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Yeganeh MH, Sinaei R, Rouhi M, Shiari R, Parvaneh VJ, Rahmani K, Sheikhbahaei E. Investigating the comparative effect of vitamin D level with the type of complications in Henoch Schönlein purpura and Kawasaki disease. Reumatol Clin (Engl Ed) 2024; 20:199-203. [PMID: 38644031 DOI: 10.1016/j.reumae.2024.04.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/14/2023] [Revised: 12/23/2023] [Accepted: 12/29/2023] [Indexed: 04/23/2024]
Abstract
INTRODUCTION AND OBJECTIVES Henoch Schönlein purpura (HSP) and Kawasaki disease (KD) are two main inflammatory diseases among childhood vasculitis. Considering the anti-inflammatory effects of 25-hydroxyvitamin D3, we decided to investigate the association of serum 25-hydroxy vitamin D3 level with the type and severity of these conditions. MATERIALS AND METHODS The present study was performed as a historical cohort of 254 affected children with KD and HSP vasculitis. The required data were extracted, using a researcher-made questionnaire from patients' electronic file, and then they were analyzed after collecting information of the patients. RESULTS In HSP group, 54% of participants were boys. Similarly, in KD group, boys were more affected than girls. The comparative 25-hydroxyvitamin vitamin D3 level in HSP patients with and without renal involvement (P=0.02), hematuria (P=0.14), and in two groups with and without heart disease, and also with and without coronary artery dilatation in KD patients (P<0.001) were significant. DISCUSSION AND CONCLUSIONS The findings showed that insufficient level of vitamin D3 were significantly associated with the exacerbation of complications of both diseases, and therefore it seems that vitamin D deficiency can be an effective predictive factor of severity in HSP and KD patients.
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Affiliation(s)
| | - Reza Sinaei
- Department of Pediatrics, School of Medicine, Kerman University of Medical Sciences, Kerman, Iran; Clinical Research Development Unit, Afzalipour Hospital, Kerman University of Medical Sciences, Kerman, Iran
| | - Mitra Rouhi
- Department of Pediatrics, School of Medicine, Mofid Children's Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | - Reza Shiari
- Department of Pediatric Rheumatology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Vadood Javadi Parvaneh
- Department of Pediatrics, School of Medicine, Mofid Children's Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Khosro Rahmani
- Department of Pediatric Rheumatology, School of Medicine, Mofid Children's Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Erfan Sheikhbahaei
- School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
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Mansilla-Polo M, Luque-Luna M, Morgado-Carrasco D. Vitamin D and Skin Cancer: A Controversial Society. Literature Update and Review. Actas Dermosifiliogr 2024:S0001-7310(24)00265-5. [PMID: 38556198 DOI: 10.1016/j.ad.2024.03.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Revised: 03/12/2024] [Accepted: 03/17/2024] [Indexed: 04/02/2024] Open
Abstract
Vitamin D (VD) deficiency has been associated with various tumors. However, the association between VD and skin cancer is controversial. Although in non-melanoma skin cancer, adequate or even high levels of VD can be associated with a higher risk of developing tumors, this could be biased by the direct association between sun exposure and VD levels. Regarding melanoma, results are contradictory. Most studies analyzed state that higher levels of VD could reduce the risk of melanoma, be associated with melanomas with better prognosis and with an enhanced antitumor response, and also with fewer adverse events associated with melanoma immunotherapy. However, prospective studies of adequate methodological quality are still needed to assess the association between VD levels and its supplementation and development/prognosis in skin cancer.
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Affiliation(s)
- M Mansilla-Polo
- Servicio de Dermatología, Hospital Universitario y Politécnico La Fe, Valencia, España; Instituto de Investigación Sanitaria (IIS) La Fe, Valencia, España
| | - M Luque-Luna
- Servicio de Dermatología, Hospital Clínic, Universitat de Barcelona, Barcelona, España
| | - D Morgado-Carrasco
- Servicio de Dermatología, Hospital Clínic, Universitat de Barcelona, Barcelona, España; Servicio de Dermatología, Hospital de Figueres, Fundació Salut Empordà, Figueres, Girona, España.
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Massa A, Isasi-Fuster A, Requena C, Manrique-Silva E, Kumar R, Nagore E. Nodular type but not vitamin D levels increases the risk of second primary cancers in melanoma patients: An observational study of 663 patients. Actas Dermosifiliogr 2024; 115:143-149. [PMID: 37832865 DOI: 10.1016/j.ad.2023.10.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2023] [Accepted: 10/08/2023] [Indexed: 10/15/2023] Open
Abstract
BACKGROUND Vitamin D deficiency associates with the risk of developing many diseases, including cancer. At the molecular level, vitamin D appears to have an antineoplastic effect. However, the role of vitamin D deficiency in cancer pathogenesis remains unelucidated and numerous studies have resulted in discordant results. This study aimed to determine whether vitamin D deficiency during melanoma diagnosis increases the risk of developing non-cutaneous second primary cancers (SPC). MATERIALS AND METHODS A retrospective study on 663 patients diagnosed with melanoma between 1 January 2011 and 31 October 2022. The effect of each variable on the development of a subsequent non-cutaneous cancer was performed using Kaplan-Meier curves and differences were assessed by log-rank tests. Cox proportional hazard univariate and multivariate models were used to quantify the effect of each variable in the time to develop a non-cutaneous neoplasia. RESULTS Out of 663 patients, 34 developed a non-cutaneous SPC. There was no statistically significant association between vitamin D levels and non-cutaneous SPC development (log-rank, p=0.761). Age>60 years, stage III/IV, and nodular melanoma subtype were significantly associated with the development of a SPC. After multivariate analysis, only age>60 years (HR 3.4; HR CI 95%: 1.5-7.6) and nodular melanoma subtype (HR 2.2; HR CI 95%: 1.0-4.8) were included in the final model. CONCLUSIONS Our results suggest that vitamin D deficiency is not associated with an increased risk of developing non-cutaneous SPC in melanoma patients. However, age over 60 years and nodular melanoma subtype increase the risk for non-cutaneous SPC development.
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Affiliation(s)
- A Massa
- Section of Dermatology, Department of Clinical and Experimental Medicine, University of Parma, Parma, Italy
| | - A Isasi-Fuster
- School of Medicine, Universidad Católica de Valencia San Vicente Mártir, València, Spain
| | - C Requena
- Department of Dermatology, Fundación Instituto Valenciano de Oncología, València, Spain
| | - E Manrique-Silva
- Department of Dermatology, Fundación Instituto Valenciano de Oncología, València, Spain
| | - R Kumar
- Institute of Medical Biometry, University of Heidelberg, Heidelberg, Germany; Institute of Experimental Medicine, Czech Academy of Sciences, Prague, Czech Republic
| | - E Nagore
- School of Medicine, Universidad Católica de Valencia San Vicente Mártir, València, Spain; Department of Dermatology, Fundación Instituto Valenciano de Oncología, València, Spain.
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Massa A, Isasi-Fuster A, Requena C, Manrique-Silva E, Kumar R, Nagore E. Nodular Type but Not Vitamin D Levels Increases the Risk of Second Primary Cancers in Melanoma Patients: An Observational Study of 663 Patients. Actas Dermosifiliogr 2024; 115:T143-T149. [PMID: 38048949 DOI: 10.1016/j.ad.2023.10.038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2023] [Accepted: 10/08/2023] [Indexed: 12/06/2023] Open
Abstract
BACKGROUND Vitamin D deficiency associates with the risk of developing many diseases, including cancer. At the molecular level, vitamin D appears to have an antineoplastic effect. However, the role of vitamin D deficiency in cancer pathogenesis remains unelucidated and numerous studies have resulted in discordant results. This study aimed to determine whether vitamin D deficiency during melanoma diagnosis increases the risk of developing non-cutaneous second primary cancers (SPC). MATERIALS AND METHODS A retrospective study on 663 patients diagnosed with melanoma between 1 January 2011 and 31 October 2022. The effect of each variable on the development of a subsequent non-cutaneous cancer was performed using Kaplan-Meier curves and differences were assessed by log-rank tests. Cox proportional hazard univariate and multivariate models were used to quantify the effect of each variable in the time to develop a non-cutaneous neoplasia. RESULTS Out of 663 patients, 34 developed a non-cutaneous SPC. There was no statistically significant association between vitamin D levels and non-cutaneous SPC development (log-rank, p=0.761). Age>60 years, stage III/IV, and nodular melanoma subtype were significantly associated with the development of a SPC. After multivariate analysis, only age>60 years (HR 3.4; HR CI 95%: 1.5-7.6) and nodular melanoma subtype (HR 2.2; HR CI 95%: 1.0-4.8) were included in the final model. CONCLUSIONS Our results suggest that vitamin D deficiency is not associated with an increased risk of developing non-cutaneous SPC in melanoma patients. However, age over 60 years and nodular melanoma subtype increase the risk for non-cutaneous SPC development.
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Affiliation(s)
- A Massa
- Section of Dermatology, Department of Clinical and Experimental Medicine, University of Parma, Parma, Italy
| | - A Isasi-Fuster
- Facultad de Medicina, Universidad Católica de Valencia San Vicente Mártir, València, Spain
| | - C Requena
- Servicio de Dermatología, Fundación Instituto Valenciano de Oncología, València, Spain
| | - E Manrique-Silva
- Servicio de Dermatología, Fundación Instituto Valenciano de Oncología, València, Spain
| | - R Kumar
- Institute of Medical Biometry, University of Heidelberg, Heidelberg, Germany; Institute of Experimental Medicine, Czech Academy of Sciences, Prague, Czech Republic
| | - E Nagore
- Facultad de Medicina, Universidad Católica de Valencia San Vicente Mártir, València, Spain; Servicio de Dermatología, Fundación Instituto Valenciano de Oncología, València, Spain.
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Manero-Azua Á, Pereda A, González Cabrera N, Martínez de Salinas Santamaría MÁ, Cámara Balda A, Pérez de Nanclares G. Vitamin D deficiency in adulthood: Presentation of 2familial cases simulating pseudohypoparathyroidism. Med Clin (Barc) 2023; 161:493-497. [PMID: 37500374 DOI: 10.1016/j.medcli.2023.06.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Revised: 06/15/2023] [Accepted: 06/18/2023] [Indexed: 07/29/2023]
Abstract
BACKGROUND AND OBJECTIVE The clinical and biochemical overlap of various pathologies of phosphocalcic metabolism can lead to misdiagnosis and consequent clinical management. One example is pseudohypoparathyroidism, which can be confused with vitamin D-dependent rickets (VDDR1) if appropriate biochemical determinations are not performed. PATIENTS AND METHODS Two pairs of siblings, from independent families, were clinically diagnosed in adolescence with pseudohypoparathyroidism due to hypocalcaemia, elevated parathyroid hormone levels and normal or elevated phosphorus values. After ruling out alterations in GNAS, a massive sequencing study of genes associated with other differential diagnoses was carried out. RESULTS Two genetic variants in the CYP27B1 gene potentially associated with the phenotype were identified. Pathogenic variants in this gene are associated with VDDR1A. Clinical-biochemical re-evaluation of the patients confirmed this diagnosis and treatment was adapted. CONCLUSIONS Although VDDR1A is an infrequently diagnosed pathology in adulthood, in cases of hypocalcaemia with elevated PTH values, determination of the 1,25(OH)2D3 and 25(OH)D3 forms of vitamin D is relevant to reach a correct diagnosis.
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Affiliation(s)
- África Manero-Azua
- Grupo de Investigación en Enfermedades Raras, Laboratorio de (epi) Genética Molecular, Instituto de Investigación Sanitaria Bioaraba, Hospital Universitario Araba-Txagorritxu, Vitoria-Gasteiz, Álava, España
| | - Arrate Pereda
- Grupo de Investigación en Enfermedades Raras, Laboratorio de (epi) Genética Molecular, Instituto de Investigación Sanitaria Bioaraba, Hospital Universitario Araba-Txagorritxu, Vitoria-Gasteiz, Álava, España
| | - Natalia González Cabrera
- Servicio de Endocrinología y Nutrición, Hospital Universitario Araba-Txagorritxu, Vitoria-Gasteiz, Álava, España
| | | | - Alejandro Cámara Balda
- Servicio de Endocrinología y Nutrición, Hospital de San Pedro, Logroño, La Rioja, España
| | - Guiomar Pérez de Nanclares
- Grupo de Investigación en Enfermedades Raras, Laboratorio de (epi) Genética Molecular, Instituto de Investigación Sanitaria Bioaraba, Hospital Universitario Araba-Txagorritxu, Vitoria-Gasteiz, Álava, España.
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Ruiz-Tagle C, Romero F, Naves R, Balcells ME. Vitamin D and cathelicidin levels and susceptibility to Mycobacterium tuberculosis infection acquisition in household contacts. Enferm Infecc Microbiol Clin (Engl Ed) 2023; 41:489-493. [PMID: 36707289 DOI: 10.1016/j.eimce.2022.04.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Accepted: 04/27/2022] [Indexed: 01/26/2023]
Abstract
INTRODUCTION Vitamin D deficiency has been proposed to confer susceptibility to acquiring tuberculosis infection by impairing the innate immune response. METHODS In an exploratory study, we examined whether the levels of 25-hydroxyvitamin D3 (25(OH)D3) in serum, and cathelicidin - an antimicrobial peptide-induced under calcitriol - in the nasal fluid, would associate with the risk of acquiring tuberculosis infection. RESULTS Within a prospective cohort of 231 tuberculosis household contacts tested with repeated interferon-gamma release assays, we serially analyzed all the uninfected contacts acquiring tuberculosis infection at follow-up ("converters", n=18), and an age and sex-matched control group of contacts not acquiring tuberculosis infection ("non-converters", n=36). The median levels of serum 25(OH)D3 did not differ between convertors and non-converters at baseline (14.9 vs. 13.2 ng/ml, p=0.41), nor at follow-up (19.0 vs 18.6ng/ml, p=0.83). Similarly, cathelicidin levels did not differ between both groups. CONCLUSION These data argue against a major role for hypovitaminosis D in tuberculosis infection susceptibility.
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Affiliation(s)
- Cinthya Ruiz-Tagle
- Departamento de Enfermedades Infecciosas del Adulto, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Francisco Romero
- Facultad de Ciencias Biológicas, Universidad Andrés Bello, Santiago, Chile
| | - Rodrigo Naves
- Instituto de Ciencias Biomédicas, Facultad de Medicina, Universidad de Chile, Santiago, Chile
| | - María Elvira Balcells
- Departamento de Enfermedades Infecciosas del Adulto, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile.
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Mangas-Sánchez C, Garriga-García M, Serrano-Nieto MJ, Garcia-Romero R, Álvarez Beltrán M, Crehuá-Gaudiza E, Vicente-Santamaría S, Martínez-Costa C, Díaz-Martín JJ, Bousoño-García C, González-Jiménez D. Safety and efficacy of a new supplementation protocol in patients with cystic fibrosis and vitamin D deficiency. An Pediatr (Barc) 2023; 98:257-266. [PMID: 36932016 DOI: 10.1016/j.anpede.2023.02.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Accepted: 12/23/2022] [Indexed: 03/17/2023] Open
Abstract
OBJECTIVES Based on the European and American Cystic Fibrosis (CF) consensus recommendations, an increase in vitamin D (VD) supplementation in patients with CF and insufficient or defficient levels was proposed. The objective of our study was to determine the safety and efficacy of this new protocol. MATERIAL AND METHODS Multicentre nonrandomized uncontrolled experimental study. Patients with insufficient levels (<30 ng/mL) received increasing doses of VD (between 800 and 10 000 IU/day). Patients were followed up for 12 months, during which their vitamin and nutritional status, pulmonary function and calcium and phosphate metabolism were assessed. STATISTICAL ANALYSIS t test for paired data and multivariate logistic regression analysis. RESULTS Thirty patients aged 1-39 years (median, 9.1) completed the follow-up. Two patients were dropped from the study on account of 25-OH VD levels greater than 100 ng/mL at 3 months without clinical or laboratory signs of hypercalcaemia. At 12 months, we observed an increase of 7.6 ng/mL (95% CI, 4.6-10 ng/mL) in the mean 25-OH VD level and an improvement in vitamin status: 37% achieved levels of 30 ng/mL or greater, 50% levels between 20 and 30 ng/mL and 13% remained with levels of less than 20 ng/mL. We found no association between improved VD levels and pulmonary function. CONCLUSIONS The proposed protocol achieved an increase in serum VD levels and a decrease in the percentage of patients with VD insufficiency, although it was still far from reaching the percentages of sufficiency recommended for this entity.
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Affiliation(s)
- Carmen Mangas-Sánchez
- Unidad de Gastroenterología y Nutrición Pediátrica, Hospital Central de Asturias, Oviedo, Spain.
| | | | | | - Ruth Garcia-Romero
- Unidad de Gastroenterología y Nutrición Pediátrica, Hospital Miguel Servet, Zaragoza, Spain
| | - Marina Álvarez Beltrán
- Unidad de Gastroenterología y Nutrición Pediátrica, Hospital Vall d'Hebron. Barcelona, Spain
| | - Elena Crehuá-Gaudiza
- Sección de Gastroenterología y Nutrición Pediátrica, Hospital Clínico Universitario de Valencia, Valencia, Spain
| | | | - Cecilia Martínez-Costa
- Sección de Gastroenterología y Nutrición Pediátrica, Hospital Clínico Universitario de Valencia, Valencia, Spain
| | - Juan José Díaz-Martín
- Unidad de Gastroenterología y Nutrición Pediátrica, Hospital Central de Asturias, Oviedo, Spain
| | - Carlos Bousoño-García
- Unidad de Gastroenterología y Nutrición Pediátrica, Hospital Central de Asturias, Oviedo, Spain
| | - David González-Jiménez
- Unidad de Gastroenterología y Nutrición Pediátrica, Hospital Central de Asturias, Oviedo, Spain
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Carrazco-Peña KB, Farías-Moreno K, Toro-Equihua MD, Aguilar-Mancilla ZC, Trujillo-Magallón M, Solórzano-Rodríguez MA, Trujillo-Hernández B. Components of frailty, sarcopenia and their association with vitamin D deficiency. Cross-sectional, analytical study. GAC MED MEX 2023; 158:343-348. [PMID: 36657111 DOI: 10.24875/gmm.m22000711] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
Abstract
INTRODUCTION In older adults, the association of frailty and sarcopenia with vitamin D deficiency is well known, but the association of the components of frailty syndrome has been poorly studied. OBJECTIVE To determine the association of the components of frailty and sarcopenia with vitamin D insufficiency in older adults. METHODS Adults were studied, in whom age, education, marital status, history of fractures, hospitalizations, anthropometric indicators, sarcopenia, Charlson index, polypharmacy, Fried's frailty phenotype, and plasma vitamin D were recorded; figures < 30 ng/mL were considered indicative of vitamin D insufficiency. Descriptive and inferential statistics were used for statistical analysis. The association was determined by binary logistic regression. RESULTS One-hundred and seventy-five adults with a mean age of 71.7 ± 6.7 years (95% CI = 60-90 years) were studied. Binary logistic regression showed that the variables associated with vitamin D deficiency were exhaustion (OR = 2.6, 95% CI = 1.0-6.5, p = 0.03), frailty (OR = 9.2, 95% CI = 2.5-34.1, p = 0.001) and pre-frailty (OR = 4.6, 95% CI = 2.1-10.0, p < 0.001). CONCLUSION The frail and pre-frail phenotypes, as well as exhaustion, are associated with vitamin D insufficiency.
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Affiliation(s)
| | | | | | - Zahira C Aguilar-Mancilla
- Specialty Hospital 14, Centro Médico Nacional "Adolfo Ruiz Cortines", Instituto Mexicano del Seguro Social, Veracruz
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Oteo-Álvaro Á, Marín Becerra MT, Fernández-Fernández T, Arrieta-Bartolomé G. Evaluation of factors related to the occurrence of new fragility fractures: A case-control study. Rev Esp Cir Ortop Traumatol (Engl Ed) 2023; 67:12-20. [PMID: 35973553 DOI: 10.1016/j.recot.2022.08.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2022] [Revised: 08/01/2022] [Accepted: 08/05/2022] [Indexed: 01/07/2023] Open
Abstract
INTRODUCTION Fragility fractures (FF) are frequent in osteoporotic patients. There are a series of risk factors and clinical variables that could predict their appearance. MATERIAL AND METHOD A retrospective observational study of cases and controls was carried out. Cases were defined by the presence of FF (326 participants) and controls by patients with similar characteristics without FF (629 participants). RESULTS Certain factors increase the risk of FF, such as a previous diagnosis of type 2 DM (OR: 2.001), 1ng/mL elevations of CTX (OR: 1.88), having a parental history of hip fracture (OR: 1.667), 5-year increase in age (OR: 1.39), and 1kg/m2 increases in BMI (OR: 1.041). In contrast, other factors evaluated decreased this risk, such as maintaining 25(OH)D levels≥30ng/mL (OR: 0.686) and a T-score≥-2.5 (OR: 0.642). CONCLUSIONS Levels of 25(OH)D≥30ng/mL and a T-score at the femoral neck≥-2.5 are protective factors for FF, while a previous diagnosis of type 2 DM, an elevated CTX, a parental history of hip fracture, an increase of 1kg/m2 in BMI and an increase in age by 5 years would be predisposing to FF.
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Oteo-Álvaro Á, Marín Becerra MT, Fernández-Fernández T, Arrieta-Bartolomé G. [Translated article] Evaluation of factors related to the occurrence of new fragility fractures: A case-control study. Rev Esp Cir Ortop Traumatol (Engl Ed) 2023; 67:T12-T20. [PMID: 36244607 DOI: 10.1016/j.recot.2022.10.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2022] [Accepted: 08/05/2022] [Indexed: 11/06/2022] Open
Abstract
INTRODUCTION Fragility fractures (FF) are frequent in osteoporotic patients. There are a series of risk factors and clinical variables that could predict their appearance. MATERIAL AND METHOD A retrospective observational study of cases and controls was carried out. Cases were defined by the presence of FF (326 participants) and controls by patients with similar characteristics without FF (629 participants). RESULTS Certain factors increase the risk of FF, such as a previous diagnosis of type 2 DM (OR: 2.001), 1ng/mL elevations of CTX (OR: 1.88), having a parental history of hip fracture (OR: 1.667), 5-year increase in age (OR: 1.39), and 1kg/m2 increases in BMI (OR: 1.041). In contrast, other factors evaluated decreased this risk, such as maintaining 25(OH)D levels≥30ng/mL (OR: 0.686) and a T-score≥-2.5 (OR: 0.642). CONCLUSIONS Levels of 25(OH)D≥30ng/mL and a T-score at the femoral neck≥-2.5 are protective factors for FF, while a previous diagnosis of type 2 DM, an elevated CTX, a parental history of hip fracture, an increase of 1kg/m2 in BMI and an increase in age by 5 years would be predisposing to FF.
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Affiliation(s)
- Á Oteo-Álvaro
- Hospital Universitario HM Madrid, HM Hospitales, Madrid, Spain.
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Martin-Romero A, Perelló-Martínez J, Hidalgo-Santiago JC, Michan-Doña A, Bosco López Sáez J, Gómez-Fernández P. Effect of the administration of different forms of vitamin D on central blood pressure and aortic stiffness, and its implication in the reduction of albuminuria in chronic kidney disease. Clin Investig Arterioscler 2022; 34:311-321. [PMID: 35817704 DOI: 10.1016/j.arteri.2022.05.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Revised: 04/24/2022] [Accepted: 05/04/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND AND OBJECTIVES Vitamin D(vitD) participates in phospho-calcium metabolism and exerts multiple pleiotropic effects. There is tissue 1-α (OH)ase that converts 25-OH cholecalciferol (25 (OH) D) in calcitriol that exerts autocrine and paracrine effects. 25 (OH)D deficiency could limit these tissue effects of vitD. The administration of nutritional vitD and the activator of the vitD receptor, paricalcitol, may promote beneficial effects on vascular and renal function. The objective of this work was to study in subjects with chronic kidney disease (CKD) the effect that the administration of different forms of vitD has on arterial function and albuminuria, and the possible relationship between the modifications of these variables. PATIENTS AND METHODS We studied in 97 patients with CKD stages 3-4 the effect of the administration of cholecalciferol (group 2; n: 35) and paricalcitol (n: 31; group 3) on parameters derived from brachial blood pressure, aortic blood pressure and on aortic stiffness studied using carotid-femoral pulse velocity (Vpc-f), and on albuminuria. A group of patients with stages 3-4 CKD who did not receive vitD therapy served as a control group (n: 31; group 1). All parameters were studied at baseline and after the follow-up period which was 7 ± 2 months. RESULTS In the baseline phase, no differences were observed between the groups in brachial systolic blood pressure (bSBP), central systolic blood pressure (SBP), brachial pulse pressure (bPP), and central pulse pressure (pCP) or in aortic stiffness that was increased in all groups with a baseline Vpc-f value of 10.5 (9.2-12.1) m/sec. The baseline albuminuria value in the grouped patients was 229 (43-876) mg / g (median (interquartile range)), with no differences between the groups. Serum calcium and phosphorus increased significantly in those treated with cholecal-ciferol (native vitD) and paricalcitol (active vitD). Parathormone (PTH) values decreased in those treated with paricalcitol.bPP and cPP decreased in all groups treated with native and active vitD. No significant changes in bPP and cPP were observed in the control group. Vpc-f did not change significantly in any of the groups, although the variation was quantitatively greater in group 3 (11.2±2 vs. 10.7±1.6 (P=.06)). No differences were observed in the changes in Vpc-f between the groups when adjusted to the baseline values of estimated glomerular filtration rate (eGFR), albuminuria, PTH, vitD, brachial and central blood pressure parameters, and their changes with treatment.Those who received treatment with native and active vitD presented a significant decrease in albuminuria of 17% (group 2) and 21% (group 3) compared to a 16% increase in the untreated group (group 1) (P=.01). A decrease in albuminuria ≥30% was observed more frequently in the groups treated with some form of vitD (group 2: 23%; group 3: 45%) than in the control group (13%) (P=.03). The decrease in albuminuria observed in the groups treated with any of the forms of vitD did not vary when the baseline values of the biochemical parameters of phosphorus-calcium metabolism, those of arterial function (PPb, PPc, Vpc-f) or its modifications were introduced as covariates. There was no significant correlation between changes in Vpc-f and albuminuria. In logistic regression, changes in arterial function parameters were also not explanatory for the ≥30% decrease in albuminuria. CONCLUSIONS In patients with CKD stages 3-4, treated with RAS blockers and with residual albuminuria, the administration of or paricalcitol reduces brachial and aortic pulse pressures, and albuminuria. The decrease in albuminuria does not seem to be mediated, at least not decisively, by changes in central hemodynamics or aortic stiffness.
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Affiliation(s)
| | | | | | - Alfredo Michan-Doña
- Unidad de Medicina Interna, Hospital Universitario, Jerez de la Frontera, Cádiz, España
| | | | - Pablo Gómez-Fernández
- Unidad de Factores de Riesgo Vascular, Hospital Universitario, Jerez de la Frontera, Cádiz, España.
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Manzanos I, Martino P, Audisio E, Bonet J. Vitamin D: Between the brightness of the sun and the darkness of depression. Rev Colomb Psiquiatr (Engl Ed) 2022; 51:199-205. [PMID: 36075856 DOI: 10.1016/j.rcpeng.2020.08.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Accepted: 08/10/2020] [Indexed: 06/15/2023]
Abstract
INTRODUCTION The scientific literature suggests a relationship between vitamin D (VitD) and the onset, treatment and prognosis of depression. However, this line of research continues to be controversial. The aim of the study was to analyse the relationship between depression and VitD values, controlling for the influence of the season. MATERIAL AND METHODS Observational and cross-sectional study. The sample was made up of 150 adult female volunteer participants (aged between 28 and 78 years). The sample was stratified into three groups: a) depression without treatment, b) depression under treatment with antidepressants, and c) without depression (control). VitD values (ng/ml) were compared. RESULTS Significant differences were found between the three groups surveyed. The group of participants with depression without treatment obtained the lowest VitD values (mean 18.62ng/ml; SD 8.42), compatible with severe insufficiency. The group of participants with depression in treatment obtained higher values than the previous group, although in an insufficient range (mean 23.80ng/ml; SD 11.30). The third group (control) obtained the highest values and in accordance with the desirable range (mean 30.19ng/ml; SD 10.21). There were no age differences between the groups. When controlling for possible effects of the season, the previous differences in VitD between the three groups were maintained, with an evident decrease of all the mean levels in the winter period. CONCLUSIONS Depression is associated with insufficient VitD values. Treatment with antidepressants improves these values, although they continue to be insufficient. The findings of this study reinforce the evidence for an association between depression and VitD.
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Affiliation(s)
- Inés Manzanos
- Centro de Endocrinología, Junín, Buenos Aires, Argentina.
| | - Pablo Martino
- Centro de Investigación en Neurociencias de Rosario (CINR), Facultad de Psicología, Universidad Nacional de Rosario, Rosario, Santa Fe, Argentina
| | - Eduardo Audisio
- Facultad de Psicología, Universidad Nacional de Rosario, Rosario, Santa Fe, Argentina
| | - José Bonet
- Centro de Estrés de la Fundación Favaloro, Universidad Favaloro, Ciudad Autónoma de Buenos Aires, Argentina
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13
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Moro R, Sánchez-Silva A, Aguerralde-Martin M, González-Cuevas R, Peruilh-Bagolini L, Traves V, Manrique-Silva E, Requena C, Nagore E. Prognostic Value of Vitamin D Serum Levels in Cutaneous Melanoma. Actas Dermosifiliogr 2022; 113:347-353. [PMID: 35623724 DOI: 10.1016/j.ad.2021.11.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Revised: 09/28/2021] [Accepted: 11/01/2021] [Indexed: 01/03/2023] Open
Abstract
INTRODUCTION Vitamin D plays a fundamental role in many metabolic pathways, including those involved in cell proliferation and the immune response. Serum levels of this vitamin have been linked to melanoma risk and prognosis. This study aimed to assess the prognostic value of vitamin D serum level in melanoma. MATERIAL AND METHODS Retrospective, observational, longitudinal, and analytical study of 286 patients with a histologic diagnosis of melanoma in whom serum levels of vitamin D were measured at the time of diagnosis. We analyzed associations between serum level and epidemiologic and clinical variables and pathology findings; we also analyzed the influence of vitamin D on overall survival. An iterative loop was used to identify a vitamin D serum level to test for its an association with survival. RESULTS A vitamin D level less than 9.25ng/mL was associated with a histologic finding of ulceration. After a median follow-up period of 39.4 months, 24 patients (8.4%) had died. The cutoff of 9.25ng/mL was associated with lower overall survival according to both the Kaplan-Meier curves and multivariate Cox regression analysis. CONCLUSION Vitamin D levels less than 9.25ng/mL are associated with ulceration in melanoma and serve as an independent prognostic factor for overall survival in this disease.
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Affiliation(s)
- R Moro
- Escuela de Doctorado, Universidad Católica de Valencia San Vicente Mártir, Valencia, España; Clinica San Carlo, Paderno Dugnano, Italia
| | - A Sánchez-Silva
- Facultad de Medicina, Universidad Católica de Valencia San Vicente Mártir, Valencia, España
| | - M Aguerralde-Martin
- Máster de Ingeniería de Análisis de Datos, Toma de Decisiones y Mejora de Procesos, Universidad Politécnica de Valencia, Valencia, España
| | - R González-Cuevas
- Servicio de Dermatología, Hospital del Salvador, Santiago, Chile; Facultad de Medicina, Universidad de Chile, Santiago, Chile
| | - L Peruilh-Bagolini
- Facultad de Medicina, Universidad de Chile, Santiago, Chile; Fundación Arturo López Pérez (FALP), Oncologic Institute, Santiago, Chile
| | - V Traves
- Servicio de Anatomía Patológica, Instituto Valenciano de Oncología, Valencia, España
| | - E Manrique-Silva
- Escuela de Doctorado, Universidad Católica de Valencia San Vicente Mártir, Valencia, España; Servicio de Dermatología, Instituto Valenciano de Oncología, Valencia, España
| | - C Requena
- Servicio de Dermatología, Instituto Valenciano de Oncología, Valencia, España
| | - E Nagore
- Máster de Ingeniería de Análisis de Datos, Toma de Decisiones y Mejora de Procesos, Universidad Politécnica de Valencia, Valencia, España; Servicio de Dermatología, Instituto Valenciano de Oncología, Valencia, España.
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García Estévez DA, López Díaz LM, Pardo Parrado M, Pérez Lorenzo G, Sabbagh Casado NA, Ozaita Arteche G, Rodríguez Gómez D. Epidemiology of myasthenia gravis in the province of Ourense (Galicia, Spain). Neurologia (Engl Ed) 2022:S2173-5808(22)00013-X. [PMID: 35249845 DOI: 10.1016/j.nrleng.2020.06.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2019] [Accepted: 06/12/2020] [Indexed: 11/20/2022] Open
Abstract
INTRODUCTION Myasthenia gravis (MG) is an autoimmune disease affecting nerve transmission at the level of the neuromuscular junction, and typically causes fluctuating muscle weakness. Epidemiological studies show an increase in MG prevalence, particularly among the older population. OBJECTIVE We performed a retrospective epidemiological study to determine the incidence and prevalence of MG in the province of Ourense (Galicia, Spain), characterised by population ageing. MATERIAL AND METHODS Patients were selected from our clinical neuromuscular diseases database by searching for patients with an active prescription for pyridostigmine bromide. Incidence was estimated for the period 2009-2018. We calculated prevalence at 31/12/2018. According to census data for the province of Ourense, the population on 1/1/2019 was 307 651, of whom 96 544 (31.4%) were aged ≥ 65 years. RESULTS We identified 80 cases of MG, with a prevalence rate of 260 cases/1 000 000 population (95% CI, 202.7-316.4), rising to 517.9/1 000 000 population in those aged ≥ 65 (95% CI, 363.2-672.9). Cumulative incidence in the study period was 15.4 cases per 1 000 000 person-years. Early onset (≤ 50 years) was recorded in 29.1% of cases. CONCLUSION The prevalence of MG in our health district is one of the highest published figures, and the disease is highly prevalent in the older population.
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Korkmaz FN, Ozen G, Unal AU, Odabasi A, Can M, Asıcıoglu E, Tuglular S, Direskeneli H. Vitamin D levels in patients with small and medium vessel vasculitis. Reumatol Clin (Engl Ed) 2022; 18:141-146. [PMID: 35277211 DOI: 10.1016/j.reumae.2020.11.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/27/2020] [Accepted: 11/12/2020] [Indexed: 06/14/2023]
Abstract
OBJECTIVES To determine the prevalence of vitamin D deficiency in patients with small and medium vessel systemic vasculitis. METHODS In this cross-sectional study, 25-hydroxy (OH) vitamin D3 levels were measured in adult patients with systemic small and medium vessel vasculitis including antineutrophil cytoplasmic antibody-associated vasculitis (AAV), cryoglobulinaemic vasculitis (CryV), IgA vasculitis (IgAV) and polyarteritis nodosa (PAN), and age- and sex-matched healthy subjects (HS) and patients with rheumatoid arthritis (RA) as control groups. 25OH vitamin D3 levels<30ng/ml and <20ng/ml were regarded as insufficiency and deficiency, respectively. RESULTS Fifty-seven patients (42 AAV, 2 CryV, 8 IgA vasculitis, 5 PAN) with systemic vasculitis, 101 HS, and 111 RA patients were included. The mean 25OH vitamin D3 level was 21.8±14.2ng/mL in patients with vasculitis, 42.7±27.6ng/mL in HS (p<.001) and 20.1±18.47ng/mL in patients with RA (p=.54). Vitamin D insufficiency and deficiency were significantly higher in patients with systemic vasculitis compared to HS (75.4% vs 33.7%, p<.001; %50 vs 21.8%, p<.001, respectively). Vitamin D status was not different in patients with systemic vasculitis compared to RA. There was a negative correlation between vitamin D status and CRP levels (=-.364, p=.007). The multivariate logistic regression analysis showed that renal involvement was significantly associated with vitamin D deficiency/insufficiency in patients with vasculitis (OR 22.5 [95% CI 1.6-128.9]. CONCLUSION Vitamin D deficiency and insufficiency are more frequent in patients with systemic small and medium vessel vasculitis and RA than HS. Renal involvement is one of the factors associated with vitamin D deficiency/insufficiency in patients with vasculitis.
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Affiliation(s)
- Fatma Nur Korkmaz
- Ankara University, School of Medicine, Department of Internal Medicine, Division of Endocrinology, Ankara, Turkey.
| | - Gulsen Ozen
- University of Nebraska Medical Center, Department of Internal Medicine, Omaha, NE, USA
| | - Ali Ugur Unal
- Marmara University, School of Medicine, Department of Internal Medicine, Division of Rheumatology, Istanbul, Turkey
| | - Asli Odabasi
- Marmara University, School of Medicine, Department of Internal Medicine, Istanbul, Turkey
| | - Meryem Can
- Medipol Mega Hospitals Complex, Department of Rheumatology, İstanbul, Turkey
| | - Ebru Asıcıoglu
- Marmara University, School of Medicine Hospital, Department of Internal Medicine, Division of Nephrology, Istanbul, Turkey
| | - Serhan Tuglular
- Marmara University, School of Medicine Hospital, Department of Internal Medicine, Division of Nephrology, Istanbul, Turkey
| | - Haner Direskeneli
- Marmara University, School of Medicine, Department of Internal Medicine, Division of Rheumatology, Istanbul, Turkey
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16
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Martínez-Rodríguez EJ, Gutiérrez-Mejía J, Ríos-Castañeda C, Rojas-Maya S, Soto-Mota A. Evaluation of the usefulness of vitamin D as a predictor of mortality in patients with COVID-19. GAC MED MEX 2022; 158:31-35. [PMID: 35404928 DOI: 10.24875/gmm.m22000637] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Accepted: 07/08/2021] [Indexed: 01/19/2023] Open
Abstract
INTRODUCTION One of the functions of vitamin D is to regulate respiratory epithelium inflammatory response; therefore, deficiency of this vitamin in the context of COVID-19 could constitute a predictive biomarker of the disease outcome. OBJECTIVE To evaluate the usefulness of vitamin D for predicting mortality in patients with COVID-19. METHODS Observational, retrospective study in which 154 patients diagnosed with COVID-19 were included, out of whom 111 survived and 43 died. Vitamin D concentration was determined in all of them. RESULTS A log-rank p-value < 0.032 was obtained for survival when vitamin D concentration was used as a categorical variable (≤ 20 ng/mL and > 20 ng/mL). On Cox proportional analysis, age and vitamin D concentration were shown to be risk factors associated with mortality in patients with COVID-19 (age: HR = 1.036, 95% CI = 1.016-1.058, p < 0.001; vitamin D: HR (≤ 20 ng/mL and > 20 ng/mL) = 0.478, 95% CI = 0.237-0.966, p < 0.040). CONCLUSION Age and vitamin D concentration were predictive factors for mortality in COVID-19-infected patients.
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Affiliation(s)
- Erick J Martínez-Rodríguez
- Department of Hospital Reaction for Disasters, Instituto Nacional de Ciencias Médicas y Nutrición "Salvador Zubirán"
| | - Juan Gutiérrez-Mejía
- Department of Hospital Reaction for Disasters, Instituto Nacional de Ciencias Médicas y Nutrición "Salvador Zubirán"
| | - Camilo Ríos-Castañeda
- Neurochemistry Department, Instituto Nacional de Neurología y Neurocirugía "Manuel Velasco Suárez"
| | - Sonia Rojas-Maya
- Clinical Laboratory Department, Instituto Nacional de Ciencias Médicas y Nutrición "Salvador Zubirán". Mexico City, Mexico
| | - Adrián Soto-Mota
- Department of Hospital Reaction for Disasters, Instituto Nacional de Ciencias Médicas y Nutrición "Salvador Zubirán"
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El Mokadem M, Boshra H, Abd El Hady Y, Abd El Hameed AS. Relationship of serum vitamin D deficiency with coronary artery disease severity using multislice CT coronary angiography. Clin Investig Arterioscler 2021; 33:282-288. [PMID: 33906751 DOI: 10.1016/j.arteri.2021.02.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Revised: 02/05/2021] [Accepted: 02/11/2021] [Indexed: 12/29/2022]
Abstract
AIM To assess the relationship between vitamin D deficiency and severity of coronary artery disease using multislice CT coronary angiography. METHODS 100 patients diagnosed with coronary artery disease during multislice CT coronary angiography were subjected to full evaluation of coronary artery disease severity followed by measurement of serum vitamin D level. RESULTS The mean value of serum vitamin D level was 13.35±7.49ng/ml. 76% of the patients had vitamin D deficiency (<20ng/ml). 41% of the patients had single vessel disease, 28% had two vessel diseases, and 31% had multi-vessel disease. Patients with vitamin D deficiency had higher degree of coronary stenosis, higher coronary Ca score (p<0.001) and higher number of affected vessels compared with normal vitamin D level subgroup (p<0.001). Vitamin D level showed a significant negative correlations with age (r=-0.290, p=0.003), coronary Ca score (r=-0.630, p<0.001) and severity of coronary lesions. Multivariate linear regression analysis showed that dyslipidemia and vitamin D level were independent predictors of percent severity of coronary stenosis. CONCLUSION In addition to traditional cardiovascular risk factors, vitamin D deficiency looks to be independent predictor of coronary artery disease severity including percent stenosis, number of the affected vessels as well as degree of coronary calcification.
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Affiliation(s)
- Mostafa El Mokadem
- Cardiology Department, Faculty of Medicine, Beni-Suef University, Beni-Suef, Egypt.
| | - Hesham Boshra
- Cardiology Department, Faculty of Medicine, Beni-Suef University, Beni-Suef, Egypt
| | - Yasser Abd El Hady
- Cardiology Department, Faculty of Medicine, Beni-Suef University, Beni-Suef, Egypt
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Abril Rubio A, Arjona González P, Castillo Fernández N, Salmerón Portela P, Hidalgo Martín F, Mancera Romero J. [Adequacy of the prescription of vitamin D in Primary Care]. Semergen 2021; 48:38-44. [PMID: 34465546 DOI: 10.1016/j.semerg.2021.07.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Revised: 07/20/2021] [Accepted: 07/26/2021] [Indexed: 10/20/2022]
Abstract
OBJECTIVES To evaluate the adequacy of vitamin D treatment based on clinic evidence in a Primary Care Center as well as to analyze some characteristics of the prescriptions made. MATERIALS AND METHODS Descriptive cross-sectional study. Primary Care. Patients above 14 years old with vitamin D prescription. Main variable was the therapeutic adequacy with vitamin D compounds (adequacy was considered when there was a clinical indication for treatment and blood vitamin D levels below 20ng/ml). Other clinical variables were collected. Frequency and association measures were used for statistical analysis. Level of statistical significance was considered <0.05. RESULTS 430 patients, 346 women (80.5%, 95% CI=77-84). Record of vitamin D values in 216 (50.2%, 95% CI=45-55). Screening/treatment indications in 219 patients (50.9%, 95% CI=46-56), of those in 150 patients vitamin D values were recorded (68.5%, 95% CI=62-75), average (±SD) was 21.22±12ng/ml, deficiency criteria in 86 (57.3%, 95% CI=51-64), insufficiency in 37 (24.7%, 95% CI=19-30) and sufficiency in 27 (18%, 95% CI=13-23). 86 patients (20%, 95% CI=16-24) had treatment indications plus vitamin D deficiency with no differences between genders. CONCLUSIONS Only 20% of the patients had treatment indications plus vitamin D deficiency. Female predominance. Just over half had indications for screening of serological vitamin D values and/or indications for treatment with vitamin D compounds.
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Affiliation(s)
- A Abril Rubio
- Medicina Familiar y Comunitaria, CS Ciudad Jardín, DS Málaga-Guadalhorce, Málaga, España.
| | - P Arjona González
- Medicina Familiar y Comunitaria, CS Ciudad Jardín, DS Málaga-Guadalhorce, Málaga, España
| | - N Castillo Fernández
- Medicina Familiar y Comunitaria, CS Ciudad Jardín, DS Málaga-Guadalhorce, Málaga, España
| | - P Salmerón Portela
- Medicina Familiar y Comunitaria, CS Ciudad Jardín, DS Málaga-Guadalhorce, Málaga, España
| | - F Hidalgo Martín
- Medicina Familiar y Comunitaria, CS Colmenar, AGS Este de Málaga-Axarquía, Málaga, España
| | - J Mancera Romero
- Medicina Familiar y Comunitaria, CS Ciudad Jardín, DS Málaga-Guadalhorce, Málaga, España
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Naghedi A, Haghaninejad H, Varastehravan H, Naghedi A, Farshadi N. Effect of vitamin D supplements on left ventricular ejection fraction in patients with heart failure: A systematic review and meta-analysis of randomized controlled trials. Rev Port Cardiol 2021; 40:447-455. [PMID: 34274087 DOI: 10.1016/j.repce.2021.07.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Accepted: 10/26/2020] [Indexed: 12/17/2022] Open
Abstract
Cardiovascular diseases (CVD) are the most common cause of death worldwide. Among CVDs, heart failure (HF) is known to be the most common cause of hospitalization in patients over 65. Despite all proposed treatments for CVDs, mortality and morbidity still remain high. There are controversial reports available on vitamin D efficacy in patients with HF. In this systematic review and meta-analysis, we aimed to investigate whether vitamin D is effective at enhancing ejection fraction (EF) in patients with HF. We performed a systematic search across different databases (PubMed, SCOPUS, Web of Science, EMBASE, SciELO and Google Scholar) up to 1 Jan 2020 without any language or location limitations. Our suggested Population/Intervention/Comparison/Outcome/Type of study (PICOT) was P: patients with HF, I: vitamin D, C: placebo or no treatment, O: EF and T: clinical trials. To achieve the highest sensitivity, only keywords associate with P and I were selected for the search query. A total number of 5397 primary studies were found, of which 13 were elected for data synthesis. Clinical trials were published and available since 2005 up to 2019 and a total number of 1215 patients were included. Our results showed that vitamin D can significantly enhance left ventricular EF in HF patients by 3.304% (95% confidence interval [CI] 0.954, 5.654, p=0.006). Based on our observations, we conclude that before conducting a large number of high quality clinical trials and further meta-analysis, vitamin D should be prescribed to all patients with HF.
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Affiliation(s)
- Aryan Naghedi
- Department of Cardiology, Shahid Sadoughi Hospital, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
| | - Hasan Haghaninejad
- Department of Cardiology, Yazd Cardiovascular Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Hamidreza Varastehravan
- Department of Cardiology, Yazd Cardiovascular Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Arvin Naghedi
- Department of Mathematics, Yazd University, Yazd, Iran
| | - Nima Farshadi
- Department of Cardiology, Shahid Sadoughi Hospital, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
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Naghedi A, Haghaninejad H, Varastehravan H, Naghedi A, Farshadi N. Effect of vitamin D supplements on left ventricular ejection fraction in patients with heart failure: A systematic review and meta-analysis of randomized controlled trials. Rev Port Cardiol 2021; 40:447-55. [PMID: 34053778 DOI: 10.1016/j.repc.2020.10.014] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Cardiovascular diseases (CVD) are the most common cause of death worldwide. Among CVDs, heart failure (HF) is known to be the most common cause of hospitalization in patients over 65. Despite all proposed treatments for CVDs, mortality and morbidity still remain high. There are controversial reports available on vitamin D efficacy in patients with HF. In this systematic review and meta-analysis, we aimed to investigate whether vitamin D is effective at enhancing ejection fraction (EF) in patients with HF. We performed a systematic search across different databases (PubMed, SCOPUS, Web of Science, EMBASE, SciELO and Google Scholar) up to 1 Jan 2020 without any language or location limitations. Our suggested Population/Intervention/Comparison/Outcome/Type of study (PICOT) was P: patients with HF, I: vitamin D, C: placebo or no treatment, O: EF and T: clinical trials. To achieve the highest sensitivity, only keywords associate with P and I were selected for the search query. A total number of 5397 primary studies were found, of which 13 were elected for data synthesis. Clinical trials were published and available since 2005 up to 2019 and a total number of 1215 patients were included. Our results showed that vitamin D can significantly enhance left ventricular EF in HF patients by 3.304% (95% confidence interval [CI] 0.954, 5.654, p=0.006). Based on our observations, we conclude that before conducting a large number of high quality clinical trials and further meta-analysis, vitamin D should be prescribed to all patients with HF.
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Tarazona-Santabalbina FJ, Cuadra L, Cancio JM, Carbonell FR, Garrote JMPC, Casas-Herrero Á, Martínez-Velilla N, Serra-Rexach JA, Formiga F. VitaminD supplementation for the prevention and treatment of COVID-19: a position statement from the Spanish Society of Geriatrics and Gerontology. Rev Esp Geriatr Gerontol 2021; 56:177-182. [PMID: 33642133 PMCID: PMC8055189 DOI: 10.1016/j.regg.2021.02.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Revised: 01/31/2021] [Accepted: 02/03/2021] [Indexed: 02/07/2023]
Abstract
The coronavirus disease 2019 (COVID-19) produces severe respiratory symptoms such as bilateral pneumonia associated to a high morbidity and mortality, especially in patients of advanced age. Vitamin D deficiency has been reported in several chronic conditions associated with increased inflammation and dysregulation of the immune system. Vitamin D in modulates immune function too. Vitamin D receptor (VDR) is expressed by most immune cells, including B and T lymphocytes, monocytes, macrophages, and dendritic cells and the signalling of vitamin D and VDR together has an anti-inflammatory effect. Some studies have reported that vitamin D treatment could be useful for the prevention and treatment of COVID-19 because vitamin D plays an important role as a modulator of immunocompetence. Over the last few months, some studies have hypothesized the possible beneficial effect of vitamin D supplementation in patients with COVID-19 in order to improve the immune balance and prevent the hyperinflammatory cytokine storm. Some preliminary studies have already shown promising results with vitamin D supplementation in hospitalized COVID-19 patients. Vitamin D should be administered daily until adequate levels are achieved due to vitamin D behaves as a negative acute phase reactant (APR). Despite the lack of evidence on specific doses of vitamin D to treat COVID-19 in older adults, authors consider it is necessary to standardize the use in clinical practice. These recommendations advice supplement vitamin D in a protocoled fashion based on expert opinions, level of evidence 5.
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Affiliation(s)
- Francisco J Tarazona-Santabalbina
- Geriatric Service, Hospital Universitario de la Ribera, Alzira, Valencia, Spain. CIBERFES, Centro de Investigación Biomédica en Red Fragilidad y Envejecimiento Saludable, Madrid, Spain.
| | - Leonor Cuadra
- Departament of Geriatric Medicine and Palliative Care, Badalona Serveis Assistencials, Barcelona, Spain. Catalonia Geriatrics and Gerontology Society, Barcelona, Spain
| | - José Manuel Cancio
- Centro Sociosanitario El Carme, Servicio de Geriatría y Cuidados Paliativos de BSA (Badalona Servicios Asistenciales), Badalona, Spain; Badalona Welfare Services: Badalona Serveis Assistencials SA, Badalona, Spain
| | - Ferran Roca Carbonell
- Servicio de Geriatría Hospital Universitari de la Santa Creu, Vic, Spain; Hospital Universitari de Vic: Hospital General de Vic, Spain
| | - Juan Manuel Pérez-Castejón Garrote
- Doctor en Medicina por la UB Especialista en Geriatria, Jefe del Servicio de Geriatria y Cuidados Paliativos de Badalona Serveis Assistencials BSA, CSS El Carme Badalona, Spain; Badalona Welfare Services: Badalona Serveis Assistencials SA, Badalona, Spain
| | - Álvaro Casas-Herrero
- Navarrabiomed, Complejo Hospitalario de Navarra (CHN), (UPNA), IdiSNA, Pamplona, Spain; CIBER of Frailty and Healthy Aging (CIBERFES), Instituto de Salud Carlos III, Madrid, Spain; Hospital de Navarra: Complejo Hospitalario de Navarra, Spain
| | - Nicolás Martínez-Velilla
- Navarrabiomed, Complejo Hospitalario de Navarra (CHN), (UPNA), IdiSNA, Pamplona, Spain; CIBER of Frailty and Healthy Aging (CIBERFES), Instituto de Salud Carlos III, Madrid, Spain; Hospital de Navarra: Complejo Hospitalario de Navarra, Spain
| | - José Antonio Serra-Rexach
- Jefe del Servicio de Geriatría Hospital General Universitario Gregorio Marañón Profesor Titular de Medicina, Departarmento de Medicina, Facultad de Medicina Universidad Complutense CIBER-Fragilidad y Envejecimiento Saludable Madrid, Spain; Hospital General Universitario Gregorio Marañón: Hospital General Universitario Gregorio Maranon, Spain
| | - Francesc Formiga
- Programa de Geriatría, Servicio medicina Interna, Hospital de Bellvitge, L'Hospitalet de Llobregat, Barcelona, Spain; Systemic Diseases and Ageing Group, Cardiovascular, Respiratory and Systemic Diseases and Cellular Ageing Program, Translational Medicine Area, Bellvitge Biomedical Research Institute (IDIBELL), L'Hospitalet de Llobregat, Spain
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Rubio Herrera MA, Bretón Lesmes I. Obesity in the COVID era: A global health challenge. ENDOCRINOL DIAB NUTR 2021; 68. [PMID: 33162383 PMCID: PMC8032558 DOI: 10.1016/j.endien.2020.10.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/07/2023]
Abstract
Obesity is a chronic disease that leads to an increased risk of mortality and morbidity, and the impact of the COVID-19 pandemic may create a new health challenge. There is clear evidence showing that some biological and social factors associated with obesity involve an increased risk of COVID-19 infection, hospitalization, and greater severity compared to people with normal weight. Undoubtedly, obesity involves a low-grade proinflammatory state that produces a dysregulation of the immune system that compromises its ability to respond to respiratory infection by COVID-19 and so produces a worsening of the disease. In this review, the main epidemiological and pathophysiological data that associate obesity with COVID-19 are described.
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Affiliation(s)
- Miguel A Rubio Herrera
- Servicio de Endocrinología y Nutrición, Hospital Clínico San Carlos. IDISSC. Facultad de Medicina, Universidad Complutense, Madrid, España.
| | - Irene Bretón Lesmes
- Servicio de Endocrinología y Nutrición, Hospital Universitario Gregorio Marañón. Facultad de Medicina, Universidad Complutense, Madrid, España
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Korkmaz FN, Ozen G, Unal AU, Odabasi A, Can M, Asıcıoglu E, Tuglular S, Direskeneli H. Vitamin D Levels in Patients With Small and Medium Vessel Vasculitis. Reumatol Clin (Engl Ed) 2021; 18:S1699-258X(20)30275-8. [PMID: 33454206 DOI: 10.1016/j.reuma.2020.11.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/27/2020] [Revised: 11/11/2020] [Accepted: 11/12/2020] [Indexed: 11/28/2022]
Abstract
OBJECTIVES To determine the prevalence of vitamin D deficiency in patients with small and medium vessel systemic vasculitis. METHODS In this cross-sectional study, 25-hydroxy (OH) vitamin D3 levels were measured in adult patients with systemic small and medium vessel vasculitis including antineutrophil cytoplasmic antibody-associated vasculitis (AAV), cryoglobulinaemic vasculitis (CryV), IgA vasculitis (IgAV) and polyarteritis nodosa (PAN), and age- and sex-matched healthy subjects (HS) and patients with rheumatoid arthritis (RA) as control groups. 25OH vitamin D3 levels<30ng/ml and <20ng/ml were regarded as insufficiency and deficiency, respectively. RESULTS Fifty-seven patients (42 AAV, 2 CryV, 8 IgA vasculitis, 5 PAN) with systemic vasculitis, 101 HS, and 111 RA patients were included. The mean 25OH vitamin D3 level was 21.8±14.2ng/mL in patients with vasculitis, 42.7±27.6ng/mL in HS (p<.001) and 20.1±18.47ng/mL in patients with RA (p=.54). Vitamin D insufficiency and deficiency were significantly higher in patients with systemic vasculitis compared to HS (75.4% vs 33.7%, p<.001; %50 vs 21.8%, p<.001, respectively). Vitamin D status was not different in patients with systemic vasculitis compared to RA. There was a negative correlation between vitamin D status and CRP levels (=-.364, p=.007). The multivariate logistic regression analysis showed that renal involvement was significantly associated with vitamin D deficiency/insufficiency in patients with vasculitis (OR 22.5 [95% CI 1.6-128.9]. CONCLUSION Vitamin D deficiency and insufficiency are more frequent in patients with systemic small and medium vessel vasculitis and RA than HS. Renal involvement is one of the factors associated with vitamin D deficiency/insufficiency in patients with vasculitis.
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Affiliation(s)
- Fatma Nur Korkmaz
- Ankara University, School of Medicine, Department of Internal Medicine, Division of Endocrinology, Ankara, Turkey.
| | - Gulsen Ozen
- University of Nebraska Medical Center, Department of Internal Medicine, Omaha, NE, USA
| | - Ali Ugur Unal
- Marmara University, School of Medicine, Department of Internal Medicine, Division of Rheumatology, Istanbul, Turkey
| | - Asli Odabasi
- Marmara University, School of Medicine, Department of Internal Medicine, Istanbul, Turkey
| | - Meryem Can
- Medipol Mega Hospitals Complex, Department of Rheumatology, İstanbul, Turkey
| | - Ebru Asıcıoglu
- Marmara University, School of Medicine Hospital, Department of Internal Medicine, Division of Nephrology, Istanbul, Turkey
| | - Serhan Tuglular
- Marmara University, School of Medicine Hospital, Department of Internal Medicine, Division of Nephrology, Istanbul, Turkey
| | - Haner Direskeneli
- Marmara University, School of Medicine, Department of Internal Medicine, Division of Rheumatology, Istanbul, Turkey
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Reyes-Muñoz E, Sosa SEY, Flores-Robles CM, Arce-Sánchez L, Martínez-Cruz N, Gutiérrez-Castrellón P. Suplementos nutricionales para prevención de diabetes mellitus gestacional: lecciones aprendidas basadas en la evidencia. GAC MED MEX 2020; 156:S43-S50. [PMID: 33373343 DOI: 10.24875/gmm.m20000437] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Introduction Gestational diabetes mellitus (GDM) affects between 5 and 40% of pregnant women. Recently different interventions with nutritional supplements have been evaluated for prevention of GDM. Aim To perform a synthesis of the evidence on the efficacy of nutritional supplements (myo-inositol, probiotics, and vitamin D) in the prevention of GDM. Methods A systematic search in PubMed and Cochrane library was performed, including systematic reviews of randomized clinical trials (RCTs), published in English or Spanish until May 2020, using the keywords: "prevention", "gestational diabetes", "hyperglycemia and pregnancy", "supplementation", "probiotics", "myo-inositol" and "vitamin D". Results 10 systematic reviews that met the inclusion criteria were analyzed. Myo-inositol supplementation compared to placebo decreased the incidence of GDM (RR: 0.44 [0.27-0.87]; five RCTs), low quality of evidence. Although the supplementation with vitamin D or probiotics during pregnancy could reduce the incidence of GDM the evidence is limited. Conclusions Myo-inositol supplementation is effective for prevention of GDM in high-risk women. Supplementation with vitamin D or probiotics probably decreases the incidence of GDM.
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Affiliation(s)
- Enrique Reyes-Muñoz
- Coordinación de Endocrinología Ginecológica y Perinatal, Instituto Nacional de Perinatología Isidro Espinosa de los Reyes. Ciudad de México, México
| | - Salvador Espino Y Sosa
- Subdirección de Investigación clínica, Instituto Nacional de Perinatología Isidro Espinosa de los Reyes. Ciudad de México, México
| | - Claudia M Flores-Robles
- Coordinación de Endocrinología, Instituto Nacional de Perinatología Isidro Espinosa de los Reyes. Ciudad de México, México
| | - Lidia Arce-Sánchez
- Coordinación de Endocrinología, Instituto Nacional de Perinatología Isidro Espinosa de los Reyes. Ciudad de México, México
| | - Nayeli Martínez-Cruz
- Coordinación de Endocrinología, Instituto Nacional de Perinatología Isidro Espinosa de los Reyes. Ciudad de México, México
| | - Pedro Gutiérrez-Castrellón
- Centro de Investigación Translacional en Ciencias de la Salud, Hospital General Dr. Manuel Gea González. Ciudad de México, México.,Sociedad Latinoamericana de Gastroenterologia, Hepatología y Nutrición Pediátrica. Ciudad de México, México
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Oberti V, Sanchez Ortiz M, Allende V, Masquijo J. Prevalence of hypovitaminosis D in patients with juvenile osteochondritis dissecans. Rev Esp Cir Ortop Traumatol (Engl Ed) 2020; 65:132-137. [PMID: 33281101 DOI: 10.1016/j.recot.2020.07.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Revised: 07/05/2020] [Accepted: 07/07/2020] [Indexed: 10/22/2022] Open
Abstract
BACKGROUND Juvenile osteochondritis dissecans (JOCD) is an acquired joint disease of unknown etiology that affects skeletally immature patients and has the potential to progress to osteoarthritis. Recent studies have reported a high prevalence of vitaminD deficiency in patients with osteochondral lesions. The aim of our study was to determine serum vitaminD levels in patients diagnosed with JOCD. METHODS Serum 25(OH)D levels of 31 patients (22 males) presenting 40 lesions (29 JOCD of the knee, and 11 of the ankle) were evaluated. The average age was 11.9±2.9years. HypovitaminosisD was defined as a value less than 30ng/mL and was divided into vitaminD insufficiency (20 to 30ng/mL) and vitaminD deficiency (<20ng/mL). RESULTS HypovitaminosisD was present in 45.2% of the evaluated patients (32.2% insufficiency and 13% deficiency). No significant differences were found in the mean values and incidence of hypovitaminosis between those patients in which the sample was taken in warm or cold season (P=.267 and P=.875, respectively). Patients who required surgery had a higher incidence of hypovitaminosis than those treated conservatively (60% versus 31%, P=.054). There was no correlation in the incidence of hypovitaminosis with sex, location, stability of the lesion, or if the lesion was uni- or bilateral. CONCLUSION In our series, almost half of the patients diagnosed with JOCD presented abnormal serum levels of vitaminD. A two-fold incidence of hypovitaminosis was observed in patients requiring surgical treatment compared to patients managed conservatively. The association found in this study does not imply causation, but it should be considered within the set of actions for the treatment of these injuries.
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Affiliation(s)
- V Oberti
- Departamento de Ortopedia y Traumatología Infantil - Sanatorio Allende, Córdoba, Argentina
| | - M Sanchez Ortiz
- Departamento de Ortopedia y Traumatología Infantil - Sanatorio Allende, Córdoba, Argentina
| | - V Allende
- Departamento de Ortopedia y Traumatología Infantil - Sanatorio Allende, Córdoba, Argentina
| | - J Masquijo
- Departamento de Ortopedia y Traumatología Infantil - Sanatorio Allende, Córdoba, Argentina.
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Manzanos I, Martino P, Audisio E, Bonet J. Vitamin D: Between the Brightness of the sun and the Darkness of Depression. Rev Colomb Psiquiatr (Engl Ed) 2020; 51:S0034-7450(20)30086-X. [PMID: 33735022 DOI: 10.1016/j.rcp.2020.08.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Accepted: 08/10/2020] [Indexed: 11/15/2022]
Abstract
INTRODUCTION The scientific literature suggests a relationship between vitamin D (VitD) and the onset, treatment and prognosis of depression. However, this line of research continues to be controversial. The aim of the study was to analyse the relationship between depression and VitD values, controlling for the influence of the season. MATERIAL AND METHODS Observational and cross-sectional study. The sample was made up of 150 adult female volunteer participants (aged between 28 and 78 years). The sample was stratified into three groups: a) depression without treatment, b) depression under treatment with antidepressants, and c) without depression (control). VitD values (ng/ml) were compared. RESULTS Significant differences were found between the three groups surveyed. The group of participants with depression without treatment obtained the lowest VitD values (mean 18.62 ng/ml; SD 8.42), compatible with severe insufficiency. The group of participants with depression in treatment obtained higher values than the previous group, although in an insufficient range (mean 23.80 ng/ml; SD 11.30). The third group (control) obtained the highest values and in accordance with the desirable range (mean 30.19 ng/ml; SD 10.21). There were no age differences between the groups. When controlling for possible effects of the season, the previous differences in VitD between the three groups were maintained, with an evident decrease of all the mean levels in the winter period. CONCLUSIONS Depression is associated with insufficient VitD values. Treatment with antidepressants improves these values, although they continue to be insufficient. The findings of this study reinforce the evidence for an association between depression and VitD.
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Affiliation(s)
- Inés Manzanos
- Centro de Endocrinología, Junín, Buenos Aires, Argentina.
| | - Pablo Martino
- Centro de Investigación en Neurociencias de Rosario (CINR), Facultad de Psicología, Universidad Nacional de Rosario, Rosario, Santa Fe, Argentina
| | - Eduardo Audisio
- Facultad de Psicología, Universidad Nacional de Rosario, Rosario, Santa Fe, Argentina
| | - José Bonet
- Centro de Estrés de la Fundación Favaloro, Universidad Favaloro, Ciudad Autónoma de Buenos Aires, Argentina
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Santos CA, Nunes G, Barata AT, Fonseca J. Vitamin D in dysphagic patients who have undergone endoscopic gastrostomy for long-term enteral feeding. Gastroenterol Hepatol 2021; 44:13-9. [PMID: 33268156 DOI: 10.1016/j.gastrohep.2020.05.016] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/16/2020] [Revised: 05/02/2020] [Accepted: 05/08/2020] [Indexed: 11/21/2022]
Abstract
OBJECTIVE Vitamin D plays a major role in biological processes. Its deficiency is associated with increased morbidity and mortality. Patients who have undergone endoscopic gastrostomy (PEG) present with protein-energy malnutrition, and may be at risk for Vitamin D deficiency, due to their age, less sunlight exposure and lower dietary intake. We aimed to determine the prevalence of hypovitaminosis D in PEG-patients, its change under PEG-feeding, and its relationship with serum proteins and risk factors for Vitamin D deficiency. METHODS This was a prospective observational study, over 4 weeks, after gastrostomy. Data were collected at the initial PEG procedure (T0), and after 4 weeks (T1). Initial evaluation included age, gender, underlying disorder, NRS-2002, BMI, serum albumin, transferrin and Vitamin D. At T1 we assessed Vit. D, albumin, and transferrin. Vitamin D was performed with Electrochemiluminescence through Elecsys 2010 assay. Patients were fed with blended homemade meals. RESULTS 200 patients (118 males), 22-92 years of age, were studied. There were initial low values for Vit. D (181), albumin (96), transferrin (121), and BMI (124). A correlation was found between Vit. D and serum albumin (r=0.49, p=0.005) but not with transferrin (r=0.26, p=0.195). At T1 the subgroup who had Vit. D levels assessed (n=48) was part of the initial study group maintained low levels of Vitamin D despite nutritional intervention. CONCLUSION We recommend systematic Vitamin D supplementation of PEG fed patients using homemade meals or at least screening for hypovitaminosis D as a routine part of their care.
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García Estévez DA, López Díaz LM, Pardo Parrado M, Pérez Lorenzo G, Sabbagh Casado NA, Ozaita Arteche G, Rodríguez Gómez D. Epidemiology of myasthenia gravis in the province of Ourense (Galicia, Spain). Neurologia 2020; 38:S0213-4853(20)30215-2. [PMID: 32900528 DOI: 10.1016/j.nrl.2020.06.011] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2019] [Revised: 05/24/2020] [Accepted: 06/12/2020] [Indexed: 10/23/2022] Open
Abstract
INTRODUCTION Myasthenia gravis (MG) is an autoimmune disease affecting nerve transmission at the level of the neuromuscular junction, and typically causes fluctuating muscle weakness. Epidemiological studies show an increase in MG prevalence, particularly among the older population. OBJECTIVE We performed a retrospective epidemiological study to determine the incidence and prevalence of MG in the province of Ourense (Galicia, Spain), characterised by population ageing. MATERIAL AND METHODS Patients were selected from our clinical neuromuscular diseases database by searching for patients with an active prescription for pyridostigmine bromide. Incidence was estimated for the period 2009-2018. We calculated prevalence at 31/12/2018. According to census data for the province of Ourense, the population on 1/1/2019 was 307,651, of whom 96,544 (31.4%) were aged ≥ 65 years. RESULTS We identified 80 cases of MG, with a prevalence rate of 260 cases/1 000 000 population (95% CI, 202.7-316.4), rising to 517.9/1 000 000 population in those aged ≥ 65 (95% CI, 363.2-672.9). Cumulative incidence in the study period was 15.4 cases per 1 000 000 person-years. Early onset (≤ 50 years) was recorded in 29.1% of cases. CONCLUSION The prevalence of MG in our health district is one of the highest published figures, and the disease is highly prevalent in the older population.
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Affiliation(s)
- D A García Estévez
- Servicio de Neurología, Complejo Hospitalario Universitario de Ourense, Ourense, España.
| | - L M López Díaz
- Servicio de Neurología, Complejo Hospitalario Universitario de Ourense, Ourense, España
| | - M Pardo Parrado
- Servicio de Neurología, Complejo Hospitalario Universitario de Ourense, Ourense, España
| | - G Pérez Lorenzo
- Servicio de Neurología, Complejo Hospitalario Universitario de Ourense, Ourense, España
| | - N A Sabbagh Casado
- Servicio de Neurología, Complejo Hospitalario Universitario de Ourense, Ourense, España
| | - G Ozaita Arteche
- Servicio de Neurología, Complejo Hospitalario Universitario de Ourense, Ourense, España
| | - D Rodríguez Gómez
- Servicio de Neurología, Complejo Hospitalario Universitario de Ourense, Ourense, España
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Junges C, Machado TD, Nunes Filho PRS, Riesgo R, Mello EDD. Vitamin D deficiency in pediatric patients using antiepileptic drugs: systematic review with meta-analysis. J Pediatr (Rio J) 2020; 96:559-568. [PMID: 32171475 PMCID: PMC9432023 DOI: 10.1016/j.jped.2020.01.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2019] [Revised: 09/06/2019] [Accepted: 01/17/2020] [Indexed: 02/04/2023] Open
Abstract
OBJECTIVES To measure the prevalence of vitamin D deficiency (through the 25-hydroxyvitamin D metabolite) in pediatric patients using antiepileptic drugs. SOURCE OF DATA Meta-analysis of studies identified through search in the PubMed, Embase, LILACS, and Cochrane Library databases, on February 19, 2019. SUMMARY OF DATA A total of 748 articles were identified, 29 of which were relevant to the objectives of this study. The prevalence of vitamin D deficiency found was 0.32 (95% CI=0.25-0.41; I2=92%, p<0.01). In the subgroup analyses, the most significant results were observed in the group of patients using cytochrome P450-inducing antiepileptic drugs, with a prevalence of 0.33 (95% CI=0.21-0.47; I2=86%, p<0.01) and, considering the study design, in the subgroup of cohort studies, with a prevalence of 0.52 (95% CI=0.40-0.64; I2=76%, p<0.01). CONCLUSIONS Taking into account the deleterious effects of vitamin D deficiency on the bone health of individuals using antiepileptic drugs, it is suggested to include in their care 25-hydroxyvitamin D monitoring, cholecalciferol supplementation, and treatment of the deficiency, when present.
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Affiliation(s)
- Cíntia Junges
- Universidade Federal do Rio Grande do Sul (UFRGS), Programa de Pós-Graduação em Saúde da Criança e do Adolescente, Porto Alegre, RS, Brazil.
| | - Tania Diniz Machado
- Universidade Federal do Rio Grande do Sul (UFRGS), Programa de Pós-Graduação em Saúde da Criança e do Adolescente, Porto Alegre, RS, Brazil
| | | | - Rudimar Riesgo
- Universidade Federal do Rio Grande do Sul (UFRGS), Programa de Pós-Graduação em Saúde da Criança e do Adolescente, Porto Alegre, RS, Brazil
| | - Elza Daniel de Mello
- Universidade Federal do Rio Grande do Sul (UFRGS), Programa de Pós-Graduação em Saúde da Criança e do Adolescente, Porto Alegre, RS, Brazil
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Laviano E, Sanchez M, González-Nicolás MT, Palacian MP, López J, Gilaberte Y, Calmarza P, Rezusta A, Serrablo A. Surgical site infection in hepatobiliary surgery patients and its relationship with serum vitamin D concentration. Cir Esp 2020; 98:456-464. [PMID: 32723503 DOI: 10.1016/j.ciresp.2020.03.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2019] [Revised: 03/03/2020] [Accepted: 03/09/2020] [Indexed: 10/23/2022]
Abstract
INTRODUCTION While several studies have examined the correlation between vitamin D concentrations and post-surgical nosocomial infections, this relationship has yet to be characterized in hepatobiliary surgery patients. We investigated the relationship between serum vitamin D concentration and the incidence of surgical site infection (SSI) in patients in our hepatobiliary surgery unit. METHODS Participants in this observational study were 321 successive patients who underwent the following types of interventions in the hepatobiliary surgery unit of our center over a 1-year period: cholecystectomy, pancreaticoduodenectomy, total pancreatectomy, segmentectomy, hepatectomy, hepaticojejunostomy and exploratory laparotomy. Serum vitamin D levels were measured upon admission and patients were followed up for 1 month. Mean group values were compared using a Student's T-test or Chi-squared test. Statistical analyses were performed using the Student's T-test, the Chi-squared test, or logistic regression models. RESULTS Serum concentrations >33.5 nmol/l reduced the risk of SSI by 50%. Out of the 321 patients analyzed, 25.8% developed SSI, mainly due to organ-cavity infections (incidence, 24.3%). Serum concentrations of over 33.5 nmol/l reduced the risk of SSI by 50%. CONCLUSIONS High serum levels of vitamin D are a protective factor against SSI (OR, 0.99). Our results suggest a direct relationship between serum vitamin D concentrations and SSI, underscoring the need for prospective studies to assess the potential benefits of vitamin D in SSI prevention.
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Affiliation(s)
- Estefania Laviano
- Servicio de Cirugía General y Digestiva, Hospital Miguel Servet, Zaragoza, España.
| | - María Sanchez
- Servicio de Cirugía General y Digestiva, Hospital Miguel Servet, Zaragoza, España
| | | | | | - Javier López
- Medicina Familiar y Comunitaria, Sector II, Zaragoza, España
| | | | - Pilar Calmarza
- Servicio de Bioquímica, Hospital Miguel Servet, Zaragoza, España
| | - Antonio Rezusta
- Servicio de Microbiología, Hospital Miguel Servet, Zaragoza, España
| | - Alejandro Serrablo
- Servicio de Cirugía General y Digestiva, Hospital Miguel Servet, Zaragoza, España
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Sanz R, Mazzei L, Santino N, Ingrasia M, Manucha W. Vitamin D-mitochondria cross-talk could modulate the signaling pathway involved in hypertension development: a translational integrative overview. Clin Investig Arterioscler 2020; 32:144-155. [PMID: 32456803 DOI: 10.1016/j.arteri.2020.02.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/11/2019] [Revised: 02/12/2020] [Accepted: 02/27/2020] [Indexed: 12/25/2022]
Abstract
Vitamin D deficiency is a worldwide pandemic and results in osteoporosis, hypertension, and other cardiovascular diseases. At the cellular level, it produces significant oxidative stress, inflammatory markers, and mitochondrial damage. There is increasing evidence about the role of vitamin D in the regulation of the renin-angiotensin-aldosterone system (RAAS). Moreover, there is evidence of involvement in cardiovascular complications, as well as in the immune system disorders. Vitamin D values below 25ng/mL are related to an increase in vascular tone mediated by smooth muscle contraction. Furthermore, it can produce direct effects on vascular smooth muscle cells, RAAS over-regulation, modulation of calcium metabolism, and secondary hyperparathyroidism. All this predisposes patients to develop hypertrophy of the left ventricle and vascular wall, causing hypertension. In this work, a review is presented of the main mechanisms involved in the development of hypertension due to vitamin D deficiency. Among them are the link established between the levels of extra-mitochondrial inorganic phosphate, its main regulatory hormones -such as vitamin D-, the cardiovascular system, reactive oxygen species, and mitochondrial metabolism. The role of the mitochondrial vitamin D receptor and the regulation of the respiratory chain could influence arterial remodelling since its activation would reduce oxidative damage and preserve cell life. However, there are aspects not yet understood about the intricate signalling network that appeared simple in experimental trials, but complex in clinical studies. In this way, the completion of new studies as VITAL, could clarify, and thus support or refute the possible benefits of vitamin D in hypertensive cardiovascular disease.
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Affiliation(s)
- Raúl Sanz
- Laboratorio de Farmacología Experimental Básica y Traslacional, Área de Farmacología, Departamento de Patología, Facultad de Ciencias Médicas, Universidad Nacional de Cuyo, Centro Universitario, Mendoza, Argentina
| | - Luciana Mazzei
- Laboratorio de Farmacología Experimental Básica y Traslacional, Área de Farmacología, Departamento de Patología, Facultad de Ciencias Médicas, Universidad Nacional de Cuyo, Centro Universitario, Mendoza, Argentina; Instituto de Medicina y Biología Experimental de Cuyo, Consejo Nacional de Investigación Científica y Tecnológica (IMBECU-CONICET), Mendoza, Argentina
| | - Nicolás Santino
- Laboratorio de Farmacología Experimental Básica y Traslacional, Área de Farmacología, Departamento de Patología, Facultad de Ciencias Médicas, Universidad Nacional de Cuyo, Centro Universitario, Mendoza, Argentina
| | - Marco Ingrasia
- Laboratorio de Farmacología Experimental Básica y Traslacional, Área de Farmacología, Departamento de Patología, Facultad de Ciencias Médicas, Universidad Nacional de Cuyo, Centro Universitario, Mendoza, Argentina
| | - Walter Manucha
- Laboratorio de Farmacología Experimental Básica y Traslacional, Área de Farmacología, Departamento de Patología, Facultad de Ciencias Médicas, Universidad Nacional de Cuyo, Centro Universitario, Mendoza, Argentina; Instituto de Medicina y Biología Experimental de Cuyo, Consejo Nacional de Investigación Científica y Tecnológica (IMBECU-CONICET), Mendoza, Argentina.
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Aguilar Shea AL, Muñoz Moreno-Arrones O, Palacios Martínez D, Vaño-Galván S. [Vitamin D for daily practice]. Semergen 2020; 46:406-10. [PMID: 32234285 DOI: 10.1016/j.semerg.2020.02.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2019] [Revised: 02/06/2020] [Accepted: 02/11/2020] [Indexed: 11/20/2022]
Abstract
Vitamin D is a fat-soluble vitamin which has the regulation of calcium-phosphorus metabolism in the body as its main function. Vitamin D receptor is present in most of the nucleated cells of the body, and its role in multiple body processes is being discovered. The 3 main sources of vitamin D are ultraviolet sun radiation, diet, and supplementation. The skin, through solar radiation, provides 90% of the bodýs vitamin D needs. In cases of low vitamin D, sun exposure habits and diet must be reviewed, and pharmacological supplementation must be assessed. Measurement in the body is performed by determining 25-hydroxycholecalciferol with values below 20ng/ml being considered insufficient. Universal screening of vitamin D is not currently recommended, only in situations where a deficiency is suspected.
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Zhang Q, Wu Y, Lu Y, Fei X. Role of vitamin D in risk factors of patients with type 2 diabetes mellitus. Med Clin (Barc) 2020; 154:151-156. [PMID: 31255367 DOI: 10.1016/j.medcli.2019.04.019] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2018] [Revised: 04/03/2019] [Accepted: 04/04/2019] [Indexed: 10/26/2022]
Abstract
INTRODUCTION AND OBJECTIVES Previous observational studies have suggested that low vitamin D status is associated with high circulating C-reactive protein levels, as well as other plasma inflammatory cytokines. However, there is no study to explore the relationship between vitamin D status and Lp-PLA2, a new biomarker of vascular-specific inflammation. The aim of this study was to examine the association between vitamin D status and circulating Lp-PLA2 levels in subjects with type 2 diabetes mellitus. MATERIAL AND METHODS This descriptive cross-sectional study enrolled diabetic subjects who underwent physical examination at Taizhou People's Hospital between August 2016 and January 2017. Blood pressure, anthropometry, metabolic profiles, serum 25(OH)D levels and Lp-PLA2 mass levels were measured in all participants. RESULTS A total of 196 participants were recruited into this study. The vitamin D insufficiency group had higher serum LP-PLA2 levels than the vitamin D sufficiency group (t=-2.765, p=.005). A significant negative correlation was noted between Lp-PLA2 and 25(OH)D in the vitamin D insufficiency group (r=-0.364, p=0.009). However, no significant relationship between serum Lp-PLA2 concentration and 25(OH)D levels was observed in subjects with vitamin D sufficiency. CONCLUSIONS From this cohort of patients with type 2 diabetes, regardless of traditional cardiovascular risk factors, we observed a statistically significant inverse relation between Lp-PLA2 and 25(OH)D at levels <30ng/mL.
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Affiliation(s)
- Qingqing Zhang
- Department of Endocrinology, The Affiliated Taizhou People's Hospital of Nantong University, Taizhou 225300, Jiangsu, China.
| | - Yucheng Wu
- Department of Cardiology, The Affiliated Taizhou People's Hospital of Nantong University, Taizhou 225300, Jiangsu, China
| | - Yu Lu
- Department of Endocrinology, The Affiliated Taizhou People's Hospital of Nantong University, Taizhou 225300, Jiangsu, China
| | - Xiaoqiang Fei
- Department of Endocrinology, The Affiliated Taizhou People's Hospital of Nantong University, Taizhou 225300, Jiangsu, China
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García-Carrasco M, Mendoza-Pinto C, Soto-Santillán RP, Méndez-Martínez S, Benítez-Contreras I, Etchegaray-Morales I, González-Parra C, Gándara-Ramírez JL, Ruiz-Argüelles A. Vitamin D in systemic lupus erythematosus with and without lupus nephritis. Rev Med Inst Mex Seguro Soc 2020; 58:394-399. [PMID: 34543544 DOI: 10.24875/rmimss.m20000063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/30/2019] [Accepted: 03/11/2019] [Indexed: 06/13/2023]
Abstract
INTRODUCCIÓN Las concentraciones séricas subóptimas de vitamina D se presentan en múltiples enfermedades crónicas, como las enfermedades autoinmunitarias. Los objetivos del estudio fueron: 1) comparar las concentraciones séricas de 25-hidroxivitamina D (25OHD3) en pacientes con lupus eritematoso sistémico (LES) con y sin nefritis lúpica (NL), y 2) evaluar la asociación de las concentraciones séricas de 25OHD3 con la actividad de la enfermedad. MATERIAL Y MÉTODOS Estudio comparativo, transversal, que incluyó 48 mujeres con LES, con y sin NL. Se excluyeron aquellas con enfermedad renal crónica en estadio IV, cáncer, hiperparatiroidismo, embarazo o lactancia. La actividad fue evaluada con el instrumento SLEDAI-2K. La concentración sérica de 25OHD3 se determinó mediante inmunoanálisis quimioluminiscente. RESULTADOS La media de edad de las pacientes con y sin NL fue de 36.3 ± 8.6 años y 42.7 ± 7.6 años, respectivamente. Se observó una elevada prevalencia de valores subóptimos de 25OHD3 en todas las pacientes (93%). Las concentraciones séricas de 25OHD3 fueron diferentes entre pacientes con y sin NL: 21.5 ± 6.8 ng/ml frente a 19.2 ± 7.1 ng/ml (p = 0.362). No se encontró correlación entre la concentración sérica de 25OHD3 y la actividad de la enfermedad (r = -045, p = 0.761). CONCLUSIONES En pacientes con LES, las concentraciones séricas de 25OHD3 fueran diferentes entre pacientes con y sin NL; sin embargo, esta diferencia no fue significativa. Además, no se encontró correlación entre las concentraciones séricas de 25OHD3 y la actividad de la enfermedad evaluada por SLEDAI-2K. BACKGROUND Sub-optimal serum vitamin D levels occur in multiple chronic diseases such as autoimmune diseases. The objectives of this study were: 1) compare the serum concentration of 25-hidroxivitamin D (25OHD3) in patients with systemic lupus erythematosus (SLE) with and without lupus nephritis (LN), and 2) evaluate the association of serum concentration of 25OHD3 with the activity of the disease. MATERIAL AND METHODS A comparative, cross-sectional study was conducted, including 48 women with SLE, with and without clinical diagnosis of LN, according to the score of renal activity evaluated by SLEDAI-2K. Patients with stage IV chronic kidney disease, cancer, hyperparathyroidism, pregnancy and lactation were excluded. The activity was evaluated by the SLEDAI-2K instrument. The serum concentration of 25OHD3 was assessed by chemiluminescent immunoassay. RESULTS The mean age of patients with and without LN was 36.3 ± 8.6 and 42.7 ± 7.6 years, respectively. High prevalence of suboptimal 25OHD3 levels was observed (93%). 25OHD3 concentrations were different between patients with and without LN, 21.5 ± 6.8 ng/mL vs. 19.2 ± 7.1 ng/mL (p = 0.362). No correlation was found between serum 25OHD3 concentration (r = −045, p = 0.761). CONCLUSIONS There were no differences found in serum concentrations of 25OHD3 in patients with or without NL. Moreover, no correlation was found between serum 25OHD3 levels and the activity of the disease evaluated by SLEDAI-2K.
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Affiliation(s)
- Mario García-Carrasco
- Instituto Mexicano del Seguro Social, Centro Médico Nacional "Gral. Manuel Ávila Camacho", Hospital de Especialidades, Unidad de Investigación de Enfermedades Autoinmunes Sistémicas
| | - Claudia Mendoza-Pinto
- Instituto Mexicano del Seguro Social, Centro Médico Nacional "Gral. Manuel Ávila Camacho", Hospital de Especialidades, Unidad de Investigación de Enfermedades Autoinmunes Sistémicas
| | | | - Socorro Méndez-Martínez
- Instituto Mexicano del Seguro Social, Órgano de Operación Administrativa Desconcentrada Estatal Puebla, Coordinación Auxiliar Médica en Investigación en Salud
| | - Ivonne Benítez-Contreras
- Instituto Mexicano del Seguro Social, Centro Médico Nacional "Gral. Manuel Ávila Camacho", Hospital de Especialidades, Unidad de Investigación de Enfermedades Autoinmunes Sistémicas
| | - Ivet Etchegaray-Morales
- Benemérita Universidad Autónoma de Puebla, Facultad de Medicina, Departamento de Inmunología y Reumatología
| | - Carlos González-Parra
- Instituto Mexicano del Seguro Social, Hospital General de Zona No. 20, Servicio de Nefrología
| | - José Luis Gándara-Ramírez
- Benemérita Universidad Autónoma de Puebla, Facultad de Medicina, Departamento de Inmunología y Reumatología
| | - Alejandro Ruiz-Argüelles
- Laboratorios Clínicos de Puebla, Sucursal Anzures, Dirección de Proyectos Especiales. Puebla, Puebla, México
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Visa Reñé N, Paredes Carmona F. Pseudo-Foster Kennedy syndrome due to idiopathic intracranial hypertension. ACTA ACUST UNITED AC 2019; 94:598-601. [PMID: 31635921 DOI: 10.1016/j.oftal.2019.09.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2019] [Revised: 09/06/2019] [Accepted: 09/09/2019] [Indexed: 11/23/2022]
Abstract
Foster-Kennedy syndrome has been diagnosed as a direct compression of the optic nerve due to an expansive process that leads to atrophy. In the contralateral eye there is papillary oedema due to intracranial hypertension secondary to the tumour mass effect. The case is presented of a 12-year-old boy with overweight (BMI 26) with right eye papillary oedema and left optic nerve atrophy, that was casually found in an ophthalmological examination. He had no other symptomatology or personal medical history. The neurological examination was normal, and the urgent cranial computed tomography showed no masses. Lumbar puncture was performed with increased cerebrospinal fluid outflow resistance (28 cm H2O). The rest of studies were normal. Until the appearance of neuroimaging, it was believed that Foster-Kennedy syndrome was pathognomonic of intracranial mass in the frontal area. Pseudo-Foster Kennedy syndrome due to idiopathic intracranial hypertension is very rare, and in the few cases that have been reported in the literature, up to 25% of them are asymptomatic.
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Porto CM, de Paula Santana da Silva T, Sougey EB. Contribuições da vitamina D no tratamento de sintomas depressivos e fatores de risco cardiovascular: protocolo de estudo para um ensaio clínico randomizado, duplo-cego e controlado por placebo. Trials 2019; 20:583. [PMID: 31601274 PMCID: PMC6788094 DOI: 10.1186/s13063-019-3699-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2019] [Accepted: 09/04/2019] [Indexed: 01/31/2023] Open
Abstract
ABSTRATO FUNDO: A depressão é uma das principais causas de incapacidade crônica em todo o mundo e um importante fator de risco cardiovascular, aumentando o risco relativo de doença arterial coronariana, bem como as taxas de morbimortalidade cardiovascular. Concomitantemente à alta prevalência de depressão, houve uma redução na exposição à luz solar com o aumento da urbanização e do uso de protetores solares, o que levou a uma redução nos níveis séricos de 25-hidroxivitamina D. Portanto, este artigo descreve uma protocolo para um ensaio clínico com o objetivo de avaliar os efeitos da suplementação de vitamina D na depressão e fatores de risco cardiovascular para contribuir com evidências sobre a influência potencial da suplementação na regulação do humor. MéTODOS: Este estudo de protocolo foi orientado pelos itens de protocolo padrão: recomendações para ensaios intervencionistas. Um ensaio clínico randomizado, controlado por placebo, duplo-cego será realizado envolvendo 224 adultos (faixa etária de 18 a 60 anos) com depressão que estão tomando antidepressivos e não têm histórico de suplementação de vitamina D, comorbidades psiquiátricas, doença renal crônica, hipercalcemia, ou neoplasia. Os participantes serão recrutados nos ambulatórios psiquiátricos de duas universidades do nordeste do Brasil. Os participantes elegíveis que fornecerem consentimento por escrito serão designados aleatoriamente para o grupo de intervenção (n = 112; suplementação de vitamina D 50.000 UI por semana durante 6 meses) ou para o grupo controle (n = 112; placebo tomado semanalmente por 6 meses). Medidas para monitorar sintomas depressivos, exames clínicos e exames laboratoriais para avaliar fatores de risco cardiovascular e níveis séricos de vitamina D serão realizadas antes e após o período de intervenção. DISCUSSãO: Até onde sabemos, este será o primeiro ensaio clínico com o objetivo de testar a eficácia da suplementação de vitamina D na redução do risco cardiovascular e como um adjuvante à terapia da depressão por um período prolongado (6 meses). Os resultados contribuirão para a compreensão dos efeitos terapêuticos da suplementação de vitamina D no tratamento da depressão e podem ajudar a orientar políticas públicas direcionadas à suplementação de vitamina para a redução do risco cardiovascular. REGISTRO DE TESTE Registro Brasileiro de Ensaios Clínicos, RBR-6yj8sj/ Número Universal de Ensaios (UTN) U1111-1217-9237 . Registrado em 23 de julho de 2018.
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Affiliation(s)
- Catarina Magalhães Porto
- Neuropsiquiatria e Ciências do Comportamento, Universidade Federal de Pernambuco (UFPE), Av. Moraes Rego, 1235, Cidade Universitária, Recife, PE CEP: 50670-901 Brasil
| | - Tatiana de Paula Santana da Silva
- Neuropsiquiatria e Ciências do Comportamento, Universidade Federal de Pernambuco (UFPE), Av. Moraes Rego, 1235, Cidade Universitária, Recife, PE CEP: 50670-901 Brasil
| | - Everton Botelho Sougey
- Neuropsiquiatria e Ciências do Comportamento, Universidade Federal de Pernambuco (UFPE), Av. Moraes Rego, 1235, Cidade Universitária, Recife, PE CEP: 50670-901 Brasil
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Parente Filho SLA, Gomes PEADC, Forte GA, Lima LLL, Silva Júnior GBD, Meneses GC, Martins AMC, Daher EDF. Kidney disease associated with androgenic-anabolic steroids and vitamin supplements abuse: Be aware! Nefrologia 2019; 40:26-31. [PMID: 31585781 DOI: 10.1016/j.nefro.2019.06.003] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2019] [Revised: 05/28/2019] [Accepted: 06/02/2019] [Indexed: 01/06/2023] Open
Abstract
The excessive chase for beauty standards and the rise of muscle dysmorphia have ultimately led to an increase in androgenic-anabolic steroids (AAS) and intramuscular injections of vitamins A, D and E (ADE) abuse, which is associated with several adverse effects and has become a public health issue. This review of literature discusses kidney injury associated with the use of AAS and ADE, highlighting the mechanisms of acute and chronic renal lesion, such as direct renal toxicity, glomerular hyperfiltration and hypercalcemia. Future perspectives regarding evaluation and early diagnosis of kidney injury in these patients are also discussed.
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Affiliation(s)
- Sérgio Luiz Arruda Parente Filho
- Medical Sciences Post-Graduation Program, Department of Internal Medicine, School of Medicine, Federal University of Ceará, Fortaleza, Ceará, Brazil
| | | | - Guilherme Aguiar Forte
- Medical Sciences Post-Graduation Program, Department of Internal Medicine, School of Medicine, Federal University of Ceará, Fortaleza, Ceará, Brazil
| | - Laio Ladislau Lopes Lima
- Medical Sciences Post-Graduation Program, Department of Internal Medicine, School of Medicine, Federal University of Ceará, Fortaleza, Ceará, Brazil
| | | | - Gdayllon Cavalcante Meneses
- Department of Clinical and Toxicological Analysis, School of Pharmacy, Federal University of Ceará, Fortaleza, Ceará, Brazil
| | - Alice Maria Costa Martins
- Department of Clinical and Toxicological Analysis, School of Pharmacy, Federal University of Ceará, Fortaleza, Ceará, Brazil
| | - Elizabeth De Francesco Daher
- Medical Sciences Post-Graduation Program, Department of Internal Medicine, School of Medicine, Federal University of Ceará, Fortaleza, Ceará, Brazil.
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Olmedo-Martín RV, González-Molero I, Olveira G, Amo-Trillo V, Jiménez-Pérez M. Sunlight exposure in inflammatory bowel disease outpatients: Predictive factors and correlation with serum vitaminD. Gastroenterol Hepatol 2019; 42:604-613. [PMID: 31472991 DOI: 10.1016/j.gastrohep.2019.07.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/20/2019] [Accepted: 07/04/2019] [Indexed: 12/31/2022]
Abstract
INTRODUCTION Sunlight exposure is the main source of vitaminD. Our aim was to describe both sun exposure and sun protection behaviour in a series of patients with inflammatory bowel disease (IBD), and to study their potential association with vitaminD concentration. PATIENTS AND METHODS A cross sectional, observational study. The clinical-demographic variables were obtained via clinical interviews and medical history review. The sunlight exposure assessment was carried out using the Sun Exposure Questionnaire and the concentration of 25-hydroxy vitaminD (25OHD) was measured by an electro-chemiluminescence immunoassay. Questionnaires were conducted on quality of life, physical activity, weekly vitaminD intake and sun protection behaviour. RESULTS 149 patients were included. In 69% of patients, deficient or insufficient 25OHD values were recorded. 67% showed low sun exposure. A modest significant correlation was observed between the total score of the solar exposure questionnaire and the 25OHD concentration in the complete series (r=0.226, P=.006) and in the summer (r=0.274, P=.01). The sun protection behaviour questionnaire score did not influence the 25OHD concentration. In the multivariate analysis, only the presence of clinical activity was associated with low sun exposure (OR=3.23). DISCUSSION Sun exposure according to the questionnaire used was low, was associated with the presence of clinical activity and was weakly correlated with serum 25OHD concentration. More studies are needed to explore the use of individual questionnaires for sun exposure and its relationship with vitaminD in patients with IBD.
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Affiliation(s)
- Raúl Vicente Olmedo-Martín
- Unidad de Gestión Clínica de Aparato Digestivo, Hospital Regional de Málaga, Málaga, España; Facultad de Medicina, Universidad de Málaga, Instituto de Investigación Biomédica de Málaga (IBIMA), Málaga, España.
| | - Inmaculada González-Molero
- Unidad de Gestión Clínica de Endocrinología y Nutrición, Hospital Regional de Málaga, Universidad de Málaga, Instituto de Investigación Biomédica de Málaga (IBIMA), CIBERDEM, Málaga, España
| | - Gabriel Olveira
- Unidad de Gestión Clínica de Endocrinología y Nutrición, Hospital Regional de Málaga, Universidad de Málaga, Instituto de Investigación Biomédica de Málaga (IBIMA), CIBERDEM, Málaga, España
| | - Victor Amo-Trillo
- Unidad de Gestión Clínica de Aparato Digestivo, Hospital Regional de Málaga, Málaga, España; Facultad de Medicina, Universidad de Málaga, Instituto de Investigación Biomédica de Málaga (IBIMA), Málaga, España
| | - Miguel Jiménez-Pérez
- Unidad de Gestión Clínica de Aparato Digestivo, Hospital Regional de Málaga, Málaga, España; Facultad de Medicina, Universidad de Málaga, Instituto de Investigación Biomédica de Málaga (IBIMA), Málaga, España
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Sousa JR, Rosa ÉPC, Nunes IFDOC, Carvalho CMRGD. Effect of vitamin D supplementation on patients with systemic lupus erythematosus: a systematic review. Rev Bras Reumatol Engl Ed 2019; 57:466-471. [PMID: 29037317 DOI: 10.1016/j.rbre.2017.08.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2016] [Accepted: 05/22/2017] [Indexed: 01/20/2023] Open
Abstract
The objective of this systematic review was to analyze clinical trials carried out for the investigation of the effect of vitamin D supplementation on systemic lupus erythematosus. The research was performed from August to September 2016, without limits regarding year of publication, restriction of gender, age, and ethnicity. For the guiding question, the PICO strategy was employed. To evaluate the quality of the publications the PRISMA protocol and Jadad scale were used. The risk of bias analysis of the clinical trials was performed using the Cochrane collaboration tool. After the process of article selection and removal of duplicates, four articles were identified as eligible. The results of three studies showed a positive effect of supplementation on disease activity reduction and significant improvement in levels of inflammatory markers, fatigue, and endothelial function. Only one study showed no improvement in disease activity after supplementation. Moreover, all studies showed an increase in serum vitamin D levels. The data from this review provide evidence on the benefits of vitamin D supplementation in patients with lupus and vitamin D insufficiency/deficiency. However, it is still necessary to elucidate whether vitamin D acts in the protection against this metabolic disorder, as well as the standardization of the type, dose and time of vitamin D supplementation.
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Muñoz-Torres M, Aguado P, Daudén E, Carrascosa JM, Rivera R. Osteoporosis and Psoriasis. Actas Dermosifiliogr (Engl Ed) 2019; 110:642-652. [PMID: 31151668 DOI: 10.1016/j.ad.2019.02.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2018] [Revised: 01/29/2019] [Accepted: 02/03/2019] [Indexed: 02/08/2023] Open
Abstract
Psoriasis is a chronic inflammatory disease associated with multiple comorbidities, particularly in patients with arthritis or more severe forms of the disease. The link between all these comorbidities is probably systemic inflammation. Several recent studies have indicated that patients with psoriasis may be at an increased risk of pathologic fractures and osteoporosis. Current guidelines on comorbidities in psoriasis do not recommend assessment of bone health. In this article, we review the available evidence on the association between psoriasis and osteoporosis. We first examine the concept of osteoporosis and the role of vitaminD in bone health and then propose an algorithm for managing and treating this condition in patients with psoriasis.
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Affiliation(s)
- M Muñoz-Torres
- Servicio de Endocrinología, Hospital Universitario San Cecilio, Granada, España
| | - P Aguado
- Servicio de Reumatología, Hospital Universitario La Paz, Madrid, España
| | - E Daudén
- Servicio de Dermatología, Hospital Universitario La Princesa, Madrid, España
| | - J M Carrascosa
- Servicio de Dermatología, Hospital Universitario Germans Trias i Pujol, Badalona, Barcelona, España
| | - R Rivera
- Servicio de Dermatología, Hospital Universitario 12 de Octubre, Madrid, España.
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Jiang W, Wu DB, Xiao GB, Ding B, Chen EQ. An epidemiology survey of vitamin D deficiency and its influencing factors. Med Clin (Barc) 2019; 154:7-12. [PMID: 31133232 DOI: 10.1016/j.medcli.2019.03.019] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2018] [Revised: 02/18/2019] [Accepted: 03/07/2019] [Indexed: 02/05/2023]
Abstract
BACKGROUND There is growing evidence that vitamin D is related to the development of a variety of diseases. The current study was performed to investigate the status of serum vitamin D distribution among adult Chinese people and reveal the influence of gender, age, seasonality and residential regions on serum vitamin D levels. METHOD This cross-sectional study included 14,302 participants aged from 18 years old to 65 years old from six major cities in China. The basic demographic information and the levels of serum vitamin D (25(OH)D) and vitamin D3 (25(OH)D3) were collected from Jan 2, 2014 to Dec 25, 2017. RESULT The prevalence of 25(OH)D3 concentration <30ng/mL reached up to 83%, in which the rate of vitamin D insufficiency (20-29ng/mL) was 32.7%, and vitamin D deficiency (10-19ng/mL) accounted for 41.9%, and vitamin D severe shortage (<10ng/mL) accounted for 8.4%. Women were more likely to have vitamin D3 deficiency and lower serum vitamin D3 concentration than men (both p<0.001). The mean concentration of serum 25(OH)D and 25(OH)D3 in summer and autumn were higher than that in spring and winter (p<0.001), and the mean concentration of serum 25(OH)D in people from Southern China was higher than that in people from other regions (p<0.001). Although the mean concentrations of serum 25(OH)D and 25(OH)D3 were both increased by age, the percentage of patients with serum 25(OH)D3 insufficiency was also increased. CONCLUSION Serum vitamin D deficiency is very common in adults in China. The level of serum vitamin D may be associated with age, sex, seasonality and residential regions.
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Affiliation(s)
- Wei Jiang
- Center of Infectious Diseases, West China Hospital of Sichuan University, Chengdu 610041, China
| | - Dong-Bo Wu
- Center of Infectious Diseases, West China Hospital of Sichuan University, Chengdu 610041, China
| | - Gui-Bao Xiao
- Department of Infectious Diseases, The First People's Hospital of Ziyang, Ziyang 641300, China
| | - Bei Ding
- ADICON Clinical Laboratory, Chengdu 610000, China
| | - En-Qiang Chen
- Center of Infectious Diseases, West China Hospital of Sichuan University, Chengdu 610041, China.
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Navarro-Triviño FJ, Arias-Santiago S, Gilaberte-Calzada Y. Vitamin D and the Skin: A Review for Dermatologists. Actas Dermosifiliogr (Engl Ed) 2019; 110:262-272. [PMID: 30857638 DOI: 10.1016/j.ad.2018.08.006] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2018] [Revised: 07/28/2018] [Accepted: 08/02/2018] [Indexed: 02/07/2023] Open
Abstract
In recent years, the growing interest in the role played by vitamin D in skin disease has given rise to the publication of many studies of the relationship between this vitamin and certain skin conditions. As dermatologists, we need to understand, among other aspects, how vitamin D is synthesized and the main sources in humans, as well as plasma levels and the factors that can modify them. Of particular interest are the latest discoveries about the role of vitamin D in skin diseases such as lupus erythematosus, ichthyosis, atopic dermatitis, hidradenitis suppurativa, acne, alopecia areata, androgenetic alopecia, melanoma, and nonmelanoma skin cancer. Also of interest is the importance of vitamin D as adjuvant therapy in patients on long-term treatment with corticosteroids. In this review, we provide an overview of the most important and most recent information regarding the relationship between vitamin D and skin disease and discuss the importance of assessing individual vitamin D status and correcting deficiencies.
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Affiliation(s)
- F J Navarro-Triviño
- Unidad de Dermatología Médico-Quirúrgica y Venereología, Hospital Comarcal Alcalá la Real, Jaén, España.
| | - S Arias-Santiago
- Unidad de Gestión Clínica de Dermatología y Venereología, Hospital Universitario Virgen de las Nieves, Granada, España
| | - Y Gilaberte-Calzada
- Servicio de Dermatología, Hospital Universitario Miguel Servet, IIS Aragón, Zaragoza, España
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Pereda CA, Nishishinya MB, Roldan EJA. 25-Hydroxyvitamin D serum levels in rheumatic female patients in southeast Spain: The paradigm of daily optimal sunshine levels and inadequate vitamin D status. ENDOCRINOL DIAB NUTR 2019; 66:181-187. [PMID: 30541681 DOI: 10.1016/j.endinu.2018.08.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2018] [Revised: 08/19/2018] [Accepted: 08/23/2018] [Indexed: 10/27/2022]
Abstract
BACKGROUND Almeria is a region in southeast Spain with optimal sunlight levels, along with low pluvial and pollution rates. If exposure to sunlight is sufficient to maintain adequate levels of vitamin D (25OHD), this population should display high serum levels. OBJECTIVES To describe 25OHD serum status in women from Almeria and evaluate the impact of long sunlight exposure along the seasons on 25OHD. METHODS Cross-sectional study, performed in women consecutively recruited from an outpatient rheumatology clinic. Serum levels of 25OHD were assessed in all patients and evaluated according to age (<48 yrs, 48-53 yrs, 54-60 yrs and >60 yrs), season, and presence or absence of menopause. Clinical and laboratory variables that could affect status of vitamin D were also considered. RESULTS The sample included 319 Caucasian female patients. Mean 25OHD were 30.2ng/ml with 195 (61.1%) exhibiting 25OHD inadequate serum levels. Season had a significant effect on 25OHD levels, with autumn being the season in which 25OHD serum levels remained well above 30ng/ml in all age bands, and winter the season with more levels of insufficiency. Menopause did not modify 25OH serum levels. Women whose age was below 48 and over 60 had inadequate levels of 25OHD during summer. CONCLUSIONS Optimal levels of sunlight could not overcome the problem of inadequate 25OHD serum levels, particularly in elderly and young female population. Vitamin D supplementation may be recommended predominantly in winter and summer in this population.
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Affiliation(s)
| | - María Betina Nishishinya
- Instituto Traumatológico Quirón, Barcelona, Spain; MD Programme in Education and Sport Sciences, Facultat de Psicologia, Ciències de l'Educació i de l'Esport Blanquerna, Barcelona, Spain
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Blarduni E, Arrospide A, Galar M, Castaño L, Mar J. [Factors associated with the prevalence of hypovitaminosis D in pregnant women and their newborns]. An Pediatr (Barc) 2018; 91:96-104. [PMID: 30591401 DOI: 10.1016/j.anpedi.2018.11.012] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2018] [Revised: 11/19/2018] [Accepted: 11/21/2018] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND The finding of hypovitaminosis in pregnancy D has prompted the debate about its supplementation. The objective of the study was to measure the prevalence of hypovitaminosis D in mothers and newborns. METHODS A one-year observational study was conducted including the measuring of vitamin D levels in mothers and in the umbilical cord blood of newborns. An analysis was made of the variables as regards maternal characteristics, delivery and sun exposure. RESULTS Values lower than 20 ng/ml were found in 64.4% of 745 mothers and 41.3% of 560 newborns, and less than 30 ng/ml in 88.7% and 67.1%, respectively. Mean levels were higher in summer-autumn than in winter-spring (21.73 and 13.70 ng / ml in mothers and 29.04 and 20.49 ng/ml in cord), and higher in the umbilical cord than in the maternal plasma. Multiple pregnancies (OR: 6.29) and non-European origin (OR: 13.09) were risk factors for maternal hypovitaminosis, while maternal supplementation (OR: 0.19), physical activity (OR: 0.57), and sun exposure (OR: 0.46) had a preventive effect. CONCLUSIONS The high rates of hypovitaminosis support the policy of giving dietary supplements to newborns. The high level of hypovitaminosis found supports the extension of screening and supplementation to all pregnant women, and not only to those with risk factors. The greater difference between mothers and newborns in seasons of low sun exposure can be interpreted as a protective effect.
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Affiliation(s)
- Elizabeth Blarduni
- Servicio de Pediatría, OSI Goierri-Alto Urola, Zumárraga, Guipúzcoa, España
| | - Arantzazu Arrospide
- Unidad de Investigación AP-OSIs, OSI Alto Deba, Arrasate-Mondragón, Guipúzcoa, España; Instituto Biodonostia, Donostia-San Sebastián, España; Red de Investigación en Servicios de Salud y Enfermedades Crónicas (REDISSEC)
| | - Mar Galar
- Servicio de Laboratorio de Análisis clínicos, OSI Goierri-Alto Urola, Zumárraga, Guipúzcoa, España
| | - Luis Castaño
- Instituto Biocruces, Hospital de Cruces, Baracaldo, Vizcaya, España; Departamento de Pediatría, Universidad del País Vasco, Baracaldo, Vizcaya, España
| | - Javier Mar
- Unidad de Investigación AP-OSIs, OSI Alto Deba, Arrasate-Mondragón, Guipúzcoa, España; Instituto Biodonostia, Donostia-San Sebastián, España; Red de Investigación en Servicios de Salud y Enfermedades Crónicas (REDISSEC).
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Özkaya F, Demirel A. Vitamin D deficiency in infertile patients. ARCH ESP UROL 2018; 71:850-855. [PMID: 30560803] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
OBJECTIVES According to the WorldHealth Organization (WHO) definition, infertility is "thefailure of a sexually active, non-contracepting couple toachieve pregnancy in one year" and is a complicateddisorder with its medical, psychosocial and economicaspects. There is some proof that vitamin D deficiencyhas important effects on the male reproductive system.There are numerous animal trials and a limited numberof human trials investigating this topic. In our study, thepurpose is to consider vitamin D deficiency as a causeof infertility and investigate the relationship of serum vitaminD levels and infertility primarily in our region whereexposure to sunlight is relatively low. MATERIALS AND METHODS Between 01.10.2014and 01.05.2015, 103 patients between the ages 20-40 that applied because of infertility were included in the study as the study group, and fertile male patientsbetween the ages 20-40 that applied for reasons otherthan infertility were included as the control group.A detailed anamnesis was obtained and physical examinationswere performed in all patients participatingin the study. The ages, duration of marriage, primarydiagnoses and presence of other diseases were questioned,semen analyses were performed. The serum testosterone,vitamin D, Ca (Calcium), follicle stimulatinghormone (FSH) and luteinizing hormone (LH) levels weretested after a 12 hour fasting period between 10:00and 12:00 in the morning. RESULTS There was no significant difference between the study group and control group in demographic features and serum testosterone levels. Vitamin D deficiency was detected in 89 (86.4%) patients of the study group and 33 (66%) of the control group. A significant difference of vitamin D deficiency rates was detected between the groups (p0.05). CONCLUSION It has been shown that vitamin D hasimportant functions in the male reproductive system. Inpatients with vitamin D deficiency, the semen parametersare affected negatively and vitamin replacement isrequired.
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Affiliation(s)
- Fatih Özkaya
- Department of Urology. Erzurum Regional Training and Research Hospital. Erzurum. Turkey
| | - Azam Demirel
- Department of Urology. Ataturk University Medical Faculty. Erzurum. Turkey
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Vázquez-Oliva G, Zamora A, Ramos R, Subirana I, Grau M, Dégano IR, Muñoz D, Fitó M, Elosua R, Marrugat J. Analysis of Plasma Albumin, Vitamin D, and Apolipoproteins A and B as Predictive Coronary Risk Biomarkers in the REGICOR Study. ACTA ACUST UNITED AC 2018; 71:910-916. [PMID: 29764762 DOI: 10.1016/j.rec.2018.01.027] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2017] [Accepted: 01/08/2018] [Indexed: 10/28/2022]
Abstract
INTRODUCTION AND OBJECTIVES New biomarkers could improve the predictive capacity of classic risk functions. The aims of this study were to determine the association between circulating levels of apolipoprotein A1 (apoA1), apolipoprotein B (apoB), albumin, and 25-OH-vitamin D and coronary events and to analyze whether these biomarkers improve the predictive capacity of the Framingham-REGICOR risk function. METHODS A case-cohort study was designed. From an initial cohort of 5404 individuals aged 35 to 74 years with a 5-year follow-up, all the participants who had a coronary event (n = 117) and a random group of the cohort (subcohort; n = 667) were selected. Finally, 105 cases and 651 individuals representative of the cohort with an available biological sample were included. The events of interest were angina, fatal and nonfatal myocardial infarction and coronary deaths. RESULTS Case participants were older, had a higher proportion of men and cardiovascular risk factors, and showed higher levels of apoB and lower levels of apoA1, apoA1/apoB ratio, 25-OH-vitamin D and albumin than the subcohort. In multivariate analyses, plasma albumin concentration was the only biomarker independently associated with coronary events (HR, 0.73; P = .002). The inclusion of albumin in the risk function properly reclassified a significant proportion of individuals, especially in the intermediate risk group (net reclassification improvement, 32.3; P = .048). CONCLUSIONS Plasma albumin levels are inversely associated with coronary risk and improve the predictive capacity of classic risk functions.
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Affiliation(s)
- Gabriel Vázquez-Oliva
- Departamento de Cardiología, Fundación Althaia, Manresa, Barcelona, Spain; Facultad de Medicina, Universidad de Girona, Girona, Spain
| | - Alberto Zamora
- Facultad de Medicina, Universidad de Girona, Girona, Spain; Unidad de Riesgo Vascular, Hospital de Blanes, Corporación de Salud del Maresme y la Selva, Blanes, Girona, Spain; Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Barcelona, Spain
| | - Rafel Ramos
- Facultad de Medicina, Universidad de Girona, Girona, Spain; Instituto Universitario de Investigación en Atención Primaria (IDIAP) Jordi Gol, Grupo de Investigación ISV, Unidad de Investigación en Atención Primaria, Girona, Spain; Atención Primaria, Instituto Catalán de Salud (ICS), Girona, Spain
| | - Isaac Subirana
- Grupo de Epidemiología y Genética Cardiovascular, Grupo del Estudio REGICOR (REgistre GIroní del COR), IMIM (Instituto Hospital del Mar de Investigaciones Médicas), Barcelona, Spain; Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
| | - María Grau
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Barcelona, Spain; Grupo de Epidemiología y Genética Cardiovascular, Grupo del Estudio REGICOR (REgistre GIroní del COR), IMIM (Instituto Hospital del Mar de Investigaciones Médicas), Barcelona, Spain
| | - Irene R Dégano
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Barcelona, Spain; Grupo de Epidemiología y Genética Cardiovascular, Grupo del Estudio REGICOR (REgistre GIroní del COR), IMIM (Instituto Hospital del Mar de Investigaciones Médicas), Barcelona, Spain; Universidad de Vic-Central de Cataluña (UVic-UCC), Vic, Barcelona, Spain
| | - Daniel Muñoz
- Grupo de Nutrición y Riesgo Cardiovascular, Grupo del Estudio REGICOR (REgistre GIroní del COR), IMIM (Instituto Hospital del Mar de Investigaciones Médicas), Barcelona, Spain; Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Barcelona, Spain
| | - Montserrat Fitó
- Grupo de Nutrición y Riesgo Cardiovascular, Grupo del Estudio REGICOR (REgistre GIroní del COR), IMIM (Instituto Hospital del Mar de Investigaciones Médicas), Barcelona, Spain; Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Barcelona, Spain
| | - Roberto Elosua
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Barcelona, Spain; Grupo de Epidemiología y Genética Cardiovascular, Grupo del Estudio REGICOR (REgistre GIroní del COR), IMIM (Instituto Hospital del Mar de Investigaciones Médicas), Barcelona, Spain; Universidad de Vic-Central de Cataluña (UVic-UCC), Vic, Barcelona, Spain
| | - Jaume Marrugat
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Barcelona, Spain; Grupo de Epidemiología y Genética Cardiovascular, Grupo del Estudio REGICOR (REgistre GIroní del COR), IMIM (Instituto Hospital del Mar de Investigaciones Médicas), Barcelona, Spain.
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de la Torre Lossa P, Moreno Álvarez M, González Guzmán MDC, López Martínez R, Ríos Acosta C. Vitamin D is not useful as a biomarker for disease activity in rheumatoid arthritis. ACTA ACUST UNITED AC 2018; 16:110-115. [PMID: 29779702 DOI: 10.1016/j.reuma.2018.02.016] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2017] [Revised: 02/19/2018] [Accepted: 02/22/2018] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To determine whether there is an association between serum vitamin D levels and the Disease Activity Index in patients with rheumatoid arthritis (RA). METHODOLOGY An analytical, retrospective, cross-sectional study was performed at the Hospital Luis Vernaza and Center for Rheumatology and Rehabilitation. We included 18 to 75-year-old patients with a diagnosis of RA according to the 2010 classification criteria, and with a 25-hydroxyvitamin D (25 [OH] D) test within the last 3 months. The activity of the disease was assessed with the 28-joint Disease Activity Score (DAS28) and C-reactive protein (CRP) as an acute-phase reactant. Spearman's rank correlation coefficient was used to establish association between the variables. RESULTS A total of 100 RA patients were studied. The mean vitamin D levels were 32.9 ± 11.5 ng/mL. In all, 45% showed insufficient 25 (OH) D and 55% had normal levels; no deficient vitamin D values were found. According to the DAS28-CRP, patients with low, moderate and high activity had an average vitamin D level of 30.4 ± 10.7, 31.9 ± 10.7, and 31.8 ± 12.1 ng/mL, respectively. There were no significant correlations between the disease activity and the serum vitamin D level (P=.60). CONCLUSION In our group of RA patients, there was no statistically significant correlation between the levels of vitamin D and the activity of the disease, nor were other determining variables associated with vitamin D levels.
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Miguel-Carrera J, García-Porrua C, de Toro Santos FJ, Picallo-Sánchez JA. [Prevalence of osteoporosis, estimation of probability of fracture and bone metabolism study in patients with newly diagnosed prostate cancer in the health area of Lugo]. Aten Primaria 2018. [PMID: 28629885 PMCID: PMC6837155 DOI: 10.1016/j.aprim.2017.03.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
Abstract
OBJECTIVE To study the prevalence of osteoporosis and fracture probability in patients diagnosed with prostate cancer. DESIGN Observational descriptive transversal study. SITE: Study performed from Primary Care of Lugo in collaboration with Rheumatology and Urology Services of our referral hospital. PARTICIPANTS Patients diagnosed with prostate cancer without bone metastatic disease from January to December 2012. MAIN MEASUREMENTS Epidemiologic, clinical, laboratory and densitometric variables involved in osteoporosis were collected. The likelihood of fracture was estimated by FRAX® Tool. RESULTS Eighty-three patients met the inclusion criteria. None was excluded. The average age was 67 years. The Body Mass Index was 28.28. Twenty-five patients (30.1%) had previous osteoporotic fractures. Other prevalent risk factors were alcohol (26.5%) and smoking (22.9%). Eighty-two subjects had vitamin D below normal level (98.80%). Femoral Neck densitometry showed that 8.9% had osteoporosis and 54% osteopenia. The average fracture risk in this population, estimated by FRAX®, was 2.63% for hip fracture and 5.28% for major fracture. Cut level for FRAX® major fracture value without DXA >5% and ≥7.5% proposed by Azagra et al. showed 24 patients (28.92%) and 8 patients (9.64%) respectively. CONCLUSIONS The prevalence of osteoporosis in this population was very high. The more frequent risk factors associated with osteoporosis were: previous osteoporotic fracture, alcohol consumption, smoking and family history of previous fracture. The probability of fracture using femoral neck FRAX® tool was low. Vitamin D deficiency was very common (98.8%).
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Affiliation(s)
- Jonatan Miguel-Carrera
- Punto de Atención Continuada Fingoi (Lugo), Estructura Organizativa de Gestión Integrada (EOXI) Lugo, Cervo y Monforte, Servicio Galego de Saúde (SERGAS), Lugo, España.
| | - Carlos García-Porrua
- Sección de Reumatología, Hospital Universitario Lucus Augusti (HULA), Servicio Galego de Saúde (SERGAS), Lugo, España
| | - Francisco Javier de Toro Santos
- Servicio de Reumatología, Instituto de Investigación Biomédica de A Coruña (INIBIC), Complejo Hospitalario Universitario de A Coruña (CHUAC), Servicio Galego de Saúde (SERGAS), Universidade da Coruña (UDC), A Coruña, España
| | - Jose Antonio Picallo-Sánchez
- Servicio de Urología, Complejo Hospitalario Universitario de A Coruña, Servicio Galego de Saúde (SERGAS), A Coruña, España
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Carrión-Barberà I, Salman-Monte TC, Castell S, Castro F, Ojeda F, Carbonell J. Prevalence and factors associated with fatigue in female patients with systemic lupus erythematosus. Med Clin (Barc) 2018; 151:353-358. [PMID: 29439873 DOI: 10.1016/j.medcli.2017.12.007] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2017] [Revised: 12/15/2017] [Accepted: 12/21/2017] [Indexed: 01/22/2023]
Abstract
OBJECTIVE To determine the prevalence of fatigue in our cohort as well as the factors to which it is associated, its relationship with demographic variables, vitamin D levels, treatment, systemic lupus erythematosus (SLE) symptoms and disease activity. METHODS A cross-sectional study was carried out including 102 consecutive female patients with SLE (American College of Rheumatology 1997 criteria) who attended the Parc de Salut Mar between January 2012 and May 2014. Variables collected were: sociodemographic data, vitamin D supplementation, fatigue VAS, pharmacological treatment, main serological markers of SLE, and plasma levels of 25(OH)-vitD. The association between fatigue and the different variables was evaluated by the Spearman's Rho correlation coefficient for the continuous variables, the Mann-Whitney U test for the categorical and the Kruskal-Wallis test for the seasons of the year. RESULTS The fatigue variable was evaluated through a fatigue VAS with a mean score of 52.84 (range 0-100), a median of 59 and a standard deviation of 29.86. A statistically significant relationship was found between fatigue and age, MHAQ, SLICC, summer and photosensitivity. As for the relationship between fatigue and vitamin D insufficiency (defined as 25-(OH)-vitD≤30 levels), the sample was divided into patients receiving vitamin D supplements (n=60) and patients without supplements (n=40), finding a significant relationship in that last group. CONCLUSIONS A statistically significant association was found between the presence of fatigue and age, MHAQ, SLICC, photosensitivity, fibromyalgia and summer, and with vitamin D insufficiency in the group of patients without supplements (n=40).
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Affiliation(s)
- Irene Carrión-Barberà
- Servicio de Reumatología, Hospital del Mar/Parc de Salut Mar, Institut Hospital del Mar d'Investigacions Mèdiques (IMIM), Departamento de Medicina, Universitat Autònoma de Barcelona, Barcelona, España.
| | - Tarek Carlos Salman-Monte
- Servicio de Reumatología, Hospital del Mar/Parc de Salut Mar, Institut Hospital del Mar d'Investigacions Mèdiques (IMIM), Departamento de Medicina, Universitat Autònoma de Barcelona, Barcelona, España
| | - Sonia Castell
- Servicio de Reumatología, Hospital del Mar/Parc de Salut Mar, Institut Hospital del Mar d'Investigacions Mèdiques (IMIM), Departamento de Medicina, Universitat Autònoma de Barcelona, Barcelona, España
| | - Francisco Castro
- Servicio de Reumatología, Hospital del Mar/Parc de Salut Mar, Institut Hospital del Mar d'Investigacions Mèdiques (IMIM), Departamento de Medicina, Universitat Autònoma de Barcelona, Barcelona, España
| | - Fabiola Ojeda
- Servicio de Reumatología, Hospital del Mar/Parc de Salut Mar, Institut Hospital del Mar d'Investigacions Mèdiques (IMIM), Departamento de Medicina, Universitat Autònoma de Barcelona, Barcelona, España
| | - Jordi Carbonell
- Servicio de Reumatología, Hospital del Mar/Parc de Salut Mar, Institut Hospital del Mar d'Investigacions Mèdiques (IMIM), Departamento de Medicina, Universitat Autònoma de Barcelona, Barcelona, España
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Candel Romero C, Forner Cordero Á, Sánchez Santos JC, Pereiró Berenguer I. Relationship between vitamin D, osteoporotic fracture and falls. Med Clin (Barc) 2017. [PMID: 28625513 DOI: 10.1016/j.medcli.2017.04.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE Link low levels of vitamin D, osteoporotic fracture and falls. PATIENTS AND METHOD Transversal observational study with the study variables of age, levels of vitamin D, osteoporotic fracture and falls. The study population was patients evaluated by the Rehabilitation Department, Hospital of Sagunto, from January 2013 to December 2014. RESULTS Of the 242 patients who underwent vitamin D analysis, 70.6% showed levels under 30ng/ml. Forty-eight percent of the patients with below normal levels of vitamin D suffered a fracture, opposed to 32.4% patients with normal levels. Thus, controlling by age, patients with low levels of vitamin D are 4.8 times more likely to suffer a fracture than those with normal levels. Regarding falls, controlling by age, there is a higher risk of falling (adjusted OR 2.68) in those patients with low levels of vitamin D. CONCLUSIONS Patients with low vitamin D levels are more likely to suffer falls and fractures.
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Affiliation(s)
| | - Ángeles Forner Cordero
- Servicio de Rehabilitación, Hospital de Sagunto, Sagunto, Valencia, España; Facultad de Medicina, Valencia, España
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