Treatment with 50000 IU Vitamin D2 Every Other Week and Effect on Serum 25-Hydroxyvitamin D2, 25-Hydroxyvitamin D3, and Total 25-Hydroxyvitamin D in Aclinical Setting

ObjectiveTo examine the effect of 50 000 IU-vitamin D₂ supplementation in a clinical setting on serum total 25-hydroxyvitamin D (25[OH]D), 25-hydroxyvitamin D₂ (25[OH]D₂), and 25-hydroxyvitamin D₃ (25[OH]D₃).MethodsThis retrospective cohort study was performed in an urban tertiary referral hospital in Boston, Massachusetts. Patients who had been prescribed 50 000 IU vitamin D₂ repletion and maintenance programs were identified through a search of our electronic medical record. Baseline and follow-up total serum 25(OH)D, 25(OH)D₂, and 25(OH)D₃ levels were compared.ResultsWe examined the medical records of 48 patients who had been prescribed 50 000 IU vitamin D₂ in our clinic. Mean ± standard deviation baseline total 25(OH) D was 31.0 ± 10.6 ng/mL and rose to 48.3 ± 13.4 ng/mL after treatment (P <.001). 25(OH)D₂ increased from 4.2 ± 4.3 ng/mL to 34.6 ± 12.3 ng/mL after treatment (P <.001), for an average of 158 days (range, 35-735 days). Serum 25(OH)D3 decreased from 26.8 ± 10.8 ng/mL to 13.7 ± 7.9 ng/mL (P <.001).ConclusionsFifty thousand IU vitamin D₂ repletion and maintenance therapy substantially increases total 25(OH)D and 25(OH)D2 despite a decrease in serum 25(OH)D3. This treatment program is an appropriate and effective strategy to treat and prevent vitamin D deficiency.(Endocr Pract. 2012;18:399-402)     

Insignificant Medium-Term Vitamin D Status Change after 25-Hydroxyvitamin D Testing in a Large Managed Care Population

Objectives

To examine the clinical utility of 25-hydroxyvitamin D (25(OH)D) testing in achieving medium-term vitamin D (VD) sufficiency in a managed care population.

Methods

Retrospective study of a continuously-enrolled patient population in a 3-year period between 2011 and 2013. Primary outcome was VD status at ∼1 year after 25(OH)D testing. Patient demographics, comorbidities, medications, and 25(OH)D test results were gathered from relevant databases and multivariate logistic regression analysis used to study the risk factors of persistent VD deficiency or insufficiency.

Results

Of 22,784 patients, 7533 (females 69.3%) did 14,563 25(OH)D tests, with an estimated cost of $582,520. Of the 7533 patients, 1126 had another 25(OH)D test at 300–400 days after the first one. Based on the two test results, 234 patients (20.8%) maintained sufficient 25(OH)D levels; 132 (11.7%) turned from VD-sufficient into VD-insufficient or -deficient; 538 (47.8%) remained VD-insufficient or -deficient, and only 222 (19.7%) improved to be VD-sufficient. Overall, only 8.0% more patients were VD-sufficient at ∼1 year after 25(OH)D testing. Only younger age and higher BMI were independent risk factors for persistent low 25(OH)D levels and high-dose VD use was not associated with achieving VD sufficiency.

Conclusions

25(OH)D testing only benefits a small portion of patients thus lacks clinical utility in achieving VD sufficiency in the medium term but incurs a significant cost. A practical strategy to treat VD deficiency or insufficiency is needed; without it, 25(OH)D testing adds little value to most patients’ health and should be used with discretion.     

Serum 25-Hydroxyvitamin D Levels and Dry Eye Syndrome: Differential Effects of Vitamin D on Ocular Diseases

Purpose

To investigate associations between serum 25-hydroxyvitamin D levels and dry eye syndrome (DES), and to evaluate the differential effect of vitamin D on ocular diseases including age-related macular disease (AMD), diabetic retinopathy (DR), cataract, and DES.

Methods

A total of 16,396 participants aged >19 years were randomly selected from the Korean National Health and Nutrition Examination Survey. All participants participated in standardized interviews, blood 25-hydroxyvitamin D level evaluations, and comprehensive ophthalmic examinations. DES was defined by a history of clinical diagnosis of dry eyes by a physician. The association between vitamin D and DES was compared to the associations between vitamin D and AMD, DR, cataract, and DES from our previous studies.

Results

The odds of DES non-significantly decreased as the quintiles of serum 25-hydroxyvitamin D levels increased (quintile 5 versus 1, OR = 0.85, 95%CI: 0.55–1.30, P for trend = 0.076) after adjusting for potential confounders including age, sex, hypertension, diabetes, smoking status, and sunlight exposure times. The relative odds of DES (OR = 0.70, 95% CI: 0.30–1.64) and cataract (OR = 0.76, 95% CI: 0.59–0.99) were relatively high, while those of DR (OR = 0.37, 95% CI: 0.18–0.76) and late AMD (OR = 0.32, 95% CI: 0.12–0.81) were lower in men.

Conclusions

The present study does not support an association between serum 25-hydroxyvitamin D levels and DES. The preventive effect of serum 25-hydroxyvitamin D may be more effective for DR and late AMD than it is for cataract and DES.     

Low Serum 25-Hydroxyvitamin D Concentrations Are Associated with Increased Risk for Melanoma and Unfavourable Prognosis

Background

Low vitamin D status (serum 25(OH)D concentration) is associated with increased incidence and unfavourable outcome of various types of cancer. However, there are limited data on influence of serum 25(OH)D on risk and prognosis of malignant melanoma.

Methods

Basal serum 25(OH)D concentrations were retrospectively analyzed in a cohort of melanoma patients (n = 324) and healthy controls (n = 141). We tested the hypothesis that serum 25(OH)D concentrations are predictive of melanoma risk, thickness of primary melanomas, and overall survival (OS).

Results

Median serum 25(OH)D concentrations were significantly lower (p = 0.004) in melanoma patients (median = 13.6 ng/ml) as compared to controls (median = 15.6 ng/ml). Primary tumors of patients with low serum 25(OH)D concentrations (<10 ng/ml) had significantly (p = 0.006) greater Breslow thickness (median: 1.9 mm) as compared to patients with higher levels (>20 ng/ml; median: 1.00 mm). Patients with 25(OH)D serum concentrations in the lowest quartile had inferior overall survival (median: 80 months) comparing with the highest quartile (median: 195 months; p = 0.049).

Conclusions

Our data support the concept that serum 25(OH)D concentrations are associated with risk and prognosis of melanoma. Whether normalizing serum 25(OH)D concentrations in these patients improves outcomes will require testing in future clinical trials.     

Vitamin D Binding Protein Genotype Is Associated with Serum 25-Hydroxyvitamin D and PTH Concentrations,as Well as Bone Health in Children and Adolescents in Finland

Vitamin D binding protein (DBP)/group-specific component (Gc), correlates positively with serum vitamin D metabolites, and phenotype influences serum 25-hydroxyvitamin D (S-25(OH)D) concentration. The protein isoform has been associated with decreased bone mineral density (BMD) and increased fracture risk. We examined the role of GC genotypes in S-25(OH)D status and BMD in 231 Finnish children and adolescents aged 7−19 yr. BMD was measured with DXA from lumbar spine (LS), total hip, and whole body, and for 175 subjects, radial volumetric BMD was measured with pQCT. Background characteristic and total dietary intakes of vitamin D and calcium were collected. The concentrations of 25(OH)D, parathyroid hormone (PTH), calcium and other markers of calcium homeostasis were determined from blood and urine. Genotyping was based on single-nucleotide polymorphism (rs4588) in the GC gene. The genotype distribution was: GC 1/1 68%, GC 1/2 26% and GC 2/2 6%. A significant difference emerged in 25(OH)D and PTH concentrations between the genotypes, (p = 0.001 and 0.028 respectively, ANCOVA). There was also a linear trend in: Gc 2/2 had the lowest 25(OH)D and PTH concentrations (p = 0.025 and 0.012, respectively). Total hip bone mineral content was associated with GC genotype (BMC) (p = 0.05, ANCOVA) in boys. In regression analysis, after adjusting for relevant covariates, GC genotype was associated with LS BMC and strength and strain index (SSI) Z-score in both genders, and LS BMD in boys. In conclusion, the present study demonstrates the association between GC genotypes and S-25(OH)D and PTH concentrations. The results show the influence of DBP genetic variation on bone mass accrual in adolescence.     

Serum 25-Hydroxyvitamin D and Insulin Resistance in Apparently Healthy Adolescents

Purpose

Vitamin D deficiency is a common condition that is associated with diabetes and insulin resistance. However, the association between vitamin D and insulin resistance has not been fully studied, especially in the general adolescent population. Therefore, we assessed the association between serum 25-hydroxyvitamin D [25(OH)D] level and insulin resistance among apparently healthy Korean adolescents.

Methods

A total of 260 (135 male and 125 female) adolescents in a rural high school were assessed for serum 25(OH)D, fasting plasma glucose, and insulin. All of the participants were aged 15 to 16 years old, and without known hypertension or diabetes. Serum 25(OH)D was analyzed both as a continuous and categorical variable in association with insulin resistance. Insulin resistance was estimated by homeostasis model assessment (HOMA-IR). Increased insulin resistance was operationally defined as a HOMA-IR value higher than the sex-specific 75th percentile.

Results

In male adolescents, every 10 ng/ml decrease in 25(OH)D level was associated with a 0.25 unit increase in HOMA-IR (p = 0.003) after adjusting for age and BMI. Compared to those in the highest quartile, male adolescents in the lowest 25(OH)D quartile were at significantly higher risk for insulin resistance: unadjusted odds ratio 4.06 (95% CI, 1.26 to 13.07); age and BMI adjusted odds ratio 3.59 (95% CI, 1.03 to 12.57). However, 25(OH)D level, either in continuous or categorical measure, was not significantly associated with insulin resistance among female adolescents.

Conclusions

This study suggests that serum 25(OH)D level may be inversely associated with insulin resistance in healthy male adolescents.     

Prognostic Value of Serum 25-Hydroxyvitamin D in Patients with Stroke

We aimed to evaluate the association between 25-hydroxyvitamin D [25(OH) D] levels and both clinical severity at admission and outcome at discharge in patients with acute ischemic stroke (AIS). From June 2012 to October 2013, consecutive first-ever AIS patients admitted to the Department of Emergency of The Fourth Affiliated Hospital of Harbin Medical University, China were identified. Clinical information was collected. Serum 25(OH) D levels were measured at baseline. Stroke severity was assessed at admission using the National Institutes of Health Stroke Scale (NIHSS) score. Functional outcome was evaluated at discharge using the modified Rankin scale (m-Rankin). Multivariate analyses were performed using logistic regression models. During the study period, 326 patients were diagnosed as AIS and were included in the analysis. Serum 25(OH) D levels reduced with increasing severity of stroke as defined by the NIHSS score. There was a negative correlation between levels of 25(OH) D and the NIHSS (r = ? 0.389, P = 0.000). In multivariate analyses, serum 25(OH) D level was an independent prognostic marker of discharge favorable functional outcome and survival [odds ratio 3.96 (2.85–7.87) and 3.36 (2.12–7.08), respectively, P = 0.000 for both, adjusted for NHISS, other predictors and vascular risk factors] in patients with AIS. Serum 25(OH) D levels are a predictor of both severity at admission and favorable functional outcome in patients with AIS. Additional research is needed on vitamin D supplementation to improve the outcome of post-stroke patients.     

The Importance of Body Weight for the Dose Response Relationship of Oral Vitamin D Supplementation and Serum 25-Hydroxyvitamin D in Healthy Volunteers

Unlike vitamin D recommendations by the Institute of Medicine, the Clinical Practice Guidelines by the Endocrine Society acknowledge body weight differentials and recommend obese subjects be given two to three times more vitamin D to satisfy their body''s vitamin D requirement. However, the Endocrine Society also acknowledges that there are no good studies that clearly justify this. In this study we examined the combined effect of vitamin D supplementation and body weight on serum 25-hydroxyvitamin (25(OH)D) and serum calcium in healthy volunteers. We analyzed 22,214 recordings of vitamin D supplement use and serum 25(OH)D from 17,614 healthy adult volunteers participating in a preventive health program. This program encourages the use of vitamin D supplementation and monitors its use and serum 25(OH)D and serum calcium levels. Participants reported vitamin D supplementation ranging from 0 to 55,000 IU per day and had serum 25(OH)D levels ranging from 10.1 to 394 nmol/L. The dose response relationship between vitamin D supplementation and serum 25(OH)D followed an exponential curve. On average, serum 25(OH)D increased by 12.0 nmol/L per 1,000 IU in the supplementation interval of 0 to 1,000 IU per day and by 1.1 nmol/L per 1,000 IU in the supplementation interval of 15,000 to 20,000 IU per day. BMI, relative to absolute body weight, was found to be the better determinant of 25(OH)D. Relative to normal weight subjects, obese and overweight participants had serum 25(OH)D that were on average 19.8 nmol/L and 8.0 nmol/L lower, respectively (P<0.001). We did not observe any increase in the risk for hypercalcemia with increasing vitamin D supplementation. We recommend vitamin D supplementation be 2 to 3 times higher for obese subjects and 1.5 times higher for overweight subjects relative to normal weight subjects. This observational study provides body weight specific recommendations to achieve 25(OH)D targets.     

广泛性焦虑障碍血清25-羟维生素D、维生素B12与认知功能和临床疗效的关系

摘要 目的：探讨广泛性焦虑障碍（GAD）患者血清25-羟维生素D[25（OH）D]、维生素B12（VB12）与认知功能和临床疗效的关系。方法：选择2018年4月~2022年6月期间空军军医大学第一附属医院心理科门诊收治的186例GAD患者作为GAD组。另选取同期于我院体检健康的志愿者120例作为对照组。采用威斯康星卡片分类测验（WCST）评估并对比两组患者的认知功能，检测并对比两组患者的血清25（OH）D、VB12水平。采用Pearson相关性分析血清25（OH）D、VB12与认知功能的相关性。GAD组给予常规治疗，按照治疗效果分为有效组和无效组，对比有效组和无效组在治疗前后血清25（OH）D、VB12水平变化。结果：GAD组的血清25（OH）D、VB12水平低于对照组（P<0.05）。对照组完成总分类数、正确反应数、总反应数均多于GAD组，错误应答数、持续性错误数少于GAD组（P<0.05）。Pearson相关性分析结果显示，血清25（OH）D、VB12水平与错误应答数、持续性错误呈负相关；而与总分类数、正确反应数、总反应数呈正相关（P<0.05）。186例患者中，痊愈36例，疗效显著53例，有效62例，无效35例。按照治疗情况将患者分为有效组（n=151）和无效组（n=35）。两组治疗后血清25（OH）D、VB12水平均升高，且有效组高于对照组（P<0.05）。结论：GAD患者的25（OH）D、VB12水平下降，且与其认知功能下降有关，25（OH）D、VB12水平较低的GAD患者其治疗效果也相对更差，提示临床诊疗过程中应密切关注患者25（OH）D、VB12水平以制定相应的治疗措施。     

Serum 25-Hydroxyvitamin D Level and Influenza Vaccine Immunogenicity in Children and Adolescents

Background

Vaccination is an important strategy in the prevention of influenza, but immunologic response to vaccination can vary widely. Recent studies have shown an association between serum 25-hydroxyvitamin D (25[OH]D) levels and immune function. The purpose of this study was to determine if serum 25(OH)D level correlates with influenza vaccine immunogenicity in children and adolescents.

Methods

We conducted a prospective cohort study of children age 3 to 15 years of age vaccinated with trivalent influenza vaccine (A/Brisbane/59/2007[H1N1]-like virus, A/Brisbane/10/2007 [H3N2]-like virus and B/Florida/4/2006-like virus) in Hutterite communities in Alberta, Saskatchewan and Manitoba. Serum 25(OH)D levels were measured at baseline and immunogenicity was assessed using hemagluttination inhibition (HAI) titers done at baseline and 3–5 weeks post vaccination. Logistic regression was used to assess the relationship between serum 25(OH)D level as both a continuous and dichotomous variable and seroprotection, seroconversion, fold increase in geometric mean titer (GMT) and post vaccination titer.

Results

A total of 391 children and adolescents were included in the study and 221 (57% had post-vaccination HAI titers. The median serum 25(OH)D level was 61.0 nmol/L (Interquartile range [IQR] 50.0, 71.0). No relationship was found between serum 25(OH)D level and seroprotection (post-vaccination titer ≥40 and ≥320) or seroconversion (post-vaccination titer ≥40 for participants with pre-vaccine titer <10 or four-fold rise in post-vaccination titer for those with a pre-vaccine titer ≥10).

Conclusion

Serum 25(OH)D level was not associated with influenza vaccine immunogenicity in otherwise healthy children and adolescents. Other strategies to enhance influenza vaccine response should continue to be evaluated in this population.The role of serum 25(OH)D level in vaccine responsiveness in other populations, especially those hyporesponsive to influenza vaccination, requires further study.     

支气管哮喘患儿血清25 羟维生素D3水平对病情评估及临床转归的意义

目的：探讨支气管哮喘患儿血清25 羟维生素D3[25-(OH)D3］水平对病情严重程度及临床转归的影响。方法：选取144 例 支气管哮喘患儿为研究对象,依据病情严重程度分为轻度间歇组、轻度持续组、中度持续组及重度持续组,选取60 例健康儿童作 为对照组,检测血清25-(OH)D3 水平;在治疗4 周后应用儿童哮喘控制测试评分系统(C-ACT)对患儿哮喘控制情况给予评价,将 所有患儿分为未控制组、部分控制组及完全控制组,比较各组血清25-(OH)D3 水平的差异。结果：对照组、轻度间歇组、轻度持续 组、中度持续组、重度持续组5 组之间血清25-(OH)D3 水平存在显著的统计学差异(P＜0.05),从对照组到重度持续组血清25- (OH)D3 水平逐渐降低(P＜0.05);完全控制组、部分控制组及未控制组三组血清25-(OH)D3 水平亦存在显著的统计学差异(P＜ 0.05),从完全控制组到未控制组血清25-(OH)D3 水平亦呈现逐渐降低趋势(P＜0.05);血清25-(OH)D3 水平与病情严重程度呈负 相关(rs =-0.489, P＜0.05),血清25-(OH)D3 水平与C-ACT 评分亦呈负相关(rs =-0.470, P＜0.05);随着血清25-(OH)D3 水平下降 程度的加重,患儿发生重度持续发作、出现C-ACT 评分＜19 分的风险值(OR)则逐渐增大。结论：血清25-(OH)D3 水平与哮喘患儿 病情严重程度及病情控制情况密切相关,早期血清维生素D 水平对于哮喘患儿病情及近期预后具有一定意义。     

Serum 25-Hydroxyvitamin D Status and Longitudinal Changes in Weight and Waist Circumference: Influence of Genetic Predisposition to Adiposity

Studies of the relationship between serum 25-hydroxyvitamin D (25(OH)D) and changes in measures of adiposity have shown inconsistent results, and interaction with genetic predisposition to obesity has rarely been examined. We examined whether 25(OH)D was associated with subsequent annual changes in body weight (ΔBW) or waist circumference (ΔWC), and whether the associations were modified by genetic predisposition to a high BMI, WC or waist-hip ratio adjusted for BMI (WHR_BMI). The study was based on 10,898 individuals from the Danish Inter99, the 1958 British Birth Cohort and the Northern Finland Birth Cohort 1966. We combined 42 adiposity-associated Single Nucleotide Polymorphisms (SNPs) into four scores indicating genetic predisposition to BMI, WC and WHR_BMI, or all three traits combined. Linear regression was used to examine the association between serum 25(OH)D and ΔBW or ΔWC, SNP-score × 25(OH)D interactions were examined, and results from the individual cohorts were meta-analyzed. In the meta-analyses, we found no evidence of an association between 25(OH)D and ΔBW (-9.4 gram/y per 10 nmol/L higher 25(OH)D [95% CI: -23.0, +4.3; P = 0.18]) or ΔWC (-0.06 mm/y per 10 nmol/L higher 25(OH)D [95% CI: -0.17, +0.06; P = 0.33]). Furthermore, we found no statistically significant interactions between the four SNP-scores and 25(OH)D in relation to ΔBW or ΔWC. Thus, in view of the narrow CIs, our results suggest that an association between 25(OH)D and changes in measures of adiposity is absent or marginal. Similarly, the study provided evidence that there is either no or very limited dependence on genetic predisposition to adiposity.     

肥胖儿童血清25-羟维生素D水平的研究

目的：探讨肥胖儿童血清25-（OH）D的水平,为临床评估维生素D营养状况与儿童肥胖症关系的研究提供参考。方法：将2009年5月至10月收治的儿童依据体重指数分成3组,抽取空腹静脉血检测血清中25-（OH）D水平,并进行组间比较。结果：通过分析25-（OH）D水平,肥胖组婴儿指标显著低于正常儿和瘦婴儿,统计学分析差异有显著性意义。结论：肥胖婴儿较正常儿和瘦婴儿25-（OH）D水平低,更易患佝偻病。提示防治佝偻病,对肥胖婴儿尤应重视,更要补充维生素D。     

Serum 25-Hydroxyvitamin D and the Incidence of Acute Viral Respiratory Tract Infections in Healthy Adults

Background

Declining serum concentrations of 25-hydroxyvitamin D seen in the fall and winter as distance increases from the equator may be a factor in the seasonal increased prevalence of influenza and other viral infections. This study was done to determine if serum 25-hydroxyvitamin D concentrations correlated with the incidence of acute viral respiratory tract infections.

Methodology/Findings

In this prospective cohort study serial monthly concentrations of 25-hydroxyvitamin D were measured over the fall and winter 2009–2010 in 198 healthy adults, blinded to the nature of the substance being measured. The participants were evaluated for the development of any acute respiratory tract infections by investigators blinded to the 25-hydroxyvitamin D concentrations. The incidence of infection in participants with different concentrations of vitamin D was determined. One hundred ninety-five (98.5%) of the enrolled participants completed the study. Light skin pigmentation, lean body mass, and supplementation with vitamin D were found to correlate with higher concentrations of 25-hydroxyvitamin D. Concentrations of 38 ng/ml or more were associated with a significant (p<0.0001) two-fold reduction in the risk of developing acute respiratory tract infections and with a marked reduction in the percentages of days ill.

Conclusions/Significance

Maintenance of a 25-hydroxyvitamin D serum concentration of 38 ng/ml or higher should significantly reduce the incidence of acute viral respiratory tract infections and the burden of illness caused thereby, at least during the fall and winter in temperate zones. The findings of the present study provide direction for and call for future interventional studies examining the efficacy of vitamin D supplementation in reducing the incidence and severity of specific viral infections, including influenza, in the general population and in subpopulations with lower 25-hydroxyvitamin D concentrations, such as pregnant women, dark skinned individuals, and the obese.     

肥胖儿童血清25- 羟维生素D 水平的研究

目的:探讨肥胖儿童血清25-(OH)D的水平,为临床评估维生素D营养状况与儿童肥胖症关系的研究提供参考。方法:将2009年5月至10月收治的儿童依据体重指数分成3组,抽取空腹静脉血检测血清中25-(OH)D水平,并进行组间比较。结果:通过分析25-(OH)D水平,肥胖组婴儿指标显著低于正常儿和瘦婴儿,统计学分析差异有显著性意义。结论:肥胖婴儿较正常儿和瘦婴儿25-(OH)D水平低,更易患佝偻病。提示防治佝偻病,对肥胖婴儿尤应重视,更要补充维生素D。     

Serum Concentrations of Vitamin D Metabolites in Cayo Santiago Rhesus Macaques

Serum 25-hydroxyvitamin D (25[OH]D), an index of vitamin D nutrition, and the calcium-regulating hormone 1,25-dihydroxyvitamin D (1,25[OH]₂D) were measured in rhesus macaques of various ages. Both metabolites were much higher in monkeys than in man. For 25(OH)D there was no sex difference, and this metabolite increased with age (P > 0.05). The 1,25(OH)₂D fell with age for males (P < 0.02), but not for females. Pregnant or lactating females had significantly elevated 1,25(OH)₂D levels (P < 0.025).     

Urinary Calcium Excretion in Primary Hyperparathyroidism: Relationship to 25-Hydroxyvitamin D Status

ObjectiveTo determine the prevalence of vitamin D deficiency in patients with primary hyperparathyroidism (PHPT) and evaluate the relationship between urinary calcium excretion and serum 25-hydroxyvitamin D (25-OH-D) levels in patients with PHPT.MethodsWe present a case report and a review of the medical records of patients with PHPT. Of 75 patients with PHPT substantiated by hypercalcemia and increased levels of intact parathyroid hormone (iPTH), 35 were identified with laboratory evaluation of vitamin D levels and 24-hour urinary calcium excretion. These study subjects were stratified as 25-OH-D deficient, insufficient, or replete (on the basis of serum values of < 15, 15 to 25, or > 25 ng/mL, respectively). Total 24-hour urinary calcium excretion and the fractional excretion of calcium (FECa) were analyzed as a function of 25-OH-D status.ResultsOf the 35 study subjects, 14 (40%) and 13 (37%) had 25-OH-D deficiency or insufficiency, respectively. Those patients with a 25-OH-D level < 15 ng/mL had higher serum iPTH concentrations as well as lower urinary calcium excretion and FECa. No significant correlations were found, however, between 25-OH-D status and iPTH concentrations (r = -0.21; P = 0.23), total 24-hour urinary calcium excretion (r = 0.07; P = 0.7), or FECa (r = 0.04; P = 0.8).ConclusionVitamin D deficiency (25-OH-D levels < 15 ng/mL) was common in our population of patients with PHPT. Urinary calcium excretion was not significantly altered by 25-OH-D deficiency in patients with newly recognized PHPT. Measurements of total urinary calcium excretion and FECa can be reliably used to rule out familial benign hypocalciuric hypercalcemia in the initial evaluation of PHPT, regardless of 25-OH-D status. Determining 25-OH-D concentrations best assesses the vitamin D status. (Endocr Pract. 2005;11:37-42)     

Serum 25-Hydroxyvitamin D Deficiency in Chinese Patients with Vitiligo: A Case-Control Study

Background

Low vitamin D levels have been noted in patients with a variety of autoimmune diseases. A recent study showed that low vitamin D levels may be associated with vitiligo.

Objectives

To assess 25-hydroxyvitamin D (25(OH)D) status in Chinese patients with vitiligo in comparison of normal controls and explore possible affecting factors.

Methods

We performed a case-control study including 171 patients, 50 controls in 25(OH)D lowest months and 30 patients, 20 controls in 25(OH)D highest months. Demographic and clinical variables of patients were analyzed to determine the correlation with 25(OH) D levels.

Results

25(OH)D mean value of patients was highest in September and October, lowest in March. None of the patients and normal controls had ‘sufficient’ 25(OH)D (> = 75 nmol/L). No significant difference was found in either 25(OH)D mean values or insufficiency/deficiency ratio between patients and controls in 25(OH)D highest and lowest periods. Female patients were at a higher risk of 25(OH)D deficiency than male patients(P = 0.019). For non-segmental type, patients with 25(OH)D deficiency were more likely to have autoimmune thyroid disease than those with insufficiency (P = 0.016). Sex (P = 0.035), thyroid conditions (p = 0.034), testing month (p = 0.049) were independent factors affecting 25(OH)D level in multivariate analysis.

Conclusion

Chinese population lack 25(OH)D universally. 25(OH)D level shows no correlation with onset of vitiligo in Chinese. However deficient 25(OH)D level may be linked to autoimmune disorders in patients.     

Serum Levels of 25-Hydroxyvitamin D and Functional Outcome among Postmenopausal Women with Hip Fracture

Objective

The main objective of the current study was to assess the distribution and its prognostic value of serum 25-hydroxyvitamin D (25[OH] D) levels assessed at admission in Chinese postmenopausal women with hip fracture.

Methods

From January 1, 2012 to December 31, 2013, all postmenopausal women with first-ever hip fracture were recruited to participate in the study. Serum 25[OH] D levels were measured at admission. The functional evaluation at the time of discharge was performed by the Barthel Index (BI). The prognostic value of 25[OH] D to predict the functional outcome within discharge was analyzed by logistic regression analysis, after adjusting for the possible confounders.

Results

In our study, 261 patients were included and assessed. In the 76 patients with an unfavorable functional outcome, serum 25(OH) D levels were lower compared with those in patients with a favorable outcome [11.8(IQR, 9.9–16.1)ng/ml; 16.8(IQR, 13.6–21.4)ng/ml, respectively; P<0.0001]. In multivariate analysis, there was an increased risk of unfavorable outcome associated with serum 25(OH) D levels ≤ 20ng/ml (OR 5.24, 95%CI: 3.11–8.15; P<0.0001) after adjusting for possible confounders.

Conclusions

Our data support an association between serum 25[OH] D levels and prognosis in Chinese postmenopausal women with hip fracture.     

Long Term Association between Serum 25-Hydroxyvitamin D and Mortality in a Cohort of 4379 Men

Objective

A number of observational studies have shown an inverse association between circulating 25-hydroxyvitamin D and total mortality, but a reverse J-shaped association has also been reported. In a large nested case-control study, serum-25-hydroxyvitamin D (s-25(OH)D) was positively associated with incident prostate cancer. Based on the same study population, the primary aim of the present study was to investigate the association between s-25(OH)D and total mortality.

Methods

Men participating in population based health screenings during 1981–1991 and enrolled in a nested case-control study were followed throughout 2007 with respect to all-cause and cause-specific mortality. Hazard ratios (HR) with 95% confidence intervals (CI) were calculated using Cox proportional hazards regression.

Results

In men with prostate cancer (n = 2282), there was a significant inverse association between s-25(OH)D and total mortality after controlling for potential confounders (HR = 1.25 (95% CI 1.05–1.50), s-25(OH)D <50 nmol/l versus s-25(OH)D ≥50 nmol/l). The corresponding figure among controls (n = 2147) was HR = 1.15 (95% CI 0.88–1.50) and in the total study population HR = 1.19 (95% CI 1.03–1.38). For cause-specific deaths, we found no significant associations.

Conclusions

In this study population, s-25(OH)D was inversely associated with total mortality during more than two decades of follow-up, despite, as previous reported, high s-25(OH)D was associated with increased risk of prostate cancer.