR) has recently re-emerged among developed countries. Vitamin D deficiency can influence biochemical results of patients with fibroblast growth factor 23 (FGF23)-related hereditary hypophosphatemic rickets (HR), making differential diagnosis difficult. In the present study we evaluated the utility of serum FGF23 levels in the diagnosis of DR and during its treatment. The study group comprised 24 children with DR and 8 children with HR. Serum FGF23 levels and bone metabolism-related measurements were assessed. Serum FGF23 levels in patients with DR were less than 19 pg/ml, while those in patients with HR were more than 57 pg/ml. There were significant differences in serum levels of calcium, phosphate, parathyroid hormone, and 1,25-dihydroxyvitamin D, as well as tubular maximum phosphate reabsorption per glomerular filtration rate between patients with DR and HR, but these values were not fully mutually exclusive. In addition, serum FGF23 and phosphate levels were increased following treatment. Serum FGF23 level is the most critical biochemical marker for distinguishing DR from HR and might be a good indicator of biochemical response to the intervention. Serum FGF23 levels show utility for the diagnosis of DR and in the assessment of its response to treatment.

  17. Ultrastructure of parathyroid glands of growing chickens with vitamin D deficiency rickets.

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    Okada, K; Fujimoto, Y; Itakura, C; Goto, M

    1983-04-01

    Ultrastructural studies were conducted on the parathyroid glands (PTG) of 2- to 7-week-old nontreated control growing broiler chickens (group A, 6 chickens); the same aged chickens with experimentally induced vitamin D deficiency rickets (18 morbid chickens each from groups B, C, and D); and in 4- to 9-week-old chickens naturally affected with rickets (group E, 8 chickens). Four types of principal cells were classified in the PTG of clinically normal birds and in PTG of birds with secondary hyperparathyroidism as follows: Type I cell (small cell in the resting phase); type II cell (medium-sized cell with well-developed rough-surfaced endoplasmic reticulum in the synthesizing phase); type III cell (large cell with well-developed Golgi apparatus and cytoplasmic organelles in the packaging and secretory phase); and type IV cell (medium-sized cell with poor cytoplasmic organelles in the involuting phase). Many coated vesicles were observed in type II and type III cells. In young control chickens, principal cells of the PTG were considered in the resting phase; in older control chickens, there were increased numbers of cells in the synthesizing phase. In the vitamin D deficiency groups, principal cells were in the synthesizing and packaging and secretory phases. In birds with naturally occurring rickets, principal cells were in packaging and secretory phases, with a small number of cells in the involuting phase. The ultrastructural changes of the PTG from the initial to final phases in growing chickens with secondary hyperparathyroidism were demonstrated.

  18. Can Stoss Therapy Be Used in Children with Vitamin D Deficiency or Insufficiency without Rickets?

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    Koçyiğit, Cemil; Çatlı, Gönül; İnce, Gülberat; Özkan, Elif Büşra; Dündar, Bumin Nuri

    2017-06-01

    Stoss vitamin D treatment has been recommended for its non-skeletal benefits in adults, but there is a lack of data on the optimal dose of vitamin D stoss therapy in children with vitamin D deficiency/insufficiency without rickets. This study aimed to compare efficiency/side effects of two different stoss therapy regimens (10 000 IU/kg and 300 000 IU vitamin D3) administered in children with vitamin D deficiency/insufficiency without rickets. Sixty-four children who had vitamin D deficiency/insufficiency were studied. A serum 25-hydroxyvitamin-D (25-OH-D) level of 15-20 ng/mL was considered as vitamin D insufficient and <15 ng/mL was considered as vitamin D deficient. The patients were divided into two groups according to the stoss therapy doses they received. Serum calcium, phosphate, alkaline phosphatase, 25-OH-D, parathyroid hormone levels, and spot urine calcium/creatinine ratios before/after treatment were recorded. Wrist radiography and renal ultrasonography were performed. The mean age of the subjects was 10.6±4.4 years. Thirty-two children were treated with a single vitamin D3 dose of 10 000 IU/kg and 32 patients received 300 000 IU. No difference was found in 25-OH-D levels between the two groups at presentation. The mean level of 25-OH-D was higher in the 10 000 IU/kg group at the second week of therapy. There was no difference between the groups at post-treatment weeks 4 and 12. The 25-OH-D was found to be below optimal levels (≥30 ng/mL) in 66.5% and <20 ng/mL in 21.8% of patients at the third month in both groups. None developed hypercalcemia and/or hypercalciuria. Nephrolithiasis was not detected in any patient. This study showed that both doses of stoss therapy used in the treatment of vitamin D insufficiency/deficiency are effective and safe. However, an optimal level of 25-OH-D cannot be maintained for more than three months.

  19. Vitamin D deficiency and rickets in children and adolescents with ichthyosiform erythroderma in type IV and V skin.

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    Chouhan, K; Sethuraman, G; Gupta, N; Sharma, V K; Kabra, M; Khaitan, B K; Sreenivas, V; Ramam, M; Kusumakar, S; Thulkar, S; Paller, A S

    2012-03-01

    Ichthyosiform erythroderma due to keratinizing disorders may suppress cutaneous vitamin D synthesis, leading to vitamin D deficiency and rickets. To determine the prevalence of vitamin D deficiency and rickets in children and adolescents with congenital ichthyosis and other keratinizing disorders with erythroderma and scaling. In this cross-sectional study, 45 children and adolescents with ichthyosiform erythroderma due to keratinizing disorders, and 66 controls (group 1: age and sex matched, with skin diseases other than keratinizing disorders; group 2: age and sex matched, healthy volunteers) were included. Evidence of rickets was determined clinically (physical examination and radiographs) and biochemically {serum calcium, phosphorus, alkaline phosphatase, 25-hydroxy vitamin D [25(OH)D] and parathyroid hormone (PTH)}. All patients in the disease group had clinical, radiological or biochemical evidence of rickets [25(OH)D65pgmL(-1) ) was also significantly higher in the disease group than in controls (PChildren and adolescents with various forms of ichthyosiform erythroderma, especially those with pigmented skin (types IV-VI), are at increased risk of developing vitamin D deficiency and clinical rickets. © 2011 The Authors. BJD © 2011 British Association of Dermatologists.

  20. Prevalence of classic signs and symptoms of rickets and vitamin D deficiency in Mongolian children and women.

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    Uush, Tserendolgor

    2013-07-01

    In order to assess the current nutrition status of Mongolian population, including rickets and vitamin D deficiency of children and women, the Fourth National Nutrition Cross-Sectional Survey was conducted in 21 aimags (provinces) of 4 economic regions of the country and capital city Ulaanbaatar in 2010. Children of age under five years, and non-pregnant women of reproductive age were used as subjects for assessing rickets and vitamin D deficiency. A total of 400 households were randomly selected from each of 4 economic regions and Ulaanbaatar city. Clinical examinations were performed on 706 children of age under five years. Interviews were used to assess vitamin D supplement use. The serum level of 25-hydroxyvitamin D was measured in 524 children aged 6-59 months and in 867 women of reproductive age. This survey found that 21.8% of children had vitamin D deficiency, 20.6% had low vitamin D reserve, and 30.0% of women had vitamin D deficiency and 22.2% had low vitamin D reserve. The prevalence of vitamin D deficiency in children (35.0%, 95% CI, 24.7-47.0) and women (54.9%, 95% CI 45.5-64.0) in the Eastern Region was (35.0%, 95% CI, 24.7-47.0) significantly higher than in the Western, Khangai, Central Regions, and Ulaanbaatar. Further it was found that 27.4% of children under-two years had received vitamin D supplementation. The proportion of children, who did not receive vitamin D supplementation had a higher prevalence of vitamin D deficiency than that of the children of the Eastern Region. None of the women who were involved in this survey had received vitamin D supplementation; 10.2% of them had delivered in the past 12 months, and 22.5% were breastfeeding. The prevalence of classic signs and symptoms of rickets were commonly reported among children of age under five, and skeletal abnormalities more commonly reported in children aged 12-47 months. In conclusion, there is a high prevalence of classic signs and symptoms of rickets in children of age under five

  1. [Vitamin D-deficiency rickets: a case report from Burkina Faso].

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    Sagna, Y; Ouédraogo, D-D; Dao, F; Diallo, O; Tiéno, H; Guira, O; Traoré, L O; Yanogo, A R D; Drabo, Y J

    2013-01-01

    Deficiency rickets results from a deficiency of vitamin D that is responsible for deficient calcium absorption, leading to failure of bone mineralization and cartilage bone growth, especially in children. We report the case of a 9-year-old girl who shows signs of rickets. Her family history, which includes similar malformations in several family members, led us to suggest vitamin D-resistant rickets, but all laboratory tests and response to treatment indicated deficiency rickets. Prophylaxis, at least for some very poor people, should be proposed for certain populations at risk, even in tropical zones.

  2. Vitamin D deficiency rickets in an adolescent with severe atopic dermatitis.

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    Borzutzky, Arturo; Grob, Francisca; Camargo, Carlos A; Martinez-Aguayo, Alejandro

    2014-02-01

    Atopic dermatitis (AD) affects 10% to 20% of children worldwide. Its severity may be inversely correlated with 25-hydroxyvitamin D (25OHD) levels. Although low levels of vitamin D (VD) can cause rickets in infants, VD deficiency rickets is an unusual presentation in teenagers. We report the case of a 14-year-old girl with severe AD and fish allergy since early childhood. She lived at high latitude (with less sun exposure) and, because of her atopic disorders, avoided sunlight and fish. Laboratory studies showed elevated alkaline phosphatase and parathyroid hormone levels and low serum calcium; her serum 25OHD level was rickets due to VD deficiency. Treatment with VD increased her 25OHD level to 44 nmol/L, with normalization of alkaline phosphatase, parathyroid hormone, and calcium. Moreover, we observed a dramatic improvement in her AD severity with VD treatment. This case demonstrates the complex interaction between VD deficiency, AD, and food allergy. We advise a high index of suspicion of VD deficiency rickets in children of all ages with AD, particularly during accelerated growth periods and in the presence of other risk factors such as darker skin, living at high latitude, sun avoidance, and low intake of VD-rich foods. The concomitant improvement in bone-related parameters and AD severity may reflect a double benefit of VD treatment, a possibility that warrants research on VD as potential treatment for AD.

  3. Vitamin D Deficiency

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    ... disease osteoporosis. Severe vitamin D deficiency can cause rickets in children and osteomalacia in adults. Both problems cause soft, ... The oral dose is once daily or weekly. Children with rickets or at risk of this disease may get ...

  4. Myelofibrosis in severe combined immunodeficiency due to vitamin D deficiency rickets.

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    al-Eissa, Y A; al-Mashhadani, S A

    1994-01-01

    An infant with severe combined immunodeficiency is described in whom a refractory anemia and thrombocytopenia developed after the age of 6 months, associated with poor growth and frequent episodes of upper respiratory tract infections and diarrhea. He required frequent blood and platelet transfusions. Bone marrow biopsy provided evidence that the anemia and thrombocytopenia were the results of myelofibrosis which was secondary to vitamin D deficiency. Therapy with 1,25-dihydroxycholecalciferol resulted in resolution of the hematologic and skeletal abnormalities, but he remained susceptible to recurrent serious infections and died at the age of 13 months.

  5. The Effect of Vitamin D Treatment on Serum Adiponectin Levels in Children with Vitamin D Deficiency Rickets

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    Döneray, Hakan; Keskin, Halil

    2009-01-01

    Objective: Adiponectin and its receptors are known to be expressed in osteoblasts and may have important functions in normal bone cells. The aim of this study was to investigate the effect of vitamin D therapy on serum adiponectin levels in children with vitamin D deficiency rickets (VDDR). Methods: 21 patients with VDDR were included in the study. Patients were treated with 300,000 U D3 (IM) and calcium lactate (50mg/kg/ day, PO, for 10 days). Anthropometric parameters and serum biochemical markers including calcium (Ca), phosphorus (P), alkaline phosphatase (ALP), intact parathormone (iPTH), 25-hydroxyvitamin D (25(OH)D), and adiponectin levels were measured before and after one month of therapy. Results: Weight and length, but not BMI, increased significantly after treatment. Serum 25(OH)D level increased significantly after treatment, while serum adiponectin level decreased (4.21±1.84 vs 52.73±17.63 ng/ml, p<0.000; 150.1±66.14 vs 84.29±9.06 mg/ml, p<0.000, respectively). No significant correlations were found between serum adiponectin and 25(OH)D levels before and after treatment or between delta adiponectin concentrations and delta 25(OH)D levels. Conclusion: Serum adiponectin levels are increased in patients with VDDR, a finding which is probably related to increased osteoblastic activity. Conflict of interest:None declared. PMID:21274306

  6. Rickets

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    ... such as celiac disease In addition to dietary rickets, children can get an inherited form of the disease. ... and deformities of the bones and teeth. Your child's doctor uses lab and ... D that are lacking in the diet. Rickets is rare in the United States.

  7. Rickets: Part I.

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    Shore, Richard M; Chesney, Russell W

    2013-01-01

    Rickets is characterized by impaired mineralization and ossification of the growth plates of growing children caused by a variety of disorders, the most frequent of which is nutritional deficiency of vitamin D. Despite ample knowledge of its etiology and the availability of cost-effective methods of preventing it, vitamin D deficiency rickets remains a significant problem in developing and developed countries. This two-part review covers the history, etiology, pathophysiology and clinical and radiographical findings of vitamin D deficiency rickets. Other less frequent causes of rickets and some of the disorders entering into the differential diagnoses of rickets are also considered. Controversial issues surrounding vitamin D deficiency include determination of what constitutes vitamin D sufficiency and the potential relationship between low levels of vitamin D metabolites in many individuals and unexplained fractures in infants.

  8. [Bone and joint diseases in children. Rickets].

    Science.gov (United States)

    Tanaka, Hiroyuki

    2010-06-01

    Rickets is a disorder of growth plate chondrocytes. Its basic pathophysiology has been revealed as a defect in apoptosis of hypertrophic chondrocytes induced by low phosphate concentration in the body fluid. This review summarized recent topics in two major forms of rickets, vitamin D deficient rickets and hereditary hypophosphatemic rickets. Vitamin D deficient rickets reappeared all over the world due to environmental change. The knowledge in basic pathophysiology of the hereditary hypophosphatemic rickets is increasing rapidly after the discovery of fibroblast growth factor 23 and the responsible genes have been revealed. The finding may support to uncover the whole truth of phosphate metabolism.

  9. Congenital Rickets: Report of Four Cases

    Directory of Open Access Journals (Sweden)

    R Vakili

    2014-04-01

    Full Text Available Introduction: Vitamin D deficiency and rickets continue to be health problems in developing countries and most of the infants with congenital rickets may present with hypocalcemic seizure.   Case Report: In this article, the report on four infants who presented with hypocalcemic seizures but subsequently were found to have congenital rickets is presented. All of them had hypocalcaemia and low level of serum 25- hydroxy vitamin D. Their mothers had not received vitamin D supplementation during pregnancy and so evidence of vitamin D deficiency was presented.   Conclusion: Although current vitamin D supplementation guidelines for infants was effective in prevention of rickets in Iranian children, it is necessary to evaluate women before pregnancy to prevent this entity. Also infants without vitamin D supplementation therapy who present with seizures during the first 6 months of age should undergo biochemical and other investigations for rickets.   Keywords:Congenital rickets, Vitamin D deficiency, Hypocalcemia, Seizure.  

  10. Nutritional rickets around the world.

    Science.gov (United States)

    Prentice, Ann

    2013-07-01

    Nutritional rickets is a major public health problem in many countries of the world. The disease is characterized by deformities of the long bones, enlargement of the wrists and costochondral junctions, hypotonia and, in infants, craniotabes and delayed fontanelle closure. Predominantly caused by severe vitamin D deficiency, rickets can also be associated with hypocalcemic seizures and cardiac failure. First presentation is typically at 6-24 months of age, although hypocalcemia may be evident in younger infants. In many affluent industrialized countries, the prevalence of rickets in the general population diminished after the introduction of clean-air legislation and dietary supplementation. However, in such countries, vitamin-D deficiency rickets has re-emerged in recent years, particularly among groups with limited exposure to UVB-containing sunshine. Infants at risk of rickets tend to be those whose mothers had poor vitamin D status during pregnancy and those exclusively breast-fed for a prolonged period with little skin exposure to UVB. In other countries of the world, the prevalence of rickets can be high, even in regions with abundant year-round UVB-containing sunshine. In general, this is also due to vitamin D deficiency related to limited sun exposure. However, reports from Africa and Asia suggest that there may be other etiological factors involved. Studies in South Africa, Nigeria, The Gambia and Bangladesh have identified rickets in children, typically 3-5 years old at first presentation, in whom plasma 25-hydroxyvitamin D concentrations are higher than those characteristic of primary vitamin D deficiency. Calcium deficiency has been implicated, and in some, but not all, disturbances of phosphate metabolism, renal compromise and iron deficiency may also be involved. Continuing studies of the etiology of nutritional rickets will provide evidence to underpin guidelines for the prevention and treatment of rickets world-wide. This article is part of a

  11. Nutritional rickets around the world: an update.

    Science.gov (United States)

    Creo, Ana L; Thacher, Tom D; Pettifor, John M; Strand, Mark A; Fischer, Philip R

    2017-05-01

    Worldwide, nutritional rickets continues to be an evolving problem with several causes. This paper provides an updated literature review characterising the prevalence, aetiology, pathophysiology and treatment of nutritional rickets worldwide. A systematic review of articles on nutritional rickets from various geographical regions was undertaken. For each region, key information was extracted, including prevalence, cause of rickets specific to the region, methods of confirming the diagnosis and current treatment and preventive measures. Calcium deficiency continues to be a major cause of rickets in Africa and Asia. Vitamin D deficiency rickets is perhaps increasing in the Americas, Europe and parts of the Middle East. There continues to be a distinct presentation of calcium-predominant versus vitamin D predominant rickets, although there are overlapping features. More careful diagnosis of rickets and reporting of 25-OHD concentrations has improved accurate knowledge of rickets prevalence and better delineated the cause. Nutritional rickets continues to be an evolving and multi-factorial problem worldwide. It is on a spectrum, ranging from isolated vitamin D deficiency to isolated calcium deficiency. Specific areas which require emphasis include a consistent community approach to screening and diagnosis, vitamin D supplementation of infants and at-risk children, prevention of maternal vitamin D deficiency and the provision of calcium in areas with low calcium diets.

  12. Congenital Rickets: Report of Four Cases

    Directory of Open Access Journals (Sweden)

    Rahim Vakili

    2014-01-01

    Full Text Available Introduction: Vitamin D deficiency and rickets continue to be health problems in developing countries and most of the infants with congenital rickets may present with hypocalcemic seizure.   Case Report In this article, the report on four infants who presented with hypocalcemic seizures but subsequently were found to have congenital rickets is presented. All of them had hypocalcaemia and low level of serum 25- hydroxy vitamin D. Their mothers had not received vitamin D supplementation during pregnancy and so evidence of vitamin D deficiency was presented.   Conclusion: Although current vitamin D supplementation guidelines for infants was effective in prevention of rickets in Iranian children,  it is necessary to evaluate women before pregnancy  to prevent this entity. Also infants without vitamin D supplementation therapy who present with seizures during the first 6 months of age should undergo biochemical and other investigations for rickets.

  13. Incidental Rickets in the Emergency Department Setting

    Directory of Open Access Journals (Sweden)

    John V. Zurlo

    2012-01-01

    Full Text Available Vitamin D deficiency rickets is a childhood osteomalacia, with impaired skeletal development and potentially skeletal deformities. The radiographic findings of rickets are many but include widening, fraying, and cupping of the metaphysis. Developmental delay and related complications of seizure and tetany have also been reported. This medical entity is often thought of as a classic medical disease of the past. However, it persists, and the recognition of rickets is on the rise. The reemergence of rickets correlates with the increase in the number of children exclusively breastfed and with the frequent use of sun block in the pediatric population. We present two cases of rickets, diagnosed through a visit to the Emergency Department made for unrelated symptoms. These two cases illustrate the importance of diagnosing rickets as an “incidental” finding. With early detection, dietary supplementation can be initiated potentially sparing the patient symptomatic disease.

  14. Vitamin D deficiency: a paediatric orthopaedic perspective.

    Science.gov (United States)

    Clarke, Nicholas M P; Page, Jonathan E

    2012-02-01

    At the turn of the last century, rickets (vitamin D deficiency) was one of the most common musculoskeletal diseases of the paediatric population presenting to physicians. Today, the most common referral pathway for these patients ends in a paediatric orthopaedic outpatient clinic. Vitamin D deficiency is a clinical entity that can affect all children and should be looked for in all children with musculoskeletal symptoms. The child at risk of rickets is now white, breastfed, protected from the sun and obese. Vitamin D deficiency can present as atypical muscular pain, pathological fractures or slipped upper femoral epiphysis. Obesity is linked with lower vitamin D levels; however, in the paediatric population, this does not necessarily equal clinical disorder. Vitamin D supplements can be used to reduce the risk of pathological fractures in the cerebral palsy child. It should also form part of the differential diagnosis in the work-up of nonaccidental injuries. Children with a low vitamin D present with a higher incidence of fractures from normal activities. Vitamin D levels need to be assessed before any form of orthopaedic surgery, as it can affect growth, both in the diaphysis of the bone and in the growth plate. Vitamin D levels are a key element in the successful practice of paediatric orthopaedics. It is not just the possible cause of disorder presenting to the clinician but also extremely important in ensuring the successful postoperative recovery of the patient.

  15. Maternal vitamin D deficiency associated with neonatal hypocalcaemic convulsions

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    Tibbott Rebecca

    2007-09-01

    Full Text Available Abstract Maternal vitamin D insufficiency is not uncommon. Infants born to mothers who are deficient in vitamin D and or calcium, usually due to cultural modifications in their diets or clothing habits, and in addition are breastfed, are at risk of developing vitamin D deficiency and hypocalcaemia. We present a case of neonatal hypocalcaemic seizures secondary to vitamin D deficiency. Rickets in children resulting from vitamin D deficiency is well documented. It is also becoming clear that there is a positive correlation between maternal vitamin D status during pregnancy and lactation and the development of rickets both in infancy and childhood. The correlation between maternal vitamin D, neonatal vitamin D and hypocalcaemia is not well documented.

  16. Nutritional rickets in twins: a case report

    Directory of Open Access Journals (Sweden)

    D. Frasca

    2013-06-01

    Full Text Available Vitamin D deficiency rickets in infants attributable to inadeguate vitamin D intake and decreased exposure to sunligh continue to be reported in the United States and other Western Countries. The American Academy of Pediatrics raccomend that all infants, children and adolescent have a minumin intake of 400 UI of vitamin D per day. We describe a case of deficiency-related rickets in two moroccan twins aged 10 months.

  17. Maternal vitamin D deficiency

    African Journals Online (AJOL)

    GB

    2017-05-01

    May 1, 2017 ... ABSTRACT. BACKGROUND: A rare but reversible cause of dilated cardiomyopathy occurs in infants born to vitamin D deficient mothers due to hypocalcaemia. CASE REPORT: We report a case of dilated cardiomyopathy due to hypocalcaemia secondary to maternal vitamin D deficiency in an.

  18. Vitamin D deficiency presenting with cardiogenic shock in an infant

    Directory of Open Access Journals (Sweden)

    Manish Kumar

    2011-01-01

    Full Text Available A 2-month-old child was referred as a case of dilated cardiomyopathy with cardiogenic shock. On evaluation, hypocalcemia secondary to severe vitamin D deficiency was found. There were no clinical or radiological features of rickets. The child had developed multiorgan failure due to cardiogenic shock at the time of admission and could not be saved despite adequate ventilatory and pharmacologic support. Hypocalcemia should be considered as an important differential diagnosis in cases of dilated cardiomyopathy in infants.

  19. Vitamin D deficiency and supplementation : Studies from infancy to young adulthood

    OpenAIRE

    Holmlund-Suila, Elisa

    2016-01-01

    Vitamin D deficiency in infancy and childhood impairs normal bone development and growth: defective bone mineralization leads to rickets. For many decades in Finland, vitamin D supplementation in infants has been successful in preventing rickets. However, along with increasing knowledge of non-skeletal vitamin D actions, optimal serum 25-hydroxyvitamin D (25OHD) concentration, has been under debate. The optimal vitamin D status and the dose of supplemental vitamin D in different populations m...

  20. Iron and Vitamin D Deficiency in Healthy Young Children in Western Europe Despite Current Nutritional Recommendations

    NARCIS (Netherlands)

    Akkermans, Marjolijn D.; van der Horst-Graat, Judith M.; Eussen, Simone R. B. M.; van Goudoever, Johannes B.; Brus, Frank

    2016-01-01

    Iron deficiency (ID) and vitamin D deficiency (VDD) are the 2 most common micronutrient deficiencies in young children worldwide and may lead to impaired neurodevelopment and rickets, respectively. Risk factors for ID and VDD differ between populations. The objective of this study was to determine

  1. Nutritional Rickets among Children in a Sun Rich Country

    Directory of Open Access Journals (Sweden)

    Bener Abdulbari

    2010-09-01

    Full Text Available Objective. This study describes the magnitude and characteristics of nutritional rickets and associated risk factors among children in Qatar. Subjects. A consecutive sample of 730 healthy subjects who visited the primay health care clinics were approached and 540 (73.9% subjects gave consent. Mehods. Nutritional rickets diagnosis was based on clinical radiologic and biochemical parameters and normalization of alkaline phosphatase level after 6 weeks course of daily vitamin D therapy. Results. The study revealed that 23.9% of the studied children had nutritional rickets. The mean SD age of those with rickets (3.76 years 1.51 was slightly higher than those without rickets (3.57 years 1.45. Family history of vitamin D deficiency (44.2%; P = .001 and diabetes mellitus (53.5%; P = .002 were significantly higher in rachitic children than in nonrachitic children. The children with rickets spent a significantly shorter average duration (26.86 minutes 19.94 under the sun than those without rickets (30.59 minutes 15.72; . A significantly larger proportion of rachitic children was afflicted with vitamin D deficiency (75.2% versus 62.2%; , secondary hypothyroidism (100% versus 7.5%; P = .009 and muscular weakness (56.6% versus 26.3%; . Conclusion. The most important risk factors were low vitamin D and calcium intakes, lack of exposure to sunlight, prolonged breast feeding without supplementation of vitamin D.

  2. Rickets or abuse? A histologic comparison of rickets and child abuse-related fractures.

    Science.gov (United States)

    Kepron, Charis; Pollanen, Michael S

    2015-03-01

    The bone changes of vitamin D deficiency rickets have been invoked as an alternate explanation for child-abuse related fractures identified through medical imaging. The lack of modern histopathologic comparisons between these two entities limits the abilities of the forensic pathologist to address this differential diagnosis, both in their autopsy reports and on the witness stand. We report a comparison of the histologic appearance of the bones in a two year old child with vitamin D deficiency rickets with fractures occurring in three young children with child abuse. In the case of rickets, there was marked architectural disorganization of endochondral ossification at the costochondral junctions and growth plates of long bones. The child abuse-related fractures showed osteochondral callus at different stages of healing, either centered on a discrete fracture line or at metaphyses (e.g. classical metaphyseal lesions). In many instances, the healing fractures disrupted the line of endochondral ossification. In none of the child abuse-related fractures was there any similarity to the histologic appearance of rickets. The maturation disturbance in the growth plate that occurs in rickets is a distinctive entity that cannot be confused histologically with healing fractures, including the classical metaphyseal lesion.

  3. Chest Pain and Costochondritis Associated with Vitamin D Deficiency: A Report of Two Cases

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    Robert C. Oh

    2012-01-01

    Full Text Available Vitamin D is integral for bone health, and severe deficiency can cause rickets in children and osteomalacia in adults. Although osteomalacia can cause severe generalized bone pain, there are only a few case reports of chest pain associated with vitamin D deficiency. We describe 2 patients with chest pain that were initially worked up for cardiac etiologies but were eventually diagnosed with costochondritis and vitamin D deficiency. Vitamin D deficiency is known to cause hypertrophic costochondral junctions in children (“rachitic rosaries” and sternal pain with adults diagnosed with osteomalacia. We propose that vitamin D deficiency may be related to the chest pain associated with costochondritis. In patients diagnosed with costochondritis, physicians should consider testing and treating for vitamin D deficiency.

  4. Epidemiology of nutritional rickets in children

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    Al-Atawi M

    2009-01-01

    Full Text Available In most developing countries, nutritional rickets is a major health problem. The aim of this study was to explore the magnitude of nutritional rickets among Saudi infants, and the various clinical presentations, as well as to address the possible operating risk factors behind the disease. We carried out a retrospective study at King Abdulaziz Medical City-King Fahad National Guard Hospital in Riyadh, Saudi Arabia. The records of Saudi infants under the age of 14 months over a 10-year period (between January 1990 and January 2000 were reviewed. Infor-mation collected included age, sex, clinical presentations, biochemical, radiological findings, infant nutrition, presence of other nutritional deficiencies and exposure to sunlight. There were 283 infants diagnosed with nutritional rickets due to Vitamin D deficiency (67% males who were between 6 and 14 months of age. Among the total, 70% were exclusively breast-fed, and 23% were breast-fed until the age of 1 year. The most frequent clinical presentation was hypo-calcemic convulsions (34% followed by chest infections (33% and gastroenteritis (25%. In conclusion, nutritional rickets is still prevalent in Saudi Arabia with the primary etiology being vitamin D deficiency. Therefore we recommend that every infant, who is exclusively on breast-feeding, has routine supplement of vitamin D in the range of 200 IU/day (alone or as apart of multivitamin, started soon after birth until the time of weaning.

  5. Vitamin d deficiency in breast-fed toddlers.

    Science.gov (United States)

    Biser-Rohrbaugh, A; Hadley-Miller, N

    2001-01-01

    The evaluation of genu varum and intoeing in young toddlers is a frequent problem seen by the primary care physician and the orthopaedic surgeon. This report describes six nonwhite breast-fed toddlers with extreme genu varum. Clinical and radiographic findings were consistent with vitamin D-deficiency rickets. Within 3 to 6 months of the initiation of ergocalciferol treatment, reparative processes were evident on both radiographic and clinical examinations. Laboratory studies also showed underlying correction. With the current emphasis on the benefits of breast-feeding and the limitation of sunlight, this diagnosis must remain on the differential in the evaluation of genu varum.

  6. Nutritional rickets in immigrant and refugee children.

    Science.gov (United States)

    Thacher, Tom D; Pludowski, Pawel; Shaw, Nick J; Mughal, M Zulf; Munns, Craig F; Högler, Wolfgang

    2016-01-01

    Immigrant and refugee populations bring public health challenges to host nations. In the current global refugee crisis, children are the most vulnerable subpopulation. Diseases that were considered rare in the host nation may be highly prevalent among immigrant children. The prevalence of nutritional rickets is increasing in high-income countries, largely driven by an influx of immigrant populations. Nutritional rickets is a bone disease in early childhood resulting in bone pain, delayed motor development, and bending of the bones, caused by vitamin D deficiency and/or inadequate dietary calcium intake. The consequences of nutritional rickets include stunted growth, developmental delay, lifelong bone deformities, seizures, cardiomyopathy, and even death. Nutritional rickets is most commonly seen in children from the Middle East, Africa, and South Asia in high-income countries. Dark skin pigmentation, sun avoidance, covering the skin, and prolonged breast feeding without vitamin D supplementation, are important risk factors for vitamin D deficiency, and combined with a lack of dairy products in the diet, these deficiencies can result in insufficient calcium supply for bone mineralization. We recommend screening all immigrant and refugee children under 5 years of age from these ethnic groups for nutritional rickets, based on clinical features, and confirming the diagnosis with radiographs of the wrists and knees. Because nutritional rickets is entirely preventable, public health policies must address the need for universal vitamin D supplementation and adequate dietary calcium to protect children from this scourge. Vitamin D supplementation of all infants and children with 400 IU/d during the first year of life and dietary or supplemental intakes of at least 600 IU/d of vitamin D and 500 mg/d of calcium thereafter, will effectively prevent nutritional rickets. We call on national health authorities of host countries to implement health check lists and prevention

  7. Vitamin D deficiency in India: prevalence, causalities and interventions.

    Science.gov (United States)

    G, Ritu; Gupta, Ajay

    2014-02-21

    Vitamin D deficiency prevails in epidemic proportions all over the Indian subcontinent, with a prevalence of 70%-100% in the general population. In India, widely consumed food items such as dairy products are rarely fortified with vitamin D. Indian socioreligious and cultural practices do not facilitate adequate sun exposure, thereby negating potential benefits of plentiful sunshine. Consequently, subclinical vitamin D deficiency is highly prevalent in both urban and rural settings, and across all socioeconomic and geographic strata. Vitamin D deficiency is likely to play an important role in the very high prevalence of rickets, osteoporosis, cardiovascular diseases, diabetes, cancer and infections such as tuberculosis in India. Fortification of staple foods with vitamin D is the most viable population based strategy to achieve vitamin D sufficiency. Unfortunately, even in advanced countries like USA and Canada, food fortification strategies with vitamin D have been only partially effective and have largely failed to attain vitamin D sufficiency. This article reviews the status of vitamin D nutrition in the Indian subcontinent and also the underlying causes for this epidemic. Implementation of population based educational and interventional strategies to combat this scourge require recognition of vitamin D deficiency as a public health problem by the governing bodies so that healthcare funds can be allocated appropriately.

  8. Vitamin D Deficiency in India: Prevalence, Causalities and Interventions

    Directory of Open Access Journals (Sweden)

    Ritu G

    2014-02-01

    Full Text Available Vitamin D deficiency prevails in epidemic proportions all over the Indian subcontinent, with a prevalence of 70%–100% in the general population. In India, widely consumed food items such as dairy products are rarely fortified with vitamin D. Indian socioreligious and cultural practices do not facilitate adequate sun exposure, thereby negating potential benefits of plentiful sunshine. Consequently, subclinical vitamin D deficiency is highly prevalent in both urban and rural settings, and across all socioeconomic and geographic strata. Vitamin D deficiency is likely to play an important role in the very high prevalence of rickets, osteoporosis, cardiovascular diseases, diabetes, cancer and infections such as tuberculosis in India. Fortification of staple foods with vitamin D is the most viable population based strategy to achieve vitamin D sufficiency. Unfortunately, even in advanced countries like USA and Canada, food fortification strategies with vitamin D have been only partially effective and have largely failed to attain vitamin D sufficiency. This article reviews the status of vitamin D nutrition in the Indian subcontinent and also the underlying causes for this epidemic. Implementation of population based educational and interventional strategies to combat this scourge require recognition of vitamin D deficiency as a public health problem by the governing bodies so that healthcare funds can be allocated appropriately.

  9. Rickets and tracheobronchomalacia

    OpenAIRE

    Bangalore, Harish; Bisht, Suniti; Inusa, Baba

    2009-01-01

    Rickets is increasingly encountered in practice, even in the Western world. One recent publication reports an overall incidence of 7.5 per 100 000 children. Respiratory infections are well known to be associated with rickets. We present a case of rickets with severe respiratory complications. Tracheobronchomalacia was detected on bronchoscopy. We believe that tracheobronchomalacia may be a hitherto unrecognised finding in rickets and may need to be investigated further.

  10. [Vitamin D deficiency in childhood: an opportunity for prevention].

    Science.gov (United States)

    López-González, Desirée; Méndez-Sánchez, Lucía; Guagnelli, Miguel Ángel; Clark, Patricia

    The prevalence of vitamin D deficiency in the pediatric population has increased in recent years and continues to be underdiagnosed and undertreated. According to data from the "ENSANUT 2006" (National Health and Nutrition Survey), the prevalence of vitamin D deficiency in Mexico was 16% in children aged 2-12 years. Vitamin D plays a critical role in the formation and bone homeostasis and consequently on growth. Its deficiency is clearly associated with diseases such as rickets and osteomalacia, and it has been linked to other diseases such as obesity, metabolic syndrome, diabetes, cancer, respiratory infections and immune system disease. Specific risk groups have been described in the medical literature for vitamin D deficiency in which supplementation may offer a benefit. Currently, there is still controversy in defining the serum levels of proficiency and dose supplementation. In Mexico, the daily suggested intake of vitamin D is 5.6μg (224 IU), which is significantly lower than the recommendations in the U.S. and Europe (i.e., between 400 and 1000 IU/day). An increase in vitamin D deficiency has been reported in recent years. There is no consensus regarding the sufficiency levels of vitamin D. Cut-off values vary from 20 to 30ng/ml. Therefore, the objective of this review was to provide an overview of the problem in the pediatric population and to describe the groups at risk, as well as to analyze the current recommendations for vitamin D supplementation. Vitamin D deficiency was considered rare in Mexico according to the National Institute of Medical Science and Nutrition Salvador Zubirán. Lack of evidence did not help to establish the international recommended daily intake. Currently, vitamin D deficiency must be recognized as a health problem, worthy of attention and action. We suggest that prospective studies are carried out in our country where the relationship between serum vitamin D deficiency and poor bone mineralization will be established. Copyright

  11. Vitamin D deficiency in Europe

    DEFF Research Database (Denmark)

    Cashman, Kevin D.; Dowling, Kirsten G; Škrabáková, Zuzana

    2016-01-01

    25(OH)D values from national health/nutrition surveys. OBJECTIVE: This study applied VDSP protocols to serum 25(OH)D data from representative childhood/teenage and adult/older adult European populations, representing a sizable geographical footprint, to better quantify the prevalence of vitamin D......BACKGROUND: Vitamin D deficiency has been described as being pandemic, but serum 25-hydroxyvitamin D [25(OH)D] distribution data for the European Union are of very variable quality. The NIH-led international Vitamin D Standardization Program (VDSP) has developed protocols for standardizing existing...... sera. These data were combined with standardized serum 25(OH)D data from 4 previously standardized studies (for a total n = 55,844). Prevalence estimates of vitamin D deficiency [using various serum 25(OH)D thresholds] were generated on the basis of standardized 25(OH)D data. RESULTS: An overall pooled...

  12. FGF23 is elevated in Gambian children with rickets.

    Science.gov (United States)

    Prentice, Ann; Ceesay, Mustapha; Nigdikar, Shailja; Allen, Stephen J; Pettifor, John M

    2008-04-01

    Fibroblast growth factor 23 (FGF23) is a phosphaturic factor that is elevated in several diseases associated with hypophosphatemia and rickets. Rickets in the absence of vitamin D deficiency has been reported in African and Asian populations with a low calcium intake but the definition of risk factors has proved elusive. The aim of the study was to characterize the biochemical profile and measure FGF23 in a series of Gambian children who had presented with rickets of unknown etiology and a plasma 25-hydroxyvitamin D (25OHD) above the range typical of vitamin D-deficiency rickets. The 46 patients (30 males, 16 females) had bone deformities typical of rickets and were 1.1-16.4 years old (geometric mean, 3.4 years). Active rickets (on radiographs and/or elevated plasma alkaline phosphatase) was present in 28%. Plasma 25-hydroxyvitamin D was above 20 nmol/l in all patients. Concentrations of plasma FGF23, phosphate and other relevant biochemical analytes were measured in stored samples of fasting, early morning plasma and compared with those measured in samples collected from local children and stored under similar conditions. The rickets patients had lower plasma phosphate, lower 25-hydroxyvitamin D, higher 1,25-dihydroxyvitamin D and elevated total alkaline phosphatase than local children. Those with active rickets had raised parathyroid hormone concentration. The patients had significantly higher FGF23 concentration than local children (geometric mean (-1SD, +1SD, range) RU/ml: 367 (87, 1552, 46-7052, n=39) vs 51 (23, 112, 3-130, n=30), pchildren, some grossly so (up to 50-fold). There was no significant difference in FGF23 concentration between those with active rickets and the other patients. Plasma phosphate was significantly and inversely correlated with FGF23 concentration. Some clinical improvements were noted after 6-12 months, during which time calcium and vitamin D had been prescribed, but FGF23 remained elevated in many patients. These data suggest that

  13. Role of calcium deficiency in development of nutritional rickets in Indian children: a case control study.

    Science.gov (United States)

    Aggarwal, Varun; Seth, Anju; Aneja, Satinder; Sharma, Bhawna; Sonkar, Pitamber; Singh, Satveer; Marwaha, Raman K

    2012-10-01

    Nutritional rickets is usually attributed to vitamin D deficiency. Studies from some tropical countries have postulated low dietary intake of calcium as the cause of nutritional rickets. Both vitamin D and dietary calcium deficiency are highly prevalent in India. Information on their relative contribution in the development of rickets in Indian children is limited. The aim was to study the role of calcium and vitamin D deficiency in causation of nutritional rickets in young Indian children. In a case-control study, 67 children with nutritional rickets and 68 age- and sex-matched healthy controls were compared for demographic factors, nutritional status, sun exposure (UV score), dietary calcium and phytate intake (for subjects not breast-fed at presentation), and biochemical parameters [serum calcium, inorganic phosphate, alkaline phosphatase, 25-hydroxyvitamin D (25OHD), and PTH]. Mean intake of calcium (204±129 vs. 453±234 mg/d; Prickets, significant negative correlations were seen between dietary calcium intake and radiological score (r=-0.28; P=0.03) and PTH (r=-0.26; P=0.02). No correlation was found between serum 25OHD level and radiological score or biochemical parameters of rickets. Rickets develops when low dietary calcium intake coexists with a low or borderline vitamin D nutrition status.

  14. The Vitamin D Deficiency Pandemic: a Forgotten Hormone Important for Health

    Directory of Open Access Journals (Sweden)

    Holick Michael F

    2010-07-01

    Full Text Available Early in the twentieth century more than 80 percent of children in industrialized Europe and North America were ravaged by the devastating skeletal consequences of rickets. Finding that exposure to ultraviolet radiation or sunlight treated and prevented rickets led to the ultraviolet irradiation of foods including milk. These practices along with the fortification of a variety of foods including dairy products with vitamin D and widespread use of cod liver oil eradicated rickets as a significant health problem by the late 1930s. Many countries mandated the fortification of milk with vitamin D to prevent rickets during wartime shortages. In the 1950s, in Europe, many countries forbid fortification of dairy and food products except breakfast cereals and margarine because of an outbreak of vitamin D intoxication in neonates.Vitamin D deficiency has again become a major public health interest with its association with osteoporosis, osteomalacia, fractures, and more recently with prevention of cancer, diabetes, heart disease and other chronic illnesses. Regular sun exposure has decreased due to changing lifestyles. Vitamin D deficiency is especially prevalent in dark skinned children and adults living in Northern latitudes, and obese children and adults. Improving the vitamin D status worldwide would have dramatic effects on public health, and reduce healthcare costs for many chronic diseases. The most cost-effective way to remedy this deficiency is to increase food fortification with higher levels of vitamin D along with sensible sun exposure, and adequate vitamin D supplementation. I review the pathophysiology of vitamin D deficiency and its health consequences and provide recommendations for a new policy approach to this vital public health issue.

  15. Nutritional rickets in Denmark

    DEFF Research Database (Denmark)

    Beck-Nielsen, Signe; Jensen, Tina Kold; Gram, Jeppe

    2009-01-01

    INTRODUCTION: This study describes clinical and biochemical characteristics of nutritional rickets and risk factors at diagnosis among children living in Denmark. All medical records from patients with rickets referred to or discharged from hospitals in Southern Denmark from 1985 to 2005 were...... identified by register search. MATERIALS AND METHODS: Patients included were younger than 15 years of age and fulfilled the diagnostic criteria of primary, nutritional rickets. A total of 112 patients with nutritional rickets were included: 29 were of ethnic Danish origin, and 83 were immigrants. RESULTS......: Patients diagnosed before the age of 4 (median 1.4) years displayed the classic clinical signs of rickets, whereas patients diagnosed after the age of 4 (median 12.5) years had few clinical signs and unspecific symptoms. Ethnic Danish patients were only diagnosed before age 24 months, and they accounted...

  16. Vitamin D deficiency and stroke

    Directory of Open Access Journals (Sweden)

    2012-12-01

    Full Text Available Vitamin D comprises a group of fat-soluble pro-hormones, obtained from sun exposure, food, and supplements, and it must undergo two hydroxylation reactions to be activated in the body. Several studies have shown the role of vitamin D in mineral metabolism regulation, especially calcium, phosphorus, and bone metabolism. Some factors such as inadequate vitamin intake and liver or kidney disorders can lead to vitamin D deficiency. Furthermore, vitamin D malnutrition may also be linked to susceptibility to chronic diseases such as heart failure, peripheral artery disease, high blood pressure, cognitive impairment including foggy brain and memory loss, and autoimmune diseases including diabetes type I. Recent research has revealed that low levels of vitamin D increase the risk of cardiovascular-related morbidity (Sato et al., 2004 and mortality (Pilz et al., 2008. Also, hypertension contributes to a reduction in bone mineral density and increase in the incidence of stroke and death. This article reviews the function and physiology of vitamin D and examines the effects of vitamin D deficiency on susceptibility to stroke, as a cardiovascular event, and its morbidity and subsequent mortality.

  17. Epidermolytic hyperkeratosis with rickets

    Directory of Open Access Journals (Sweden)

    Nayak Surajit

    2006-01-01

    Full Text Available A 6-year-old child presented with generalized hyperkeratosis, most marked over the flexures; windswept deformity of the legs; and limping since 3 years. On the basis of the clinical, histopathologic and biochemical findings, he was diagnosed as a case of epidermolytic hyperkeratosis with rickets. He was treated with parenteral vitamin D3 and calcium supplements orally. Nutritional rickets has been reported in children with various types of ichthyosis like lamellar and X-linked types. We report this case of epidermolytic hyperkeratosis with rickets for its rarity.

  18. Vitamin D–deficiency rickets among children in Canada

    Science.gov (United States)

    Ward, Leanne M.; Gaboury, Isabelle; Ladhani, Moyez; Zlotkin, Stanley

    2007-01-01

    Background Based on regional and anecdotal reports, there is concern that vitamin D–deficiency rickets is persistent in Canada despite guidelines for its prevention. We sought to determine the incidence and clinical characteristics of vitamin D–deficiency rickets among children living in Canada. Methods A total of 2325 Canadian pediatricians were surveyed monthly from July 1, 2002, to June 30, 2004, through the Canadian Paediatric Surveillance Program to determine the incidence, geographic distribution and clinical profiles of confirmed cases of vitamin D-deficiency rickets. We calculated incidence rates based on the number of confirmed cases over the product of the length of the study period (2 years) and the estimates of the population by age group. Results There were 104 confirmed cases of vitamin D–deficiency rickets during the study period. The overall annual incidence rate was 2.9 cases per 100 000. The incidence rates were highest among children residing in the the north (Yukon Territory, Northwest Territories and Nunavut). The mean age at diagnosis was 1.4 years (standard deviation [SD] 0.9, min–max 2 weeks–6.3 years). Sixty-eight children (65%) had lived in urban areas most of their lives, and 57 (55%) of the cases were identified in Ontario. Ninety-two (89%) of the children had intermediate or darker skin. Ninety-eight (94%) had been breast-fed, and 3 children (2.9%) had been fed standard infant formula. None of the breast-fed infants had received vitamin D supplementation according to current guidelines (400 IU/d). Maternal risk factors included limited sun exposure and a lack of vitamin D from diet or supplements during pregnancy and lactation. The majority of children showed clinically important morbidity at diagnosis, including hypocalcemic seizures (20 cases, 19%). Interpretation Vitamin D–deficiency rickets is persistent in Canada, particularly among children who reside in the north and among infants with darker skin who are breast

  19. Vitamin D Deficiency in Children Undergoing Vertical Expandable Prosthetic Titanium Rib Treatment.

    Science.gov (United States)

    Li, Ying; Jong, Nahbee; Caird, Michelle S; Tenfelde, Allison; Nowicki, Philip; Shedden, Kerby; Nelson, Virginia S; Farley, Frances A

    2015-12-01

    Vitamin D deficiency is prevalent in the pediatric population and multiple risk factors have been identified. Low vitamin D levels can result in poor bone mineralization and have been associated with a significantly higher risk of forearm fracture in children. Vitamin D deficiency has also been associated with pediatric critical illness. The purpose of this study was to determine whether children undergoing vertical expandable prosthetic titanium rib (VEPTR) treatment have low vitamin D levels. Patients undergoing VEPTR treatment at a single institution were prospectively enrolled (VEPTR). All patients either had a diagnosis of thoracic insufficiency syndrome (TIS), or were at risk of developing TIS secondary to progressive scoliosis or chest wall deformity. Exclusion criteria were patients with rickets and patients receiving vitamin D supplementation at the time of VEPTR insertion. A group of healthy children who presented with fractures during the winter season were used as controls (FX). Vitamin D status and risk factors for vitamin D deficiency were evaluated. Vitamin D deficiency was defined as serum 25-hydroxyvitamin D (25-OH-D) obesity, or multivitamin use. Low vitamin D levels are common in children undergoing VEPTR treatment. In our series, the prevalence of vitamin D deficiency in this patient population was similar to reported rates in the general pediatric population. Vitamin D status should be routinely monitored in children undergoing VEPTR treatment and supplementation should be initiated if necessary.

  20. Severe vitamin D deficiency in 6 Canadian First Nation formula-fed infants

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    Melissa L. Gross

    2013-04-01

    Full Text Available Background. Rickets was first described in the 17th century and vitamin D deficiency was recognized as the underlying cause in the early 1900s. Despite this long history, vitamin D deficiency remains a significant health concern. Currently, vitamin D supplementation is recommended in Canada for breast fed infants. There are no recommendations for supplementation in formula-fed infants. Objective. The objective of this report is to bring attention to the risk of severe vitamin D deficiency in high risk, formula fed infants. Design. A retrospective chart review was used to create this clinical case series. Results. Severe vitamin D deficiency was diagnosed in six formula-fed infants over a two-and-a-half year period. All six infants presented with seizures and they resided in First Nation communities located at latitude 54 in the province of Manitoba. While these infants had several risk factors for vitamin D deficiency, they were all receiving cow's milk based formula supplemented with 400 IU/L of vitamin D. Conclusion. This report suggests that current practice with regards to vitamin D supplementation may be inadequate, especially for high-risk infants. Health care professionals providing service to infants in a similar situation should be aware of this preventable condition. Hopefully this would contribute to its prevention, diagnosis and management.

  1. Increasing incidence of nutritional rickets: a population-based study in Olmsted County, Minnesota.

    Science.gov (United States)

    Thacher, Tom D; Fischer, Philip R; Tebben, Peter J; Singh, Ravinder J; Cha, Stephen S; Maxson, Julie A; Yawn, Barbara P

    2013-02-01

    To determine temporal trends in incidence and risk factors of nutritional rickets in a community-based population. Rochester Epidemiology Project data were used to identify all children (aged rickets, vitamin D deficiency, hypovitaminosis D, rachitis, osteomalacia, genu varum, genu valgum, craniotabes, hypocalcemia, hypocalcemic seizure, and tetany. Record abstraction was performed to select individuals with radiographic confirmation of rickets. Age- and sex-matched controls were identified for the evaluation of risk factors. The main outcome measure was radiographic evidence of rickets without identifiable inherited, genetic, or nonnutritional causes. Incidence rates were calculated using Rochester Epidemiology Project census data. Of 768 children with eligible diagnostic codes, 23 had radiographic evidence of rickets; of these, 17 children had nutritional rickets. All 17 children were younger than 3 years, and 13 (76%) were of nonwhite race/ethnicity. Clinical presentation included poor growth (n=12), leg deformity (n=8), motor delay (n=5), leg pain (n=3), weakness (n=3), and hypocalcemia or tetany (n=2). The incidence of nutritional rickets in children younger than 3 years was 0, 2.2, 3.7, and 24.1 per 100,000 for the decades beginning in 1970, 1980, 1990, and 2000, respectively (P=.003 for incidence trend). Nutritional rickets was associated with black race, breast-feeding, low birth weight, and stunted growth (Prickets remains rare, but its incidence has dramatically increased since 2000. Not all cases of rickets can be attributed to vitamin D deficiency. Copyright © 2013 Mayo Foundation for Medical Education and Research. Published by Elsevier Inc. All rights reserved.

  2. Dental complications of rickets in early childhood: case report on 2 young girls.

    Science.gov (United States)

    Davit-Béal, Tiphaine; Gabay, Julie; Antoniolli, Pauline; Masle-Farquhar, Jeanne; Wolikow, Maryse

    2014-04-01

    Vitamin D is an essential hormone for calcium gut absorption. It is also involved in child growth, cancer prevention, immune system responses, and tooth formation. Due to inadequate vitamin D intake and/or decreased sunlight exposure, vitamin D deficiency has resurfaced in developed countries despite known inexpensive and effective preventive methods. Vitamin D deficiency is a common cause of rickets, a condition that affects bone development in children and that can have serious dental complications. Deficiency during pregnancy can cause enamel hypoplasia of primary teeth. Enamel regeneration is currently impossible; hypoplasia is therefore irreversible, and once affected, teeth are prone to fast caries development. Deficiency during early childhood can affect permanent teeth and ensuing caries can sometimes lead to tooth loss at a young age. Oral manifestations of rickets should be diagnosed early by both physicians and dentists to prevent severe dental complications. This case study presents 2 young girls with rickets in early childhood who suffered from subsequent serious tooth decay.

  3. Relationship between rickets and incomplete distal renal tubular acidosis in children

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    Oduwole Abiola O

    2010-08-01

    Full Text Available Abstract Background In the Sub Saharan Africa Rickets has now been established to be due primarily to calcium deficiency and sometimes in combination with vitamin D deficiency. The main thrust of management is calcium supplementation with or without vitamin D. An observation was made that some children with nutritional rickets do not respond to this management modality. The recently reported high prevalence of Incomplete Distal Renal Tubular Acidosis (idRTA in adults with osteoporosis as brought to fore the possibility of this being a possible cause of calcium wastage and therefore the poor response in these group of children with rickets. Aim To determine the prevalence of idRTA amongst a cohort of subjects with rickets To show a relationship between rickets and incomplete distal renal acidosis To determine the response of children with rickets and idRTA to addition of Shohl's solution to therapy Methodology Two separate cohorts of children with rickets performed the ammonium chloride loading test to detect those with incomplete renal tubular acidosis. Following identification for idRTA, Shohl's solution was added to therapy of calcium and vitamin D supplementation and their response compared to those without idRTA on calcium and vitamin D supplementation solely. Results 50 children with rickets aged from two to six years of age and composed of 29 females and 21males were investigated. Incomplete renal tubular acidosis was found in 38% of them. Prevalence of idRTA was highest amongst those aged 3-6 years of age. Those with idRTA had worse limb deformities, biochemical and radiological parameters than those who hadn't. Rate of response on those with idRTA treated with Shohl's solution was at par with those without idRTA. Conclusion Incomplete idRTA exist amongst children with rickets and should be looked out for in severe rickets and older children. Treatment of idRTA will lead to optimal response and healing of rickets.

  4. Relationship between rickets and incomplete distal renal tubular acidosis in children.

    Science.gov (United States)

    Oduwole, Abiola O; Giwa, Olayiwola S; Arogundade, Rasheed A

    2010-08-11

    In the Sub Saharan Africa Rickets has now been established to be due primarily to calcium deficiency and sometimes in combination with vitamin D deficiency. The main thrust of management is calcium supplementation with or without vitamin D. An observation was made that some children with nutritional rickets do not respond to this management modality. The recently reported high prevalence of Incomplete Distal Renal Tubular Acidosis (idRTA) in adults with osteoporosis as brought to fore the possibility of this being a possible cause of calcium wastage and therefore the poor response in these group of children with rickets. To determine the prevalence of idRTA amongst a cohort of subjects with ricketsTo show a relationship between rickets and incomplete distal renal acidosisTo determine the response of children with rickets and idRTA to addition of Shohl's solution to therapy Two separate cohorts of children with rickets performed the ammonium chloride loading test to detect those with incomplete renal tubular acidosis. Following identification for idRTA, Shohl's solution was added to therapy of calcium and vitamin D supplementation and their response compared to those without idRTA on calcium and vitamin D supplementation solely. 50 children with rickets aged from two to six years of age and composed of 29 females and 21males were investigated. Incomplete renal tubular acidosis was found in 38% of them. Prevalence of idRTA was highest amongst those aged 3-6 years of age. Those with idRTA had worse limb deformities, biochemical and radiological parameters than those who hadn't. Rate of response on those with idRTA treated with Shohl's solution was at par with those without idRTA. Incomplete idRTA exist amongst children with rickets and should be looked out for in severe rickets and older children. Treatment of idRTA will lead to optimal response and healing of rickets.

  5. [Rickets in a child].

    Science.gov (United States)

    Kristinsdottir, Harpa; Jonasdottir, Soffía; Bjornsson, Sigurdur; Ludvigsson, Petur

    2011-09-01

    Vitamin D is necessary for normal bone growth. Deficiency of vitamin D can lead to rickets in children and osteomalacia in adults. It is difficult to reach the recommended daily dose of vitamin D in children without cod liver oil or other vitamin D supplementation. Several cases of rickets have been diagnosed in Iceland the past few years. Studies suggest a worldwide increase in the prevalence of the disorder. We report on a girl who was diagnosed with rickets at the age of 27 months. She received inadequate amounts of vitamin D supplementation in the form of AD drops and cod liver oil. Because of food allergy she was on a restricted diet which limited her intake of dietary vitamin D. After diagnosis, she received a high-dose vitamin D therapy (Stoss therapy) which corrected the deficiency. Key words: rickets, food allergy, vitamin D.

  6. Клініко-лабораторна характеристика вітамін D-дефіцитного рахіту у дітей раннього віку при ожирінні = Clinical-laboratory characteristics of vitamin D-deficient rickets in infants with obesity

    OpenAIRE

    Тokarchuk, N. I.; Pugach, M. М.; Chekotun, Т. V.; Starinetz, L. S.; Savicka, T. V.; Lagoda, V. V.

    2015-01-01

    Тokarchuk N. I., Pugach M. М., Chekotun Т. V., Starinetz L. S., Savicka T. V., Lagoda V. V. Клініко-лабораторна характеристика вітамін D-дефіцитного рахіту у дітей раннього віку при ожирінні = Clinical-laboratory characteristics of vitamin D-deficient rickets in infants with obesity. Journal of Education, Health and Sport. 2015;5(11):111-116. ISSN 2391-8306. DOI http://dx.doi.org/10.5281/zenodo.33536 http://ojs.ukw.edu.pl/index.php/johs/article/view/2015%3B5%2811%29%3A111-116 https://...

  7. Effect of intramuscular cholecalciferol megadose in children with nutritional rickets.

    Science.gov (United States)

    Bothra, Meenakshi; Gupta, Nandita; Jain, Vandana

    2016-06-01

    The treatment practices for vitamin D deficiency rickets are highly variable. Though a single intramuscular (IM) megadose of vitamin D is economical, and ensures good compliance, it poses the risk of hypervitaminosis D. This observational study was conducted to assess the duration of effect and safety of single IM megadose of cholecalciferol in the treatment of vitamin D deficiency rickets. Children younger than 14 years with rickets were enrolled. Baseline investigations included radiograph of wrists and estimation of serum calcium, phosphate, alkaline phosphatase (ALP), 25(OH) vitamin D and parathormone (PTH) levels. All children received a single IM megadose of vitamin D3. Biochemical parameters were re-evaluated at 1.5, 3 and 6 months after the megadose and the values were compared to the baseline. We enrolled 21 children, out of which nine remained under active follow-up till 6 months. Radiological evidence of rickets was present in all 21 children, 14 had hypocalcemia at the time of presentation. After IM cholecalciferol megadose, median 25 hydroxy vitamin D [25(OH)D] level remained significantly more than the baseline till 6 months after the megadose. At 1.5 months after the vitamin D megadose, three (30%) of the children were found to develop toxic levels of vitamin D (>150 ng/mL), although none had hypercalcemia or any clinical manifestation of vitamin D toxicity. At 3 months and 6 months after the megadose, 25(OH)D levels remained in the sufficient range (20-100 ng/mL) in seven out of the eight children who came for follow-up. A single IM megadose of vitamin D may be effective in significantly increasing the 25(OH)D levels for at least 6 months in children with rickets, but elevation of 25(OH)D to toxic range raises concern regarding its safety.

  8. Vitamin D Deficiency and Chronic Lung Disease

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    Christopher R Gilbert

    2009-01-01

    Full Text Available Vitamin D deficiency is increasingly being recognized as a prevalent problem in the general population. Patients with chronic lung diseases such as asthma, cystic fibrosis, chronic obstructive lung disease and interstitial pneumonia appear to be at increased risk for vitamin D deficiency for reasons that are not clear.

  9. Prevention of Vitamin D deficiency in infancy: daily 400 IU vitamin D is sufficient

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    Cizmecioglu Filiz M

    2011-06-01

    Full Text Available Summary Aim-objective Vitamin D deficiency and rickets in developing countries continues to be a major health problem. Additionally, the increase of cases of rickets in children of some ethnic groups in the United States and European countries has provided this issue to be updated. Obviously, powerful strategies are necessary to prevent vitamin D deficiency nation-wide. In 2005, a nationwide prevention program for vitamin D deficiency was initiated, recommending 400 IU vitamin D per a day. This study was designed to evaluate the efficacy of the prevention program. Methods Eighty-five infants who were recalled as part of the national screening program for congenital hypothyroidism between February 2010 and August 2010 at Kocaeli University Children's Hospital were evaluated in terms of their vitamin D status as well. All babies had been provided with free vitamin D (Cholecalciferol solution and recommended to receive 400 IU (3 drops daily. Information regarding the age at start of supplementation, the dosage and compliance were obtained from the mothers with face-to-face interview. Serum 25-hydroxy vitamin D (25-OH-D, alkaline phosphatase (AP, parathormone (PTH levels were measured. Results The mean age at which Vitamin D3 supplementation began was 16.5 ± 20.7 (3-120 days. Ninety percent of cases (n:76 were receiving 3 drops (400 IU vitamin D3 per day as recommended; 70% of cases (n:59 were given vitamin D3 regularly, the remainder had imperfect compliance. Among those children who are older than 12 months, only 20% continued vitamin D supplementation. No subject had clinical signs of rickets. The mean 25-OH-D level was 42,5 ± 25,8 (median: 38.3 ng/ml. Ten subjects (12% had their serum 25-OH-D levels lower than 20 ng/ml (6 between 15-20 ng/ml, 3 between 5-15 ng/ml and only one Conclusions 400 U/day vitamin D seems adequate to prevent vitamin D deficiency. However, we believe that the program for preventing vitamin D deficiency in Turkey, needs

  10. Vitamin D deficiency in adolescents

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    Ashraf T Soliman

    2014-01-01

    Full Text Available The prevalence of severe vitamin D deficiency (VDD in adolescents is variable but considerably high in many countries, especially in Middle-east and Southeast Asia. Different factors attribute to this deficiency including lack of sunlight exposure due to cultural dress codes and veiling or due to pigmented skin, and less time spent outdoors, because of hot weather, and lower vitamin D intake. A potent adaptation process significantly modifies the clinical presentation and therefore clinical presentations may be subtle and go unnoticed, thus making true prevalence studies difficult. Adolescents with severe VDD may present with vague manifestations including pain in weight-bearing joints, back, thighs and/or calves, difficulty in walking and/or climbing stairs, or running and muscle cramps. Adaptation includes increased parathormone (PTH and deceased insulin-like growth factor-I (IGF-I secretion. PTH enhances the tubular reabsorption of Ca and stimulates the kidneys to produce 1, 25-(OH 2D3 that increases intestinal calcium absorption and dissolves the mineralized collagen matrix in bone, causing osteopenia and osteoporosis to provide enough Ca to prevent hypocalcaemia. Decreased insulin like growth factor-I (IGF-I delays bone growth to economize calcium consumption. Radiological changes are not uncommon and include osteoporosis/osteopenia affecting long bones as well as vertebrae and ribs, bone cysts, decalcification of the metaphysis of the long bones and pseudo fractures. In severe cases pathological fractures and deformities may occur. Vitamin D treatment of adolescents with VDD differs considerably in different studies and proved to be effective in treating all clinical, biochemical, and radiological manifestations. Different treatment regiments for VDD have been discussed and presented in this mini-review for practical use. Adequate vitamin D replacement after treating VDD, improving calcium intake (milk and dairy products, encouraging

  11. Vitamin D dependent rickets type I

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    Chan Jong Kim

    2011-02-01

    Full Text Available Vitamin D is present in two forms, ergocalciferol (vitamin D2 produced by plants and cholecalciferol (vitamin D3 produced by animal tissues or by the action of ultraviolet light on 7-dehydrocholesterol in human skin. Both forms of vitamin D are biologically inactive pro-hormones that must undergo sequential hydroxylations in the liver and the kidney before they can bind to and activate the vitamin D receptor. The hormonally active form of vitamin D, 1,25-dihydroxyvitamin D3 [1,25(OH2D], plays an essential role in calcium and phosphate metabolism, bone growth, and cellular differentiation. Renal synthesis of 1,25(OH2D from its endogenous precursor, 25-hydroxyvitamin D (25OHD, is the rate-limiting and is catalyzed by the 1?#7016;ydroxylase. Vitamin D dependent rickets type I (VDDR-I, also referred to as vitamin D 1?#7016;ydroxylase deficiency or pseudovitamin D deficiency rickets, is an autosomal recessive disorder characterized clinically by hypotonia, muscle weakness, growth failure, hypocalcemic seizures in early infancy, and radiographic findings of rickets. Characteristic laboratory features are hypocalcemia, increased serum concentrations of parathyroid hormone (PTH, and low or undetectable serum concentrations of 1,25(OH2D despite normal or increased concentrations of 25OHD. Recent advances have showed in the cloning of the human 1?#7016;ydroxylase and revealed mutations in its gene that cause VDDR-I. This review presents the biology of vitamin D, and 1?#7016;ydroxylase mutations with clinical findings.

  12. Rickets on MR images

    Energy Technology Data Exchange (ETDEWEB)

    Ecklund, K.; Jaramillo, D. [Department of Radiology, Children`s Hospital, Boston, MA (United States); Doria, A.S. [Department of Radiology, Instituto da Crianca - Hospital das Clinicas da Faculdade de Medicina da Universidade de Sao Paulo (Brazil)

    1999-09-01

    Background. The pathologic changes at the physis in patients with rickets have been well demonstrated histologically. Radiographs can depict only the associated osseous abnormalities. Patients and methods. We report two children in whom MR imaging demonstrated rachitic changes in the physeal cartilage beyond the well-recognized bony features. Results. The striking appearance of the physes and the physes of the secondary ossification centers confirm that MR imaging can successfully evaluate the cartilaginous structures of the developing skeleton. Conclusion. Though MR imaging is clearly unnecessary for the diagnosis of rickets, it is important that the typical features are not misinterpreted as other pathology. (orig.) With 6 figs., 6 refs.

  13. Rickets in Denmark

    DEFF Research Database (Denmark)

    Beck-Nielsen, Signe

    2012-01-01

    in the past, but by introduction of preventative administration of cod liver oil and vitamin D supplementation, nutritional rickets became a rarity. During the last decades, case reports of nutritional rickets reappear in the industrialized countries. It is the general conception that in the industrialized...... among Scandinavian patients have not been characterized. Especially, the disease in adult patients is not well described. Moreover, there are conflicting reports of the benefits of medical treatment throughout childhood, and in addition on gender differences in disease severity....

  14. Vitamin D deficiency in pediatric critical illness

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    Kiran B. Hebbar, MD, FCCM

    2014-12-01

    Conclusions: Vitamin D deficiency is common in the pediatric critical care population. Significant seasonal differences were noted even in the critically ill. The role of vitamin D in certain diseases like asthma in critically ill children merit further study.

  15. Prevalence & potential significance of vitamin D deficiency in Asian Indians.

    Science.gov (United States)

    Goswami, R; Mishra, S K; Kochupillai, N

    2008-03-01

    Studies from our center and other parts of India have drawn attention towards wide prevalence of vitamin D deficiency (VDD) in our country. VDD has been reported in all age groups including toddlers, school children, pregnant women and their neonates and adult males and females residing in rural and urban India. We reviewed implications of VDD in our population based on the preliminary data available from Indian studies on skeletal health. Besides, a brief review is made on the importance of VDD in various other disorders prevalent in equivalent proportions among Indians such as type 2 diabetes mellitus (DM), cardiovascular diseases (CVD), immune competence including relation to tuberculosis, malignancy and osteoarthritis. Data from the West have also associated VDD with increased prevalence of type 2DM, CVD, autoimmune disorders, tuberculosis, prostate, breast and colon malignancy and osteoarthritis. Such association has not been studied to date in our country. Overall results of various studies conducted to date in urban and rural Indians indicate that widely prevalent VDD is functionally relevant to skeletal health including osteomalacia and rickets. However, there is a need to explore its association with osteoporosis related fractures and various other non skeletal disorders linked with VDD.

  16. Ichthyosis associated with rickets in two Indian children

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    Dimple Kothari

    2013-01-01

    Full Text Available We wish to report two cases of rickets due to vitamin D deficiency secondary to underlying ichthyotic skin disorder. The first case is of an 8-year-old male with history of multiple fluid-filled lesions over the body that would rupture to heal with thickening and scaling of skin, suggestive of epidermolytic hyperkeratosis, and the second is of a 14-year-old female with thick, large, quadrilateral scales over the extremities and back clinically consistent with lamellar ichthyosis. Both showed improvement with parenteral vitamin D3 and oral calcium supplements in addition to topical emollients.

  17. “English Disease”: Historical Notes on Rickets, the Bone–Lung Link and Child Neglect Issues

    Science.gov (United States)

    Zhang, Mingyong; Shen, Fan; Petryk, Anna; Tang, Jingfeng; Chen, Xingzhen; Sergi, Consolato

    2016-01-01

    Nutritional or classical rickets (here labeled as “rickets”) is a worldwide disease involving mostly infants and young children having inadequate sunlight exposure, often associated with a low dietary intake of Vitamin D. Rickets targets all layers of society independently of economic status with historical information spanning more than two millennia. Vitamin D is critical for the absorption of calcium and prevention of rickets in children as well as osteomalacia in adults. The initial and misleading paradigm of the 19th and 20th centuries that rickets may have been the consequence of infection has been, indeed, reversed following the identification of the Vitamin D molecule’s important role in the function of the immune system. Although traditionally considered limited to osteopathology, Vitamin D deficiency is now known to be linked to infection, inflammation, and carcinogenesis. In this review, we consider the key historical (Whistler, pre-Whistler and post-Whistler descriptors) and social facts around rickets; highlight the osteo-pathological features of rickets and the pathology of the upper and lower respiratory tract, stressing the fact that lungs remain the main secondary organ affected by Vitamin D deficiency; and emphasize the public health role in identifying the cases of child neglect or abuse based on the evaluation of the costochondral region. PMID:27854286

  18. “English Disease”: Historical Notes on Rickets, the Bone–Lung Link and Child Neglect Issues

    Directory of Open Access Journals (Sweden)

    Mingyong Zhang

    2016-11-01

    Full Text Available Nutritional or classical rickets (here labeled as “rickets” is a worldwide disease involving mostly infants and young children having inadequate sunlight exposure, often associated with a low dietary intake of Vitamin D. Rickets targets all layers of society independently of economic status with historical information spanning more than two millennia. Vitamin D is critical for the absorption of calcium and prevention of rickets in children as well as osteomalacia in adults. The initial and misleading paradigm of the 19th and 20th centuries that rickets may have been the consequence of infection has been, indeed, reversed following the identification of the Vitamin D molecule’s important role in the function of the immune system. Although traditionally considered limited to osteopathology, Vitamin D deficiency is now known to be linked to infection, inflammation, and carcinogenesis. In this review, we consider the key historical (Whistler, pre-Whistler and post-Whistler descriptors and social facts around rickets; highlight the osteo-pathological features of rickets and the pathology of the upper and lower respiratory tract, stressing the fact that lungs remain the main secondary organ affected by Vitamin D deficiency; and emphasize the public health role in identifying the cases of child neglect or abuse based on the evaluation of the costochondral region.

  19. Renal rickets-practical approach

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    Manisha Sahay

    2013-01-01

    Full Text Available Rickets/osteomalacia is an important problem in a tropical country. Many cases are due to poor vitamin D intake or calcium deficient diets and can be corrected by administration of calcium and vitamin D. However, some cases are refractory to vitamin D therapy and are related to renal defects. These include rickets of renal tubular acidosis (RTA, hypophosphatemic rickets, and vitamin D dependent rickets (VDDR. The latter is due to impaired action of 1α-hydroxylase in renal tubule. These varieties need proper diagnosis and specific treatment.

  20. Vitamin D deficiency in early pregnancy.

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    Shannon K Flood-Nichols

    Full Text Available Vitamin D deficiency is a common problem in reproductive-aged women in the United States. The effect of vitamin D deficiency in pregnancy is unknown, but has been associated with adverse pregnancy outcomes. The objective of this study was to analyze the relationship between vitamin D deficiency in the first trimester and subsequent clinical outcomes.This is a retrospective cohort study. Plasma was collected in the first trimester from 310 nulliparous women with singleton gestations without significant medical problems. Competitive enzymatic vitamin D assays were performed on banked plasma specimens and pregnancy outcomes were collected after delivery. Logistic regression was performed on patients stratified by plasma vitamin D concentration and the following combined clinical outcomes: preeclampsia, preterm delivery, intrauterine growth restriction, gestational diabetes, and spontaneous abortion.Vitamin D concentrations were obtained from 235 patients (mean age 24.3 years, range 18-40 years. Seventy percent of our study population was vitamin D insufficient with a serum concentration less than 30 ng/mL (mean serum concentration 27.6 ng/mL, range 13-71.6 ng/mL. Logistic regression was performed adjusting for age, race, body mass index, tobacco use, and time of year. Adverse pregnancy outcomes included preeclampsia, growth restriction, preterm delivery, gestational diabetes, and spontaneous abortion. There was no association between vitamin D deficiency and composite adverse pregnancy outcomes with an adjusted odds ratio of 1.01 (p value 0.738, 95% confidence intervals 0.961-1.057.Vitamin D deficiency did not associate with adverse pregnancy outcomes in this study population. However, the high percentage of affected individuals highlights the prevalence of vitamin D deficiency in young, reproductive-aged women.

  1. Tumoral calcinosis with vitamin D deficiency

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    Kannan Subramanian

    2008-01-01

    Full Text Available A 50-year-old woman presented with recurrent calcified mass in the left gluteal region. The clinical, radiological, and biochemical profile confirmed the diagnosis of tumoral calcinosis. She also had associated vitamin D deficiency. The patient underwent surgical removal of the mass to relieve the sciatic nerve compression and was managed with acetazolamide, calcium carbonate, and aluminium hydroxide gel with which she showed significant improve-ment. The management implications and effect of vitamin D deficiency on phosphate metabolism in the setting of tumoral calcinosis is discussed.

  2. More than metabolic: Considering the broader paleoepidemiological impact of vitamin D deficiency in bioarchaeology.

    Science.gov (United States)

    Snoddy, Anne Marie E; Buckley, Hallie R; Halcrow, Siân E

    2016-06-01

    Vitamin D deficiency has traditionally been viewed as a metabolic bone disease by bioarchaeologists and considered primarily in terms of the development of specific musculoskeletal changes used for diagnosis in paleopathological research. These skeletal manifestations are usually interpreted as representing general ill-health. Clinical research shows that vitamin D is also integral to a number of extra-skeletal physiological processes including immunoregulation, blood pressure homeostasis, cell division, and programmed cell death. Vitamin D deficiency and sub-clinical insufficiency are thought to be risk factors for infectious and autoimmune diseases, as well as certain cancers and cardiovascular diseases. Epidemiological work indicates that the skeletal manifestations of vitamin D deficiency represent the extreme end of a spectrum of morbidity associated with negative health outcomes, including increased risk for secondary tuberculosis. This article provides a review of clinical research on the extra-skeletal roles of vitamin D and the pathological consequences of poor vitamin D status. Additionally, it presents an interpretive model for bioarchaeological analyses of rickets and osteomalacia for consideration of the whole-body impact of poor vitamin D nutriture and possible comorbidities that may have affected the wider population. Am J Phys Anthropol 160:183-196, 2016. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

  3. X-linked hypophosphatemic rickets without 'rickets'

    Energy Technology Data Exchange (ETDEWEB)

    Econs, M.J.; Feussner, J.R.; Quarles, L.D. (Duke Univ. Medical Center, Durham, NC (USA). Dept. of Medicine Veterans Administration Medical Center, Durham, NC (USA). Health Services Research Field Program); Samsa, G.P. (Duke Univ. Medical Center, Durham, NC (USA). Dept. of Biometry Veterans Administration Medical Center, Durham, NC (USA). Health Services Research Field Program); Effman, E.L.; Vogler, J.B.; Martinez, S. (Duke Univ. Medical Center, Durham, NC (USA). Dept. of Radiology Veterans Administration Medical Center, Durham, NC (USA). Health Services Research Field Program); Friedman, N.E. (Duke Univ. Medical Center, Durham, NC (USA). Dept. of Pediatrics Veterans Administration Medical Center, Durham, NC (USA). Health Services Research Field Program); Drezner, M.K. (Duke Univ. Medical Center, Durham, NC (USA). Dept. of Medicine Duke Univ. Medical Center, Durham, NC (USA). Dept. of Cell Biology Veterans Administration Medical Center, Durham, NC (USA). Health Services Research F

    1991-02-01

    Wrist and knee radiographs from children with X-linked hypophosphatemic rickets were analyzed and compared with those from normal children and children with established rickets to assess whether radiographically apparent rickets is a consistent abnormality in X-linked hypophosphatemia. The absence or presence of rickets was correctly identified in 94.8% of wrist and knee films from normal and positive controls. In contrast, patients with X-linked hypophosphatemia exhibited rachitic abnormalities in only 5 of 11 wrist and 13 of 15 knee radiographs. Our data indicate that radiographically detectable rickets is a variable abnormality of X-linked hypophosphatemia and does not provide an unambiguous index for the diagnosis of this disease. (orig./GDG).

  4. Vitamin D Deficiency: The Missing Etiological Factor in the Development of Juvenile Osteochondrosis Dissecans?

    Science.gov (United States)

    Maier, Gerrit S; Lazovic, Djordje; Maus, Uwe; Roth, Klaus E; Horas, Konstantin; Seeger, Jörn B

    2016-12-22

    Vitamin D deficiency can result in rickets and hypocalcemia during infant and childhood growth. There is an increasing interest in the role of vitamin D with regards to childhood bone health. Osteochondrosis dissecans (OD) is a common disease affecting different joints. To date, the exact etiology of OD still remains unclear. The aim of this study was to evaluate a possible association of vitamin D deficiency and juvenile OD. A retrospective chart review of the years 2010 to 2015 of all orthopaedic patients with an initial diagnosis of juvenile OD admitted to undergo operative treatment of the OD was performed. Patient demographics, medical history, information on sports activity (if available) and serum vitamin D (25-OH-D) level on admission date were obtained. For statistical comparison, we measured baseline prevalence of vitamin D insufficiency in age-matched orthopaedic patients presenting at the department of pediatric orthopaedics. A total of 80 patients were included in this study. Overall, 97.5% (n=78) of tested patients in the OD group had serum vitamin D levels below the recommended threshold of 30 ng/mL (mean value of 10.1 ng/mL (±6.7 ng/mL)). Over 60% (n=49) were vitamin D deficient, 29 patients (37%) showed serum levels below 10 ng/mL corresponding to a severe vitamin D deficiency. Of note, only 2 patients (2.5%) reached serum vitamin D levels above the recommended threshold of 30 ng/mL. No statistical difference was found in respect to sports activity level before onset of the symptoms (P=0.09). Statistical analysis found a significant difference in vitamin D levels between patients with OD and patients without an OD (P=0.026). We found an unexpected high prevalence of vitamin D deficiency in juveniles diagnosed with OD presenting with significant lower mean 25-OH-D level compared with a control group. These results suggest that vitamin D deficiency is potentially associated with the development of OD. Thus, vitamin D deficiency might be an important

  5. Vitamin D deficiency and heart disease

    NARCIS (Netherlands)

    Pilz, Stefan; Tomaschitz, Andreas; Drechsler, Christiane; de Boer, Rudolf A.

    Vitamin D deficiency is present in the vast majority of patients with chronic kidney disease (CKD), and correcting a poor vitamin D status is recommended as a treatment of CKD-mineral and bone disorders. In this review, we summarize the molecular and clinical data on the role of vitamin D status for

  6. Vitamin D Deficiency and Tuberculosis Progression

    OpenAIRE

    Talat, Najeeha; Perry, Sharon; Parsonnet, Julie; Dawood, Ghaffar; Hussain, Rabia

    2010-01-01

    To assess the association between vitamin D deficiency and tuberculosis disease progression, we studied vitamin D levels in a cohort of tuberculosis patients and their contacts (N = 129) in Pakistan. Most (79%) persons showed deficiency. Low vitamin D levels were associated with a 5-fold increased risk for progression to tuberculosis.

  7. Treatment of Vitamin D deficient states

    Science.gov (United States)

    UpToDate performs a continuous review of over 330 journals and other resources to synthesize and provide the latest medical information for clinicians. Updates are added as important new information is published. This document reviews the prevalence and treatment of vitamin D deficient states. Sever...

  8. Clinical implications of vitamin D deficiency

    Directory of Open Access Journals (Sweden)

    Beata Matyjaszek-Matuszek

    2015-06-01

    Full Text Available Vitamin D deficiency is a common medical problem worldwide and its prevalence rises along with latitude, obesity, sedentary lifestyle, limited sunlight exposure and aging. A great body of evidence has shown that patients with vitamin D deficiency have increased cardiovascular risks and total mortality. Conversely, the presence of comorbidities progressive with age such as abdominal obesity, insulin resistance, type 2 diabetes and hypertension places the patients at an increased risk of vitamin D deficiency. The multidirectional effect of vitamin D deficiency is present in different phases of the aging process. Based on the literature review, the risk factors for vitamin D insufficiency most often found in post-menopausal women include limited sun exposure and time spent outdoors, inadequate dietary vitamin D intake, winter season and increased age. Vitamin D supplementation in this group might offer prevention of falls and fractures and may be beneficial for cardiovascular health, what may be especially important in osteoporotic and elderly populations. Prevention and treatment processes involve education regarding sunlight exposure and pharmacological cholecalciferol supplementation according to the recommendations for Central Europe. This manuscript reviews the role of vitamin D and its deficiency and considers their clinical implications, with particular regard to peri- and postmenopausal women.

  9. Prevention and consequences of vitamin D deficiency in pregnant and lactating women and children: A symposium to prioritise vitamin D on the global agenda.

    Science.gov (United States)

    Schoenmakers, Inez; Pettifor, John M; Peña-Rosas, Juan-Pablo; Lamberg-Allardt, Christel; Shaw, Nick; Jones, Kerry S; Lips, Paul; Glorieux, Francis H; Bouillon, Roger

    2016-11-01

    The Department of Nutrition for Health and Development of the World Health Organization (WHO) in collaboration with the Executive Committee of the 18th Vitamin D Workshop (VDW), organised a joint symposium on the prevention and consequences of vitamin D deficiency in pregnant women and children, convening experts on vitamin D, clinicians and policy-makers. The overall aim was to identify priority areas for research and to discuss the need for global options for policy, with a focus on the prevention of rickets in infants and children and vitamin D deficiency in pregnant women. The scope and purpose were: (i) to present the WHO research strategy for health, addressing vitamin D-related public health problems and the process for the development of evidence-informed guidelines in general and how vitamin D interventions in diverse populations could be prioritised; (ii) to provide an overview of vitamin D status in children and pregnant and lactating women across the world; (iii) to review the health risks associated with vitamin D deficiency in children and in pregnant women and their offspring; (iv) to understand the aetiology of vitamin D deficiency in pregnant women and children; (v) to identify and interpret biomarkers to assess vitamin D status and to consider possible clinical and biochemical screening tools for determining the prevalence of nutritional rickets in at risk groups or communities; and (vi) to provide an overview of policies and recommendations on vitamin D across the world. The format of the symposium was a composite of comprehensive scientific presentations and a panel debate with international experts on WHO guidelines, nutritional rickets, nutritional policy and consequences of vitamin D deficiency during pregnancy. This paper summarizes the content and outcomes of the panel debate. Copyright © 2015 Elsevier Ltd. All rights reserved.

  10. Tumoral calcinosis with vitamin D deficiency

    OpenAIRE

    Kannan Subramanian; Ravikumar Latha; Mahadevan Shiraam; Natarajan Mayilvahanan; Satya Anjali; Bhat Rekha; Sriram Usha

    2008-01-01

    A 50-year-old woman presented with recurrent calcified mass in the left gluteal region. The clinical, radiological, and biochemical profile confirmed the diagnosis of tumoral calcinosis. She also had associated vitamin D deficiency. The patient underwent surgical removal of the mass to relieve the sciatic nerve compression and was managed with acetazolamide, calcium carbonate, and aluminium hydroxide gel with which she showed significant improve-ment. The management implications and effect of...

  11. Vitamin D deficiency and severe asthma.

    Science.gov (United States)

    Poon, Audrey H; Mahboub, Bassam; Hamid, Qutayba

    2013-11-01

    Vitamin D has received tremendous amount of attention recently due to the ever-increasing reports of association between vitamin D deficiency and a wide range of conditions, from cancer to fertility to longevity. The fascination of disease association with vitamin D deficiency comes from the relatively easy solution to overcome such a risk factor, that is, either by increase in sun exposure and/or diet supplementation. Many reviews have been written on a protective role of vitamin D in asthma and related morbidities; here, we will summarize the epidemiological evidence supporting a role of vitamin D against hallmark features of severe asthma, such as airway remodeling and asthma exacerbations. Furthermore, we discuss data from in vitro and in vivo studies which provide insights on the potential mechanisms of how vitamin D may protect against severe asthma pathogenesis and how vitamin D deficiency may lead to the development of severe asthma. Approximately 5-15% of asthmatic individuals suffer from the more severe forms of disease in spite of aggressive therapies and they are more likely to have irreversible airflow obstruction associated with airway remodeling. At present drugs commonly used to control asthma symptoms, such as corticosteroids, do not significantly reverse or reduce remodeling in the airways. Hence, if vitamin D plays a protective role against the development of severe asthma, then the most effective therapy may simply be a healthy dose of sunshine. Copyright © 2013 Elsevier Inc. All rights reserved.

  12. Vitamin D deficiency and adult asthma exacerbations.

    Science.gov (United States)

    Salas, Natalie Mariam; Luo, Li; Harkins, Michelle S

    2014-11-01

    There is growing evidence indicating a connection between vitamin D deficiency and the severity of asthma exacerbations. This study seeks to assess the relationship between vitamin D deficiency and the number and severity of asthma exacerbation in adults. A retrospective analysis was conducted in 92 patients being treated for asthma at the University of New Mexico Adult Asthma Clinic. Serum 25-hydroxyvitamin D3 levels were analyzed in adults with mild to severe persistent asthma. Using multi-variant modeling, the relationship was examined between serum vitamin D levels and the odds of asthma exacerbations ranging in severity from moderate to severe over the span of five years. This study demonstrates that vitamin D sufficiency was significantly associated with a decreased total number of asthma exacerbations (incidence rate ratio [IRR]: 0.61, 95% confidence interval [CI]: 0.44-0.84, p = 0.002), decreased total severe asthma exacerbations (IRR: 0.41, 95% CI: 0.24-0.72, p = 0.002) and decreased emergency room visits (IRR: 0.42, 95% CI: 0.20-0.88, p = 0.023). Vitamin D deficiency may be linked to the risk of severe asthma exacerbations in adults.

  13. Vitamin D deficiency among healthy Egyptian females.

    Science.gov (United States)

    Botros, Raif M; Sabry, Inas M; Abdelbaky, Rania S; Eid, Yara M; Nasr, Merihan S; Hendawy, Laila M

    2015-01-01

    Vitamin D deficiency is becoming endemic in many parts of the world. To study vitamin D status in Egyptian females of different age groups. A cross-sectional study was conducted on 404 females, who were categorized into group 1 (51 nursing females); group 2 (50 pregnant females); group 3 (208 females of childbearing age); group 4 (38 elderly females); and group 5 (57 geriatric females). Females completed a questionnaire regarding dietary calcium and vitamin D intake, sun exposure, and clothing habits, and performed laboratory tests including calcium, PO4, alkaline phosphatase, intact PTH, and 25-OH vitamin D levels. Median and IQR of vitamin D levels across groups 1, 2, 3 and 5 were in the deficient range, being lowest in groups 3, 5, and 1, respectively. Vitamin D deficiency was found in 72.6% of the nursing group, 54% of the pregnant group, 72% of the childbearing age group, 39.5% of the elderly group, and 77.2% of the geriatric group. Vitamin D was significantly higher in non-veiled females [23ng/dl] as compared to veiled females [16.7ng/dl]. Vitamin D levels with poor, fair, and good sun exposure were 14.1, 14, and 37ng/dl, respectively. These results show a high prevalence of vitamin D deficiency among healthy Egyptian females. Copyright © 2015 SEEN. Published by Elsevier España, S.L.U. All rights reserved.

  14. Primary hyperparathyroidism masquerading as rickets: diagnostic challenge and treatment outcomes.

    Science.gov (United States)

    Dutta, Deep; Kumar, Manoj; Das, Ram Narayan; Datta, Saumik; Biswas, Dibakar; Ghosh, Sujoy; Mukhopadhyay, Satinath; Chowdhury, Subhankar

    2013-01-01

    Primary hyperparathyroidism (PHPT) is extremely uncommon among children and is more likely to be associated with genetic syndromes, multiglandular involvement, and more severe symptoms. Rickets can very rarely be the presenting feature of PHPT in children. Rickets was diagnosed in a 12-year-old girl presenting with short stature, genu valgum, eversion deformity at the ankle joints, and flat feet. Radiograms showed generalized osteopenia, widening of the distal ends of the long bones along with splaying, cupping and fraying. Biochemical evaluation revealed low serum calcium (7.8 mg/dL), low phosphorus (1.4 mg/dL), vitamin-D deficiency [25-hydroxy-vitamin-D (25(OH)D): 8.7 ng/mL], and elevated intact parathyroid hormone (PTH, 811 pg/mL). Re-evaluation due to lack of clinical improvement following vitamin-D and calcium supplementation revealed hypercalcemia 11.9 mg/dL, normal 25(OH)D 41 ng/mL, persistence of elevated PTH 632 pg/mL. A 99mTc-sestamibi scan showed increased uptake at the lower pole of the right lobe of the thyroid. A right inferior parathyroidectomy was performed. Histopathology revealed chief cell type parathyroid adenoma. Last evaluated 4 months after surgery, the bone pains and proximal weakness had resolved, with significant improvement in the patient's quality of life. Rickets in the setting of PHPT often masks the classical phenotype of PHPT. In a child with rickets, lack of improvement following vitamin-D supplementation, hypercalcemia at presentation or following vitamin-D supplementation are warning signs which necessitate further evaluation to rule out PHPT.

  15. Evaluation of Stature Development During Childhood and Adolescence in Individuals with Familial Hypophosphatemic Rickets

    Directory of Open Access Journals (Sweden)

    Mauro M.S. Borghi

    2005-01-01

    Full Text Available This review was conducted to study the diagnosis, treatment, and growth progression in infants and adolescents with familial hypophosphatemic rickets. The bibliographic search was carried out utilizing the electronic databases MEDLINE, OVID, and LILACS and by direct research within the last 15 years using the keywords rickets, familial hypophosphatemia, vitamin D deficiency, stature growth, childhood, and adolescence. Article selection was done by comparing the evaluation of the growth in patients with familial hypophosphatemic rickets, including the variables that might affect them, for possible future therapeutic proposals. It is concluded that the most significant fact in the treatment of familial hypophosphatemic rickets in infancy was the magnitude of the final stature. The use of growth hormone can be helpful in these patients. However, research reporting treatments with the use of the growth hormone for rickets are controversial. The majority of the authors agree that treatment using vitamin D and phosphate enables some statural growth in cases of early diagnosis, reflecting a better prognosis.

  16. Incidence of ricket clinical symptoms and relation between clinical and laboratory findings in infants

    Directory of Open Access Journals (Sweden)

    Čukalović M.

    2014-01-01

    Full Text Available Rickets presents osteomalacia which is developed due to negative balance of calcium and / or phosphorus during growth and development. Therefore it appears only in children. The most common reason of insufficient mineralization is deficiency of vitamin D, which is necessary for inclusion of calcium in cartilage and bones. As result, proliferation of cartilage and bone tissue appears, creating calluses on typical places. Bones become soft and curve, resulting in deformities. Our present study included 86 infants, in whom, besides other diseases, clinical and laboratory signs of rickets were identified. In our study, rickets is most common (82.5% in infants older than 6 months. By clinical picture, craniotabes is present in 46.5% of cases, Harisson groove in 26.7%, rachitic bracelets in 17.4%, rachitic rosary in 17.4% and carpopedal spasms in 2.3% of cases. Leading biochemical signs of vitamin D deficient rickets is hypophosphatemia (in 87.3% of cases, normal calcemia (in 75.6% of cases and increased values of alkaline phosphatase (in 93% of cases. It has been shown that rickets in infant age may later affect higher incidence of juvenile diabetes, infection of lower respiratory tract, osteoporosis, and so on.

  17. Prevention of nutritional rickets in Nigerian children with dietary calcium supplementation.

    Science.gov (United States)

    Thacher, Tom D; Fischer, Philip R; Isichei, Christian O; Zoakah, Ayuba I; Pettifor, John M

    2012-05-01

    Nutritional rickets in Nigerian children usually results from dietary calcium insufficiency. Typical dietary calcium intakes in African children are about 200mg daily (approximately 20-28% of US RDAs for age). We sought to determine if rickets could be prevented with supplemental calcium or with an indigenous food rich in calcium. We enrolled Nigerian children aged 12 to 18months from three urban communities. Two communities were assigned calcium, either as calcium carbonate (400mg) or ground fish (529±109mg) daily, while children in all three communities received vitamin A (2500IU) daily as placebo. Serum markers of mineral homeostasis and forearm bone density (pDEXA) were measured and radiographs were obtained at enrollment and after 18months of supplementation. The overall prevalence of radiographic rickets at baseline was 1.2% and of vitamin D deficiency [serum 25(OH)Dchildren enrolled, 390 completed the 18-month follow-up. Rickets developed in 1, 1, and 2 children assigned to the calcium tablet, ground fish, and control groups, respectively (approximate incidence 6.4/1000 children/year between 1 and 3years of age). Children who developed rickets in the calcium-supplemented groups had less than 50% adherence. Compared with the group that received no calcium supplementation, the groups that received calcium had a greater increase in areal bone density of the distal and proximal 1/3 radius and ulna over time (Prickets. Copyright © 2012 Elsevier Inc. All rights reserved.

  18. Relationship of calcium absorption with 25(OH)D and calcium intake in children with rickets.

    Science.gov (United States)

    Thacher, Tom D; Abrams, Steven A

    2010-11-01

    Nutritional rickets has long been considered a disease caused by vitamin D deficiency, but recent data indicate that inadequate dietary calcium intake is an important cause of rickets, particularly in tropical countries. Children with rickets due to calcium deficiency do not have very low 25(OH)D concentrations, and serum 1,25(OH)(2) D values are markedly elevated. Studies of Nigerian children with rickets demonstrated they have high fractional calcium absorption. A high-phytate diet was demonstrated to increase calcium absorption compared with the fasting state, and enzymatic dephytinization did not significantly improve calcium absorption. When given vitamin D, children with rickets have a marked increase in 1,25(OH)(2) D concentrations without any change in fractional calcium absorption. No positive relationship was found between fractional calcium absorption and serum 25(OH)D concentrations in children on low-calcium diets. More research is needed to understand the interaction between calcium and vitamin D and the role of vitamin D in calcium absorption. © 2010 International Life Sciences Institute.

  19. Vitamin D deficiency in hemodialysis patients

    Directory of Open Access Journals (Sweden)

    Beena Bansal

    2012-01-01

    Full Text Available Background : Vitamin D [(25(OHD] deficiency and insufficiency is common in patients with chronic kidney disease (CKD. 25(OHD has been found to have beneficial effects on bone, cardiovascular and immune functions. There are little data about vitamin D levels in Indian patients on dialysis. This study was undertaken to determine the vitamin D status of Indian CKD patients on hemodialysis. Materials and Methods : We included 45 patients on maintenance hemodialysis coming to Medanta, Medicity, Gurgaon. 25(OHD levels were measured with radioimmunoassay (Diasorin method and parathyroid hormone (PTH was measured using electrochemiluminiscence immunoassay (ECLIA. Results : The mean age of patients was 55 ± 13 years. 32/45 (71% were males. 23/45 (51% were diabetics. The median duration of hemodialysis was 5.5 months (range 1-74 months. 33/45 (74% patients were on thrice weekly hemodialysis. The mean level of vitamin D was 10.14 ± 8.7 ng/ml. Majority of the patients [43/45 (95.5%] were either vitamin D deficient or had insufficient levels. 40/45 (88.9% were vitamin D deficient (levels <20 ng/ml; of these, 29/40 (64.4% had severe vitamin D deficiency (levels <10 ng/ml and 3/45 (6.7% had insufficient levels (20-30 ng/ml of vitamin D. Only 2/45 (4.4% patients had normal levels of vitamin D. 23/45 (51% of patients were receiving calcitriol. The mean levels of serum calcium, phosphorus, alkaline phosphatase, and albumin were 8.8 ± 0.64 mg/dl, 5.0 ± 0.7 mg/dl, 126 ± 10.3 IU/l and 3.6 ± 0.62 g/dl, respectively. PTH levels ranged from 37 to 1066 pg/ml, and the median was 195.8 pg/ml. There was a weak correlation between 25(OHD levels and weight, sex, hemoglobin, albumin, alkaline phosphatase, and presence of diabetes. There was, however, no correlation with duration of dialysis or PTH levels. Conclusion : Vitamin D deficiency and insufficiency are universal in our hemodialysis patients, with severe vitamin D deficiency in two-third of patients.

  20. Nutritional rickets in Norway: a nationwide register-based cohort study.

    Science.gov (United States)

    Meyer, Haakon E; Skram, Kristina; Berge, Ingvill Almås; Madar, Ahmed A; Bjørndalen, Hilde Johanne

    2017-05-29

    Poor vitamin D status has been reported to be highly prevalent in many non-western immigrant groups living in Norway and other western countries. However, data on rickets are scarce, and the aim of the current study was to identify new cases of nutritional rickets in Norway in the period 2008-2012 among children under the age of 5 years. Register-based cohort study. The Norwegian population from 2008 to 2012. Children with nutritional rickets under the age of 5 years. Nutritional rickets. Patients with ICD10 (International Statistical Classification of Diseases and Related Health Problems, 10th revision) diagnosis code E55.0 (active rickets) treated at all Norwegian hospitals were identified in the Norwegian Patient Registry. We were able to review 85% of the medical records for diagnosis confirmation. In addition, we identified patients with the diagnoses E55.9, E64.3 and E83.3 to identify individuals with rickets who had been given other diagnoses. Nutritional rickets was confirmed in 39 children aged 0-4 years with the diagnosis of E55.0. In addition, three patients with the diagnosis of unspecified vitamin D deficiency (E55.9) were classified as having nutritional rickets, giving a total of 42 patients. Mean age at diagnosis was 1.40 years (range 0.1-3.5 years), and 93% had a non-western immigrant background. The incidence rate of rickets was estimated to be 0.3 per 10 000 person-years in the total Norwegian child population under the age of 5 years and 3.1 per 10 000 person-years in those with an immigrant background from Asia or Africa. The number of children with nutritional rickets in Norway remained low in the period 2008-2012. Nearly all children had a non-western immigrant background. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  1. Vitamin D deficiency and severe hyperparathyroidism.

    Science.gov (United States)

    Jonard, S; Gauthier-Morgenstern, M; Douillard, C; Leteurtre, E; Nocaudie, M; Leroy, X; Proye, C; Marchandise, X; Wemeau, J L; Vantyghem, M C

    2002-12-01

    The typical manifestations of severe hypercalcemia with osteitis fibrosa cystica have become exceedingly rare. We describe the case of a woman hospitalized for a tibial tumor with functional impotence, leading to a diagnosis of primary hyperparathyroidism (HPT I) associated with profound vitamin D deficiency. This 31-year-old woman was admitted, after two pregnancies complicated by the HELLP syndrome. Preoperative laboratory values were as follows: calcemia 4.05 mmol/l (2.2-2.6); urinary calcium 30 mmol/24 h (1.25-7.5); parathormone (PTH) 1 195 pg/ml (10-60); and 25 OH-vitamin D 13 nmol/l (22-120). Specific MIBI uptake by the tibial lesion oriented the diagnosis towards a brown tumor. After surgical excision of a parathyroid adenoma and the brown tumor (associated with tibial fracture), calcemia fell to 1.55 mmol/l and normalized after three months. Urinary calcium fell to 0.1 mmol/24 h and remained low during the 2 years following surgery. Vitamin D levels rapidly normalized on supplementation (87 nmol/l). PTH levels fell markedly after surgery but remained higher than normal till 2 years after surgery despite normalization of calcemia three months after. Bone repair, estimated by means of bone densitometry, improved from preoperative Z-score values of - 6.54, - 5.20 and - 3.50 in the left femoral neck, right femoral neck and lumbar spine, respectively, to - 0.20, - 1.55 and - 0.28, respectively, one year after surgery. In conclusion, this case illustrates: 1) the severe osseous expression of HPT probably related to vitamin D deficiency; 2) specific MIBI uptake by the bone lesion, orientating the diagnosis towards a brown tumor; 3) the consequences of vitamin D deficiency on postoperative outcome, with transient severe initial hypocalcemia related to bone calcium avidity; 4) a possible link between HPT and the HELLP syndrome.

  2. Vitamin D deficiency in chronic idiopathic urticaria.

    Science.gov (United States)

    Movahedi, Masoud; Tavakol, Marzieh; Hirbod-Mobarakeh, Armin; Gharagozlou, Mohammad; Aghamohammadi, Asghar; Tavakol, Zahra; Momenzadeh, Kaveh; Nabavi, Mohammad; Dabbaghzade, Abbas; Mosallanejad, Asieh; Rezaei, Nima

    2015-04-01

    Chronic urticaria is the most common skin diseases, characterized by chronic cutaneous lesions which severely debilitates patients in several aspects of their everyday life. Vitamin D is known to exert several actions in the immune system and to influence function and differentiation of mast cells, central role players in the pathogenesis of chronic idiopathic urticaria. This study was performed to evaluate the relationship between vitamin D levels and susceptibility to chronic idiopathic urticaria. One hundred and fourteen patients with chronic idiopathic urticaria were recruited in this study along with one hundred and eighty seven sex-matched and age-matched healthy volunteers as the control group. For each patient, urticaria activity score was calculated and autologous serum skin test was done. Vitamin D metabolic statue was measured in serum as 25 hydroxyvitamin D using enzyme immunoassay method. Patients with chronic idiopathic urticaria significantly showed lower levels of vitamin D. Vitamin D deficiency was significantly associated with increased susceptibility to chronic idiopathic urticaria. There was a significant positive correlation between vitamin D levels and urticaria activity score. This study showed that patients with chronic idiopathic urticaria had reduced levels of vitamin D, while vitamin D deficiency could increase susceptibility to chronic idiopathic urticaria.

  3. Rickets in alpacas (Lama pacos) in New Zealand.

    Science.gov (United States)

    Hill, F I; Thompson, K G; Grace, N D

    1994-12-01

    Rickets was diagnosed in two weaner alpacas from a flock showing ill thrift and lameness during the winter of 1992. Both animals had abnormally shaped ribs with occasional healing fractures, irregular thickening of growth plates and metaphyseal haemorrhages. The mean serum phosphorus concentrations of the alpacas fell during June and July, even though lambs grazing the same pasture had normal serum phosphorus concentrations and the phosphorus concentration of the pasture was considered adequate. Vitamin D deficiency may also have contributed to the osteodystrophy. The alpacas had a thick fleece during the winter, and diurnal Vitamin D, synthesis resulting from solar irradiation is likely to have been minimal, especially considering the reduced sunshine hours recorded during the 1992 winter. Surviving alpacas recovered after treatment with monosodium phosphate and an oral Vitamin D supplement. It is possible alpacas are more susceptible to deficiencies of phosphorus and Vitamin D than other grazing animals in New Zealand.

  4. Infantile osteopetrosis with superimposed rickets.

    Science.gov (United States)

    Gonen, Korcan Aysun; Yazici, Zeynep; Gokalp, Gokhan; Ucar, Ayse Kalyoncu

    2013-01-01

    Rickets is a complication of infantile osteopetrosis and pre-treatment recognition of this complication is important. To describe four children with infantile osteopetrosis complicated by rickets (osteopetrorickets) and review the relevant literature. Retrospective chart analysis of four infants with osteopetrorickets and a systematic review of the relevant literature. We saw five children with infantile osteopetrosis, of whom four had superimposed rickets, for a period of 12 years. The review of the literature (including the current four children), yielded 20 children with infantile osteopetrorickets. The children ranged in age from 2 months to 12 months. In all children, hepatosplenomegaly was found. Sixteen (80%) children had visual impairments and eight (40%) children had hearing impairments. Serum calcium-phosphorus product was less than 30 in 18 children (90%). Twelve children (60%) were hypocalcemic and 18 (90%) were hypophosphatemic. In all children, the radiological examination demonstrated diffuse bony sclerosis and metaphyseal splaying and fraying of long bones. Five children (25%) had pathological fracture of extremities and 15 (75%) had rachitic rosary. Rickets as a complication to infantile osteopetrosis is not uncommon. Skeletal roentgenograms are of critical importance in the diagnosis of both osteopetrosis and superimposed rickets.

  5. Management of nutritional rickets in Indian children: a randomized controlled trial.

    Science.gov (United States)

    Aggarwal, Varun; Seth, Anju; Marwaha, Raman K; Sharma, Bhavna; Sonkar, Pitamber; Singh, Satveer; Aneja, Satinder

    2013-04-01

    Rickets is usually attributed to vitamin D deficiency. However, recent studies have implicated dietary calcium deficiency in its etiology. Information on relative efficacy of calcium, vitamin D or both together in healing of rickets is limited. To study effect of treatment with calcium, vitamin D or a combination of these two on healing of nutritional rickets in young children. Randomized controlled trial. Sixty-seven cases of nutritional rickets in the age group of 6 months to 5 years were randomly allocated to receive vitamin D (600 000 IU single intramuscular dose), calcium (75 mg/kg/day elemental calcium orally) or a combination of the above two for a period of 12 weeks. The demographic parameters, nutritional status, dietary calcium and phytate intake were assessed for all. Radiographs (wrist and knee) and biochemical parameters (serum calcium, inorganic phosphate, alkaline phosphatase, 25-hydroxycholecalciferol and parathyroid hormone) were evaluated at baseline, 6 and 12 weeks for evidence of healing. Mean dietary intake of calcium in all cases was low (204 ± 129 mg/day). Mean serum 25-hydroxycholecalciferol D level was 15.9 ± 12.4 ng/ml, and 82.1% of patients had serum vitamin D levels rickets was observed in all treatment groups, albeit to a variable extent. The combined end point of normal serum alkaline phosphatase and complete radiological healing at 12 weeks was observed in 50% subjects on combination therapy as compared with 15.7% subjects on vitamin D alone and 11.7% on calcium alone. Children with rickets had a low serum vitamin D level and a low dietary calcium intake. The best therapeutic response was seen with a combination of vitamin D and calcium than either of them given alone. CTRI/2010/091/000448.

  6. Phosphate homeostasis and genetic mutations of familial hypophosphatemic rickets.

    Science.gov (United States)

    Razali, Nurul Nadirah; Hwu, Ting Tzer; Thilakavathy, Karuppiah

    2015-09-01

    Hypophosphatemic rickets (HR) is a syndrome of hypophosphatemia and rickets that resembles vitamin D deficiency, which is caused by malfunction of renal tubules in phosphate reabsorption. Phosphate is an essential mineral, which is important for bone and tooth structure. It is regulated by parathyroid hormone, 1,25-dihydroxyvitamin D and fibroblast-growth-factor 23 (FGF23). X-linked hypophosphatemia (XLH), autosomal dominant HR (ADHR), and autosomal recessive HR (ARHR) are examples of hereditary forms of HR, which are mainly caused by mutations in the phosphate regulating endopeptidase homolog, X-linked (PHEX), FGF23, and, dentin matrix protein-1 (DMP1) and ecto-nucleotide pyro phosphatase/phosphodiesterase 1 (ENPP1) genes, respectively. Mutations in these genes are believed to cause elevation of circulating FGF23 protein. Increase in FGF23 disrupts phosphate homeostasis, leading to HR. This review aims to summarize phosphate homeostasis and focuses on the genes and mutations related to XLH, ADHR, and ARHR. A compilation of XLH mutation hotspots based on the PHEX gene database and mutations found in the FGF23, DMP1, and ENPP1 genes are also made available in this review.

  7. Can Subclinical Rickets Cause SCFE? A Prospective, Pilot Study.

    Science.gov (United States)

    Arkader, Alexandre; Woon, Regina P; Gilsanz, Vicente

    2015-01-01

    Slipped capital femoral epiphysis (SCFE) is a common disorder of the growing hip; however, its etiology remains unknown. Vitamin D (25-OH) is a major regulator of bone homeostasis and calcium metabolism. Vitamin D deficiency is one of the major causes of rickets, and rickets has been associated with SCFE. Increased body mass index (BMI) has been linked to SCFE and obese children are known to have lower vitamin D levels. Therefore, we hypothesize that children who develop SCFE may have subclinical rickets predisposing them to the development of physeal disease. This was a pilot, prospective study designed to determine the relationship between vitamin D, bone, muscle, and fat in patients with SCFE. We enrolled 20 consecutive patients with idiopathic SCFE aged 9 to 14 years. Upon diagnosis, vitamin D, PTH, T4, and thyroid-stimulating hormone blood levels were obtained. A single-slice computed tomography was used to measure cortical bone density (CBD) of the femur. Demographics, BMI, and the results obtained were compared to generate a relationship between vitamin D levels and SCFE. Twenty patients were enrolled, 13 males and 7 females, at an average age of 12 years (range, 9 to 14 y), and mean BMI% was 93.9 (range, 81.3 to 99.5). There were 15 stable and 5 unstable SCFE. Overall, mean and SD values for vitamin D, 25-OH were within the normal range (43.9 ± 13.5). We found no difference in values in vitamin D between nonobese (BMI children are known to have lower levels of vitamin D and a higher prevalence of SCFE, we found no correlation between low vitamin D and the development of SCFE in this subset of patients.

  8. Vitamin D deficiency in refugees in Italy

    Directory of Open Access Journals (Sweden)

    L.G. De Filippis

    2017-09-01

    Full Text Available The objective of the research is to determine 25[OH]D serum levels in refugees in Italy. In the following research we have taken into consideration the results of the monitoring of Vitamin D levels in 46 refugees of the Italian Service for protection of refugees and asylum seekers (SPRAR system. The indicator of overall vitamin D status used was the circulating serum level of 25(OHD. Data was analyzed using Microsoft Excel. In the refugees tested, the mean level of 25(OHD resulted 9.18 ng/mL. The standard deviation was 4.8, with a minimal level of 4.3 and a maximum of 27.4. This figure indicates a clear condition of hypovitaminosis in refugees. While it is general assumption that migratory phenomena may induce the spread of tropical or infectious diseases, widely attested literature demonstrates how chronic pathologies and diseases related to altered lifestyles are the most relevant for Italian case records. Indeed, among the aforementioned diseases, Vitamin D deficiency so far lacks acknowledgement at a national level. Considering the results of lower-than-desirable vitamin D levels found in refugees in Italy, it is necessary to take this parameter into consideration when analyzing individuals who have faced migratory phenomena in order to mitigate the effects of hypovitaminosis D.

  9. Predictors of Vitamin D Deficiency in Predialysis Patients with Stage ...

    African Journals Online (AJOL)

    2018-02-07

    Feb 7, 2018 ... Objective: Vitamin D status and risk factors of Vitamin D deficiency in chronic kidney disease (CKD) patients in China have been seldom reported before. In this study, we aim to investigate serum 25-hydroxyvitamin D [25(OH)D] status and find the predictors of Vitamin D deficiency in predialysis patients with ...

  10. Predictors of Vitamin D Deficiency in Predialysis Patients with Stage ...

    African Journals Online (AJOL)

    Objective: Vitamin D status and risk factors of Vitamin D deficiency in chronic kidney disease (CKD) patients in China have been seldom reported before. In this study, we aim to investigate serum 25‑hydroxyvitamin D [25(OH)D] status and find the predictors of Vitamin D deficiency in predialysis patients with Stage 3–5 CKDs ...

  11. Complications of vitamin D deficiency from the foetus to the infant: One cause, one prevention, but who's responsibility?

    Science.gov (United States)

    Högler, Wolfgang

    2015-06-01

    Calcium and phosphorus represent building material for bones. The supplier of these bone minerals is the hormone calcitriol, which originates from vitamin D, itself made by sunshine in human skin. Requirement for bone minerals is highest during phases of rapid growth, and no one grows faster than the foetus and the infant, making them particularly vulnerable. Deprivation of calcium, whether through low calcium intake or low vitamin D, leads to serious health consequences throughout life, such as hypocalcaemic seizures, dilated cardiomyopathy, skeletal myopathy, congenital and infantile rickets, and osteomalacia. These 5 conditions are often summarised as 'symptomatic vitamin D deficiency', are fully reversible but also fully preventable. However, the increasing prevalence of rickets and osteomalacia, and the deaths from hypocalcaemic cardiomyopathy, demand action from global health care providers. Clarification of medical and parental responsibilities is a prerequisite to deliver successful prevention programmes. The foetus and infant have the human right to be protected against harm, and vitamin D supplementation has the same public health priority as vaccinations. Copyright © 2015 Elsevier Ltd. All rights reserved.

  12. Vitamin D Deficiency in India: Prevalence, Causalities and Interventions

    OpenAIRE

    Ritu G; Ajay Gupta

    2014-01-01

    Vitamin D deficiency prevails in epidemic proportions all over the Indian subcontinent, with a prevalence of 70%–100% in the general population. In India, widely consumed food items such as dairy products are rarely fortified with vitamin D. Indian socioreligious and cultural practices do not facilitate adequate sun exposure, thereby negating potential benefits of plentiful sunshine. Consequently, subclinical vitamin D deficiency is highly prevalent in both urban and rural settings, and acros...

  13. Vitamin D Deficiency in a Sunny Country: The Missing Chain

    OpenAIRE

    Al-Jurayyan NA

    2016-01-01

    Vitamin D deficiency continues to be an important health problem around the world. It has been reported in healthy children, young adults, middle age adults and elderly, and common among both males and females. Recent studies have shown that Vitamin D deficiency or insufficieny are associated with other pathologic conditions. Vitamin D plays an important role in skeletal development and bone health maintenance. Because the symptoms and signs of Vitamin D deficieny are insidious, or nonspecifi...

  14. Vitamin D Deficiency and Insufficiency in Hospitalized COPD Patients.

    Directory of Open Access Journals (Sweden)

    Evgeni Mekov

    Full Text Available 31-77% of patients with COPD have vitamin D deficiency and insufficiency, with results being highly variable between studies. Vitamin D may also correlate with disease characteristics.To find out the prevalence of vitamin D deficiency and insufficiency in patients with COPD admitted for exacerbation and a risk factors for lower vitamin D levels among comorbidities and COPD characteristics.152 patients were studied for vitamin D serum levels (25(OHD. All of them were also assessed for diabetes mellitus (DM and metabolic syndrome (MS. Data were gathered also for smoking status and exacerbations in last year. All patients completed CAT and mMRC questionnaires and underwent spirometry.A total of 83,6% of patients have reduced levels of vitamin D. 42,8% (65/152 have vitamin D insufficiency (defined as 25-50 nmol/L and 40,8% (62/152 have vitamin D deficiency (<25 nmol/L. The mean level of 25(OHD for all patients is 31,97 nmol/L (95%CI 29,12-34,68. Vitamin D deficiency and insufficiency are more prevalent in females vs. males (97,7 vs 77,8%; p = 0.003. The prevalence and severity of vitamin D deficiency and insufficiency in this study is significantly higher when compared to an unselected Bulgarian population (prevalence 75,8%; mean level 38,75 nmol/L. Vitamin D levels correlate with quality of life (measured by the mMRC scale and lung function (FVC, FEV1, FEV6, FEF2575, FEV3, but not with FEV1/FVC ratio and PEF, it does not correlate with the presence of arterial hypertension, DM, MS and number of moderate, severe and total exacerbations. Vitamin D deficiency is a risk factor for longer hospital stay.The patients with COPD admitted for exacerbation are a risk group for vitamin D deficiency and insufficiency, which is associated with worse disease characteristics.

  15. RICKETS AT THE MEDICI COURT OF FLORENCE: THE CASE OF DON FILIPPINO (1577-1582).

    Science.gov (United States)

    Castagna, Maura; Giuffra, Valentina; Fattori, Silvia; Vitiello, Angelica; Caramella, Davide; Giustini, Davide; Fornaciari, Gino

    2014-01-01

    Among the children found in the crypt of the Grand Duke Giangastone in S. Lorenzo Basilica (Florence), the skeletal remains of a 5-year-old child still wearing his fine high social status clothing were recovered. This child of the Medici family was identified as Don Filippino (1577-1582), son of the Grand Duke Francesco I (1541-1587) and Giovanna from Austria (1547 - 1578). The prince showed several pathological deformities of the cranial and post-cranial skeleton, including enlargement of the cranium, thinning of the cranial vault bones (craniotabes), platybasia and marked bending of femora, tibiae and fibulae. Differential diagnosis suggests that Don Filippino was affected by rickets. The occurrence of this metabolic disease related to vitamin D deficiency in a Renaissance high social class individual can be explained by the practice of very prolonged breast-feeding, up until two years of age. Maternal milk contains insufficient vitamin D ratios and retarded weaning severely exposes children to a higher risk of developing rickets, especially if dietary habits are combined with inadequate exposure to sunlight. Historical sources describe Don Filippino as frail and sickly, with frequent illnesses and persistent slight fevers, and it can be supposed that the child was frequently confined indoors, especially in the cold season. Integration of osteoarchaeological evidence with historical documentation suggests that bone lesions observed in the skeletal remains of Don Filippino are compatible with a diagnosis of rickets, caused by the custom of prolonged breast-feeding associated with inadequate sunlight exposure to sunlight. Historical sources describe Don Filippino as frail and sickly, with frequent illnesses and persistent slight fevers, and it can be supposed that the child was frequently confined indoors, especially in the cold season. Integration of osteoarchaeological evidence with historical documentation suggests that bone lesions observed in the skeletal

  16. TUBULAR DISORDERS WITH RICKETS-LIKE SYNDROME

    Directory of Open Access Journals (Sweden)

    N.N. Kartamysheva

    2011-01-01

    Full Text Available Often under the guise of «ordinary» Rickets are more severe kidney diseases, developing as a result of inherited or acquired, primary or secondary defects in the renal tubules. Incorrect diagnosis leads to an inadequate therapy, rapid progression of disease and renal failure. The article describes the main approaches to the diagnosis and treatment of disorders of tubular rachitis similar syndrome, presents a number of clinical cases in author's practice.Key words: tubulopathy, acidosis, electrolyte disorders, rickets, rickets-like syndrome, diagnostics, treatment, children.

  17. Vitamin D deficiency in patients with malignancy in Brisbane.

    Science.gov (United States)

    Morton, Adam; Hardy, Janet; Morton, Anthony; Tapuni, Angela; Anderson, Helen; Kingi, Ngaire; Shannon, Catherine

    2014-08-01

    This study aims to investigate the prevalence and factors predictive of vitamin D deficiency in patients with malignancy in Brisbane, Australia (latitude 27° S). This is a prospective cross-sectional study measuring serum levels of 25-hydroxyvitamin D (25-OHD) in 100 subjects with non-haematological cancer at least 18 years of age not taking vitamin D supplements attending a day oncology unit and oncology/palliative care inpatient ward in Brisbane, Australia. Thirty-seven per cent of outpatient and 49 % of inpatient subjects respectively were vitamin D deficient. Functional status was predictive of low vitamin D levels. There was a high prevalence of vitamin D deficiency in patients with cancer in Brisbane, Australia.

  18. Developmental vitamin D deficiency and autism: Putative pathogenic mechanisms.

    Science.gov (United States)

    Ali, Asad; Cui, Xiaoying; Eyles, Darryl

    2018-01-01

    Autism is a neurodevelopmental disease that presents in early life. Despite a considerable amount of studies, the neurobiological mechanisms underlying autism remain obscure. Both genetic and environmental factors are involved in the development of autism. Vitamin D deficiency is emerging as a consistently reported risk factor in children. One reason for the prominence now being given to this risk factor is that it would appear to interact with several other epidemiological risk factors for autism. Vitamin D is an active neurosteroid and plays crucial neuroprotective roles in the developing brain. It has important roles in cell proliferation and differentiation, immunomodulation, regulation of neurotransmission and steroidogenesis. Animal studies have suggested that transient prenatal vitamin D deficiency is associated with altered brain development. Here we review the potential neurobiological mechanisms linking prenatal vitamin D deficiency and autism and also discuss what future research targets must now be addressed. Crown Copyright © 2017. Published by Elsevier Ltd. All rights reserved.

  19. Role of vitamin D deficiency in continued hyperparathyroidism following parathyroidectomy.

    Science.gov (United States)

    Redman, Carolyn; Bodenner, Donald; Stack, Brendan

    2009-09-01

    The aim of this study was to investigate vitamin D deficiency as an etiology for patients with elevated parathormone (PTH) levels after parathyroidectomy. Fifity-five patients were identified who had undergone parathyroidectomy between January 2003 and November 2006 with complete records that included measurements of preoperative and postoperative PTH, vitamin D, calcium, ionized calcium, and sestamibi localization results. Thirteen patients (24%) had elevated PTH at 1 week postoperatively. Sixty-two percent of these patients (N = 8, 15% overall) had vitamin D deficiency. Thirty-one percent (N = 4, 7% overall) had persistent biochemical evidence of primary hyperparathyroidism. Three of the 4 had a subsequent positive sestamibi parathyroid localization of an additional adenoma (5.5% series incidence of double adenomas). Given the known prevalence of vitamin D deficiency, consideration should be given to preoperative vitamin D testing to avoid confusion about the etiology of persistently elevated PTH following surgery.

  20. High prevalence of vitamin D deficiency in Cambodian women

    DEFF Research Database (Denmark)

    Smith, Geoffry; Wimalawansa, Sunil J; Laillou, Arnaud

    2016-01-01

    Recent studies have shown that in spite of being generally close to the equator; vitamin D deficiency is common in South East Asian countries. In order to quantify micronutrient status for women and children in Cambodia; a nationally-representative survey was conducted in 2014 linked to the Cambo......Recent studies have shown that in spite of being generally close to the equator; vitamin D deficiency is common in South East Asian countries. In order to quantify micronutrient status for women and children in Cambodia; a nationally-representative survey was conducted in 2014 linked...

  1. Relationship between polymorphisms in vitamin D metabolism-related genes and the risk of rickets in Han Chinese children.

    Science.gov (United States)

    Zhang, Yuling; Yang, Shufen; Liu, Ye; Ren, Lihong

    2013-09-30

    Vitamin D deficiency rickets is common in China. Genetic factors may play an important role in the susceptibility to rickets. Our study aimed to identify the relationship between three vitamin D-related genes (group specific component [GC], cytochrome P450, family 2, subfamily R, polypeptide 1 (CYP2R1), and 7-dehydrocholesterol reductase/nicotinamide-adenine dinucleotide synthetase 1 (DHCR7/NADSYN1) and rickets in Han Chinese children from northeastern China. A total of 506 Han children from northeastern China were enrolled in the current study. Twelve SNPs in three candidate genes were genotyped using the SNaPshot assay. Linear regression was used to examine the effect of 12 single-nucleotide polymorphisms (SNPs) on the risk of rickets. In our case-control cohort, six alleles of the 12 SNPs conferred a significantly increased risk of rickets in GC (rs4588 C, P = 0.003, OR: 0.583, 95% CI: 0.412-0.836; rs222020 C, P = 0.009, OR: 1.526, 95% CI: 1.117-2.0985; rs2282679 A, P = 0.010, OR: 0.636, 95% CI: 0.449-0.900; and rs2298849 C, P = 0.001, OR: 1.709, 95% CI: 1.250-2.338) and in CYP2R1 (rs10741657 G, P = 0.019, OR: 1.467, 95% CI: 1.070-2.011; and rs2060793 G, P = 0.023, OR: 0.689, 95% CI: 0.502-0.944). The results remained significant after adjustment for sex and body mass index. We further analyzed the effect of genotypes under three different genetic models. After using Bonferroni's method for multiple corrections, rs4588, rs2282679, and rs2298849 of the GC gene were significantly associated with rickets under the dominant (P =0.003 for rs4588, P =0.024 for rs2282679, and P =0.005 for rs2298849) and additive models (P = 0.006 for rs4588, P = 0.024 for rs2282679, and P = 0.005 for rs2298849). Haplotype analysis showed that the CAT haplotype of the GC gene (P = 0.005) and the GAA haplotype of the CYP2R1 gene (P = 0.026) were associated with susceptibility to rickets. This case-control study confirmed the strong effect of GC

  2. CALCIUM DEFICIENCY AND CAUSATION OF RICKETS IN ...

    African Journals Online (AJOL)

    hi-tech

    2005-03-03

    Mar 3, 2005 ... East African Medical Journal Vol. 82 No. ... religion, occupation, educational status and residence the ... immune status and the association of rickets with protein- ..... American Academy of Pediatrics, Committee on Nutrition.

  3. Radiological rickets in extremely low birthweight infants

    Energy Technology Data Exchange (ETDEWEB)

    Lyon, A.J.; McIntosh, N.; Wheeler, K.; Williams, J.E.

    1987-01-01

    Forty-eight infants of birthweight less than 1000 grams who survived for more than 28 days, had wrist X-rays to prospectively determine the incidence of radiological rickets. Twelve infants (25%) had normal X-rays throughout, 10 infants (21%) showed osteopoenia and 26 infants (54%) had classical changes or rickets of which 8 (17% of the total) had spontaneous fractures. There was poor correlation between peak values of serum alkaline phosphatase and the radiological changes.

  4. [Medical treatment of children with hypophosphataemic rickets].

    Science.gov (United States)

    Rahbek, Elise Torp; Nielsen, Line Hougaard; Beck-Nielsen, Signe Sparre; Christesen, Henrik Thybo

    2014-02-24

    Hypophosphataemic rickets is a rare, genetic disorder resulting in defect bone mineralisation and rickets. The current medical treatment consists of phosphate supplementation and alfacalcidol, but side effects such as secondary hyperparat-hyroidism and nephrocalcinosis are common. This treatment regimen often fails to prevent bone deformity and reduced final height. The rarity and complexity of these diseases call for centralised specialist care and international collaboration. Future medical treatment may be improved by addition of new promising experimental treatments.

  5. High Prevalence of Vitamin D Deficiency among Pregnant Saudi Women

    Directory of Open Access Journals (Sweden)

    Nora A. Al-Faris

    2016-02-01

    Full Text Available Vitamin D deficiency has emerged as a public health problem worldwide due to its important role in health and disease. The present work is intended to examine prevalence of vitamin D deficiency among pregnant Saudi women and related risk factors. A cross-sectional study was carried out at King Fahad Medical City in Riyadh, Saudi Arabia. Serum 25-hydroxy vitamin D (25(OHD was measured by enzyme-linked immunosorbent assay in 160 pregnant women during the first trimester of pregnancy. Socio-demographic, lifestyle and maternal characteristics were collected and vitamin D intake was assessed using a 24-h dietary recall. Weight and height were measured using standardized methods. Vitamin D deficiency (25(OHD < 50 nmol/L and insufficiency (25(OHD = 50–74 nmol/L were reported in 50% and 43.8% of the study sample, respectively. Median serum 25(OHD concentration was 49.9 nmol/L. Adequate vitamin D intake (≥600 IU/day was reported among only 8.1% of pregnant women. Age group, educational level, sun exposure frequency and daytime and daily practice of exercise were significantly associated with vitamin D status. Overall, vitamin D deficiency was common among pregnant Saudi women in Riyadh. Steps should be taken to address the current situation, including increased sunlight exposure, consumption of fatty fish, and vitamin D supplements.

  6. The frequency of vitamin D deficiency among asthmatic Egyptian ...

    African Journals Online (AJOL)

    EL-HAKIM

    The frequency of vitamin D deficiency among asthmatic Egyptian children. INTRODUCTION. Asthma is defined as a common chronic inflammatory disease of the airways characterized by variable and recurrent symptoms, reversible airflow obstruction, and bronchospasm. Children have smaller airways than adults, which ...

  7. effects of Vitamin D deficiency on pregnancy outcomes.

    African Journals Online (AJOL)

    8. Dror DK. Vitamin D status during pregnancy: ma- ternal, fetal, and postnatal Outcomes. Curr Opin Obstet. Gynecol 2011; 23 (6): 422-426. 9. Merewood A, Mehta SD, Chen TC, Bauchner H,. Holick MF. Association between vitamin D deficiency and primary cesarean section. J Clin Endocrinol Metab. 2009; 94 (3): 940-945.

  8. (D) deficiency in children and adolescents suffering from bronchial ...

    African Journals Online (AJOL)

    Detection of Vitamin (D) deficiency in children and adolescents suffering from bronchial asthma in Suez Canal University Hospital, Ismailia. ... Egyptian Journal of Pediatric Allergy and Immunology (The). Journal Home ... Therefore, the examination of relationship between vitamin D and bronchial asthma was important.

  9. Maternal vitamin D deficiency: a culprit for hypocalcaemia induced ...

    African Journals Online (AJOL)

    Case Report: We report a case of dilated cardiomyopathy due to hypocalcaemia secondary to maternal vitamin D deficiency in an infant presented with seizure disorder and heart failure. This was a four-month old female infant with respiratory distress and acute heart failure. The cause of her cardiac failure was dilated ...

  10. Vitamin D deficiency in patients with liver cirrhosis.

    Science.gov (United States)

    Konstantakis, Christos; Tselekouni, Paraskevi; Kalafateli, Maria; Triantos, Christos

    2016-01-01

    There is ongoing evidence that vitamin D is related to the pathophysiology of cirrhosis. Although the incidence of vitamin D deficiency in chronic liver diseases and cirrhosis is strongly documented, its pathogenic association with advanced liver fibrosis remains controversial. There is evidence of a significant relation of 25(OH)D levels with the degree of liver dysfunction, considering that an inverse correlation of 25(OH)D levels with both Child-Pugh score and Model for End-Stage Liver Disease has been reported. In addition, vitamin D deficiency has been shown to increase the risk for overall mortality and infections in patients with cirrhosis. Vitamin D deficiency has been also associated with advanced stages of hepatocellular carcinoma and poor prognosis. Finally, there are studies suggesting that patients with chronic hepatitis C and normal vitamin D levels have higher virological response to treatment. However, there are not enough studies conducted in cirrhotic-only populations. The association between vitamin D and cirrhosis demonstrates a great potential for clinical application. The relation between vitamin D deficiency and the degree of liver function, degree of fibrosis and infectious complications could support its use as a prognostic index and a diagnostic tool.

  11. Vitamin D Deficiency in an Inpatient Forensic Intellectual Disability Service

    Science.gov (United States)

    Chester, Verity; Simmons, Hayley; Henriksen, Marie; Alexander, Regi T.

    2017-01-01

    No research has examined vitamin D deficiency among inpatients within forensic intellectual disability services, despite their potentially increased risk. Tests of serum 25(OHD) concentration in blood are routinely offered to patients within the service as part of the admission and annual physical health check. Results were classified as deficient…

  12. Awareness of vitamin D deficiency among at-risk patients

    Directory of Open Access Journals (Sweden)

    Alemu Esubalew

    2012-01-01

    Full Text Available Abstract Background Vitamin D deficiency is a significant problem for a growing proportion of the UK population. Individuals with dark or covered skin are at particularly high risk due to ethno-cultural, environmental and genetic factors. We assessed the level of awareness of vitamin D deficiency among at-risk patients in order to identify groups most in need of education. Findings A cross-sectional survey using a piloted questionnaire was conducted among consecutive at-risk patients without a diagnosis of Vitamin D deficiency arriving at a large inner city general practice in the North West of England over a five day period. The survey was completed by 221 patients. The mean age was 35 years. 28% of them (n = 61 had never heard about vitamin D. Older patients (p = 0.003 were less likely to have heard about vitamin D. 54% of participants were unaware of the commonest symptoms of vitamin D deficiency. 34% did not expose their skin other than their face in the last one year, and 11% did not include vitamin D rich foods in their diet. Conclusion The majority of at-risk patients are aware of vitamin D; nevertheless, there is a significant lack of knowledge among older people, who have higher morbidity. A programme of targeted education of the at-risk population is recommended.

  13. Predictors of Vitamin D Deficiency in Predialysis Patients with Stage ...

    African Journals Online (AJOL)

    2017-12-05

    Dec 5, 2017 ... study, hospitalized predialysis patients who were diagnosed of Stage 3–5 CKD and had taken measurement of ... function with eGFR <30 ml/min/1.73 m2 are independent predictors of Vitamin D deficiency in ... tweak, and build upon the work non-commercially, as long as the author is credited and the new ...

  14. Fractures in infants and toddlers with rickets

    Energy Technology Data Exchange (ETDEWEB)

    Chapman, Teresa; Done, Stephen [Seattle Children' s Hospital, Department of Radiology, Seattle, WA (United States); Sugar, Naomi; Feldman, Kenneth [Seattle Children' s Hospital, Children' s Protection Program, Seattle, WA (United States); Marasigan, Joanne; Wambold, Nicolle [University of Washington, College of Arts and Sciences, Seattle, WA (United States)

    2010-07-15

    Rickets affects young infants and toddlers. However, there is a paucity of literature regarding the types of fractures that occur in rachitic patients. To evaluate the age of patients at which radiographically evident rickets occurs, and to characterize the age incidence and fractures that are observed in infants and toddlers with radiographically evident rickets. A retrospective study of children younger than 24 months was performed. Clinical data and radiographs were reviewed. Radiographs obtained within 1 month of the diagnosis were evaluated for the presence or absence of osteopenia, presence or absence of fraying-cupping, and presence and characterization of fractures. After exclusion criteria were applied, 45 children were included in the study. Children with rickets evident by radiograph were in the age range of 2-24 months. Fractures were present in 17.5% of the study group, exclusively in mobile infants and toddlers. Fracture types included transverse long bone fractures, anterior and anterior-lateral rib fractures, and metaphyseal fractures. All fractures occurred exclusively in patients with severe, overtly evident rickets. Fractures occur in older infants and toddlers with overt rickets and can be seen by radiograph. Fractures do not resemble high-risk non-accidental trauma fractures. (orig.)

  15. Possible association between vitamin D deficiency and restless legs syndrome

    Directory of Open Access Journals (Sweden)

    Oran M

    2014-05-01

    Full Text Available Mustafa Oran,1 Cuneyt Unsal,2 Yakup Albayrak,2 Feti Tulubas,3 Keriman Oguz,4 Okan Avci,1 Nilda Turgut,4 Recep Alp,4 Ahmet Gurel3 1Department of Internal Medicine, 2Department of Psychiatry, 3Department of Biochemistry, 4Department of Neurology, Namik Kemal University, Faculty of Medicine, Tekirdağ, Turkey Background and aim: Restless legs syndrome (RLS is a distressing sleep disorder that occurs worldwide. Although there have been recent developments in understanding the pathophysiology of RLS, the exact mechanism of the disease has not been well elucidated. An increased prevalence of neurologic and psychiatric diseases involving dopaminergic dysfunction in vitamin D-deficient patients led us to hypothesize that vitamin D deficiency might result in dopaminergic dysfunction and consequently, the development of RLS (in which dopaminergic dysfunction plays a pivotal role. Thus, the aim of this study was to evaluate the relationship between vitamin D deficiency and RLS. Methods: One hundred and fifty-five consecutive patients, 18–65 years of age, who were admitted to the Department of Internal Medicine with musculoskeletal symptoms and who subsequently underwent neurological and electromyography (EMG examination by the same senior neurologist, were included in this study. The patients were divided into two groups according to serum 25-hydroxyvitamin D (25(OHD (a vitamin D metabolite used as a measure of vitamin D status level: 36 patients with serum 25(OHD levels ≥20 ng/mL comprised the normal vitamin D group, and 119 patients with serum 25(OHD levels <20 ng/mL comprised the vitamin D deficiency group. The two groups were compared for the presence of RLS and associated factors. Results: The two groups were similar in terms of mean age, sex, mean body mass index (BMI, and serum levels of calcium, phosphate, alkaline phosphatase (ALP, and ferritin. The presence of RLS was significantly higher in the vitamin D deficiency group (χ2=12.87, P<0

  16. Vitamin D deficiency and insufficiency among patients with prostate cancer.

    Science.gov (United States)

    Trump, Donald L; Chadha, Manpreet K; Sunga, Annette Y; Fakih, Marwan G; Ashraf, Umeer; Silliman, Carrie G; Hollis, Bruce W; Nesline, Mary K; Tian, Lili; Tan, Wei; Johnson, Candace S

    2009-10-01

    To assess the frequency of vitamin D deficiency among men with prostate cancer, as considerable epidemiological, in vitro, in vivo and clinical data support an association between vitamin D deficiency and prostate cancer outcome. The study included 120 ambulatory men with recurrent prostate cancer and 50 with clinically localized prostate cancer who were evaluated and serum samples assayed for 25-OH vitamin D levels. Then 100 controls (both sexes), matched for age and season of serum sample, were chosen from a prospective serum banking protocol. The relationship between age, body mass index, disease stage, Eastern Cooperative Oncology Group performance status, season and previous therapy on vitamin D status were evaluated using univariate and multivariate analyses. The mean 25-OH vitamin D level was 25.9 ng/mL in those with recurrent disease, 27.5 ng/mL in men with clinically localized prostate cancer and 24.5 ng/mL in controls. The frequency of vitamin D deficiency (<20 ng/mL) and insufficiency (20-31 ng/mL) was 40% and 32% in men with recurrent prostate; 28% had vitamin D levels that were normal (32-100 ng/mL). Among men with localized prostate cancer, 18% were deficient, 50% were insufficient and 32% were normal. Among controls, 31% were deficient, 40% were insufficient and 29% were normal. Metastatic disease (P = 0.005) and season of blood sampling (winter/spring; P = 0.01) were associated with vitamin D deficiency in patients with prostate cancer, while age, race, performance status and body mass index were not. Vitamin D deficiency and insufficiency were common among men with prostate cancer and apparently normal controls in the western New York region.

  17. Vitamin D deficiency in critically ill patients with traumatic injuries.

    Science.gov (United States)

    Dickerson, Roland N; Van Cleve, Jonathan R; Swanson, Joseph M; Maish, George O; Minard, Gayle; Croce, Martin A; Brown, Rex O

    2016-01-01

    Vitamin D depletion has been associated with increased rate of infections, lengthened hospital stay, and worsened mortality for critically ill patients. The purpose of this study was to evaluate the prevalence and variables associated with vitamin D deficiency in critically ill patients with severe traumatic injuries. Critically ill adult patients admitted to the trauma intensive care unit (ICU) between June 2013 and June 2014, referred to the nutrition support service for enteral or parenteral nutrition, and had a serum 25-hydroxyvitamin D (25-OH vitamin D) concentration determination were retrospectively evaluated. Patients were stratified as vitamin D sufficient, insufficient, deficient, or severely deficient based on a 25-OH vitamin D concentration of 30-80, 20-29.9, 13.1-19.9, and ≤13 ng/mL, respectively. One hundred and twenty-one patients out of 158 (76 %) patients were vitamin D deficient or severely deficient. Thirty-one patients (20 %) were insufficient and 6 (4 %) had a normal 25-OH vitamin D concentration. 25-OH vitamin D was determined 7.5 ± 5.1 days after ICU admission. African-Americans had a greater proportion of patients with deficiency or severe deficiency compared to other races (91 versus 64 %, P = 0.02). Penetrating gunshot or knife stab injury, African-American race, and obesity (elevated body mass index) were significantly associated with vitamin D deficiency or severe deficiency: OR 9.23 (1.13, 75.40), 4.0 (1.4, 11.58), and 1.12 (1.03, 1.23), P traumatic injuries exhibit vitamin D deficiency or severe deficiency. Penetrating injuries, African-American race, and obesity are significant risk factors for deficiency. Severity of injury, extent of inflammation (elevated C-reactive protein concentration), or hospital admission during the winter season did not significantly influence the prevalence of vitamin D deficiency.

  18. VITAMIN D DEFICIENCY IN JAMMU IN SUBJECTS WITH NO COMORBIDITY- A PRELIMINARY STUDY

    Directory of Open Access Journals (Sweden)

    Sidharth Kapoor

    2017-11-01

    Full Text Available BACKGROUND Deficiency of the vitamin D may result in metabolic bone diseases leading to rickets in children or osteomalacia in adults.1,2 The vitamin D may provide protection against hypertension, cancer and multiple sclerosis.3 The vitamin D level is regulated through the interaction of various factors including intestinal absorption, renal function, serum calcium level and Parathyroid Hormone (PTH.3 The 2 main sources for vitamin D are synthesis in the skin on exposure to Ultraviolet-B (UVB light from sunlight and dietary intake. The aim of the study is to evaluate status of the vitamin D of a cohort of Jammu population with no comorbidity. A questionnaire was given to 119 patients (77 males and 42 females where information regarding intake of calcium and vitamin D supplementation, intake of calcium rich food and exposure to vitamin D was sought. MATERIALS AND METHODS Estimation of serum 25-hydroxyvitamin D (25(OH3 and plasma Parathyroid Hormone (PTH intact levels was done the subjects. Serum 25 (OH 2D3 levels did not differ significantly between males and females, although the levels were low (males 9.72 ng/mL ± 4.2 and females 8.5 ng/mL ± 4.7. RESULTS The vitamin D was still in the deficiency range even after excluding the subjects with very high PTH levels. CONCLUSION There was a high prevalence of a vitamin D deficiency in this sample of Jammu despite >70% of participants having adequate exposure to sunlight and >80% reporting adequate intake of dairy products.

  19. Time to Do Something for Vitamin D Deficiency; A Review

    Directory of Open Access Journals (Sweden)

    Mehrnoush Kosaryan

    2015-01-01

    Full Text Available Context: Vitamin D deficiency is a common nutritional disorder in Iran. Vitamin D is an essential health factor from birth onward. This study was conducted to summarize epidemiologic researches regarding vitamin D deficiency in different parts of the country and to conclude if food fortification is necessary. Evidence Acquisition: The study was designed in Thalassemia Research Center, Sari, Iran. It was a narrative review on the current situation of vitamin D deficiency in Iran. Related literature of the studies, in Farsi and English, conducted in the recent decade were explored. Data source of the study was Medline, SID, PubMed, Scopus, Request, Web-of-knowledge, Springer, Ovid, and Google Scholar. Results: Twenty five cross-sectional researches were found regarding vitamin D status in Iran from 2003 to 2013. There was also a Meta-analysis conducted in 2008. The total amount of 25(OH D3 was measured mostly by radio immune assay (RIA method. Most of the studies were done on adults. Definition of vitamin D deficiency was based on cut off of the kit in most studies; however in some studies the serum parathyroid hormone (PTH was measured and cut off for diagnosis based on increased PTH. Maximum rate of sever vitamin D deficiency was reported as 47% in 2011. Conclusions: Vitamin D deficiency is very frequent in Iran. Dealing with a national important nutritional problem is important. One way is to fortify suitable foods or edible products such as milk or cooking oil. Increasing public awareness about the problem and motivating people to do something on their expense is another option. In the current case taking vitamin D supplements on a regular basis, daily, weekly, or any other routines which could be available and cost effective may solve the problem. For people above one year old it is recommended to take 300’000 IU (as intramuscular injection or oral dose of vitamin D as a starting dose, then 50,000 IU oral dose every three months.

  20. [Relationship between vitamin D deficiency and metabolic syndrome].

    Science.gov (United States)

    González-Molero, Inmaculada; Rojo, Gemma; Morcillo, Sonsoles; Pérez-Valero, Vidal; Rubio-Martín, Eleazara; Gutierrez-Repiso, Carolina; Soriguer, Federico

    2014-06-06

    Vitamin D deficiency and metabolic syndrome are 2 very common health problems in the Spanish population. It has been suggested that patients with metabolic syndrome may be vitamin D deficient more often than subjects without it and that low vitamin D levels may predispose to metabolic syndrome development. However, the results of prospective and intervention studies have been different and such relationship remains unclear. We assessed the relationship between 25-hydroxyvitamin D levels and the prevalence and incidence of metabolic syndrome. We undertook a population-based cohort study in Spain. At baseline (1996-1998), 1,226 subjects were evaluated. Follow-up visits were performed in 2002-2004 and 2005-2007.At baseline and follow-up, participants underwent an interview and a standardized clinical examination with an oral glucose tolerance test in those subjects without known diabetes. At the second visit, 25-hydroxyvitamin D levels and intact parathyroid hormone levels were measured. The prevalence of metabolic syndrome at the second and third visit was 29.4 and 42.5%, respectively. Mean levels of 25-hydroxyvitamin D were lower in subjects with metabolic syndrome: 21.7 (6.21) vs 23.35 (6.29) ng/ml, P<.001.The prevalence of vitamin D deficiency (25-hydroxyvitamin D<20 ng/ml) at the second evaluation was 34.7%, with significant differences between subjects with and without metabolic syndrome(34.6 vs 26.5%, P<.01). Men with vitamin D deficiency had more frequently hypertension and metabolic syndrome than men with normal levels. Women with vitamin D deficiency had more frequently hyperglycemia, hypertension, increased waist circumference and hypertriglyceridemia. In a prospective study, 25-hydroxyvitamin D values<20 ng/ml were not significantly associated with an increased risk of developing metabolic syndrome in the next 5 years (odds ratio 0,99, 95% confidence interval 0.57-1.7, P=.97) after adjusting by sex and age. Vitamin D deficiency is associated with an

  1. The bony manifestation of Rickets. A case report.

    African Journals Online (AJOL)

    reports describing the syndrome of rickets appeared in the English literature around 1650, suggesting that the disease is an ancient one1 . There are multiple causes of rickets and osteomalacia, and the various metabolic defects in rickets, osteomalacia, and renal .... urea, uric acid, creatinine, low or normal calcium,.

  2. Vitamin D deficiency in childhood: old lessons and current challenges.

    Science.gov (United States)

    Antonucci, Roberto; Locci, Cristian; Clemente, Maria Grazia; Chicconi, Elena; Antonucci, Luca

    2018-02-05

    Hypovitaminosis D in childhood is a re-emerging public health problem in developed countries. New life style habits, current "epidemics" of obesity in children and adolescents worldwide, and other preventable risk factors may play a role in favoring the occurrence of vitamin D deficiency. In addition to skeletal consequences, hypovitaminosis D has been found to be involved in the development of serious health extra-skeletal problems in childhood, including atopy and autoimmunity. The increasing concerns about the global health impact of vitamin D deficiency make further research necessary to fill the gaps of knowledge in this field, and particularly to establish universally accepted "normal" serum 25(OH)D levels in the pediatric population, and to improve strategies for the screening, prevention and treatment of hypovitaminosis D. This review discusses the key points of hypovitaminosis D in childhood in the light of new knowledge, and highlights the limitations of current strategies to control this condition.

  3. Vitamin D deficiency among children and adolescents living in Denmark

    DEFF Research Database (Denmark)

    Beck-Nielsen, Signe; Mølgaard, Christian

    2014-01-01

    Based on the available Danish studies, vitamin D insufficiency, defined as the concentration of serum 25 hydroxy vitamin D (25(OH)D) < 50 nmol/l, is primarily prevalent among teenagers, children from immigrant families, and this especially by the end of winter. Measurement of the 25(OH)D concentr......Based on the available Danish studies, vitamin D insufficiency, defined as the concentration of serum 25 hydroxy vitamin D (25(OH)D) children from immigrant families, and this especially by the end of winter. Measurement of the 25(OH...... deficiency and rickets in Denmark....

  4. Vitamin D deficiency in critically ill patients with traumatic injuries

    OpenAIRE

    Dickerson, Roland N.; Van Cleve, Jonathan R.; Swanson, Joseph M.; Maish, George O.; Minard, Gayle; Croce, Martin A.; Brown, Rex O.

    2016-01-01

    Background Vitamin D depletion has been associated with increased rate of infections, lengthened hospital stay, and worsened mortality for critically ill patients. The purpose of this study was to evaluate the prevalence and variables associated with vitamin D deficiency in critically ill patients with severe traumatic injuries. Methods Critically ill adult patients admitted to the trauma intensive care unit (ICU) between June 2013 and June 2014, referred to the nutrition support service for ...

  5. Slipped capital femoral epiphysis with severe vitamin D deficiency.

    Science.gov (United States)

    Skelley, Nathan W; Papp, Derek F; Lee, Rushyuan J; Sargent, M Catherine

    2010-12-01

    Slipped capital femoral epiphysis is a relatively common disorder in late childhood and early adolescence, with an incidence in the United States of approximately 10 per 100,000. Although clinicians have theorized that contributing factors to the development of slipped capital femoral epiphysis include 25-hydroxyvitamin D deficiency and other nutritional deficiencies, the roles of these factors have not been fully analyzed. This article presents a case of a morbidly obese 13-year-old African-American boy who presented with sudden worsening of chronic hip pain and was diagnosed with stable, bilateral, grade-III slipped capital femoral epiphysis and severe vitamin D deficiency. He was initially treated with bilateral single-screw percutaneous fixation, however, after continued pain and nonunion, a right valgus subtrochanteric osteotomy was performed in association with correction of his severe vitamin D deficiency. This procedure led to improvement of his hip function and successful resolution of the pain. Approximately 3 months after the second operation and vitamin supplementation, the patient had signs of union, and his weight bearing progressed without discomfort. Although the osteotomy provided substantial biomechanical advantage by changing the forces across the physis from shear to compressive, correction of the vitamin D deficiency was critical in providing metabolic capacity for bone healing. Vitamin D plays an important role in bone formation and development, but the level of 25-hydroxyvitamin D is not routinely measured during assessment and treatment of slipped capital femoral epiphysis patients. The early detection and proper treatment of vitamin D may assist in the treatment of patients with slipped capital femoral epiphysis. Copyright 2010, SLACK Incorporated.

  6. The aetiology of rickets-like lower limb deformities in Malawian children.

    Science.gov (United States)

    Braithwaite, V S; Freeman, R; Greenwood, C L; Summers, D M; Nigdikar, S; Lavy, C B D; Offiah, A C; Bishop, N J; Cashman, J; Prentice, A

    2016-07-01

    Debilitating rickets-like lower limb deformities are common in children throughout the world, particularly in Malawi, Africa where the causes are unknown. We have identified that Blount disease and calcium deficiency rickets are the likely causes of these deformities and propose calcium supplementation as a potential treatment of Malawian rickets. Surgical correction of rickets-like lower limb deformities is the most common paediatric operation performed at Beit Cure Orthopaedic Hospital, Malawi. The aim of this study was to investigate the aetiology of these deformities. Children with a tibio-femoral angle of deformity >20° were enrolled (n = 42, 3.0-15.0 years). Anthropometric and early life and well-being data were collected. Early morning serum and urine samples were collected on the morning of the operation for markers of calcium and phosphate homeostasis. Knee radiographs were obtained, and the children were diagnosed with either Blount (BD, n = 22) or evidence of rickets disease (RD, n = 20). As BD is a mechanical rather than metabolic disease, BD were assumed to be biochemically representative of the local population and thus used as a local reference for RD. There were no differences in anthropometry or early life experiences between BD and RD. Parathyroid hormone (PTH), 1,25-dihydroxyvitamin D, total alkaline phosphatase and urinary phosphate were significantly higher and serum phosphate, 25-hydroxyvitamin D (25OHD) and tubular maximal reabsorption of phosphate significantly lower in RD than BD. There was no difference in serum calcium, fibroblast growth factor 23 or markers of iron status between groups. All children had 25OHD > 25 nmol/L. Vitamin D deficiency is not implicated in the aetiology of RD or BD in Malawian children. The cause of RD in Malawi is likely to be dietary calcium deficiency leading to elevated PTH resulting in increased losses of phosphate from the bone and glomerular filtrate. The causes of BD remain unclear

  7. The Vitamin D Deficiency Pandemic: a Forgotten Hormone Important for Health

    OpenAIRE

    Holick Michael F

    2010-01-01

    Early in the twentieth century more than 80 percent of children in industrialized Europe and North America were ravaged by the devastating skeletal consequences of rickets. Finding that exposure to ultraviolet radiation or sunlight treated and prevented rickets led to the ultraviolet irradiation of foods including milk. These practices along with the fortification of a variety of foods including dairy products with vitamin D and widespread use of cod liver oil eradicated rickets as a signific...

  8. Follow-up study of Gambian children with rickets-like bone deformities and elevated plasma FGF23: possible aetiological factors.

    Science.gov (United States)

    Braithwaite, Vickie; Jarjou, Landing M A; Goldberg, Gail R; Jones, Helen; Pettifor, John M; Prentice, Ann

    2012-01-01

    We have previously reported on a case-series of children (n=46) with suspected calcium-deficiency rickets who presented in The Gambia with rickets-like bone deformities. Biochemical analyses discounted vitamin D-deficiency as an aetiological factor but indicated a perturbation of Ca-P metabolism involving low plasma phosphate and high circulating fibroblast growth factor-23 (FGF23) concentrations. A follow-up study was conducted 5 years after presentation to investigate possible associated factors and characterise recovery. 35 children were investigated at follow-up (RFU). Clinical assessment of bone deformities, overnight fasted 2 h urine and blood samples, 2-day weighed dietary records and 24 h urine collections were obtained. Age- and season-matched data from children from the local community (LC) were used to calculate standard deviation scores (SDS) for RFU children. None of the RFU children had radiological signs of active rickets. However, over half had residual leg deformities consistent with rickets. Dietary Ca intake (SDS-Ca=-0.52 (0.98) p=0.04), dietary Ca/P ratio (SDS-Ca/P=-0.80 (0.82) p=0.0008) and TmP:GFR (SDS-TmP:GFR=-0.48 (0.81) p=0.04) were significantly lower in RFU children compared with LC children and circulating FGF23 concentration was elevated in 19% of RFU children. Furthermore an inverse relationship was seen between haemoglobin and FGF23 (R(2)=25.8, p=0.004). This study has shown differences in biochemical and dietary profiles between Gambian children with a history of rickets-like bone deformities and children from the local community. This study provided evidence in support of the calcium deficiency hypothesis leading to urinary phosphate wasting and rickets and identified glomerular filtration rate and iron status as possible modulators of FGF23 metabolic pathways. Copyright © 2011 Elsevier Inc. All rights reserved.

  9. Vitamin D deficiency in children living in Jeddah, Saudi Arabia

    Directory of Open Access Journals (Sweden)

    Maha M. H. K. Mansour

    2012-01-01

    Full Text Available Objective: Vitamin D deficiency is an unrecognized epidemic and a common health problem worldwide. This study was conducted to evaluate the vitamin D status in children living in Jeddah, Saudi Arabia and to study its relation to various variables. Materials and Methods: A cross-sectional study was conducted in the pediatric clinic in Jeddah Clinic Hospital-Kandarah, Jeddah, KSA, from October through December 2010, in which 510 healthy children aged 4-15 years were enrolled. Serum calcium, phosphorus, alkaline phosphatase and 25-hydroxyvitamin D [25(OHD] were measured. Dietary vitamin D intake and duration of daily sunlight exposure were determined. 25(OHD levels <20 ng/mL and <7 ng/mL were defined as relative and severe vitamin D deficiency, respectively. Results: The mean concentration of 25(OHD was 13.07 ± 7.81 ng/mL. Seventy subjects (13.72% had normal 25(OHD level ranging 20-70 ng/mL. Three hundred (58.82% had relative 25(OHD deficiency and 140 (27.45% had severe deficiency (P=0.000. 220 (43.14% subjects were males and 290 (56.86% were females having a statistically significant higher incidence of 25(OHD deficiency (P=0.019. 54.9% were Saudis, 27.45% were Yemenis and 11.76% were Egyptians. Saudis and Yemenis were more subjected to 25(OHD deficiency in comparison to Egyptians and other nationalities (P=0.01. There were significant inverse correlations between 25(OHD levels and bony aches (P=0.000. 56.25% of asymptomatic children had vitamin D deficiency (P=0.000. Duration of sunlight exposure and daily intake of vitamin D had significant effects on serum level of vitamin D (P=0.000. Conclusions: A high prevalence of vitamin D deficiency in children living in Jeddah was observed in this study. Vitamin D supplementation of food products can prevent vitamin D deficiency in these children.

  10. The effect of vitamin D2 and vitamin D3 on intestinal calcium absorption in Nigerian children with rickets.

    Science.gov (United States)

    Thacher, Tom D; Obadofin, Michael O; O'Brien, Kimberly O; Abrams, Steven A

    2009-09-01

    Children with calcium-deficiency rickets have high 1,25-dihydroxyvitamin D values. The objective of the study was to determine whether vitamin D increased calcium absorption. This was an experimental study. The study was conducted at a teaching hospital. Participants included 17 children with nutritional rickets. The participants were randomized to 1.25 mg oral vitamin D(3) (n = 8) or vitamin D(2) (n = 9). Fractional calcium absorption 3 da after vitamin D administration was measured. Mean baseline 25-hydroxyvitamin D concentrations were 20 ng/ml (range 5-31 ng/ml). The increase in 25-hydroxyvitamin D was equivalent after vitamin D(3) (29 +/- 10 ng/ml) or vitamin D(2) (29 +/- 17 ng/ml). Mean 1,25-dihydroxyvitamin D values increased from 143 +/- 76 pg/ml to 243 +/- 102 pg/ml (P = 0.001), and the increase in 1,25-dihydroxyvitamin D did not differ between vitamin D(2) and vitamin D(3) (107 +/- 110 and 91 +/- 102 ng/ml, respectively). The increment in 1,25-dihydroxyvitamin D was explained almost entirely by the baseline 25-hydroxyvitamin D concentration (r(2) = 0.72; P rickets in Nigerian children is not primarily due to vitamin D-deficient calcium malabsorption.

  11. Rickets of prematurity: a case report.

    Science.gov (United States)

    Airede, A I

    1991-12-01

    A case report is given, and an attempt made to summarize our knowledge about this disorder. An extremely premature infant (birth weight 750 grammes) developed progressive rickets resulting in fractures despite phosphate, calcium and calciferol (vitamin D) supplementation. The patient had mild respiratory distress syndrome but later developed broncopulmonary dysplasia. Initial biochemical evidence of rickets occurred by the 6th week of post-natal life (or 31 weeks post-conceptional age). Although the serum levels of vitamin D or 1-alphahydroxy vitamin D were not determined, it is assumed that the levels of the active metabolite was probably low since clinical, biochemical and radiologic cure of the rickets occurred following its usage.

  12. Vitamin D deficiency reduces the benefits of progesterone treatment after brain injury in aged rats

    OpenAIRE

    Cekic, Milos; Cutler, Sarah M.; VanLandingham, Jacob W.; Stein, Donald G.

    2009-01-01

    Administration of the neurosteroid progesterone (PROG) has been shown to be beneficial in a number of brain injury models and in two recent clinical trials. Given widespread vitamin D deficiency and increasing traumatic brain injuries (TBIs) in the elderly, we investigated the interaction of vitamin D deficiency and PROG with cortical contusion injury in aged rats. Vitamin D deficient (VitD-deficient) animals showed elevated inflammatory proteins (TNFα, IL-1β, IL-6, NFκB p65) in the brain eve...

  13. Predicting vitamin D deficiency in older Australian adults.

    Science.gov (United States)

    Tran, Bich; Armstrong, Bruce K; McGeechan, Kevin; Ebeling, Peter R; English, Dallas R; Kimlin, Michael G; Lucas, Robyn; van der Pols, Jolieke C; Venn, Alison; Gebski, Val; Whiteman, David C; Webb, Penelope M; Neale, Rachel E

    2013-11-01

    There has been a dramatic increase in vitamin D testing in Australia in recent years, prompting calls for targeted testing. We sought to develop a model to identify people most at risk of vitamin D deficiency. This is a cross-sectional study of 644 60- to 84-year-old participants, 95% of whom were Caucasian, who took part in a pilot randomized controlled trial of vitamin D supplementation. Baseline 25(OH)D was measured using the Diasorin Liaison platform. Vitamin D insufficiency and deficiency were defined using 50 and 25 nmol/l as cut-points, respectively. A questionnaire was used to obtain information on demographic characteristics and lifestyle factors. We used multivariate logistic regression to predict low vitamin D and calculated the net benefit of using the model compared with 'test-all' and 'test-none' strategies. The mean serum 25(OH)D was 42 (SD 14) nmol/1. Seventy-five per cent of participants were vitamin D insufficient and 10% deficient. Serum 25(OH)D was positively correlated with time outdoors, physical activity, vitamin D intake and ambient UVR, and inversely correlated with age, BMI and poor self-reported health status. These predictors explained approximately 21% of the variance in serum 25(OH)D. The area under the ROC curve predicting vitamin D deficiency was 0·82. Net benefit for the prediction model was higher than that for the 'test-all' strategy at all probability thresholds and higher than the 'test-none' strategy for probabilities up to 60%. Our model could predict vitamin D deficiency with reasonable accuracy, but it needs to be validated in other populations before being implemented. © 2013 John Wiley & Sons Ltd.

  14. VITAMIN D DEFICIENCY AND ITS HEALTH CONSEQUENCES – A REVIEW

    Directory of Open Access Journals (Sweden)

    V Jyoti

    2012-10-01

    Full Text Available The world is currently facing an unrecognized and untreated pandemic of Vitamin D Deficiency (VDD1. VDD is a significant public health problem in both developed and developing countries, including India2. It is highly prevalent across all age groups. Vitamin D (VD is a prehormone that humans obtain from foods and dietary supplements and by endogenous skin synthesis from7-dehydrocholesterol with sunlight exposure3. The present article reviews the etiology of VDD, physiological functions, sources, health consequences and prevalence of VDD in different regions of India.

  15. [Vitamin D deficiency and morbimortality in critically ill paediatric patients].

    Science.gov (United States)

    García-Soler, Patricia; Morales-Martínez, Antonio; Rosa-Camacho, Vanessa; Lillo-Muñoz, Juan Antonio; Milano-Manso, Guillermo

    2017-08-01

    To determine the prevalence and risks factors of vitamin D deficiency, as well as its relationship with morbidity and mortality in a PICU. An observational prospective study in a tertiary children's University Hospital PICU conducted in two phases: i: cohorts study, and ii: prevalence study. The study included 340 critically ill children with ages comprising 6 months to 16 years old. Chronic kidney disease, known parathyroid disorders, and vitamin D supplementation. Total 25-hydroxyvitamin D [25(OH)D] was measured in the first 48hours of admission to a PICU. Parathormone, calcium, phosphate, blood gases, blood count, C-reactive protein, and procalcitonin were also analysed. A record was also made of demographic features, characteristics of the episode, and complications during the PICU stay. The overall prevalence rate of vitamin D deficiency was 43.8%, with a mean of 22.28 (95% CI 21.15-23.41) ng/ml. Patients with vitamin D deficiency were older (61 vs 47 months, P=.039), had parents with a higher level of academic studies (36.5% vs 20%, P=.016), were admitted more often in winter and spring, had a higher PRISM-III (6.8 vs 5.1, P=.037), a longer PICU stay (3 vs 2 days, P=.001), and higher morbidity (61.1% vs 30.4%, P<001) than the patients with sufficient levels of 25(OH)D. Patients who died had lower levels of 25(OH)D (14±8.81ng/ml versus 22.53±10.53ng/ml, P=.012). Adjusted OR for morbidity was 5.44 (95%CI; 2.5-11.6). Vitamin D deficiency is frequent in critically ill children, and it is related to both morbidity and mortality, although it remains unclear whether it is a causal relationship or it is simply a marker of severity in different clinical situations. Copyright © 2016 Asociación Española de Pediatría. Publicado por Elsevier España, S.L.U. All rights reserved.

  16. The vitamin D deficiency pandemic: Approaches for diagnosis, treatment and prevention.

    Science.gov (United States)

    Holick, Michael F

    2017-06-01

    Vitamin D deficiency and insufficiency is a global health issue that afflicts more than one billion children and adults worldwide. The consequences of vitamin D deficiency cannot be under estimated. There has been an association of vitamin D deficiency with a myriad of acute and chronic illnesses including preeclampsia, childhood dental caries, periodontitis, autoimmune disorders, infectious diseases, cardiovascular disease, deadly cancers, type 2 diabetes and neurological disorders. This review is to put into perspective the controversy surrounding the definition for vitamin D deficiency and insufficiency as well as providing guidance for how to treat and prevent vitamin D deficiency.

  17. Phenotype Presentation of Hypophosphatemic Rickets in Adults

    DEFF Research Database (Denmark)

    Beck-Nielsen, Signe S; Brusgaard, Klaus; Rasmussen, Lars M

    2010-01-01

    Hypophosphatemic rickets (HR) is a group of rare disorders caused by excessive renal phosphate wasting. The purpose of this cross-sectional study of 38 HR patients was to characterize the phenotype of adult HR patients. Moreover, skeletal and endodontic severity scores were defined to assess...

  18. Role of bone scanning in neonatal rickets

    Energy Technology Data Exchange (ETDEWEB)

    Saul, P.D.; Lloyd, D.J.; Smith, F.W.

    1983-03-01

    Preterm infants are at increased risk from rickets. Radionuclide bone scanning is a useful aid in suspected cases. It offers advantages over conventional radiology in terms of sensitivity, radiation dose and extent of examination. Unsuspected fractures of clinical or medicolegal significance may be detected. Two cases are described in which the technique confirmed the diagnosis and assisted management.

  19. Evaluation of children with nutritional rickets.

    Science.gov (United States)

    Cesur, Yasar; Doğan, Murat; Ariyuca, Sevil; Basaranoglu, Murat; Bektas, Mehmet Selçuk; Peker, Erdal; Akbayram, Sinan; Caksen, Hüseyin

    2011-01-01

    To evaluate the clinical findings, risk factors, therapy and outcome in 946 children with nutritional rickets. This retrospective study included a review of medical records of patients with nutritional rickets between March 2004 and 2009. Patients who displayed both the biochemical inclusion criteria and the clinical signs/symptoms or radiological signs of rickets were included in the study. The present study included 946 patients aged between 4 months and 15 years. Distribution of the cases showed a density between December and May. The age at diagnosis, showed two peaks and most of the patients were in the age range 0-23 months and 12.0-15 years. In infants and young children, most of the patients had been admitted to the hospital due to infectious diseases. In older children, short stature and obesity were the most common complaints. Children aged between 0-23 months and 12.0-15 years were under most risk for nutritional rickets, especially in winter and spring and vitamin D should be given to them as supplementation dose.

  20. CALCIUM DEFICIENCY AND CAUSATION OF RICKETS IN ...

    African Journals Online (AJOL)

    hi-tech

    2005-03-03

    Mar 3, 2005 ... Objective: To assess the role of calcium in the development of clinical rickets among. Ethiopian children coming to Jimma Specialised Hospital outpatient, department. Design: Case control study. Settings: Jimma Specialised Teaching Hospital and surrounding urban and rural community in the catchment ...

  1. Vitamin D deficiency in girls from South Brazil: a cross-sectional study on prevalence and association with vitamin D receptor gene variants.

    Science.gov (United States)

    Santos, Betânia R; Mascarenhas, Luis P G; Satler, Fabíola; Boguszewski, Margaret C S; Spritzer, Poli Mara

    2012-06-08

    Vitamin D deficiency has been associated with a multitude of disorders including diabetes, defective insulin secretion as well as rickets and poor bone health. Vitamin D is also a concern during childhood and adolescence and has been reported in girls from South Brazil. We determined the prevalence of vitamin D deficiency in girls from South Brazil and investigated whether the genotypic distribution of the BsmI, ApaI and TaqI polymorphisms of the VDR gene and their haplotypes were associated with vitamin D levels. Cross-sectional study including 234 apparently healthy girls aged 7 to 18 years. Height and weight were measured for calculation of body mass index (BMI) percentiles for age. Plasma levels of 25-hydroxyvitamin D [25(OH)D] were assessed. Participants were genotyped for ApaI (rs7975232), TaqI (rs731236), and BsmI (rs1544410) SNPs. The median and interquartile range (25-75%) of BMI percentile was 62.0 (33.3 - 84.9). The frequency of overweight/obesity was 24.9%. Circulating levels of 25(OH)D (≥ 30 ng/mL) were adequate in 9.4%; insufficient in 54.3% (20-29 ng/mL); and deficient in 36.3% (children and adolescents.

  2. Vitamin D deficiency decreases survival of bacterial meningoencephalitis in mice.

    Science.gov (United States)

    Djukic, Marija; Sostmann, Nadine; Bertsch, Thomas; Mecke, Marianne; Nessler, Stefan; Manig, Anja; Hanisch, Uwe-Karsten; Triebel, Jakob; Bollheimer, L Cornelius; Sieber, Cornel; Nau, Roland

    2015-01-07

    Meningoencephalitis caused by Escherichia coli is associated with high rates of mortality and risk of neurological sequelae in newborns and infants and in older or immunocompromised adults. A high prevalence of neurological disorders has been observed in geriatric populations at risk of hypovitaminosis D. In vivo, we studied the effects of vitamin D3 on survival and the host's immune response in experimental bacterial meningoencephalitis in mice after intracerebral E. coli infection. To produce different systemic vitamin D3 concentrations, mice received a low, standard, or high dietary vitamin D3 supplementation. Bacterial titers in blood, spleen, and brain homogenates were determined. Leukocyte infiltration was assessed by histological scores, and tissue cytokine or chemokine concentrations were measured. Mice fed a diet with low vitamin D3 concentration died earlier than control animals after intracerebral infection. Vitamin D deficiency did not inhibit leukocyte recruitment into the subarachnoid space and did not lead to an increased density of bacteria in blood, spleen, or brain homogenates. The release of proinflammatory interleukin (IL)-6 was decreased and the release of anti-inflammatory IL-10 was increased in mice fed a diet with high vitamin D3 supplementation. Our observations suggest a detrimental role of vitamin D deficiency in bacterial central nervous system infections. Vitamin D may exert immune regulatory functions.

  3. Vitamin D deficiency: the time to ignore it has passed.

    LENUS (Irish Health Repository)

    Haroon, Muhammad

    2010-10-01

    It is true to say that it is just over the past decade and even more so in this new decade that it has become appreciated how vitally important vitamin D is for optimum health. This \\'sunshine\\' vitamin could justifiably be called \\'the nutrient of this decade\\'. Until recently, vitamin D was known primarily for its role in bone health. However, as a result of advances in research this perspective has changed. While it is true to say that the classic function of vitamin D is to control calcium and vitamin D metabolism, we now know that the importance of vitamin D spreads far wider than just bone health. There is much ongoing research with regard to its emerging role in immunopathology, as a potent inhibitor of cellular growth, stimulator of insulin secretion, modulator of immune function and inhibitor of renin production. This review discusses the current evidence with regard to the clinical consequences of vitamin D deficiency and underscores the fact that physicians should be vigilant in searching for and treating this preventable and treatable condition. Furthermore, this review highlights the fact that the time is opportune for rheumatologists to agree upon clinical guidelines to advise practitioners as to when and in which patients to check for, what target vitamin D level to aim for and how best to treat vitamin D deficiency.

  4. Vitamin D deficiency in type 1 narcolepsy: a reappraisal.

    Science.gov (United States)

    Dauvilliers, Yves; Evangelista, Elisa; Lopez, Regis; Barateau, Lucie; Scholz, Sabine; Crastes de Paulet, Barbara; Carlander, Bertrand; Jaussent, Isabelle

    2017-01-01

    Narcolepsy type 1 (NT1) is considered to be an immune-mediated disease in which environmental factors, such as vitamin D, might play a major role. The association between NT1 and vitamin D deficiency has previously been reported. The aim of this case-control study was to reassess vitamin D levels in a large clinic-based adult and paediatric population of patients with NT1 by considering several potential confounding factors. The serum level of 25-hydroxyvitamin D (25OHD) was measured in 174 Caucasian patients with NT1 and 174 controls. Demographic and clinical features, body mass index (BMI), Pandemrix® vaccination, age, and season at the time of blood sampling were recorded. Between-group comparisons were made using univariate and multivariate logistic regression analyses. When appropriate, interaction terms were tested using the Wald Chi-squared test. Age, BMI, and season of blood sampling were different between groups. Conversely, the 25OHD level and fraction of subjects with vitamin D deficiency (serum level treatment, and Pandemrix® vaccination. Vitamin D levels were not associated with NT1 in a large case-control population when potential demographic and clinical confounding factors were taken into account. Copyright © 2016 Elsevier B.V. All rights reserved.

  5. Links between Vitamin D Deficiency and Cardiovascular Diseases

    Directory of Open Access Journals (Sweden)

    Ioana Mozos

    2015-01-01

    Full Text Available The aim of the present paper was to review the most important mechanisms explaining the possible association of vitamin D deficiency and cardiovascular diseases, focusing on recent experimental and clinical data. Low vitamin D levels favor atherosclerosis enabling vascular inflammation, endothelial dysfunction, formation of foam cells, and proliferation of smooth muscle cells. The antihypertensive properties of vitamin D include suppression of the renin-angiotensin-aldosterone system, renoprotective effects, direct effects on endothelial cells and calcium metabolism, inhibition of growth of vascular smooth muscle cells, prevention of secondary hyperparathyroidism, and beneficial effects on cardiovascular risk factors. Vitamin D is also involved in glycemic control, lipid metabolism, insulin secretion, and sensitivity, explaining the association between vitamin D deficiency and metabolic syndrome. Vitamin D deficit was associated in some studies with the number of affected coronary arteries, postinfarction complications, inflammatory cytokines and cardiac remodeling in patients with myocardial infarction, direct electromechanical effects and inflammation in atrial fibrillation, and neuroprotective effects in stroke. In peripheral arterial disease, vitamin D status was related to the decline of the functional performance, severity, atherosclerosis and inflammatory markers, arterial stiffness, vascular calcifications, and arterial aging. Vitamin D supplementation should further consider additional factors, such as phosphates, parathormone, renin, and fibroblast growth factor 23 levels.

  6. Calcium and Vitamin D deficiency in Otolaryngological Diseases

    Directory of Open Access Journals (Sweden)

    Upadhyay Animesh A

    2016-06-01

    Full Text Available A prospective study to observe the prevalence of deficiency of vitamin D and Calcium in outpatients of otolaryngology clinic at R.C.S.M Government Medical College Kolhapur, India. The patients attending outpatient of otolaryngology clinic with various complaints and not responding to conventional treatment were advised for assessment of vitamin D [25 (OH D] level in blood. To establish the presence of Calcium and Vitamin D deficiency in patients with otolaryngological diseases. The age, sex, occupation, chief complaints, obesity and provisional diagnosis was noted in all cases. A total of 86 patients were examined, maximum patients were in the age group of 7–15 years. The chief complaints in majority of the patients were sore throat with recurrent upper respiratory tract infection. Only three patient’s vitamin D levels were found to be within normal limits. In the remaining 83 (96.51 % cases it was either deficient (as in: 57 (66.28 % or insufficient (as in 21 (24.42 %. The incidence of vitamin D deficiency is high in Ear Nose Throat disease (E.N.T. patients. The results of vitamin supplementation were promising in cases of Pharyngitis, URTI with asthma, post operation of Chronic Suppurative Otitis Media, empirical supplementation of vitamin D in all E.N.T. patients not responding to conventional treatment is worth trying

  7. Vitamin d deficiency in e.N.T. Patients.

    Science.gov (United States)

    Taneja, M K; Taneja, Vivek

    2013-01-01

    A prospective study to observe the prevalence of deficiency of vitamin D in out patients of otolaryngology clinic at Indian Institute of ear diseases, Muzaffarnagar. The patients attending outpatient of otolaryngology clinic with various complaints and not responding to conventional treatment were advised for assessment of vitamin D [25 (OH)D] level in blood. The age, sex, occupation, colour of skin, chief complaints, obesity, provisional diagnosis, and incidence of sun exposure was noted in all cases. A total of 86 patients were examined, maximum patients were in the age group of 7-15 years. The chief complaints in majority of the patients were sore throat with recurrent upper respiratory tract infection. Only in three patient's vitamin D level was found to be with in normal limits. In rest 83 (96.51 %) it was either deficient 57 (66.28 %) or insufficient 21 (24.42 %). The incidence of vitamin D deficiency is extremely common in Ear Nose Throat disease (E.N.T.) patients. The results of vitamin supplementation were promising in cases of benign paroxysmal positional vertigo with cervical spondylosis and URTI with asthma, empirical supplementation of vitamin D in all E.N.T. patients not responding to conventional treatment is worth trying. At place of sun screen, use of pomegranates and blueberries may be encouraged to prevent sunburn and eliminate Vitamin D deficiency.

  8. Clinical, biochemical, and radiological manifestations of vitamin D deficiency in newborns presented with hypocalcemia

    Directory of Open Access Journals (Sweden)

    Ashraf Soliman

    2013-01-01

    Full Text Available Introduction: The Clinical and radiological manifestations of newborns with severe VDD have not been studied well. Materials and Methods: We studied the clinical, biochemical, and radiological manifestations of 10 full-term (FT newborns (6: M, 4: F infant presented to with symptomatic hypocalcemia (seizure secondary to vitamin D deficiency (VDD during the first 10 days of life are described. All were exclusively breastfed since birth. All their mothers have low 25 hydroxy vitamin D (25OHD level 60 ng/mL and 60% had decreased magnesium (Mg concentrations (<0.7 mmol/L. Their alkaline phosphatase (ALP concentrations were significantly higher than normal newborns. All other laboratory results (liver function tests, urea and electrolytes, C reactive protein, lumbar puncture, blood culture, and lactate were normal. In all patients, seizures ceased within 2 days of starting treatment with alphacalcidol and calcium. Radiological manifestations included metaphyseal band of relative lucency (osteopenia, just under the line of provisional calcification, within distal radius (7/10, femur (4/10, and tibia (3/10, mild cupping and haziness of distal radius (2/10. Discussion: Newborns with VDD had significantly lower serum calcium, ALP and PTH and higher phosphate concentrations, compared to older infants with VDD rickets. In newborns with VDD, serum calcium levels were correlated significantly with 25OHD (r = 0.597, P < 0.001, Mg concentrations (r = 0.436, P < 0.001 and negatively with ALP concentrations (r = −0.451, P < 0.001. Serum PTH concentrations were correlated significantly with serum Mg (r = 0.78, P < 0.0001 but not with serum calcium (r = −0.103, P = 0.3 or 25OHD (r = −0.03, P = 0.7 concentrations. Conclusion: The clinical, biochemical, and radiological manifestations of VDD in newborns indicate that they are less adapted to VDD compared to older infants. VD supplementation for mothers and newborns should be considered to avoid short

  9. The effect of nutritional rickets on bone mineral density.

    Science.gov (United States)

    Thacher, Tom D; Fischer, Philip R; Pettifor, John M

    2014-11-01

    Nutritional rickets is caused by impaired mineralization of growing bone. The effect of nutritional rickets on areal bone mineral density (aBMD) has not been established. Our objective was to determine if aBMD is lower in children with active rickets than in healthy control children. We expected that the reduction in aBMD would vary between the radial and ulnar metaphyses near the growth plates and the proximal diaphyses. Case-control study. Primary care outpatient department of a teaching hospital in Jos, Nigeria. Nigerian children with radiographically-confirmed rickets were compared with a reference group of control children without rickets from the same community. Forearm bone density measurements were performed in all children with pDXA. Age, sex, and height-adjusted bone density parameters were compared between children with rickets and control subjects. A total of 264 children with active rickets (ages 13-120 months) and 660 control children (ages 11-123 months) were included. In multivariate analyses controlling for height, age, and gender, rickets was associated with a 4% greater bone area and 7% lower aBMD of the radial and ulnar metaphyses compared with controls (P rickets on the diaphyses of the radius and ulna were more pronounced with an 11% greater bone area, 21% lower aBMD, and 24% lower bone mineral apparent density than controls (P children with rickets, aBMD values were unrelated to dairy product intake or serum calcium, phosphorus, alkaline phosphatase, or 25-hydroxyvitamin D. Metaphyseal aBMD was positively associated with radiographic severity score, attributed to bone edge detection artifact by densitometry in active rickets. Rickets results in increased bone area and reduced aBMD, which are more pronounced in the diaphyseal than in the metaphyseal regions of the radius and ulna, consistent with secondary hyperparathyroidism, generalized osteoid expansion and impaired mineralization.

  10. Vitamin D deficiency at pediatric intensive care admission

    Directory of Open Access Journals (Sweden)

    Corsino Rey

    2014-04-01

    Full Text Available OBJECTIVE:to assess whether 25hydroxivitaminD or 25(OHvitD deficiency has a high prevalence at pediatric intensive care unit (PICU admission, and whether it is associated with increased prediction of mortality risk scores.METHOD:prospective observational study comparing 25(OHvitD levels measured in 156 patients during the 12 hours after critical care admission with the 25(OHvitD levels of 289 healthy children. 25(OHvitD levels were also compared between PICU patients with pediatric risk of mortality III (PRISM III or pediatric index of mortality 2 (PIM 2 > p75 [(group A; n = 33 vs. the others (group B; n = 123]. Vitamin D deficiency was defined as < 20 ng/mL levels.RESULTS:median (p25-p75 25(OHvitD level was 26.0 ng/mL (19.2-35.8 in PICU patients vs. 30.5 ng/mL (23.2-38.6 in healthy children (p = 0.007. The prevalence of 25(OHvitD < 20 ng/mL was 29.5% (95% CI: 22.0-37.0 vs. 15.6% (95% CI: 12.2-20.0 (p = 0.01. Pediatric intensive care patients presented an odds ratio (OR for hypovitaminosis D of 2.26 (CI 95%: 1.41-3.61. 25(OHvitD levels were 25.4 ng/mL (CI 95%: 15.5-36.0 in group A vs. 26.6 ng/mL (CI 95%: 19.3-35.5 in group B (p = 0.800.CONCLUSIONS:hypovitaminosis D incidence was high in PICU patients. Hypovitaminosis D was not associated with higher prediction of risk mortality scores.

  11. Frequency of nutritional rickets in children admitted with severe pneumonia.

    Science.gov (United States)

    Haider, Nighat; Nagi, Abdul Ghaffar; Khan, Khalid Mehmood A

    2010-09-01

    To determine the frequency of nutritional rickets in children hospitalized with severe pneumonia. This study was carried out at the department of paediatric medicine at National Institute of Child Health Karachi. It is a case series done over a period of six months from 15th November 2008 to 15th may 2009. Patients admitted (n=137) with severe pneumonia were included in the study and were investigated for presence of rickets with serum calcium, phosphorus and alkaline phosphatase. Those having low to normal calcium low phosphorus and raised alkaline phosphatase were labeled as having rickets. All data collected were entered on Performa. Children with familial, vitamin D dependent/resistant rickets, secondary rickets, and cerebral palsy or on anti convulsant therapy were excluded from this study. Out of 137 patients, with severe pneumonia, 83 were male and 54 female. Frequency of nutritional rickets in children with severe pneumonia was observed in 101(74%) cases. Rickets was more common in 2 to 12 months of age, i.e., 79.8% (67/84) and in those children who were breast fed (85.3% vs. 40%). Frequency was higher in those children who were not exposed to sunlight. Pneumonia is a very common presentation of rickets. This study suggests that rickets may be more common in children who are breast fed and those who have less exposure to sunlight.

  12. Vitamin D Deficiency in Patients with Systemic Lupus Erythematosus

    Directory of Open Access Journals (Sweden)

    Suzan M. Attar

    2013-01-01

    Full Text Available Objectives: Hypovitaminosis D is common in the general population. Many studies that have been conducted to show the association between vitamin D deficiency and systemic lupus erythematosus (SLE reveal that deficiencies in vitamin D are common in this group of patients. Our aim was to study the relationship between 25(OHD and disease activity in patients with SLE.Methods: Retrospective cohort study of patients with SLE who were followed up at King Abdulaziz University Hospital, Jeddah, from January 2007 to November 2010. Demographic and clinical data were recorded and the 25(OHD levels of the patients were measured. Chi square tests, Student’s t-test, ANOVA and Pearson tests were used for data analysis. ANOVA test was followed by Bonferroni correction. A p-value <0.05 was considered significant.Results: Ninety-five patients with SLE were enrolled in the study. The levels of 25(OHD were significantly lower in patients with active SLE (n=41; 43% than in those with inactive disease (n=54; 57%; p=0.04. The mean (SD levels were 22.3 (14 nmol/L for patients with active disease against 25.0 (14 nmol/L for patients with inactive SLE. No correlation was detected between 25(OH D levels and disease activity score evaluated by SLEDAI-2K. By Pearson correlation, a significant negative correlation existed between 25(OH D and anti ds-DNA (r=-0.38; p<0.001; a positive correlation existed between 25(OHD levels and C4 (r=0.25; p=0.25. By chi square testing, azathioprine treatment (OR=3.5, low C4 (OR= 2.23, low C3 (OR=1.92, and active disease (OR=1.6 were associated with 25(OHD deficiency in SLE patients.Conclusion: Vitamin D deficiency is frequent in patients with SLE. Patients with SLE have a higher risk of developing 25(OHD deficiency in the presence of low serum C3 and C4 levels, and high anti-dsDNA levels.

  13. Vitamin D deficiency in girls from South Brazil: a cross-sectional study on prevalence and association with vitamin D receptor gene variants

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    Santos Betânia R

    2012-06-01

    Full Text Available Abstract Background Vitamin D deficiency has been associated with a multitude of disorders including diabetes, defective insulin secretion as well as rickets and poor bone health. Vitamin D is also a concern during childhood and adolescence and has been reported in girls from South Brazil. We determined the prevalence of vitamin D deficiency in girls from South Brazil and investigated whether the genotypic distribution of the BsmI, ApaI and TaqI polymorphisms of the VDR gene and their haplotypes were associated with vitamin D levels. Methods Cross-sectional study including 234 apparently healthy girls aged 7 to 18 years. Height and weight were measured for calculation of body mass index (BMI percentiles for age. Plasma levels of 25-hydroxyvitamin D [25(OHD] were assessed. Participants were genotyped for ApaI (rs7975232, TaqI (rs731236, and BsmI (rs1544410 SNPs. Results The median and interquartile range (25-75% of BMI percentile was 62.0 (33.3 – 84.9. The frequency of overweight/obesity was 24.9%. Circulating levels of 25(OHD (≥ 30 ng/mL were adequate in 9.4%; insufficient in 54.3% (20–29 ng/mL; and deficient in 36.3% (vs. GA + AA, two-tailed Student’s t-test p vs. GT + TT, two-tailed Student’s t-test p = 0.031 and TaqI (TT vs. TC + CC, two-tailed Student’s t-test p = 0.005 SNPs and the GGT haplotype (two-tailed Student’s t-test p = 0.036 were significantly associated with lower 25(OHD levels. Conclusions 25-hydroxyvitamin D deficiency and insufficiency were highly prevalent in this sample. The BsmI, ApaI and TaqI wild variants of the VDR gene, as well as the GGT haplotype, were associated with lower vitamin D levels, suggesting that VDR gene polymorphisms could be linked to higher susceptibility to vitamin D deficiency in a sub-population of children and adolescents.

  14. Nutritional Rickets in a Tropical Environment: The Roles of Habitat ...

    African Journals Online (AJOL)

    A survey of under five was carried out at a military base to determine the prevalence of nutritional rickets and the possible predisposing factor/s. 9,105 under five children were enrolled. 38 children were confirmed to have rickets. This gives a prevalence of 4.2 per 1000 under fives in the base. These were made up of 12 ...

  15. Celiac disease presenting as rickets in Saudi children.

    Science.gov (United States)

    Assiri, Asaad; Saeed, Anjum; AlSarkhy, Ahmed; El Mouzan, Mohammed Issa; El Matary, Wael

    2013-01-01

    Rickets is commonly seen as a sign of malabsorption like celiac disease if it is not treated appropriately with vitamin D and calcium supplements. The aim of this study was to examine the frequency of diagnosis of celiac disease among children with unexplained rickets in Saudi children at a tertiary hospital setting. Retrospective review of records of patients referred over 10 years to a pediatric gastroenterology and hepatology unit. The study included all patients referred for evaluation of unexplained rickets and osteomalacia and screened for celiac disease. The diagnosis of rickets was made on the basis of history, physical examination, biochemical and radiological investigations. The diagnosis of celiac disease was made based on the ESPGHAN (European Society for Pediatric Gastroenterology, Hepatology, and Nutrition) criteria. Twenty-six children with a mean (SD) age of 9.5 (4.6) years (5 males, range 1-15 years) were referred for evaluation of unexplained rickets and were screened for celiac disease. The diagnosis of celiac disease based on small bowel biopsy findings was confirmed in 10 (38.4%) patients with rickets. Serological markers for celiac disease including antiendomyseal antibodies and antitissue transglutaminase antibodies were positive in all ten children. Rickets is not an uncommon presentation of celiac disease in Saudi children and pediatricians should consider celiac disease as an underlying cause for rickets.

  16. Rickets in Rural Kenyan Preschool Children: Case Report | Bwibo ...

    African Journals Online (AJOL)

    Clinical rickets has not been reported previously in Embu district, Kenya. Baseline clinical assessments performed for a nutrition intervention study in preschool children (n=324) identified 28 cases of rickets (8.6% of study sample). Clinical characteristics included: delays of sitting, walking, and teething; bone and chest ...

  17. Rickets in black children beyond infancy in Natal | Bhimma | South ...

    African Journals Online (AJOL)

    Objective: To determine the clinical spectrum of rickets among black children admitted to King Edward VIII Hospital, Durban. Design: Prospective study of black children with rickets beyond infancy. Setting: Hospital-based population; King Edward VIII Hospital, Durban. Participants: A total of 37 patients, aged 1 - 12 years, ...

  18. Vitamin D deficiency in Swiss elite wheelchair athletes.

    Science.gov (United States)

    Flueck, J L; Hartmann, K; Strupler, M; Perret, C

    2016-11-01

    This is a retrospective analysis of total serum 25-hydroxyvitamin D (25[OH]D) in Swiss elite wheelchair athletes. The aim was to investigate the occurrence of vitamin D deficiency in Swiss elite wheelchair athletes over the whole year and to detect differences between winter and summer months, and between indoor and outdoor athletes. This study was conducted in Switzerland. A total of 164 blood samples from 72 Swiss elite wheelchair athletes (mean±s.d.: age 32±13 years) were analyzed for total serum 25[OH]D. All participants were members of the national team in their discipline. The following disciplines have been included: rugby, athletics, cycling, tennis, ski alpine, curling and basketball. According to general guidelines, insufficient vitamin D status was defined between 50 and 75 nmol l-1, deficiency below 50 nmol l-1 and severe deficiency below 27.5 nmol l-1. In all, 73.2% of all samples showed an insufficiency/deficiency in vitamin D status. Total serum 25[OH]D was significantly higher during summer compared with winter months (69.5±21.4 nmol l-1 vs 51.5±21.9 nmol l-1; Pwheelchair athletes. Conclusively, we recommend supplementation with vitamin D-especially during winter-to prevent a deficiency and an impairment of performance.

  19. Coronary artery disease and its association with Vitamin D deficiency

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    Ramesh Aggarwal

    2016-01-01

    Full Text Available Coronary artery disease (CAD has become the latest scourge of humankind and referred to in this article as CAD, is the end result of the accumulation of atheromatous plaques within the walls of coronary arteries that supply the myocardium, a process also known as atherosclerosis and manifests mostly in the form of chronic stable angina or acute coronary syndrome. Vitamin D has attracted considerable interest recently due to its role in a number of extraskeletal disease processes including multiple sclerosis, malignancies, diabetes mellitus, and CAD. It is also known as sunshine vitamin due to its production in the body following exposure to ultraviolet rays, and it is a unique vitamin as it acts like a hormone with its receptor present in a wide range of tissues including endothelium, which is the important mediator of atherosclerosis and subsequent CAD. A large number of studies conducted in the past have provided the basic scientific framework and this article attempts to explore the role of Vitamin D deficiency in the pathogenesis of CAD and stresses the need for further research to fill up gap in our knowledge.

  20. Vitamin D deficiency is unrelated to type of atrial fibrillation and its complications

    DEFF Research Database (Denmark)

    Qayyum, Faiza; Landex, Nadia Lander; Agner, Bue Ross

    2012-01-01

    Vitamin D plays an important role in a broad range of organ functions, including the cardiovascular system. Only one study has tested the association between vitamin D deficiency and arrhythmia and it found no association. The aim of the present study was to evaluate the association between vitamin...... D deficiency and the type of atrial fibrillation (AF) and complications to AF....

  1. Vitamin D deficiency reduces the benefits of progesterone treatment after brain injury in aged rats.

    Science.gov (United States)

    Cekic, Milos; Cutler, Sarah M; VanLandingham, Jacob W; Stein, Donald G

    2011-05-01

    Administration of the neurosteroid progesterone (PROG) has been shown to be beneficial in a number of brain injury models and in two recent clinical trials. Given widespread vitamin D deficiency and increasing traumatic brain injuries (TBIs) in the elderly, we investigated the interaction of vitamin D deficiency and PROG with cortical contusion injury in aged rats. Vitamin D deficient (VitD-deficient) animals showed elevated inflammatory proteins (TNFα, IL-1β, IL-6, NFκB p65) in the brain even without injury. VitD-deficient rats with TBI, whether given PROG or vehicle, showed increased inflammation and greater open-field behavioral deficits compared to VitD-normal animals. Although PROG was beneficial in injured VitD-normal animals, in VitD-deficient subjects neurosteroid treatment conferred no improvement over vehicle. A supplemental dose of 1,25-dihydroxyvitamin D(3) (VDH) given with the first PROG treatment dramatically improved results in VitD-deficient rats, but treatment with VDH alone did not. Our results suggest that VitD-deficiency can increase baseline brain inflammation, exacerbate the effects of TBI, and attenuate the benefits of PROG treatment; these effects may be reversed if the deficiency is corrected. Copyright © 2009 Elsevier Inc. All rights reserved.

  2. The role of vitamin D deficiency in cardiovascular disease: where do we stand in 2013?

    NARCIS (Netherlands)

    Pilz, S.; Gaksch, M.; O'Hartaigh, B.; Tomaschitz, A.; Marz, W.

    2013-01-01

    The high worldwide prevalence of vitamin D deficiency is largely the result of low sunlight exposure with subsequently limited cutaneous vitamin D production. Classic manifestations of vitamin D deficiency are linked to disturbances in bone and mineral metabolism, but the identification of the

  3. Vitamin D deficiency in Crohn's disease: prevalence, risk factors and supplement use in an outpatient setting.

    LENUS (Irish Health Repository)

    Suibhne, Treasa Nic

    2012-03-01

    Vitamin D deficiency impacts on bone health and has potential new roles in inflammation. We aimed to determine the prevalence of and risk factors for vitamin D deficiency and to explore vitamin D supplement usage in patients with Crohn\\'s disease (CD) in an outpatient setting, compared with controls.

  4. Periodontal diseases in patients with vitamin D-resistant rickets.

    Science.gov (United States)

    Japaridze, N V; Margvelashvili, V V; Shengelia, M I; Chigladze, T T; Kalandadze, M N

    2015-02-01

    To define the risk of development of periodontal diseases at vitamin D-resistant rickets. The material for the study was based on the data from 13 children of 0-18 years with vitamin D-resistant rickets (I group), 68 children with vitamin D-dependent rickets (II group), and the control group included 61 children of the same ages. The patients were divided into 3 age groups: I group of 0-5 years (deciduous/milk teeth occlusion), II group of 6-12 of years (mixed bite), III group of 13-18 years (permanent occlusion). For the qualitative data the differences between the groups were detected by using F criteria but for the quantitative data the differences between the groups were detected by Student's t test for independent selection. Mathematical processing was performed using statistical software SPSS-22. In all three groups the gingivitis of mild and moderate forms were fixed, among them acute course was revealed only in the group of vitamin D-resistant rickets. The rate of chronic, local, catarrhal and generalized gingivitis in the group of vitamin D-resistant rickets was reliably higher in comparison with both vitamin D-dependant rickets and control groups. In addition, a mild form of periodontitis with chronic course was revealed in all three groups the rate of which was reliably higher in the group of vitamin D-resistant rickets comparing with the ones of vitamin D-dependant rickets and control groups. the rate of inflammatory periodontal diseases in children with vitamin D-resistant rickets is higher than in children with vitamin D-dependent rickets and the control groups.

  5. Global Consensus Recommendations on Prevention and Management of Nutritional Rickets.

    Science.gov (United States)

    Munns, Craig F; Shaw, Nick; Kiely, Mairead; Specker, Bonny L; Thacher, Tom D; Ozono, Keiichi; Michigami, Toshimi; Tiosano, Dov; Mughal, M Zulf; Mäkitie, Outi; Ramos-Abad, Lorna; Ward, Leanne; DiMeglio, Linda A; Atapattu, Navoda; Cassinelli, Hamilton; Braegger, Christian; Pettifor, John M; Seth, Anju; Idris, Hafsatu Wasagu; Bhatia, Vijayalakshmi; Fu, Junfen; Goldberg, Gail; Sävendahl, Lars; Khadgawat, Rajesh; Pludowski, Pawel; Maddock, Jane; Hyppönen, Elina; Oduwole, Abiola; Frew, Emma; Aguiar, Magda; Tulchinsky, Ted; Butler, Gary; Högler, Wolfgang

    2016-02-01

    Vitamin D and calcium deficiencies are common worldwide, causing nutritional rickets and osteomalacia, which have a major impact on health, growth, and development of infants, children, and adolescents; the consequences can be lethal or can last into adulthood. The goals of this evidence-based consensus document are to provide health care professionals with guidance for prevention, diagnosis, and management of nutritional rickets and to provide policy makers with a framework to work toward its eradication. A systematic literature search examining the definition, diagnosis, treatment, and prevention of nutritional rickets in children was conducted. Evidence-based recommendations were developed using the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) system that describe the strength of the recommendation and the quality of supporting evidence. Thirty-three nominated experts in pediatric endocrinology, pediatrics, nutrition, epidemiology, public health, and health economics evaluated the evidence on specific questions within five working groups. The consensus group, representing 11 international scientific organizations, participated in a multiday conference in May 2014 to reach a global evidence-based consensus. This consensus document defines nutritional rickets and its diagnostic criteria and describes the clinical management of rickets and osteomalacia. Risk factors, particularly in mothers and infants, are ranked, and specific prevention recommendations including food fortification and supplementation are offered for both the clinical and public health contexts. Rickets, osteomalacia, and vitamin D and calcium deficiencies are preventable global public health problems in infants, children, and adolescents. Implementation of international rickets prevention programs, including supplementation and food fortification, is urgently required.

  6. Implications of vitamin D deficiency in lithiasic patient and in general population.

    Science.gov (United States)

    Millán-Rodríguez, F; Gavrilov, P; Gracia-García, S; Angerri-Feu, O; Sánchez-Martín, F M; Villavicencio-Mavrich, H

    2015-05-01

    Vitamin D deficiency causes problems in mineral metabolism but also overall health. In first place a review of the topic was carried out. Then, in order to contextualize it in lithiasic patient, a study on Vitamin D deficiency and its possible relationship with impaired PTH levels is performed. A review of topics such as metabolism, epidemiology and the relationship of vitamin D deficiency with several pathologies was performed. Besides a multivariate analysis and a correlation study between vitamin D and PTH levels was conducted in 100 lithiasic patients. We present a review of Vitamin D metabolism, receptors and functions, as well as about its valuation methodology and the treatment of its deficiency. Lithiasic patients show a higher vitamin D deficiency than general population. Vitamin D deficiency has been significantly associated with increased PTH levels. In addition, there is enough literature showing a relationship between vitamin D deficiency not only with bone disease, but also with multiple diseases. vitamin D levels should be measured in all lithiasic patients, and those with vitamin D deficiency should be treated. Copyright © 2014 AEU. Publicado por Elsevier España, S.L.U. All rights reserved.

  7. Vitamin D deficiency in inflammatory bowel disease: prevalence and predictors in a Norwegian outpatient population.

    Science.gov (United States)

    Frigstad, Svein Oskar; Høivik, Marte; Jahnsen, Jørgen; Dahl, Sandra Rinne; Cvancarova, Milada; Grimstad, Tore; Berset, Ingrid Prytz; Huppertz-Hauss, Gert; Hovde, Øistein; Torp, Roald; Bernklev, Tomm; Moum, Bjørn; Jelsness-Jørgensen, Lars-Petter

    2017-01-01

    Vitamin D deficiency is common in inflammatory bowel disease (IBD). The aims of the present study were to determine the prevalence of vitamin D deficiency and to identify clinical and epidemiological variables associated with vitamin D deficiency in an outpatient population with IBD. Participants were recruited from nine hospitals in the southeastern and western regions of Norway as part of an observational, multicentre study from March 2013 to April 2014. Clinical and epidemiological data were collected by interview and from medical records. All analyses of serum 25-hydroxyvitamin D (25-OH-D) were performed in the same laboratory. In total, 49% (200/408) of the patients had a 25-OH-D concentration D deficiency. No such association was observed with the Simple Clinical Colitis Activity Index (SCCAI) scores in UC, but in UC patients, vitamin D deficiency was associated with elevated faecal calprotectin >100 mg/kg. In patients with CD, there were significantly more relapses during the previous year in patients with vitamin D deficiency. Vitamin D deficiency was common, especially in CD, and was associated with increased disease activity, a relapsing disease course and higher inflammatory activity.

  8. Prevalence of vitamin D deficiency in international adoptees within the first 6 months after adoption.

    Science.gov (United States)

    Gustafson, Kimara L; Eckerle, Judith K; Howard, Cynthia R; Andrews, Beth; Polgreen, Lynda E

    2013-12-01

    Vitamin D deficiency impairs bone health and development. To determine the prevalence of and risk factors for vitamin D deficiency in pediatric international adoptees. A prospective cohort (N = 189) study from a single international adoption clinic was conducted. Total 25-hydroxy vitamin D [25(OH)D] level was measured at the initial clinical assessment (within 6 months of adoption). Vitamin D deficiency was defined as a 25(OH)D international adoptees. The significance of vitamin D insufficiency on bone development during the typical "catch-up" growth following international adoption needs to be determined.

  9. Follow-up study of Gambian children with rickets-like bone deformities and elevated plasma FGF23: Possible aetiological factors☆☆☆

    Science.gov (United States)

    Braithwaite, Vickie; Jarjou, Landing M.A.; Goldberg, Gail R.; Jones, Helen; Pettifor, John M.; Prentice, Ann

    2012-01-01

    We have previously reported on a case-series of children (n = 46) with suspected calcium-deficiency rickets who presented in The Gambia with rickets-like bone deformities. Biochemical analyses discounted vitamin D-deficiency as an aetiological factor but indicated a perturbation of Ca–P metabolism involving low plasma phosphate and high circulating fibroblast growth factor-23 (FGF23) concentrations. A follow-up study was conducted 5 years after presentation to investigate possible associated factors and characterise recovery. 35 children were investigated at follow-up (RFU). Clinical assessment of bone deformities, overnight fasted 2 h urine and blood samples, 2-day weighed dietary records and 24 h urine collections were obtained. Age- and season-matched data from children from the local community (LC) were used to calculate standard deviation scores (SDS) for RFU children. None of the RFU children had radiological signs of active rickets. However, over half had residual leg deformities consistent with rickets. Dietary Ca intake (SDS-Ca = − 0.52 (0.98) p = 0.04), dietary Ca/P ratio (SDS-Ca/P = − 0.80 (0.82) p = 0.0008) and TmP:GFR (SDS-TmP:GFR = − 0.48 (0.81) p = 0.04) were significantly lower in RFU children compared with LC children and circulating FGF23 concentration was elevated in 19% of RFU children. Furthermore an inverse relationship was seen between haemoglobin and FGF23 (R2 = 25.8, p = 0.004). This study has shown differences in biochemical and dietary profiles between Gambian children with a history of rickets-like bone deformities and children from the local community. This study provided evidence in support of the calcium deficiency hypothesis leading to urinary phosphate wasting and rickets and identified glomerular filtration rate and iron status as possible modulators of FGF23 metabolic pathways. PMID:22023931

  10. Does taurine deficiency cause metabolic bone disease and rickets in polar bear cubs raised in captivity?

    Science.gov (United States)

    Chesney, Russell W; Hedberg, Gail E; Rogers, Quinton R; Dierenfeld, Ellen S; Hollis, Bruce E; Derocher, Andrew; Andersen, Magnus

    2009-01-01

    Rickets and fractures have been reported in captive polar bears. Taurine (TAU) is key for the conjugation of ursodeoxycholic acid (UDCA), a bile acid unique to bears. Since TAU-conjugated UDCA optimizes fat and fat-soluble vitamin absorption, we asked if TAU deficiency could cause vitamin D malabsorption and lead to metabolic bone disease in captive polar bears. We measured TAU levels in plasma (P) and whole blood (WB) from captive and free-ranging cubs and adults, and vitamin D3 and TAU concentrations in milk samples from lactating sows. Plasma and WB TAU levels were significantly higher in cubs vs captive and free-ranging adult bears. Vitamin D in polar bear milk was 649.2 +/- 569.2 IU/L, similar to that found in formula. The amount of TAU in polar bear milk is 3166.4 +/- 771 nmol/ml, 26-fold higher than in formula. Levels of vitamin D in bear milk and formula as well as in plasma do not indicate classical nutritional vitamin D deficiency. Higher dietary intake of TAU by free-ranging cubs may influence bile acid conjugation and improve vitamin D absorption.

  11. Vitamin D deficiency: a new risk factor for type 2 diabetes?

    National Research Council Canada - National Science Library

    Mezza, T; Muscogiuri, G; Sorice, G P; Prioletta, A; Salomone, E; Pontecorvi, A; Giaccari, A

    2012-01-01

    Recent compelling evidence suggests a role of vitamin D deficiency in the pathogenesis of insulin resistance and insulin secretion derangements, with a consequent possible interference with type 2 diabetes mellitus...

  12. Differential Diagnosis of Primary and Secondary Hyperparathyroidism Caused by Vitamin D Deficiency

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    S.M. Cherenko

    2015-08-01

    Conclusions. Short ergocalciferol treatment can be a valuable and reliable clinical method to differentiate isolated vitamin D deficiency and asymptomatic primary hyperparathyroidism combined with a lack of vitamin D.

  13. A severe H7N9 pneumonia with syndrome of inappropriate antidiuresis and vitamin D deficiency

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    Leng Lin

    2014-01-01

    Conclusions: Some H7N9 pneumonia could cause SIAD. Early detection and appropriate treatment of SIAD in H7N9 pneumonia might be important. Our patient showed vitamin D deficiency and decline of cellular immune function.

  14. The association of vitamin D deficiency and glucose control among diabetic patients

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    Mansour S Almetwazi

    2017-12-01

    Conclusion: Vitamin D deficiency is very common in patients with diabetes. We found no significant association between vitamin D level and glycemic control in patients with diabetes after adjustment for control variables.

  15. Global consensus recommendations on prevention and management of nutritional rickets

    OpenAIRE

    Craig F Munns; Shaw, Nick (translator); Kiely, Mairead; Specker, Bonny L.; Thacher, Tom D.; Ozono, Keiichi; Michigami, Toshimi; Tiosano, Dov; Mughal, M. Zulf; Mäkitie, Outi; Ramos-Abad, Lorna; Ward, Leanne; DiMeglio, Linda A.; Atapattu, Navoda; Cassinelli, Hamilton

    2016-01-01

    Background: Vitamin D and calcium deficiencies are common worldwide, causing nutritional rickets and osteomalacia, which have a major impact on health, growth, and development of infants, children, and adolescents; the consequences can be lethal or can last into adulthood. The goals of this evidence-based consensus document are to provide health care professionals with guidance for prevention, diagnosis, and management of nutritional rickets and to provide policy makers with a framework to wo...

  16. Vitamin D deficiency and recurrent lower respiratory tract infections: a case based discussion

    Directory of Open Access Journals (Sweden)

    Cenk Aypak

    2014-09-01

    Full Text Available Lower respiratory tract infections (LRTI are among the most prevalent infectious diseases.Vitamin D deficiency has been found to be a risk factor for LRTI. We here report a case with the diagnosis of recurrent LRTI treated safely by empirical antibiotherapy and vitamin D supplementation in order to underline the importance of assessment and treatment of vitamin D deficiency in pediatric patients with the diagnosis of LRTI.

  17. Vitamin D deficiency is significantly associated with depression in patients with chronic kidney disease.

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    Jong Hyun Jhee

    Full Text Available Depression is reported to be the most common psychological problem in patients with chronic kidney disease (CKD. Several studies have reported that lower levels of serum vitamin D are significantly associated with depression. Both vitamin D deficiency and depression are prevalent in patients with CKD, yet the relationship between these two factors remains poorly understood. This study aimed to investigate the association between vitamin D levels and depression among CKD patients.Totally, 21,257 individuals who participated in the Korean National Health and Nutrition Examination Survey (KNHANES V, VI from 2010-2014 were screened for the study; 533 CKD patients were included. Vitamin D deficiency was defined as serum 25-hydroxyvitamin D3 [25(OHD3] ≤10 ng/mL. Patients were divided into vitamin D deficient or sufficient groups. Depression was screened for using the Korean version of the WHO Composite International Diagnostic Interview-Short Form. The association between vitamin D deficiency and depression was evaluated by multivariate logistic regression analysis.The mean participant age was 70.1±9.4 years; 262 patients (49.2% were male. The median 25(OHD3 level was 19.1±6.9 ng/mL. The prevalence of depression was higher in CKD patients than in the general population (14.3 vs. 11.1%, P = 0.03. Additionally, the prevalence of depression was significantly higher in CKD patients with (vs. without vitamin D deficiency (32.5% vs. 50.0%, P<0.001. Multivariate logistic regression analysis showed that vitamin D deficiency was a significant independent predictor of depression after adjusting for confounding factors (adjusted odds ratio, 6.15; 95% confidence interval, 2.02-8.75; P = 0.001.Depression was highly prevalent in CKD patients, in whom vitamin D deficiency was a significant independent predictor of depression. Therefore, management of vitamin D deficiency might help prevent depression in CKD patients.

  18. Vitamin D Deficiency and Oxidative Stress in Type 2 Diabetic Population of India.

    Science.gov (United States)

    Dhas, Yogita; Mishra, Neetu; Banerjee, Joyita

    2017-01-01

    Vitamin D deficiency is common in metropolitan cities of India and worldwide due to faulty life style. The prevalence of vitamin D deficiency has tremendously increased in India despite the fact that it is located between 8.4° and 37.6° north latitude and majority of the Indian population exposed to ample sunlight throughout the year. From published data regarding vitamin D deficiency in India estimated prevalence of vitamin D deficiency is 70%-100% in the adult population. The main identified reason for vitamin D deficiency is the lack of appropriate sunlight exposure and no consumption (in case of vegetarian population) or less consumption of vitamin D containing diet (e.g. fish, cod liver oil, beef liver and eggs). Mild to moderate vitamin D deficiency is identified as a risk factor for type 2 diabetes, due to its protective role against development of type 2 diabetes mellitus and its complications. Vitamin D may affect glucose homeostasis through increasing insulin resistance and reducing insulin secretion from beta cells of the pancreas. Vitamin D plays an important role against oxidative stress, because of its antioxidant property. Till date very few studies determined the link between vitamin D and oxidative stress in type 2 diabetes mellitus and its complications. However, more studies are needed to evaluate an underlying mechanism of vitamin D in amelioration of the oxidative stress in type 2 diabetes mellitus. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.

  19. Vitamin D deficiency and airflow limitation in the Baltimore Longitudinal Study of Ageing.

    Science.gov (United States)

    Moberg, Mia; Elango, Palchamy; Ferrucci, Luigi; Spruit, Martijn A; Wouters, Emiel F; Rutten, Erica P A

    2015-09-01

    Vitamin D deficiency is common in patients with chronic obstructive pulmonary disease (COPD) and has also been linked to comorbidities often present in COPD. The aim of this study was to investigate whether vitamin D deficiency was related specifically to airflow limitation or whether vitamin D deficiency was determined by conditions that frequently coexist with COPD: insulin resistance, hypertension, anaemia, obesity and hypercholesterolaemia. For this cross-sectional analysis, we included 897 subjects from the Baltimore Longitudinal Study of Aging. Subjects taking vitamin D supplements were excluded. Airflow limitation was defined as FEV1 /FVC 30 kg/m(2)) (OR: 1.9, P < 0.002) were significantly associated with vitamin D deficiency in the adjusted multivariate regression analysis. Physical activity was associated with a decreased risk of vitamin D deficiency. Airflow limitation was not an independent determinant of vitamin D deficiency. The effect of weight loss and increased physical activity on vitamin D levels should be investigated further in intervention studies. © 2015 Stichting European Society for Clinical Investigation Journal Foundation.

  20. Transient prenatal Vitamin D deficiency is associated with hyperlocomotion in adult rats.

    Science.gov (United States)

    Burne, Thomas H J; Becker, Axel; Brown, Jillanne; Eyles, Darryl W; Mackay-Sim, Alan; McGrath, John J

    2004-10-05

    Rat experiments have shown that prenatal Vitamin D deficiency leads to altered neonatal brain morphology, cell density and neurotrophin expression. In the current study we examined the hypothesis that Vitamin D deficiency during early development alters adult behaviour even when there is an intervening period in which the animal receives normal Vitamin D in later development. Rats were conceived and born to Vitamin D deficient dams (Birth); conceived, born and weaned from Vitamin D deficient dams (Weaning); or deficient in Vitamin D from conception to 10 weeks of age (Life). Litters were standardized to three males and three females per litter. All rat offspring were rendered normocalcaemic with calcium supplemented water (2 mM) after weaning. Control animals were born to mothers fed a normal diet but subject to similar litter size and calcium supplementation. At 10 weeks all animals were tested on the holeboard test, elevated plus maze test, social interaction observation, acoustic startle response test, prepulse inhibition of the acoustic startle response and a forced swim test. Early Vitamin D deficiency (Birth group) enhanced locomotion in the holeboard test and increased activity in the elevated plus maze. Thus, transient prenatal Vitamin D deficiency induces hyperlocomotion in adulthood, without severe motor abnormalities.

  1. Vitamin D deficiency and psychotic features in mentally ill adolescents: A cross-sectional study

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    Gracious Barbara L

    2012-05-01

    Full Text Available Abstract Background Vitamin D deficiency is a re-emerging epidemic, especially in minority populations. Vitamin D is crucial not only for bone health but for proper brain development and functioning. Low levels of vitamin D are associated with depression, seasonal affective disorder, and schizophrenia in adults, but little is known about vitamin D and mental health in the pediatric population. Methods One hundred four adolescents presenting for acute mental health treatment over a 16-month period were assessed for vitamin D status and the relationship of 25-OH vitamin D levels to severity of illness, defined by presence of psychotic features. Results Vitamin D deficiency (25-OH D levels Conclusions Vitamin D deficiency and insufficiency are both highly prevalent in adolescents with severe mental illness. The preliminary associations between vitamin D deficiency and presence of psychotic features warrant further investigation as to whether vitamin D deficiency is a mediator of illness severity, result of illness severity, or both. Higher prevalence of vitamin D deficiency but no greater risk of psychosis in African Americans, if confirmed, may have special implications for health disparity and treatment outcome research.

  2. An Unusual Case of Hypercalcemia Associated with Graves’ Disease and Vitamin D Deficiency

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    Evgenia Korytnaya

    2011-01-01

    Full Text Available Objective To present a case of hypercalcemia associated with thyrotoxicosis in a patient with vitamin D deficiency and review biochemical changes during the course of treatment. Methods We report a case, describe the changes in serum calcium, phosphorus, parathyroid hormone in Graves’ disease and concomitant Vitamin D deficiency. We compare our findings to those reported in literature. Results Our patient had hypercalcemia secondary to thyrotoxicosis alone, which was confirmed by low parathyroid hormone level and resolution of hypercalcemia with treatment of thyrotoxicosis. The case was complicated by a concomitant vitamin D deficiency. Serum calcium elevation in patients with thyrotoxicosis occurs secondary to hyperthyroidism alone or due to concurrent hyperparathyroidism. Hypercalcemia from thyrotoxicosis is usually asymptomatic and is related to bone resorption. Vitamin D deficiency can be seen in patients with thyrotoxicosis because of accelerated metabolism, poor intestinal absorption and increased demand during bone restoration phase. Coexistence of hypercalcemia and Vitamin D deficiency in patients with thyrotoxicosis is rare, but possible, and 25-hydroxyvitamin D levels should be checked. The definite treatment for hypercalcemia in thyrotoxicosis is correction of thyroid function. Conclusion Hypercalcemia in thyrotoxicosis should be distinguished from concomitant hyperparathyroidism and confirmed by resolution of hypercalcemia with control of thyrotoxicosis. Patients with hypercalcemia and thyrotoxicosis may also have vitamin D deficiency and 25-OH Vitamin D levels should be checked.

  3. Relationship Between Vitamin D Deficiency and Markers of Metabolic Syndrome Among Overweight and Obese Adults.

    Science.gov (United States)

    Kaseb, Fatemeh; Haghighyfard, Kimia; Salami, Maryam-Sadat; Ghadiri-Anari, Akram

    2017-06-01

    In recent years, metabolic syndrome, obesity, diabetes and cardiovascular disease has had a tremendous elevation growth. Many studies have demonstrated negative correlation between vitamin D deficiency and indexes of metabolic syndrome in obese patients. This study was designed to find the relation between vitamin D deficiency and markers of metabolic syndrome among overweight and obese adults referred to obesity center of Shahid Sadoughi hospital in 2014. Eighty-nine overweight and obese adults (79 women and 10 men), who 13 subjects were overweight and 76 subjects were obese were recruited in this cross-sectional study. Total cholesterol, high-density lipoprotein cholesterol, triglyceride, plasma glucose and vitamin D were measured. IDF criteria were used for identifying subjects with metabolic syndrome. Demographic questionnaire was completed. Statistical analysis was performed using SPSS version 16.0. Fisher exact test, logistic regression, and Spearman correlation coefficient were used. The frequency of vitamin D deficiency was 93.2%. According to IDF criteria, the frequency of metabolic syndrome was 36%. There was no significant relationship between vitamin D deficiency and metabolic syndrome. Among metabolic syndrome indicators, there was a significant direct relationship between vitamin D level with FBS (P=0.013) and SBP (P=0.023). There was no significant relationship between vitamin D deficiency and metabolic syndrome. Due to the lack of relationship between vitamin D deficiency and metabolic syndrome, small number of participants in this study and very low case of normal vitamin D level, further studies are needed.

  4. [Relationship between vitamin D deficiency and metabolic syndrome in adult population of the Community of Madrid].

    Science.gov (United States)

    Gradillas-García, Antonio; Álvarez, Julia; Rubio, José Antonio; de Abajo, Francisco J

    2015-04-01

    Previous studies have suggested an association between MS and vitamin D deficiency, but data are not conclusive. This study was intended to find out if metabolic syndrome, according to the 2009 IDF/AHA/NHLBI, is associated to the presence of vitamin D deficiency. A cross-sectional study was conducted on a sample of 326 subjects aged 18 years or older, recruited from a health center in Alcalá de Henares. Participants underwent an interview and a standardized clinical examination. In a second visit, blood tests were performed in 255 subjects to quantify serum levels of 25-hydroxyvitamin D (25 OH-VitD) and different laboratory parameters associated to MS. The association between vitamin D deficiency and metabolic syndrome (and each of its components) was examined. In the study population, MS prevalence was 36.1% and prevalence of vitamin D deficiency (25 OH-Vit D<20 ng/mL) was 56.3%. MS was more common in the group of patients with vitamin D deficiency (43.4%) than in the group with no deficiency (26.8%, P=.006), with an estimated prevalence ratio of 1.62 (95% CI: 1.13-2.31). Adjustment for age, sex, and body mass index did not change such association. There is a significant association between vitamin D deficiency and MS. Both conditions are highly prevalent in our population. Copyright © 2014 SEEN. Published by Elsevier España, S.L.U. All rights reserved.

  5. Vitamin d deficiency in a multiethnic healthy control cohort and altered immune response in vitamin D deficient European-American healthy controls.

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    Lauren L Ritterhouse

    Full Text Available In recent years, vitamin D has been shown to possess a wide range of immunomodulatory effects. Although there is extensive amount of research on vitamin D, we lack a comprehensive understanding of the prevalence of vitamin D deficiency or the mechanism by which vitamin D regulates the human immune system. This study examined the prevalence and correlates of vitamin D deficiency and the relationship between vitamin D and the immune system in healthy individuals.Healthy individuals (n = 774 comprised of European-Americans (EA, n = 470, African-Americans (AA, n = 125, and Native Americans (NA, n = 179 were screened for 25-hydroxyvitamin D [25(OHD] levels by ELISA. To identify the most noticeable effects of vitamin D on the immune system, 20 EA individuals with severely deficient (24.8 ng/mL vitamin D levels were matched and selected for further analysis. Serum cytokine level measurement, immune cell phenotyping, and phosphoflow cytometry were performed.Vitamin D sufficiency was observed in 37.5% of the study cohort. By multivariate analysis, AA, NA, and females with a high body mass index (BMI, >30 demonstrate higher rates of vitamin D deficiency (p<0.05. Individuals with vitamin D deficiency had significantly higher levels of serum GM-CSF (p = 0.04, decreased circulating activated CD4+ (p = 0.04 and CD8+ T (p = 0.04 cell frequencies than individuals with sufficient vitamin D levels.A large portion of healthy individuals have vitamin D deficiency. These individuals have altered T and B cell responses, indicating that the absence of sufficient vitamin D levels could result in undesirable cellular and molecular alterations ultimately contributing to immune dysregulation.

  6. Serum 25-hydroxyvitamin d deficiency in ischemic stroke and subtypes in Indian patients.

    Science.gov (United States)

    Chaudhuri, Jaydip Ray; Mridula, K Rukmini; Alladi, Suvarna; Anamika, A; Umamahesh, M; Balaraju, Banda; Swath, A; Bandaru, Vcs Srinivasarao

    2014-01-01

    Vitamin D deficiency is common across all age groups and may contribute to cardiovascular diseases. Serum 25-hydroxyvitamin D deficiency causing ischemic stroke has been documented in recent reports. To investigate the association of serum 25-hydroxyvitamin D deficiency with ischemic stroke and subtypes. We recruited 250 consecutive ischemic stroke patients and 250 age and sex matched controls attending the Department of Neurology, at Yashoda hospital, Hyderabad, India, from January 2011 to December 2012. All ischemic stroke patients underwent stroke subtyping. We measured 25-hydroxyvitamin D by chemiluminescence test, serum calcium, phosphorus, alkaline phosphatase, and C-reactive protein (CRP) in cases and controls. Out of 250 stroke patients, 190 (76%) were men and mean age was 58.4±11.1 years (age range-26-89 years). 25-hydroxyvitamin D deficiency was observed in 122 (48.8%) stroke patients and 79 (31.6%) controls (P=0.001). Among stroke patients, serum 25-hydroxyvitamin D deficiency was found in 54.9% (50/91) of patients with large artery atherosclerosis, 54% (20/37) in cardioembolic stroke, 44.4% (20/45) in small artery diseases, 42.8% (15/35) in stroke of other determined etiology and 40.4% (17/42) in stroke of un-determined etiology. Multiple logistic regression analysis showed an independent association of 25-hydroxyvitamin D deficiency with ischemic stroke (odds ratio: 1.6; 95% CI 1.2-2.8). The association was strongest with large artery atherosclerosis (odds ratio: 2.4; 95% CI 1.6-3.5) and cardioembolic stroke (odds ratio: 2.0; 95% CI 1.0-3.2). We found that 25-hydroxyvitamin D deficiency had an independent association with ischemic stroke. The association was established in large artery arthrosclerosis and cardioembolic stroke.

  7. Vitamin D deficiency and anemia risk in children: a review of emerging evidence

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    Uwaezuoke SN

    2017-05-01

    Full Text Available Samuel N Uwaezuoke1,2 1Department of Paediatrics, College of Medicine, University of Nigeria, Nsukka, 2Department of Paediatrics, University of Nigeria Teaching Hospital, Ituku-Ozalla, Nigeria Abstract: There has been renewed scientific interest in the sequelae of vitamin D deficiency, given the emerging evidence on the diverse biologic functions of vitamin D, besides its fundamental role in bone and mineral metabolism. For the past decade, the evidence in the medical literature pointing to a relationship between anemia risk and vitamin D deficiency has been accumulating. This paper critically reviews the current evidence linking vitamin D deficiency to anemia risk in children. The synthesized evidence indicates that the studies, which were preponderantly conducted among the adult population, not only reported a bidirectional relationship between vitamin D deficiency and anemia but also showed a racial effect. In studies conducted among children, similar results were reported. Although the causal association of vitamin D deficiency with anemia risk (especially iron-deficiency anemia remains debatable, the noncalcemic actions of the vitamin and its analogs hold prospects for several novel clinical applications. There is, however, unanimity in many reports suggesting that vitamin D deficiency is directly associated with anemia of chronic disease or inflammation. Despite the advances in unraveling the role of vitamin D in iron homeostasis, further research is still required to validate causality in the relationship between vitamin D deficiency and anemia, as well as to determine its optimal dosing, the ideal recipients for therapeutic intervention, and the preferred analogs to administer. Keywords: calcitriol deficiency, childhood anemia, iron homeostasis, causal link

  8. Global Consensus Recommendations on Prevention and Management of Nutritional Rickets

    Science.gov (United States)

    Munns, Craig F.; Shaw, Nick; Kiely, Mairead; Specker, Bonny L.; Thacher, Tom D.; Ozono, Keiichi; Michigami, Toshimi; Tiosano, Dov; Mughal, M. Zulf; Mäkitie, Outi; Ramos-Abad, Lorna; Ward, Leanne; DiMeglio, Linda A.; Atapattu, Navoda; Cassinelli, Hamilton; Braegger, Christian; Pettifor, John M.; Seth, Anju; Idris, Hafsatu Wasagu; Bhatia, Vijayalakshmi; Fu, Junfen; Goldberg, Gail; Sävendahl, Lars; Khadgawat, Rajesh; Pludowski, Pawel; Maddock, Jane; Hyppönen, Elina; Oduwole, Abiola; Frew, Emma; Aguiar, Magda; Tulchinsky, Ted; Butler, Gary

    2016-01-01

    Background: Vitamin D and calcium deficiencies are common worldwide, causing nutritional rickets and osteomalacia, which have a major impact on health, growth, and development of infants, children, and adolescents; the consequences can be lethal or can last into adulthood. The goals of this evidence-based consensus document are to provide health care professionals with guidance for prevention, diagnosis, and management of nutritional rickets and to provide policy makers with a framework to work toward its eradication. Evidence: A systematic literature search examining the definition, diagnosis, treatment, and prevention of nutritional rickets in children was conducted. Evidence-based recommendations were developed using the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) system that describe the strength of the recommendation and the quality of supporting evidence. Process: Thirty-three nominated experts in pediatric endocrinology, pediatrics, nutrition, epidemiology, public health, and health economics evaluated the evidence on specific questions within five working groups. The consensus group, representing 11 international scientific organizations, participated in a multiday conference in May 2014 to reach a global evidence-based consensus. Results: This consensus document defines nutritional rickets and its diagnostic criteria and describes the clinical management of rickets and osteomalacia. Risk factors, particularly in mothers and infants, are ranked, and specific prevention recommendations including food fortification and supplementation are offered for both the clinical and public health contexts. Conclusion: Rickets, osteomalacia, and vitamin D and calcium deficiencies are preventable global public health problems in infants, children, and adolescents. Implementation of international rickets prevention programs, including supplementation and food fortification, is urgently required. PMID:26745253

  9. Prediction of Vitamin D Deficiency Among Tabriz Elderly and Nursing Home Residents Using Stereotype Regression Model

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    Zohreh Razzaghi

    2011-07-01

    Full Text Available Objectives: Vitamin D deficiency is one of the most important health problems of any society. It is more common in elderly even in those dwelling in rest homes. By now, several studies have been conducted on vitamin D deficiency using current statistical models. In this study, corresponding proportional odds and stereotype regression methods were used to identify threatening factors related to vitamin D deficiency in elderly living in rest homes and comparing them with those who live out of the mentioned places. Methods & Materials: In this case-control study, there were 140 older persons living in rest homes and 140 ones not dwelling in these centers. In the present study, 25(OHD serum level variable and age, sex, body mass index, duration of exposure to sunlight variables were regarded as response and predictive variables to vitamin D deficiency, respectively. The analyses were carried out using corresponding proportional odds and stereotype regression methods and estimating parameters of these two models. Deviation statistics (AIC was used to evaluate and compare the mentioned methods. Stata.9.1 software was elected to conduct the analyses. Results: Average serum level of 25(OHD was 16.10±16.65 ng/ml and 39.62±24.78 ng/ml in individuals living in rest homes and those not living there, respectively (P=0.001. Prevalence of vitamin D deficiency (less than 20 ng/ml was observed in 75% of members of the group consisting of those living in rest homes and 23.78% of members of another group. Using corresponding proportional odds and stereotype regression methods, age, sex, body mass index, duration of exposure to sunlight variables and whether they are member of rest home were fitted. In both models, variables of group and duration of exposure to sunlight were regarded as meaningful (P<0.001. Stereotype regression model included group variable (odd ratio for a group suffering from severe vitamin D deficiency was 42.85, 95%CI:9.93-185.67 and

  10. Associations between organochlorine pesticides and vitamin D deficiency in the U.S. population.

    Science.gov (United States)

    Yang, Jin-Hoon; Lee, Yu-Mi; Bae, Sang-Geun; Jacobs, David R; Lee, Duk-Hee

    2012-01-01

    Recently low dose organochlorine (OC) pesticides have been strongly linked to various chronic diseases including diabetes and cardiovascular diseases. Both field and animal studies have suggested a possibility that persistent lipophilic chemicals like OC pesticides can cause vitamin D deficiency, but there have been no human studies of exposure to any chemical as a possible cause of vitamin D deficiency. This study was performed to examine if serum concentrations of OC pesticides were associated with serum concentrations of 25-hydroxyvitamin D (25(OH)D) in the U.S. general population. Cross-sectional associations of serum OC pesticides with serum 25(OH)D were investigated in 1,275 subjects aged ≥20 in the National Health and Nutrition Examination Survey (NHANES), 2003-2004. We selected 7 OC pesticides detectable in ≥80% of participants. Among the 7 OC pesticides, p,p'-DDT (β = -0.022, PDDT showed consistent inverse associations in all subgroups, although stronger associations tended to be observed among subjects with old age, white race, or chronic diseases. The current study suggests that the background exposure to some OC pesticides leads to vitamin D deficiency in human. Considering the importance of vitamin D deficiency in the development of chronic diseases, chemical exposure as a possible cause of vitamin D deficiency should be evaluated in prospective and experimental studies.

  11. Successful public health action to reduce the incidence of symptomatic vitamin D deficiency.

    Science.gov (United States)

    Moy, Robert John; McGee, Eleanor; Debelle, Geoff D; Mather, Ian; Shaw, Nicholas J

    2012-11-01

    In response to a resurgence of symptomatic cases of vitamin D deficiency in a high-risk predominantly ethnic minority population, a programme of universal rather than targeted vitamin D supplementation was begun with a public awareness campaign about the importance of vitamin D. To evaluate the effectiveness of this programme in reducing case numbers. Cases of symptomatic vitamin D deficiency in children under 5 years resident in a primary care trust catchment area presenting at local hospitals were identified through laboratory records of low vitamin D levels which were cross-checked against medical records to confirm the diagnosis. Comparisons were made of the case incidence rate, level of public knowledge and vitamin supplement uptake rate at the onset of the programme in 2005 and 4 years later. The number of cases of symptomatic vitamin D deficiency in those under 5 years fell by 59% (case incidence rate falling from 120/100 000 to 49/100 000) despite the supplement uptake rate rising only to 17%. Public awareness of vitamin D deficiency rose to near universal levels. A programme of universal rather than targeted Healthy Start vitamin D supplementation for pregnant and lactating women and young children has led to a substantial decrease in cases of symptomatic vitamin D deficiency in a high-risk population. Supplementation was also started at a younger age than in the national programme. This approach has implications for the delivery of vitamin D supplementation programmes in similar populations.

  12. Vitamin D deficiency in adults: when to test and how to treat.

    Science.gov (United States)

    Kennel, Kurt A; Drake, Matthew T; Hurley, Daniel L

    2010-08-01

    Recent evidence for the nonskeletal effects of vitamin D, coupled with recognition that vitamin D deficiency is common, has revived interest in this hormone. Vitamin D is produced by skin exposed to ultraviolet B radiation or obtained from dietary sources, including supplements. Persons commonly at risk for vitamin D deficiency include those with inadequate sun exposure, limited oral intake, or impaired intestinal absorption. Vitamin D adequacy is best determined by measurement of the 25-hydroxyvitamin D concentration in the blood. Average daily vitamin D intake in the population at large and current dietary reference intake values are often inadequate to maintain optimal vitamin D levels. Clinicians may recommend supplementation but be unsure how to choose the optimal dose and type of vitamin D and how to use testing to monitor therapy. This review outlines strategies to prevent, diagnose, and treat vitamin D deficiency in adults.

  13. Vitamin D deficiency in adolescents in a tier 4 psychiatric unit.

    Science.gov (United States)

    Stewart, Neil F; Lewis, Simon N

    2017-06-01

    Aims and method To review the current clinical practice and guidelines for testing and treating vitamin D deficiency in adolescents admitted to a tier 4 adolescent psychiatric unit in north London. The blood test results of 56 patients admitted between 2012 and 2014 were examined to determine whether vitamin D levels had been tested. For those individuals who were tested for vitamin D, results were analysed by gender and ethnicity. Results Of 56 patients admitted, 48% were tested for vitamin D deficiency and in 81.5% of cases we uncovered deficiency or severe deficiency; 18.5% had the minimum levels of vitamin D for bone health as per our trust guidelines. Clinical implications Adolescents within tier 4 adolescent mental health services may be at higher risk of vitamin D deficiency and so assessment of vitamin D levels should be considered as part of a standard physical health review for this group of young people.

  14. Vitamin D Deficiency and the Lung: Disease Initiator or Disease Modifier?

    Directory of Open Access Journals (Sweden)

    Graeme R. Zosky

    2013-07-01

    Full Text Available Vitamin D deficiency is a global public health problem and has been associated with an increased incidence and severity of many diseases including diseases of the respiratory system. These associations have largely been demonstrated epidemiologically and have formed the basis of the justification for a large number of clinical supplementation trials with a view to improving disease outcomes. However, the trials that have been completed to date and the ongoing experimental studies that have attempted to demonstrate a mechanistic link between vitamin D deficiency and lung disease have been disappointing. This observation raises many questions regarding whether vitamin D deficiency is truly associated with disease pathogenesis, is only important in the exacerbation of disease or is simply an indirect biomarker of other disease mechanisms? In this review, we will briefly summarize our current understanding of the role of vitamin D in these processes with a focus on lung disease.

  15. An update on the association of vitamin D deficiency with common infectious diseases.

    Science.gov (United States)

    Watkins, Richard R; Lemonovich, Tracy L; Salata, Robert A

    2015-05-01

    Vitamin D plays an important role in modulating the immune response to infections. Deficiency of vitamin D is a common condition, affecting both the general population and patients in health care facilities. Over the last decade, an increasing body of evidence has shown an association between vitamin D deficiency and an increased risk for acquiring several infectious diseases, as well as poorer outcomes in vitamin D deficient patients with infections. This review details recent developments in understanding the role of vitamin D in immunity, the antibacterial actions of vitamin D, the association between vitamin D deficiency and common infections (like sepsis, pneumonia, influenza, methicillin-resistant Staphylococcus aureus, human immunodeficiency virus type-1 (HIV), and hepatitis C virus (HCV)), potential therapeutic implications for vitamin D replacement, and future research directions.

  16. Obesity is associated with Vitamin D deficiency in Danish children and adolescents

    DEFF Research Database (Denmark)

    Plesner, Johanne Lind; Dahl, Maria; Fonvig, Cilius Esmann

    2018-01-01

    Sufficient serum concentrations of vitamin D are required to maintain bone health during growth. The aims of this study were to determine whether vitamin D deficiency is more prevalent among children and adolescents with obesity compared to their normal weight peers and to identify clinical...... and biochemical variables associated with vitamin D deficiency. One thousand four hundred and eighty-four children and adolescents with overweight/obesity and 2143 population-based controls were recruited from the Danish Childhood Obesity Biobank. Anthropometric variables and fasting concentrations of serum 25.......5% of the children and adolescents with obesity (body mass index [BMI] standard deviation score [SDS]>2.33) exhibited vitamin D deficiency, with an odds ratio (OR) 3.41 (confidence interval [CI]: 2.27-5.71; p

  17. [Updates on rickets and osteomalacia: guidelines for diagnosis of rickets and osteomalacia].

    Science.gov (United States)

    Ohata, Yasuhisa; Ozono, Keiichi

    2013-10-01

    Rickets and osteomalacia are disorders of calcification characterized by defects of bone and cartilage mineralization during growth, and bone mineralization in adults, respectively. The specific x-ray findings including a cupping, flaring, and fraying of metaphysis and the elevation of the level of serum alkaline phosphatase are essential for the diagnosis of rickets. In addition, hypophosphatemia, hypocalcemia, and some symptoms including born deformity, spinal curvature, craniotabes, enlargement of the anterior fontanel, rachitic rosary, and joint swelling are also important. Clinicians need to consider the different normal ranges of the levels of serum alkaline phosphatase and phosphate depending on their patient's age when they diagnose their childhood patients. In contrast, the radiographic diagnosis of osteomalacia is difficult. The hypophosphatemia or hypocalcemia and the elevation of serum bone alkaline phosphatase are essential for the diagnosis of osteomalacia. Moreover, some clinical features including muscle weakness and bone pain, the decrease of bone density, and the finding of multiple uptake in bone scintigraphy or of the pseudofracture in bone x-ray study are also important. It is very useful for the differential diagnosis to measure the serum levels of 25-hydroxy vitamin D and fibroblast growth factor 23.

  18. Prevalence of Vitamin D Deficiency in Adult Outpatients With Bipolar Disorder or Schizophrenia.

    Science.gov (United States)

    Boerman, Remco; Cohen, Dan; Schulte, Peter F J; Nugter, Annet

    2016-12-01

    Several studies show an association between schizophrenia and low levels of vitamin D. To date, there are only few studies about the prevalence of vitamin D deficiency in patients with bipolar disorder. We hypothesized that vitamin D deficiency is less common among patients with bipolar disorder than among patients with schizophrenia or schizoaffective disorder. A second hypothesis is that vitamin D deficiency is more prevalent among patients with schizophrenia, schizoaffective disorder, or bipolar disorders than among the general Dutch population.Most studies have been conducted with hospitalized patients; in this study, we only included outpatients. All outpatients of a center for bipolar disorders and all outpatients of 3 flexible assertive community treatment teams were asked to participate in this cross-sectional study. We included 118 patients with bipolar disorder and 202 patients with schizophrenia or schizoaffective disorder. Vitamin D levels were deficient in 30.3% (95% confidence interval, 25.5-35.6) of the cases. The type of psychiatric disorder was not a predictor of vitamin D deficiency. The absolute difference in risk of deficiency between the study population and the Dutch Caucasian population was 23.8% (95% confidence interval, 18.3%-29.3%). In this study, vitamin D deficiency was 4.7 times more common among outpatients with bipolar disorder, schizophrenia, or schizoaffective disorder than among the Dutch general population.Given the high prevalence of vitamin D deficiency, we believe that outpatients with bipolar disorder, schizophrenia, or schizoaffective disorder should be considered at risk of having low levels of vitamin D. Annual measurement of vitamin D levels in psychiatric outpatients with these disorders seems to be justified to maintain bone health, muscle strength, and to prevent osteoporosis.

  19. Subclinical vitamin D deficiency is increased in adolescent girls who wear concealing clothing.

    Science.gov (United States)

    Hatun, Sukru; Islam, Omer; Cizmecioglu, Filiz; Kara, Bulent; Babaoglu, Kadir; Berk, Fatma; Gökalp, Ayse Sevim

    2005-02-01

    Vitamin D deficiency continues to be a worldwide problem, especially in developing countries. The aim of this study was to investigate potential risk factors for vitamin D deficiency. Girls (n = 89) aged 13 to 17 y were enrolled in the study. Study subjects were stratified into 3 groups: Group I included girls living in a suburban area; Group II girls lived in an urban area, and Group III girls lived in an urban area and wore concealing clothes for religious reasons. At the end of winter (in April) serum 25-hydroxyvitamin D [25(OH)D] levels were measured and dietary data were collected using questionnaires. Vitamin D deficiency was defined as a serum 25(OH)D concentration concentration between 25 and 50 nmol/L. The lumbar and femur neck bone mineral densities (BMD) were measured using dual X-ray absorptiometry (DEXA). Overall, 39 girls (43.8%) had vitamin D insufficiency and 19 (21.3%) had vitamin D deficiency. In group III (wearing covered dress) the serum 25(OH)D concentrations (28.13 +/- 12.53 nmol/L) were significantly lower than in the other 2 groups, and within this group, 50% of girls were vitamin D deficient. The lumbar and femur neck BMD of girls with lower 25(OH)D levels did not differ from those with adequate vitamin D levels. We conclude that vitamin D deficiency is an important problem in Turkish adolescent girls, especially in those who follow a religious dress code; therefore, vitamin D supplementation appears to be necessary for adolescent girls.

  20. [High prevalence of vitamin D deficiency among spanish obese children and adolescents].

    Science.gov (United States)

    Gutiérrez-Medina, S; Gavela-Pérez, T; Domínguez-Garrido, M N; Blanco-Rodríguez, M; Garcés, C; Rovira, A; Soriano-Guillén, L

    2014-04-01

    Vitamin D deficiency has been associated with extra-skeletal outcomes such as, insulin resistance, type 2 diabetes, and cardiovascular disease. The aim of this study is to determine the prevalence of vitamin D deficiency among obese children and adolescents in Spain and to analyze the relationship between 25-OH-vitamin D (25-OH-D) levels and markers of abnormal glucose metabolism. A cross-sectional study was conducted in which the clinical and biochemical data were recorded for 120 obese and 50 non-overweight children in Pediatric Clinics from January 2011 to January 2013. The mean 25-OH-D levels among obese children was 19.5 ng/ml and among non-overweight children was 31.6 ng/ml. 58,3% of obese subjects, and 10% of non-overweight subjects had vitamin D deficiency. Serum 25-OH-D levels were lower in winter. Higher HOMA-SDS (3.8 versus 2.4), and triglycerides (97 versus 81 mg/dl) were found in vitamin D deficient obese children compared to obese children without vitamin D deficiency. A negative correlation was found between 25-OH-D levels and HOMA in absolute values (r=-0.2; P=.04) that was not maintained when HOMA-SDS was analyzed. There is a high prevalence of vitamin D deficiency among obese children with a multifactorial etiology. A lower 25-OH-D level could be a risk factor for developing insulin resistance and type 2 diabetes in obese population. Copyright © 2013 Asociación Española de Pediatría. Published by Elsevier Espana. All rights reserved.

  1. The incidence of vitamin D deficiency in the obese: a retrospective chart review

    Directory of Open Access Journals (Sweden)

    Deepu Daniel

    2015-02-01

    Full Text Available Objective: To determine whether the obese population is more likely to be vitamin D deficient compared to healthy and overweight individuals. Patients and methods: A retrospective chart review was performed for patients seen in two ambulatory clinics in South Florida over a 1-year period (n=402. Patients’ vitamin D levels drawn during annual wellness visits were analyzed. Subjects were categorized based on body mass index (BMI as normal (BMI 30.0. Their 25-OH vitamin D status was defined as normal (>30 ng/mL, insufficient (20.0–29.9 ng/mL, and deficient (<20 ng/mL. The study included both men and women of black, white, Hispanic, and Asian races. Other variables in the study included age, history of hypertension, and diabetes. Patients with conditions leading to vitamin D malabsorption (chronic pancreatitis, celiac disease, Crohn's disease, cystic fibrosis, ileocecal resection were excluded. Patients with prior vitamin D supplementation were also excluded. Results: The results of the study indicated a significant association of vitamin D deficiency and obesity (p<0.05. Patients who were obese had a relative risk of 3.36 (95% CI: 1.50–7.54 for vitamin D deficiency compared to subjects with normal BMI. The study also showed a significant association between vitamin D levels and obesity when controlling for age, race, and presence of hypertension (p <0.05, with Asians and blacks more likely to be vitamin D deficient. Conclusion: These results demonstrated that obesity was a risk factor for vitamin D deficiency in all races, especially the Asian and black populations. This suggests that physicians should screen for vitamin D deficiency in the obese populations, especially among Asian and black races.

  2. Vitamin D Deficiency Is Associated With the Severity of Radiation-Induced Proctitis in Cancer Patients

    Energy Technology Data Exchange (ETDEWEB)

    Ghorbanzadeh-Moghaddam, Amir [Medical Student' s Research Center, Isfahan University of Medical Sciences, Isfahan (Iran, Islamic Republic of); Gholamrezaei, Ali, E-mail: Gholamrezaei@med.mui.ac.ir [Medical Student' s Research Center, Isfahan University of Medical Sciences, Isfahan (Iran, Islamic Republic of); Poursina Hakim Research Institution, Isfahan (Iran, Islamic Republic of); Hemati, Simin [Department of Radiotherapy Oncology, Isfahan University of Medical Sciences, Isfahan (Iran, Islamic Republic of)

    2015-07-01

    Purpose: Radiation-induced injury to normal tissues is a common complication of radiation therapy in cancer patients. Considering the role of vitamin D in mucosal barrier hemostasis and inflammatory responses, we investigated whether vitamin D deficiency is associated with the severity of radiation-induced acute proctitis in cancer patients. Methods and Materials: This prospective observational study was conducted in cancer patients referred for pelvic radiation therapy. Serum concentration of 25-hydroxyvitamin D was measured before radiation therapy. Vitamin D deficiency was defined as 25-hydroxyvitamin D concentrations of <35 nmol/L and <40 nmol/L in male and female patients, respectively, based on available normative data. Acute proctitis was assessed after 5 weeks of radiation therapy (total received radiation dose of 50 Gy) and graded from 0 to 4 using Radiation Therapy Oncology Group (RTOG) criteria. Results: Ninety-eight patients (57.1% male) with a mean age of 62.8 ± 9.1 years were studied. Vitamin D deficiency was found in 57 patients (58.1%). Symptoms of acute proctitis occurred in 72 patients (73.4%) after radiation therapy. RTOG grade was significantly higher in patients with vitamin D deficiency than in normal cases (median [interquartile range] of 2 [0.5-3] vs 1 [0-2], P=.037). Vitamin D deficiency was associated with RTOG grade of ≥2, independent of possible confounding factors; odds ratio (95% confidence interval) = 3.07 (1.27-7.50), P=.013. Conclusions: Vitamin D deficiency is associated with increased severity of radiation-induced acute proctitis. Investigating the underlying mechanisms of this association and evaluating the effectiveness of vitamin D therapy in preventing radiation-induced acute proctitis is warranted.

  3. Vitamin D deficiency and its impact on asthma severity in asthmatic children.

    Science.gov (United States)

    Esfandiar, Nasrin; Alaei, Fariba; Fallah, Shahrzad; Babaie, Delara; Sedghi, Niloofar

    2016-12-17

    Despite obtaining evidences on association between vitamin D and development of lung in fetus, little is known about vitamin D level and its impact on severity of asthma in children. The present study aimed to assess the relationship between the asthma severity and vitamin D deficiency in asthmatic children. This case-control study was conducted on 106 individuals including asthmatic (n = 53) and healthy children (n = 53) who referred to Mofid hospital in Tehran in 2013. The level of serum vitamin D in both groups was measured by radioimmunoassay method at the reference lab and was categorized as sufficient (> 30 ng/ml), insufficient (20 to 30 ng/ml), or deficient (asthma in patients group was classified as controlled, partially controlled, and uncontrolled. In the groups with and without asthma, the prevalence of vitamin D deficiency was 73.6 and 49.1%, and the prevalence of vitamin D insufficiency was 18.9 and 18.9%, while normal vitamin D level was revealed in 7.5 and 32.1%, respectively with a significant difference (p = 0.005). Using the multivariate logistic regression analysis, the presence of asthma was associated with reduced level of vitamin D (OR = 1.068, 95% CI: 1.027-1.110, P = 0.001). In this context, the risk for asthma in the children with vitamin D deficiency was 6.3 times of those with normal vitamin D level. Although the presence of asthma was strongly associated with reduced level of vitamin D in serum, neither severity of asthma nor control status of asthma were associated with vitamin D deficiency. The presence of vitamin D deficiency effectively predict increased risk for childhood asthma; however the severity or control status of this event may not be predicted by confirming vitamin D deficiency.

  4. Association Between Severe Vitamin D Deficiency, Lung Function and Asthma Control.

    Science.gov (United States)

    Beyhan-Sagmen, Seda; Baykan, Ozgur; Balcan, Baran; Ceyhan, Berrin

    2017-04-01

    To examine the relationship between severe vitamin D deficiency, asthma control, and pulmonary function in Turkish adults with asthma. One hundred six asthmatic patients underwent pulmonary function tests skin prick test, peripheral blood eosinophil counts, IgE, body mass index and vitamin D levels were determined. Patients were divided into 2 subgroups according to vitamin D levels (vitamin D level<10ng/ml and vitamin D level≥10 ng/ml). Asthma control tests were performed. The mean age of subgroup i (vitamin D level<10) was 37±10 and the mean age of subgroup ii (vitamin D level≥10ng/ml) was 34±8. Sixty-six percent of patients had severe vitamin D deficiency (vitamin D level<10 ng/ml). There was a significant trend towards lower absolute FEV 1 (L) values in patients with lower vitamin D levels (P=.001). Asthma control test scores were significantly low in the severe deficiency group than the other group (P=.02). There were a greater number of patients with uncontrolled asthma (asthma control test scores<20) in the severe vitamin D deficiency group (P=.040). Patients with severe vitamin D deficiency had a higher usage of inhaled corticosteroids than the group without severe vitamin D deficiency (P=.015). There was a significant trend towards lower absolute FEV 1 (L) (P=.005, r=.272) values in patients with lower vitamin D levels. Vitamin D levels were inversely related with body mass index (P=.046). The incidence of severe vitamin D deficiency was high in adult Turkish asthmatics. In addition, lower vitamin D levels were associated with poor asthma control and decreased pulmonary function. Copyright © 2016 SEPAR. Publicado por Elsevier España, S.L.U. All rights reserved.

  5. Treatment of hypophosphataemic rickets in children remains a challenge

    DEFF Research Database (Denmark)

    Nielsen, L.; Rahbek, Elise Torp; Beck-Nielsen, Signe Sparre

    2014-01-01

    INTRODUCTION: Hypophosphataemic rickets (HR) is a rare hereditary disease characterised by hypophosphataemia, defects in bone mineralisation and rickets. MATERIAL AND METHODS: We searched the hospital files at H.C. Andersen Children's Hospital, Odense University Hospital, Denmark, for children...... with the International Classification of Diseases 10 codes E83.3B (vitamin D resistant rickets) and E83.3A1 (familiar hypophosphataemia) from 1 February 2012 to 1 May 2012. Data were collected retrospectively. RESULTS: Fifteen HR children were identified. X-linked hypophosphataemia with mutations in the phosphate......-regulating endopeptidase homologue, X-linked were present in 80%; three had autosomal recessive HR with dentin matrix protein mutations. The children were treated with phosphate and alphacalcidol for an average of 7.7 years ± 5.1 standard deviations (SD). At the latest follow-up, the mean age was 10.1 (+5.4) years...

  6. Screening and Treatment of Vitamin D Deficiency on Hospital Admission: Is There a Benefit for Medical Inpatients?

    OpenAIRE

    Graedel Lena; Merker Meret; Mueller Beat; Schuetz Philipp

    2016-01-01

    BACKGROUND: Whether screening and treatment of vitamin D deficiency improves clinical outcomes in medical inpatients remains unclear. We performed a systematic search and summarized the evidence from observational and randomized controlled studies (RCTs) on the influence of vitamin D deficiency and its treatment on patient outcomes. METHODS: The MEDLINE and EMBASE databases were searched in January 2015 using the terms "vitamin D deficiency" "vitamin D" "mortality" "inpatient" "length of stay...

  7. RICKETS IN RURAL KENYAN PRESCHOOL CHILDREN: CASE REPORT.

    Science.gov (United States)

    Bwibo, N O; Nyawade, S; Neumann, C G

    2013-03-01

    Clinical rickets has not been reported previously in Embu district, Kenya. Baseline clinical assessments performed for a nutrition intervention study in preschool children (n=324) identified 28 cases of rickets (8.6% of study sample). Clinical characteristics included: delays of sitting, walking, and teething; bone and chest deformities; widened wrists and ankles; and bowed lower extremities. Risk factors identified were short duration of breastfeeding with feeding of cereal-based supplements with little or no milk, low calcium intake, limited sunlight exposure. Vitamin D and calcium deficiencies likely contributed to these cases. Treatment with Vitamin D3 and milk resulted in clinical improvement.

  8. Incidence and prevalence of nutritional and hereditary rickets in southern Denmark

    DEFF Research Database (Denmark)

    Beck-Nielsen, Signe; Jacobsen, Bendt; Gram, Jeppe

    2009-01-01

    -2005 the average incidence of nutritional rickets in children aged 0-14.9 years and 0-2.9 years was 2.9 and 5.8 per 100,000 per year, respectively. Among immigrant children born in Denmark the average incidence was 60 (0-14.9 years) per 100,000 per year. Ethnic Danish children were only diagnosed in early...... of hypophosphatemic rickets and vitamin D-dependent rickets type 1 was 4.8 and 0.4 per 100,000 (0-14.9 years), respectively. Conclusions Nutritional rickets is rare in Southern Denmark and largely restricted to immigrants, but the incidence among ethnic Danish children was unexpectedly high. Hereditary rickets...... is the most common cause of rickets in ethnic Danish children, but nutritional rickets is most frequent among all young children....

  9. [VITAMIN D DEFICIENCY AMONG CHILDREN AND ADOLESCENTS WITH NORMAL NUTRITIONAL STATUS].

    Science.gov (United States)

    Durá-Travé, Teodoro; Gallinas-Victoriano, Fidel; Chueca Guindulain, María Jesús; Berrade-Zubiri, Sara

    2015-09-01

    to analyze the prevalence of vitamin D deficiency throughout a natural year in a pediatric population with normal nutrition status. cross sectional clinical and analytical study (calcium, phosphorus, alkaline phosphatase, calcidiol and parathyroid hormone) in 413 caucasian individuals (aged 3.1 to 15.4 years): 227 school children (96 males and 131 females) and 186 adolescents (94 males and 92 females), all of them in a normal nutrition status, during the year 2014. Vitamin D deficiency was defined according to the United States Endocrine Society guidelines. calcidiol levels were lower during spring (25.96 ± 6.64 ng/ml) and reached its maximum level in summer (35.33 ± 7.51 ng/ml); PTH levels were lower in summer (27.13 ± 7.89 pg/ml) and reached maximum level in autumn (34.73 ± 15.38 pg/ml). Vitamin D deficiency prevalence was 14.3% in summer and 75.3% in spring. PTH levels were compatible with secondary hyperparathyroidism in 8 individuals (1.9%). There was a negative correlation between calcidol and PTH levels (p nutrition status shows a high prevalence of vitamin D deficiency during the months of autumn and winter and, especially, in spring; the addition of vitamin supplements and/ or an increase in the ingestion of their natural dietary sources should be considered. Copyright AULA MEDICA EDICIONES 2014. Published by AULA MEDICA. All rights reserved.

  10. Vitamin D deficiency is not associated with early stages of thyroid autoimmunity

    NARCIS (Netherlands)

    Effraimidis, Grigoris; Badenhoop, Klaus; Tijssen, Jan G. P.; Wiersinga, Wilmar M.

    2012-01-01

    Context: Vitamin D deficiency has been identified as a risk factor for a number of autoimmune diseases including type 1 diabetes and multiple sclerosis. Objective: We hypothesized that low levels of vitamin D are related to the early stages of autoimmune thyroid disease (AITD). Design: Two

  11. Vitamin D deficiency as adverse drug reaction? A cross-sectional study in Dutch geriatric outpatients

    NARCIS (Netherlands)

    Orten-Luiten, van A.C.B.; Janse, A.; Dhonukshe-Rutten, R.A.M.; Witkamp, R.F.

    2016-01-01

    Purpose: Adverse drug reactions as well as vitamin D deficiency are issues of public health concern in older people. However, relatively little is known about the impact of drug use on vitamin D status. Our primary aim is to explore associations between drug use and vitamin D status in older

  12. Utility of sun-reactive skin typing and melanin index for discerning vitamin D deficiency.

    Science.gov (United States)

    Khalid, Arshad T; Moore, Charity G; Hall, Christopher; Olabopo, Flora; Rozario, Nigel L; Holick, Michael F; Greenspan, Susan L; Rajakumar, Kumaravel

    2017-09-01

    BackgroundSkin color, a vitamin D status determinant, can be assessed subjectively by Fitzpatrick sun-reactive skin typing (FST) and objectively by melanin index (MI). FST was validated against MI for discerning vitamin D deficiency (serum 25-hydroxyvitamin D (25(OH)D) <20 ng/ml) in children.MethodsWe measured FST, MI, and serum 25(OH)D in healthy, 8- to 18-year-old children from one of two vitamin D trials. MI from forehead, hand, and upper arm split at the median of the more racially balanced study cohort and FST (I-III vs. IV-V) were used for discriminating vitamin D deficiency.ResultsA total of 296 participants (mean age, 12.3±2.3 years; black, 208; FST IV-V, 209; 25(OH)D <20 ng/ml, 159) were studied. MI and FST had a strong positive association. Serum 25(OH)D was negatively associated with MI and FST. Sensitivity, specificity, and predictive values were similar for discriminating vitamin D deficiency between higher vs. lower MI and between FST I-III vs. IV-V. ROC area under the curves for FST (0.59) and MI (forehead (0.63); hand (0.62); and arm (0.64)) were similar.ConclusionsFST is comparable to MI for discerning vitamin D deficiency and can be deemed as an inexpensive, useful surrogate measure of skin color in the context of vitamin D research.

  13. Vitamin D Deficiency Reduces the Immune Response, Phagocytosis Rate, and Intracellular Killing Rate of Microglial Cells

    Science.gov (United States)

    Onken, Marie Luise; Schütze, Sandra; Redlich, Sandra; Götz, Alexander; Hanisch, Uwe-Karsten; Bertsch, Thomas; Ribes, Sandra; Hanenberg, Andrea; Schneider, Simon; Bollheimer, Cornelius; Sieber, Cornel; Nau, Roland

    2014-01-01

    Meningitis and meningoencephalitis caused by Escherichia coli are associated with high rates of mortality and neurological sequelae. A high prevalence of neurological disorders has been observed in geriatric populations at risk of hypovitaminosis D. Vitamin D has potent effects on human immunity, including induction of antimicrobial peptides (AMPs) and suppression of T-cell proliferation, but its influence on microglial cells is unknown. The purpose of the present study was to determine the effects of vitamin D deficiency on the phagocytosis rate, intracellular killing, and immune response of murine microglial cultures after stimulation with the Toll-like receptor (TLR) agonists tripalmitoyl-S-glyceryl-cysteine (TLR1/2), poly(I·C) (TLR3), lipopolysaccharide (TLR4), and CpG oligodeoxynucleotide (TLR9). Upon stimulation with high concentrations of TLR agonists, the release of tumor necrosis factor alpha (TNF-α) and interleukin 6 (IL-6) was decreased in vitamin D-deficient compared to that in vitamin D-sufficient microglial cultures. Phagocytosis of E. coli K1 after stimulation of microglial cells with high concentrations of TLR3, -4, and -9 agonists and intracellular killing of E. coli K1 after stimulation with high concentrations of all TLR agonists were lower in vitamin D-deficient microglial cells than in the respective control cells. Our observations suggest that vitamin D deficiency may impair the resistance of the brain against bacterial infections. PMID:24686054

  14. Hyperparathyroidism and complications associated with vitamin D deficiency in HIV-infected adults in New York City, New York.

    Science.gov (United States)

    Kwan, Candice K; Eckhardt, Benjamin; Baghdadi, Jonathan; Aberg, Judith A

    2012-09-01

    Although recent studies report a high prevalence of vitamin D deficiency in HIV-infected adults similar to that in the general population, metabolic complications of vitamin D deficiency may be worsened with HIV infection and remain insufficiently characterized. We conducted a retrospective cross-sectional cohort study to determine prevalence and correlates of vitamin D deficiency and hyperparathyroidism among HIV-infected patients attending an urban clinic. Vitamin D deficiency was defined as 25(OH)-vitamin D hyperparathyroidism as parathyroid-hormone >65 pg/ml. We used the X(2) test to compare proportions and logistic regression to assess for associations. Among 463 HIV-infected patients, the prevalence of vitamin D deficiency was 59%. The prevalence of hyperparathyroidism was 30% among patients with vitamin D deficiency, 23% among those with insufficiency, and 12% among those with sufficient vitamin D levels. Vitamin D deficiency was associated with increased odds of hyperparathyroidism. Severe vitamin D deficiency was associated with elevated alkaline phosphatase, a marker for increased bone turnover. Although efavirenz use was associated with vitamin D deficiency, and protease inhibitor use with decreased odds of vitamin D deficiency, there was no statistical difference in rates of hyperparathyroidism stratified by combination antiretroviral therapy (cART) use. Given the increased risk of osteopenia with HIV infection and cART use, vitamin D supplementation for all HIV-infected patients on cART should be prescribed in accordance with the 2011 Endocrine Society guidelines. In HIV-infected patients with severe vitamin D deficiency or hyperparathyroidism, screening for osteomalacia and osteopenia may be warranted.

  15. 'Waar is de zon die mij zal verblijden....'; vitamine D-deficiëntie en depressie bij ouderen [Can I have some sunshine to cheer me up? Vitamin D deficiency and depression in the elderly

    NARCIS (Netherlands)

    Stalpers-Konijnenburg, S.C.; Marijnissen, R.M.; Gaasbeek, A.B.; Oude Voshaar, R.C.

    2011-01-01

    Vitamin D deficiency is very common in the elderly, and the geriatric patient is probably at even greater risk. Vitamin D plays an important role in calcium homeostasis; recent studies point to a possible causal link between vitamin D deficiency and the development and severity of depression. In

  16. Associations between organochlorine pesticides and vitamin D deficiency in the U.S. population.

    Directory of Open Access Journals (Sweden)

    Jin-Hoon Yang

    Full Text Available BACKGROUND: Recently low dose organochlorine (OC pesticides have been strongly linked to various chronic diseases including diabetes and cardiovascular diseases. Both field and animal studies have suggested a possibility that persistent lipophilic chemicals like OC pesticides can cause vitamin D deficiency, but there have been no human studies of exposure to any chemical as a possible cause of vitamin D deficiency. This study was performed to examine if serum concentrations of OC pesticides were associated with serum concentrations of 25-hydroxyvitamin D (25(OHD in the U.S. general population. METHODOLOGY/PRINCIPAL FINDINGS: Cross-sectional associations of serum OC pesticides with serum 25(OHD were investigated in 1,275 subjects aged ≥20 in the National Health and Nutrition Examination Survey (NHANES, 2003-2004. We selected 7 OC pesticides detectable in ≥80% of participants. Among the 7 OC pesticides, p,p'-DDT (β = -0.022, P<0.01, p,p'-DDE (β = -0.018, P = 0.04, and β-hexachlorocyclohexane (β = -0.022, P = 0.02 showed significant inverse associations with serum 25(OHD levels. When study subjects were stratified by age, race, and the presence of various chronic diseases, p,p'-DDT showed consistent inverse associations in all subgroups, although stronger associations tended to be observed among subjects with old age, white race, or chronic diseases. CONCLUSION/SIGNIFICANCE: The current study suggests that the background exposure to some OC pesticides leads to vitamin D deficiency in human. Considering the importance of vitamin D deficiency in the development of chronic diseases, chemical exposure as a possible cause of vitamin D deficiency should be evaluated in prospective and experimental studies.

  17. Impact of air pollution on vitamin D deficiency and bone health in adolescents.

    Science.gov (United States)

    Feizabad, Elham; Hossein-Nezhad, Arash; Maghbooli, Zhila; Ramezani, Majid; Hashemian, Roxana; Moattari, Syamak

    2017-12-01

    The association between air pollution and bone health was evaluated in adolescents in the city of Tehran. This study is essentially ecological. Vitamin D deficiency among adolescents has been reported at higher rates in polluted areas than in non-polluted areas. Additionally, residence in polluted areas is associated with lower levels of bone alkaline phosphatase. The aim of this study was to evaluate the association between ambient air pollution and bone turnover in adolescents and to compare the prevalence of vitamin D deficiency between polluted and non-polluted areas of Tehran. This cross-sectional population-based study was conducted on 325 middle- and high-school students (both girls and boys) in Tehran in the winter. During the study period, detailed daily data on air pollution were obtained from archived data collected by Tehran Air Quality Control Company (AQCC). Serum levels of calcium, phosphorus, parathyroid hormone (PTH), bone-specific alkaline phosphatase, 25(OH) vitamin D, osteocalcin, cross-linked C-telopeptide (CTX), total protein, albumin, and creatinine were obtained from the study group. Vitamin D deficiency was more prevalent in polluted areas than in non-polluted areas. After adjustment for age and sex, residence in the polluted area showed a statistically significant positive association with vitamin D deficiency and a statistically significant negative association with bone turnover. Interestingly, high calcium intake (>5000 mg/week) protects against the effects of air pollution on bone turnover. Air pollution is a chief factor determining the amount of solar UVB that reaches the earth's surface. Thus, atmospheric pollution may play a significant independent role in the development of vitamin D deficiency.

  18. High prevalence of vitamin D deficiency and its association with metabolic disorders in elderly patients

    Directory of Open Access Journals (Sweden)

    Małgorzata Koziarska-Rościszewska

    2017-12-01

    Full Text Available Background . Vitamin D is considered to be an important co-factor of metabolic processes. However, the available data is ambiguous. Some data indicates an important role of vitamin D in adipocyte metabolism, and hence also in obesity – a well-known risk factor of diabetes mellitus and cardiovascular diseases (CVD. Objectives . To assess the prevalence of vitamin D deficiency and to evaluate the relationship between serum 25(OHD concentration and metabolic disorders in elderly patients attending primary care. Material and methods . This observational study was performed on 110 elderly patients: 88 females, 22 males, Caucasian, > 60 years. A questionnaire was completed concerning lifestyle and chronic diseases. Clinical examination, anthropometric measurements and laboratory tests (25(OHD, lipids, glycemia, blood morphology, serum creatinine, PT H were performed. BMI and WHR were calculated. Patients reporting physical activity (walking, Nordic walking, swimming, cycling, other ≥ 150 minutes per week were classified as “physically active”. Results . Vitamin D deficiency (25(OHD < 30 ng/ml; < 75 nmol/l was found in 84.5%, extreme deficiency (< 10 ng/ml; < 25 nmol/l in 6.3%. A significant correlation between serum vitamin D deficiency and visceral obesity was found (p = 0.02. No correlation was found with BMI, physical activity, lipids, diabetes or CVD. Conclusions . Vitamin D deficiency was found to be highly prevalent in the examined group of elderly people. Visceral obesity in the elderly is associated with vitamin D deficiency. Vitamin D supplementation may supposedly contribute to prevention of obesity and its treatment.

  19. Adverse effects of vitamin D deficiency on outcomes of patients with chronic hepatitis B.

    Science.gov (United States)

    Wong, Grace Lai-Hung; Chan, Henry Lik-Yuen; Chan, Hoi-Yun; Tse, Chi-Hang; Chim, Angel Mei-Ling; Lo, Angeline Oi-Shan; Wong, Vincent Wai-Sun

    2015-04-01

    Vitamin D is an immunomodulator that might be involved in the pathogenesis of viral hepatitis. We investigated the effects of vitamin D deficiency on long-term outcomes of patients with chronic hepatitis B (CHB). We performed a prospective cohort study of 426 patients with CHB (65% male; mean age, 41 ± 13 years), who were enrolled from 1997 through 2000. Serum levels of 25-hydroxycholecalciferol (25(OH)D3) were measured on study enrollment (baseline). Patients were followed for 159 ± 46 months until last clinic visit or death; approximately 33% received antiviral therapy during the follow-up period. The primary outcome was a clinical event (hepatocellular carcinoma, complications of cirrhosis, or death). At baseline, the patients' mean serum level of hepatitis B virus DNA was 5.0 ± 2.1 log10 IU/mL; their mean level of 25(OH)D3 was 24.3 ± 9.4 ng/mL, and 348 patients (82%) had vitamin D deficiency (vitamin D deficiency for clinical events was 1.90 (95% confidence interval [CI], 1.06-2.43; P = .04). The 15-year cumulative incidence rate of clinical events among patients with vitamin D deficiency was 25.5% (95% CI, 23.1%-27.9%), compared with 11.1% (95% CI, 7.4%-14.8%) in patients with normal serum levels of 25(OH)D3. Vitamin D deficiency is common among patients with CHB and is associated with adverse clinical outcomes. Copyright © 2015 AGA Institute. Published by Elsevier Inc. All rights reserved.

  20. High prevalence of vitamin D deficiency among children with chronic kidney disease and kidney transplant.

    Science.gov (United States)

    Coccia, Paula; Blazquez, Juliana; Contreras, Maritza; Ferrais, Verónica; Raddavero, Claudia; Ghezzi, Lidia; Busaniche, Julio; Beneitez, Gonzalo; Kozak, Andrea; Ferraris, Jorge

    2017-06-01

    Vitamin D (25(OH)D) deficiency is common among patients with chronic kidney disease (CKD). Our objective was to establish the prevalence of 25(OH)D deficiency among children with CKD and identify risk factors. A correlation was observed between 25(OH)D and parathormone intact molecule. Cross-sectional study conducted between January 2013 and December 2015. Patients younger than 19 years old with and without CKD were included. One hundred and sixty-seven patients were included. Group 1 (healthy controls): 32 participants; group 2 (stage 2-4 CKD, glomerular filtration rate between 89 and 15 mL/min/1.73 m2): 34 patients; group 3 (stage 5 CKD, dialysis): 46 patients; and group 4 (kidney transplant recipients): 55 patients. Deficiency of 25(OH)D was detected in 12.5% of healthy controls and 32% of CKD patients (p= 0.025). Also, 23% of patients in group 2, 51% in group 3, and 22% in group 4 had 25(OH)D deficiency; the mean 25(OH)D level of dialysis patients was significantly lower than that of the rest of the groups. Predictors of 25(OH)D deficiency included hypoalbuminemia, advanced CKD, and place of origin from the Northwest region of Argentina. The parathormone intact molecule was significantly higher in the group of patients with deficiency and was inversely correlated with 25(OH)D levels. Among CKD patients, 32% had 25(OH)D deficiency, which reached 51% among those with stage 5 CKD (dialysis). Predictors of deficiency included hypoalbuminemia, advanced CKD, and place of origin from the Northwest region of Argentina.

  1. Modeling the influence of vitamin D deficiency on cigarette smoke-induced emphysema.

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    Mardi A. Crane-Godreau

    2013-06-01

    Full Text Available Chronic obstructive pulmonary disease (COPD is a major cause of morbidity and mortality worldwide. While the primary risk factor for COPD is cigarette smoke exposure, vitamin D deficiency has been epidemiologically implicated as a factor in the progressive development of COPD-associated emphysema. Because of difficulties inherent to studies involving multiple risk factors in the progression of COPD in humans, we developed a murine model in which to study the separate and combined effects of vitamin D deficiency and cigarette smoke exposure. During a 16 week period, mice were exposed to one of four conditions, control diet breathing room air (CD-NS, control diet with cigarette smoke exposure (CD-CSE, vitamin D deficient diet breathing room air (VDD-NS or vitamin D deficient diet with cigarette smoke exposure (VDD-CSE. At the end of the exposure period, the lungs were examined by a pathologist and separately by morphometric analysis. In parallel experiments, mice were anesthetized for pulmonary function testing followed by sacrifice and analysis. Emphysema (determined by an increase in alveolar mean linear intercept length was more severe in the VDD-CSE mice compared to control animals and animals exposed to VDD or CSE alone. The VDD-CSE and the CD-CSE mice had increased total lung capacity and increased static lung compliance. There was also a significant increase in the matrix metalloproteinase-9: tissue inhibitor of metalloproteinases-1 ratio in VDD-CSE mice compared with all controls. Alpha-1 antitrypsin expression was reduced in VDD-CSE mice as well. In summary, vitamin D deficiency, when combined with cigarette smoke exposure, seemed to accelerate the appearance of emphysemas, perhaps by virtue of an increased protease-antiprotease ratio in the combined VDD-CSE animals. These results support the value of our mouse model in the study of COPD.

  2. Calcium deficiency and causation of rickets in Ethiopian children ...

    African Journals Online (AJOL)

    Objective: To assess the role of calcium in the development of clinical rickets among Ethiopian children coming to Jimma Specialised Hospital outpatient, department. Design: Case control study. Settings: Jimma Specialised Teaching Hospital and surrounding urban and rural community in the catchment area. Subjects: One ...

  3. Genetics Home Reference: vitamin D-dependent rickets

    Science.gov (United States)

    ... on their heads. Some affected individuals are missing body hair as well. Enlarge Frequency Rickets affects an estimated ... other processes that regulate calcium levels in the body. The VDR protein is also involved in hair growth through a process that does not require ...

  4. Vitamin D deficiency in Saudi Arabians: A reality or simply hype: A meta-analysis (2008-2015

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    Haneen Al-Alyani

    2018-01-01

    CONCLUSIONS: The currently available literature on the Saudi Arabian population suggests that the Vitamin D deficiency is around 60% and not 100% as indicated in some studies. The relatively small number of studies on the population and the different modes of diagnostic methodology used make the issue of correct figures of Vitamin D deficiency contentious.

  5. Skin cancer prevention and UV-protection: how to avoid vitamin D-deficiency?

    Science.gov (United States)

    Reichrath, J

    2009-11-01

    Because solar UV-radiation represents the most important environmental risk factor for the development of non-melanoma skin cancer, UV protection is important to prevent these malignancies. Consequently, public health campaigns were developed to improve the knowledge of the general population regarding the role of UV-radiation for the development of skin cancer. However, it has to be noted that vitamin D-mediated positive effects of UV light were not adequately considered in most of these campaigns, that often propose a strict 'no sun policy' without giving recommendations how to prevent vitamin D-deficiency. Under our living conditions, approximately 90% of all vitamin D needed by the human body has to be formed in the skin through the action of UV-B-radiation and it has been shown that strict sun protection causes vitamin D-deficiency. This dilemma represents a serious problem, for an association of vitamin D-deficiency and multiple independent diseases including various types of cancer, bone diseases, autoimmune diseases, infectious diseases, cardiovascular diseases and hypertension has now been reported in a large number of laboratory and epidemiologic investigations. Although further work is necessary to define an adequate vitamin D-status and adequate guidelines for UV-exposure, it is at present mandatory that guidelines for UV-exposure (e.g. in skin cancer prevention campaigns) consider these facts and give recommendations how to prevent vitamin D-deficiency. At present, most experts in the field agree that the evidence to date suggests that daily intake of 1000-2000 IU vitamin D could reduce the incidence of vitamin D-deficiency-related diseases with minimal risk in Europe, the US, and other countries. In this review, we analyze the present literature to help developing well-balanced guidelines on UV-protection that ensure an adequate vitamin D-status. These recommendations will hopefully protect us against vitamin D-deficiency without increasing the risk

  6. Vitamin D deficiency in a tropical country--treatment and prevention in children.

    Science.gov (United States)

    Joshi, Kriti; Bhatia, Vijayalakshmi

    2014-01-01

    Vitamin D has an important role to play in skeletal and extraskeletal health. Inspite of being a sun rich country, India has widespread vitamin D deficiency. Vitamin D deficiency can lead to serious consequences like hypocalcemic seizures and increased risk of respiratory tract infections in neonates and infants. International expert groups advocate universal supplementation for non-formula fed infants, pregnant and lactating women and those at risk of deficiency. A body of literature on vitamin D status in India is being generated, which may guide clinical practice in our country. Treatment of deficiency must be undertaken with minimally effective doses to avoid the risk of toxicity. Sensible sunshine exposure should be encouraged to facilitate vitamin D production from natural sources.

  7. A Case of Hypocalcaemia Due to Vitamin D Deficiency in ‘Hikikomori’ Syndrome

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    Takahiro Miyakoshi

    2017-09-01

    Full Text Available Objective: To describe hypocalcaemia due to vitamin D deficiency in ‘hikikomori’ syndrome. Materials and methods: A 37-year-old man with ‘hikikomori’ syndrome for a year was admitted with hypocalcaemia (serum ionic calcium 1.17 mmol/l. Serum 1,25(OH2-vitamin D3 determined by liquid chromatography–tandem mass spectrometry was depressed at 12.1 pg/ml (29.0 pmol/l and plasma intact PTH elevated at 324 ng/l. Administration of 1 μg/day 1α(OH-vitamin D3 and 1 g/day calcium lactate for 1 week normalized calcium and PTH, and raised 1,25(OH2-vitamin D3 to low normal levels. Conclusion: This is the first report of hypocalcaemia due to vitamin D deficiency in a patient with ‘hikikomori’ syndrome.

  8. Two cases of rickets presenting with poor growth, hypotonia, and respiratory problems.

    Science.gov (United States)

    Wouters, E; Wojciechowski, M; de Vries, E

    2015-06-01

    Rickets is a rare disease in developed countries. In children, it is a disease which affects growing bone. Depending on the severity, it can present with a wide variety of symptoms. Because it is such a rare disease in developed countries, symptoms suggesting rickets are often not easily recognized. This can cause a delay in diagnosing and treating rickets. Often unnecessary and sometimes invasive investigations are performed. First leading clues to rickets on physical examination are poor growth, especially length, thickening of wrists, bow legs, and craniotabes. At further examination, special attention should be paid to osteopenia and cupping and fraying at the metaphyses on X-rays. Laboratory results suggestive for rickets are elevated alkaline phosphatase and disturbances in calcium and phosphate homeostasis. In this report, we present two cases presenting with poor growth, severe pain, and respiratory problems secondary to calcipenic rickets.

  9. Patulous Subarachnoid Space of the Optic Nerve Associated with X-Linked Hypophosphatemic Rickets.

    Science.gov (United States)

    Galvez-Ruiz, Alberto; Chaudhry, Imtiaz

    2013-01-01

    Although the deficiency forms are the most common manifestations of rickets, there are other forms of rickets that are resistant to vitamin D. Of these, the most common is X-linked hypophosphatemic rickets. Rickets represents a group of multiple cranial bone disorders-craniosynostosis and the presence of Chari I malformation being the most notable-that explain the increase in intracranial pressure. We present a 4-year-old patient with an unusual association of X-linked hypophosphataemic rickets, bilateral proptosis, and prominent bilateral widening of the optic nerve sheaths. Although the association between intracranial hypertension and rickets is known, to the best of our knowledge, such a prominent distention of the subarachnoid space of the optic nerve without papilloedema has not been previously described.

  10. Spontaneous bilateral fracture neck of femur secondary to vitamin D deficiency: a case report

    Science.gov (United States)

    Desai, Mihir; Nadkarni, Sambprasad

    2015-01-01

    Summary We report a case of a patient who presented with inability to walk for 2 days which was acute in onset, with no history or preceeding trauma. On examination it was found to have stable vitals. Both lower limbs were in the flexed, abducted & externally rotated attitude, with no sensory motor deficit. Radiological investigations revealing osteoporosis and bilateral fracture neck of femur and blood investigations indicated severe vitamin D deficiency. PMID:26811714

  11. Vitamin D deficiency in rheumatoid arthritis: prevalence, determinants and associations with disease activity and disability

    OpenAIRE

    Rossini, Maurizio; Maddali Bongi, Susanna; La Montagna, Giovanni; Minisola, Giovanni; Malavolta, Nazzarena; Bernini, Luigi; Cacace, Enrico; Sinigaglia, Luigi; Di Munno, Ombretta; Adami, Silvano

    2010-01-01

    Introduction The aim of this study was to estimate the prevalence and determinants of vitamin D deficiency in patients with rheumatoid arthritis (RA) as compared to healthy controls and to analyze the association between 25-hydroxyvitamin D (25(OH)D) with disease activity and disability. Methods The study includes 1,191 consecutive RA patients (85% women) and 1,019 controls, not on vitamin D supplements, from 22 Italian rheumatology centres. Together with parameters of disease activity, funct...

  12. Vitamin D deficiency and depression among women from an urban community in a tropical country.

    Science.gov (United States)

    Moy, Foong Ming; Hoe, Victor Cw; Hairi, Noran Naqiah; Vethakkan, Shireene Ratna; Bulgiba, Awang

    2017-07-01

    To determine the association of vitamin D status with depression and health-related quality of life among women. This was a cross-sectional study conducted among women in Kuala Lumpur, Malaysia. Sociodemographic characteristics, physical activity status, perceived depression and health-related quality of life were assessed via a self-administered questionnaire. Fasting blood samples were taken for the analysis of 25-hydroxyvitamin D, parathyroid hormone, fasting blood glucose and full lipid profile. Complex samples multiple logistic regression analysis was performed. Public secondary schools in Kuala Lumpur, Malaysia. Seven hundred and seventy female teachers were included. The mean age of participants was 41·15 (95 % CI 40·51, 41·78) years and the majority were ethnic Malays. Over 70 % of them had vitamin D deficiency (<20 ng/ml or <50 nmol/l) and two-thirds were at risk for depression. In the multivariate analysis, ethnic Malays (adjusted OR (aOR)=14·72; 95 % CI 2·12, 102·21) and Indians (aOR=14·02; 95 % CI 2·27, 86·59), those at risk for depression (aOR=1·88, 95 % CI 1·27, 2·79) and those with higher parathyroid hormone level (aOR=1·13; 95 % CI 1·01, 1·26) were associated with vitamin D deficiency, while vitamin D deficiency was negatively associated with mental health-related quality of life (Mental Component Summary) scores (aOR=0·98; 95 % CI 0·97, 0·99). Vitamin D deficiency is significantly associated with depression and mental health-related quality of life among women in Kuala Lumpur, Malaysia.

  13. Prevalence of Vitamin D Deficiency in Singapore: Its Implications to Cardiovascular Risk Factors.

    Science.gov (United States)

    Bi, Xinyan; Tey, Siew Ling; Leong, Claudia; Quek, Rina; Henry, Christiani Jeyakumar

    2016-01-01

    Vitamin D deficiency is a global health challenge and has been linked to type 2 diabetes and other chronic diseases. However, the relationship between vitamin D status, body composition, and cardiovascular risks has not been well characterized in Asian populations. The objectives of this study were to examine the factors associated with the low vitamin D levels in a sunny tropical region and to assess the role of vitamin D status in cardiovascular risk factors. This was a cross-sectional study. One hundred and fourteen healthy participants (59 males and 55 females) residing in Singapore took part in this study. Plasma 25OH-D3 concentration was measured by using LC-MS/MS. Body fat (%) was measured by using three different techniques including bioelectrical impedance analysis (BIA), BOD POD, and dual-energy X-ray absorptiometry (DEXA). Basic anthropometric measurements, fasting blood glucose (FBG), fasting serum insulin (FSI), and lipid profiles were obtained using standard protocols. Approximately 42% of the participants were vitamin D deficient (< 20 ng/mL). Vitamin D status was inversely associated with body fat (%), homeostasis model assessment of insulin resistance (HOMA-IR), and total cholesterol/high density lipoprotein (TC/HDL) ratio, while positively associated with lean body mass (LBM) and hand grip strength (HGS). The high prevalence of vitamin D deficiency in a sunny tropical region reinforces the need to recognize that sunlight alone is not the precursor for optimal vitamin D status. This raises the need to investigate public health measures that will encourage exposure to sunlight without overexposure that is harmful to skin. More importantly, vitamin D deficiency is associated with increased cardiovascular risks, i.e. HOMA-IR, TC/HDL, and LDL/HDL. Future studies should attempt to elucidate the potential mechanisms.

  14. Prevalence of Vitamin D Deficiency in Singapore: Its Implications to Cardiovascular Risk Factors.

    Directory of Open Access Journals (Sweden)

    Xinyan Bi

    Full Text Available Vitamin D deficiency is a global health challenge and has been linked to type 2 diabetes and other chronic diseases. However, the relationship between vitamin D status, body composition, and cardiovascular risks has not been well characterized in Asian populations. The objectives of this study were to examine the factors associated with the low vitamin D levels in a sunny tropical region and to assess the role of vitamin D status in cardiovascular risk factors.This was a cross-sectional study. One hundred and fourteen healthy participants (59 males and 55 females residing in Singapore took part in this study. Plasma 25OH-D3 concentration was measured by using LC-MS/MS. Body fat (% was measured by using three different techniques including bioelectrical impedance analysis (BIA, BOD POD, and dual-energy X-ray absorptiometry (DEXA. Basic anthropometric measurements, fasting blood glucose (FBG, fasting serum insulin (FSI, and lipid profiles were obtained using standard protocols.Approximately 42% of the participants were vitamin D deficient (< 20 ng/mL. Vitamin D status was inversely associated with body fat (%, homeostasis model assessment of insulin resistance (HOMA-IR, and total cholesterol/high density lipoprotein (TC/HDL ratio, while positively associated with lean body mass (LBM and hand grip strength (HGS.The high prevalence of vitamin D deficiency in a sunny tropical region reinforces the need to recognize that sunlight alone is not the precursor for optimal vitamin D status. This raises the need to investigate public health measures that will encourage exposure to sunlight without overexposure that is harmful to skin. More importantly, vitamin D deficiency is associated with increased cardiovascular risks, i.e. HOMA-IR, TC/HDL, and LDL/HDL. Future studies should attempt to elucidate the potential mechanisms.

  15. Asthmatic Patients with Vitamin D Deficiency have Decreased Exacerbations after Vitamin Replacement

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    Paolo Solidoro

    2017-11-01

    Full Text Available Background: Intervention studies with vitamin D in asthma are inconclusive for several reasons, such as inadequate dosing or duration of supplementation or uncontrolled baseline vitamin D status. Our aim was to evaluate the benefit of long term vitamin D add-on in asthmatic patients with actual vitamin D deficiency, that is a serum 25-hydroxy vitamin D (25-OHD below 20 ng/mL. Methods: Serum 25-OHD, asthma exacerbations, spirometry and inhaled corticosteroids (CS dose were evaluated in a cohort of 119 asthmatic patients. Patients with deficiency were evaluated again after one year vitamin supplementation. Results: 25-OHD was low in 111 patients and was negatively related to exacerbations (p < 0.001, inhaled CS dose (p = 0.008 and asthma severity (p = 0.001. Deficiency was found in 90 patients, 55 of whom took the supplement regularly for one year, while 24 discontinued the study and 11 were not adherent. Patients with vitamin D deficiency after 12 months supplementation showed significant decrease of exacerbations (from 2.6 ± 1.2 to 1.6 ± 1.1, p < 0.001, circulating eosinophils (from 395 ± 330 to 272 ± 212 106/L, p < 0.001, and need of oral CS courses (from 35 to 20, p = 0.007 and improvement of airway obstruction. Conclusions: Asthma exacerbations are favored by vitamin D deficiency and decrease after long-term vitamin D replacement. Patients who are vitamin D deficient benefit from vitamin D supplementation.

  16. Vitamin D-deficient mice have more invasive urinary tract infection

    OpenAIRE

    Hertting, Olof; L?thje, Petra; Sullivan, Devin; Aspenstr?m, Pontus; Brauner, Annelie

    2017-01-01

    Vitamin D deficiency is a common health problem with consequences not limited to bone and calcium hemostasis. Low levels have also been linked to tuberculosis and other respiratory infections as well as autoimmune diseases. We have previously shown that supplementation with vitamin D can induce the antimicrobial peptide cathelicidin during ex vivo infection of human urinary bladder. In rodents, however, cathelicidin expression is not linked to vitamin D and therefore this vitamin D-related ef...

  17. Epidemic of Vitamin D Deficiency and Its Management: Awareness among Indian Medical Undergraduates

    OpenAIRE

    Yangshen Lhamo; Preeta Kaur Chugh; Gautam, Sandhya R.; Tripathi, C.D.

    2017-01-01

    Vitamin D deficiency is prevalent across all age groups in epidemic proportions. The purpose of this study was to acquire a baseline assessment and create awareness among medical students regarding vitamin D. A cross-sectional, voluntary survey was conducted among undergraduate medical students. Data were collected using a questionnaire which assessed the level of knowledge students had with regard to where vitamin D comes from, what it does for health, how much is recommended, factors that a...

  18. Impact of maternal vitamin D status during pregnancy on the prevalence of neonatal vitamin D deficiency

    Directory of Open Access Journals (Sweden)

    Yasser F. Aly

    2013-02-01

    Full Text Available Maternal vitamin D deficiency is not uncommon. The lack of vitamin D during pregnancy may result in poor fetal growth and altered neonatal development that may persist into later life. Recognition of risk factors and early detection of vitamin D deficiency during pregnancy is important in order to prevent neonatal vitamin D deficiency and related complications. The aim of the current study is to assess the effect of maternal vitamin D status on the neonatal vitamin D stores. A total of 92 pregnant women at the end of the 3rd trimester and their newborns were recruited from Al Khafji Joint Operation Hospital, Saudi Arabia, during the year 2011. Maternal and cord blood samples were taken for determination of serum levels of circulating 25-hydroxyvitamin D3 [25(OHD3] concentration, serum calcium (Ca++, phosphorus (PO4 and alkaline phosphatase (ALP. Compared with pregnant women with adequate vitamin D levels, women deficient in vitamin D had infants with vitamin D deficiency (X±SD 33.44±18.33 nmol/L vs 55.39±17.37 nmol/L, P=0.01. Maternal and neonatal serum 25(OHD3 levels showed a positive correlation with serum Ca++ and negative correlation with serum PO4 and ALP. Neonatal 25(OHD was related to maternal 3rd trimester levels (r=0.89, P=0.01. The newborn serum 25(OHD3\tconcentrations rely on maternal vitamin D status. Poor maternal vitamin D status may adversely affect neonatal vitamin D status and, consequently, calcium homeostasis.

  19. Cyclophilin D deficiency improves mitochondrial function and learning/memory in aging Alzheimer disease mouse model

    OpenAIRE

    Du, Heng; Guo, Lan; Zhang, Wensheng; Rydzewska, Monika; Yan, Shidu

    2009-01-01

    Mitochondrial stress is one of the early features of Alzheimer disease (AD). Mitochondrial Aβ has been linked to mitochondrial toxicity. Our recent study demonstrated that cyclophilin D (CypD) mediated mitochondrial permeability transition pore (mPTP) is an important mechanism for neuronal and synaptic stress induced by both Aβ and oxidative stress. In transgenic AD-type mice overexpressing mutant amyloid precursor protein (APP) and Aβ (mAPP), CypD deficiency improves mitochondrial and synapt...

  20. High Prevalence of Vitamin D Deficiency in Patients with Bone Tumors.

    Science.gov (United States)

    Horas, Konstantin; Maier, Gerrit; Jakob, Franz; Maus, Uwe; Kurth, Andreas; Jakuscheit, Axel; Rudert, Maximilian; Holzapfel, Boris Michael

    2017-09-14

    The aim of this study was to evaluate the prevalence of vitamin D deficiency in patients with different types of bone tumors and to elucidate whether or not there are differences in prediagnostic vitamin D levels in patients with malignant compared to benign bone tumors. Prediagnostic serum 25(OH)D levels of 105 consecutive patients that presented with bone tumors and tumor-like lesions to two Orthopedic Level I University Centers in Germany between 2011 and 2016 were measured on admission. We found an alarming and widespread rate of vitamin D deficiency in patients with bone tumors. Specifically, 83% of all patients had low vitamin D levels with a mean 25(OH)D level of 19.82 ng/ml. Notably, patients diagnosed with malignant bone tumors had significantly lower vitamin D levels compared to patients with benign bone lesions (p = 0.0008). In conclusion, it is essential to assess vitamin D levels in patients with tumors involving bone. In addition, there might be an association between vitamin D deficiency and the onset or course of primary malignant bone tumors.

  1. Vitamin D deficiency in patients with osteoarthritis undergoing total hip replacement: a cause for concern?

    Science.gov (United States)

    Nawabi, D H; Chin, K F; Keen, R W; Haddad, F S

    2010-04-01

    We measured the plasma 25-hydroxyvitamin D(3) (25(OH)D(3)) levels in 62 consecutive Caucasian patients undergoing total hip replacement for osteoarthritis. The patients were divided into two groups based on whether they were vitamin D sufficient or deficient. The groups were matched for age, gender and the American Society of Anaesthesiologists (ASA) grade. The prevalence of vitamin D deficiency in our patients was comparable with recent population-based studies performed in the United Kingdom. Patients with vitamin D deficiency had lower pre-operative Harris hip scores (Mann-Whitney test, p = 0.018) and were significantly less likely to attain an excellent outcome from total hip replacement (chi-squared test, p = 0.038). Vitamin D levels were found to positively correlate with both pre- and post-operative Harris hip scores. These results warrant further study of vitamin D deficiency in patients undergoing joint replacement as it is a risk factor for a suboptimal outcome which is relatively simple and cheap to correct.

  2. Vitamin D deficiency among northern Native Peoples: a real or apparent problem?

    Directory of Open Access Journals (Sweden)

    Peter Frost

    2012-03-01

    Full Text Available Vitamin D deficiency seems to be common among northern Native peoples, notably Inuit and Amerindians. It has usually been attributed to: (1 higher latitudes that prevent vitamin D synthesis most of the year; (2 darker skin that blocks solar UVB; and (3 fewer dietary sources of vitamin D. Although vitamin D levels are clearly lower among northern Natives, it is less clear that these lower levels indicate a deficiency. The above factors predate European contact, yet pre-Columbian skeletons show few signs of rickets—the most visible sign of vitamin D deficiency. Furthermore, because northern Natives have long inhabited high latitudes, natural selection should have progressively reduced their vitamin D requirements. There is in fact evidence that the Inuit have compensated for decreased production of vitamin D through increased conversion to its most active form and through receptors that bind more effectively. Thus, when diagnosing vitamin D deficiency in these populations, we should not use norms that were originally developed for European-descended populations who produce this vitamin more easily and have adapted accordingly.

  3. Vitamin D deficiency in rheumatoid arthritis: prevalence, determinants and associations with disease activity and disability.

    Science.gov (United States)

    Rossini, Maurizio; Maddali Bongi, Susanna; La Montagna, Giovanni; Minisola, Giovanni; Malavolta, Nazzarena; Bernini, Luigi; Cacace, Enrico; Sinigaglia, Luigi; Di Munno, Ombretta; Adami, Silvano

    2010-01-01

    The aim of this study was to estimate the prevalence and determinants of vitamin D deficiency in patients with rheumatoid arthritis (RA) as compared to healthy controls and to analyze the association between 25-hydroxyvitamin D (25(OH)D) with disease activity and disability. The study includes 1,191 consecutive RA patients (85% women) and 1,019 controls, not on vitamin D supplements, from 22 Italian rheumatology centres. Together with parameters of disease activity, functional impairment, and mean sun exposure time, all patients had serum 25(OH)D measured in a centralized laboratory. A total of 55% of RA patients were not taking vitamin D supplements; the proportion of these with vitamin D deficiency (25(OH)D level Body mass index (BMI) and sun exposure time were good predictors of 25(OH)D values (P < 0.001). The association between disease activity or functional scores and 25(OH)D levels remained statistically significant even after adjusting 25(OH)D levels for both BMI and sun exposure time. In RA patients vitamin D deficiency is quite common, but similar to that found in control subjects; disease activity and disability scores are inversely related to 25(OH)D levels.

  4. Vitamin D deficiency and hepatitis viruses-associated liver diseases: A literature review.

    Science.gov (United States)

    Hoan, Nghiem Xuan; Tong, Hoang Van; Song, Le Huu; Meyer, Christian G; Velavan, Thirumalaisamy P

    2018-01-28

    The secosteroid hormone vitamin D has, in addition to its effects in bone metabolism also functions in the modulation of immune responses against infectious agents and in inhibiting tumorigenesis. Thus, deficiency of vitamin D is associated with several malignancies, but also with a plethora of infectious diseases. Among other communicable diseases, vitamin D deficiency is involved in the pathogenesis of chronic liver diseases caused by hepatitis B and C viruses (HBV, HCV) and high prevalence of vitamin D deficiency with serum levels below 20 mg/mL in patients with HBV and HCV infection are found worldwide. Several studies have assessed the effects of vitamin D supplementation on the sustained virological response (SVR) to interferon (IFN) plus ribavirin (RBV) therapy in HBV and HCV infection. In these studies, inconsistent results were reported. This review addresses general aspects of vitamin D deficiency and, in particular, the significance of vitamin D hypovitaminosis in the outcome of HBV- and HCV-related chronic liver diseases. Furthermore, current literature was reviewed in order to understand the effects of vitamin D supplementation in combination with IFN-based therapy on the virological response in HBV and HCV infected patients.

  5. Prevalence of Vitamin D Deficiency and Its Association With Metabolic Disease in Korean Orthopedic Patients.

    Science.gov (United States)

    Kim, Ki-Tack; Kang, Kyung-Chung; Shin, Dong-Eun; Lee, Sang-Hoon; Lee, Jung-Hee; Kwon, Tae-Yoon

    2015-10-01

    Vitamin D is considered essential for bone and muscle health, and some studies have demonstrated the positive effects of vitamin D on metabolic diseases and cancer. Nevertheless, a high prevalence of vitamin D deficiency has been reported in various populations, regardless of country or race. However, no studies regarding the prevalence of vitamin D deficiency in Korean orthopedic patients currently exist. This cross-sectional study included 272 male and 937 female patients aged 50 years and older who were consecutively admitted to the authors' orthopedic department. Vitamin D (25-hydroxy vitamin D), bone turnover markers (osteocalcin, c-telopeptide), and bone mineral density were measured. The prevalence of vitamin D deficiency and its association with other factors were evaluated. Mean patient age was 67.2 ± 8.9 years, and mean level of vitamin D was 16.1 ± 9.1 ng/mL. Overall, 91.2% of patients had deficient (orthopedic patients of this region was extremely low, regardless of sex and age. Although vitamin D was not directly associated with bone mineral density, there were significant associations between vitamin D and other factors related to bone health and metabolic diseases. Copyright 2015, SLACK Incorporated.

  6. Prevalence and severity of vitamin D deficiency in patients with diabetic foot infection.

    Science.gov (United States)

    Tiwari, Shalbha; Pratyush, Daliparthy D; Gupta, Balram; Dwivedi, Awanindra; Chaudhary, Sandeep; Rayicherla, Rammohan K; Gupta, Sanjeev K; Singh, Surya Kumar

    2013-01-14

    The aim of the present research was to study the prevalence and severity of vitamin D deficiency in patients with diabetic foot infection. Patients were enrolled in two groups: diabetic patients with foot infection (n 125) as cases and diabetic patients without the infection as controls (n 164). Serum 25-hydroxyvitamin D (25(OH)D) was measured by RIA. Data were presented as means and standard deviations unless otherwise indicated and were analysed by SPSS. Results revealed that 25(OH)D (nmol/l) was significantly lower (40·25 (sd 38·35) v. 50·75 (sd 33·00); P diabetes and HbA1c were significantly higher in cases than in controls and therefore adjusted to nullify the effect of these variables, if any, on study outcome. The study concluded that vitamin D deficiency was more prevalent and severe in patients with diabetic foot infection. This study opens up the issue of recognising severe vitamin D deficiency (diabetic foot infections and the need for vitamin D supplementation in such patients for a better clinical outcome. This could be substantiated by similar data from future studies.

  7. Cyclophilin D deficiency improves mitochondrial function and learning/memory in aging Alzheimer disease mouse model.

    Science.gov (United States)

    Du, Heng; Guo, Lan; Zhang, Wensheng; Rydzewska, Monika; Yan, Shidu

    2011-03-01

    Mitochondrial stress is one of the early features of Alzheimer disease (AD). Mitochondrial Aβ has been linked to mitochondrial toxicity. Our recent study demonstrated that cyclophilin D (CypD) mediated mitochondrial permeability transition pore (mPTP) is an important mechanism for neuronal and synaptic stress induced by both Aβ and oxidative stress. In transgenic AD-type mice overexpressing mutant amyloid precursor protein (APP) and Aβ (mAPP), CypD deficiency improves mitochondrial and synaptic function and learning/memory up to 12 months old. Here we provide evidence of the protective effects of CypD deficiency in aged AD mice (22-24 months). Cyp D deficient mAPP mice demonstrate less calcium-induced mitochondrial swelling, increased mitochondrial calcium uptake capacity, preserved mitochondrial respiratory function and improved spatial learning/memory even in old age (known to be the age for late stage AD pathology and synaptic dysfunction). These data demonstrate that abrogation of CypD results in persistent life-long protection against Aβ toxicity in an Alzheimer's disease mouse model, thereby suggesting that blockade of CypD may be of benefit for Alzheimer disease treatment. Copyright © 2009 Elsevier Inc. All rights reserved.

  8. Is vitamin D deficiency involved in the immune reconstitution inflammatory syndrome?

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    Moreno-Reyes Rodrigo

    2009-04-01

    Full Text Available Abstract Background About 20–30% of persons with HIV infection, especially those living in countries with limited resources, experience an immune reconstitution inflammatory syndrome (IRIS after starting antiretroviral treatment. The active form of vitamin D, 1,25-dihydroxyvitamin D, is a key player in the clearance of pathogens and influences the level of inflammation and macrophage activation. Presentation of the hypothesis We hypothesize that low availability of 1,25-dihydroxyvitamin D, either due to vitamin D deficiency or due to polymorphisms in the vitamin D receptor or in its activating/inactivating enzymes, contributes to the appearance of IRIS. Furthermore, drug interactions with the enzymatic pathways of vitamin D could favour the development of IRIS. Testing the hypothesis Our hypothesis could be explored by a case-control study to assess the prevalence of vitamin D deficiency in HIV-infected patients on antiretroviral treatment who develop and do not develop IRIS. Implications of the hypothesis If the role of vitamin D in IRIS is confirmed, we would be able to screen patients at risk for IRIS by screening for vitamin D deficiency. After confirmation by means of a clinical trial, vitamin D supplementation could be a cheap and safe way to reduce the incidence of IRIS.

  9. The relationship between maternal and child bone density in Nigerian children with and without nutritional rickets.

    Science.gov (United States)

    Bommersbach, T J; Fischer, P R; Pettifor, J M; Thacher, T D

    2018-02-27

    We found a positive relationship between bone density in Nigerian children with and without rickets and that of their mothers. After treatment, children with rickets had greater bone density than children without rickets, indicating that children genetically programmed to have greater bone density may have a higher risk of rickets. To determine the relationship between bone density in children with and without rickets and that of their mothers METHODS: Using an unmatched case-control design, forearm areal bone mineral density (aBMD) was measured in 52 and 135 Nigerian children with and without rickets and their mothers, respectively. We performed multivariate linear regression analyses to assess the relationship between maternal and child aBMD Z-scores. Forearm aBMD Z-scores in children were associated with maternal aBMD Z-scores at metaphyseal (effect estimate 0.23; 95% CI 0.08 to 0.37) and diaphyseal (effect estimate 0.16; 0.01 to 0.30) sites, after adjustment for rickets in the child, child's age and sex, height-for-age Z-score, and weight-for-age Z-score. In the adjusted model, rickets was inversely associated with child's aBMD Z-score at the diaphyseal site only (- 0.45, - 0.65 to - 0.24). The positive relationship between maternal and child aBMD Z-scores was marginally greater in children with rickets (slope 0.56, r = 0.47) than without rickets (slope 0.19, r = 0.20) at the diaphyseal site only (P = 0.06 for interaction) but not at the metaphyseal site (slopes 0.35 and 0.30, respectively, P = 0.48). After treatment with calcium for 6 months, metaphyseal aBMD Z-scores were greater in children with treated rickets (effect estimate 0.26; 95% CI 0.02 to 0.49) than in those without rickets. In Nigerian children with and without rickets, forearm aBMD Z-scores were positively associated with maternal aBMD Z-scores. Active rickets in the child marginally modified the relationship at the diaphyseal site only. After treatment, children with

  10. Vitamin D Deficiency and Cardiometabolic Risks: A Juxtaposition of Arab Adolescents and Adults.

    Directory of Open Access Journals (Sweden)

    Nasser M Al-Daghri

    Full Text Available The recent exponential surge in vitamin D research reflects the global epidemic of vitamin D deficiency and its potential impact on several chronic diseases in both children and adults. Several subpopulations, including Arab adolescent boys and girls, remain understudied. This study aims to fill this gap. A total of 2225 apparently healthy Saudi adolescents (1187 boys and 1038 girls, aged 13-17 years old and 830 adults (368 men and 462 women, aged 18-50 years old were respectively recruited from different public schools and medical practices within Riyadh, Saudi Arabia. Anthropometrics were taken and fasting blood samples withdrawn to examine serum glucose and lipid profile by routine analysis and 25-hydroxyvitamin D by ELISA. Almost half of the girls (47.0% had vitamin D deficiency as compared to only 19.4% of the boys (p<0.001, 36.8% of the adult women and 17.7% of the adult men (p<0.001. Furthermore, in boys there were more significant inverse associations between serum 25(OHvitamin D levels and cardiometabolic indices than girls, while in contrast women had more significant associations than men. Vitamin D deficiency was significantly associated with diabetes mellitus type 2 (DMT2 [OR 3.47 (CI1.26-5.55; p<0.05] and pre-DM [OR 2.47 (CI 1.48-4.12; p<0.01] in boys. Furthermore, vitamin D insufficiency was significantly associated with abdominal obesity in boys [OR 2.75 (CI 1.1-7.1; p<0.05]. These associations for DMT2 and abdominal obesity were not observed in adult males, girls and adult women. Vitamin D deficiency/insufficiency and hyperglycemia is high among Arab adolescents. Vitamin D deficiency is mostly associated with cardiometabolic risk factors in adolescent Arab boys. This indicates a sex- and age-related disadvantage for boys with low vitamin D status and challenges the extra-skeletal protection of vitamin D correction in adolescent females.

  11. The natural history of vitamin D deficiency in African refugees living in Sydney.

    Science.gov (United States)

    Benitez-Aguirre, Paul Z; Wood, Nicholas J; Biesheuvel, Cornelis; Moreira, Conrad; Munns, Craig F

    2009-04-20

    To describe the natural history of vitamin D deficiency in an at-risk population of African migrants living in Sydney. Opportunistic study of 25-hydroxyvitamin D [25(OH)D] concentrations over time in a community-based cohort of North African refugee families living in south-western Sydney. As part of a health-screening program, serum concentrations of 25(OH)D, parathyroid hormone (PTH), calcium, phosphate (PO(4)) and alkaline phosphatase (ALP) were measured in September 2006 (end of winter, T1). Results for 25(OH)D were made available, and treatment was recommended as appropriate. In February-March 2007 (end of summer, T2), in the setting of a separate study of high-dose vitamin D (stoss) therapy, the same cohort was contacted, and measurements were repeated. Changes in 25(OH)D, PTH, ALP and PO(4) concentrations between T1 and T2 in those who had not received vitamin D supplementation in the intervening period. We collected data from 149 participants at T1; by T2, 58 participants (39%) had been excluded or lost to follow-up. Data from 91 participants (46% female), all of whom had Type VI (very dark) skin pigmentation, were included in the analysis. All 91 were 25(OH)D deficient at T1. Between T1 and T2, mean 25(OH)D serum concentration increased from 19 nmol/L (SD, 5.6 nmol/L) to 36 nmol/L (SD, 12.4 nmol/L) (P < 0.001). Of the 91 participants, 79 (87%) remained vitamin D deficient at T2. Serum PTH and ALP activity decreased between T1 and T2 (P < 0.05). Despite a significant increase in 25(OH)D serum concentration over the study period, most participants (87%) remained 25(OH)D deficient at the end of summer. Our results support the current consensus that recommends annual screening for vitamin D deficiency and routine vitamin D supplementation in at-risk populations, such as dark-skinned or veiled groups.

  12. Relationship between unexplained arthralgia and vitamin D deficiency: a case control study.

    Directory of Open Access Journals (Sweden)

    Behzad Heidari

    2014-05-01

    Full Text Available Arthralgia is a common presenting symptom of many rheumatic diseases. Vitamin D deficiency may lead to progression of skeletal symptoms to definite disease in susceptible subjects. This study was conducted to determine the relationship between vitamin D deficiency and unexplained arthralgia. Patients with arthralgia not related to a definite clinical condition were selected prospectively among subjects presented to a rheumatology clinic. Serum 25-hydroxyvitamin D (25-OHD was measured by ELISA method and levels less than 20 ng/ml were considered as deficient levels. Serum 25-OHD levels and proportion of 25-OHD deficiency was compared in patients versus control. The association of serum 25-OHD and arthralgia was assessed by calculation of odds ratio (OR using regression analysis. 167 patients with mean age of 38 ± 13.3 and 283 controls with mean age of 42.6±14.37 years (P=0.001 were studied. In patients mean serum 25-OHD was lower and proportion of deficiency was higher (P=0.001 for both.Serum 25-OHD deficiency was associated with 3.01 times increased risk of arthralgia (OR=3.01, 95% CI, 2.0- 4.25, P=0.001. After adjusment for age and sex, the risk of arthralgia remained significan at OR= 2.71(95%CI, 1.79-4.11,P=0.001.The odds of arthralgia decreased with increasing serum 25-OHD from OR=3.48 (95% CI,197-6,P=0.001 at serum <10 ng/ml to 3.39 (95%CI,1.93-5.98, P=0.001 at 10-19.9; and 1.31 (95%CI, 0.69-2.5, P=0.42 at 20-29.9 ng/ml. These findings indicate significant association of vitamin D deficiency and arthralgia. Regarding vitamin D deficiency as an environmental factor for development or progression of rheumatic diseases, this study justifies identification and correction of vitamin D deficiency in patients with arthralgia.

  13. Treating vitamin D deficiency in children with type I diabetes could improve their glycaemic control.

    Science.gov (United States)

    Giri, Dinesh; Pintus, Dona; Burnside, Girvan; Ghatak, Atrayee; Mehta, Fulya; Paul, Princy; Senniappan, Senthil

    2017-09-07

    The relationship between vitamin D deficiency and type I DM is an ongoing area of interest. The study aims to identify the prevalence of vitamin D deficiency in children and adolescents with T1DM and to assess the impact of treatment of vitamin D deficiency on their glycaemic control. Retrospective data was collected from 271 children and adolescents with T1DM. The vitamin D deficient (25(OH)D <30 nmol/L) and insufficient (25(OH)D 30-50 nmol/L) patients were treated with 6000 units of cholecalciferol and 400 units of cholecalciferol, once daily for 3 months respectively. HbA1c and 25(OH)D concentrations were measured before and at the end of the vitamin D treatment. 14.8% from the whole cohort (n = 271) were vitamin D deficient and 31% were insufficient. Among the children included in the final analysis (n = 73), the mean age and plasma 25(OH)D concentration (±SD) were 7.7 years (±4.4) and 32.2 nmol/l (±8.2) respectively. The mean 25(OH)D concentration post-treatment was 65.3 nmol/l (±9.3). The mean HbA1c (±SD) before and after cholecalciferol was 73.5 mmol/mol (±14.9) and 65 mmol/mol (±11.2) respectively (p < 0.001). Children with higher pre-treatment HbA1c had greater reduction in HbA1c (p < 0.001) and those with lower 25(OH)D concentration showed higher reduction in HbA1c (p = 0.004) after treatment. Low 25(OH)D concentrations are fairly prevalent in children and adolescents with T1DM, treatment of which, can potentially improve the glycaemic control.

  14. Dental manifestations of patient with Vitamin D-resistant rickets

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    Andreia Pereira SOUZA

    2013-12-01

    Full Text Available Patients with Vitamin D-resistant rickets have abnormal tooth morphology such as thin globular dentin and enlarged pulp horns that extend into the dentino-enamel junction. Invasion of the pulp by microorganisms and toxins is inevitable. The increased fibrotic content of the pulp, together with a reduced number of odontoblasts, decreases the response to pulp infection. The most important oral findings are characterized by spontaneous gingival and dental abscesses occuring without history of trauma or caries. Radiographic examinations revealed large pulp chambers, short roots, poorly defined lamina dura and hypoplastic alveolar ridge. These dental abscesses are common and therefore the extraction and pulpectomy are the treatment of choice. The purpose of this article is to report a case of Vitamin D-resistant rickets in a 5 year-old boy, describing the dental findings and the treatment to be performed in these cases.

  15. Dental manifestations of patient with Vitamin D-resistant rickets

    Science.gov (United States)

    SOUZA, Andréia Pereira; KOBAYASHI, Tatiana Yuriko; LOURENÇO NETO, Natalino; SILVA, Salete Moura Bonifácio; MACHADO, Maria Aparecida Andrade Moreira; OLIVEIRA, Thais Marchini

    2013-01-01

    Patients with Vitamin D-resistant rickets have abnormal tooth morphology such as thin globular dentin and enlarged pulp horns that extend into the dentino-enamel junction. Invasion of the pulp by microorganisms and toxins is inevitable. The increased fibrotic content of the pulp, together with a reduced number of odontoblasts, decreases the response to pulp infection. The most important oral findings are characterized by spontaneous gingival and dental abscesses occuring without history of trauma or caries. Radiographic examinations revealed large pulp chambers, short roots, poorly defined lamina dura and hypoplastic alveolar ridge. These dental abscesses are common and therefore the extraction and pulpectomy are the treatment of choice. The purpose of this article is to report a case of Vitamin D-resistant rickets in a 5 year-old boy, describing the dental findings and the treatment to be performed in these cases. PMID:24473729

  16. Dental abnormalities and oral health in patients with Hypophosphatemic rickets

    Directory of Open Access Journals (Sweden)

    Melissa Almeida Souza

    2010-01-01

    Full Text Available INTRODUCTION: Hypophosphatemic rickets represents a group of heritable renal disorders of phosphate characterized by hypophosphatemia, normal or low serum 1,25 (OH2 vitamin D and calcium levels. Hypophosphatemia is associated to interglobular dentine and an enlarged pulp chambers. AIM: Our goal was to verify the dental abnormalities and the oral health condition in these patients. MATERIAL AND METHODS: Prospective study of oral conditions in patients with Hypophosphatemic rickets. This report employed a simple method to be easily reproducible: oral clinical exam and radiographic evaluation. RESULTS: Fourteen patients were studied, 5 males, median age of 11years (4 to 26. Occlusion defects (85,7% and enamel hypoplasia (57,1% were significant more frequently than dental abscesses (one patient. We observed enlarged pulp chambers in 43% of the patients and hypoplasia and dentin abnormalities in 14,3%. We could not detect a significant correlation between dental abnormalities and delayed treatment (p>0,05. DMFT index for 6 to 12 years patients (n = 12 showed that the oral health is unsatisfactory (mean DMFT = 5. CONCLUSIONS: Patients with Hypophosphatemic Rickets frequently present dental alterations and these are not completely recovered with the treatment, unless dental abscess and they need a periodical oral examination.

  17. Efficacy and safety of vitamin D3 B.O.N intramuscular injection in Korean adults with vitamin D deficiency

    Directory of Open Access Journals (Sweden)

    Han Seok Choi

    2016-12-01

    Conclusion: Intramuscular injection of vitamin D3 200,000 IU was superior to placebo in terms of its impact on serum 25(OHD concentrations, and is considered to be safe and effective in Korean adults with vitamin D deficiency.

  18. Vitamin D deficiency in childhood obesity is associated with high levels of circulating inflammatory mediators, and low insulin sensitivity

    NARCIS (Netherlands)

    Reyman, M.; Verrijn Stuart, A.A.; van Summeren, M.J.H.; Rakhshandehroo, M.; Nuboer, R.; de Boer, F.K.; van den Ham, H.J.; Kalkhoven, E.; Prakken, B.J.; Schipper, H.S.

    2014-01-01

    HYPOTHESIS: Childhood obesity is accompanied by low-grade systemic inflammation, which contributes to the development of insulin resistance and cardiovascular complications later in life. As vitamin D exhibits profound immunomodulatory functions and vitamin D deficiency is highly prevalent in

  19. Depression of calcium pump activity in renal cortex of vitamin D-deficient rats with secondary hyperparathyroidism

    Energy Technology Data Exchange (ETDEWEB)

    Tsukamoto, Yusuke; Saitoh, Michiyo (Department of Medicine, Kitasato University School of Medicine, Kanagawa (Japan)); Takita, Yumiko; Nakano, Toshiaki (Medical Science Centre, Applied Research Laboratories, Chugai Pharmaceutical Co, Tokyo (Japan)); Tamura, Teiichi (Second Department of Internal Medicine, Tokyo Medical and Dental University, Tokyo (Japan))

    1990-01-01

    To examine the hormonal regulation of the ATP-dependent Ca{sup 2+} pump in the kidneys, the ATP-dependent Ca{sup 2+} uptake by the basolateral membrane vesicles in the renal cortex was measured using radioactive calcium ({sup 45}Ca{sup 2+}) in rats with vitamin D deficiency or rats undergoing thyroparathyroidectomy. The V{sub max} of the Ca{sup 2+} pump activity was increased not only by administering calcitriol, but also by normalizing the serum calcium level in vitamin D-deficient rats. PTH suppressed the Ca{sup 2+} pump activity in normocalcemic vitamin D-deficient rats. Thyroparathyroidectomy did not affect the Ca{sup 2+} pump activity in the kidneys of normal rats. It was concluded that the ATP-dependent Ca{sup 2+} pump activity was depressed by secondary hyperparathyroidism in vitamin D-deficient rats. (author).

  20. Vitamin D deficiency associates with γ-tocopherol and quadriceps weakness but not inflammatory cytokines in subjects with knee osteoarthritis

    OpenAIRE

    Barker, Tyler; Henriksen, Vanessa T; Victoria E. Rogers; Aguirre, Dale; Trawick, Roy H.; Lynn Rasmussen, G.; Momberger, Nathan G.

    2014-01-01

    Knee osteoarthritis (OA) is a degenerative joint condition and a leading cause of physical disability in the United States. Quadriceps weakness and inflammatory cytokines contribute to the pathogenesis of knee OA, and both of which, increase with vitamin D deficiency. Other micronutrients, such as vitamins C and E and β-carotene, modulate inflammatory cytokines and decrease during inflammation. The purpose of this study was to test the hypothesis that vitamin D deficiency associates with quad...

  1. The prevalence of vitamin D deficiency in consecutive new patients seen over a 6-month period in general rheumatology clinics.

    Science.gov (United States)

    Haroon, Muhammad; Bond, Ursula; Quillinan, Niamh; Phelan, Mark J; Regan, Michael J

    2011-06-01

    The objectives of this study are to assess: (a) the prevalence of vitamin D deficiency among new patients attending rheumatology outpatient departments, (b) the age profile of these low vitamin D patients and (c) whether any diagnostic category had a particularly high number of vitamin D-deficient patients. All new patients seen consecutively in general rheumatology clinics between January to June 2007 inclusive were eligible to partake in this study, and 231 out of 264 consented to do so. Parathyroid hormone, 25-hydroxyvitamin D, creatinine, calcium, phosphate, albumin and alkaline phosphatase levels were measured. We defined vitamin D deficiency as ≤53 nmol/l and severe deficiency as ≤25 nmol/l. Overall, 70% of 231 patients had vitamin D deficiency, and 26% had severe deficiency. Sixty-five percent of patients aged ≥65 and 78% of patients aged ≤30 years had low vitamin D levels. Vitamin D deficiency in each diagnostic category was as follows: (a) inflammatory joint diseases/connective tissue diseases (IJD/CTD), 69%; (b) soft tissue rheumatism, 77%; (c) osteoarthritis, 62%; (d) non-specific musculoskeletal back pain, 75% and (e) osteoporosis, 71%. Seasonal variation of vitamin D levels was noted in all diagnostic groups apart from IJD/CTD group, where the degree of vitamin D deficiency persisted from late winter to peak summer. Very high prevalence of vitamin D deficiency was noted in all diagnostic categories (p = 0.006), and it was independent of age (p = 0.297). The results suggest vitamin D deficiency as a possible modifiable risk factor in different rheumatologic conditions, and its role in IJD/CTD warrants further attention.

  2. The prevalence of vitamin D deficiency in consecutive new patients seen over a 6-month period in general rheumatology clinics.

    LENUS (Irish Health Repository)

    Haroon, Muhammad

    2012-02-01

    The objectives of this study are to assess: (a) the prevalence of vitamin D deficiency among new patients attending rheumatology outpatient departments, (b) the age profile of these low vitamin D patients and (c) whether any diagnostic category had a particularly high number of vitamin D-deficient patients. All new patients seen consecutively in general rheumatology clinics between January to June 2007 inclusive were eligible to partake in this study, and 231 out of 264 consented to do so. Parathyroid hormone, 25-hydroxyvitamin D, creatinine, calcium, phosphate, albumin and alkaline phosphatase levels were measured. We defined vitamin D deficiency as <\\/=53 nmol\\/l and severe deficiency as <\\/=25 nmol\\/l. Overall, 70% of 231 patients had vitamin D deficiency, and 26% had severe deficiency. Sixty-five percent of patients aged >\\/=65 and 78% of patients aged <\\/=30 years had low vitamin D levels. Vitamin D deficiency in each diagnostic category was as follows: (a) inflammatory joint diseases\\/connective tissue diseases (IJD\\/CTD), 69%; (b) soft tissue rheumatism, 77%; (c) osteoarthritis, 62%; (d) non-specific musculoskeletal back pain, 75% and (e) osteoporosis, 71%. Seasonal variation of vitamin D levels was noted in all diagnostic groups apart from IJD\\/CTD group, where the degree of vitamin D deficiency persisted from late winter to peak summer. Very high prevalence of vitamin D deficiency was noted in all diagnostic categories (p = 0.006), and it was independent of age (p = 0.297). The results suggest vitamin D deficiency as a possible modifiable risk factor in different rheumatologic conditions, and its role in IJD\\/CTD warrants further attention.

  3. Rationale and Design of Khuzestan Vitamin D Deficiency Screening Program in Pregnancy: A Stratified Randomized Vitamin D Supplementation Controlled Trial

    OpenAIRE

    Rostami, Maryam; Ramezani Tehrani, Fahimeh; Simbar, Masoumeh; Hosseinpanah, Farhad; Alavi Majd, Hamid

    2017-01-01

    Background Although there have been marked improvements in our understanding of vitamin D functions in different diseases, gaps on its role during pregnancy remain. Due to the lack of consensus on the most accurate marker of vitamin D deficiency during pregnancy and the optimal level of 25-hydroxyvitamin D, 25(OH)D, for its definition, vitamin D deficiency assessment during pregnancy is a complicated process. Besides, the optimal protocol for treatment of hypovitaminosis D and its effect on m...

  4. Vitamin D Deficiency and Pain: Clinical Evidence of Low Levels of Vitamin D and Supplementation in Chronic Pain States

    OpenAIRE

    Shipton, Elspeth E.; Shipton, Edward A.

    2015-01-01

    Introduction A number of studies suggest a link between low levels of 25-hydroxy vitamin D and incidence of acute and chronic pain. Clinical studies of vitamin D supplementation in patients with known vitamin D deficiency have shown mixed results in improving pain scores. Methods In this article, vitamin D deficiency risk factors are observed and adequate levels of 25-hydroxy vitamin D defined. Clinical supplementation with vitamin D is explored, including the schedules used in published clin...

  5. Use of a Loading Dose of Vitamin D for Treatment of Vitamin D Deficiency in Patients With Intestinal Failure.

    Science.gov (United States)

    Grenade, Neil; Kosar, Christina; Steinberg, Karen; Avitzur, Yaron; Wales, Paul W; Courtney-Martin, Glenda

    2017-03-01

    Vitamin D deficiency is common in patients with intestinal failure and short bowel syndrome who have been weaned of parenteral nutrition. Dietary supplementation with vitamin D is necessary to correct this deficiency. In certain cases, routine supplementation strategy may be ineffective. We report 3 cases of vitamin D deficiency in patients with intestinal failure who showed improvement in serum 25-hydroxyvitamin D levels after supplementation with a loading dose of 20,000-40,000 IU vitamin D provided weekly.

  6. Vitamin D Deficiency in Patients with Central Retinal Vein Occlusion: A Case Control Study.

    Science.gov (United States)

    Epstein, David; Kvanta, Anders; Lindqvist, Pelle G

    2017-03-01

    Central retinal vein occlusion (CRVO) has been shown to occur more often in winter/spring season. We aimed to evaluate if patients with CRVO have more vitamin D deficiency compared to matched controls. Prospective match controlled study of 72 patients with CRVO and 144 matched controls. All new CRVO cases presenting at St. Erik Eye Hospital, Stockholm, Sweden during the study period were approached to participate. Statistics Sweden provided randomly selected controls matched for age, gender, and season. The first 18 cases of CRVO and 36 controls for each of the four seasons were included and blood was drawn for 25-OH vitamin D analysis (25(OH)D). About half of the patients (51.4%) in the CRVO group had vitamin D deficiency [25(OH)D D were 55.3 nmol/l (95% CI 48.4-62.2) in the study group and 59.8 nmol/l (95% CI 55.4-64.2) in the control group (p = 0.28). In stratified analysis, the CRVO patients under 75 years had significantly lower 25(OH)D levels than the matched controls (47.8 nmol/l vs. 59.0 nmol/l, p = 0.02). Vitamin D deficiency is common in patients with CRVO. No significant differences in vitamin deficiency or 25(OH)D levels were found in comparison to the control group. However, the CRVO patients under 75 years had significantly lower 25(OH)D levels as compared to the control group.

  7. Methods chosen by parents of preschoolers to prevent vitamin D deficiency

    Directory of Open Access Journals (Sweden)

    Lucyna Sochocka

    2015-06-01

    Full Text Available Introduction. Results of the epidemiologic studies conducted over recent years indicate vitamin D deficiency, especially among children and young people. The following factors affecting occurrence of vitamin D deficiency growth should be mentioned: improper lifestyle, using UV filters and inadequate vitamin D intake. The aim of the research was an attempt to evaluate action carried out as part of preschoolers' vitamin d deficiency prophylaxis taken by their parents. Material and the methods. The research was conducted in 2014. The group contained 118 parents of children aged 4–6. The method of the diagnostic survey was utilized in the research with poll used as a technique and author's survey questionnaire provided as a tool. The obtained results of the research underwent statistical analysis. In order to define the existence of the differences or correlations between analyzed immeasurable parameters, chi–square test was used. Results. Most of the interviewed parents supply their children with fish; 14.4% (n=17 do this 2–3 a week;8.5% (n=10 would never serve their children fish. Whole milk, cheese and eggs were most frequently chosen among products containing vitamin D. Children of 93.2% (n=110 of the interviewed parents spend at least two hours a day outdoors from April to September. However, less than 89.8% (n=106 of the parents state that that children’s skin is protected with UV sunscreen at the time. 14.4% (n=17 of the interviewed parents provide their kids with vitamin D on a daily basis, all year around. Cod liver oil is the most common preparation chosen by parents who declared vitamin D supplementation. Conclusions. On-going education of parents concerning nutrition principles of children seems necessary as they are responsible for cultivating good eating habits among the young.

  8. Vitamin D deficiency is associated with functional decline and falls in frail elderly women despite supplementation.

    Science.gov (United States)

    Kotlarczyk, M P; Perera, S; Ferchak, M A; Nace, D A; Resnick, N M; Greenspan, S L

    2017-04-01

    We examined the impact of daily supplementation on vitamin D deficiency, function, and falls in female long-term care residents. Initial vitamin D deficiency was associated with greater functional decline and increased fall risk despite guideline-recommended supplementation, highlighting the importance of preventing vitamin D deficiency in frail elderly. Institute of Medicine (IOM) guidelines recommend 800 IU vitamin D daily for older adults and maintaining serum 25-hydroxyvitamin D [25(OH) D] above 20 ng/ml for optimal skeletal health. The adequacy of IOM guidelines for sustaining function and reducing falls in frail elderly is unknown. Female long-term care residents aged ≥65 enrolled in an osteoporosis clinical trial were included in this analysis (n = 137). Participants were classified based on baseline 25(OH) D levels as deficient (30 ng/ml, n = 71). Deficient women were provided initial vitamin D repletion (50,000 IU D3 weekly for 8 weeks). All were supplemented with 800 IU vitamin D3 daily for 24 months. Annual functional assessments included Activities of Daily Living (ADLs), Instrumental ADL (IADL), physical performance test (PPT), gait speed, cognition (SPMSQ), and mental health (PHQ-9). We used linear mixed models for analysis of functional measures and logistic regression for falls. Daily supplementation maintained 25(OH) D levels above 20 ng/ml in 95% of participants. All groups demonstrated functional decline. Women initially deficient had a greater decline in physical function at 12 (IADL -2.0 ± 0.4, PPT -3.1 ± 0.7, both p function and preventing falls is needed.

  9. Vitamin D deficiency is associated with inflammatory cytokine concentrations in patients with diabetic foot infection.

    Science.gov (United States)

    Tiwari, Shalbha; Pratyush, Daliparthy Devi; Gupta, Sanjeev Kumar; Singh, Surya Kumar

    2014-12-28

    Vitamin D has been recognised as a potent immunomodulator and its deficiency is common in different population groups including patients with diabetic foot infection. Diabetic foot infection reflects the altered immune status of the host. As cytokine regulation plays a significant role in infection and wound-healing processes, the present study aimed to evaluate the association between vitamin D status and inflammatory cytokine profiles in patients with diabetic foot infection. The serum concentrations of vitamin D (25-hydroxyvitamin D), IL-1β, IL-6, TNF-α and interferon-γ (IFN-γ) were measured in 112 diabetic foot infection cases and 109 diabetic controls. Severe vitamin D deficiency (25-hydroxyvitamin D concentration diabetes, HbA1C (glycosylated Hb) concentration and BMI were similar, cases had significantly higher concentrations of IL-6 (P≤ 0.001), IL-1β (P≤ 0.02) and TNF-α (P≤ 0.006) than controls. A significant negative correlation was also observed between 25-hydroxyvitamin D concentration and circulating concentrations of IL-1β (r -0.323; P≤ 0.001) as well as IL-6 (r -0.154; P≤ 0.04), but not between 25-hydroxyvitamin D and TNF-α and IFN-γ concentrations. Furthermore, a significant difference in IL-1β (P≤ 0.007) and IL-6 (P≤ 0.02) concentrations was observed in patients with severe 25-hydroxyvitamin D deficiency compared with patients with 25-hydroxyvitamin D concentration ≥ 25 nmol/l, and this difference was remarkable for TNF-α. In conclusion, severe vitamin D deficiency is associated with elevated inflammatory cytokine concentrations in diabetic patients, particularly in those with foot infection. A 25-hydroxyvitamin D concentration value diabetes mellitus.

  10. Restorative Effect of Vitamin D Deficiency on Knee Pain and Quadriceps Muscle Strength in Knee Osteoarthritis.

    Science.gov (United States)

    Heidari, Behzad; Javadian, Yahya; Babaei, Mansour; Yousef-Ghahari, Behnaz

    2015-08-01

    Both vitamin D deficiency and quadriceps muscle weakness are associated with knee osteoarthritis (KOA) and pain. The aim of this study was to determine the restorative effect of vitamin D deficiency on pain and quadriceps muscle strength in knee osteoarthritis. Patients with KOA aged ≥30 years, the presence of knee pain for at least one month or longer and serum 25-hydroxyvitamin (25-OHD) deficiencies were recruited in the study. Participants with KOA compatible with Kellgren-Lawrence grade 4, joint instability, and effusion, history of surgery or inflammatory arthropathies were excluded. Serum 25-OHD was assessed by ELISA method and concentrationsmuscle strength was measured by dynamometry method and intensity of knee pain by Western Ontario and McMaster University Osteoarthritis index scored by Likert scale and visual analog scale. All participants received 50.000 IU oral cholecalciferol weekly for at least two months. The influence of raising serum 25-OHD on quadriceps muscle strength and pain was assessed by calculation of mean changes from baseline at the end of the treatment period using paired t-test. A total of 67 patients with mean age of 50±6.6 years of age were treated for 2 months. Serum 25-OHD reached to sufficient levels in all except one patient. At the end of the study period, serum 25-OHD and quadriceps muscle strength increased significantly as compared with baseline (P=0.007 and P=0.002, respectively), whereas knee pain decreased significantly based on Western Ontario and McMaster University Osteoarthritis index (P=0.001)as well as visual analogue scale scores (P=0.001). These findings indicated that correction of vitamin D deficiency in patients with KOA exerts a significant favorable effect on quadriceps muscle strength and knee pain.

  11. Association of vitamin D deficiency with hepatitis B virus - related liver diseases.

    Science.gov (United States)

    Hoan, Nghiem Xuan; Khuyen, Nguyen; Binh, Mai Thanh; Giang, Dao Phuong; Van Tong, Hoang; Hoan, Phan Quoc; Trung, Ngo Tat; Anh, Do Tuan; Toan, Nguyen Linh; Meyer, Christian G; Kremsner, Peter G; Velavan, Thirumalaisamy P; Song, Le Huu

    2016-09-23

    As an immune modulator, vitamin D is involved in various pathophysiological mechanisms in a plethora of diseases. This study aims to correlate the vitamin D deficiency status and clinical progression of liver diseases associated with hepatitis B virus (HBV) infection in patients in Vietnam and to compare it to healthy controls. We quantified the levels of total vitamin D [25-(OH) D2 and D3] in serum samples from 400 HBV patients (chronic hepatitis B infection [CHB], n = 165; HBV-associated liver cirrhosis [LC], n = 127; HBV-associated hepatocellular carcinoma [HCC], n = 108) and 122 unrelated healthy controls (HC). Univariate and multivariate analyses were performed in order to determine the association between vitamin D levels and distinct clinical parameters. The prevalence of vitamin D inadequacy (Vitamin D deficiency (Vitamin D levels and HBV-DNA load were strongly and inversely correlated (rho = -0.57, P vitamin D levels (P = 0.0004). In addition, reduced vitamin D levels were associated with significant clinical progression of LC (Child-Pugh C versus Child-Pugh A, P = 0.0018; Child-Pugh C versus Child-Pugh B, P = 0.016). Vitamin D deficiency was observed in the majority of HBV-infected patients and associated with adverse clinical outcomes. Our findings suggest that substitution of vitamin D may be a supportive option in the treatment of chronic liver diseases, in particular of HBV-associated disorders.

  12. Effects of Vitamin D deficiency treatment on metabolic markers in Hashimoto thyroiditis patients

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    Parichehr Vahabi Anaraki

    2017-01-01

    Full Text Available Background: The aim of the current trial was to investigate the effect of Vitamin D treatment on metabolic markers in people with Vitamin D deficiency and thyroid autoimmunity. Materials and Methods: In this double-blind, randomized, placebo-controlled clinical trial, 65 Vitamin D deficient euthyroid or hypothyroid patients with positive TPO-Ab were enrolled. They randomly allocated into two groups to receive oral Vitamin D3 (50000 IU weekly and placebo for 12 weeks. Serum concentration of calcium, phosphorus, albumin, C-reactive protein, blood urea nitrogen, creatinine, glycated hemoglobin (HbA1c, insulin, fasting plasma glucose (FPG, triglyceride (TG, total cholesterol, and high-density lipoprotein were measured in both groups before and after the trial. Homeostasis model assessment estimates of beta cell function (HOMA-B and HOMA-insulin resistance (HOMA-IR were calculated before and after trial in both groups. Results: Thirty-three and thirty-two participants were allocated to Vitamin D-treated and placebo-treated groups, respectively. Mean (standard error level of Vitamin D increased significantly in Vitamin D-treated group (45.53 [1.84] ng/mL vs. 12.76 [0.74] ng/mL, P = 0.001. The mean of HbA1c and insulin was increased significantly both in Vitamin D-treated and placebo-treated groups (P < 0.05. Other variables did not meet a significant change after trial (P = NS. In between-group comparison, there was not any significant difference between Vitamin D-treated and placebo-treated groups regarding measures of HOMA-B, HOMA-IR, FPG, HbA1c, and TG (P = NS. Conclusion: Our findings showed that weekly 50000 IU oral Vitamin D3 for 12 weeks did not improve metabolic markers, IR, or insulin secretion in Vitamin D deficient patients with Hashimoto thyroiditis.

  13. Prevalence of Vitamin D Deficiency among Female Students in Secondary Guidance School in Yazd City

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    Shakiba Mehrdad

    2009-10-01

    Full Text Available Vitamin D is essential for growth and vitamin D deficiency is important issue in adolescent girls as they have a limited rapid growth period .This cross sectional study was done on 167 female students in secondary guidance school in 2006. Growth Parameters, taking supplementary vitamin D, using sunscreen creams and the type of housing and their avoidance from exposure to sunlight was recorded. Symptoms such as weakness, muscle pain, cramp and early fatigability were asked. 25-Hydroxyvitamin D was measured by RIA method, level less than 20ng /ml was considered as deficiency and less than 8ng/ml as sever deficiency. Study showed only 67 girl(40% have normal vitamin D level,60% suffered vitamin D deficiency (95% CI 52.3-67.5 and 21% out of them suffered sever deficiency (95% CI 14.8- 27.2.No correlation existed between vitamin D level and BMI in our students.There was a correlation between taking supplementary vitamin D and the serum level of 25-Hydroxyvitamin D (P <0.05 . People living in the houses with yards had higher vitamin D (P <0.05. People who run away from the sun light exposure for any reason have lower vitamin D level significantly (P <0.0001.There is no correlation between symptoms such as weakness, myalgia, cramp and vitamin D level (P >0.05"nPresent study showed that despite the fact that Yazd is a sunny city most of the days even in winter; prevalence of vitamin D deficiency among growing female is concerning and requires preventive interference.

  14. Does vitamin D supplementation improve bone density in vitamin D-deficient children?

    DEFF Research Database (Denmark)

    Winzenberg, Tania; Lamberg-Allardt, Christel; El-Hajj Fuleihan, Ghada

    2018-01-01

    INTRODUCTION: Our previous study-level (aggregate data) meta-analysis suggested that vitamin D supplements may be beneficial for bone density specifically in children with vitamin D deficiency. However, the misclassification of vitamin D status inherent in study-level data means that the results...... are not definitive and cannot provide an accurate assessment of the size of any effect. Therefore, we propose to undertake an individual patient data (IPD) meta-analysis to determine whether the effect of vitamin D supplementation on bone density in children differs according to baseline vitamin D status...... supplementation reporting bone density outcomes at least 6 months after the study commenced in children and adolescents (aged

  15. Cord blood 25(OH)-vitamin D deficiency and childhood asthma, allergy and eczema

    DEFF Research Database (Denmark)

    Chawes, Bo L; Bønnelykke, Klaus; Jensen, Pia F

    2014-01-01

    on Asthma in Childhood (COPSAC2000) at-risk mother-child cohort. Troublesome lung symptoms (TROLS), asthma, respiratory infections, allergic rhinitis, and eczema, at age 0-7 yrs were diagnosed exclusively by the COPSAC pediatricians strictly adhering to predefined algorithms. Objective assessments of lung...... with respiratory infections or asthma. We saw no association between cord blood 25(OH)-Vitamin D level and lung function, sensitization, rhinitis or eczema. The effects were unaffected from adjusting for multiple lifestyle factors. CONCLUSION: Cord blood 25(OH)-Vitamin D deficiency associated with increased risk...

  16. Osteoporosis and vitamin-D deficiency among postmenopausal women with osteoarthritis undergoing total hip arthroplasty.

    Science.gov (United States)

    Glowacki, Julie; Hurwitz, Shelley; Thornhill, Thomas S; Kelly, Michael; LeBoff, Meryl S

    2003-12-01

    Several epidemiological studies have shown a lower prevalence of osteoporotic hip fractures in patients with osteoarthritis. Other studies have demonstrated elevated bone mineral density in patients with osteoarthritis. The prevailing view is that there may be an inverse relationship between osteoarthritis and osteoporosis. The purposes of the present study were to describe a subgroup of patients with osteoarthritis who were found to have osteoporosis and to assess the vitamin-D status and other risk factors for low bone density in osteoarthritic subjects with and without osteoporosis. The bone mineral density of the spine, the proximal part of the femur, and the total body was measured with dual-energy x-ray absorptiometry in sixty-eight postmenopausal white women who were scheduled to undergo total hip replacement for advanced osteoarthritis. The serum levels of 25-hydroxyvitamin D, 1,25-dihydroxyvitamin D, intact parathyroid hormone, osteocalcin, and bone-specific alkaline phosphatase and the urinary level of N-telopeptide were measured. Information from validated lifestyle, dietary, and demographic questionnaires was also evaluated. Seventeen (25%) of the sixty-eight women had occult osteoporosis (as indicated by a T score of less than -2.5). Fifteen (22%) of the sixty-eight subjects had vitamin-D deficiency, and three (4%) had an elevated serum parathyroid hormone level. Only two of the seventeen osteoporotic women had vitamin-D deficiency. On the basis of these numbers, vitamin-D status was not correlated with bone density (p = 0.32). Analysis of the relationship between the number of years since menopause and osteoporosis or markers of elevated bone turnover showed that osteoporosis was detected throughout the postmenopausal period. A substantial portion of these sixty-eight white women with osteoarthritis of the hip had occult osteoporosis and hypovitaminosis D. Vitamin-D deficiency was not restricted to the group with low bone density. These results

  17. Vitamin D deficiency in a cohort of HIV-infected patients: clinical analysis

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    B Vandercam

    2012-11-01

    Full Text Available Purpose of the study: Observational studies have noted very high rates of low serum 25-hydroxyvitamin D [25(OHD3] levels in both general and HIV-infected populations. In HIV-infected patients, low 25(OHD3 levels are secondary to a combination of usual risk factors and HIV-specific risk factors, like antiretroviral therapy [1]. The objective of our study is to analyse the magnitude of vitamin D deficiency or insufficiency and the role of various factors such as age, sex, ethnicity, season, and antiretroviral medications in our cohort of HIV-infected patients. Methods: We prospectively collected data on 25-hydroxyvitamin D levels sampled between January 2009 and June 2011 from our cohort of 930 HIV-infected patients. Vitamin D dosage was performed using immunoassay (‘Diasorin’ - Saluggia, Italy. We divided vitamin D levels into 3 categories: 25-hydroxyvitamin D levels <20 mg/nl were considered deficient, insufficient between 20 and 29 ng/ml. Levels ≥30 ng/ml were defined as normal [2]. Data on demographic features (age, ethnicity, season, heterosexuality vs homosexuality, clinical features and laboratory findings (CD4 cell count, viral load, HAART, BMI were collected from patients’ medical records using our institutional database ‘Medical explorer v3r9, 2009’. Summary of results: Overall, 848 patients were included in our study (Table 1. Low levels of serum 25(OHD3 were seen in 89.3% of the study population, from which 69.5% were deficient and 19.8% were insufficient. On univariate analysis, female sex, high BMI, black African, heterosexuality, undetectable viral load and antiretroviral treatment were all predictors of vitamin D deficiency and insufficiency. Treatment with efavirenz and tenofovir were the most associated with low vitamin D levels. On multivariate analysis (multiple linear regression model only female sex (OR=1.14; 95% CI 0.84–0.96; p<0.001, dosage during winter months (OR=1.14; 95% CI 1–1.15; p<0.05 and HAART (OR=1

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

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    Pasquale Mansueto

    2015-01-01

    Full Text Available 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.

  19. Vitamin D deficiency in HIV-infected patients: a systematic review

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    Giusti A

    2011-11-01

    Full Text Available Andrea Giusti1, Giovanni Penco2, Giulio Pioli31Bone Clinic, Department of Gerontology and Musculoskeletal Sciences, Galliera Hospital, Genoa, Italy; 2Department of Infectious Diseases, Galliera Hospital, Genoa, Italy; 3Department of Geriatrics, ASMN Hospital, Reggio Emilia, ItalyAbstract: Advances in the diagnosis and management of human immunodeficiency virus (HIV have resulted in a dramatic decrease in mortality in HIV-infected individuals (HIV+. The subsequent increase in life expectancy of HIV+ has led to the need to consider the long-term complications of the disease and its treatment. Abnormalities in vitamin D status and metabolism are increasingly recognized as a major concern in HIV infection. In the last 5 years a number of cross-sectional and prospective studies have suggested a high prevalence of vitamin D deficiency in HIV+. Although few case-control studies have been published, it has been suggested that the prevalence of hypovitaminosis D in HIV+ is higher than in the general population, and at least in part, is related to the course of the disease and/or the antiretroviral drugs used to treat the disease. An adequate vitamin D status is important not only for bone tissue, but also for the global health status of HIV+ individuals, since a growing body of evidence has demonstrated the detrimental effects of vitamin D deficiency on multiple health outcomes. Therefore, definition of the size of the problem and identification of effective protocols for the prevention and management of vitamin D deficiency in HIV+ patients represent important steps in improving health status and reducing long-term chronic complications in individuals with HIV. Due to its immunomodulatory effects, vitamin D may also have implications in the progression of HIV infection. This systematic review was designed to determine the prevalence of vitamin D deficiency in HIV+ patients; to identify risk factors (related to the HIV infection or not potentially

  20. Size of Atlas and Axis in Adults with Hyphofosphatemic Rickets – a Comparative Study

    DEFF Research Database (Denmark)

    Gjørup, Hans; Sonnesen, Ane Liselotte; Beck-Nielsen, Signe

    Title Size of atlas and axis in adults with hyphofosphatemic rickets – a comparative study. Introduction. Deviations from normal anatomy of the cervical column are frequent in some pathologic conditions (cleft-patients, OSA-patients) and in severe malocclusions. Hypophosphatemic rickets (HR) are ...

  1. Biomarkers identified by urinary metabonomics for noninvasive diagnosis of nutritional rickets.

    Science.gov (United States)

    Wang, Maoqing; Yang, Xue; Ren, Lihong; Li, Songtao; He, Xuan; Wu, Xiaoyan; Liu, Tingting; Lin, Liqun; Li, Ying; Sun, Changhao

    2014-09-05

    Nutritional rickets is a worldwide public health problem; however, the current diagnostic methods retain shortcomings for accurate diagnosis of nutritional rickets. To identify urinary biomarkers associated with nutritional rickets and establish a noninvasive diagnosis method, urinary metabonomics analysis by ultra-performance liquid chromatography/quadrupole time-of-flight tandem mass spectrometry and multivariate statistical analysis were employed to investigate the metabolic alterations associated with nutritional rickets in 200 children with or without nutritional rickets. The pathophysiological changes and pathogenesis of nutritional rickets were illustrated by the identified biomarkers. By urinary metabolic profiling, 31 biomarkers of nutritional rickets were identified and five candidate biomarkers for clinical diagnosis were screened and identified by quantitative analysis and receiver operating curve analysis. Urinary levels of five candidate biomarkers were measured using mass spectrometry or commercial kits. In the validation step, the combination of phosphate and sebacic acid was able to give a noninvasive and accurate diagnostic with high sensitivity (94.0%) and specificity (71.2%). Furthermore, on the basis of the pathway analysis of biomarkers, our urinary metabonomics analysis gives new insight into the pathogenesis and pathophysiology of nutritional rickets.

  2. Two cases of rickets presenting with poor growth, hypotonia, and respiratory problems

    NARCIS (Netherlands)

    Wouters, E.; Wojciechowski, M.; de Vries, E.

    2015-01-01

    Rickets is a rare disease in developed countries. In children, it is a disease which affects growing bone. Depending on the severity, it can present with a wide variety of symptoms. Because it is such a rare disease in developed countries, symptoms suggesting rickets are often not easily recognized.

  3. PREVENTION AND TREATMENT OF VITAMIN D DEFICIENCY: CURRENT LOOK AT THE ISSUE

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    Yu. S. Lashkova

    2015-01-01

    Full Text Available The article presents the current data on the metabolism of vitamin D and its role in the development of bone tissue in children and the further condition thereof. Natural vitamin D sources, as well as the current routine practice of preventing deficiency of this organic substance are unable to fully satisfy a child's demand for this vitamin, which is why recommendations on vitamin D intake ought to be revised. The article details schedules for prescription of vitamin D for preventing and treating the body deficiency thereof based on results of the studies completed in the recent years. The role of the main marker enabling assessing vitamin D concentration in the body — 25(OHD — the reference values whereof are yet to be commonly established has been analyzed. The article lists recommendations on rickets prevention and treatment in children. The article presents data on the possible mechanisms of development of toxic effects in the setting of vitamin D intake.

  4. Body composition and metabolic profile in adults with vitamin D deficiency

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    Liane Murari ROCHA

    Full Text Available ABSTRACT Objective: To investigate the body composition and metabolic profile in individuals in terms of different concentrations of serum vitamin D, ranging from deficiency to sufficiency. Methods: A cross-sectional study of 106 adults of both genders, who were divided into three groups according to vitamin D levels: deficiency: <20ng/mL; insufficiency: 20-29.9ng/mL; and sufficiency: 30-100ng/mL. Anthropometric evaluation included weight, height, and body circumferences. Fat mass and lean mass were assessed using the Tetrapolar bioelectrical impedance method. Clinical and biochemical evaluations were also carried out. Insulin resistance was estimated using the Homeostasis Model Assessment Insulin index. Results: The analysis showed that the main alterations in individuals in the vitamin D deficiency group were higher triglycerides, very low density lipoprotein - cholesterol, fasting blood glucose, insulin, glycated hemoglobin, body mass index, body fat percentage, lean mass percentage, waist circumference, and Homeostasis Model Assessment Insulin than those of the vitamin D sufficient group (p<0.05. Conclusion: It was found that vitamin D deficiency causes important body composition and metabolic changes, which may lead to diseases such as diabetes Mellitus and metabolic syndrome.

  5. Persistent Primary Hyperparathyroidism, Severe Vitamin D Deficiency, and Multiple Pathological Fractures

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    Victoria Mendoza-Zubieta

    2016-01-01

    Full Text Available Persistent primary hyperparathyroidism (PHPT refers to the sustained hypercalcemia state detected within the first six months following parathyroidectomy. When it coexists with severe vitamin D deficiency, the effects on bone can be devastating. We report the case of a 56-year-old woman who was sent to this center because of persistent hyperparathyroidism. Her disease had over 3 years of evolution with nephrolithiasis and hip fracture. Parathyroidectomy was performed in her local unit; however, she continued with hypercalcemia, bone pain, and pathological fractures. On admission, the patient was bedridden with multiple deformations by fractures in thoracic and pelvic members. Blood pressure was 100/80, heart rate was 86 per minute, and body mass index was 19 kg/m2. Calcium was 14 mg/dL, parathormone 1648 pg/mL, phosphorus 2.3 mg/dL, creatinine 2.4 mg/dL, urea 59 mg/dL, alkaline phosphatase 1580 U/L, and vitamin D 4 ng/mL. She received parenteral treatment of hypercalcemia and replenishment of vitamin D. The second surgical exploration was radioguided by gamma probe. A retroesophageal adenoma of 4 cm was resected. Conclusion. Persistent hyperparathyroidism with severe vitamin D deficiency can cause catastrophic skeletal bone softening and fractures.

  6. Vitamin D deficiency as a strong predictor of asthma in children.

    Science.gov (United States)

    Bener, Abdulbari; Ehlayel, Mohammad S; Tulic, Meri K; Hamid, Qutayba

    2012-01-01

    Epidemiological studies suggest a link between vitamin D deficiency in early life and development of asthma in later life. The aim of this study was to measure serum vitamin D levels in asthmatic children and to compare these to healthy non-asthmatic controls. Asthmatic (n = 483) and healthy control (n = 483) children were recruited from the Pediatric Allergy-Immunology Clinics of Hamad General Hospital and the Primary Health Care Clinics in Qatar from October 2009 to July 2010. All children were below 16 years of age and asthma was diagnosed by a physician. Parents of all children completed extensive questionnaires documenting demographics, child's feeding practice and vitamin D intake. Serum vitamin D (25-hydroxyvitamin D), calcium, phosphorus, alkaline phosphatase, magnesium, creatinine and parathyroid hormone assays were performed. Subjects with serum containing less than 20 ng/ml vitamin D were deemed deficient. Asthmatic children had significantly reduced serum vitamin D levels compared to non-asthmatic children (p , p = 0.005) and asthma (36.4%, p = 0.009) were significantly higher in asthmatic children. Along with vitamin D deficiency, asthmatics also had reduced phosphorus (p , p = 0.006) and less physical activity (71.3%, p asthma in this population (OR 4.82; 95% CI 2.41-8.63, p asthma in Qatari children. Copyright © 2011 S. Karger AG, Basel.

  7. Vitamin D deficiency in neovascular versus nonneovascular age-related macular degeneration.

    Science.gov (United States)

    Itty, Sujit; Day, Shelley; Lyles, Kenneth W; Stinnett, Sandra S; Vajzovic, Lejla M; Mruthyunjaya, Prithvi

    2014-09-01

    To compare 25-hydroxyvitamin D (25OHD) levels in patients with neovascular age-related macular degeneration (NVAMD) with patients with nonneovascular age-related macular degeneration and control patients. Medical records of all patients diagnosed with age-related macular degeneration and tested for serum 25OHD level at a single medical center were reviewed. Control patients were selected from patients diagnosed with pseudophakia but without age-related macular degeneration. The lowest 25OHD level available for each patient was recorded. Two hundred sixteen patients with nonneovascular age-related macular degeneration, 146 with NVAMD, and 100 non-age-related macular degeneration control patients were included. The levels of 25OHD (mean ± SD) were significantly lower in NVAMD patients (26.1 ± 14.4 ng/mL) versus nonneovascular age-related macular degeneration (31.5 ± 18.2 ng/mL, P = 0.003) and control (29.4 ± 10.1 ng/mL, P = 0.049) patients. The prevalence of vitamin D insufficiency (age-related macular degeneration. Mean 25OHD levels were lower and vitamin D deficiency was more prevalent in NVAMD patients. These associations suggest that further research is necessary regarding vitamin D deficiency as a potentially modifiable risk factor for the development of NVAMD.

  8. Dysfunctional immunometabolic effects of vitamin D deficiency, increased cardiometabolic risk. Potential epidemiological alert in America?

    Science.gov (United States)

    Rosas-Peralta, Martin; Holick, Michael F; Borrayo-Sánchez, Gabriela; Madrid-Miller, Alejandra; Ramírez-Árias, Erick; Arizmendi-Uribe, Efrain

    2017-03-01

    Vitamin D deficiency is a serious public health problem worldwide that affects not only skeletal health, but also a wide range of acute and chronic diseases. However, there is still skepticism because of the lack of randomized, controlled trials to support association studies on the benefits of vitamin D for non-skeletal health. This review was based on articles published during the 1980-2015 obtained from the Cochrane Central Register of controlled trials, MEDLINE and PubMed, and focuses on recent challenges with regard to the definition of vitamin D deficiency and how to achieve optimal serum 25-hydroxyvitamin D levels from dietary sources, supplements, and sun exposure. The effect of vitamin D on epigenetic fetal programming and regulation of genes that may potentially explain why vitamin D could have such lifelong comprehensive health benefits is reviewed. Optimization of vitamin D levels in children and adults around the world has potential benefits to improve skeletal health and to reduce the risk of chronic diseases, including some types of cancer, autoimmune diseases, infectious diseases, type 2 diabetes mellitus, and severe cardiovascular disorders such as atherothrombosis, neurocognitive disorders, and mortality. Copyright © 2017 SEEN. Publicado por Elsevier España, S.L.U. All rights reserved.

  9. Vitamin D Deficiency and Allergic Rhinitis in Children: A Narrative Review

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    Javad Ghaffari

    2015-07-01

    Full Text Available Context: Allergic diseases such as allergic rhinitis (AR and immune-mediated inflammatory diseases are the most common chronic diseases among children. Although the cause of AR has yet to be clearly identified, genetic and environmental factors are known to play an important role in the development of the disease. Evidence Acquisition: In a more recent classification, AR is categorized as intermittent and permanent. Vitamin D has a known and important role in the absorption of calcium and preservation of bone density. The prevalence of vitamin D deficiency in children is reported to be between 30% and 50% in the world. Vitamin D confers the growth and development of the immune system including the development of regulatory T cells. Results: Two-thirds of the reviewed articles show a correlation between serum levels of vitamin D and allergic diseases, while the reaming ones demonstrate no correlation between vitamin D and AR and some even report a rise in the incidence of AR following the use of vitamin D supplement. Conclusions: It seems that further clinical trials and meta-analytic studies are necessary to confirm this correlation. The present study aimed at reviewing vitamin D deficiency in children with AR.

  10. Extra-skeletal effects of vitamin D deficiency in chronic kidney disease.

    Science.gov (United States)

    Chonchol, Michel; Kendrick, Jessica; Targher, Giovanni

    2011-06-01

    Cardiovascular diseases (CVD) and infectious diseases represent the two most important causes of death in patients with chronic kidney disease (CKD). The traditional risk factors of CVD do not appear to account sufficiently for the increased risk of CVD in patients with CKD, and vitamin D deficiency appears to be an important non-traditional, and potentially modifiable, CVD risk factor in this patient population. 25-Hydroxyvitamin D (25(OH)D) is converted to its biologically active form, 1,25-dihydroxyvitamin D (1,25(OH)(2)D), by the enzyme 1α-hydroxylase in the kidneys. The recent discovery that many extrarenal tissues also possess both the 1α-hydroxylase enzyme and the vitamin D receptors has provided new insights into the important physiologic autocrine and paracrine roles of vitamin D in various tissues and organs that are mainly dependent on the availability of 25(OH)D from the circulating plasma. Accordingly, the present review focuses on the rapidly expanding body of clinical and experimental evidence that supports a strong association between 25(OH)D deficiency/insufficiency and the risk of adverse CVD outcomes and infectious diseases as well as on the non-calcemic autocrine and paracrine actions of vitamin D both in the general population and in patients with CKD.

  11. A Review of Vitamin D Deficiency in the Critical Care Population

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    Kelly Massey

    2014-01-01

    Full Text Available It is well documented that a large percentage of the general population is either vitamin D insufficient or deficient. Vitamin D deficiency adversely affects bone health. More recently, it has been reported that vitamin D is an important component in immune function and glycemic control Substantial data exist that demonstrate an association between vitamin D insufficiency/deficiency and mortality/clinical outcomes of critically ill patients. The larger clinical trials addressing this association have demonstrated an increased odds ratio for mortality in both vitamin D insufficient and deficient patients when compared to those with sufficient vitamin D. There is also some evidence that vitamin D status worsens during critical illness without supplementation of this vitamin. Supplementation of vitamin D during critical illness of patients with vitamin D deficiency has been studied, but not in great detail. Daily supplementation of the recommended dietary allowance (RDA of vitamin D does very little to improve the 25(OHD serum concentrations in the critically ill patients with vitamin D insufficiency or deficiency. There is some evidence that high-dose therapy of vitamin D improves the depressed serum concentrations of this vitamin; however, there are no clinical outcome data available yet. The association between vitamin D insufficiency or deficiency and clinical outcome in the critically ill appears to be important. Supplementation of vitamin D will increase the serum concentrations of this vitamin; however the optimal dose needs to be identified along with an assessment of clinical outcome.

  12. Vitamin D-deficient mice have more invasive urinary tract infection.

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    Olof Hertting

    Full Text Available Vitamin D deficiency is a common health problem with consequences not limited to bone and calcium hemostasis. Low levels have also been linked to tuberculosis and other respiratory infections as well as autoimmune diseases. We have previously shown that supplementation with vitamin D can induce the antimicrobial peptide cathelicidin during ex vivo infection of human urinary bladder. In rodents, however, cathelicidin expression is not linked to vitamin D and therefore this vitamin D-related effect fighting bacterial invasion is not relevant. To determine if vitamin D had further protective mechanisms during urinary tract infections, we therefore used a mouse model. In vitamin D-deficient mice, we detected more intracellular bacterial communities in the urinary bladder, higher degree of bacterial spread to the upper urinary tract and a skewed cytokine response. Furthermore, we show that the vitamin D receptor was upregulated in the urinary bladder and translocated into the cell nucleus after E. coli infection. This study supports a more general role for vitamin D as a local immune response mediator in the urinary tract.

  13. Vitamin D-deficient mice have more invasive urinary tract infection.

    Science.gov (United States)

    Hertting, Olof; Lüthje, Petra; Sullivan, Devin; Aspenström, Pontus; Brauner, Annelie

    2017-01-01

    Vitamin D deficiency is a common health problem with consequences not limited to bone and calcium hemostasis. Low levels have also been linked to tuberculosis and other respiratory infections as well as autoimmune diseases. We have previously shown that supplementation with vitamin D can induce the antimicrobial peptide cathelicidin during ex vivo infection of human urinary bladder. In rodents, however, cathelicidin expression is not linked to vitamin D and therefore this vitamin D-related effect fighting bacterial invasion is not relevant. To determine if vitamin D had further protective mechanisms during urinary tract infections, we therefore used a mouse model. In vitamin D-deficient mice, we detected more intracellular bacterial communities in the urinary bladder, higher degree of bacterial spread to the upper urinary tract and a skewed cytokine response. Furthermore, we show that the vitamin D receptor was upregulated in the urinary bladder and translocated into the cell nucleus after E. coli infection. This study supports a more general role for vitamin D as a local immune response mediator in the urinary tract.

  14. Relationship between vitamin D deficiency and visually evoked potentials in multiple sclerosis.

    Science.gov (United States)

    López-Méndez, P; Sosa-Henríquez, M; Ruiz-Pérez, Á

    2016-05-01

    To evaluate the possible relationship between serum 25-OH vitamin D levels and visually evoked potentials (VEP) in patients with multiple sclerosis (MS), residents in the south zone of Gran Canaria. The study included 49 patients with MS, on whom 25-OH-vitamin D was determined, along with VEP, and a neurological examination to determine incapacity. Clinical variables, such as a history of optic neuritis were recorded. The mean value of 25-OH-vitamin D of the patients was 28.1±9.5ng/ml. The VEP latency was 119.1±23.2ms and the amplitude, 8.5±4.4 μV. Patients with a higher 25-OH-vitamin D had a greater number of outbreaks in the year prior to the study (P=.049), and those with vitamin D deficiency and previous optic neuritis showed no reduction in the amplitude of the VEP (P=.006). Patients with vitamin D deficiency have lower clinical activity of the MS and show no axonal involvement in VEP after having suffered optic neuritis. These relationships, although statistically significant, do not seem clinically plausible, thus new studies are needed to try and confirm this possible relationship. Copyright © 2016 Sociedad Española de Oftalmología. Published by Elsevier España, S.L.U. All rights reserved.

  15. Prevalence of Vitamin D Deficiency in Patients with Bone Metastases and Multiple Myeloma.

    Science.gov (United States)

    Maier, Gerrit Steffen; Horas, Konstantin; Kurth, Andreas Alois; Lazovic, Djordje; Seeger, Jörn Bengt; Maus, Uwe

    2015-11-01

    Breast and prostate cancer are amongst the most prevalent malignancies globally and up to 40% of patients will develop metastatic disease, particularly to the skeleton. Multiple myeloma is the most common cancer to affect bone with up to 90% of patients developing bone lesions. Although several studies demonstrated that endocrine changes such as vitamin D deficiency promote secondary cancer growth in bone, relatively few have reported its prevalence. For this reason, the purpose of the present study was to evaluate the prevalence of hypovitaminosis D in patients with bone metastases and multiple myeloma. Serum 25-OH-D levels of patients with metastatic bone disease were measured on admission. Statistical analyses was performed to evaluate for possible confounders of hypo-vitaminosis D. We found a widespread and alarming rate of vitamin D deficiency in patients with metastatic bone disease and multiple myeloma. Of note, patients with bone metastases due to breast cancer, prostate cancer and multiple myeloma rarely reached sufficient serum 25-OH-D levels. It is of utmost clinical importance to assess vitamin D levels in cancer patients, especially in those with, or at high risk of developing metastatic bone disease. Copyright© 2015 International Institute of Anticancer Research (Dr. John G. Delinassios), All rights reserved.

  16. Cyclophilin D deficiency attenuates mitochondrial and neuronal perturbation and ameliorates learning and memory in Alzheimer's disease.

    Science.gov (United States)

    Du, Heng; Guo, Lan; Fang, Fang; Chen, Doris; Sosunov, Alexander A; McKhann, Guy M; Yan, Yilin; Wang, Chunyu; Zhang, Hong; Molkentin, Jeffery D; Gunn-Moore, Frank J; Vonsattel, Jean Paul; Arancio, Ottavio; Chen, John Xi; Yan, Shi Du

    2008-10-01

    Cyclophilin D (CypD, encoded by Ppif) is an integral part of the mitochondrial permeability transition pore, whose opening leads to cell death. Here we show that interaction of CypD with mitochondrial amyloid-beta protein (Abeta) potentiates mitochondrial, neuronal and synaptic stress. The CypD-deficient cortical mitochondria are resistant to Abeta- and Ca(2+)-induced mitochondrial swelling and permeability transition. Additionally, they have an increased calcium buffering capacity and generate fewer mitochondrial reactive oxygen species. Furthermore, the absence of CypD protects neurons from Abeta- and oxidative stress-induced cell death. Notably, CypD deficiency substantially improves learning and memory and synaptic function in an Alzheimer's disease mouse model and alleviates Abeta-mediated reduction of long-term potentiation. Thus, the CypD-mediated mitochondrial permeability transition pore is directly linked to the cellular and synaptic perturbations observed in the pathogenesis of Alzheimer's disease. Blockade of CypD may be a therapeutic strategy in Alzheimer's disease.

  17. High Prevalence of Vitamin D Deficiency in Native versus Migrant Mothers and Newborns in the North of Italy: A Call to Act with a Stronger Prevention Program.

    Directory of Open Access Journals (Sweden)

    Francesco Cadario

    Full Text Available Vitamin D status during pregnancy is related to neonatal vitamin D status. Vitamin D deficiency has been associated with an increased risk of rickets in children and osteomalacia in adults. Aim of this study was to investigate 25OHD levels in maternal serum and in neonatal blood spots in native and migrant populations living in Novara (North Italy, 45°N latitude.We carried out a cross sectional study from April 1st 2012 to March 30th 2013, in a tertiary Care Center. Maternal blood samples after delivery and newborns' blood spots were analyzed for 25OHD levels in 533 pairs. Maternal country of origin, skin phototype, vitamin D dietary intake and supplementation during pregnancy were recorded. Multivariate regression analysis, showed a link between neonatal and maternal 25OHD levels (R-square:0.664. Severely deficient 25OHD values (<25 nmol/L were found in 38% of Italian and in 76.2% of migrant's newborns (p <0.0001, and in 18% of Italian and 48,4% of migrant mothers (p <0.0001 while 25OHD deficiency (≥25 and <50 nmol/L was shown in 40.1% of Italian and 21.7% of migrant's newborns (p <0.0001, and in 43.6% of Italian and 41.3% of migrant mothers (p <0.0001. Italian newborns and mothers had higher 25OHD levels (34.4±19.2 and 44.9±21.2 nmol/L than migrants (17.7±13.7 and 29.7±16.5 nmol/L; p<0.0001. A linear decrease of 25OHD levels was found with increasing skin pigmentation (phototype I 42.1 ±18.2 vs phototype VI 17.9±10.1 nmol/l; p<0.0001. Vitamin D supplementation resulted in higher 25OHD values both in mothers and in their newborns (p<0.0001.Vitamin D insufficiency in pregnancy and in newborns is frequent especially among migrants. A prevention program in Piedmont should urgently be considered and people identified as being at risk should be closely monitored. Vitamin D supplementation should be taken into account when considering a preventative health care policy.

  18. Markers of subclinical atherosclerosis in premenopausal women with vitamin D deficiency and effect of vitamin D replacement.

    Science.gov (United States)

    Gurses, Kadri Murat; Tokgozoglu, Lale; Yalcin, Muhammed Ulvi; Kocyigit, Duygu; Dural, Muhammet; Canpinar, Hande; Yorgun, Hikmet; Sahiner, Mehmet Levent; Kaya, Ergun Baris; Akin, Safak; Gurlek, Alper; Guc, Dicle; Aytemir, Kudret

    2014-12-01

    Recent studies have revealed a relationship between vitamin D deficiency and atherosclerosis. This study aims to investigate the impact of vitamin D deficiency and replacement on markers of subclinical atherosclerosis in young premenopausal women in whom vitamin D deficiency is prevalent. Thirty-one premenopausal vitamin D deficient women and 27 age and gender-matched control subjects were enrolled in this study. Markers of subclinical atherosclerosis including carotid intima-media thickness (cIMT), flow-mediated dilatation (FMD), endothelial progenitor cell (EPC) count and cytokine levels were determined at baseline. All measurements were repeated at 6-month follow-up in vitamin D-deficient subjects after vitamin D replacement. Vitamin D deficient premenopausal women had lower FMD (9.9 ± 1.3 vs. 13.8 ± 1.7%, p < 0.001) and EPC counts at baseline. This population also had lower IL-10 and higher IL-17 levels. A 6-month vitamin D replacement therapy resulted in a significant increase in FMD (9.9 ± 1.3 vs. 11.4 ± 1.4%, p < 0.001) and EPC counts. Furthermore, cytokine profile shifted toward a more anti-inflammatory phenotype including elevated IL-10 and decreased IL-17 levels. cIMT was not different between patient and control groups and did not change following vitamin D replacement. Change in 25(OH)D and IL-17 levels were independent predictors of the change in FMD measurements following vitamin D replacement. This study demonstrates that endothelial function is impaired in otherwise healthy vitamin D deficient young premenopausal women and improves with 6-month replacement therapy. Immune-modulatory effects of vitamin D may, at least partly, be responsible for its beneficial effects on vascular health. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  19. Assessment criteria for vitamin D deficiency/insufficiency in Japan - proposal by an expert panel supported by Research Program of Intractable Diseases, Ministry of Health, Labour and Welfare, Japan, The Japanese Society for Bone and Mineral Research and The Japan Endocrine Society [Opinion].

    Science.gov (United States)

    Okazaki, Ryo; Ozono, Keiichi; Fukumoto, Seiji; Inoue, Daisuke; Yamauchi, Mika; Minagawa, Masanori; Michigami, Toshimi; Takeuchi, Yasuhiro; Matsumoto, Toshio; Sugimoto, Toshitsugu

    2017-01-30

    Vitamin D is indispensable for the maintenance of bone and mineral health. Inadequate vitamin D action increases the risk for various musculoskeletal/mineral events including fracture, fall, secondary hyperparathyroidism, diminished response to antiresorptives, rickets/osteomalacia, and hypocalcemia. Its most common cause in recent years is vitamin D deficiency/insufficiency, clinically defined by low serum 25-hydroxyvitamin D [25(OH)D] level. Guidelines for vitamin D insufficiency/deficiency defined by serum 25(OH)D concentrations have been published all over the world. In Japan, however, the information on the associations between serum 25(OH)D and bone and mineral disorders has not been widely shared among healthcare providers, partly because its measurement had not been reimbursed with national medical insurance policy until August 2016. We have set out to collect and analyze Japanese data on the relationship between serum 25(OH)D concentration and bone and mineral events. Integrating these domestic data and published guidelines worldwide, here we present the following assessment criteria for vitamin D sufficiency/insufficiency/deficiency using serum 25(OH)D level in Japan. 1) Serum 25(OH)D level equal to or above 30 ng/mL is considered to be vitamin D sufficient. 2) Serum 25(OH)D level less than 30 ng/mL but not less than 20 ng/mL is considered to be vitamin D insufficient. 3) Serum 25(OH)D level less than 20 ng/mL is considered to be vitamin D deficient. We believe that these criteria will be clinically helpful in the assessment of serum 25(OH)D concentrations and further expect that they will form a basis for the future development of guidelines for the management of vitamin D deficiency/insufficiency.

  20. Assessment criteria for vitamin D deficiency/insufficiency in Japan: proposal by an expert panel supported by the Research Program of Intractable Diseases, Ministry of Health, Labour and Welfare, Japan, the Japanese Society for Bone and Mineral Research and the Japan Endocrine Society [Opinion].

    Science.gov (United States)

    Okazaki, Ryo; Ozono, Keiichi; Fukumoto, Seiji; Inoue, Daisuke; Yamauchi, Mika; Minagawa, Masanori; Michigami, Toshimi; Takeuchi, Yasuhiro; Matsumoto, Toshio; Sugimoto, Toshitsugu

    2017-01-01

    Vitamin D is indispensable for the maintenance of bone and mineral health. Inadequate vitamin D action increases the risk for various musculoskeletal/mineral events including fracture, fall, secondary hyperparathyroidism, diminished response to antiresorptives, rickets/osteomalacia, and hypocalcemia. Its most common cause in recent years is vitamin D deficiency/insufficiency, clinically defined by a low serum 25-hydroxyvitamin D [25(OH)D] level. Guidelines for vitamin D insufficiency/deficiency defined by serum 25(OH)D concentrations have been published all over the world. In Japan, however, the information on the associations between serum 25(OH)D and bone and mineral disorders has not been widely shared among healthcare providers, partly because its measurement had not been reimbursed with national medical insurance policy until August 2016. We have set out to collect and analyze Japanese data on the relationship between serum 25(OH)D concentration and bone and mineral events. Integrating these domestic data and published guidelines worldwide, here, we present the following assessment criteria for vitamin D sufficiency/insufficiency/deficiency using serum 25(OH)D level in Japan. (1) Serum 25(OH)D level equal to or above 30 ng/ml is considered to be vitamin D sufficient. (2) Serum 25(OH)D level less than 30 ng/ml but not less than 20 ng/ml is considered to be vitamin D insufficient. (3) Serum 25(OH)D level less than 20 ng/ml is considered to be vitamin D deficient. We believe that these criteria will be clinically helpful in the assessment of serum 25(OH)D concentrations and further expect that they will form a basis for the future development of guidelines for the management of vitamin D deficiency/insufficiency.

  1. Treatment of hypophosphataemic rickets in children remains a challenge.

    Science.gov (United States)

    Nielsen, Line Hougaard; Rahbek, Elise Torp; Beck-Nielsen, Signe Sparre; Christesen, Henrik Thybo

    2014-07-01

    Hypophosphataemic rickets (HR) is a rare hereditary disease characterised by hypophosphataemia, defects in bone mineralisation and rickets. We searched the hospital files at H.C. Andersen Children's Hospital, Odense University Hospital, Denmark, for children with the International Classification of Diseases 10 codes E83.3B (vitamin D resistant rickets) and E83.3A1 (familiar hypophosphataemia) from 1 February 2012 to 1 May 2012. Data were collected retrospectively. Fifteen HR children were identified. X-linked hypophosphataemia with mutations in the phosphate-regulating endopeptidase homologue, X-linked were present in 80%; three had autosomal recessive HR with dentin matrix protein mutations. The children were treated with phosphate and alphacalcidol for an average of 7.7 years ± 5.1 standard deviations (SD). At the latest follow-up, the mean age was 10.1 (+5.4) years, and the mean height had declined 0.8 SD from the first contact. A total of 40% had an actual height below -2.0 SD, and 40% underwent surgery for leg deformities. Among the medically treated patients, five had genu varus with a mean medial femoral condyle distance of 6.6 cm (+ 2.79), and two patients had genu valgus with a mean medial malleolus distance of 12.3 cm (+ 1.77). Episodes of secondary hyperparathyroidism were seen in 87%, and one patient developed transient nephrocalcinosis. The current medical treatment for HR is insufficient. The rarity of the disease and the treatment difficulties of HR call for centralised management. International multi-centre trials including novel treatment options are warranted.

  2. Vitamin D Deficiency among Adults with History of Pulmonary Tuberculosis in Korea Based on a Nationwide Survey

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    Mi Hyun Joo

    2017-04-01

    Full Text Available We investigated the prevalence of vitamin D deficiency among individuals who have a history of tuberculosis (TB diagnosis in Korea. Using the 5th Korean National Health and Nutrition Examination Survey, we selected 805 individuals with a history of TB diagnosis and 16,049 controls without a history of TB. Vitamin D deficiency was defined as a 25(OHD level less than 20 ng/mL. Vitamin D deficiency was revealed in 71.7% of the individuals with a history of TB diagnosis and in 72.1% of the controls. Vitamin D deficiency was more likely in women than in men, in people who engaged in other jobs or were unemployed than in people who engaged in skilled agricultural, forestry, and fishery jobs, and in people who walked 3–5 days per week than in people who walked 6–7 days per week. Vitamin D deficiency was highly prevalent in the TB group. Regular examination and strategies to increase vitamin D levels in individuals with a history of TB are needed, as vitamin D is associated with TB conditions and bone disease.

  3. Vitamin D Deficiency among Adults with History of Pulmonary Tuberculosis in Korea Based on a Nationwide Survey.

    Science.gov (United States)

    Joo, Mi Hyun; Han, Mi Ah; Park, Sun Mi; Shin, Hwan Ho

    2017-04-10

    We investigated the prevalence of vitamin D deficiency among individuals who have a history of tuberculosis (TB) diagnosis in Korea. Using the 5th Korean National Health and Nutrition Examination Survey, we selected 805 individuals with a history of TB diagnosis and 16,049 controls without a history of TB. Vitamin D deficiency was defined as a 25(OH)D level less than 20 ng/mL. Vitamin D deficiency was revealed in 71.7% of the individuals with a history of TB diagnosis and in 72.1% of the controls. Vitamin D deficiency was more likely in women than in men, in people who engaged in other jobs or were unemployed than in people who engaged in skilled agricultural, forestry, and fishery jobs, and in people who walked 3-5 days per week than in people who walked 6-7 days per week. Vitamin D deficiency was highly prevalent in the TB group. Regular examination and strategies to increase vitamin D levels in individuals with a history of TB are needed, as vitamin D is associated with TB conditions and bone disease.

  4. Lower pain and higher muscular strength in immigrant women with vitamin D deficiency following vitamin D treatment.

    Science.gov (United States)

    Englund, Marianne; Persson, Jan; Bergström, Ingrid

    2017-01-01

    Vitamin D deficiency is common among immigrants in the Nordic region. It may lead to osteomalacia with severe musculoskeletal pain. There are reports that vitamin D deficiency without osteomalacia may lead to pain but little is known of the effect of treatment. To investigate whether a moderate dose of cholecalciferol and calcium improves strength and pain in a group of vitamin D deficient women. Twentyfive immigrant women with vitamin D deficiency diagnosed during pregnancy were treated postpartum with a daily dose of 1,600 IU cholecalciferol and 1,000 mg of calcium. They were examined at the start of treatment and again after 3 months of treatement and the results were statistically compared. Southern parts of Stockholm. Serum 25-hydroyvitamin D (25(OH)D), serum-parathyroid hormone (PTH), pain measured by a visual analogue scale (VAS), musculoskeletal strength by performance on a chair stand test (seconds), and bone tenderness by pressure algometer (kilo-Pascal). Following the treatment, the 21 women attending had lowered cm in VAS, improved musculoskeletal strength, - and 25(OH)D levels were normalized. A moderate dose of vitamin D normalized l vitamin D levels, improved muscular strength and reduced pain in this group of vitamin D deficient immigrant women.

  5. PREVALENCE OF VITAMIN D DEFICIENCY IN A POPULATION OF INDIAN WOMEN- A CALL FOR UNIVERSAL SUPPLEMENTATION?

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    Hema Divakar

    2017-06-01

    Full Text Available BACKGROUND With improvement in serum vitamin D testing, there emerged an understanding that Vitamin D Deficiency (VDD exists in sunny regions of the world where it was once thought to be a rare occurrence. In addition, new understanding on the deleterious effects of VDD on health has also grown over the last several years to include not only skeletal disorders, but cardiovascular disease, diabetes, cancer, infectious and autoimmune diseases. The aim of the study was to examine the prevalence of Vitamin D Deficiency (VDD among pregnant and non-pregnant women at a Multispecialty Hospital in Bengaluru, India. MATERIALS AND METHODS This is a retrospective chart review study. Charts belonging to all women who presented to Divakars Speciality Hospital from October 1, 2015, to November 1, 2016, were selected for initial review. Charts for all non-pregnant women who presented for a routine annual checkup and pregnant women in their 12th week of pregnancy were reviewed. All charts selected included serum 25 (OH D levels that were obtained as part of routine care services. Charts of 213 pregnant women and 370 nonpregnant were reviewed. Serum 25 (OH D levels for each patient were collected and entered into a Microsoft® Excel spreadsheet for analysis by physician researchers along with information regarding patient’s age, employment status and education level. Serum 25 (OH D level of 20.0 to <30.0 ng/mL was classified as vitamin D insufficiency and levels <20 ng/mL were classified as being vitamin D deficient. Data were compiled as percentages and means across population characteristics. Pearson’s correlations were calculated to assess the correlation between 25 (OH D levels and population parameters. A P value of <0.05 was considered statistically significant. RESULTS The mean age of the pregnant women and non-pregnant women was 29 and 43, respectively. Mean serum vitamin D level of pregnant women and non-pregnant women was 15.1 and 19.4, respectively

  6. Early animal models of rickets and proof of a nutritional deficiency hypothesis.

    Science.gov (United States)

    Chesney, Russell W

    2012-03-01

    In the period between 1880 and 1930, the role of nutrition and nutritional deficiency as a cause of rickets was established based upon the results from 6 animal models of rickets. This greatly prevalent condition (60%-90% in some locales) in children of the industrialized world was an important clinical research topic. What had to be reconciled was that rickets was associated with infections, crowding, and living in northern latitudes, and cod liver oil was observed to prevent or cure the disease. Several brilliant insights opened up a new pathway to discovery using animal models of rickets. Studies in lion cubs, dogs, and rats showed the importance of cod liver oil and an antirachitic substance later termed vitamin D. They showed that fats in the diet were required, that vitamin D had a secosteroid structure and was different from vitamin A, and that ultraviolet irradiation could prevent or cure rickets. Several of these experiments had elements of serendipity in that certain dietary components and the presence or absence of sunshine or ultraviolet irradiation could critically change the course of rickets. Nonetheless, at the end of these studies, a nutritional deficiency of vitamin D resulting from a poor diet or lack of adequate sunshine was firmly established as a cause of rickets.

  7. Association of swaddling, rickets onset and bone properties in children in Ulaanbaatar, Mongolia.

    Science.gov (United States)

    Urnaa, Vaanchig; Kizuki, Masashi; Nakamura, Keiko; Kaneko, Akie; Inose, Tomoko; Seino, Kaoruko; Takano, Takehito

    2006-09-01

    To examine the influence of duration of completely or partially wrapped swaddling on rickets onset and bone properties in children of school age. Case-control study. Subjects were 73 children aged 7-10 years with a history of rickets (cases) and 70 children with no history of rickets (controls) in Ulaanbaatar, Mongolia. The periods of completely and partially wrapped swaddling, rickets onset and age-standardized mid-tibial cortical speed of sound (TCSOS) were examined. The associations between swaddling duration and rickets onset and that between swaddling duration and TCSOS were analysed. All except one control child were completely wrapped from the first month after birth. The durations of completely wrapped and partially wrapped swaddling were similar among cases (3.6 and 4.7 months) and controls (3.1 and 4.4 months) (P=0.42 and P=0.65, respectively). Standardized TCSOS values of cases and controls were -0.572 and -0.038, respectively (P=0.06). The duration of swaddling did not show associations with rickets onset and standardized TCSOS among both cases and controls. Standardized TCSOS of cases with skeletal deformities at examination (-1.467, n=18) was lower than that of cases without skeletal deformities (-0.280, n=55) (Prickets onset nor bone properties in school-aged children in Ulaanbaatar. Bone properties of school-aged children who had suffered from rickets and with skeletal deformities were poorer than those in children without skeletal deformities and children without a history of rickets. Prevention of persistent skeletal deformities among the children who have suffered from rickets is critical to promote healthy bone development in Mongolia.

  8. Vitamin D deficiency in cirrhosis relates to liver dysfunction rather than aetiology

    DEFF Research Database (Denmark)

    Knudsen, Mikkel Malham; Jørgensen, S. P.; Ott, P.

    2011-01-01

    groups, serum vitamin D levels decreased with increasing liver disease severity, as determined by the Child-Pugh score. CONCLUSION: Vitamin D deficiency in cirrhosis relates to liver dysfunction rather than aetiology, with lower levels of vitamin D in alcoholic cirrhosis than in primary biliary cirrhosis.......Abstract AIM: To examine the vitamin D status in patients with alcoholic cirrhosis compared to those with primary biliary cirrhosis. METHODS: Our retrospective case series comprised 89 patients with alcoholic cirrhosis and 34 patients with primary biliary cirrhosis who visited our outpatient clinic...... in 2005 and underwent a serum vitamin D status assessment. RESULTS: Among the patients with alcoholic cirrhosis, 85% had serum vitamin D levels below 50 nmol/L and 55% had levels below 25 nmol/L, as compared to 60% and 16% of the patients with primary biliary cirrhosis, respectively (P

  9. The impact of air pollutants, UV exposure and geographic location on vitamin D deficiency.

    Science.gov (United States)

    Hoseinzadeh, Edris; Taha, Parisa; Wei, Chiang; Godini, Hatam; Ashraf, Ghulam Md; Taghavi, Mahmoud; Miri, Mohammad

    2018-02-01

    Vitamin D (VD) is an important nutrient for preventing several chronic diseases, and vitamin D deficiency (VDD) causes many diseases. Air pollution has been reported as one of the most significant factors that causes VDD. Some epidemiological studies have evaluated VDD prevalence, and presented air pollution as a potential cause of VDD. In addition, recent case studies have found that VDD is associated with air pollutants. Nearly all reports agree that air pollution affects VD levels by reducing sun exposure, especially UVB radiation. Sun exposure accounts for >90% of VD production in humans. Recent studies have demonstrated that tropospheric ozone and particulate matter are independent risks to VD levels and cause deficiency. However, obtaining comprehensive conclusions on the impact of air pollution on VDD is necessary. This study aims to review all related papers to determine how air pollution can affect VD levels. Copyright © 2018 Elsevier Ltd. All rights reserved.

  10. Vitamin D deficiency is associated with anxiety and depression in fibromyalgia.

    Science.gov (United States)

    Armstrong, D J; Meenagh, G K; Bickle, I; Lee, A S H; Curran, E-S; Finch, M B

    2007-04-01

    Fibromyalgia is a complex problem in which symptoms of anxiety and depression feature prominently. Low levels of vitamin D have been frequently reported in fibromyalgia, but no relationship was demonstrated with anxiety and depression. Seventy-five Caucasian patients who fulfilled the ACR criteria for fibromyalgia had serum vitamin D levels measured and completed the Fibromyalgia Impact Questionnaire (FIQ) and Hospital Anxiety and Depression Score (HADS). Deficient levels of vitamin D was found in 13.3% of the patients, while 56.0% had insufficient levels and 30.7% had normal levels. Patients with vitamin D deficiency (fibromyalgia and occurs more frequently in patients with anxiety and depression. The nature and direction of the causal relationship remains unclear, but there are definite implications for long-term bone health.

  11. Vitamin D deficiency: A potential risk factor for Clostridium difficile infection

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    Youssef D

    2012-10-01

    Full Text Available Dima Youssef,1 William B Grant,2 Alan N Peiris3,41Department of Internal Medicine, Division of Infectious Diseases, 2Sunlight, Nutrition and Health Research Center, San Francisco, CA USA; 3Department of Medicine, Mountain Home VAMC, 4Department of Medicine, East Tennessee State University, Johnson City, Tennessee, USAIn the July 3, 2012 issue of the journal of Risk Management and Healthcare Policy, Martinez et al present a nice review on Clostridium difficile (C. difficile infections.1 The different manifestations of this challenging disease along with the high cost and burden on the health care system were discussed. While the authors did an admirable job in discussing traditional risk factors, they do not mention vitamin D deficiency.View original paper by Martinez and colleagues.

  12. The practice of vitamin D deficiency assessment in a geriatric day hospital.

    LENUS (Irish Health Repository)

    Osuafor, C

    2016-04-01

    There has been no clear consensus on the assessment and treatment of vitamin D deficiency prior to the publication of the National Osteoporosis Society (NOS) Vitamin D Guideline in 2014. The aim of our study was to assess the practice in a medicine for the older person day hospital setting relative to this guideline. A 6-month retrospective analysis of all new patients who attended service from January to July 2013 was carried out. Seventy-six patients were included in the final analysis. Mean age was 83 years. 39 (51%) patients had sufficient levels while 37 (49%) patients had insufficient levels; 14 (19%) being inadequate and 23 (30%) deficient. Eighteen patients who had insufficient levels were subsequently prescribed supplements; 13 (72%) received vitamin D3 in combination with calcium while 5 (28%) received vitamin D3 alone. Based on the findings of this study, we have made some recommendations and adopted the guideline

  13. Fracture in Duchenne Muscular Dystrophy: Natural History and Vitamin D Deficiency.

    Science.gov (United States)

    Perera, Nadia; Sampaio, Hugo; Woodhead, Helen; Farrar, Michelle

    2016-08-01

    The present study examined the natural history of fracture and vitamin D levels in Duchenne muscular dystrophy patients, who are vulnerable to osteoporosis and fractures. Retrospective analysis of a cohort of 48 Duchenne muscular dystrophy patients revealed that 43% of patients experienced ≥1 fracture. Fracture probabilities at ages 6, 9, 12, and 15 years were 4%, 9%, 31%, and 60% respectively, accelerating around the time of ambulation loss (mean age 11.8 ± 2.7 years). Chronic corticosteroid therapy was utilized in 69% of patients and was associated with all vertebral fractures. A history of vitamin D deficiency occurred in 84%, and 35% were currently deficient. Despite chronic vitamin D supplementation, 38% remained deficient. These results demonstrate that osteoporosis and fracture remain major concerns in Duchenne muscular dystrophy. Bone health should be optimized well before loss of ambulation, however current levels of vitamin D supplementation may be inadequate given high levels of deficiency. © The Author(s) 2016.

  14. Maternal Vitamin D Deficiency and Fetal Programming - Lessons Learned from Humans and Mice

    Directory of Open Access Journals (Sweden)

    Christoph Reichetzeder

    2014-09-01

    Full Text Available Background/Aims: Cardiovascular disease partially originates from poor environmental and nutritional conditions in early life. Lack of micronutrients like 25 hydroxy vitamin D3 (25OHD during pregnancy may be an important treatable causal factor. The present study explored the effect of maternal 25OHD deficiency on the offspring. Methods: We performed a prospective observational study analyzing the association of maternal 25OHD deficiency during pregnancy with birth outcomes considering confounding. To show that vitamin D deficiency may be causally involved in the observed associations, mice were set on either 25OHD sufficient or insufficient diets before and during pregnancy. Growth, glucose tolerance and mortality was analyzed in the F1 generation. Results: The clinical study showed that severe 25OHD deficiency was associated with low birth weight and low gestational age. ANCOVA models indicated that established confounding factors such as offspring sex, smoking during pregnancy and maternal BMI did not influence the impact of 25OHD on birth weight. However, there was a significant interaction between 25OHD and gestational age. Maternal 25OHD deficiency was also independently associated with low APGAR scores 5 minutes postpartum. The offspring of 25OHD deficient mice grew slower after birth, had an impaired glucose tolerance shortly after birth and an increased mortality during follow-up. Conclusions: Our study demonstrates an association between maternal 25OHD and offspring birth weight. The effect of 25OHD on birth weight seems to be mediated by vitamin D controlling gestational age. Results from an animal experiment suggest that gestational 25OHD insufficiency is causally linked to adverse pregnancy outcomes. Since birth weight and prematurity are associated with an adverse cardiovascular outcome in later life, this study emphasizes the need for novel monitoring and treatment guidelines of vitamin D deficiency during pregnancy.

  15. [Metabolism and effects of vitamin D. Definition of vitamin D deficiency].

    Science.gov (United States)

    Souberbielle, Jean-Claude

    2014-01-01

    There is a growing interest for vitamin D in the medical and scientific community as well as in the public media as illustrated by a huge number of publications. Most experts claim that vitamin D deficiency/insufficiency is widespread with potential important public health consequences. It may seem surprising for many persons that a deficiency in a vitamin may be so frequent in countries where food is so diversified and easily available. In fact, vitamin D is not a vitamin stricto sensu as it is mainly synthesized in the skin under the action of UVB rays, while its food sources are scarce. Furthermore, UVB rays are absent during a marked part of the year at latitudes greater than 35-40°, while pollution, cloud cover reduce the number of UVB reaching the earth, and many factors such as age, skin pigmentation, covering clothes, sun creams reduce the capacity of the skin to synthesize vitamin D3. Vitamin D must be hydroxylated to form 1,25-dihydroxyvitamin D (1,25OH2D), the active metabolite. As 1,25OH2D is released into the bloodstream and binds to a receptor present in several distant tissues, it may be considered as a hormone, vitamin D being thus a pre-prohormone. In the present article, we review briefly the metabolism and various effects of vitamin D as well as vitamin D treatments. We define vitamin D deficiency/insufficiency considering separately the population and the patient level and propose our opinion according to which patients may beneficiate from vitamin D testing. © Société de Biologie, 2014.

  16. Vitamin D deficiency and outcomes in pediatric hematopoietic stem cell transplantation.

    Science.gov (United States)

    Beebe, Kristen; Magee, Kyrie; McNulty, Annmarie; Stahlecker, Jennifer; Salzberg, Dana; Miller, Holly; Mirea, Lucia; Adams, Roberta; Ngwube, Alexander

    2018-02-01

    Pediatric patients undergoing hematopoietic stem cell transplantation (HSCT) are frequently diagnosed with vitamin D deficiency, which may impact outcomes. To estimate the prevalence of vitamin D deficiency and examine its association with short-term survival in pediatric HSCT patients. Patients undergoing HSCT at Phoenix Children's Hospital were retrospectively identified. Routine serum 25-hydroxyvitamin D measurements were described prior to transplant and at 100 days and 1-year post-HSCT. Associations of pre-HSCT vitamin D groups (i.e., normal ≥30 ng/ml, insufficient 20-29 ng/ml, and deficient <30 ng/ml) with demographics, clinical factors, and outcomes were examined using nonparametric tests and Cox proportional hazards analyses. Among 72 study subjects, the median vitamin D pre-HSCT was 26 ng/ml (range: 19-34 ng/ml). Levels were insufficient and deficient in 25 (35%) and 20 (28%) patients, respectively, with only two (3%) patients on supplemental therapy pre-HSCT. Despite supplemental therapy provided to 46 (74%) subjects, insufficient/deficient rates did not significantly change between pre-HSCT and 100 days post-HSCT, but mean vitamin D levels significantly increased by 1-year post-HSCT (P = 0.01).Vitamin D pre-HSCT was not associated with the development of acute or chronic graft-versus-host disease (GVHD) or delayed engraftment. Overall 1-year survival was significantly lower for patients with deficient (65%) compared to normal (93%) pre-HSCT vitamin D (P = 0.001). Suboptimal vitamin D levels are common in pediatric patients scheduled to receive HSCT and are associated with lower overall 1-year survival. Further study is warranted to delineate the mechanisms underlying the role of vitamin D in successful HSCT. © 2017 Wiley Periodicals, Inc.

  17. The Relationship between Maternal Vitamin D Deficiency and Low Birth Weight Neonates

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    Nasrin Khalessi

    2015-10-01

    Full Text Available Objective:Maternal hypovitaminosis D may impair fetal growth and cause adverse pregnancy outcomes including intrauterine growth restriction and neonatal low birth weight. The aim of this study is to evaluate the relationship between maternal vitamin D status and neonate’s birth weight.Materials and methods:A cross-sectional, descriptive analytical study was carried out in the nursery ward of 2 hospitals (Tehran-Iran during one year (January 2011- January 2012. One hundred and two neonates were categorized into two groups, neonates with birth weight< 2500 gr (n=52 and neonates with birth weight>2500 gr (n=50. Data regarding medical history, physical examination and anthropometric measurements of neonates were noted in a questionnaire. Birth time blood samples of their mothers were analyzed for serum 25-(OH-vitamin D by ELISA method. Maternal vitamin D status was compared in two groups.Results:Mean maternal vitamin D (vit D level was 31.46 nmol/L. Forty eight percent of mothers had vitamin D deficiency, 27.5% had vit D insufficiency and 24.5% were normal. Mean maternal vitamin D level of LBW neonates was lower than other group; 25.05 vs. 38.13 (p= 0.001. All mothers of neonates with head circumference ≤ 33 cm also had vitamin D deficiency (p= 0.007.Conclusion:Maternal Vitamin Ddeficiency may increase the risk of low birth weight neonate and modifying maternal nutrition behavior and their vit D level could be beneficial on pregnancy outcome.

  18. Vitamin D Deficiency: A Potential Modifiable Risk Factor for Cardiovascular Disease in Children with Severe Obesity.

    Science.gov (United States)

    Iqbal, Anoop Mohamed; Dahl, Amanda R; Lteif, Aida; Kumar, Seema

    2017-08-28

    Severe obesity is associated with abnormal lipids and increased risk for cardiovascular disease. Obesity is a risk factor for vitamin D deficiency. We examined relationship between 25-hydroxy vitamin D (25(OH)D) concentrations and lipids in children with severe obesity. Medical records of 376 children were reviewed. Linear regression models and logistic regression were used to examine the relationship between 25(OH)D and lipids after adjustment for age, gender, season of blood draw, body mass index (BMI) z-score, and BMI % of 95th percentile. Two-hundred sixty-three out of 376 children (70%) had 25(OH)D concentrations < 30 ng/mL. Concentrations of 25(OH)D were positively correlated with those of high-density lipoprotein cholesterol (HDL-C) (r² = 0.08, r = 0.22, β = 0.16, 95% CI = 0.05-0.27, p = 0.004). HDL-C was lower in children with 25(OH)D < 30 ng/mL (n = 263) compared to those with 25(OH)D ≥ 30 ng/mL (n = 113) (41.3 ± 10.2 vs. 46.4 ± 12 mg/dL, p < 0.0001). Children with 25(OH)D concentrations < 30 ng/mL had greater adjusted odds of low HDL-C (<40 mg/dL) compared with those with 25(OH)D ≥ 30 ng/mL (47.9% vs. 29.2%, OR 2.15 (1.33-3.51), p = 0.0019). Total cholesterol and non-HDL-C were not correlated with 25(OH)D concentrations. Vitamin D deficiency is highly prevalent in children with severe obesity. Prospective clinical trials are warranted to determine if vitamin D supplementation can improve HDL-C and potentially decrease risk for cardiovascular disease in children with obesity.

  19. The association between vitamin D deficiency and type 2 diabetes mellitus in elderly patients.

    Science.gov (United States)

    Hidayat, Rudy; Setiati, Siti; Soewondo, Pradana

    2010-07-01

    to identify the association between vitamin D deficiency and type-2 diabetes mellitus in elderly population. a study was conducted at the geriatric clinic of Cipto Mangunkusumo Hospital in November 2007, with a cross-sectional design. The accessible population of our study were patients with type-2 diabetes mellitus and non-diabetes mellitus patients who visited the clinic for treatment. The subject criteria were: patients >60 years old with operational definition of type-2 diabetes mellitus, and willing to participate in the study. Data collected included characteristics, such as age, sex, education level, history of family illness, frequency of outdoor activity, duration of direct sun exposure in their outdoor activities, history of using sun protector; and the laboratory data such as 25(OH)D3 serum level, calcium and albumin serum level. Data analysis was done by Chi-Square test and multivariate analysis was performed by logistic regression technique to control some identified confounding factors. All data processing and statistical analyses were done with SPSS 11.5 for windows. we found a total number of 78 subjects. Of them, 40 subjects were with DM, and 38 subjects without DM. Most subjects were female (66.7%), and obese (44.9%). Direct sun exposure of most subjects was indicated by the frequency of outdoor activity of more than 3 times a week (74.4%). Duration of exposure in most subjects was less than 15 minutes (43.6%), with application of sun protector agent (56.4%). The prevalence of vitamin D deficiency was 78.2%, with a cut-off of diabetes mellitus cannot be proven statistically in our study (p=0.482; OR=0.8; CI=0.5-1.3).

  20. Spontaneous rickets in the wild arctic fox Alopex lagopus

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    Ogden, J.A.; Conlogue, G.J.

    1981-10-01

    Normal and rachitic, skeletally immature arctic foxes (Alopex lagopus) were subjected to physical examination, roentgenographic studies, and in some cases histologic studies. The involved animals had active rickets coupled with antecedent normal diaphyseal bone formation. Evaluation of all the long bones showed highly variable manifestations of the disease, which undoubtedly reflect different rates of physeal endochondral transformation and metaphyseal remodeling. Histologic examination showed distinct patterns of widening of the physes and variable osteodystrophy in the trabecular and cortical bone of the metaphyses and epiphyseal ossification centers. These aforementioned factors certainly would necessitate different regional calcium needs and, therefore, different regional responses to an overall calcium deficiency. The physes involved in the most rapid growth rates in this period showed the most widening of the growth plate, and the most dystrophic changes in the metaphysis. Skeletal injuries, including metaphyseal fractures and slow-down of longitudinal growth (particularly in the ulna) were also evident. Because of apparent dietary differences in the affected and normal fox kits, this juvenile-onset disease was presumed due to calcium-deficient intake following weaning. To the best of our knowledge this is the first report of spontaneously occurring rickets in a wild animal in its natural habitat. There are several possible mechanisms for the variable widening of the physis and the loss of bone mineralization in these fox kits: calcium-deficient diet, binding of calcium in the bowel by high phosphorus intake, secondary hyperparathyroidism, and vitamin A toxicity.

  1. Clinical presentation and etiology of osteomalacia/rickets in adolescents

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    Mohammad A Hazzazi

    2013-01-01

    Full Text Available This study was conducted to determine the causes and clinical presentations of osteomalacia/rickets in adolescents seen at the King Abdulaziz Medical City (KAMC, Riyadh. Because osteomalacia and rickets constitute the same entity, the term osteomalacia will be used for future discussion. A retrospective file review was performed on all adolescents (10-16 years with osteomalacia, defined as alkaline phosphatase levels ≥500 IU/L, seen at the KAMC, Riyadh, from 2000 to 2006. We recorded the signs and symptoms, dietary history and amount of sun exposure at presentation. A total of 135 patients were found to fit the inclusion criteria for the study. Of them, 57 had nutritional causes, with a mean age of 13.2 years, and included 32 females. At diagnosis, 22 patients were found to have bone pain, 10 had bone deformities, eight had pathological fractures and 17 were asymptomatic. Secondary causes for osteomalacia were found in 59 cases who had liver and renal disease and in 19 other patients who were on medications such as anticonvulsants and steroids, which are known to cause osteomalacia. Our study indicates that osteomalacia is a significant health burden that deserves special attention. Bone pain is the most common presenting symptom at diagnosis. Because of the high risk of osteomalacia associated with the use of anticonvulsants and steroids, it is advised that all patients on these drugs should be routinely screened for secondary osteomalacia.

  2. Case Report: Pycnodysostosis Associated with Spondylolysis and Spondylolisthesis Mimicking Rickets

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    Hidayet Sarı

    2011-04-01

    Full Text Available Pycnodysostosis is a skeletal dysplasia, which is mainly characterized by short stature, increased bone density, separated cranial sutures with open fontanel, bone fragility, small hands and feets. We present a female patient, with pycnodysostosis has been misdiagnosed as rickets for a long period. Patient also had spondylolysis and spondylolisthesis at L5 vertebra. Patient was undergone the external fixation and patient were spent external fixation surgery due to spondylolysis and spondylolisthesis at L4-5 level and right femoral neck fracture. In conclusion, genetical skeletal dysplasia such as pycnodysostosis should be considered out of rickets if exists short stature, bone fragility and open fontanel. In patient with pycnodysostosis occurs bone fragility at an earlier age appears despite the increase in bone mineral density. Also, the development of spondylolysis and isthmic type of spondylolisthesis as well as bone fragility must be considered in the pycnodysostosis. Therefore, we emphasize to prevent high-impact trauma such as falling and crash in patients with pycnodysostosis. (Turkish Journal of Osteoporosis 2011;17:26-9

  3. A systematic review of nutritional rickets in Ethiopia: status and prospects.

    Science.gov (United States)

    Wondale, Yimenu; Shiferaw, Fetsum; Lulseged, Sileshi

    2005-07-01

    Nutritional rickets contributes to the high burden of illness and death among Ethiopian children below 5 years of age. Lack of adequate information appears to have negatively influenced the impact of prevention and treatment programs. The objective of this systematic review is to review existing body of knowledge about nutritional rickets in Ethiopia and develop recommendations that will guide development of strategies for effective interventions and research. Published and unpublished information on nutritional rickets in Ethiopia was collected systematically. The information was critically reviewed and discussed in the context of regional and global situation. The major cause of nutritional rickets in Ethiopian children is lack of exposure to sunshine and/or inadequate intake of vitamin D. Lack of awareness and traditional beliefs are major causes for not exposing infants to sunshine. The disease is associated with poor socioeconomic status, low birth weight, protein-energy malnutrition and common childhood infections. Severe form of rickets is commonly seen at about 18 months of age. Rickets predisposes Ethiopian children to pneumonia. Diagnostic criteria used in most studies include two or more clinical signs and a characteristic radiological or biochemical abnormality. There are critical gaps in our knowledge about the epidemiology, ecology, and potentially effective interventions to prevent and treat rickets in Ethiopian children. Most of the studies on nutritional rickets in Ethiopia have been conducted in hospital settings. There is a need for well designed epidemiological and ecological studies. The biologic basis for the striking association between PEM and active rickets seen in Ethiopia needs to be determined The role of calcium deficiency, the part played by genetic factors, the nature of the association between the duration of breastfeeding and rickets, and the role of complimentary feeds in Ethiopian children need to be explored. Studies are required

  4. Prevention of rickets in Asian children: assessment of the Glasgow campaign.

    OpenAIRE

    Dunnigan, M G; Glekin, B M; Henderson, J B; McIntosh, W B; Sumner, D; Sutherland, G R

    1985-01-01

    In March 1979 the Greater Glasgow Health Board launched a campaign to reduce the high prevalence of rickets in Asian children in the city. A precampaign survey had shown that voluntary low dose vitamin D supplementation would reduce the prevalence of rickets in Asian children. A survey carried out two and three years after the launch of the official campaign also showed a reduction in the prevalence of rickets in children taking low dose supplements equivalent to about 2.5 micrograms (100 IU)...

  5. Serum 25-hydroxy-vitamin D levels in malnourished children with rickets.

    OpenAIRE

    Raghuramulu, N; Reddy, V

    1980-01-01

    Serum levels of calcium, phosphorus, alkaline phosphatase, and 25 hydroxy-vitamin D (25-OH-D3) were measured in normal and malnourished children with and without rickets. Children with rickets had clinical, biochemical, and x-ray evidence of the disease; most of them were malnourished. 25-OH-D3 levels were lower than in normal children. After treatment with vitamin D their condition improved. 25-OH-D3 levels were also found to be reduced in malnourished children without rickets. These studies...

  6. Bony manifestation of rickets in a sunny city - a case report from Yazd, Iran

    OpenAIRE

    Mohammadhosain Afrand; Vajiheh Modaresi

    2014-01-01

    Rickets is disease that occurs in growing bones in which defective mineralization occurs in both the bone and the cartilage of the epiphyseal growth plate, resulting in the retardation of growth and skeletal deformities. Rickets is more common in areas with less sunlight. However, this case report presents a case of the bony manifestation of rickets with the intake of vitamin D supplements in Yazd, a city in central Iran that has sunshine almost every day. A patient was referred to an out-pat...

  7. Is vitamin D deficiency a public health concern for low middle income countries? A systematic literature review.

    Science.gov (United States)

    Cashman, Kevin D; Sheehy, Tony; O'Neill, Colette M

    2018-01-17

    Vitamin D deficiency has been receiving increasing attention as a potential public health concern in low and lower-middle income countries (LMICs), of which there are currently 83. We aimed to conduct a comprehensive systematic literature review (SLR) of available data on vitamin D status and prevalence of vitamin D deficiency in all 83 LMICs. We followed the general methodology for SLRs in the area of serum 25-hydroxyvitamin D. Highest priority was placed on identifying relevant population-based studies, followed by cross-sectional studies, and to a lesser extent case-control studies. We adopted the public health convention that a prevalence of vitamin D deficiency (serum 25-hydroxyvitamin D  20% in the entire population and/or at-risk population subgroups (infants, children, women of child-bearing age, pregnancy) constitutes a public health issue that may warrant intervention. Our SLR revealed that of the 83 LMICs, 65% (n = 54 countries) had no published studies with vitamin D data suitable for inclusion. Using data from the remaining third, a number of LMICs had evidence of excess burden of vitamin D deficiency in one or more population subgroup(s) using the above convention (Afghanistan, Pakistan, India, Tunisia and Mongolia) as well as possibly other LMICs, albeit with much more limited data. Several LMICs had no evidence of excess burden. Vitamin D deficiency is a public health issue in some, but certainly not all, LMICs. There is a clear need for targeting public health strategies for prevention of vitamin D deficiency in those LMICs with excess burden.

  8. Vitamin D deficiency associates with γ-tocopherol and quadriceps weakness but not inflammatory cytokines in subjects with knee osteoarthritis

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    Tyler Barker

    2014-01-01

    Full Text Available Knee osteoarthritis (OA is a degenerative joint condition and a leading cause of physical disability in the United States. Quadriceps weakness and inflammatory cytokines contribute to the pathogenesis of knee OA, and both of which, increase with vitamin D deficiency. Other micronutrients, such as vitamins C and E and β-carotene, modulate inflammatory cytokines and decrease during inflammation. The purpose of this study was to test the hypothesis that vitamin D deficiency associates with quadriceps weakness, an increase in serum cytokines, and a decrease in circulating micronutrients in subjects with knee OA. Subjects (age, 48±1 y; serum 25(OHD, 25.8±1.1 ng/mL with knee OA were categorized as vitamin D deficient (n=17; serum 25(OHD≤20 ng/mL, insufficient (n=21; serum 25(OHD 20–29 ng/mL, or sufficient (n=18; serum 25(OHD≥30 ng/mL. Single-leg strength (concentric knee extension–flexion contraction cycles at 60 °/s and blood cytokine, carotene (α and β, ascorbic acid, and tocopherol (α and γ concentrations were measured. Quadriceps peak torque, average power, total work, and deceleration were significantly (all p<0.05 impaired with vitamin D deficiency. Serum γ-tocopherol concentrations were significantly (p<0.05 increased with vitamin D deficiency. In the vitamin D sufficient group, γ-tocopherol inversely correlated (r=−0.47, p<0.05 with TNF-α, suggesting a pro-inflammatory increase with a γ-tocopherol decrease despite a sufficient serum 25(OHD concentration. We conclude that vitamin D deficiency is detrimental to quadriceps function, and in subjects with vitamin D sufficiency, γ-tocopherol could have an important anti-inflammatory role in a pathophysiological condition mediated by inflammation.

  9. Knowledge, attitude and practice regarding vitamin D deficiency among female students in Saudi Arabia: a qualitative exploration.

    Science.gov (United States)

    Christie, Floor T E; Mason, Linda

    2011-08-01

    Vitamin D deficiency is associated with numerous chronic diseases including cancer, heart disease and diabetes type 1 and 2. It is currently estimated that one billion people suffer from vitamin D deficiency worldwide. A major cause is lack of sun exposure, and this is evident even in countries at mid and low latitudes. Although a high prevalence has been found in Saudi Arabia, little is known to date about the reasons for this and, consequently about, reduction methodologies. The study's aim was to investigate the knowledge, attitude and practice (KAP) towards vitamin D deficiency, sun exposure, supplementation and fortification in a sample of female Saudi Arabian students. A focus group and eight in depth one-to-one semi-structured interviews were conducted and analysed using thematic analysis. Participants were limited in their knowledge about vitamin D and vitamin D deficiency. They reported limited sun exposure due to intense heat, cultural reasons for covering the body, and an infrastructure that makes sun exposure difficult. Important barriers for the prevention of vitamin D deficiency in Saudi Arabia were highlighted. Recommendations for more research in specific areas including the prevalence of vitamin D deficiency and recommended daily allowances of supplementation are made. Governmental actions including increasing awareness of the importance of vitamin D and guidelines on how to obtain it are necessary. Creating areas where women, particularly those of lower socio-economic status, can enjoy sun exposure as well as fortifying more foods would go some way towards tackling this problem. © 2011 The Authors. International Journal of Rheumatic Diseases © 2011 Asia Pacific League of Associations for Rheumatology and Blackwell Publishing Asia Pty Ltd.

  10. Vitamin D deficiency associates with γ-tocopherol and quadriceps weakness but not inflammatory cytokines in subjects with knee osteoarthritis.

    Science.gov (United States)

    Barker, Tyler; Henriksen, Vanessa T; Rogers, Victoria E; Aguirre, Dale; Trawick, Roy H; Lynn Rasmussen, G; Momberger, Nathan G

    2014-01-01

    Knee osteoarthritis (OA) is a degenerative joint condition and a leading cause of physical disability in the United States. Quadriceps weakness and inflammatory cytokines contribute to the pathogenesis of knee OA, and both of which, increase with vitamin D deficiency. Other micronutrients, such as vitamins C and E and β-carotene, modulate inflammatory cytokines and decrease during inflammation. The purpose of this study was to test the hypothesis that vitamin D deficiency associates with quadriceps weakness, an increase in serum cytokines, and a decrease in circulating micronutrients in subjects with knee OA. Subjects (age, 48±1 y; serum 25(OH)D, 25.8±1.1 ng/mL) with knee OA were categorized as vitamin D deficient (n=17; serum 25(OH)D≤20 ng/mL), insufficient (n=21; serum 25(OH)D 20-29 ng/mL), or sufficient (n=18; serum 25(OH)D≥30 ng/mL). Single-leg strength (concentric knee extension-flexion contraction cycles at 60 °/s) and blood cytokine, carotene (α and β), ascorbic acid, and tocopherol (α and γ) concentrations were measured. Quadriceps peak torque, average power, total work, and deceleration were significantly (all p<0.05) impaired with vitamin D deficiency. Serum γ-tocopherol concentrations were significantly (p<0.05) increased with vitamin D deficiency. In the vitamin D sufficient group, γ-tocopherol inversely correlated (r=-0.47, p<0.05) with TNF-α, suggesting a pro-inflammatory increase with a γ-tocopherol decrease despite a sufficient serum 25(OH)D concentration. We conclude that vitamin D deficiency is detrimental to quadriceps function, and in subjects with vitamin D sufficiency, γ-tocopherol could have an important anti-inflammatory role in a pathophysiological condition mediated by inflammation.

  11. [Prevalence of vitamin D deficiency and associated factors in women and newborns in the immediate postpartum period].

    Science.gov (United States)

    do Prado, Mara Rúbia Maciel Cardoso; Oliveira, Fabiana de Cássia Carvalho; Assis, Karine Franklin; Ribeiro, Sarah Aparecida Vieira; do Prado Junior, Pedro Paulo; Sant'Ana, Luciana Ferreira da Rocha; Priore, Silvia Eloiza; Franceschini, Sylvia do Carmo Castro

    2015-01-01

    To assess the prevalence of vitamin D deficiency and its associated factors in women and their newborns in the postpartum period. This cross-sectional study evaluated vitamin D deficiency/insufficiency in 226 women and their newborns in Viçosa (Minas Gerais, BR) between December 2011 and November 2012. Cord blood and venous maternal blood were collected to evaluate the following biochemical parameters: vitamin D, alkaline phosphatase, calcium, phosphorus and parathyroid hormone. Poisson regression analysis, with a confidence interval of 95% was applied to assess vitamin D deficiency and its associated factors. Multiple linear regression analysis was performed to identify factors associated with 25(OH)D deficiency in the newborns and women from the study. The criteria for variable inclusion in the multiple linear regression model was the association with the dependent variable in the simple linear regression analysis, considering p<0.20. Significance level was α<5%. From 226 women included, 200 (88.5%) were 20 to 44 years old; the median age was 28 years. Deficient/insufficient levels of vitamin D were found in 192 (85%) women and in 182 (80.5%) neonates. The maternal 25(OH)D and alkaline phosphatase levels were independently associated with vitamin D deficiency in infants. This study identified a high prevalence of vitamin D deficiency and insufficiency in women and newborns and the association between maternal nutritional status of vitamin D and their infants' vitamin D status. Copyright © 2015 Sociedade de Pediatria de São Paulo. Publicado por Elsevier Editora Ltda. All rights reserved.

  12. Vitamin D Deficiency in Community-Dwelling Elderly Is Not Associated with Age-Related Macular Degeneration.

    Science.gov (United States)

    Cougnard-Grégoire, Audrey; Merle, Bénédicte M J; Korobelnik, Jean-Francois; Rougier, Marie-Bénédicte; Delyfer, Marie-Noëlle; Féart, Catherine; Le Goff, Mélanie; Dartigues, Jean-François; Barberger-Gateau, Pascale; Delcourt, Cécile

    2015-08-01

    Elderly persons are at elevated risk of vitamin D deficiency, which is involved in various health problems. However, its relation with age-related macular degeneration (AMD) is debated. We investigated factors associated with plasma 25-hydroxyvitamin D [25(OH)D] deficiency and the associations between plasma 25(OH)D concentrations and AMD in elderly subjects. Antioxydants, Lipides Essentiels, Nutrition et maladies OculaiRes (ALIENOR) is a population-based study on eye diseases performed in elderly residents of Bordeaux, France. Plasma 25(OH)D concentrations were assessed from blood samples and categorized as role for vitamin D in AMD. © 2015 American Society for Nutrition.

  13. DOES VITAMIN D DEFICIENCY CONTRIBUTE TO THE SEVERITY OF ASTHMA IN CHILDREN AND ADULTS?

    Science.gov (United States)

    Ahmed, Syed Zaryab; Jaleel, Anila; Hameed, Kamran; Qazi, Salman; Suleman, Ahsan

    2015-01-01

    Role of vitamin D in the health of bones has been well established for over decades; It was known that its deficiency caused rickets in children and osteomalacia in adults. Later it was discovered that these can be corrected by giving vitamin D. Researchers discovered that vitamin D can be synthesized by exposure to sun. Hence it was also named "the sunshine vitamin". As time passed it was observed that low levels of vitamin D were associated with multiple diseases. This sparked the interest of the scientific community to further the research on vitamin D which led to the studies that started associating vitamin D with various diseases like cancers (prostate, colon and breast), autoimmune diseases (rheumatoid arthritis), infectious diseases (tuberculosis, hepatitis B, hepatitis C, HIV), cardiovascular diseases, mental illnesses (schizophrenia), diabetes mellitus (type 1, type 2 and gestational) and allergic conditions like asthma. With time, more studies were carried out relating levels of vitamin D to development of asthma, asthma exacerbations and risk factors leading to development of asthma like respiratory tract infections with positive associations. A number of studies were carried out which tried to explain the possible molecular mechanisms relating deficiency of vitamin D in pathogenesis of asthma. This review summarizes the role of vitamin D in development of asthma and probable mechanisms relating vitamin D to the pathogenesis of asthma.

  14. High prevalence of vitamin D deficiency in elderly patients with advanced osteoarthritis scheduled for total knee replacement associated with poorer preoperative functional state

    OpenAIRE

    Jansen, JA; Haddad, FS

    2013-01-01

    Vitamin D deficiency has been reported previously in patients with osteoarthritis undergoing total hip arthroplasty. We found a high prevalence of vitamin D deficiency in elderly patients with advanced knee osteoarthritis scheduled for total knee replacement and also a significant association with a lower preoperative functional state. A review of the literature is given on vitamin D deficiency in patients with knee osteoarthritis and the association with lower outcome scores after arthroplas...

  15. High prevalence of vitamin D deficiency in elderly patients with advanced osteoarthritis scheduled for total knee replacement associated with poorer preoperative functional state.

    Science.gov (United States)

    Jansen, J A; Haddad, F S

    2013-11-01

    Vitamin D deficiency has been reported previously in patients with osteoarthritis undergoing total hip arthroplasty. We found a high prevalence of vitamin D deficiency in elderly patients with advanced knee osteoarthritis scheduled for total knee replacement and also a significant association with a lower preoperative functional state. A review of the literature is given on vitamin D deficiency in patients with knee osteoarthritis and the association with lower outcome scores after arthroplasty is discussed.

  16. Vitamin D deficiency, oxidative stress and antioxidant status: only weak association seen in the absence of advanced age, obesity or pre-existing disease.

    Science.gov (United States)

    Wang, Erica W; Siu, Parco M; Pang, Marco Y; Woo, Jean; Collins, Andrew R; Benzie, Iris F F

    2017-07-01

    Vitamin D deficiency (plasma 25-hydroxycholecalciferol (25(OH)D)70 % of participants were vitamin D deficient. No significant correlations and no biomarker differences across 25(OH)D quartiles or groups were seen except for total antioxidant status. A weak direct association (r 0·252, Pstress biomarkers in the absence of advanced age, obesity and disease, though some evidence of depleted antioxidant status in those with vitamin D deficiency was seen. Poor antioxidant status may pre-date increased oxidative stress. Study of effects of correction of deficiency on antioxidant status and oxidative stress in vitamin D-deficient but otherwise healthy subjects is needed.

  17. Familial vitamin D resistant rickets: End-organ resistance to 1,25-dihydroxyvitamin D

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    Sangita Choudhury

    2013-01-01

    Full Text Available Rickets is softening of bones due to defective mineralization of cartilage in the epiphyseal growth plate, leading to widening of ends of long bones, growth retardation, and skeletal deformities in children. The predominant cause is deficiency or impaired metabolism of vitamin D. The observation that some forms of rickets could not be cured by regular doses of vitamin D, led to the discovery of rare inherited abnormalities of vitamin D metabolism or vitamin D receptor. Vitamin D dependent rickets (VDDR is of two types: Type I is due to defective renal tubular 25-hydroxyvitamin D 1-α hydroxylase and type II is due to end-organ resistance to active metabolite of vitamin D. Typical signs are observed from the first month of life. The patient with rickets described below had markedly increased serum alkaline phosphatase and 1,25-dihydroxyvitamin D. We attribute these abnormalities to impaired end-organ responsiveness to 1,25-dihydroxyvitamin D.

  18. The relationship of maternal bone density with nutritional rickets in Nigerian children.

    Science.gov (United States)

    Hsu, Jennifer; Fischer, Philip R; Pettifor, John M; Thacher, Tom D

    2017-04-01

    Factors that affect maternal bone mineral density may be related to the risk of nutritional rickets in their offspring. Our aim was to determine the relationship between maternal areal bone mineral density (aBMD) and rickets in Nigerian children. Using a case-control design, we measured forearm aBMD in 56 and 135 mothers of children with and without nutritional rickets, respectively. Active rickets was confirmed or excluded in all children radiographically. Using logistic regression, we assessed the association of maternal aBMD, adjusted for parity, pregnancy and lactation status, duration of most recent completed lactation, age of menarche, height, body mass index, and maternal age with nutritional rickets. The median (range) age of all mothers was 30years (17-47years), and parity was 4 (1-12). A total of 36 (19%) were pregnant and 55 (29%) were currently breast feeding. Mean (±SD) metaphyseal forearm aBMDs were 0.321±0.057 and 0.316±0.053g/cm 2 in mothers of children with and without rickets, respectively (P=0.60). Diaphyseal forearm aBMDs were 0.719±0.071 and 0.715±0.072g/cm 2 , respectively (P=0.69). In an adjusted analysis, maternal forearm aBMD, bone mineral content and bone area at metaphyseal and diaphyseal sites were not associated with rickets in the child. In the adjusted analysis, rickets was associated with shorter duration of most recently completed lactation (aOR 0.91 for each additional month; 95% CI 0.83-0.99), older maternal age (aOR 1.07 for each additional year; 1.00-1.14), and less frequent maternal use of lead-containing eye cosmetics (aOR 0.20; 95% CI 0.05-0.64), without any difference in maternal blood lead levels. Maternal age, parity, age of menarche, height, and body mass index were not associated with having had a child with rickets in multivariate analysis. Nutritional rickets in Nigerian children was not associated with maternal forearm aBMD. Other unidentified maternal characteristics and practices likely contribute to the risk

  19. Peculiarities of rickets of children who were born prematurely and suffered bronchopulmonary dysplasia

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    Yablon О.S.

    2016-05-01

    Full Text Available Objective: to establish the clinical and metabolic peculiarities of rickets of children who were born prematurely and suffered bronchopulmonary dysplasia and to evaluate the effectiveness of specific and nonspecific prevention of rickets of these children. Materials and methods. 15 infants with clinical manifestations of rickets who were born preterm (gestational age 28,87 0,56 weeks, weight 1214,0077 ,91 g and transferred to the neonatal bronchopulmonary dysplasia (first group investigated serum total calcium, the level of ionized calcium, inorganic phosphorus in serum, activity of alkaline phosphatase in serum. The results were compared with those of 25 premature babies of the same age and severity of rickets without bronchopulmonary dysplasia (second group and 10 term infants of the same age and severity of rickets (group. Results. Children with rickets and osteomalacia bronchopulmonary dysplasia symptoms prevailed, particularly kraniotabes (60.00% and availability Harissonovoyi grooves (33.33% (p<0.05, deformity of the sternum (93.33% and expanding the lower aperture (100.00% (p<0.01. The data indicate that the depth of metabolic disorders in premature babies with rickets and bronchopulmonary dysplasia fairly similar as prevailing without bronchopulmonary dysplasia of premature babies and of children who were born full-term. The children of the first group all indicators biochemistry blood were significantly lower than similar indicators in children with group comparison, the level of total calcium — 1.84±0.04 mmol/l and inorganic phosphorus — 1.44±0.02 mmol/l (p<0.01, and ionized calcium — 1.06±0.03 mmol/l. The activity of alkaline phosphatase (663.53±55.10 U/L significantly prevailing rate of term infants (p<0,05. In premature infants antenatal and postnatal prevention of rickets was broken. Conclusion. It has been established that rickets in premature infants in the background bronchopulmonary dysplasia began earlier, had mostly

  20. IS THERE A LINK BETWEEN SUNLIGHT EXPOSURE AND 25-HYDROXYVITAMIN D DEFICIENCY IN CHRONIC KIDNEY DISEASE PATIENTS?

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    Angela Yee-Moon Wang

    2012-06-01

    In conclusion, our study confirmed an extremely high prevalence of vitamin D deficiency and an important association between outdoor sunlight exposure and 25(OHD deficiency in Chinese stage 3-5 CKD patients. Further study is needed to determine whether increasing daily outdoor sunlight exposure may represent a cost-free treatment for correcting nutritional 25(OHD deficiency in the CKD population.

  1. A Novel Rat Model of Vitamin D Deficiency: Safe and Rapid Induction of Vitamin D and Calcitriol Deficiency without Hyperparathyroidism

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    Andrea W. D. Stavenuiter

    2015-01-01

    Full Text Available Vitamin D deficiency is associated with a range of clinical disorders. To study the mechanisms involved and improve treatments, animal models are tremendously useful. Current vitamin D deficient rat models have important practical limitations, including time requirements when using, exclusively, a vitamin D deficient diet. More importantly, induction of hypovitaminosis D causes significant fluctuations in parathyroid hormone (PTH and mineral levels, complicating the interpretation of study results. To overcome these shortcomings, we report the successful induction of vitamin D deficiency within three weeks, with stable serum PTH and minerals levels, in Wistar rats. We incorporated two additional manoeuvres compared to a conventional diet. Firstly, the vitamin D depleted diet is calcium (Ca enriched, to attenuate the development of secondary hyperparathyroidism. Secondly, six intraperitoneal injections of paricalcitol during the first two weeks are given to induce the rapid degradation of circulating vitamin D metabolites. After three weeks, serum 25-hydroxyvitamin D3 (25D and 1,25-dihydroxyvitamin D3 (1,25D levels had dropped below detection limits, with unchanged serum PTH, Ca, and phosphate (P levels. Therefore, this model provides a useful tool to examine the sole effect of hypovitaminosis D, in a wide range of research settings, without confounding changes in PTH, Ca, and P.

  2. A novel rat model of vitamin D deficiency: safe and rapid induction of vitamin D and calcitriol deficiency without hyperparathyroidism.

    Science.gov (United States)

    Stavenuiter, Andrea W D; Arcidiacono, Maria Vittoria; Ferrantelli, Evelina; Keuning, Eelco D; Vila Cuenca, Marc; ter Wee, Piet M; Beelen, Robert H J; Vervloet, Marc G; Dusso, Adriana S

    2015-01-01

    Vitamin D deficiency is associated with a range of clinical disorders. To study the mechanisms involved and improve treatments, animal models are tremendously useful. Current vitamin D deficient rat models have important practical limitations, including time requirements when using, exclusively, a vitamin D deficient diet. More importantly, induction of hypovitaminosis D causes significant fluctuations in parathyroid hormone (PTH) and mineral levels, complicating the interpretation of study results. To overcome these shortcomings, we report the successful induction of vitamin D deficiency within three weeks, with stable serum PTH and minerals levels, in Wistar rats. We incorporated two additional manoeuvres compared to a conventional diet. Firstly, the vitamin D depleted diet is calcium (Ca) enriched, to attenuate the development of secondary hyperparathyroidism. Secondly, six intraperitoneal injections of paricalcitol during the first two weeks are given to induce the rapid degradation of circulating vitamin D metabolites. After three weeks, serum 25-hydroxyvitamin D3 (25D) and 1,25-dihydroxyvitamin D3 (1,25D) levels had dropped below detection limits, with unchanged serum PTH, Ca, and phosphate (P) levels. Therefore, this model provides a useful tool to examine the sole effect of hypovitaminosis D, in a wide range of research settings, without confounding changes in PTH, Ca, and P.

  3. Parathyroid hormone-related protein and calcium regulation in vitamin D-deficient sea bream (Sparus auratus).

    NARCIS (Netherlands)

    Abbink, W.; Hang, X.M.; Guerreiro, P.M.; Spanings, F.A.T.; Ross, H.A.; Canario, A.V.; Flik, G.

    2007-01-01

    Gilthead sea bream (Sparus auratus L.) were fed a vitamin D-deficient diet for 22 weeks. Growth rate, whole body mineral pools and calcium balance were determined. Plasma parathyroid hormone-related protein (PTHrP) and calcitriol levels were assessed. Expression of mRNA for pthrp and pth1r was

  4. Obstructive sleep apnea and objective short sleep duration are independently associated with the risk of serum vitamin D deficiency.

    Science.gov (United States)

    Piovezan, Ronaldo D; Hirotsu, Camila; Feres, Marcia C; Cintra, Fatima D; Andersen, Monica L; Tufik, Sergio; Poyares, Dalva

    2017-01-01

    Studies demonstrate an association between vitamin D (25(OH)D) deficiency and sleep disturbances, such as obstructive sleep apnea (OSA) and short sleep duration. However, to date, no studies have concurrently and objectively evaluated the effect of these factors on 25(OH)D. To evaluate whether OSA and objective short sleep duration are independently associated with reduced 25(OH)D in an adult population sample. A cross-sectional study included 657 individuals from the city of Sao Paulo, Brazil, as part of the ERA project. Participants fulfilled questionnaires and underwent clinical evaluation, polysomnography and blood sample collection for 25(OH)D quantification. OSA was classified into three categories (mild, moderate and severe). The risk of 25(OH)D deficiency was considered as levelsShort sleep duration was defined as total sleep timeshort sleep duration showed significant independent associations with the risk of 25(OH)D deficiency (moderate OSA: OR for 25(OH)Dshort sleep duration: OR for 25(OH)Dshort sleep duration are independently associated with the risk of 25(OH)D deficiency in an adult population. Age-related changes in vitamin D metabolism and the frequency of sleep disorders may be involved in these associations. Future studies exploring whether 25(OH)D levels may modulate OSA and sleep curtailment-related outcomes are needed.

  5. Vitamin A, E, and D Deficiencies in Tunisian Very Low Birth Weight Neonates: Prevalence and Risk Factors

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    Samira Fares

    2014-06-01

    Conclusion: Vitamin A, E, and D deficiencies are very common in Tunisian VLBW neonates and are associated with pre-eclampsia. Improved nutritional and health support for pregnant women and high dose vitamins A, E, and D supplementation in VLBW neonates are strongly required in Tunisia.

  6. Iron and vitamin D deficiency in children living in Western-Europe : Diagnostic tests, epidemiological aspects, and prevention

    NARCIS (Netherlands)

    Akkermans, M.D.

    2017-01-01

    Iron deficiency (ID) and vitamin D deficiency (VDD) are two of the most common micronutrient deficiencies in young children worldwide and they contribute substantially to the global burden of disease due to their varied negative health consequences. Micronutrient deficiencies in European children

  7. Sunlight exposure or vitamin D supplementation for vitamin D-deficient non-western immigrants: a randomized clinical trial

    NARCIS (Netherlands)

    Wicherts, I.S.; Boeke, A.J.P.; van der Meer, I.M.; van Schoor, N.M.; Knol, D.L.; Lips, P.T.A.M.

    2011-01-01

    Summary: Vitamin D deficiency is very common in non-western immigrants. In this randomized clinical trial, vitamin D 800 IU/day or 100,000 IU/3 months were compared with advised sunlight exposure. Vitamin D supplementation was more effective than advised sunlight exposure in improving vitamin D

  8. Is there any difference between Vitamin D deficiency among heart failure and Non-heart failure elderly with cardiovascular disease?

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    Zohreh Taraghi

    2016-02-01

    Full Text Available Vitamin D deficiency is common among the elderly with and without heart failure (HF. This study was designed to identify the degree of vitamin D deficiency among HF and Non- HF elderly with cardiovascular disease. In this study, fifty hospitalized elderly patients with HF (26 women and 24 men, age range 60-90 years and fifty elderly without HF were randomly selected. The level of serum 25-hydroxy vitamin D was measured using the Eliza method. There were no significantly difference between two groups regarding to the mean age, living location, life style parameters, mean years of disease involvement and disease severity, cardiovascular risk factors and co-morbidities, except for renal problems(P=0/039, hemoglobin levels(P=0/044, and creatinine levels (P=0/048. In both groups, the majority of patients, were moderately vitamin D deficient and there was no significantly difference between two groups. Considering the high prevalence of vitamin D deficiency among HF and Non-HF elderly with cardiovascular disease, its monitoring and correcting seems essential.

  9. Vitamin D Deficiency Is Not Associated With Growth or the Incidence of Common Morbidities Among Tanzanian Infants.

    Science.gov (United States)

    Sudfeld, Christopher R; Manji, Karim P; Smith, Emily R; Aboud, Said; Kisenge, Rodrick; Fawzi, Wafaie W; Duggan, Christopher P

    2017-10-01

    The objective of this study was to examine risk factors for vitamin D deficiency and determine the association of vitamin D status with child growth and incidence of common morbidities among Tanzanian infants. A prospective cohort of 581 Tanzanian infants born to human immunodeficiency virus (HIV)-uninfected mothers had serum 25-hydroxyvitamin D assessed at 6 weeks and 6 months of age. Infants were seen at monthly clinic visits for growth monitoring until 18 months of age. Physicians examined infants every 3 months or when an illness was noted to document morbidities. The prevalence of vitamin D deficiency (vitamin D deficiency as compared formula-fed infants. After multivariate adjustment, there was no association of vitamin D status at 6 weeks or 6 months with the incidence of stunting, wasting, or underweight. There was also no association of low vitamin D with the incidence of diarrhea, upper respiratory infection, acute lower respiratory tract infection, or malaria. Vitamin D deficiency is common during early infancy, particularly among exclusively breastfed infants; however, these observational data suggest it may not be an important contributor to morbidity and growth among the general population of Tanzanian infants. Future studies of vitamin D among high-risk infants, including those with low birthweight and exposed to HIV, may be warranted.

  10. Vitamin D deficiency and calcium intake in reference to increased body mass index in children and adolescents.

    Science.gov (United States)

    Al-Musharaf, Sara; Al-Othman, Abdulaziz; Al-Daghri, Nasser M; Krishnaswamy, Soundararajan; Yusuf, Deqa S; Alkharfy, Khalid M; Al-Saleh, Yousef; Al-Attas, Omar S; Alokail, Majed S; Moharram, Osama; Yakout, Sobhy; Sabico, Shaun; Chrousos, George P

    2012-07-01

    Vitamin D deficiency has been linked to several chronic diseases in adults. Studies focusing on children and adolescents, however, are limited. In this randomized cross-sectional study, we aimed to determine the prevalence of vitamin D deficiency and its relationship with childhood obesity and dietary calcium intake among a population of healthy urban Saudi children and adolescents. To achieve this, 331 randomly selected Saudi children (53.8% females and 46.2% males) aged 6-17 years were included. Demographic, medical, and dietary information were collected; anthropometrics were measured. Levels of serum fasting glucose, lipid profile, 25(OH) D, and for albumin corrected calcium were analyzed. Vitamin D deficiency was noted in all subjects, with girls having significantly lower vitamin D levels than boys. Mean calcium intake was found to be 60% of the required dietary allowance (RDA), while the mean vitamin D intake was 23% of RDA. Vitamin D status and calcium intake were comparable in both normal and overweight/obese children and adolescents. Vitamin D status was highest among children who had calcium intake >800 mg/day. In adolescents there was insignificant but decreasing trend in BMI, which was observed to be highest among those whose calcium intake was 800 mg/day. results from this study suggest the importance of vitamin D fortification and increased dietary calcium in the Saudi diet to meet RDA requirements and avoid onset of vitamin D deficiency-related diseases in Saudi children and adolescents.

  11. Lactose intolerance: lack of evidence for short stature or vitamin D deficiency in prepubertal children.

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    Nithya Setty-Shah

    Full Text Available The health consequences of lactose intolerance (LI are unclear.To investigate the effects of LI on stature and vitamin D status.LI subjects will have similar heights and vitamin D status as controls.Prepubertal children of ages 3-12 years with LI (n=38, age 8.61 ± 3.08y, male/female 19/19 were compared to healthy, age- and gender-matched controls (n=49, age 7.95±2.64, male/female 28/21.prepubertal status (boys: testicular volume <3cc; girls: Tanner 1 breasts, diagnosis of LI by hydrogen breath test, and no history of calcium or vitamin D supplementation. Vitamin D deficiency was defined as 25-hydroxyvitamin D [25(OHD] <50 nmol/L. Gender-adjusted midparental target height (MPTH z-score was calculated using NCHS data for 18 year-old adults. Data were expressed as mean ± SD.There was no significant difference in 25(OHD between the LI and non-LI subjects (60.1±21.1, vs. 65.4 ± 26.1 nmol/L, p = 0.29. Upon stratification into normal weight (BMI <85(th percentile vs. overweight/obese (BMI ≥85(th percentile, the normal weight controls had significantly higher 25(OHD level than both the normal weight LI children (78.3 ± 32.6 vs. 62.9 ± 23.2, p = 0.025, and the overweight/obese LI children (78.3±32.6 vs. 55.3±16.5, p = 0.004. Secondly, there was no overall difference in height z-score between the LI children and controls. The normal weight LI patients had similar height as normal controls (-0.46 ± 0.89 vs. -0.71 ± 1.67, p = 0.53, while the overweight/obese LI group was taller than the normal weight controls (0.36 ± 1.41 vs. -0.71 ± 1.67, p = 0.049, and of similar height as the overweight/obese controls (0.36 ± 1.41 vs. 0.87 ± 1.45, p = 0.28. MPTH z-score was similar between the groups.Short stature and vitamin D deficiency are not features of LI in prepubertal children.

  12. Effect of vitamin D deficiency and replacement on endothelial functions in Behçet's disease.

    Science.gov (United States)

    Can, M; Gunes, M; Haliloglu, O A; Haklar, G; Inanç, N; Yavuz, D G; Direskeneli, H

    2012-01-01

    Endothelial dysfunction is previously demonstrated in Behçet's disease (BD) and vitamin D is implicated to affect endothelial functions. We aimed to evaluate the status of serum 25(OH)Vit D3 levels and its association with disease activity, endothelial function and carotis intima media thickness (CIMT) in patients with BD. Thirty-six BD (F/M: 22/14, mean age: 39.6 years) patients and 51 healthy controls (F/M: 28/23, mean age: 34.5 years) were studied. Rheumatoid arthritis (RA) (n=33) patients (F/M: 26/7, mean age: 50.82 years) were also enrolled, as a disease control group. Endothelial function was evaluated by brachial artery flow mediated dilatation (FMD) and CIMT with B-Mode ultrasound. The vitamin D-deficient BD patients received 1000 IU Vitamin D3 daily for 3 months. Less than 50 nmol/L levels of 25(OH) Vit D3 were present in 61.1% (n=22) of BD and 35.3% (n=18) of HC (serum 25(OH)Vit D3 levels: BD: 44.5 (9-112) vs HC: 56 (14-125) nmol/lt, p=0.01). CIMT and FMD were also significantly different between BD and HC [0.56 (0.35-9.26) vs. 0.39 (0-0.52) and 5.20 (0.56-30.58) vs. 9.04 (-6.9-34.17), p=0.001 and p=0.02, respectively]. However, no correlation was observed between 25(OH)VitD3 levels and CIMT or FMD (r=0.6, p=0.7 and r=0.03, p=0.8, respectively) at baseline. CIMT measurements improved after replacement therapy (0.56 vs. 0.49, p=0.02), FMD measurements also improved, but not reaching statistical significance (5.2 vs. 8.28, p=0.06). A high presence of vitamin D deficiency was observed in BD patients from Turkey and replacement of vitamin D had favourable effects on endothelial function.

  13. Vitamin D deficiency and the risk of tuberculosis: a meta-analysis

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    Huang SJ

    2016-12-01

    Full Text Available Shao-Jun Huang,1 Xian-Hua Wang,2 Zhi-Dong Liu,1 Wen-Li Cao,3 Yi Han,1 Ai-Guo Ma,2 Shao-Fa Xu1 1Department of Thoracic Surgery, Beijing Chest Hospital, Capital Medical University, Beijing, People’s Republic of China; 2Department of Nutrition and Food Hygiene, Institute of Human Nutrition, Medical College of Qingdao University, Qingdao, People’s Republic of China; 3Department of Pulmonary Medicine, Beijing Geriatric Hospital, Beijing, People’s Republic of China Background and aim: To conduct meta-analyses of all published studies on various aspects of association between vitamin D and tuberculosis (TB.Methods: PubMed and Web of Knowledge were searched for all properly controlled studies on vitamin D and TB. Pooled odds ratio, mean difference or standardized mean difference, and its corresponding 95% confidence interval were calculated with the Cochrane Review Manager 5.3.Results: A significantly lower vitamin D level was found in TB patients vs controls; vitamin D deficiency (VDD was associated with an increased risk of TB, although such an association was lacking in the African population and in the human immunodeficiency virus-infected African population. A significantly lower vitamin D level was found in human immunodeficiency virus-TB-coinfected African patients receiving antiretroviral treatment who developed TB-associated immune reconstitution inflammatory syndrome vs those who did not develop TB-associated immune reconstitution inflammatory syndrome. VDD was associated with an increased risk of developing active TB in those subjects with latent TB infection and with an increased risk of tuberculin skin test conversion/TB infection conversion, and the trend toward a lower vitamin D level in active TB patients vs latent TB infection subjects did not reach statistical significance, indicating that VDD was more likely a risk factor than a consequence of TB. This concept was further strengthened by our result that anti-TB treatment did not

  14. The impact of Vitamin D deficiency on asthma, allergic rhinitis and wheezing in children: An emerging public health problem

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    Abdulbari Bener

    2014-01-01

    Full Text Available Background: Vitamin D deficiency has been declared a public health problem for both adults and children worldwide. Asthma and related allergic diseases are the leading causes of morbidity in children. The objective of this study was to investigate the potential role of Vitamin D deficiency in childhood asthma and other allergic diseases such as allergic rhinitis and wheezing. Materials and Methods: This cross-sectional study was conducted in Primary Health Care Centers (PHCs, from March 2012 to October 2013. A total of 2350 Qatari children below the age of 16 were selected from PHCs, and 1833 agreed to participate in this study giving a response rate of (78%. Face-to-face interviews with parents of all the children were based on a questionnaire that included variables such as socio-demographic information, assessment of nondietary covariates, Vitamin D intake, type of feeding, and laboratory investigations. Their health status was assessed by serum Vitamin D (25-hydoxyvitamin D, family history and body mass index. Results: Most of the children who had asthma (38.5%, allergic rhinitis (34.8% and wheezing (35.7% were below 5 years. Consanguinity was significantly higher in parents of children with allergic rhinitis (48.6%, followed by those with asthma (46.4% and wheezing (40.8% than in healthy children (35.9% (P < 0.001. The proportion of severe Vitamin D deficiency was significantly higher in children with wheezing (23.4%, allergic rhinitis (18.5%, and asthma (17% than in healthy children (10.5%. Exposure to the sun was significantly less in Vitamin D deficient children with asthma (60.3%, allergic rhinitis (62.5% and wheezing (64.4% than in controls (47.1% (P = 0.008. It was found that Vitamin D deficiency was a significant correlate for asthma (odds ratio [OR] =2.31; P < 0.001, allergic rhinitis (OR = 1.59; P < 0.001 and wheezing (relative risk = 1.29; P = 0.05. Conclusion: The study findings revealed a high prevalence of Vitamin D deficiency

  15. Prevalence of rickets-like bone deformities in rural Gambian children.

    Science.gov (United States)

    Jones, Helen L; Jammeh, Lamin; Owens, Stephen; Fulford, Anthony J; Moore, Sophie E; Pettifor, John M; Prentice, Ann

    2015-08-01

    The aim of this study was to estimate the burden of childhood rickets-like bone deformity in a rural region of West Africa where rickets has been reported in association with a low calcium intake. A population-based survey of children aged 0.5-17.9 years living in the province of West Kiang, The Gambia was conducted in 2007. 6221 children, 92% of those recorded in a recent census, were screened for physical signs of rickets by a trained survey team with clinical referral of suspected cases. Several objective measures were tested as potential screening tools. The prevalence of bone deformity in children children children children children (9% of those with clinically-confirmed deformity, 0.05% of those screened) had active rickets on X-ray at the time of medical examination. This emphasises the difficulties in comparing prevalence estimates of rickets-like bone deformities from population surveys and clinic-based studies. Interpopliteal distance showed promise as an objective screening measure for bow-leg deformity. In conclusion, this population survey in a rural region of West Africa with a low calcium diet has demonstrated a significant burden of rickets-like bone deformity, whether based on physical signs under survey conditions or after clinical examination, especially in boys < 5.0 years. Copyright © 2015 The Authors. Published by Elsevier Inc. All rights reserved.

  16. Upper spine morphology in hypophosphatemic rickets and healthy controls

    DEFF Research Database (Denmark)

    Gjørup, Hans; Sonnesen, Liselotte; Beck-Nielsen, Signe S

    2014-01-01

    BACKGROUND/OBJECTIVES: The aim of this study was to describe upper spine morphology in adult patients with hypophosphatemic rickets (HR) compared with controls to assess differences in spine morphology in terms of severity of skeletal impact and to study associations between spine morphology...... and craniofacial morphology. MATERIAL/METHODS: The study population comprised 36 HR patients and 49 controls. The atlas and axis dimensions were measured on cephalograms, and the differences between the groups were estimated by regression analysis. The upper spine morphology was visually assessed to estimate...... and the axis and the prevalence of the FUS were increased in HR patients compared with controls. Upper spine dimensions were associated with craniofacial dimensions, primarily in relation to the posterior cranial fossa....

  17. Vitamin D Deficiency; This clandestine endemic disease is veiled no more

    Directory of Open Access Journals (Sweden)

    Moeness Moustafa Alshishtawy

    2012-05-01

    Full Text Available Recently, scientists have generated a strong body of evidence providing new information about the preventive effect of vitamin D on a broad range of disorders. This evidence suggests that vitamin D is much more than a nutrient needed for bone health; it is an essential hormone required for regulation of a large number of physiological functions. Sufficient concentration of serum 25-hydroxyvitamin D is essential for optimising human health. This article reviews the present state-of-the-art knowledge about vitamin D’s status worldwide and refers to recent articles discussing some of the general background of vitamin D, including sources, benefits, deficiencies, and dietary requirements, especially in pregnancy. They offer evidence that vitamin D deficiency could be a major public health burden in many parts of the world, mostly because of sun deprivation. The article also discusses the debate about optimal concentration of circulating serum 25-hydroxyvitamin D, and explores different views on the amount of vitamin D supplementation required to achieve and maintain this concentration.

  18. Osteoporosis and Vitamin D Deficiency in Patients with Sickle Cell Disease

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    Zeynep Ozdemir

    2016-07-01

    Full Text Available Aim: Bone disorders such as osteopenia or osteoporosis are the most common clinical manifestations seen in sickle cell disease (SCD with a high of morbidity. There are many reasons, including vitamin D deficiency for the appearance of bone problems. In the present study we aimed to evaluate osteopathy in patients with SCD using bone mineral densitometry (BMD and biochemical indices. Material and Method: 61 patients (29 female, 32 male were included in the study. The age, gender, and biochemical parameters with BMD were evaluated using dual energy X-ray absorptiometry from lumbar vertebrae. According to Z scores, [-2] was considered as osteoporosis. Multivariate analysis was performed to determine the factors influencing BMD. Results: There were a total of 61 SCD patients. The average age was 21.06±5.06 (15-27 years and the mean BMI was 19.15±2.98 kg/m2. 23 patients were osteopenic (11 female, 12 male (37.7% and 26 were osteoporotic (12 female, 13 male (44.3%. Twelve patients (6 female and 6 male (18% had normal Z scores. Vitamin D was found severely deficient (

  19. Vitamin D Deficiency and Increased Risk of Bladder Carcinoma: A Meta-Analysis

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    Hui Zhang

    2015-11-01

    Full Text Available Background/Aims: Vitamin D status in relation to bladder carcinoma risk was still inconsistent. This study was carried out to evaluate the relationship between vitamin D status and bladder carcinoma risk through a meta-analysis approach. Methods: Pubmed, Web of Science, CNKI, and Embase were searched systemically to find eligible studies from the earliest available date to April 16, 2015. The search terms “vitamin D”, “25-hydroxyvitamin D”, “bladder cancer” or “bladder carcinoma” were used to retrieve relevant studies. The exposure of interest was intake of vitamin D or serum vitamin D levels, and the outcome of interest was bladder carcinoma incidence or mortality. The pooled risk ratio (RR values and their 95%CIs were calculated through meta-analysis. Results: Seven studies with a total of 62,141 participants met the inclusion criteria and were finally included into the meta-analysis. There was no heterogeneity among those included studies (I2 = 0%, P = 0.53. The pooled RR of bladder carcinoma for the lowest category versus the highest category of vitamin D was 1.34 (95% CI 1.17-1.53, P Conclusion: Vitamin D deficiency is associated with increased risk of bladder carcinoma in present study.

  20. Vitamin D Deficiency Is Not Associated with Diabetic Retinopathy or Maculopathy.

    Science.gov (United States)

    Alam, Uazman; Amjad, Yasar; Chan, Anges Wan Shan; Asghar, Omar; Petropoulos, Ioannis N; Malik, Rayaz A

    2016-01-01

    Experimental and clinical studies suggest a possible association between vitamin D deficiency and both diabetic retinopathy and maculopathy. We have performed a cross-sectional study in adults with types 1 and 2 diabetes mellitus. The relationship between the presence and severity of diabetic retinopathy and maculopathy with serum 25-hydroxyvitamin D concentration was evaluated using logistic regression analyses in the presence of demographic and clinical covariates. 657 adults with diabetes were stratified based on retinopathy grading: No Diabetic Retinopathy (39%), Background Diabetic Retinopathy (37%), Preproliferative Diabetic Retinopathy (21%), and Proliferative Diabetic Retinopathy (3%), respectively. There were no differences in serum 25-hydroxyvitamin D concentrations (25(OH)D) between the groups (15.3 ± 9.0 versus 16.4 ± 10.5 versus 15.9 ± 10.4 versus 15.7 ± 8.5 ng/mL, P = NS). Logistic regression analysis demonstrated no statistically significant relationship between the severity of retinopathy and serum 25(OH)D. Furthermore, there was no difference in serum 25(OH)D between those with (n = 94, 14%) and those without (n = 563, 86%) Diabetic Maculopathy (16.2 ± 10.0 versus 15.8 ± 9.8, P = NS) and no relationship was demonstrated by logistic regression analyses between the two variables. This study has found no association between serum 25(OH)D and the presence and severity of diabetic retinopathy or maculopathy.

  1. Hypocalcemia and Tetany Caused by Vitamin D Deficiency in a Child With Intestinal Lymphangiectasia

    Directory of Open Access Journals (Sweden)

    Ying-Yi Lu

    2009-10-01

    Full Text Available Primary intestinal lymphangiectasia is a rare disease of children, which is characterized by chronic diarrhea and complicated with malnutrition, including fat-soluble vitamin deficiency. We report a girl aged 4 years and 8 months who was diagnosed with the disease by endoscopic duodenal biopsy at 8 months of age. She presented initially with chronic diarrhea at 4 months of age. Generalized edema with hypoalbuminemia frequently occurred despite regular albumin supplements. Multiple vitamins initially were not supplied regularly. Episodes of tetany caused by hypocalcemia developed 4 years after the diagnosis of intestinal lymphangiectasia. Imaging study (long-bone X-ray and dual-energy X-ray absorptiometry revealed low bone density. Complicated vitamin D deficiency [low serum 25-hydroxy vitamin D concentration (< 12.48 mmol/L, the detection limit] and secondary hyperparathyroidism were confirmed via blood testing. Vitamin D supplementation for 3 months improved her bone density, secondary hyperparathyroidism and frequent tetany. Vitamin D status should be monitored in patients with intestinal lymphangiectasia.

  2. Prevalence and Prognostic Implications of Vitamin D Deficiency in Chronic Kidney Disease

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    Yoshitsugu Obi

    2015-01-01

    Full Text Available Vitamin D is an important nutrient involved in bone mineral metabolism, and vitamin D status is reflected by serum total 25-hydroxyvitamin D (25[OH]D concentrations. Vitamin D deficiency is highly prevalent in patients with chronic kidney disease (CKD, and nutritional vitamin D supplementation decreases elevated parathyroid hormone concentrations in subgroups of these patients. Furthermore, vitamin D is supposed to have pleiotropic effects on various diseases such as cardiovascular diseases, malignancies, infectious diseases, diabetes, and autoimmune diseases. Indeed, there is cumulative evidence showing the associations of low vitamin D with the development and progression of CKD, cardiovascular complication, and high mortality. Recently, genetic polymorphisms in vitamin D-binding protein have received great attention because they largely affect bioavailable 25(OHD concentrations. This finding suggests that the serum total 25(OHD concentrations would not be comparable among different gene polymorphisms and thus may be inappropriate as an index of vitamin D status. This finding may refute the conventional definition of vitamin D status based solely on serum total 25(OHD concentrations.

  3. Prevalence and prognostic implications of vitamin D deficiency in chronic kidney disease.

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    Obi, Yoshitsugu; Hamano, Takayuki; Isaka, Yoshitaka

    2015-01-01

    Vitamin D is an important nutrient involved in bone mineral metabolism, and vitamin D status is reflected by serum total 25-hydroxyvitamin D (25[OH]D) concentrations. Vitamin D deficiency is highly prevalent in patients with chronic kidney disease (CKD), and nutritional vitamin D supplementation decreases elevated parathyroid hormone concentrations in subgroups of these patients. Furthermore, vitamin D is supposed to have pleiotropic effects on various diseases such as cardiovascular diseases, malignancies, infectious diseases, diabetes, and autoimmune diseases. Indeed, there is cumulative evidence showing the associations of low vitamin D with the development and progression of CKD, cardiovascular complication, and high mortality. Recently, genetic polymorphisms in vitamin D-binding protein have received great attention because they largely affect bioavailable 25(OH)D concentrations. This finding suggests that the serum total 25(OH)D concentrations would not be comparable among different gene polymorphisms and thus may be inappropriate as an index of vitamin D status. This finding may refute the conventional definition of vitamin D status based solely on serum total 25(OH)D concentrations.

  4. Vitamin D deficiency is independently associated with mortality among critically ill patients

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    Rafael Barberena Moraes

    2015-05-01

    Full Text Available OBJECTIVE: Studies suggest an association between vitamin D deficiency and morbidity/mortality in critically ill patients. Several issues remain unexplained, including which vitamin D levels are related to morbidity and mortality and the relevance of vitamin D kinetics to clinical outcomes. We conducted this study to address the association of baseline vitamin D levels and vitamin D kinetics with morbidity and mortality in critically ill patients. METHOD: In 135 intensive care unit (ICU patients, vitamin D was prospectively measured on admission and weekly until discharge from the ICU. The following outcomes of interest were analyzed: 28-day mortality, mechanical ventilation, length of stay, infection rate, and culture positivity. RESULTS: Mortality rates were higher among patients with vitamin D levels 12 ng/mL (32.2% vs. 13.2%, with an adjusted relative risk of 2.2 (95% CI 1.07-4.54; p< 0.05. There were no differences in the length of stay, ventilation requirements, infection rate, or culture positivity. CONCLUSIONS: This study suggests that low vitamin D levels on ICU admission are an independent risk factor for mortality in critically ill patients. Low vitamin D levels at ICU admission may have a causal relationship with mortality and may serve as an indicator for vitamin D replacement among critically ill patients.

  5. Childhood asthma and vitamin D deficiency in Turkey: is there cause and effect relationship between them?

    Science.gov (United States)

    2013-01-01

    Background Epidemiological studies show that vitamin D deficiency and insufficiency are common worldwide and associated with many diseases including asthma. Our aim was to evaluate vitamin D insufficiency and its clinical consequences. Methods This cross-sectional study was carried out on 170 children consisted of 85 who were asthmatic and 85 who were not, aged 2 to 14 years in Tekirdag, Turkey, from September 2009 to May 2010. Children’s basal serum D vitamin levels were determined, and their eating habits, vitamin D intake, exposure to sunlight and use of health services during the previous year were investigated. The severity of asthma and levels of asthma control were assessed according to the Global Initiative for Asthma guidelines. Results The difference between mean vitamin D levels in the asthmatic group (mean +/- SD) 16.6 +/- 8.5 ng/mL and the healthy control group (mean +/- SD) 28.2 +/- 19.5 ng/mL was found to be statistically significant (p vitamin D (p respiratory tract infections leading to emergency unit admissions and number of hospitalizations (p vitamin D level increased the severity of asthma (p vitamin D, further studies should be conducted to explore the interrelation between all such factors. PMID:24330502

  6. Murine Pancreatic Acinar Cell Carcinoma Growth Kinetics Are Independent of Dietary Vitamin D Deficiency or Supplementation

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    James Dooley

    2017-06-01

    Full Text Available Vitamin D has been proposed as a therapeutic strategy in pancreatic cancer, yet evidence for an effect of dietary vitamin D on pancreatic cancer is ambiguous, with conflicting data from human epidemiological and intervention studies. Here, we tested the role of dietary vitamin D in the in vivo context of the well-characterized Ela1-TAg transgenic mouse model of pancreatic acinar cell carcinoma. Through longitudinal magnetic resonance imaging of mice under conditions of either dietary vitamin D deficiency (<5 IU/kg vitamin D or excess (76,500 IU/kg vitamin D, compared to control diet (1,500 IU/kg vitamin D, we measured the effect of variation of dietary vitamin D on tumor kinetics. No measurable impact of dietary vitamin D was found on pancreatic acinar cell carcinoma development, growth or mortality, casting further doubt on the already equivocal data supporting potential therapeutic use in humans. The lack of any detectable effect of vitamin D, within the physiological range of dietary deficiency or supplementation, in this model further erodes confidence in vitamin D as an effective antitumor therapeutic in pancreatic acinar cell carcinoma.

  7. [Vitamin D deficiency in children admitted to the paediatric intensive care unit].

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    Bustos B, Raúl; Rodríguez-Nuñez, Iván; Peña Zavala, Rubén; Soto Germani, Gonzalo

    Vitamin D is essential for bone health, as well as for cardiovascular and immune function. In critically ill adults vitamin D deficiency (VDD) is common, and is associated with sepsis and higher critical illness severity. To establish the prevalence of VDD and its association with clinically relevant outcomes in children admitted to a Paediatric Intensive Care Unit (PICU) in Concepcion, Chile. Prospective observational cohort study in 90 consecutive children admitted to the PICU in a university general hospital. Blood was collected on admission to PICU and analysed for 25-OH-D levels. Severity of illness and vasopressor use were assessed using PRISM, PELOD, and vasoactive-inotropic score (VIS) score. VDD was defined as a serum 25-OH-D level40ml/kg in the first 24h of admission (RR 1.5; 95%CI: 1.1-2.1, P<.05). In this study, VDD at PICU admission was prevalent in critically ill children and was associated with adverse clinical outcomes. Further studies are needed to assess the potential benefit of optimizing vitamin D status in the PICU. Copyright © 2016 Sociedad Chilena de Pediatría. Publicado por Elsevier España, S.L.U. All rights reserved.

  8. Relationship of vitamin D deficiency with glucolipid metabolism and insulin resistance in obese children

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    Wei Sun

    2016-07-01

    Full Text Available Objective: To study the relationship of vitamin D deficiency with glucolipid metabolism and insulin resistance in obese children. Methods: A total of 40 cases of obese children, 40 cases of overweight children and 40 cases of healthy children were studied and enrolled in obese group, overweight group and control group respectively, and serum was collected to detect 1, 25-(OH2D3 content, glucolipid metabolism indicator and adipocytokine content. Results: Serum 1, 25-(OH2D3 content of three groups were different and showed the trend of control group>overweight group>obese group; the trend of FINS, TC, TG and LDL content as well as HOMA-IR was control groupoverweight group>obese group; 1, 25-(OH2D3 content was negatively correlated with FINS, TC, TG, LDL, HOMAIR, APN, Nesfatin-1, Apelin, Omentin-1 and Vaspin, and positively correlated with HDL; APN, Nesfatin-1, Apelin, Omentin-1 and Vaspin content in obese and overweight children with 1, 25-(OH2D3 deficiency were lower than those in children with normal 1, 25-(OH2D3. Conclusions: Serum 1, 25-(OH2D3 content significantly decreases in obese children, and 1, 25-(OH2D3 deficiency will reduce the synthesis and secretion of adipocytokines so as to cause insulin resistance and then lead to glucolipid metabolism disorder.

  9. Long-term vitamin D deficiency in older adult C57BL/6 mice does not affect bone structure, remodeling and mineralization

    NARCIS (Netherlands)

    Meijden, K.; Buskermolen, J.; Essen, van H.; Schuurman, Teun; Steegenga, W.T.; Brouwer, E.M.; Langenbach, G.E.J.; Ruijven, van L.J.; Heijer, den M.; Lips, P.; Bravenboer, N.

    2016-01-01

    Animal models show that vitamin D deficiency may have severe consequences for skeletal health. However, most studies have been performed in young rodents for a relatively short period, while in older adult rodents the effects of long-term vitamin D deficiency on skeletal health have not been

  10. Vitamin D deficiency and low hemoglobin level as risk factors for severity of acute lower respiratory tract infections in Egyptian children: A case-control study

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    Abeer S. El Sakka

    2014-03-01

    Conclusion: Vitamin D deficiency was associated with severity of ALRTIs. Low hemoglobin level was more prevalent in those children. Improving the nutritional status in children by preventing vitamin D deficiency and low hemoglobin might influence the outcome of children with ALRTI.

  11. Types and Clinical Profile of Rickets in a Tertiary Care Hospital

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    Shohela Akhter

    2009-11-01

    Full Text Available Normal 0 false false false MicrosoftInternetExplorer4 st1\\:*{behavior:url(#ieooui } /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Table Normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-parent:""; mso-padding-alt:0cm 5.4pt 0cm 5.4pt; mso-para-margin:0cm; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:10.0pt; font-family:"Times New Roman"; mso-ansi-language:#0400; mso-fareast-language:#0400; mso-bidi-language:#0400;} Background: There are different types of rickets. Rickets presents with various clinical signs and symptoms. Familial X linked hypophosphatamic rickets (XLHR is reported to be the commonest one. Objectives: To find out the types of rickets and the presenting features of rickets. Setting: Department Paediatrics, Bangabandhu Sheikh Mujib Medical University (BSMMU. Design: Descriptive type of study. Methods: A total number of 20 children with rickets were included in this study during the period of January 2004 to July 2008. A questionnaire was used for compiling the information. Data were compiled manually and expressed as frequency distribution table. Result: Male: Female ratio was 13:7. Mean age of the patients was 49.36 months. Nutritional and familial hypophosphatamic rickets constituted the majority, each of the type being 40%. Common clinical presentations included limb weakness (90%, growth failure (90% and repeated respiratory tract infection (80%. Widening of the wrist were present in 90% of patients. Rachitic rosary and protruded abdomen were present in 80% of cases. Radiological findings of rickets were present in 100% of patients. Conclusion: Nutritional and XLHR rickets were the common type. Common clinical features were weakness of limbs, growth failure and widening of wrists. Key words: Rickets; nutritional; XLHR; RTA.DOI: 10.3329/bsmmuj.v2i1.3703 BSMMU J 2009; 2(1: 3-7

  12. Vitamin D deficiency in Korean children: prevalence, risk factors, and the relationship with parathyroid hormone levels

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    In Hyuk Chung

    2014-06-01

    Full Text Available PurposeThis study was performed to investigate the relationship between serum vitamin D and parathyroid hormone (PTH levels as well as to describe the prevalence and the risk factors of vitamin D deficiency (VDD in Korean children.MethodsParticipants were 1,212 children aged 4 to 15 years, who visited Bundang CHA Medical Center (located at 37°N between March 2012 and February 2013. Overweight was defined as body mass index≥85th percentile. Participants were divided into 4 age groups and 2 seasonal groups. VDD was defined by serum 25-hydroxyvitamin D (25OHD <20 ng/mL.ResultsThe level of 25OHD was significantly lower in overweight group than in normal weight group (17.1±5.1 ng/mL vs. 19.1±6.1 ng/mL, P<0.001. Winter-spring season (odds ratio [OR], 4.46; 95% confidence interval [CI], 3.45-5.77, older age group (OR, 1.60; 95% CI, 1.36-1.88, and overweight (OR, 2.21; 95% CI, 1.62-3.01 were independently related with VDD. The PTH levels were significantly higher in VDD group compared to vitamin D insufficiency and sufficiency group (P<0.001. In normal weight children, 25OHD (β=-0.007, P<0.001 and ionized calcium (β=-0.594, P=0.007 were independently related with PTH, however, these associations were not significant in overweight children.ConclusionVDD is very common in Korean children and its prevalence increases in winter-spring season, in overweight children and in older age groups. Further investigation on the vitamin D and PTH metabolism according to adiposity is required.

  13. In utero vitamin D deficiency predisposes offspring to long-term adverse adipose tissue effects.

    Science.gov (United States)

    Belenchia, Anthony M; Johnson, Sarah A; Ellersieck, Mark R; Rosenfeld, Cheryl S; Peterson, Catherine A

    2017-09-01

    The fetal period represents an important window of susceptibility for later obesity and metabolic disease. Maternal vitamin D deficiency (VDD) during pregnancy is a global concern that may have long-lasting consequences on offspring metabolic health. We sought to determine whether a VDD in utero environment affects fetal adipose tissue development and offspring metabolic disease predisposition in adulthood. Furthermore, we sought to explore the extent to which the VDD intrauterine environment interacts with genetic background or postnatal environment to influence metabolic health. Eight-week-old P0 female C57BL/6J mice were fed either a VDD diet or sufficient diet (VDS) from four weeks before pregnancy (periconception) then bred to male A(vy)/a mice. Females were maintained on the diets throughout gestation. At weaning, A(vy)/a and a/a male F1 offspring were randomized to low-fat (LFD) or high-fat diet (HFD) until 19 weeks of age, at which point serum and adipose tissue were harvested for analyses. Mice born to VDD dams weighed less at weaning than offspring born to VDS dams but experienced rapid weight gain in the four weeks post weaning, and acquired a greater ratio of perigonadal (PGAT) to subcutaneous (SQAT) than control offspring. Additionally, these mice were more susceptible to HFD-induced adipocyte hypertrophy. Offspring of VDD dams also had greater expression of Pparg transcript. These novel findings demonstrate that in utero VDD, an easily correctable but highly prevalent health concern, predisposes offspring to long-term adipose tissue consequences and possible adverse metabolic health complications. © 2017 Society for Endocrinology.

  14. [Knowledge and prevention management of vitamin D deficiency in primary care].

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    Senan Sanz, M R; Gilaberte Calzada, Y; Olona Tabueña, N; Magallón Botaya, R

    2014-01-01

    To determine the knowledge and management of vitamin D (Vit D) in primary care (PC). Observational study. A total of 69 primary care centres, with 57 in Barcelona and 12 in Huesca. All medical and nursing graduates of these centres. A specifically designed questionnaire was used to collect knowledge on the actions of Vit D (on bone metabolism, cardiovascular and immune systems), its deficiency and prevention measures. Of the total of 2100 professionals, 785 completed the survey (37.78%), of whom 79.9% were women. Their mean age was 47 years (SD: 9.7). Only 4.8% knew the overall actions of Vitamin D, although the majority (66%) knew only its effects on bone metabolism. Almost two-thirds (62.4%) were unaware that its deficiency was a common problem, and 54.9% believed that photoprotection was contraindicated. Almost three-quarters of those surveyed (73.6%) never or almost never determined Vit D levels in their patients. A minority (23%) offered advice to maintain an adequate level of Vit D, with the most frequent being sun exposure (16.8%). Pediatricians were more knowledgeable (p<.001) and offered more advice for maintaining adequate levels of Vit D in blood (p<.001). Most of the professionals were unaware of the overall actions of Vit D, or that its deficiency was common, or the factors contributing to this. The advice that was more often offered to avoid its deficiency was not the safest. Paediatricians are more aware of how to prevent Vit D deficiency. Copyright © 2013 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España. All rights reserved.

  15. PREVALENCE OF VITAMIN D DEFICIENCY IN DIFFERENT GROUPS OF CHRONIC RENAL FAILURE PATIENTS.

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    Bistra T. Galunska

    2015-09-01

    Full Text Available Purpose: To determine and compare the vitamin D status of different groups CKD patients on hemodialysis, peritoneal dialysis, or no renal replacement therapy and to evaluate the effect of vitamin D therapy. Patients and Methods: This pilot study enrolled 40 consecutive CKD patients (21 men, 19 women divided into three groups: 15 CKD patients in 1,2,3,4 stage of the disease without renal replacement therapy (RRT; 10CKD patients on hemodialysis (HD and 15 CKD patients on peritoneal dialysis (PD, ten of which were on vitamin D therapy. Vitamin D status was determined by serum 25-xydroxyvitamin D (25OHD. Results: Ninety percent of patients were in vitamin D deficiency/insufficiency; and only 4 patients (10.0% reached 25OHD levels above 75nmol/L. The median 25OHD level was 31.15nmol/L (interquartile range: 16.67-48.33nmol/L.Tendency of worse vitamin D status in women than in men was observed. Higher 25OHD levels were found in pre-dialysis patients (median 44.81nmol/L, 25%-75% percentile 16.24-52.21nmol/L and lower in HD (median 31.15nmol/L, 25%-75% percentile 13.04-64.45nmol/L and PD patients (median 33.38nmol/L, 25%-75% percentile 23.15-48.49nmol/L, but the difference did not reach statistical significance. Better vitamin D status was found in the PD group of patients receiving vitamin D preparations (p<0.05. Conclusions: 25OHD deficiency/insufficiency is prevalent in renal failure patients with or without renal replacement therapy. It seems that vitamin D therapy improves the vitamin D status of PD patients. Further larger studies are needed to clarify the effect of specific type vitamin D therapy on serum 25OHD levels and clinical outcome in different groups of CKD patients.

  16. Lactose intolerance: lack of evidence for short stature or vitamin D deficiency in prepubertal children.

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    Setty-Shah, Nithya; Maranda, Louise; Candela, Ninfa; Fong, Jay; Dahod, Idris; Rogol, Alan D; Nwosu, Benjamin Udoka

    2013-01-01

    The health consequences of lactose intolerance (LI) are unclear. To investigate the effects of LI on stature and vitamin D status. LI subjects will have similar heights and vitamin D status as controls. Prepubertal children of ages 3-12 years with LI (n=38, age 8.61 ± 3.08y, male/female 19/19) were compared to healthy, age- and gender-matched controls (n=49, age 7.95±2.64, male/female 28/21). prepubertal status (boys: testicular volume children (78.3 ± 32.6 vs. 62.9 ± 23.2, p = 0.025), and the overweight/obese LI children (78.3±32.6 vs. 55.3±16.5, p = 0.004). Secondly, there was no overall difference in height z-score between the LI children and controls. The normal weight LI patients had similar height as normal controls (-0.46 ± 0.89 vs. -0.71 ± 1.67, p = 0.53), while the overweight/obese LI group was taller than the normal weight controls (0.36 ± 1.41 vs. -0.71 ± 1.67, p = 0.049), and of similar height as the overweight/obese controls (0.36 ± 1.41 vs. 0.87 ± 1.45, p = 0.28). MPTH z-score was similar between the groups. Short stature and vitamin D deficiency are not features of LI in prepubertal children.

  17. Vitamin D deficiency is associated with impaired disease control in asthma-COPD overlap syndrome patients.

    Science.gov (United States)

    Odler, Balázs; Ivancsó, István; Somogyi, Vivien; Benke, Kálmán; Tamási, Lilla; Gálffy, Gabriella; Szalay, Balázs; Müller, Veronika

    2015-01-01

    The association between vitamin D and clinical parameters in obstructive lung diseases (OLDs), including COPD and bronchial asthma, was previously investigated. As asthma-COPD overlap syndrome (ACOS) is a new clinical entity, the prevalence of vitamin D levels in ACOS is unknown. Our aim was to assess the levels of circulating vitamin D (25-hydroxyvitamin D [25(OH)D]) in different OLDs, including ACOS patients, and its correlation with clinical parameters. A total of 106 men and women (control, n=21; asthma, n=44; COPD, n=21; and ACOS, n=20) were involved in the study. All patients underwent detailed clinical examinations; disease control and severity was assessed by disease-specific questionnaires (COPD assessment test, asthma control test, and modified Medical Research Council); furthermore, 25(OH)D levels were measured in all patients. The 25(OH)D level was significantly lower in ACOS and COPD groups compared to asthma group (16.86±1.79 ng/mL and 14.27±1.88 ng/mL vs 25.66±1.91 ng/mL). A positive correlation was found between 25(OH)D level and forced expiratory volume in 1 second (r=0.4433; P, forced vital capacity (FVC) (r=0.3741; P=0.0004), forced expiratory flow between 25% and 75% of FVC (r=0.4179; P, and peak expiratory flow (r=0.4846; PAsthma control test total scores and the 25(OH)D level showed a positive correlation in the ACOS (r=0.4761; P=0.0339) but not in the asthma group. Higher COPD assessment test total scores correlated with decreased 25(OH)D in ACOS (r=-0.4446; P=0.0495); however, this was not observed in the COPD group. Vitamin D deficiency is present in ACOS patients and circulating 25(OH)D level may affect disease control and severity.

  18. Role of parathyroid hormone in determination of fat mass in patients with Vitamin D deficiency

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    Raman K Marwaha

    2017-01-01

    Full Text Available Background: Obesity has become a global epidemic and it is rising is Asia. Vitamin D deficiency (VDD is widely prevalent in the Indian subcontinent. Studies have linked VDD to obesity and shown correlation between parathyroid hormone (PTH, 25-hydroxy Vitamin D (25(OHD, and fat mass (FM. However, studies on the role of PTH among subjects with VDD are lacking. Objective: The objective of this study is to study the role of PTH in the determination of FM in participants with VDD. Subjects: Five hundred and fifty-one adults (m:247, f:304 were included in this study. Materials and Methods: Total and regional (trunk, arm, and leg FM was assessed by dual X-ray absorptometry. Biochemical and hormonal parameters such as calcium, phosphorus, alkaline phosphatase, ionic calcium, 25(OHD, and PTH were also analyzed. Results: The mean age of the study population was 58.8 ± 15.8 years (Male: [63.3 ± 13.1], Female: [55.2 ± 16.9]. FM and body mass index were significantly lower in females with higher levels of serum 25(OHD. Total FM was negatively correlated with serum 25(OHD (r = −0.363, P < 0.0001 and positively correlated with serum PTH (r: 0.262, P < 0.0001 in females only. Females with VDD and secondary hyperparathyroidism had higher FM than those with normal PTH. Conclusions: Females with VDD had higher total and regional FM. However, this correlation was evident only in those with high serum PTH levels, suggesting a potential role of PTH in the accumulation of FM.

  19. Vitamin D deficiency in pregnant women and their neonates in spring time in western Turkey.

    Science.gov (United States)

    Halicioglu, Oya; Aksit, Sadik; Koc, Feyza; Akman, Sezin A; Albudak, Esin; Yaprak, Isin; Coker, Isil; Colak, Ayfer; Ozturk, Can; Gulec, Ebru S

    2012-01-01

    Although Turkey is located in a sunny region, vitamin D deficiency is still a serious health problem in pregnant women and their infants, especially among the low socio-economic status Turkish population. This study was carried out in order to measure serum 25-hydroxyvitamin D3 [25(OH)D] concentrations of the pregnant women in the last trimester and in their neonates at delivery and to determine the factors associated with maternal serum 25(OH)D concentrations. Among the patients visiting the Ege Obstetrics and Gynecology Hospital in the period March to May 2008, 258 healthy pregnant women ≥37 weeks of gestation were included in this study. The information on different characteristics such as the number of pregnancies and births, nutritional status, vitamin and mineral support during gestation, educational status, clothing style and the economic level of the family was collected from women. Blood samples from the mothers and umbilical cord of the newborns were taken to measure 25(OH)D. The mean 25(OH)D concentrations of the mothers and their infants were 11.5 ± 5.4 ng/mL and 11.5 ± 6.8 ng/mL, respectively. We found a strong positive correlation between maternal serum and umbilical cord blood 25(OH)D concentrations (r = 0.651, P women had a covered dressing style. 25(OH)D concentrations of these covered dressing mothers and their infants were 9.7 ± 5.1 ng/mL and 9.7 ± 5.6 ng/mL, respectively, which were significantly lower compared with those of uncovered mothers and their babies (P nutritional status of the mothers. These findings suggest that much more effective vitamin D prophylaxis programmes should be implemented for pregnant women as well as for their babies. © 2011 Blackwell Publishing Ltd.

  20. Restorative Effect of Vitamin D Deficiency on Knee Pain and Quadriceps Muscle Strength in Knee Osteoarthritis

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    Behzad Heidari

    2015-10-01

    Full Text Available Both vitamin D deficiency and quadriceps muscle weakness are associated with kneeosteoarthritis (KOA and pain. The aim of this study was to determine the restorative effect of vitamin Ddeficiency on pain and quadriceps muscle strength in knee osteoarthritis. Patients with KOA aged≥30years, the presence of knee pain for at least one month or longer and serum 25-hydroxyvitamin (25-OHDdeficiencies were recruited in the study. Participants with KOA compatible with Kellgren-Lawrence grade4, joint instability, and effusion, history of surgery or inflammatory arthropathies were excluded. Serum25-OHD was assessed by ELISA method and concentrationsQuadriceps muscle strength was measured by dynamometry method and intensity of knee pain by WesternOntario and McMaster University Osteoarthritis index scored by Likert scale and visual analog scale. Allparticipants received 50.000 IU oral cholecalciferol weekly for at least two months. The influence ofraising serum 25-OHD on quadriceps muscle strength and pain was assessed by calculation of meanchanges from baseline at the end of the treatment period using paired t-test. A total of 67 patients withmean age of 50±6.6 years of age were treated for 2 months. Serum 25-OHD reached to sufficient levels inall except one patient. At the end of the study period, serum 25-OHD and quadriceps muscle strengthincreased significantly as compared with baseline (P=0.007 and P=0.002, respectively, whereas knee paindecreased significantly based on Western Ontario and McMaster University Osteoarthritis index (P=0.001as well as visual analogue scale scores (P=0.001.These findings indicated that correction of vitamin Ddeficiency in patients with KOA exerts a significant favorable effect on quadriceps muscle strength andknee pain.

  1. [Vitamin D deficiency in pregnancy and its impact on the fetus, the newborn and in childhood].

    Science.gov (United States)

    Urrutia-Pereira, Marilyn; Solé, Dirceu

    2015-01-01

    Vitamin D deficiency (VDD) in pregnant women and their children is an important health problem with severe consequences for the health of both. Thus, the objectives of this review were to reassess the magnitude and consequences of VDD during pregnancy, lactation and infancy, associated risk factors, prevention methods, and to explore epigenetic mechanisms in early fetal life capable of explaining many of the non-skeletal benefits of vitamin D (ViD). Original and review articles, and consensus documents with elevated level of evidence for VDD-related clinical decisions on the health of pregnant women and their children, as well as articles on the influence of ViD on epigenetic mechanisms of fetal programming of chronic diseases in adulthood were selected among articles published on PubMed over the last 20 years, using the search term VitD status, in combination with Pregnancy, Offspring health, Child outcomes, and Programming. The following items were analyzed: ViD physiology and metabolism, risk factors for VDD and implications in pregnancy, lactation and infancy, concentration cutoff to define VDD, the variability of methods for VDD detection, recommendations on ViD replacement in pregnant women, the newborn and the child, and the epigenetic influence of ViD. VDD is a common condition among high-risk pregnant women and their children. The routine monitoring of serum 25(OH)D3 levels in antenatal period is mandatory. Early preventive measures should be taken at the slightest suspicion of VDD in pregnant women, to reduce morbidity during pregnancy and lactation, as well as its subsequent impact on the fetus, the newborn and the child. Copyright © 2014 Associação de Pediatria de São Paulo. Publicado por Elsevier Editora Ltda. All rights reserved.

  2. Vitamin D deficiency in children with recurrent respiratory infections, with or without immunoglobulin deficiency.

    Science.gov (United States)

    Dąbrowska-Leonik, Nel; Bernatowska, Ewa; Pac, Małgorzata; Filipiuk, Wiktor; Mulawka, Jan; Pietrucha, Barbara; Heropolitańska-Pliszka, Edyta; Bernat-Sitarz, Katarzyna; Wolska-Kuśnierz, Beata; Mikołuć, Bożena

    2017-11-09

    The objective of this study was to evaluate thevitamin D concentration in patients with recurrent respiratory infections with or without immunoglobulin G, A or M (IgG, IgA, IgM) deficiency, and to find a correlation between the vitamin D concentration and the response to hepatitis B vaccination. The study involved 730 patients with recurrent respiratory infections. The concentration of 25-hydroxyvitamin D (25(OH)D), immunoglobulins G, A and M, anti-HBs was determined. The tests showed that 11% of patients presented IgG levels below the age related reference values. Children with reduced IgG concentration were also found to have significantly lower vitamin D concentrations in comparison to children with normal IgG. Vitamin D deficiency was observed in schoolchildren between 7 and 18 years of age. No correlation was found between 25(OH)D concentration and Hbs antibody levels. An investigation of a large group of patients who have recurrent infection found patients with IgG deficiency to whom special proceeding have to be performed: 1. Significantly lower vitamin D concentration observed in the group of children with IgG deficiency implicated in long-lasting monitoring of vitamin D level require adding to the practice guidelines for Central Europe 2013. 2. Intervention treatment with suitable doses of vitamin D to clarified metabolism of vitamin D has to be plan for children with IgG deficiency and significant lower vitamin D concentration. Copyright © 2017 Medical University of Bialystok. Published by Elsevier B.V. All rights reserved.

  3. Vitamin D Deficiency in Pregnant Ukrainian Women: Effects of Alcohol Consumption on Vitamin D Status.

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    Carlson, Charles R; Uriu-Adams, Janet Y; Chambers, Christina D; Yevtushok, Lyubov; Zymak-Zakutnya, Natalya; Chan, Priscilla H; Schafer, Jordan J; Wertelecki, Wladimir; Keen, Carl L

    2017-01-01

    Heavy alcohol consumption can alter vitamin D status; however, the relationships between alcohol consumption and vitamin D concentrations in pregnant women have not been well studied. The aim of this study was to investigate the vitamin D status in a population of alcohol-exposed (N = 180) and low/unexposed control (N = 179) Ukrainian pregnant women. Women who attended prenatal care facilities in 2 regions of Ukraine (Rivne and Khmelnytsky) for a routine prenatal visit were screened for the study. At the time of enrollment (20.4 ± 7.0 weeks of gestation), blood samples and alcohol consumption data (during a typical week around conception and the most recent 2 weeks) were collected. Vitamin D status was assessed by 25-hydroxyvitamin D [25(OH)D] concentrations. A high prevalence of suboptimal vitamin D status in pregnant Ukrainian women was observed. Overall, 50.1% and 33.4% of the women were classified as vitamin D deficient [25(OH)D D ≥ 20 ng/mL and ≤30 ng/mL], respectively, based on 2011 Endocrine Society guidelines. Alcohol-exposed women had significantly lower 25(OH)D concentrations than low/unexposed women in Spring (p = 0.006) and Winter (p = 0.022). When vitamin D concentrations were grouped into sunny season (Summer + Fall) compared to not sunny season (Winter + Spring), there was a significant ethanol by season interaction (p = 0.0028), with alcohol-drinking women having lower circulating vitamin D compared to low/unexposed women in seasons of low sun availability. These data suggest that when vitamin D concentrations are generally low (e.g., during seasons of low sun availability), alcohol consumption during pregnancy has a negative impact on vitamin D status.

  4. Vitamin D deficiency in pregnancy and its impact on the fetus, the newborn and in childhood

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    Marilyn Urrutia-Pereira

    2015-03-01

    Full Text Available OBJECTIVE: Vitamin D deficiency (VDD in pregnant women and their children is an important health problem with severe consequences for the health of both. Thus, the objectives of this review were to reassess the magnitude and consequences of VDD during pregnancy, lactation and infancy, associated risk factors, prevention methods, and to explore epigenetic mechanisms in early fetal life capable of explaining many of the non-skeletal benefits of vitamin D (ViD. DATA SOURCE: Original and review articles, and consensus documents with elevated level of evidence for VDD-related clinical decisions on the health of pregnant women and their children, as well as articles on the influence of ViD on epigenetic mechanisms of fetal programming of chronic diseases in adulthood were selected among articles published on PubMed over the last 20 years, using the search term VitD status, in combination with Pregnancy, Offspring health, Child outcomes, and Programming. DATA SYNTHESIS: The following items were analyzed: ViD physiology and metabolism, risk factors for VDD and implications in pregnancy, lactation and infancy, concentration cutoff to define VDD, the variability of methods for VDD detection, recommendations on ViD replacement in pregnant women, the newborn and the child, and the epigenetic influence of ViD. CONCLUSIONS: VDD is a common condition among high-risk pregnant women and their children. The routine monitoring of serum 25(OHD3 levels in antenatal period is mandatory. Early preventive measures should be taken at the slightest suspicion of VDD in pregnant women, to reduce morbidity during pregnancy and lactation, as well as its subsequent impact on the fetus, the newborn and the child.

  5. Vitamin D deficiency aggravates chronic kidney disease progression after ischemic acute kidney injury.

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    Janaína Garcia Gonçalves

    Full Text Available Despite a significant improvement in the management of chronic kidney disease (CKD, its incidence and prevalence has been increasing over the years. Progressive renal fibrosis is present in CKD and involves the participation of several cytokines, including Transforming growth factor-β1 (TGF-β1. Besides cardiovascular diseases and infections, several studies show that Vitamin D status has been considered as a non-traditional risk factor for the progression of CKD. Given the importance of vitamin D in the maintenance of essential physiological functions, we studied the events involved in the chronic kidney disease progression in rats submitted to ischemia/reperfusion injury under vitamin D deficiency (VDD.Rats were randomized into four groups: Control; VDD; ischemia/reperfusion injury (IRI; and VDD+IRI. At the 62 day after sham or IRI surgery, we measured inulin clearance, biochemical variables and hemodynamic parameters. In kidney tissue, we performed immunoblotting to quantify expression of Klotho, TGF-β, and vitamin D receptor (VDR; gene expression to evaluate renin, angiotensinogen, and angiotensin-converting enzyme; and immunohistochemical staining for ED1 (macrophages, type IV collagen, fibronectin, vimentin, and α-smooth mucle actin. Histomorphometric studies were performed to evaluate fractional interstitial area.IRI animals presented renal hypertrophy, increased levels of mean blood pressure and plasma PTH. Furthermore, expansion of the interstitial area, increased infiltration of ED1 cells, increased expression of collagen IV, fibronectin, vimentin and α-actin, and reduced expression of Klotho protein were observed. VDD deficiency contributed to increased levels of plasma PTH as well as for important chronic tubulointerstitial changes (fibrosis, inflammatory infiltration, tubular dilation and atrophy, increased expression of TGF-β1 and decreased expression of VDR and Klotho protein observed in VDD+IRI animals.Through inflammatory

  6. Simultaneous bilateral posterior fracture dislocation of the shoulders in a young man with unexpected severe vitamin D deficiency

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    O'Neill D

    2012-05-01

    Full Text Available Deborah O’Neill1, Jagdish R Nair1, Khalid A Binymin1,21Rheumatology Unit, Southport General Hospital, Southport, 2Rheumatology Department, Liverpool University, Liverpool, Merseyside, UKAbstract: Simultaneous bilateral posterior fracture dislocation of the shoulders is a rare clinical presentation. There are three main etiologies described in the literature. Given that it presents with relatively uncharacteristic symptoms, in many cases it is diagnosed late. We present the case of a man who was admitted with bilateral posterior fracture dislocation of the shoulders following a seizure. Investigations revealed severe vitamin D deficiency as the principal contributory factor to his injury. This is an important association because failure to recognize and treat this can result in significant morbidity in susceptible groups.Keywords: bilateral fracture, dislocation, shoulder, vitamin D deficiency

  7. Vitamin D deficiency and lower respiratory tract infections in children: a systematic review and meta-analysis of observational studies.

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    Jat, Kana Ram

    2017-01-01

    Studies related to vitamin D deficiency and lower respiratory tract infections (LRTI) in children have inconsistent findings. The objective of this systematic review was to assess the prevalence of vitamin D deficiency in children with LRTI, and to evaluate the correlation between vitamin D levels and the incidence and severity of LRTI. A total of 12 studies enrolling 2279 participants were included in our analysis. Children with LRTI were found to have significantly lower mean vitamin D levels as compared to controls There was likewise a correlation between vitamin D levels and incidence and severity of LRTI. Large randomised controlled trials are needed to evaluate effect of vitamin D supplementation for LRTI. © The Author(s) 2016.

  8. Surfactant protein d deficiency in mice is associated with hyperphagia, altered fat deposition, insulin resistance, and increased Basal endotoxemia

    DEFF Research Database (Denmark)

    Stidsen, Jacob V; Khorooshi, Reza; Rahbek, Martin K U

    2012-01-01

    Pulmonary surfactant protein D (SP-D) is a host defence lectin of the innate immune system that enhances clearance of pathogens and modulates inflammatory responses. Recently it has been found that systemic SP-D is associated with metabolic disturbances and that SP-D deficient mice are mildly obese....... However, the mechanism behind SP-D's role in energy metabolism is not known.Here we report that SP-D deficient mice had significantly higher ad libitum energy intake compared to wild-type mice and unchanged energy expenditure. This resulted in accumulation but also redistribution of fat tissue. Blood...... pressure was unchanged. The change in energy intake was unrelated to the basal levels of hypothalamic Pro-opiomelanocortin (POMC) and Agouti-related peptide (AgRP) gene expression. Neither short time systemic, nor intracereberoventricular SP-D treatment altered the hypothalamic signalling or body weight...

  9. Prevalence and determinants of vitamin D deficiency in the third trimester of pregnancy: a multicentre study in Switzerland.

    Science.gov (United States)

    Krieger, Jean-Philippe; Cabaset, Sophie; Canonica, Claudia; Christoffel, Ladina; Richard, Aline; Schröder, Therese; von Wattenwyl, Begoña Lipp; Rohrmann, Sabine; Lötscher, Katharina Quack

    2018-02-01

    Vitamin D deficiency during pregnancy is associated with negative health consequences for mothers and their infants. Data on the vitamin D status of pregnant women in Switzerland are scarce. A three-centre study was conducted in the obstetric departments of Zurich, Bellinzona and Samedan (Switzerland) to investigate the prevalence and determinants of vitamin D deficiency (serum 25-hydroxyvitamin D (25(OH)D)D in pregnant women and their offspring at birth (n 278). Demographic and questionnaire data were used to explore the determinants of vitamin D deficiency. Median concentration of serum 25(OH)D in the third trimester of pregnancy was 46·0 nmol/l (1st-3rd quartiles: 30·5-68·5), representing a 53·4 % prevalence of vitamin D deficiency. 25(OH)D levels in the umbilcal cord blood (median: 50·0 nmol/l; 1st-3rd quartiles: 31·0-76·6) strongly correlated with mothers' serum 25(OH)D (Spearman's correlation ρ=0·79, PD deficiency in pregnant women were centre of study, country of origin, season of delivery and vitamin D supplement intake. Near-term BMI, skin colour, use of sunscreen and mothers' education, although each not individually significant, collectively improved the ability of the model to explain vitamin D status. Low vitamin D levels were common in this sample of pregnant women and their newborns' cord blood. Vitamin D supplement intake was the most actionable determinant of vitamin D status, suggesting that vitamin D supplementation during pregnancy should receive more attention in clinical practice.

  10. Vitamin D deficiency is associated with increased mortality in critically ill patients especially in those requiring ventilatory support

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    Ameya Joshi

    2014-01-01

    Full Text Available Introduction: Vitamin D (VitD classically recognized for its role in the musculoskeletal system, has been implicated in myriad of conditions such as diabetes, immune dysfunction, cancers, heart disease, metabolic syndrome, etc. We studied the role of VitD in acute care setting and its correlation with mortality. Materials and Methods: A total of 85 consecutive consenting patients admitted in medical intensive care unit of tertiary care hospital who fulfilled the inclusion criteria were included. All patients were evaluated clinically, and blood samples were collected for hemogram, biochemical investigations including serum calcium, phosphorus, alkaline phosphatase, magnesium, along with 25(OH VitD, 1,25(OH VitD and intact parathormone levels. Simplified acute physiology score (SAPS II was calculated for all patients. Results: VitD was deficient (<30 ng/ml in 27 patients (32%. The overall mortality was more in VitD deficient group as compared to VitD sufficient group (74 vs. 41%; P < 0.05. The actual mortality in VitD deficient group was higher than the mortality predicted by SAPS II score (50 vs. 74%; P < 0.0507. VitD deficiency was also associated with more mortality among those requiring ventilator support (95% vs. 40%; P < 0.05 as well as with higher blood glucose (124.5 ± 29.7 vs. 94.8 ± 19.8: P < 0.01 levels. Conclusion: VitD deficiency was associated with increased mortality, poor ventilator outcomes, and increased blood glucose in critically ill patients.

  11. VitaminA, E, and D deficiencies in tunisian very low birth weight neonates: prevalence and risk factors.

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    Fares, Samira; Sethom, Mohamed Marouane; Khouaja-Mokrani, Chahnez; Jabnoun, Sami; Feki, Moncef; Kaabachi, Naziha

    2014-06-01

    Preterm neonates are at high risk of vitamin deficiencies, which may expose them to increased morbidity and mortality. This study aimed to determine the prevalence and risk factors for vitamin A, E, and D deficiencies in Tunisian very low birth weight (VLBW) neonates. A total of 607 VLBW and 300 term neonates were included in the study. Plasma vitamins A and E were assessed by high performance liquid chromatography and vitamin D was assessed by radioimmunoassay. Prevalence of vitamin A, E, and D deficiencies were dramatically elevated in VLBW neonates and were significantly higher than term neonates (75.9% vs. 63.3%; 71.3% vs. 55.5%; and 65.2% vs. 40.4%, respectively). In VLBW neonates, the prevalence of vitamin deficiencies was significantly higher in lower classes of gestational age and birth weight. Vitamin E deficiency was associated with pre-eclampsia [odds ratio (OR) (95% confidence interval, 95% CI), 1.56 (1.01-2.44); p < 0.01] and gestational diabetes [4.01 (1.05-17.0); p < 0.01]. Vitamin D deficiency was associated with twin pregnancy [OR (95% CI), 2.66 (1.33-5.35); p < 0.01] and pre-eclampsia [2.89 (1.36-6.40); p < 0.01]. Vitamin A, E, and D deficiencies are very common in Tunisian VLBW neonates and are associated with pre-eclampsia. Improved nutritional and health support for pregnant women and high dose vitamins A, E, and D supplementation in VLBW neonates are strongly required in Tunisia. Copyright © 2013. Published by Elsevier B.V.

  12. Vitamin D Deficiency Increases the Risk of Gestational Diabetes Mellitus: A Meta-Analysis of Observational Studies

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    Meng-Xi Zhang

    2015-10-01

    Full Text Available The results investigating the relationship between vitamin D levels and gestational diabetes mellitus (GDM are inconsistent. Thus, we focused on evaluating the association of vitamin D deficiency with GDM by conducting a meta-analysis of observed studies. A systematic literature search was conducted via PubMed, MEDLINE, and Cochrane library to identify eligible studies before August 2015. The meta-analysis of 20 studies including 9209 participants showed that women with vitamin D deficiency experienced a significantly increased risk for developing GDM (odds ratio (OR = 1.53; 95% confidence intervals (CI, 1.33, 1.75 with a little heterogeneity (I2 = 16.20%, p = 0.252. A noteworthy decrease of 4.93 nmol/L (95% CI, −6.73, −3.14 in serum 25(OHD was demonstrated in the participants with GDM, and moderate heterogeneity was observed (I2 = 61.40%, p = 0.001. Subgroup analysis with study design showed that there were obvious heterogeneities in nested case–control studies (I2 > 52.5%, p < 0.07. Sensitivity analysis showed that exclusion of any single study did not materially alter the overall combined effect. In summary, the evidence from this meta-analysis indicates a consistent association between vitamin D deficiency and an increased risk of GDM. However, well-designed randomized controlled trials are needed to elicit the clear effect of vitamin D supplementation on prevention of GDM.

  13. Parathyroid hormone response to severe vitamin D deficiency is sex associated: an observational study of 571 hip fracture inpatients.

    Science.gov (United States)

    Di Monaco, M; Castiglioni, C; Vallero, F; Di Monaco, R; Tappero, R

    2013-02-01

    To investigate the association between sex and parathyroid hormone response to severe vitamin D deficiency after hip fracture. Cross-sectional study. Rehabilitation hospital in Italy. 571 consecutive inpatients with hip fracture and severe vitamin D deficiency (serum 25-hydroxyvitamin D secondary hyperparathyroidism (serum PTH >75pg/ml) or functional hypoparathyroidism, i.e., inappropriate normal levels of PTH (≤75pg/ml). Among the 571 patients, 336 (59%) had functional hypoparathyroidism, whereas 235 (41%) had secondary hyperparathyroidism. PTH status was significantly different between sexes (p=0.003): we found functional hypoparathyroidism in 61% of women and 43% of men (secondary hyperparathyroidism in 39% of women and 57% of men). The significance of the between-sex difference was maintained after adjustment for age, estimated GFR, phosphate, albumin-adjusted total calcium, albumin, Barthel index scores, 25-hydroxyvitamin D, and hip fracture type (either cervical or trochanteric). The adjusted odds ratio was 1.85 (95%CI from 1.09 to 3.13; p=0.023). Data shows that PTH response to vitamin D deficiency was sex-associated following a fracture of the hip. The higher prevalence of secondary hyperparathyroidism may play a role in the known prognostic disadvantage found in hip-fracture men.

  14. Adaptation of calcium absorption during treatment of nutritional rickets in Nigerian children.

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    Oramasionwu, Gloria E; Thacher, Tom D; Pam, Sunday D; Pettifor, John M; Abrams, Steven A

    2008-08-01

    Nutritional rickets in Nigerian children has been effectively treated with Ca supplementation. High values of Ca absorption efficiency have been observed in untreated children, but whether Ca absorption efficiency changes during treatment with Ca is unknown. Our objective in conducting this study was to identify the effect of Ca therapy on Ca absorptive efficiency in children with primary Ca-deficient nutritional rickets. Twelve children with radiographically active rickets, 2 to 14 years of age (median 39 months) participated in the study. We assessed dietary Ca intake via dietary recalls, and measured biochemical markers of Ca and vitamin D homeostasis. Fractional Ca absorption was measured using a dual tracer stable isotope method, before and after 2 weeks of treatment with 15.0 mmol elemental Ca daily. Ten children had adequate urine collection for inclusion in the analysis. Usual dietary Ca intake was 4.2 (SD 1.0) mmol/d. The median Ca absorption prior to treatment was 72 % (range 52-97 %) and decreased significantly to 57 % (31-84 %) (P = 0.004) after 2 weeks of supplementation. We conclude that Nigerian children with rickets adapt to Ca supplementation with a small decrease in Ca absorptive capacity, but retain very high absorptive levels during supplementation. Overall Ca absorption efficiency was comparable with that identified in other populations with low Ca intakes. These data demonstrate that although absorptive capacity is regulated by supplementation, recovery from rickets likely occurs through efficient use of both dietary and supplemental Ca.

  15. Meals and dephytinization affect calcium and zinc absorption in Nigerian children with rickets.

    Science.gov (United States)

    Thacher, Tom D; Aliu, Oluseyi; Griffin, Ian J; Pam, Sunday D; O'Brien, Kimberly O; Imade, Godwin E; Abrams, Steven A

    2009-05-01

    Nutritional rickets resulting from calcium insufficiency is common in Nigeria and high dietary phytate is thought to inhibit calcium and zinc absorption. We compared the effects of a high-phytate meal and enzymatic dephytinization on calcium and zinc absorption in Nigerian children with and without rickets. Nineteen children with rickets and 15 age-matched control children, aged 2-10 y, were given calcium (600 mg/d) and ergocalciferol (1250 microg/wk). After 6 wk, calcium and zinc absorption were measured in both groups with and without maize porridge using stable isotopes. One week later, absorption measurements were repeated to assess the effects of enzymatic dephytinization and fermentation of the maize porridge. The phytate concentration of maize porridge (3.87 +/- 0.38 g/kg wet weight) was reduced by enzymatic dephytinization (2.83 +/- 0.41 g/kg; P rickets or by fermentation of maize porridge. Calcium absorption was greater with a meal (61.3 +/- 25.1%) than without (27.8 +/- 14.6%; P Rickets was not associated with impaired calcium or zinc absorption. Calcium absorption was enhanced by maize porridge, but zinc absorption was reduced. Enzymatic dephytinization increased zinc absorption. Multiple strategies may be required to optimize calcium and zinc absorption in deficient populations.

  16. Bony manifestation of rickets in a sunny city - a case report from Yazd, Iran

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    Mohammadhosain Afrand

    2014-01-01

    Full Text Available Rickets is disease that occurs in growing bones in which defective mineralization occurs in both the bone and the cartilage of the epiphyseal growth plate, resulting in the retardation of growth and skeletal deformities. Rickets is more common in areas with less sunlight. However, this case report presents a case of the bony manifestation of rickets with the intake of vitamin D supplements in Yazd, a city in central Iran that has sunshine almost every day. A patient was referred to an out-patient general pediatric clinic for deformities of the legs and growth disturbance, with his height far below the normal range. The changes that were most evident in his X-rays were the bowing of the long bones of the legs and forearms and the cupping of the wrist metaphyseal region. In summary, we present a patient with bony manifestation of rickets despite living in a sunny area and taking vitamin D supplements. Thus, it is important to remember that rickets is still a common disease among children in Iran. More studies of this issue should be conducted, including the identification of abnormal cases and rescheduling vitamin D supplementation programs.

  17. Afebrile seizures and electrocardiography abnormality: an unusual presentation of nutritional rickets.

    Science.gov (United States)

    Gad, Kg; Khan, Ma; Mahmood, K

    2014-08-01

    Nutritional rickets is not uncommon in the western world and has been reported widely. Occasionally, children have presented to paediatrics with afebrile seizures secondary to hypocalcaemia due to hypovitaminosis D. However, association of nutritional rickets with electrocardiography changes and prolonged QT interval is not well documented. It is a rare, potentially serious and yet easy-to-treat complication as shown in our case. Our case also highlights the importance of awareness and education of both parents and clinicians regarding this relatively common but easily treatable condition. We report a case of undiagnosed nutritional rickets presenting as 'Afebrile' seizure in a seven-month-old Somali girl. Her initial blood work-up showed low ionised calcium (0.8 mmol/l) on blood gas sampling, confirmed by laboratory result (adjusted 1.49 mmol/l). She had prolonged QTc on electrocardiography which reverted to normal with treatment. She was treated with intravenous as well as oral calcium after which she had no further seizures. We present a unique case of nutritional rickets-associated hypocalcaemia. This case highlights the resurgence of nutritional rickets in western societies. We need to keep this disease in our list of diagnoses as it is a potentially serious and yet easily treatable disease. We should be more vigilant for screening ethnic minorities as alarmingly high rates of hypovitaminosis D have been found in ethnic minorities living in Great Britain. © The Author(s) 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

  18. Bony manifestation of rickets in a sunny city - a case report from Yazd, Iran

    Directory of Open Access Journals (Sweden)

    Mohammadhosain Afrand

    2014-02-01

    Full Text Available Rickets is disease that occurs in growing bones in which defective mineralization occurs in both the bone and the cartilage of the epiphyseal growth plate, resulting in the retardation of growth and skeletal deformities. Rickets is more common in areas with less sunlight. However, this case report presents a case of the bony manifestation of rickets with the intake of vitamin D supplements in Yazd, a city in central Iran that has sunshine almost every day. A patient was referred to an out-patient general pediatric clinic for deformities of the legs and growth disturbance, with his height far below the normal range. The changes that were most evident in his X-rays were the bowing of the long bones of the legs and forearms and the cupping of the wrist metaphyseal region. In summary, we present a patient with bony manifestation of rickets despite living in a sunny area and taking vitamin D supplements. Thus, it is important to remember that rickets is still a common disease among children in Iran. More studies of this issue should be conducted, including the identification of abnormal cases and rescheduling vitamin D supplementation programs

  19. Three-year successful cinacalcet treatment of secondary hyperparathyroidism in a patient with x-linked dominant hypophosphatemic rickets

    DEFF Research Database (Denmark)

    Grove-Laugesen, Diana; Rejnmark, Lars

    2014-01-01

    Hypophosphatemic rickets (HR) is a rare inherited disorder characterized by a classic rickets phenotype with low plasma phosphate levels and resistance to treatment with vitamin D. Development of secondary hyperparathyroidism (SHPT) as a direct consequence of treatment is a frequent complication...

  20. Maternal vitamin D deficiency causes smaller muscle fibers and altered transcript levels of genes involved in protein degradation, myogenesis, and cytoskeleton organization in the newborn rat.

    Science.gov (United States)

    Max, Daniela; Brandsch, Corinna; Schumann, Sarah; Kühne, Hagen; Frommhagen, Matthias; Schutkowski, Alexandra; Hirche, Frank; Staege, Martin S; Stangl, Gabriele I

    2014-02-01

    Epidemiologic data reveal associations between low serum concentrations of 25-hydroxyvitamin D (25(OH)D) and higher risk of falls and muscle weakness. Fetal stage is critical for the development of skeletal muscle, but little information is available on the impact of maternal vitamin D deficiency on muscles of offspring. To investigate the morphology and transcriptome of gastrocnemius muscle in newborns in response to maternal vitamin D deficiency, 14 female rats were fed either a vitamin D₃ deficient (0 IU/kg) or a vitamin D₃ adequate diet (1000 IU/kg) 8 weeks prior to conception, during pregnancy, and lactation. Analysis of cholecalciferol, 25(OH)D₃ and 1,25-dihydroxyvitamin D₃ show that dams fed the vitamin D deficient diet and their newborns suffered from a relevant vitamin D deficiency. Muscle cells of vitamin D deficient newborns were smaller than those of vitamin D adequate newborns (p < 0.05). Muscle transcriptome of the newborns revealed 426 probe sets as differentially expressed (259 upregulated, 167 downregulated) in response to vitamin D deficiency (fold change ≥1.5, p < 0.05). The effected genes are involved in protein catabolism, cell differentiation and proliferation, muscle cell development, and cytoskeleton organization. Maternal vitamin D deficiency has a major impact on morphology and gene expression profile of skeletal muscle in newborns. © 2013 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

  1. Vitamin D deficiency is associated with impaired disease control in asthma–COPD overlap syndrome patients

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    Odler B

    2015-09-01

    Full Text Available Balázs Odler,1 István Ivancsó,1 Vivien Somogyi,1 Kálmán Benke,2 Lilla Tamási,1 Gabriella Gálffy,1 Balázs Szalay,3 Veronika Müller11Department of Pulmonology, 2Heart and Vascular Centre, 3Department of Laboratory Medicine, Semmelweis University, Budapest, HungaryIntroduction: The association between vitamin D and clinical parameters in obstructive lung diseases (OLDs, including COPD and bronchial asthma, was previously investigated. As asthma–COPD overlap syndrome (ACOS is a new clinical entity, the prevalence of vitamin D levels in ACOS is unknown.Aim: Our aim was to assess the levels of circulating vitamin D (25-hydroxyvitamin D [25(OHD] in different OLDs, including ACOS patients, and its correlation with clinical parameters.Methods: A total of 106 men and women (control, n=21; asthma, n=44; COPD, n=21; and ACOS, n=20 were involved in the study. All patients underwent detailed clinical examinations; disease control and severity was assessed by disease-specific questionnaires (COPD assessment test, asthma control test, and modified Medical Research Council; furthermore, 25(OHD levels were measured in all patients.Results: The 25(OHD level was significantly lower in ACOS and COPD groups compared to asthma group (16.86±1.79 ng/mL and 14.27±1.88 ng/mL vs 25.66±1.91 ng/mL. A positive correlation was found between 25(OHD level and forced expiratory volume in 1 second (r=0.4433; P<0.0001, forced vital capacity (FVC (r=0.3741; P=0.0004, forced expiratory flow between 25% and 75% of FVC (r=0.4179; P<0.0001, and peak expiratory flow (r=0.4846; P<0.0001 in OLD patient groups. Asthma control test total scores and the 25(OHD level showed a positive correlation in the ACOS (r=0.4761; P=0.0339 but not in the asthma group. Higher COPD assessment test total scores correlated with decreased 25(OHD in ACOS (r=-0.4446; P=0.0495; however, this was not observed in the COPD group.Conclusion: Vitamin D deficiency is present in ACOS patients and

  2. 25-hydroxyvitamin D deficiency, exacerbation frequency and human rhinovirus exacerbations in chronic obstructive pulmonary disease

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    Quint Jennifer K

    2012-06-01

    Full Text Available Abstract Background 25-hydroxyvitamin D deficiency is associated with COPD and increased susceptibility to infection in the general population. Methods We investigated whether COPD patients deficient in 25-hydroxyvitamin D were more likely to be frequent exacerbators, had reduced outdoor activity and were more susceptible to human rhinovirus (HRV exacerbations than those with insufficient and normal levels. We also investigated whether the frequency of FokI, BsmI and TaqIα 25-hydroxyvitamin D receptor (VDR polymorphisms differed between frequent and infrequent exacerbators. Results There was no difference in 25-hydroxyvitamin D levels between frequent and infrequent exacerbators in the summer; medians 44.1nmol/L (29.1 – 68.0 and 39.4nmol/L (22.3 – 59.2 or winter; medians 24.9nmol/L (14.3 – 43.1 and 27.1nmol/L (19.9 – 37.6. Patients who spent less time outdoors in the 14 days prior to sampling had lower 25-hydroxyvitamin D levels (p = 0.02. Day length was independently associated with 25-hydroxyvitamin D levels (p = 0.02. There was no difference in 25-hydroxyvitamin D levels between baseline and exacerbation; medians 36.2nmol/L (IQR 22.4-59.4 and 33.3nmol/L (23.0-49.7; p = 0.43. HRV positive exacerbations were not associated with lower 25-hydroxyvitamin D levels at exacerbation than exacerbations that did not test positive for HRV; medians 30.0nmol/L (20.4 – 57.8 and 30.6nmol/L (19.4 – 48.7. There was no relationship between exacerbation frequency and any VDR polymorphisms (all p > 0.05. Conclusions Low 25-hydroxyvitamin D levels in COPD are not associated with frequent exacerbations and do not increase susceptibility to HRV exacerbations. Independent of day length, patients who spend less time outdoors have lower 25-hydroxyvitamin D concentration.

  3. Vitamin D deficiency in critically ill children: a systematic review and meta-analysis.

    Science.gov (United States)

    McNally, James Dayre; Nama, Nassr; O'Hearn, Katie; Sampson, Margaret; Amrein, Karin; Iliriani, Klevis; McIntyre, Lauralyn; Fergusson, Dean; Menon, Kusum

    2017-11-23

    Vitamin D deficiency (VDD) has been hypothesized not only to be common but also to represent a potentially modifiable risk factor for greater illness severity and clinical outcome during critical illness. The objective of this systematic review was to determine the frequency of VDD in pediatric critical illness and its association with clinical outcomes. MEDLINE, Embase, and CENTRAL were searched through December 12, 2016, with no date or language restrictions. The primary objective was to estimate the prevalence of VDD in the pediatric intensive care unit (PICU) and compare vitamin D status with healthy control populations. Secondary objectives were to evaluate whether VDD is associated with mortality, increased illness severity, PICU interventions, and patient clinical course. Random effects meta-analysis was used to calculate pooled VDD event rate, compare levels with those of control subjects, and evaluate for associations between VDD and clinical outcome. Among 2700 citations, 17 studies meeting study eligibility were identified. The studies reported a total of 2783 critically ill children and had a median sample size of 120 (range 12-511). The majority of studies used a 25-hydroxyvitamin D [25(OH)D] level less than 50 nmol/L to define VDD, and the pooled VDD prevalence was 54.8 (95% CI 45.4-63.9). Average 25(OH)D levels were significantly lower in PICU patients than in healthy control subjects (pooled difference -17.3 nmol/L, 95% CI -14.0 to -20.6). In a meta-analysis calculation, we found that VDD was associated with increased mortality (OR 1.62, 95% CI 1.11-2.36), illness severity, and need for PICU interventions. Approximately 50% of critically ill children have VDD at the time of PICU admission, defined as a blood total 25(OH)D concentration under 50 nmol/L. VDD was further determined to be associated with greater illness severity, multiple organ dysfunction, and mortality in the PICU setting. Clinical trials are required to determine if optimization

  4. Truncated recombinant human SP-D attenuates emphysema and type II cell changes in SP-D deficient mice.

    Science.gov (United States)

    Knudsen, Lars; Ochs, Matthias; Mackay, Rosemarie; Townsend, Paul; Deb, Roona; Mühlfeld, Christian; Richter, Joachim; Gilbert, Fabian; Hawgood, Samuel; Reid, Kenneth; Clark, Howard

    2007-10-03

    Surfactant protein D (SP-D) deficient mice develop emphysema-like pathology associated with focal accumulations of foamy alveolar macrophages, an excess of surfactant phospholipids in the alveolar space and both hypertrophy and hyperplasia of alveolar type II cells. These findings are associated with a chronic inflammatory state. Treatment of SP-D deficient mice with a truncated recombinant fragment of human SP-D (rfhSP-D) has been shown to decrease the lipidosis and alveolar macrophage accumulation as well as production of proinflammatory chemokines. The aim of this study was to investigate if rfhSP-D treatment reduces the structural abnormalities in parenchymal architecture and type II cells characteristic of SP-D deficiency. SP-D knock-out mice, aged 3 weeks, 6 weeks and 9 weeks were treated with rfhSP-D for 9, 6 and 3 weeks, respectively. All mice were sacrificed at age 12 weeks and compared to both PBS treated SP-D deficient and wild-type groups. Lung structure was quantified by design-based stereology at the light and electron microscopic level. Emphasis was put on quantification of emphysema, type II cell changes and intracellular surfactant. Data were analysed with two sided non-parametric Mann-Whitney U-test. After 3 weeks of treatment, alveolar number was higher and mean alveolar size was smaller compared to saline-treated SP-D knock-out controls. There was no significant difference concerning these indices of pulmonary emphysema within rfhSP-D treated groups. Type II cell number and size were smaller as a consequence of treatment. The total volume of lamellar bodies per type II cell and per lung was smaller after 6 weeks of treatment. Treatment of SP-D deficient mice with rfhSP-D leads to a reduction in the degree of emphysema and a correction of type II cell hyperplasia and hypertrophy. This supports the concept that rfhSP-D might become a therapeutic option in diseases that are characterized by decreased SP-D levels in the lung.

  5. Truncated recombinant human SP-D attenuates emphysema and type II cell changes in SP-D deficient mice

    Directory of Open Access Journals (Sweden)

    Mühlfeld Christian

    2007-10-01

    Full Text Available Abstract Background Surfactant protein D (SP-D deficient mice develop emphysema-like pathology associated with focal accumulations of foamy alveolar macrophages, an excess of surfactant phospholipids in the alveolar space and both hypertrophy and hyperplasia of alveolar type II cells. These findings are associated with a chronic inflammatory state. Treatment of SP-D deficient mice with a truncated recombinant fragment of human SP-D (rfhSP-D has been shown to decrease the lipidosis and alveolar macrophage accumulation as well as production of proinflammatory chemokines. The aim of this study was to investigate if rfhSP-D treatment reduces the structural abnormalities in parenchymal architecture and type II cells characteristic of SP-D deficiency. Methods SP-D knock-out mice, aged 3 weeks, 6 weeks and 9 weeks were treated with rfhSP-D for 9, 6 and 3 weeks, respectively. All mice were sacrificed at age 12 weeks and compared to both PBS treated SP-D deficient and wild-type groups. Lung structure was quantified by design-based stereology at the light and electron microscopic level. Emphasis was put on quantification of emphysema, type II cell changes and intracellular surfactant. Data were analysed with two sided non-parametric Mann-Whitney U-test. Main Results After 3 weeks of treatment, alveolar number was higher and mean alveolar size was smaller compared to saline-treated SP-D knock-out controls. There was no significant difference concerning these indices of pulmonary emphysema within rfhSP-D treated groups. Type II cell number and size were smaller as a consequence of treatment. The total volume of lamellar bodies per type II cell and per lung was smaller after 6 weeks of treatment. Conclusion Treatment of SP-D deficient mice with rfhSP-D leads to a reduction in the degree of emphysema and a correction of type II cell hyperplasia and hypertrophy. This supports the concept that rfhSP-D might become a therapeutic option in diseases that are

  6. Rationale and Design of Khuzestan Vitamin D Deficiency Screening Program in Pregnancy: A Stratified Randomized Vitamin D Supplementation Controlled Trial.

    Science.gov (United States)

    Rostami, Maryam; Ramezani Tehrani, Fahimeh; Simbar, Masoumeh; Hosseinpanah, Farhad; Alavi Majd, Hamid

    2017-04-07

    Although there have been marked improvements in our understanding of vitamin D functions in different diseases, gaps on its role during pregnancy remain. Due to the lack of consensus on the most accurate marker of vitamin D deficiency during pregnancy and the optimal level of 25-hydroxyvitamin D, 25(OH)D, for its definition, vitamin D deficiency assessment during pregnancy is a complicated process. Besides, the optimal protocol for treatment of hypovitaminosis D and its effect on maternal and neonatal outcomes are still unclear. The aim of our study was to estimate the prevalence of vitamin D deficiency in the first trimester of pregnancy and to compare vitamin D screening strategy with no screening. Also, we intended to compare the effectiveness of various treatment regimens on maternal and neonatal outcomes in Masjed-Soleyman and Shushtar cities of Khuzestan province, Iran. This was a two-phase study. First, a population-based cross-sectional study was conducted; recruiting 1600 and 900 first trimester pregnant women from health centers of Masjed-Soleyman and Shushtar, respectively, using stratified multistage cluster sampling with probability proportional to size (PPS) method. Second, to assess the effect of screening strategy on maternal and neonatal outcomes, Masjed-Soleyman participants were assigned to a screening program versus Shushtar participants who became the nonscreening arm. Within the framework of the screening regimen, an 8-arm blind randomized clinical trial was undertaken to compare the effects of various treatment protocols. A total of 800 pregnant women with vitamin D deficiency were selected using simple random sampling from the 1600 individuals of Masjed-Soleyman as interventional groups. Serum concentrations of 25(OH)D were classified as: (1) severe deficient (20ng/ml). Those with severe and moderate deficiency were randomly divided into 4 subgroups and received vitamin D3 based on protocol and were followed until delivery. Data was analyzed

  7. Concave distal end of ulna metaphysis alone is not a sign of rickets

    Energy Technology Data Exchange (ETDEWEB)

    Oestreich, Alan E. [Cincinnati Children' s Hospital Medical Center, Department of Radiology, 5031, Cincinnati, OH (United States)

    2015-07-15

    Statements have been made in the literature and in legal testimony that misrepresent the radiographic finding of concave distal end of the ulnar metaphysis. To demonstrate that a concave distal end of the ossified ulna in infancy can be normal. Eighty distal wrists of randomly selected infants in the first year of life with radiographic evidence that ruled out rickets were reviewed. In 16 of the cases (20%), mild or moderate concavity of the distal end of the ulna was seen. An intact metaphyseal collar of distal radius or ulna confirmed the absence of radiographic rickets. The finding of 20% of concave distal ulnas in the first year of life confirms the widely acknowledged statements that concave distal end of the ulna alone is not indicative of rickets. Statements to the contrary are not justified. (orig.)

  8. Children with nutritional rickets referred to hospitals in Copenhagen during a 10-year period

    DEFF Research Database (Denmark)

    Pedersen, Pernille; Michaelsen, K F; Mølgaard, C

    2003-01-01

    AIM: To describe the prevalence of nutritional rickets among children admitted to three large paediatric departments in the Copenhagen area during a 10 y period. METHODS: Retrospective analysis of cases identified from the diagnosis registers fulfilling the diagnostic criteria for nutritional...... joints. Two children had generalized convulsions. None of the cases had received vitamin D supplementation. CONCLUSION: Nutritional rickets is still present among immigrants in Denmark, and it is likely that the prevalence of mild cases is high. Prevention through vitamin D supplementation is important...... rickets. RESULTS: Forty cases were identified, distributed in two distinct age groups: 0.5-4 y (n = 31) and 9-15 y (n = 9). All cases were immigrants, of whom 95% were born in Denmark. The main symptoms in the younger age group were bowed legs and clumsy walk, and in the peripubertal group were painful...

  9. Sagittal synostosis in X-linked hypophosphatemic rickets and related diseases

    Energy Technology Data Exchange (ETDEWEB)

    Currarino, Guido [Texas Scottish Rite Hospital, Department of Radiology, Dallas, TX (United States)

    2007-08-15

    The recent observations of two new cases of X-linked hypophosphatemic rickets associated with premature closure of the sagittal suture prompted a review of similar cases seen in this institution. To review the clinical records and skull radiographs of 28 children with hypophosphatemic rickets in order to investigate the frequency and type of craniosynostosis and other cranial vault changes seen in these conditions and to review the literature for relevant findings. Clinical and imaging records were reviewed on 28 patients with hypophosphatemic rickets, all younger than 18 years. Most patients had X-linked hypophosphatemic rickets and a few had autosomal-dominant hypophosphatemic rickets or were non-familial cases. Of the 28 patients, 13 had sagittal synostosis. Dolichocephaly was present in ten patients. The configuration of the cranial vault in some of these ten patients with dolichocephaly varied somewhat from that seen in nonsyndromic sagittal synostosis. In one patient, a Chiari I malformation was demonstrated by MRI. In another patient with increased intracranial pressure the sagittal suture closure was associated with lambdoidal synostosis. Dolichocephaly was not present in three patients, suggesting that the synostosis started later than in the other patients, probably in the second year of life, a period of slower brain growth than in the first year. The two patients in this group of three showed thickening and sclerosis of the cranial vault of uncertain etiology. There is an increased risk of sagittal synostosis in hypophosphatemic rickets and related diseases in children. The appearance of the cranial vault in this type of synostosis can vary from that seen in nonsyndromic synostosis. In this setting, careful clinical and imaging follow-up is warranted. (orig.)

  10. Comparison of metabolism of vitamins D2 and D3 in children with nutritional rickets.

    Science.gov (United States)

    Thacher, Tom D; Fischer, Philip R; Obadofin, Michael O; Levine, Michael A; Singh, Ravinder J; Pettifor, John M

    2010-09-01

    Children with calcium-deficiency rickets may have increased vitamin D requirements and respond differently to vitamin D(2) and vitamin D(3). Our objective was to compare the metabolism of vitamins D(2) and D(3) in rachitic and control children. We administered an oral single dose of vitamin D(2) or D(3) of 1.25 mg to 49 Nigerian children--28 with active rickets and 21 healthy controls. The primary outcome measure was the incremental change in vitamin D metabolites. Baseline serum 25-hydroxyvitamin D [25(OH)D] concentrations ranged from 7 to 24 and 15 to 34 ng/mL in rachitic and control children, respectively (p children with rickets (29 ± 17 and 25 ± 11 ng/mL, respectively) and in control children (33 ± 13 and 31 ± 16 ng/mL, respectively). 1,25(OH)(2)D rose significantly (p children with rickets. By contrast, control children had no significant increase in 1,25(OH)(2)D (19 ± 28 and 16 ± 38 pg/mL after vitamin D(2) and D(3) administration, respectively). We conclude that in the short term, vitamins D(2) and D(3) similarly increase serum 25(OH)D concentrations in rachitic and healthy children. A marked increase in 1,25(OH)(2)D in response to vitamin D distinguishes children with putative dietary calcium-deficiency rickets from healthy children, consistent with increased vitamin D requirements in children with calcium-deficiency rickets. © 2010 American Society for Bone and Mineral Research.

  11. Interventions for the prevention of nutritional rickets in term born children.

    Science.gov (United States)

    Lerch, C; Meissner, T

    2007-10-17

    Nutritional rickets is a disease of growing children leading to bone deformities, bone pain, convulsions or delayed motor development. Today, high-incidence of nutritional rickets is mainly found in low-income countries. To assess the effects of various interventions on the prevention of nutritional rickets in term born children. Studies were obtained from computerised searches of The Cochrane Library, MEDLINE, EMBASE, LILACS and reference lists of relevant articles. We contacted authors of studies or reviews to obtain further studies. Studies were included if they were randomised controlled clinical trials, controlled clinical trials or prospective cohort studies comparing any intervention for the prevention of nutritional rickets in term born children with placebo or no intervention. Minimum duration of the intervention was three months for children under 12 months or six months for children over 12 months. Two authors independently extracted data and assessed study quality. Authors of studies were contacted to obtain missing information. Four studies enrolled approximately 1700 participants. Trials lasted between nine months to two years. Three studies were randomised controlled trials, two of which showed a cluster randomised design; one trial probably was a controlled trial with researcher controlled group assignment. In children up to three years of age in Turkey, Vitamin D compared to no intervention showed a relative risk of 0.04 (95% confidence interval (CI) 0 to 0.71). Despite a marked non-compliance, a Chinese trial in children up to three years of age comparing a combined intervention of supplementation of vitamin D, calcium and nutritional counseling showed a relative risk of 0.76 (95% CI 0.61 to 0.95) compared to no intervention. In two studies conducted in older children in China and in France no rickets occurred in both the intervention and control group. There a only few studies on the prevention of nutritional rickets in term born children. Until

  12. Acute Hematogenous Osteomyelitis in a Five-Month-Old Male with Rickets

    Directory of Open Access Journals (Sweden)

    Lucia J. Santiago

    2017-01-01

    Full Text Available Osteomyelitis is defined as an infection of the bone, bone marrow, and the surrounding soft tissues. Most cases of acute hematogenous osteomyelitis in children are caused by Gram-positive bacteria, principally Staphylococcus aureus. We present a case where a 5-month-old male had an acute onset of decreased movement of his left leg and increased irritability and was subsequently diagnosed with rickets and hematogenous osteomyelitis with bacteremia. The case explores a possible association between hematogenous osteomyelitis and rickets.

  13. [Long term follow up of a patient with type I vitamin D-dependent rickets].

    Science.gov (United States)

    Velásquez-Jones, Luis; Medeiros, Mara; Valverde-Rosas, Saúl; Jiménez-Triana, Clímaco; Del Moral-Espinosa, Irma; Romo-Vázquez, José Carlos; Franco-Alvarez, Isidro

    Vitamin D dependent rickets type I is a rare hereditary disease due to a mutation in CYP27B1 encoding the 1α-hydroxylase gene. Clinically, the condition is characterized by hypocalcemic rickets in early infancy due to a deficit in the production of the vitamin D active metabolite 1,25-dihydroxy-vitamin D 3 . We report the case of a patient diagnosed at 11 months with follow-up until 9 years of age. The pathophysiology of the disease and the relevance of early diagnosis and management are discussed. Copyright © 2015. Publicado por Masson Doyma México S.A.

  14. Quality-of-life indicators and falls due to vitamin D deficiency

    Directory of Open Access Journals (Sweden)

    Cheema MR

    2016-02-01

    Full Text Available Muhammad Raza Cheema, Ahmad Yar Chaudhry Department of Geriatrics, University Hospitals Coventry and Warwickshire, NHS Hospitals, Coventry, UK Objective: To determine whether the number of falls and quality-of-life indicators relate to serum levels of vitamin D, parathyroid hormone (PTH, and calcium levels.Design: A prospective study.Participants: Patients being admitted with a fall with or without sustaining a fragility fracture post fall.Measurements: Measured frequency of falling, SF-12 questionnaire, serum concentrations of 25-hydroxyvitamin D, calcium, and PTH levels before and after treatment with vitamin D supplementation.Results: The mean age (N=38 of the cohort was 80.2±12. In all, 76.3% of the cohort had sustained a fragility fracture after the fall. The cohort was vitamin D deficient with the pretreatment mean value of 24.2±17 nmol/L and posttreatment mean value of 99±40 nmol/L with a statistically significant mean difference of 74.7 nmol/L (confidence interval [CI] 61.27–88.3, P=0.001. The levels of calcium and PTH were statistically significant after treatment with a mean difference of 0.16 (CI 0.1–0.2, P=0.001, and 3.7 (CI –4.8 to –2.5, P=0.001, respectively. After treatment, the mean difference of physical component score (PCS and mental component score for the whole cohort was 2.9 (CI –0.69 to 6.6, P=0.10, and 1.05 (CI –2.6 to 4.7, P=0.56, respectively. However, a subgroup analysis for cohort aged ≤70 years provided a statistically significant effect on PCS with a mean difference of 8.9 (CI 1.3–16.4, P=0.03, but a statistically insignificant improvement in mental component score with a mean difference of 6.0 (CI –17 to –5.0, P=0.20. However, a statistically significant improvement in PCS SF-12 was observed in patients ≤70 years of age 2.9 (1.3–16.4, P=0.03. The mean number of falls for the whole cohort pre- and posttreatment was 1.11±0.92 vs 0.97±0.99 (P=0.68, respectively.Conclusion: Patients who had

  15. Reprint of "Vitamin D deficiency in pregnant women impairs regulatory T cell function".

    Science.gov (United States)

    Vijayendra Chary, A; Hemalatha, R; Seshacharyulu, M; Vasudeva Murali, M; Jayaprakash, D; Dinesh Kumar, B

    2015-04-01

    Regulatory T cells and IgE receptors (CD23 and CD21) on B cells were assessed in vitamin D deficient pregnant women. For this, 153 pregnant women were recruited from a government hospital and were categorized into three groups based on 25-hydroxyvitamin D3 (25(OH)D3) status. Regulatory T cell population (Treg cells) and CD23/CD21 expression on B cells were quantified by FACS ARIA II in maternal blood at third trimester; and the same parameters were evaluated in cord blood soon after delivery. In addition, TGF β and IL-10 were quantified in maternal and cord blood by using Milliplex kits. In a representative sample of eight women from each group (vitamin D sufficient, insufficient and deficient), placental tissues were processed for mRNA expressions of vitamin D receptor (VDR), retinoic acid receptor (RXR), vitamin D binding protein (VDBP) and vitamin D regulating enzymes. Of the 153 pregnant women, 18 were sufficient (≥30ng/mL), 55 were insufficient (20-29ng/mL) and 80 were deficient (≤19ng/mL) for 25(OH)D3 status. The maternal blood Treg cell population (mean (%)±SE) was lower (pdeficient (0.2±0.01) pregnant women compared to insufficient (0.34±0.01) and sufficient (0.45±0.02) pregnant women. Similarly, cord blood Treg cell population (mean (%)±SE) was also lower (pdeficient (0.63±0.03) pregnant women when compared to insufficient (1.05±0.04) and sufficient (1.75±0.02) pregnant women. Mean (%)±SE of B cells with CD23 and CD21 in maternal blood was higher (pdeficient pregnant women (0.35±0.02; 1.65±0.04) when compared to insufficient (0.22±0.02; 0.55±0.05) and sufficient (0.15±0.02; 0.21±0.01) pregnant women. Similarly, mean (%)±SE of B cell population with CD23 and CD21 in cord blood was also higher (pdeficient (0.41±0.02; 1.2±0.03) when compared to insufficient (0.32±0.01; 0.6±0.05) and sufficient (0.2±0.01; 0.4±0.02) pregnant women. Regulatory cytokines, TGF β and IL-10 were lower (pdeficient subjects. In the placenta tissue of women

  16. Disease-specific definitions of vitamin D deficiency need to be established in autoimmune and non-autoimmune chronic diseases: a retrospective comparison of three chronic diseases

    OpenAIRE

    Broder, Anna R; Tobin, Jonathan N.; Putterman, Chaim

    2010-01-01

    Introduction We compared the odds of vitamin D deficiency in three chronic diseases: systemic lupus erythematosus (SLE), rheumatoid arthritis (RA), and type 2 diabetes (T2DM), adjusting for medications, demographics, and laboratory parameters, common to all three diseases. We also designed multivariate models to determine whether different factors are associated with vitamin D deficiency in different racial/ethnic groups. Methods We identified all patients with non-overlapping diagnoses of SL...

  17. Vitamin D deficiency was common among nursing home residents and associated with dementia: a cross sectional study of 545 Swedish nursing home residents.

    Science.gov (United States)

    Arnljots, Rebeka; Thorn, Jörgen; Elm, Marie; Moore, Michael; Sundvall, Pär-Daniel

    2017-10-10

    Residents of nursing homes may have low 25-hydroxyvitamin D (25OHD) concentrations. Associations between vitamin D and cognitive performance, dementia and susceptibility to infections are not clearly established. The aim of this study was to investigate the prevalence of vitamin D deficiency and to identify associated factors among residents of nursing homes for elderly. In this cross-sectional study blood samples for analysis of 25OHD were collected from all participating residents of Swedish nursing homes for the elderly from January to March 2012. dementia too severe to collect a blood test, terminally ill or refusing participation. Serum 25OHD concentrations. Logistic regression to evaluate factors associated with vitamin D deficiency (25OHD vitamin D supplementation 17%, dementia 55%, lack of appetite ≥3 months 45% and any antibiotic treatment during the last 6 months 30%. Serum 25OHD concentrations: mean 34 nmol/L (SD 21, median 27, range 4-125), 82% (448/545) had 25OHD vitamin D deficiency (25OHD vitamin D supplementation 0.075 (0.031-0.18; p Vitamin D deficiency was common among nursing home residents and strongly associated with dementia. Regardless of causality or not, it is important to be alert for vitamin D deficiency in nursing homes residents with dementia. As expected vitamin D supplementation was associated with less vitamin D deficiency, however lack of appetite, staying outdoors and skin phototype were not significant predictors. Antibiotic treatments during the last 6 months were associated with vitamin D deficiency, potentially supporting the hypothesis that vitamin D deficiency is associated with infections.

  18. Prevalence of Vitamin D Deficiency and Its Associations with Skin Color in Pregnant Women in the First Trimester in a Sample from Switzerland.

    Science.gov (United States)

    Richard, Aline; Rohrmann, Sabine; Quack Lötscher, Katharina C

    2017-03-10

    Vitamin D deficiency in pregnancy has negative clinical consequences, such as associations with glucose intolerance, and has been shown to be distributed differently in certain ethnic groups. In some countries, a difference in the rate of vitamin D deficiency was detected in pregnant women depending on their skin color. We examined the prevalence of vitamin D deficiency (Switzerland and evaluated the association of skin color with vitamin D deficiency. In a single-center cohort study, the validated Fitzpatrick scale and objective melanin index were used to determine skin color. Of the 204 pregnant women included, 63% were vitamin D deficient. The mean serum 25-hydroxyvitamin D concentration was 26.1 ng/mL (95% confidence interval (CI) 24.8-27.4) in vitamin D-sufficient women and 10.5 ng/mL (95% CI 9.7-11.5) in women with deficiency. In the most parsimonious model, women with dark skin color were statistically significantly more often vitamin D deficient compared to women with light skin color (OR 2.60; 95% CI 1.08-6.22; adjusted for age, season, vitamin D supplement use, body mass index, smoking, parity). This calls for more intense counseling as one policy option to improve vitamin D status during pregnancy, i.e., use of vitamin D supplements during pregnancy, in particular for women with darker skin color.

  19. Interrelationships between chronic tension-type headache, musculoskeletal pain, and vitamin D deficiency: Is osteomalacia responsible for both headache and musculoskeletal pain?

    Directory of Open Access Journals (Sweden)

    Sanjay Prakash

    2013-01-01

    Full Text Available Background: Headache, musculoskeletal symptoms, and vitamin D deficiency are common in the general population. However, the interrelations between these three have not been delineated in the literature. Materials and Methods: We retrospectively studied a consecutive series of patients who were diagnosed as having chronic tension-type headache (CTTH and were subjected to the estimation of serum vitamin D levels. The subjects were divided into two groups according to serum 25(OH D levels as normal (>20 ng/ml or vitamin D deficient (<20 ng/ml. Results: We identified 71 such patients. Fifty-two patients (73% had low serum 25(OH D (<20 ng/dl. Eighty-three percent patients reported musculoskeletal pain. Fifty-two percent patients fulfilled the American College of Rheumatology criteria for chronic widespread pain. About 50% patients fulfilled the criteria for biochemical osteomalacia. Low serum 25(OH D level (<20 ng/dl was significantly associated with headache, musculoskeletal pain, and osteomalacia. Discussion: These suggest that both chronic musculoskeletal pain and chronic headache may be related to vitamin D deficiency. Musculoskeletal pain associated with vitamin D deficiency is usually explained by osteomalacia of bones. Therefore, we speculate a possibility of osteomalacia of the skull for the generation of headache (osteomalacic cephalalgia?. It further suggests that both musculoskeletal pain and headaches may be the part of the same disease spectrum in a subset of patients with vitamin D deficiency (or osteomalacia, and vitamin D deficiency may be an important cause of secondary CTTH.

  20. Prevalence of Vitamin D Deficiency and Its Associations with Skin Color in Pregnant Women in the First Trimester in a Sample from Switzerland

    Directory of Open Access Journals (Sweden)

    Aline Richard

    2017-03-01

    Full Text Available Vitamin D deficiency in pregnancy has negative clinical consequences, such as associations with glucose intolerance, and has been shown to be distributed differently in certain ethnic groups. In some countries, a difference in the rate of vitamin D deficiency was detected in pregnant women depending on their skin color. We examined the prevalence of vitamin D deficiency (<20 ng/mL in women in early pregnancy in Switzerland and evaluated the association of skin color with vitamin D deficiency. In a single-center cohort study, the validated Fitzpatrick scale and objective melanin index were used to determine skin color. Of the 204 pregnant women included, 63% were vitamin D deficient. The mean serum 25-hydroxyvitamin D concentration was 26.1 ng/mL (95% confidence interval (CI 24.8–27.4 in vitamin D–sufficient women and 10.5 ng/mL (95% CI 9.7–11.5 in women with deficiency. In the most parsimonious model, women with dark skin color were statistically significantly more often vitamin D deficient compared to women with light skin color (OR 2.60; 95% CI 1.08–6.22; adjusted for age, season, vitamin D supplement use, body mass index, smoking, parity. This calls for more intense counseling as one policy option to improve vitamin D status during pregnancy, i.e., use of vitamin D supplements during pregnancy, in particular for women with darker skin color.

  1. Vitamin D deficiency: What does it mean for chronic obstructive pulmonary disease (COPD)? a compherensive review for pulmonologists.

    Science.gov (United States)

    Kokturk, Nurdan; Baha, Ayse; Oh, Yeon-Mok; Young Ju, Jung; Jones, Paul W

    2018-02-01

    Vitamin D deficiency and Chronic Obstructive Pulmonary Disease (COPD) are both under-recognized health problems, world-wide. Although Vitamin D has long been known for calcemic effects it also has less known noncalcemic effects. Recent data have shown that Vitamin D deficiency is highly prevalent in patients with COPD and correlates with forced expiratory volume in one second (FEV 1 ) and FEV 1 decline. The objective of this work was to review the current literature on vitamin D deficiency in relation with COPD. A literature search, using the words "vitamin D" and "COPD", was undertaken in Pubmed database. The noncalcemic effects of vitamin D relating with COPD may be summarised as increasing antimicrobial peptide production, regulation of inflammatory response and airway remodelling. Vitamin D inhibits the production of several proinflammatory cytokines and leads to suppression Th1 and Th17 responses which may be involved in the pathogenesis of COPD. Vitamin D insufficiency may also contribute to chronic respiratory infections and airway colonization so returning vitamin D concentrations to an optimal range in patients with COPD might reduce bacterial load and concomitant exacerbations.Vitamin D is also important for COPD-related comorbodities such as osteoporosis, muscle weakness and cardiovascular diseases. Data about the effect of Vitamin D supplementation on those comorbidities in relation with COPD are been scarce. Improving the blood level of Vitamin D into the desired range may have a beneficial effect bones and muscles, but more studies are needed to test to test that hypothesis. © 2017 John Wiley & Sons Ltd.

  2. Severe vitamin D deficiency upon admission in critically ill patients is related to acute kidney injury and a poor prognosis.

    Science.gov (United States)

    Zapatero, A; Dot, I; Diaz, Y; Gracia, M P; Pérez-Terán, P; Climent, C; Masclans, J R; Nolla, J

    2017-08-25

    To evaluate the prevalence of vitamin D deficiency in critically ill patients upon admission to an Intensive Care Unit (ICU) and its prognostic implications. A single-center, prospective observational study was carried out from January to November 2015. Patients were followed-up on until death or hospital discharge. The department of Critical Care Medicine of a university hospital. All adults admitted to the ICU during the study period, without known factors capable of altering serum 25(OH)D concentration. Determination of serum 25(OH)D levels within the first 24h following admission to the ICU. Prevalence and mortality at 28 days. The study included 135 patients, of which 74% presented deficient serum 25(OH)D levels upon admission to the ICU. Non-survivors showed significantly lower levels than survivors (8.14ng/ml [6.17-11.53] vs. 12ng/ml [7.1-20.30]; P=.04], and the serum 25(OH)D levels were independently associated to mortality (OR 2.86; 95% CI 1.05-7.86; P=.04]. The area under the ROC curve was 0.61 (95% CI 0.51-0.75), and the best cut-off point for predicting mortality was 10.9ng/ml. Patients with serum 25(OH)D<10.9ng/ml also showed higher acute kidney injury rates (13 vs. 29%; P=.02). Vitamin D deficiency is highly prevalent upon admission to the ICU. Severe Vitamin D deficiency (25[OH]D<10.9ng/ml) upon admission to the ICU is associated to acute kidney injury and mortality. Copyright © 2017 Elsevier España, S.L.U. y SEMICYUC. All rights reserved.

  3. Case-control study of breast milk calcium in mothers of children with and without nutritional rickets.

    Science.gov (United States)

    Thacher, Tom D; Pettifor, John M; Fischer, Philip R; Okolo, Selina N; Prentice, Ann

    2006-07-01

    Despite similarly low calcium intakes and normal vitamin D status, only some Nigerian children develop nutritional rickets. We hypothesized that mothers with children who had developed rickets might have lower breast-milk calcium concentration than mothers with normal children and compared the breast-milk calcium concentration of mothers who had had children with rickets with those who had not (controls). We collected breast milk from 35 Nigerian mothers who had previously had children with nutritional rickets. For each case mother, we collected breast milk from three matched control mothers at the same stage of lactation (+/-4 weeks) who had had no children with rickets. Data were collected about parity, stage of lactation, and the infant's intake. The mother's bone density was measured. The mean breast milk calcium concentration of mothers of children with rickets (4.30+/-1.24 mmol/L) was less than that of control mothers (4.65+/-1.03 mmol/L; P=0.034 in multivariate regression controlling for duration of lactation and resumption of menses). Forearm bone mineral content was significantly related to breast milk calcium concentration (r=0.20) after adjusting for height, weight, and bone area (P=0.028). Reduced breast-milk calcium concentration may contribute to a reduced calcium intake in infancy and predispose children to nutritional rickets.

  4. Prevalence, determinants and clinical correlates of vitamin D deficiency in adults with inhaled corticosteroid-treated asthma in London, UK.

    Science.gov (United States)

    Jolliffe, David A; Kilpin, Kate; MacLaughlin, Beverley D; Greiller, Claire L; Hooper, Richard L; Barnes, Neil C; Timms, Peter M; Rajakulasingam, Raj K; Bhowmik, Angshu; Choudhury, Aklak B; Simcock, David E; Hyppönen, Elina; Corrigan, Christopher J; Walton, Robert T; Griffiths, Christopher J; Martineau, Adrian R

    2018-01-01

    Vitamin D deficiency is common in children with asthma, and it associates with poor asthma control, reduced forced expiratory volume in one second (FEV1) and increased requirement for inhaled corticosteroids (ICS). Cross-sectional studies investigating the prevalence, determinants and clinical correlates of vitamin D deficiency in adults with asthma are lacking. We conducted a multi-centre cross-sectional study in 297 adults with a medical record diagnosis of ICS-treated asthma living in London, UK. Details of potential environmental determinants of vitamin D status, asthma control and medication use were collected by questionnaire; blood samples were taken for analysis of serum 25(OH)D concentration and DNA extraction, and participants underwent measurement of weight, height and fractional exhaled nitric oxide concentration (FeNO), spirometry and sputum induction for determination of lower airway eosinophil counts (n=35 sub-group). Thirty-five single nucleotide polymorphisms (SNP) in 11 vitamin D pathway genes (DBP, DHCR7, RXRA, CYP2R1, CYP27B1, CYP24A1, CYP3A4 CYP27A1, LRP2, CUBN, VDR) were typed using Taqman allelic discrimination assays. Linear regression was used to identify environmental and genetic factors independently associated with serum 25(OH)D concentration, and to determine whether vitamin D status was independently associated with Asthma Control Test (ACT) score, ICS dose, FeNO, forced vital capacity (FVC), FEV1 or lower airway eosinophilia. Mean serum 25(OH)D concentration was 50.6nmol/L (SD 24.9); 162/297 (54.5%) participants were vitamin D deficient (serum 25(OH)D concentration asthma control investigated. Vitamin D deficiency is common among UK adults with ICS-treated asthma, and classical environmental determinants of serum 25(OH)D operate in this population. However, in contrast to studies conducted in children, we found no association between vitamin D status and markers of asthma severity or control. Crown Copyright © 2016. Published by

  5. Vitamin D Deficiency in Egyptian Systemic Lupus Erythematosus Patients: How Prevalent and Does it Impact Disease Activity?

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    Nouran M. Abaza

    2016-01-01

    Full Text Available Background The emerging role of vitamin D in immunology and autoimmune disorders has been a worldwide interest in the last decade. Systemic lupus erythematosus (SLE patients are particularly at a delicate position predisposing them to suffer from vitamin D deficiency due to the multiple risk factors accompanying the disease. Whether vitamin D deficiency is also involved as a risk factor for developing SLE and affecting its course is a considerable concern. Objectives The objective of this study was to estimate the prevalence of vitamin D deficiency in SLE patients and its relation to disease. MATERIALS AND METHODS: In our observational cross-sectional study, serum levels of vitamin D [25(OHD] in 60 SLE patients and 30 age- and sex-matched healthy controls were assessed and estimated for deficiency and insufficiency at 10 and 30 ng/mL, respectively. Disease activity was evaluated by SLE disease activity index (SLEDAI, irreversible organ damage by Systemic Lupus International Collaborating Clinics/American College of Rheumatology Damage Index (SLICC/ACR DI, and severity by Severity of Disease Index. Fatigue was measured by visual analog scale. Results Significantly lower levels of 25(OHD were found in SLE patients (17.6 ± 6.9 ng/mL in comparison to controls (79.0 ± 28.7 ng/mL, with a statistically high significant difference ( t = -11.2, P < 0.001. High prevalence of vitamin D insufficiency and deficiency was detected as 73.3% and 23.3%, respectively. Vitamin D had a highly significant negative correlation with SLEDAI ( r = -0.495, P < 0.001, SLICC ( r = -0.431, P < 0.05, and fatigue ( r = -0.436, P < 0.05. Conclusion Vitamin D deficiency and insufficiency were found to be prevalent in SLE patients in our study and related to disease activity and fatigue. If needed, routine screening and consequent repletion of vitamin D are recommended in SLE patients. Restoring adequate vitamin D levels in SLE patients should be more explored as a potential

  6. Vitamin D Deficiency in South Sharqiya in Oman and its Impact in ENT Patients- A Retrospective Study

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    Hasan Abdul Cader Segana

    2016-12-01

    Full Text Available Introduction Vitamin D deficiency has multitude of causes and can present with varying clinical manifestations. Studies show that it can lead on to recurrent respiratory infections, ear infections and deafness. Vitamin D also has immunomodulant action. Here we discuss the varying features concerning an Otolaryngologist in general as far as Vitamin D metabolism is concerned. Materials and Methods This retrospective study was performed on 800 patients 152 males and 648 females of different socioeconomic background at secondary level regional referral hospital under Ministry of Health in Sultanate of Oman. The patients attending the outpatient clinic with various complaints and not responding to conventional treatment were advised for assessment of vitamin D [25 (OH D] level in blood. The patients were evaluated with general history, blood samples of serum calcium, phosphate, alkaline phosphatase and serum vitamin D level were measured by the most standardized laboratory of the country. Results Out of 800 patients, 275 cases had Vitamin D levels below 20 ng/ml and 167 patients had values greater than 30 ng/ml in serum.81% patients with vitamin D deficiency were females.56.25% patients were between third and sixth decade. Otolaryngologic manifestations were acute and recurrent URTI (n=352 44%. 7% of the patients presented with recurrent ear infection (otitis externa. The rest of them presented to a lesser extent with deafness, otosclerosis. Discussion Vitamin D deficiency has been reported worldwide as one of the commonest deficiency diseases. It can lead to autoimmune dysfunctions, Beta cell dysfunction in pancreas, Multiple sclerosis, recurrent chest infections and congestive cardiac failure. Studies have shown the involvement of cochlea with sensorineural hearing loss and otosclerosis. Conclusion Vitamin D deficiency has multi system implications as patients presenting with different signs and symptoms. Mass level screening and vitamin D

  7. [Vitamin D deficiency in a cohort over 65 years: prevalence and association with sociodemographic and health factors].

    Science.gov (United States)

    Mateo-Pascual, Carmen; Julián-Viñals, Rosa; Alarcón-Alarcón, Teresa; Castell-Alcalá, Maria Victoria; Iturzaeta-Sánchez, Jose Manuel; Otero-Piume, Angel

    2014-01-01

    Vitamin D deficiency is common in the elderly, especially among institutionalized and/or hip fracture patients. However, there are few population studies on the prevalence of this deficiency in the general population over 64 years in our environment. The aim of this study was to determine the prevalence of vitamin D deficiency in an urban population cohort of over 64 years, and analyze its relationship with sociodemographic, climatic, and health factors. Cross-sectional study from «Peñagrande cohort», a population-based cohort consisting of people over 64 years. We determined 25-hydroxyvitamin D levels, and recorded sociodemographic data (age, sex, marital status, education, socioeconomic status), season of measurement and health variables (comorbidity, obesity, malnutrition, renal failure, cognitive impairment, vitamin D supplements, and disability). A total of 468 individuals with a mean age of 76.0 years (SD: 7.7) were included, of which 53.4% were women. The mean value of vitamin D was 20.3 ± 11.7 ng/mL. The large majority (86.3%, 95% CI: 83.0-89.5) had a vitamin insufficiency (≤ 30 ng/ml), and 35.2% (95% CI: 30.8-39.7) showed severe vitamin deficiency (≤ 15 ng/ml). Vitamin insufficiency increases linearly with age (OR 1.06; 95% CI: 1.01-1.11), and was associated with low socioeconomic status (OR 3.29; 95% CI: 1.55-6.95). Severe vitamin D deficiency increases with age (OR 1.06; 95% CI: 1.02-1.09), female gender (OR 1.80; 95% CI: 1.18-2.75) and with cognitive impairment (OR 1.71; 95% CI: 1.04-2.83). The prevalence of vitamin D deficiency in people over 65 years of age in our community is high. It would be advisable to determine the vitamin D values in the high risk elderly in order to introduce measures of pharmacological supplementation in those with inadequate levels. Copyright © 2013 SEGG. Published by Elsevier Espana. All rights reserved.

  8. Periapical and endodontic status of permanent teeth in patients with hypophosphatemic rickets

    DEFF Research Database (Denmark)

    Andersen, Mette Guldbæk; Beck-Nielsen, Signe; Haubek, Dorte

    2012-01-01

    Summary  Hypophosphatemic rickets (HR) is a rare hereditary disease in which dental problems in terms of spontaneous periapical infections are frequently reported. Most previous reports have been based on a small number of HR patients and have been published before the disease could be confirmed...

  9. Seizure as a presenting manifestation of vitamin D dependent rickets type 1

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    P Radha Rani

    2013-01-01

    Full Text Available There are two types of vitamin D dependent rickets (VDDR that cause rickets in children. VDDR type 1 (VDDR-I is caused by an inborn error of vitamin D metabolism, which interferes with renal conversion of calcidiol (25OHD to calcitriol (1,25(OH 2 D by the enzyme 1-α-hydroxylase. Patients with VDDR-I have mutations of chromosome 12 that affect the gene for the enzyme 1-α-hydroxylase, resulting in decreased levels of 1,25(OH vitamin D. Clinical features include growth failure, hypotonia, weakness, rachitic rosary, convulsions, tetany, open fontanels and pathologic fractures. We report a case of VDDR-I in 14-month-old male child. Establishing an early diagnosis of these genetic forms of rickets is challenging, especially in developing countries where nutritional rickets is the most common variety of the disease where genetic diagnosis is not always possible because of financial constraints. A prompt diagnosis is necessary to initiate adequate treatment, resolve biochemical features and prevent complications, such as severe deformities that may require surgical intervention.

  10. Vitamin D: a poor screening tool for biochemical and radiological rickets.

    Science.gov (United States)

    Foley, Giles T; Yates, Edward W; Wadia, Farokh; Paton, Robin W

    2012-10-01

    This retrospective study aims to determine if a relationship exists between serum 25-hydroxyvitamin D level and the diagnosis of biochemical or radiological rickets in children with bone and joint pain, muscle fatigue or varus/valgus knees. A retrospective biochemistry database and case note study was undertaken on 115 new patients referred to the senior authors' elective Paediatric Orthopaedic Clinic in 2010. Their mean age was 10.95 years (95% CI 10.24-11.68). Mean serum vitamin D was 18.27 mcg/l (95% CI 16.13-20.41), while 30 mcg/l is the normal threshold. One hundred and three children (88%) had vitamin D levels below normal. Winter/springtime blood samples were more likely to be deficient and this was statistically significant. Three Asian females (2.61%) were diagnosed with radiological rickets. Vitamin D levels below normal are common in children presenting with vague limb or back pain, but this rarely presents with biochemical or radiological rickets. Serum vitamin D level is not a suitable screening tool for biochemical or radiological rickets. Vitamin D requirement in children is unclear and requires further study.

  11. The bony manifestation of Rickets. A case report | Leon | Journal of ...

    African Journals Online (AJOL)

    Bowing of long bones of the legs and cupping of the wrist metaphyseal region were the radiographic changes most evident. Although the primary management of rickets is conservative, the orthopedist's role can be crucial. The orthopedist's responsibilities include establishing a diagnosis and treating osseous complications ...

  12. A Novel PHEX Mutation in Japanese Patients with X-Linked Hypophosphatemic Rickets

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    Tetsuya Kawahara

    2015-01-01

    Full Text Available X-linked hypophosphatemic rickets (XLH is a dominant inherited disorder characterized by renal phosphate wasting, aberrant vitamin D metabolism, and abnormal bone mineralization. Inactivating mutations in the gene encoding phosphate-regulating gene with homologies to endopeptidases on the X chromosome (PHEX have been found to be associated with XLH. Here, we report a 16-year-old female patient affected by hypophosphatemic rickets. We evaluated her serum fibroblast growth factor 23 (FGF23 levels and conducted sequence analysis of the disease-associated genes of FGF23-related hypophosphatemic rickets: PHEX, FGF23, dentin matrix protein 1, and ectonucleotide pyrophosphatase/phosphodiesterase 1. She was diagnosed with XLH based on her clinical features and family history. Additionally, we observed elevated FGF23 levels and a novel PHEX exon 9 mutation (c.947G>T; p.Gly316Val inherited from her father. Although bioinformatics showed that the mutation was neutral, Gly316 is perfectly conserved among humans, mice, and rats, and there were no mutations in other FGF23-related rickets genes, suggesting that in silico analysis is limited in determining mutation pathogenicity. In summary, we present a female patient and her father with XLH harboring a novel PHEX mutation that appears to be causative of disease. Measurement of FGF23 for hypophosphatemic patients is therefore useful for the diagnosis of FGF23-dependent hypophosphatemia.

  13. Dental Aspect of Distal Tubular Renal Acidosis with Genu Valgum Secondary to Rickets: A Case Report

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    Rakesh N. Bahadure

    2012-01-01

    Full Text Available Distal renal tubular acidosis is a disease that occurs when the kidneys do not remove acid properly into the urine, leaving the blood too acidic (called acidosis. Distal renal tubular acidosis (type I RTA is caused by a defect in the kidney tubes that causes acid to build up in the bloodstream. It ultimately results rickets which include chronic skeletal pain, in skeletal deformities, skeletal fractures. Rickets is among the most frequent childhood diseases in many developing countries. Dental problems in rickets include delayed eruption of permanent teeth, premature fall of deciduous teeth, defects in structure of teeth, enamel defects in permanent teeth (hypoplastic, pulp defects, intraglobular dentine, and caries tooth. Herewith, reported a case of distal tubular renal acidosis with genu valgum secondary to rickets, with pain and extraoral swelling associated with right and left mandibular 1st permanent molars. Teeth were infected with pulp without being involved with caries. Radiographically cracks in enamel and dentin were observed. Pulp revascularization with 46 and root canal treatment was done for 36 with followup of 1 year.

  14. [Vitamin D deficiency prediction by patient questionnaire and secondary hyperparathyroidism in a cohort of 526 healthy subjects in their fifties].

    Science.gov (United States)

    Laroche, Michel; Nigon, Delphine; Gennero, Isabelle; Lassoued, Slim; Pouilles, Jean-Michel; Trémolières, Florence; Vallet, Marion; Tack, Ivan

    2015-01-01

    Can vitamin D deficiency be predicted by patient questionnaire? Does it lead to secondary hyperparathyroidism that may cause excessive bone resorption? We studied non-osteoporotic subjects in their fifties, in whom vitamin D levels are often tested. Patients hospitalised for degenerative osteoarthritis or consulting for assessment of menopause, without renal failure and not treated with vitamin D, completed a questionnaire on sun exposure and underwent measurement of serum calcium, creatinine, 25OH vitamin D, PTH and CTX. Five hundred and twenty-six subjects, mean age 54.6 years (71% women), were investigated throughout the year. 25OH vitamin D levels were correlated with sun exposure and varied according to the month of the year, unlike PTH and CTX levels. From November to May, over 90% of subjects had 25OH vitamin D levelsvitamin D levelsvitamin D. Serum CTX levels were not correlated with PTH or 25OH vitamin D. Only 13% of subjects presented with secondary hyperparathyroidism, characterised by serum calcium65pg/mL, associated with increased CTX levels. Vitamin D deficiency can be predicted by patient questionnaire. It very rarely leads to secondary hyperparathyroidism. Copyright © 2015. Published by Elsevier Masson SAS.

  15. Are Systematic Screening for Vitamin D Deficiency and Vitamin D Supplementation Currently Feasible for Ankylosing Spondylitis Patients?

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    Mickael Essouma

    2017-01-01

    Full Text Available Beyond its role in calcium and phosphorus metabolism for healthy bone mineralization, there is increasing awareness for vitamin D contribution in modulation of immune reactions. Given that ankylosing spondylitis (AS is a chronic inflammatory disease involving excess immune/inflammatory activity and posing great therapeutic challenges, it is conceivable to claim that vitamin D treatment may be a safe and effective treatment to influence or modify the primary disease and its related comorbidities. Nevertheless, consistent body of research supporting this hypothesis is still lacking. In this paper, we examine whether systematic screening and treatment for vitamin D deficiency are feasible at present. We will review the immunomodulatory role of vitamin D and its contribution in initiation and progression of AS, as well as how they would determine the occurrence of comorbid conditions. Our conclusion is that despite the overwhelmed interest about vitamin D treatment in AS patients, systematic screening and treatment for vitamin D deficiency of all AS patients are not feasible as yet. This stresses the need for further extensive well-designed research to prove vitamin D efficacy in AS beyond bone protection. And if utility is proven, personalized treatment regimes, duration of treatment, and threshold values for vitamin D should be provided.

  16. A cost effective complement to managing the vitamin D deficient and anemic dialysis patient in the bundled world.

    Science.gov (United States)

    Larkin, John; Bea, Liza; Sharma, Amit

    2012-07-01

    Vitamin D deficiency is a common health complication in patients with chronic kidney disease and can be treated with an abundance of classical and advanced pharmaceutics. However, the impact of bundling in dialysis clinics limits the use of the most optimal therapeutics and desired efficacy targets in end-stage renal disease patients. To address this issue, we investigated the benefits of adding a cost-effective antioxidant and vitamin D nutraceutical (MV-ONE, Nephrian Inc.) to patient regiments. This nutraceutical was used in an attempt to replete vitamin D levels and decrease inflammation that dialysis patients experience. Additionally, we investigated the potential of this therapy to reduce the need for erythropoietin-stimulating agents. Results indicate MV-ONE caused: (1) increases in 25-OH vitamin D (p = 0.0058), (2) decreases in ESA dose (p = 0.0475), and (3) no change in C-reactive protein (p = 0.3290). Overall, this suggests the addition of MV-ONE does benefit the vitamin D deficiency and anemia observed in ESRD patients.

  17. Vitamin D deficiency may be a risk factor for recurrent pregnancy losses by increasing cellular immunity and autoimmunity.

    Science.gov (United States)

    Ota, Kuniaki; Dambaeva, Svetlana; Han, Ae-Ra; Beaman, Kenneth; Gilman-Sachs, Alice; Kwak-Kim, Joanne

    2014-02-01

    Do women with recurrent pregnancy losses (RPL) and low vitamin D have increased prevalence of auto- and cellular immune abnormalities when compared with women with RPL who have normal vitamin D, and does vitamin D have any effect on cellular immunity in vitro? A high proportion of women with RPL have vitamin D deficiency and the risk of auto- and cellular immune abnormalities is increased in women with RPL and vitamin D deficiency. Vitamin D deficiency in pregnant women is associated with increased risk of obstetrical complications such as pre-eclampsia, bacterial vaginosis associated preterm delivery, gestational diabetes mellitus and small-for-gestational age births. A retrospective cross-sectional study of 133 women with RPL who were enrolled in a 2-year period, together with laboratory experiments. Women with three or more consecutive spontaneous abortions prior to 20 weeks of gestation who were enrolled at the University clinic. Serum vitamin D level, cellular activity and autoimmune parameters in vivo and in vitro were measured. Sixty-three out of 133 women (47.4%) had low vitamin D (Rosalind Franklin University of Medicine and Science. None of the authors has any conflict of interest to declare. N/A.

  18. Prenatal Vitamin D Deficiency Induces an Early and More Severe Experimental Autoimmune Encephalomyelitis in the Second Generation

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    Francois Feron

    2012-08-01

    Full Text Available In a previous study, we demonstrated that mouse adult F1 offspring, exposed to a vitamin D deficiency during pregnancy, developed a less severe and delayed Experimental Autoimmune Encephalomyelitis (EAE, when compared with control offspring. We then wondered whether a similar response was observed in the subsequent generation. To answer this question, we assessed F2 females whose F1 parents (males or females were vitamin D-deprived when developing in the uterus of F0 females. Unexpectedly, we observed that the vitamin D deficiency affecting the F0 pregnant mice induced a precocious and more severe EAE in the F2 generation. This paradoxical finding led us to assess its implications for the epidemiology of Multiple Sclerosis (MS in humans. Using the REFGENSEP database for MS trios (the patient and his/her parents, we collected the parents’ dates of birth and assessed a potential season of birth effect that could potentially be indicative of the vitamin D status of the pregnant grandmothers. A trend for a reduced number of births in the Fall for the parents of MS patients was observed but statistical significance was not reached. Further well powered studies are warranted to validate the latter finding.

  19. The Effect of Weight Loss on Serum Vitamin D Levels in Obese Women with Vitamin D Deficiency

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    Hülya Yilmaz Önal

    2017-12-01

    Full Text Available Today, the simultaneous increase of obesity and vitamin D deficiency is estimated to affect over one billion people in the world. An association between vitamin D deficiency and obesity is well known, but the mechanisms are not totally clear yet. This study was designed to investigate the effect of weight loss on serum vitamin D levels in obese women. Methods: The study has been performed on 44 obese women who were admitted to the in TEV Sultanbeyli State Hospital Nutrition and Dietetics Clinic between the dates October 2016 and April 2017. In the first meeting, the demographic features and dietary habits were interrogated with a questionnaire form; 3-day food consumption records were taken; body compositions were determined with anthropometric measurements and the biochemical parameters were analyzed. After the first meeting, a specific weight loss diet program was generated, and nutritional education was given to the subjects. Results: The correlation between vitamin D and BMI values after the study showed a positive correlation (r=0.52 in the 5-10% weight loss group and a negative correlation (r=-0.52 in the >10% weight loss group. But this relationship was not found to be statistically significant because the total number of subjects was low (p>0.05. Conclusions: This study shows that there may be a higher rise in vitamin D levels in patients with larger volumes of body fat loss. Therefore, there is a need for prospective studies with larger numbers of subjects.

  20. STOSS THERAPY AND WEEKLY VITAMIN D THERAPY IN THE MANAGEMENT OF NUTRITIONAL RICKETS IN CHILDREN- A COMPARATIVE STUDY

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    Madhava Vijayakumar

    2017-01-01

    Full Text Available BACKGROUND The Aim of the study is to study the risk factors of nutritional rickets in children of age 1-5 years and to compare the effectiveness of classical single mega dose vitamin D administration (stoss therapy and weekly cholecalciferol administration. METHODS 50 children of age group 1-5 year with clinical, biochemical and radiological features of nutritional rickets and an equal number of age and gender matched control were included in the study. Their risk factors were compared. Those children with rickets were divided randomly into two groups of equal numbers. For one group, single oral dose of 6,00,000 IU of vitamin D and for the other group, weekly oral dose of 60,000 IU of vitamin D was administered for 8 weeks. All children were given calcium supplementation. Regular follow up was done at 1, 2, 6, 9 and 12 months and the improvement was assessed clinically, radiologically and as per the laboratory results. RESULTS Major risk factors for the development of nutritional rickets were prematurity, low birth weight, high birth order, consumption of complementary feeds poor in calcium, lack of adequate sunlight exposure and prolonged exclusive breast feeding. Response to treatment was comparable both clinically and as per the investigation results among those who received single massive dose and those on weekly vitamin D therapy. CONCLUSION Increased birth order, prematurity and low birth weight were important risk factors for rickets. Inadequate dietary calcium and inadequate sunlight exposure increased chance of getting rickets. Supplementation of vitamin D and calcium were protective. Inadequate maternal sunlight exposure, lack of antenatal and post-natal calcium and vitamin D supplementation showed a significant association with rickets. The most common clinical feature of rickets was bow legs. Both massive single dose therapy and weekly vitamin D administration were equally effective and revealed no significant difference in clinical

  1. Renin-angiotensin system activity in vitamin D deficient, obese individuals with hypertension: An urban Indian study

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    Sunil Kumar Kota

    2011-01-01

    Full Text Available Background: Elevated renin-angiotensin-aldosterone system (RAAS activity is an important mechanism in the development of hypertension. Both obesity and 25-hydroxy vitamin D [25(OHD] deficiency have been associated with hypertension and augmented renin-angiotensin system (RAS activity. We tried to test the hypothesis that vitamin D deficiency and obesity are associated with increased RAS activity in Indian patients with hypertension. Materials and Methods: Fifty newly detected hypertensive patients were screened. Patients with secondary hypertension, chronic kidney disease, or coronary artery disease were excluded. Patients underwent measurement of vitamin D and plasma renin and plasma aldosterone concentrations. They were divided into three groups according to their baseline body mass index (BMI; normal <25 kg/m 2 , overweight 25-29.9 kg/m 2 and obese ≥30 kg/m 2 and 25(OHD levels (deficient <20 ng/ml, insufficient 20-29 ng/ml and optimal ≥30 ng/ml. Results: A total of 50 (male:female = 32:18 patients were included, with a mean age of 49.5 ± 7.8 years, mean BMI of 28.3 ± 3.4 kg/m 2 and a mean 25(OHD concentration of 18.5 ± 6.4 ng/ml. Mean systolic blood pressure (SBP was 162.4 ± 20.2 mm Hg and mean diastolic blood pressure (DBP was 100.2 ± 11.2 mm Hg. All the three blood pressure parameters [SBP, DBP and mean arterial pressure (MAP] were significantly higher among individuals with lower 25(OHD levels. The P values for trends in SBP, DBP and MAP were 0.009, 0.01 and 0.007, respectively. Though all the three blood pressure parameters (SBP, DBP and MAP were higher among individuals with higher BMIs, they were not achieving statistical significance. Increasing trends in PRA and PAC were noticed with lower 25(OHD and higher BMI levels. Conclusion: Vitamin D deficiency and obesity are associated with stimulation of RAAS activity. Vitamin D supplementation along with weight loss may be studied as a therapeutic strategy to reduce tissue RAS

  2. Prevalence, determinants and clinical correlates of vitamin D deficiency in patients with Chronic Obstructive Pulmonary Disease in London, UK.

    Science.gov (United States)

    Jolliffe, David A; James, Wai Yee; Hooper, Richard L; Barnes, Neil C; Greiller, Claire L; Islam, Kamrul; Bhowmik, Angshu; Timms, Peter M; Rajakulasingam, Raj K; Choudhury, Aklak B; Simcock, David E; Hyppönen, Elina; Walton, Robert T; Corrigan, Christopher J; Griffiths, Christopher J; Martineau, Adrian R

    2018-01-01

    Vitamin D deficiency is common in patients with chronic obstructive pulmonary disease (COPD), yet a comprehensive analysis of environmental and genetic determinants of serum 25-hydroxyvitamin D (25[OH]D) concentration in patients with this condition is lacking. We conducted a multi-centre cross-sectional study in 278 COPD patients aged 41-92 years in London, UK. Details of potential environmental determinants of vitamin D status and COPD symptom control and severity were collected by questionnaire, and blood samples were taken for analysis of serum 25(OH)D concentration and DNA extraction. All participants performed spirometry and underwent measurement of weight and height. Quadriceps muscle strength (QS) was measured in 134 participants, and sputum induction with enumeration of lower airway eosinophil and neutrophil counts was performed for 44 participants. Thirty-seven single nucleotide polymorphisms (SNP) in 11 genes in the vitamin D pathway (DBP, DHCR7, CYP2R1, CYP27B1, CYP24A1, CYP27A1, CYP3A4, LRP2, CUBN, RXRA, and VDR) were typed using Taqman allelic discrimination assays. Linear regression was used to identify environmental and genetic factors independently associated with serum 25(OH)D concentration and to determine whether vitamin D status or genetic factors independently associated with % predicted forced expiratory volume in one second (FEV 1 ), % predicted forced vital capacity (FVC), the ratio of FEV 1 to FVC (FEV 1 :FVC), daily inhaled corticosteroid (ICS) dose, respiratory quality of life (QoL), QS, and the percentage of eosinophils and neutrophils in induced sputum. Mean serum 25(OH)D concentration was 45.4nmol/L (SD 25.3); 171/278 (61.5%) participants were vitamin D deficient (serum 25[OH]D concentration COPD severity. Vitamin D deficiency was common in this group of COPD patients in the UK, and it associated independently with reduced % predicted FEV1 and FVC. However, genetic variation in the vitamin D pathway was not associated with vitamin D

  3. Growth, nutritional status, and signs of rickets in 0-5-year-old children in a Kashin-Beck disease endemic area of Central Tibet.

    Science.gov (United States)

    Rooze, Shancy; Dramaix-Wilmet, Michèle; Mathieu, Françoise; Bally, Pascale; Yangzom, Dikki; Li, Jin Zhong; Goyens, Philippe

    2012-08-01

    In order to describe the growth of 0-5-year-old Tibetan children living in a Kashin-Beck disease (KBD) endemic rural area and to examine the relationship between anthropometric indicators and clinical signs of rickets, we analyzed the baseline data of a cohort of 668 children enrolled in a prospective program of calcium and vitamin D supplementation. Tibetan children suffer from growth retardation. Z score of weight-for-age, height-for-age, weight-for-height was below -2 in 32.5%, 27.7%, and 12.1% of the children, respectively. Clinical signs of severe rickets are highly prevalent. Underweight, stunting, and clinical rickets increases with age. Prevalence of malnutrition was higher in the presence of signs of rickets. The proportion of children with a head circumference Z score rickets were observed. Stunting and underweight are frequent and probably associated with rickets.

  4. Vitamin D deficiency and low ionized calcium are linked with semen quality and sex steroid levels in infertile men

    DEFF Research Database (Denmark)

    Jensen, Martin Blomberg; Lawaetz, Jacob Gerner; Andersson, Anna-Maria

    2016-01-01

    ), 25-hydroxyvitamin D (25-OHD), ionized calcium (Ca(2+)) and karyotype. There were 179 men excluded due to serious comorbidities or anabolic steroid usage, leaving 1248 patients for analyses. MAIN RESULTS AND THE ROLE OF CHANCE: Men with 25-OHD >75 nmol/l had higher sperm motility and 66 and 111......STUDY QUESTION: Are low vitamin D levels linked with semen quality and sex steroids in infertile men? SUMMARY ANSWER: Infertile men with vitamin D deficiency had lower sperm motility, total numbers of motile sperm, Inhibin B, sex-hormone-binding-globulin (SHBG) and testosterone/estradiol ratio......, but higher levels of free sex steroids, than infertile men with normal vitamin D levels. WHAT IS KNOWN ALREADY: Low vitamin D levels have been associated with decreased sperm motility in healthy men, but a relationship between vitamin D and calcium with semen quality and especially sex steroids has not been...

  5. Lack of Definite Association of Vitamin D Deficiency with Diabetic Neuropathy. Investigation in Greek and in Bangladeshi Patients

    Science.gov (United States)

    ZAMBELIS, THOMAS; PAPADAKIS, GEORGE; KOKOTIS, PANAGIOTIS; VILLIOTOU, VASSILIKI; DOGKAS, NIKOLAOS; KARANDREAS, NIKOLAOS

    2017-01-01

    Aim: Determination of the 25(OH) vitamin D levels in Greek-born and in Bangladeshi immigrant patients in Greece with diabetes with and without polyneuropathy. Materials and Methods: The method for the detection and staging of polyneuropathy proposed by Dyck, 1988 was used. Results: A total of 111 Bangladeshi immigrants and 101 Greek diabetic patients took part in the study. Vitamin D levels were significantly lower in Bangladeshi than in Greek diabetic patients, and were significantly lower in Greek patients with small-fiber neuropathy. In Bangladeshi patients, there was no statistically significant difference in the subgroup of patients with polyneuropathy in comparison to those without polyneuropathy. Conclusion: The association of vitamin D deficiency only with a small number of Greek patients with exclusively small-fiber neuropathy does not allow us to draw a definite conclusion on the role of vitamin D in the pathogenesis of diabetic neuropathy. PMID:28358709

  6. Bilateral Simultaneous Avulsion Fractures of the Proximal Tibia in a 14-Year-Old Athlete with Vitamin-D Deficiency

    Directory of Open Access Journals (Sweden)

    Ziad Harb

    2015-01-01

    Full Text Available Fractures involving the proximal tibial epiphysis are rare and form 0.5% of all epiphyseal injuries. The specific anatomical and developmental features of the proximal tibial epiphysis make it vulnerable to unique patterns of fractures. Vitamin-D plays a vital role in bone homeostasis and its deficiency has an impact on fracture risk and healing. We present the first ever reported case of simultaneous bilateral proximal tibial physeal fractures in an athlete with vitamin-D deficiency. Treatment consisted of plaster immobilisation, and the patient made a full recovery and returned to preinjury level of activities. We report this case for its uniqueness and as an educational review of the importance of the developmental anatomy of the proximal tibia. We review the literature and discuss how the stages of the growing physis determine the type of fracture sustained.

  7. Brown tumor in mandible as a first sign of vitamin D deficiency: A rare case report and review.

    Science.gov (United States)

    Arunkumar, K V; Kumar, Sanjeev; Deepa, D

    2012-03-01

    Central giant cell granulomas (CGCGs) are uncommon but the most aggressive benign intraosseous tumors of jaws, with an unpredictable outcome. They account for less than 7% of all benign jaw lesions, with a female to male ratio of about 2:1. The classical "brown tumor" is commonly seen in the long bones, pelvis, and ribs. Facial bone involvement is rare and usually appears as solitary or multilocular soap bubble like radiolucencies. CGCGs are traditionally treated by both surgical and intralesional injection, with a variable recurrence rate. Here, we report a 12-year-old female patient with mandibular brown tumor as a first sign of secondary hyperthyroidism induced due to vitamin D deficiency and hypocalcemia.

  8. Brown tumor in mandible as a first sign of vitamin D deficiency: A rare case report and review

    Directory of Open Access Journals (Sweden)

    K V Arunkumar

    2012-01-01

    Full Text Available Central giant cell granulomas (CGCGs are uncommon but the most aggressive benign intraosseous tumors of jaws, with an unpredictable outcome. They account for less than 7% of all benign jaw lesions, with a female to male ratio of about 2:1. The classical "brown tumor" is commonly seen in the long bones, pelvis, and ribs. Facial bone involvement is rare and usually appears as solitary or multilocular soap bubble like radiolucencies. CGCGs are traditionally treated by both surgical and intralesional injection, with a variable recurrence rate. Here, we report a 12-year-old female patient with mandibular brown tumor as a first sign of secondary hyperthyroidism induced due to vitamin D deficiency and hypocalcemia.

  9. High prevalence of vitamin D deficiency among inner-city African American youth with asthma in Washington, DC.

    Science.gov (United States)

    Freishtat, Robert J; Iqbal, Sabah F; Pillai, Dinesh K; Klein, Catherine J; Ryan, Leticia M; Benton, Angela S; Teach, Stephen J

    2010-06-01

    The goal of this study was to examine the prevalence of vitamin D insufficiency and deficiency among urban African-American (AA) youth with asthma compared with control subjects without asthma. A cross-sectional case-control study was conducted at an urban pediatric medical center. Total 25-hydroxyvitamin D insufficiency (confidence interval: 4.4 to 399] for insufficiency and 46/85 [54%] vs 1/21 [5%], adjusted odds ratio = 20 [95% confidence interval: 1.4 to 272] for deficiency). Most of this sample of urban AA youth with persistent asthma were vitamin D deficient or insufficient. Given the emerging associations between low vitamin D levels and asthma, strong consideration should be given to routine vitamin D testing in urban AA youth, particularly those with asthma. Copyright 2010 Mosby, Inc. All rights reserved.

  10. Serum vitamin D deficiency and risk of hospitalization for heart failure: Prospective results from the Moli-sani study.

    Science.gov (United States)

    Costanzo, S; De Curtis, A; Di Castelnuovo, A; Persichillo, M; Bonaccio, M; Pounis, G; Cerletti, C; Donati, M B; de Gaetano, G; Iacoviello, L

    2018-03-01

    Evidence indicates that Vitamin D deficiency may be associated with increased risk of cardiovascular disease, although findings on risk of heart failure (HF) are controversial. We investigated the relationship between serum Vitamin D and the incidence of hospitalization for HF in a large prospective cohort of Italian adults. 19,092 (49% men, age range 35-99 years) HF-free individuals from the Moli-sani study, with complete data on serum Vitamin D (25-hydroxyvitamin) levels and incident hospitalized HF, were analysed. The cohort was followed up for a median of 6.2 years. Baseline serum Vitamin D levels were categorized in deficient (D was 12.2%, 79.6% and 8.2%, respectively. During follow-up, 562 admissions to hospital for HF were identified. The incidence of HF was 1.6%, 2.9% and 5.3%, respectively in subjects with normal, insufficient and deficient levels of Vitamin D. After multivariable analysis, individuals with deficiency of Vitamin D had a higher risk of hospitalization for HF (HR: 1.61, 95%CI: 1.06-2.43) than those with normal levels. Further adjustment for subclinical inflammation did not substantially change the association between Vitamin D deficiency and HF. Deficiency of Vitamin D was associated, independently of known HF risk factors, with an increased risk of hospitalization for HF in an Italian adult population. Copyright © 2017 The Italian Society of Diabetology, the Italian Society for the Study of Atherosclerosis, the Italian Society of Human Nutrition, and the Department of Clinical Medicine and Surgery, Federico II University. Published by Elsevier B.V. All rights reserved.

  11. The impact of adult vitamin D deficiency on behaviour and brain function in male Sprague-Dawley rats.

    Directory of Open Access Journals (Sweden)

    Jacqueline H Byrne

    Full Text Available BACKGROUND: Vitamin D deficiency is common in the adult population, and this has been linked to depression and cognitive outcomes in clinical populations. The aim of this study was to investigate the effects of adult vitamin D (AVD deficiency on behavioural tasks of relevance to neuropsychiatric disorders in male Sprague-Dawley rats. METHODS: Ten-week old male Sprague-Dawley rats were fed a control or vitamin D deficient diet for 6 weeks prior to, and during behavioural testing. We first examined a range of behavioural domains including locomotion, exploration, anxiety, social behaviour, learned helplessness, sensorimotor gating, and nociception. We then assessed locomotor response to the psychomimetic drugs, amphetamine and MK-801. Attention and vigilance were assessed using the 5 choice serial reaction time task (5C-SRT and the 5 choice continuous performance task (5C-CPT and, in a separate cohort, working memory was assessed using the delay match to sample (DMTS task. We also examined excitatory and inhibitory neurotransmitters in prefrontal cortex and striatum. RESULTS: AVD-deficient rats were deficient in vitamin D3 (<10 nM and had normal calcium and phosphate levels after 8-10 weeks on the diet. Overall, AVD deficiency was not associated with an altered phenotype across the range of behavioural domains tested. On the 5C-SRT AVD-deficient rats made more premature responses and more head entries during longer inter-trial intervals (ITI than control rats. On the 5C-CPT AVD-deficient rats took longer to make false alarm (FA responses than control rats. AVD-deficient rats had increases in baseline GABA levels and the ratio of DOPAC/HVA within the striatum. CONCLUSIONS: AVD-deficient rats exhibited no major impairments in any of the behavioural domains tested. Impairments in premature responses in AVD-deficient rats may indicate that these animals have specific alterations in striatal systems governing compulsive or reward-seeking behaviour.

  12. Vitamin D deficiency predisposes to adherent-invasive Escherichia coli-induced barrier dysfunction and experimental colonic injury.

    Science.gov (United States)

    Assa, Amit; Vong, Linda; Pinnell, Lee J; Rautava, Jaana; Avitzur, Naama; Johnson-Henry, Kathene C; Sherman, Philip M

    2015-02-01

    Adherent-invasive Escherichia coli (AIEC) colonization has been strongly implicated in the pathogenesis of Crohn's disease. Environmental triggers such as vitamin D deficiency have emerged as key factors in the pathogenesis of inflammatory bowel diseases. The aim of this study was to investigate the effects of 1,25(OH)2D3 on AIEC infection-induced changes in vivo and in vitro. Barrier function was assessed in polarized epithelial Caco-2-bbe cells grown in medium with or without vitamin D and challenged with AIEC strain LF82. Weaned C57BL/6 mice were fed either a vitamin D-sufficient or -deficient diet for 5 weeks and then infected with AIEC, in the absence and presence of low-dose dextran sodium sulphate. Disease severity was assessed by histological analysis and in vivo intestinal permeability assay. Presence of invasive bacteria was assessed by transmission electron microscopy. Caco-2-bbe cells incubated with 1,25(OH)2D3 were protected against AIEC-induced disruption of transepithelial electrical resistance and tight-junction protein redistribution. Vitamin D-deficient C57BL/6 mice given a course of 2% dextran sodium sulphate exhibited pronounced epithelial barrier dysfunction, were more susceptible to AIEC colonization, and showed exacerbated colonic injury. Transmission electron microscopy of colonic tissue from infected mice demonstrated invasion of AIEC and fecal microbiome analysis revealed shifts in microbial communities. These data show that vitamin D is able to mitigate the deleterious effects of AIEC on the intestinal mucosa, by maintaining intestinal epithelial barrier homeostasis and preserving tight-junction architecture. This study highlights the association between vitamin D status, dysbiosis, and Crohn's disease.

  13. Relation between Vitamin D Deficiency and Severity of Chronic Obstructive Pulmonary Disease-A Case Control Study.

    Science.gov (United States)

    Sanket, Shah; Madireddi, Jagadesh; Stanley, Weena; Sura, Pradeep; Prabhu, Mukhyaprana

    2016-01-01

    Chronic obstructive pulmonary disease (COPD) is a chronic inflammatory disorder characterized by irreversible and progressive limitation of expiratory airflow. COPD is now considered as a systemic disease with several extra-pulmonary manifestations which include osteoporosis, muscle weakness, arrhythmia, stroke, cancer etc. The role of vitamin D in skeletal integrity is well established. Role of it in several other diseases like autoimmune, infectious, respiratory and cardiovascular diseases has been increasingly recognised. Data on vitamin D status in COPD in Indian population was limited while those comparing vitamin D with stage, pack year and body mass index were lacking. To assess Vitamin D in subjects with COPD and matched controls and also to study the variability in serum vitamin D levels with COPD disease characteristics. A total of 162 patients aged 18-65 years from south India presenting to kasturba hospital were included in the study. Serum 25- hydroxy-vitamin D were measured in 81 COPD patients (combined COPD stage A-D) and compared with 81 age and gender matched controls. Level Vitamin D was assessed using logistic regression analysis. COPD patients had an increased risk for vitamin D deficiency compared to controls after adjustment for age and gender(OR =2.687 (1.40,5.13)). Variables associated with lower 25(OH) D levels in COPD patients were higher pack year (p=0.001), current smoking status (p=0.026), Low BMI (p=0.02), and GOLD stage III- IV (p=0.001). COPD was associated with an increased risk of vitamin D deficiency, and there was a significant association between vitamin D levels and Combined COPD stage severity. Also, a higher pack year and a low BMI are associated with lower levels of vitamin D.

  14. Low vitamin D deficiency in Irish toddlers despite northerly latitude and a high prevalence of inadequate intakes.

    Science.gov (United States)

    Ní Chaoimh, Carol; McCarthy, Elaine K; Hourihane, Jonathan O'B; Kenny, Louise C; Irvine, Alan D; Murray, Deirdre M; Kiely, Mairead E

    2016-12-26

    While reports of inadequate vitamin D intakes among young children are widespread, data on the prevalence of vitamin D deficiency are inconsistent. We aimed to quantify vitamin D intake and serum 25-hydroxyvitamin D [25(OH)D] concentrations in children aged 2 years in the prospective Cork BASELINE Birth Cohort Study. Serum 25(OH)D was analysed using UPLC-MS/MS in 741 children living in Cork, Ireland (51°N). Two-day weighed food diaries were collected in 467 children, and 294 provided both a blood sample and a food diary. Mean (SD) 25(OH)D concentrations were 63.4 (20.4) nmol/L [winter: 54.5 (19.9), summer: 71.2 (17.5)]. The prevalence of vitamin D deficiency (D intake of 3.5 (3.1) µg/day, 96% had intakes below 10 µg/day, the current IOM estimated average requirement and the SACN safe intake value for this age group. After adjustment for season, vitamin D intake (µg/day) was associated with higher 25(OH)D concentrations [adjusted estimate (95% CI) 2.5 (1.9, 3.1) nmol/L]. Children who did not consume vitamin D-fortified foods or supplements had very low vitamin D intakes (1.2 (0.9) µg/day), and during winter, 12 and 77% were D status during winter, especially among children who did not consume fortified foods or nutritional supplements. Our data indicate the need for dietary strategies to increase vitamin D intakes in this age group. This report provides further evidence that DRVs for vitamin D should be based on experimental data in specific population groups and indicates the need for dose-response RCTs in young children.

  15. Vitamin d deficiency is associated with insulin resistance independent of intracellular calcium, dietary calcium and serum levels of parathormone, calcitriol and calcium in premenopausal women.

    Science.gov (United States)

    Ferreira, Thaís da Silva; Rocha, Tatiana Martins; Klein, Márcia Regina Simas Torres; Sanjuliani, Antonio Felipe

    2015-04-01

    There is evidence that vitamin D deficiency is associated with increased risk of cardiovascular disease. However, it is not known if this association is independent of dietary calcium, intracellular calcium and serum levels of parathormone, calcitriol and calcium. To investigate the independent relationship of vitamin D deficiency with insulin resistance, lipid profile, inflammatory status, blood pressure and endothelial function. Cross-sectional study conducted with 73 healthy Brazilian premenopausal women aged 18 - 50 years. All participants were evaluated for: 25 hydroxyvitamin D serum levels, anthropometric parameters, body composition, calcium metabolism, insulin resistance, lipoprotein profile, inflammatory status, blood pressure and endothelial function. Endothelial function was assessed by reactive hyperemia index using Endo-PAT 2000®. Women were stratified in two groups: with vitamin D deficiency (25 hydroxyvitamin D independent of dietary calcium, intracellular calcium and serum levels of parathormone, calcitriol and calcium in healthy premenopausal women. Copyright AULA MEDICA EDICIONES 2014. Published by AULA MEDICA. All rights reserved.

  16. [Prevalence and risk factors of vitamin D deficiency in healthy adults aged 18-65 years in northern France].

    Science.gov (United States)

    Deplanque, X; Wullens, A; Norberciak, L

    2017-06-01

    Screening and treatment of vitamin D deficiency are the subject of several publications. A lot of recognized risk factors have increased steadily, leading to the recognition of populations at risk. Despite their exposure to the same risk factors as other populations, there are no recommendations concerning healthy adults, a population rarely studied. To determine the prevalence of vitamin D deficiency in healthy adults aged 18-65 years residing in northern France and to search for correlated risk factors at 20ng/mL. Descriptive, prospective, single-center epidemiology study; 297 subjects studied in January and February, 2015. The prevalence of vitamin D deficiency was determined at three serum levels (10, 20 and 30ng/mL). A self-administered questionnaire was used to identify risk factors correlated with vitamin D deficiency (vitamin D serum level was strictly less than 30ng/mL in 92.3% of participants, strictly less than 20ng/mL in 75.1%, and strictly less than 10ng/mL in 27.9%. Male gender (P=0.0001), age (P=0.012), no vacations in sunny regions (P=0.03) and no intake of prescription vitamin supplements (P=0.002) were independent risk factors of vitamin D deficiency (vitamin D deficiency is frequent in healthy adults and is often severe. A systematic screening and supplementation strategy would limit the development of many pathological complications and ensure good nutritional balance. Copyright © 2016 Société Nationale Française de Médecine Interne (SNFMI). Published by Elsevier SAS. All rights reserved.

  17. Vitamin D deficiency among smear positive pulmonary tuberculosis patients and their tuberculosis negative household contacts in Northwest Ethiopia: a case-control study.

    Science.gov (United States)

    Tessema, Belay; Moges, Feleke; Habte, Dereje; Hiruy, Nebiyu; Yismaw, Shewaye; Melkieneh, Kassahun; Kassie, Yewulsew; Girma, Belaineh; Melese, Muluken; Suarez, Pedro G

    2017-05-11

    Vitamin D is a fat-soluble vitamin that increases the immunity against tuberculosis (TB), decreases the re-activation of latent TB and reduces the severity of active TB disease. Epidemiological studies on the prevalence of vitamin D deficiency, and its association with TB showed inconsistent results in different countries. This study was aimed to determine the prevalence of vitamin D deficiency and its association with TB in Northwest Ethiopia. A case-control study was conducted among smear positive pulmonary tuberculosis patients and their household contacts without symptoms suggestive of TB. Study participants were recruited at 11 TB diagnostic health facilities in North and South Gondar zones of Amhara region between May 2013 and April 2015. The spot-morning-spot sputum samples and 5 ml blood sample were collected prior to commencing TB treatment for the diagnosis of TB and serum vitamin D assay, respectively. The diagnosis of TB was performed using smear microscopy and GeneXpert. Serum vitamin D level was analyzed using VIDAS 25 OH Vitamin D Total testing kits (Biomerieux, Marcy I'Etoile, France) on mini VIDAS automated immunoassay platform. Vitamin D status was interpreted as deficient (100 ng/ml). Of the total study participants, 134 (46.2%) were vitamin D deficient, and only 56 (19.3%) had sufficient vitamin D level. A total of 59 (61.5%) TB patients and 75 (38.7%) non TB controls were vitamin D deficient. Results of multivariate logistic regression analyses showed a significantly higher vitamin D deficiency among tuberculosis cases (p controls in Ethiopia where there is year round abundant sunshine. Study participants with tuberculosis, females, older age groups, and urban residents had significantly higher prevalence of vitamin D deficiency. These findings warrant further studies to investigate the role of vitamin D supplementation in the prevention and treatment of tuberculosis in high TB burden countries like Ethiopia.

  18. The ambiguity of ethnicity as risk factor of vitamin D deficiency--a case study of Danish vitamin D policy documents

    DEFF Research Database (Denmark)

    Mygind, Anna; Traulsen, Janine Morgall; Nørgaard, Lotte Stig

    2011-01-01

    OBJECTIVES: To explore how ethnic minorities at risk of vitamin D deficiency are constructed in Danish policy documents (current as of April 2009), regarding vitamin D supplementation. METHODS: Ten policy documents were analysed through content analysis, focusing on definitions and explanations o...... are constructed very differently in Danish policies current as of April 2009. A more precise definition of ethnic minorities in policies and research may be helpful in seeking to identify which ethnic minorities are and are not at risk of vitamin D deficiency....

  19. Familial hypophosphataemic rickets affecting a father and his two daughters: a case report.

    Science.gov (United States)

    Ekpebegh, C O; Blanco-Blanco, E

    2010-01-01

    Hypophosphataemic rickets (HR) is a rare cause of short stature associated with limb deformities. To report the clinical and laboratory features of HR in two siblings and their father. Following the diagnosis of HR in a 4-year-old girl, her siblings and parents were screened using clinical, laboratory, and radiological parameters. Short stature, lower limb deformities, frontal bossing and hypophosphataemia were present in all three patients. Serum alkaline phosphatase (ALP) was markedly elevated in both siblings who were aged two and 11 years but only minimally raised in their 43-year-old father. While spontaneous mutation is the presumed aetiology in the father, X linked dominant inheritance is the likely cause in both daughters. Hypophosphataemic rickets should be considered in the differential diagnosis of short stature associated with limb deformities regardless of a family history of HR. Serum ALP may not be remarkably elevated when the diagnosis is made in adulthood.

  20. Comparison of Limestone and Ground Fish for Treatment of Nutritional Rickets in Children in Nigeria.

    Science.gov (United States)