scholarly journals High-Dose Cholecalciferol Booster Therapy is Associated with a Reduced Risk of Mortality in Patients with COVID-19: A Cross-Sectional Multi-Centre Observational Study

Nutrients ◽  
2020 ◽  
Vol 12 (12) ◽  
pp. 3799
Author(s):  
Stephanie F. Ling ◽  
Eleanor Broad ◽  
Rebecca Murphy ◽  
Joseph M. Pappachan ◽  
Satveer Pardesi-Newton ◽  
...  
Keyword(s):  
Vitamin D ◽  
Observational Study ◽  
Large Population ◽  
Public Health Issue ◽  
High Dose ◽  
Cross Sectional ◽  
Pharmacological Management ◽  
Baseline Serum ◽  
Risk Of Mortality ◽  
Reduced Risk

The worldwide pandemic of 2019 novel coronavirus disease (COVID-19) has posed the most substantial and severe public health issue for several generations, and therapeutic options have not yet been optimised. Vitamin D (in its “parent” form, cholecalciferol) has been proposed in the pharmacological management of COVID-19 by various sources. We aimed to determine whether COVID-19 mortality was affected by serum 25-hydroxyvitamin D (25(OH)D) levels, vitamin D status, or cholecalciferol therapy, and to elucidate any other predictors of COVID-19 mortality. Patients hospitalised with COVID-19 were opportunistically recruited from three UK hospitals, and their data were collected retrospectively. Logistic regression was used to determine any relationships between COVID-19 mortality and potential predictors, including 25(OH)D levels and cholecalciferol booster therapy. A total of 986 participants with COVID-19 were studied, of whom 151 (16.0%) received cholecalciferol booster therapy. In the primary cohort of 444 patients, cholecalciferol booster therapy was associated with a reduced risk of COVID-19 mortality, following adjustment for potential confounders (ORadj 0.13, 95% CI 0.05–0.35, p < 0.001). This finding was replicated in a validation cohort of 541 patients (ORadj 0.38, 95% CI 0.17–0.84, p = 0.018). In this observational study, treatment with cholecalciferol booster therapy, regardless of baseline serum 25(OH)D levels, appears to be associated with a reduced risk of mortality in acute in-patients admitted with COVID-19. Further work with large population studies needs to be carried out to determine adequate serum 25(OH)D levels, as well as multi-dose clinical trials of cholecalciferol therapy to assess maximum efficacy.

Vitamin D Treatment Is Associated with Reduced Risk of Mortality in Patients with COVID-19: A Cross-Sectional Multi-Centre Observational Study

2020 ◽  
Author(s):  
Stephanie Fenxi Ling ◽  
Eleanor Broad ◽  
Rebecca Murphy ◽  
Joseph Mundattuchundayil Pappachan ◽  
Satveer Pardesi-Newton ◽  
...  
Keyword(s):  
Vitamin D ◽  
Observational Study ◽  
Cross Sectional ◽  
Risk Of Mortality ◽  
Reduced Risk

scholarly journals Assessing longitudinal and cross-sectional effects of age on adult obesity in an Iranian population: results from a large population-based cohort study

2021 ◽  
Author(s):  
Mahsa Rafiee Alhossaini ◽  
Anoshirvan Kazemnejad ◽  
Farid Zayeri ◽  
Masoumeh Sadeghi
Keyword(s):  
Odds Ratio ◽  
Large Population ◽  
Significant Risk ◽  
High Rate ◽  
Noncommunicable Diseases ◽  
Public Health Issue ◽  
Related Factors ◽  
Cross Sectional ◽  
Longitudinal Effects ◽  
Prevalence Of Obesity

Abstract Background Obesity is a significant risk factor for Noncommunicable diseases, and it is related to many adverse health consequences. The risk of obesity commonly changes with age, which is called a longitudinal or aging effect. Also, individuals born or enter to the study of the same age have similar living conditions that may influence their obesity risk in a particular way; this is a cross-sectional effect. In the current study, an advanced statistical model is used to distinguish between longitudinal and cross-sectional effects of age on the risk of obesity for men and women. Methods Participants are a group of 6504 Iranian adults over 35 years of age in 2001, who live in the central region of Iran. They were followed up for 12 years in a large community-based study. Various medical indexes, including Body Mass Index, were collected in 2001, 2007, and 2013. The Marginal Logistic Regression model, which includes linear and quadratic effects of the Baseline Age and its difference with current age, is used. Results Between 2001 and 2013, the prevalence of obesity raised from 13% to 18% in men and from 31% to 44% in women. The odds of obesity for women was approximately three times the odds of obesity for men on average adjusting for the age effects. Both cross-sectional and longitudinal effects of age were significantly associated with the odds ratio of obesity. There was a rise in the prevalence of obesity for individuals with Baseline Age 35 to 55 and a decline thereafter. Also, the odds ratio of obesity across one’s life course, had about 3% increase, on average, by each year aging, regardless of the age at baseline. Conclusions The high rate of obesity and its fast growth is a serious public health issue among Iranians, especially in adults age 35-55, and women. In the present study, Baseline Age was more strongly associated with the risk of obesity than aging. Considering both cross-sectional and longitudinal effects of age, helps us to understand the effect of age on obesity better and to identify the related factors.

scholarly journals Short term, high-dose vitamin D supplementation for COVID-19 disease: a randomised, placebo-controlled, study (SHADE study)

2020 ◽  
pp. postgradmedj-2020-139065 ◽  
Author(s):  
Ashu Rastogi ◽  
Anil Bhansali ◽  
Niranjan Khare ◽  
Vikas Suri ◽  
Narayana Yaddanapudi ◽  
...  
Keyword(s):  
Vitamin D ◽  
Inflammatory Markers ◽  
Intervention Group ◽  
Vitamin D Supplementation ◽  
Controlled Study ◽  
Control Group ◽  
High Dose ◽  
Baseline Serum ◽  
Cholecalciferol Supplementation ◽  
And Control

BackgroundVitamin D has an immunomodulatory role but the effect of therapeutic vitamin D supplementation in SARS-CoV-2 infection is not known.AimEffect of high dose, oral cholecalciferol supplementation on SARS-CoV-2 viral clearance.DesignRandomised, placebo-controlled.ParticipantsAsymptomatic or mildly symptomatic SARS-CoV-2 RNA positive vitamin D deficient (25(OH)D<20 ng/ml) individuals.InterventionParticipants were randomised to receive daily 60 000 IU of cholecalciferol (oral nano-liquid droplets) for 7 days with therapeutic target 25(OH)D>50 ng/ml (intervention group) or placebo (control group). Patients requiring invasive ventilation or with significant comorbidities were excluded. 25(OH)D levels were assessed at day 7, and cholecalciferol supplementation was continued for those with 25(OH)D <50 ng/ml in the intervention arm. SARS-CoV-2 RNA and inflammatory markers fibrinogen, D-dimer, procalcitonin and (CRP), ferritin were measured periodically.Outcome measureProportion of patients with SARS-CoV-2 RNA negative before day-21 and change in inflammatory markers.ResultsForty SARS-CoV-2 RNA positive individuals were randomised to intervention (n=16) or control (n=24) group. Baseline serum 25(OH)D was 8.6 (7.1 to 13.1) and 9.54 (8.1 to 12.5) ng/ml (p=0.730), in the intervention and control group, respectively. 10 out of 16 patients could achieve 25(OH)D>50 ng/ml by day-7 and another two by day-14 [day-14 25(OH)D levels 51.7 (48.9 to 59.5) ng/ml and 15.2 (12.7 to 19.5) ng/ml (p<0.001) in intervention and control group, respectively]. 10 (62.5%) participants in the intervention group and 5 (20.8%) participants in the control arm (p<0.018) became SARS-CoV-2 RNA negative. Fibrinogen levels significantly decreased with cholecalciferol supplementation (intergroup difference 0.70 ng/ml; P=0.007) unlike other inflammatory biomarkers.ConclusionGreater proportion of vitamin D-deficient individuals with SARS-CoV-2 infection turned SARS-CoV-2 RNA negative with a significant decrease in fibrinogen on high-dose cholecalciferol supplementation.Trial register numberNCT04459247.

scholarly journals 4086 HIV-Associated Myocardial Diastolic Dysfunction and Soluble ST2 Concentration in Tanzanian Adults: A Cross-Sectional Study

2020 ◽  
Vol 4 (s1) ◽  
pp. 96-96
Author(s):  
Justin Kingery ◽  
Rahul Hosalli ◽  
Bernard Desdarius ◽  
Fredrick Kalokola ◽  
Edmund Damas ◽  
...  
Keyword(s):  
Diastolic Dysfunction ◽  
Large Population ◽  
Cross Sectional Study ◽  
Sub Saharan Africa ◽  
Secondary Outcome ◽  
Level Shift ◽  
Sectional Study ◽  
Cross Sectional ◽  
Baseline Serum ◽  
Soluble St2

OBJECTIVES/GOALS: To determine the prevalence of myocardial diastolic dysfunction (DD) and association of serum concentration of the cardiac biomarker serum soluble ST2 in HIV-infected as compared to uninfected Tanzanian adults at the time of HIV diagnosis. METHODS/STUDY POPULATION: In this cross-sectional study we consecutively enrolled HIV-infected participants and uninfected controls at a large, referral HIV clinic in Mwanza, Tanzania. Standardized history, physical examination, echocardiography and serum samples were obtained. The primary outcome was prevalence of myocardial diastolic dysfunction in HIV-infected as compared to uninfected adults. The secondary outcome was the association of baseline serum sST2 concentration with diastolic dysfunction prevalence. Regression models were used to quantify the associations. RESULTS/ANTICIPATED RESULTS: We enrolled 388 HIV-infected, ART naïve and 461 HIV-uninfected controls. Participants with HIV had a higher prevalence of DD (OR = 2.44, p = 0.001, controlled for age, sex, hypertension and BMI) and more severe dysfunction (66.7% vs 42.5%, p = 0.056) at an earlier age. Baseline serum sST2 concentration was significantly associated with DD in HIV-infected but not uninfected participants (p = 0.04 and 0.90, respectively). More HIV-infected adults with concurrent DD exceeded the threshold of 35ng/mL as compared to controls (15.7% vs 5.3%, p<0.0001). Additionally, a significant population level shift to higher sST2 concentration was observed in HIV-infected adults with dysfunction as compared to both HIV-infected without and HIV-uninfected adults with dysfunction (Kolmogrov-Smirnov test: p = 0.02 and 0.04). DISCUSSION/SIGNIFICANCE OF IMPACT: In a large population of HIV-infected adults in sub-Saharan Africa, HIV infection is associated with myocardial diastolic dysfunction. This dysfunction is associated with higher sST2 concentrations. Therefore, we conclude that the sST2 pathway may provide insight into the pathophysiologic mechanisms of dysfunction in HIV-infected adults.

scholarly journals Vitamin D supplementation does not improve CVD risk factors in vitamin D-insufficient subjects

2018 ◽  
Vol 7 (6) ◽  
pp. 840-849 ◽  
Author(s):  
Julia Kubiak ◽  
Per Medbøe Thorsby ◽  
Elena Kamycheva ◽  
Rolf Jorde
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Vitamin D ◽  
Controlled Trial ◽  
Hdl Cholesterol ◽  
Vitamin D Supplementation ◽  
High Dose ◽  
Cvd Risk Factors ◽  
Cvd Risk ◽  
Baseline Serum

Objective Low serum 25(OH)D levels are associated with cardiovascular disease (CVD) and some of its risk factors. However, in interventional studies, the effects of vitamin D supplementation have been uncertain, possibly due to inclusion of vitamin D-sufficient subjects. Our aim was therefore to examine effects of vitamin D supplementation on CVD risk factors in vitamin D-insufficient subjects. Design Double-blinded randomized controlled trial. Methods A 4-month interventional study with high-dose vitamin D (100,000 IU loading dose, followed by 20,000 IU/week) or placebo with measurements of blood pressure, lipids (total-, LDL- and HDL-cholesterol, triglycerides, apolipoproteins A1 and B), and glucose metabolism parameters (blood glucose, HbA1c, serum human receptors for advanced glycation end products (sRAGE), insulin, C-peptide and HOMA-IR). Results A total of 422 subjects with mean serum 25(OH)D level 34 nmol/L were included, with 411 subjects completing the study. Serum 25(OH)D levels increased with 56 nmol/L and decreased with 4 nmol/L in the vitamin D and placebo group, respectively. We found no statistically significant differences between the two groups in any of the measured CVD risk factors, except for a minor increase in sRAGE in the vitamin D group. Stratified analyses of subjects with low baseline serum 25(OH)D levels alone, or combined with blood pressure, lipid and HOMA-IR values above the median for the cohort, did not skew the results in favour of vitamin D supplementation. Conclusion Supplementation with vitamin D in subjects with baseline vitamin D insufficiency does not improve CVD risk factor profile.

scholarly journals High-dose versus low-dose ergocalciferol for correcting hypovitaminosis D after fragility hip fracture: A randomized controlled trial

2021 ◽  
Author(s):  
Atthakorn Jarusriwanna ◽  
Suchat Phusunti ◽  
Pojchong Chotiyarnwong ◽  
Aasis Unnanuntana
Keyword(s):  
Vitamin D ◽  
Hip Fracture ◽  
Dose Group ◽  
Low Dose ◽  
Hypovitaminosis D ◽  
Optimal Level ◽  
Vitamin D Supplementation ◽  
High Dose ◽  
Baseline Serum ◽  
Fragility Hip Fracture

Abstract Background: Hypovitaminosis D can be observed in most fragility hip fracture patients. However, measurement of 25-hydroxyvitamin D (25(OH)D) level is costly and may not be available in some centers. Without the baseline serum 25(OH)D level, the appropriate dose of vitamin D supplementation is not known. The aim of this study was to evaluate the effectiveness and safety of vitamin D supplementation in fragility hip fracture patients compared between high- and low-dose vitamin D supplementation. Methods: A total of 140 patients diagnosed with fragility hip fracture were randomly allocated to either the high-dose (60,000 IU/week) or low-dose (20,000 IU/week) vitamin D2 supplementation group for 12 weeks. The number of patients who achieved optimal vitamin D level (serum 25(OH)D > 30 ng/mL), the proportion of patients who developed hypercalcemia, and the functional outcome were compared between groups. Results: Of the 140 patients who were enrolled, 21 patients were lost to follow-up during the study period. The remaining 119 patients (58 and 61 in the high- and low-dose group, respectively) were included in the final analysis. The high-dose group had a higher rate of serum 25(OH)D restoration to optimal level than the low-dose group (82.8% vs 52.5%, respectively; p < 0.001). Approximately 3.4% and 1.6% of patients in the high- and low-dose groups, respectively, had mild transient hypercalcemia, but none developed moderate, severe, or symptomatic hypercalcemia. There were no differences in functional outcome scores between groups.Conclusions: In treatment settings where baseline serum 25(OH)D level can’t be evaluated in older adults with fragility hip fracture, we recommend high-dose vitamin D2 of approximately 60,000 IU/week for 12 weeks, with subsequent switch to a maintenance dose. This regimen effectively restored serum vitamin D to an optimal level in 82.8% of patients without causing symptomatic hypercalcemia.

scholarly journals Maternal 17q21 genotype influences prenatal vitamin D effects on offspring asthma/recurrent wheeze

2021 ◽  
pp. 2002012
Author(s):  
Hanna M. Knihtilä ◽  
Rachel S. Kelly ◽  
Nicklas Brustad ◽  
Mengna Huang ◽  
Priyadarshini Kachroo ◽  
...  
Keyword(s):  
Vitamin D ◽  
High Risk ◽  
Protective Effect ◽  
High Dose ◽  
Protective Effects ◽  
Maternal Genotype ◽  
Genotype Variation ◽  
Recurrent Wheeze ◽  
Randomised Controlled ◽  
Reduced Risk

BackgroundPrenatal vitamin D3 supplementation has been linked to reduced risk of early life asthma/recurrent wheeze. This protective effect appears to be influenced by variations in the 17q21 functional SNP rs12936231 of the child, which regulates the expression of ORMDL3, and for which the high-risk CC-genotype is associated with early-onset asthma. However, this does not fully explain the differential effects of supplementation. We investigated the influence of maternal rs12936231 genotype variation on the protective effect of prenatal vitamin D3 supplementation against offspring asthma/recurrent wheeze.MethodsWe determined the rs12936231 genotype of mother-child pairs from two randomised-controlled trials: the Vitamin D Antenatal Asthma Reduction Trial (VDAART, n=613) and the Copenhagen Prospective Studies on Asthma in Childhood 2010 (COPSAC2010, n=563) to examine the effect of maternal genotype variation on offspring asthma/recurrent wheeze at age 0–3 years between groups who received high-dose prenatal vitamin D3 supplementation versus placebo.ResultsOffspring of mothers with low-risk GG-genotype or GC-genotype who received high-dose vitamin D3 supplementation had a significantly reduced risk of asthma/recurrent wheeze when compared to the placebo group (hazard ratio [HR], 0.54; 95% confidence interval [CI], 0.37–0.77; p<0.001 for VDAART and HR, 0.56; 95% CI, 0.35–0.92; p=0.021 for COPSAC2010), whereas no difference was observed among the offspring of mothers with high-risk CC-genotype (HR, 1.05; 95% CI, 0.61–1.84; p=0.853 for VDAART and HR, 1.11; 95% CI, 0.54–2.28; p=0.785 for COPSAC2010).ConclusionMaternal 17q21 genotype has an important influence on the protective effects of prenatal vitamin D3 supplementation against offspring asthma/recurrent wheeze.

25-OH-VITAMIN D IS NOT ASSOCIATED WITH COGNITIVE PERFORMANCE AMONG MEXICAN COMMUNITY-DWELLING OLDER PERSONS

2015 ◽  
pp. 1-6
Author(s):  
A.P. NAVARRETE-REYES ◽  
I. GARCÍA-MUÑOZ ◽  
J.M.A. GARCÍA-LARA ◽  
N.M. TORRES-CARRILLO ◽  
H. AMIEVA ◽  
...  
Keyword(s):  
Vitamin D ◽  
Cognitive Performance ◽  
Latin American ◽  
Cross Sectional Study ◽  
Community Dwelling ◽  
Public Health Issue ◽  
Cross Sectional ◽  
Vitamin D Levels ◽  
Mexican Community ◽  
25 Oh Vitamin D

Background: Low cognitive performance has been associated with a wide array of adverse health-related outcomes in elderly populations. Recently, the effect of vitamin D on cognition has been studied; however, its benefits are still controversial. Moreover, most studies have been carried out on North-American and European populations where vitamin D deficiency could represent a greater public-health issue when compared to Latin American ones. Objective: To investigate the association between 25-OH-vitamin D and cognitive performance in Mexican community-dwelling elderly. Design, Setting and Participants: Cross-sectional study sample of 331 community-dwelling elderly aged 70 and older, participating in the Mexican Study of Nutritional and Psychosocial Markers of Frailty. Measurements: Serum 25-OH-vitamin D, cognitive performance as per the Mini-Mental State Examination (MMSE) and the IST (Isaacs Set Test), as well as several elements from the comprehensive geriatric assessment. Results: Mean age of participants was 79.3 years (SD 5.9), 54.1% were women. The mean serum 25-OH-vitamin D level was 59.0 (SD 23.3) nmol/L while mean MMSE score was 22.3 (SD 3.4) and mean IST score was 37.1 (SD 9.1). Although 25-OH-vitamin D levels were lower across all the definitions of low cognitive perfomance, the difference between groups was not statistically significant in any of them. Conclusion: No association between 25-OH-vitamin D level and cognitive performance was found in this population of Mexican community-dwelling elderly. Further investigation is required in order to clarify its existence and if so, to delineate its characteristics.

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