Calcium Metabolism of Pregnant Rats Fed a Vitamin D-Depleted Diet
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Abstract:
The effects of vitamin D (VD) deficiency on calcium (Ca) metabolism during pregnancy were evaluated in rats fed VD-repleted (VD-repleted rats) and VD-depleted (VD-depleted rats) diets. In the VD-depleted rats, the plasma concentrations of 1,25-dihydroxyvitamin D and Ca decreased severely, whereas the parathyroid hormone concentrations increased. The Ca contents of the feces of the VD-depleted rats were higher than those of the VD-repleted rats. The fetal Ca contents of the VD-repleted and VD-depleted rats increased continuously, but that of the VD-depleted rats was lower. These data reveal that VD deficiency during pregnancy induces severe hypocalcemia due to reduced intestinal absorption of Ca and elevated fetal demand for Ca.Prevalence and risk factors for vitamin D deficiency in patientswith widespread musculoskeletal pain
Background/aim: The aim of this study was to examine the prevalence of 25-hydroxyvitamin D (25(OH) vitamin D) deficiency in patients complaining of widespread musculoskeletal pain. Materials and methods: In this cross-sectional study, 14,925 patients (13,589 females and 1336 males; mean age: 47.0 years, range: 20-99 years) were included. Serum 25(OH) vitamin D was measured by ELISA. The patients were classified into two groups: 1) patients with vitamin D deficiency (<20 ng/mL) and 2) patients without vitamin D deficiency (>20 ng/mL). Results: The prevalence of vitamin D deficiency was 73.9%. A multivariate logistic regression model showed that low 25(OH) vitamin D level was associated with sex, age, and month in which 25(OH) hypovitaminosis was determined. The risk of a low 25(OH) vitamin D was level was 1.74 times higher in female patients than in males. The risk of low 25(OH) vitamin D level was highest in March during the year. Conclusion: Our results indicate that vitamin D deficiency should be considered in patients with widespread musculoskeletal pain and some precautions, such as sunbathing during summer, should be recommended for patients with a risk of vitamin D deficiency.
Hypovitaminosis
Cross-sectional study
Sunbathing
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Background
Vitamin D plays a key role in osteoporosis and also contributes to sarcopenia, muscle weakness, fatigue and depression. Patients with COPD are likely to be at higher risk of Vitamin D deficiency due to reduced mobility especially outdoors, with previous studies in the London area demonstrating prevalence rates around 60%.1 However, within our population group in the North East of England, little is known about the prevalence of Vitamin D deficiency.Aims
To identify the prevalence of serum 25-hydroxyvitamin D (25(OH)-D) deficiency in patients admitted with an acute exacerbation of COPD.Method
We identified 50 patients admitted with an exacerbation of COPD. Data on demographics and prescription of vitamin D supplementation was recorded. 25(OH)-D titres were measured.Results
50 patients included, mean age 73.6 years (age range 45–95 years). 44% of patients were prescribed vitamin D supplementation (95% of supplementation was in the form of combined calcium and vitamin D). Overall 62% of patients were found to have low 25(OH)-D titres. Of those not taking vitamin D supplementation, only 14% of patient had sufficient 25(OH)-D titres (≥50 nmol/L). 11% were 25(OH)-D insufficient (30–50 nmol/L), 57% were 25(OH)-D deficient (8–30 nmol/L) and 18% were profoundly deficient (<8 nmol/L). Of those patients taking vitamin D supplementation, 68% were found to have sufficient 25(OH)-D titres, whilst 32% still had inadequate 25(OH)-D highlighting potential issues with compliance or insufficient replacement.Conclusions
We have demonstrated a very high prevalence of vitamin D deficiency amongst our patients with COPD, with 86% of our patients having inadequate vitamin D titres who were not on vitamin D supplementation. This is leading them to increased exposure to the risks of vitamin D deficiency, including the impact on bone health in at already 'at-risk' population. In response to this, locally we are now measuring 25(OH)-D titres routinely on patients with COPD and prescribing vitamin D supplementation when indicated, forming part of our new multisystem, comprehensive, holistic assessment of COPD patients.Reference
Joliffe, et al. Prevalence, determinants and clinical correlates of Vitamin D deficiency in patients with chronic obstructive pulmonary disease in London, UK., 2017. J Steroid Biochem Mol Biochem.Cite
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Calcifediol
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Sunlight
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Background: Many benefits are ascribed to vitamin D beyond its well-known effects on calcium and bone metabolism.Vitamin D in adequate amounts is apparently beneficial to muscle, lessening the risk of falls and fractures in the elderly.The elderly produce less vitamin D in their skin than younger persons do, and they also spend less time in the sun; they are therefore at greater risk of vitamin D deficiency.Methods: We used gas chromatography with mass spectrometry coupling to measure the 25-OH-vitamin D level of 1578 elderly persons (72% women) who were consecutively admitted to an elderly care rehabilitation facility in Trier, Germany, from July 2009 to March 2011.Their mean and median age was 82 years.Results: 89% of the patients had 25-OH-vitamin D deficiency (defined as a level below 20 ng/mL), and 67% had a severe deficiency (below 10 ng/mL).Only 4% had levels in the target range (30-60 ng/mL); none had a level above 100 ng/mL.Conclusion: Many of these patients were deficient in vitamin D. Persons of very advanced age need a better supply of vitamin D not only to keep their bones healthy, but also to lessen the risk of falls and fractures.►Cite this as:
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Aim: The aim of this study was to test the hypothesis that vitamin D deficiency is associated with abnormal levels of calcium and parathyroid hormone (PTH). Methods: Vitamin D requests at a tertiary hospital in South Africa over 2 years were retrospectively analysed along with calcium and PTH levels. Results: Only when the 25-hydroxyvitamin D (25(OH)D) level dropped below 25 nmol/l, was there a significant rise in PTH. A subnormal 25(OH)D level was also not always related to hypocalcaemia, as more than half of patients with their 25(OH)D level below 25 nmol/l had calcium levels in the reference range. However, all patients with calcium levels below 1.8 mmol/l were shown to have vitamin D insufficiency. Conclusion: Hypovitaminosis D may co-exist with a blunted PTH response. Therefore, assumptions about vitamin D status should not be made based on PTH and calcium values. 25(OH)D measurements should be requested when vitamin D deficiency is clinically suspected, irrespective of biochemical results.
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To clarify the nutritional status of vitamin D in Japanese, effects of dietary intake of vitamin D on plasma levels of intact and highly sensitive parathyroid hormone (I-PTH and HS-PTH), 25-hydroxyvitamin D (25-OH-D), 1,25-dihydroxyvitamin D (1,25(OH)2D), calcium (Ca) and phosphorus (P(i)) in 79 healthy Japanese were investigated. The plasma levels of 25-OH-D in men were significantly higher than those in women, whereas those of HS-PTH in men were significantly lower than those in women. The levels of 25-OH-D in men were generally higher than those in women. Significant correlations were observed between the dietary vitamin D intake and the plasma 25-OH-D or HS-PTH levels. Correlations between the plasma 25-OH-D levels and the plasma HS-PTH levels were also significant. These results suggest that dietary intake of sufficient amounts of vitamin D is effective for improving the vitamin D nutritional status through normalizing PTH levels.
Calcifediol
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Vitamin D is obtained from cutaneous production when 7-dehydrocholesterol is converted to vitamin D(3) (cholecalciferol) by ultraviolet B radiation or by oral intake of vitamin D. Rickets appeared to have been conquered with vitamin D intake, and many health care professionals thought the major health problems resulting from vitamin D deficiency had been resolved. However, rickets can be considered the tip of the vitamin D deficiency iceberg. In fact, vitamin D deficiency remains common in children and adults. An individual’s vitamin D status is best evaluated by measuring the circulating 25-hydroxyvitamin D (25(OH)D 3 ) concentration. There is increasing agreement that the optimal circulating 25(OH)D 3 level should be approximately 30 ng/mL or above. Using this definition, it has been estimated that approximately three-quarters of all adults have low levels. In utero and during childhood, vitamin D deficiency can cause growth retardation and skeletal deformities and may increase the risk of hip fracture later in life. Vitamin D deficiency in adults can exacerbate osteopenia and osteoporosis, cause osteomalacia and muscle weakness, and increase the risk of fracture. More recently, associations between low vitamin D status and increased risk for various non-skeletal morbidities have been recognized; whether all of these associations are causally related to low vitamin D status remains to be determined. The discovery that most tissues and cells in the body have vitamin D receptors and that several possess the enzymatic machinery to convert the 25-hydroxyvitamin D 3 , to the active form, 1,25-dihydroxyvitamin D 3 , has provided new insights into the function of this vitamin. Of great interest is its role in decreasing the risk of many chronic illnesses, including common cancers, autoimmune diseases, infectious diseases, and cardiovascular disease. In this review I consider the nature of vitamin D deficiency, discuss its role in skeletal and non-skeletal health, and suggest strategies for prevention and treatment. Orv. Hetil., 2011, 152, 1312–1319.
Osteomalacia
Osteopenia
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