scholarly journals Vitamin D and the Immune System. When? Why? How?

2020 ◽  
Vol 2 (1) ◽  
pp. 1
Author(s):  
Alida Moise ◽  
Carmen Balescu-Arion
Keyword(s):  
Vitamin D ◽  
Immune System ◽  
Vitamin D Deficiency ◽  
Critically Ill ◽  
Causal Relation ◽  
The Body ◽  
Cell Phenotype ◽  
Target Cells ◽  
Vitamin D Levels ◽  
High Doses

Vitamin D, called “the sunshine vitamin” is essential for the good functioning of the human body. Vitamin D generates its principal effects via the vitamin D receptor (VDR), a specific zinc-finger nuclear receptor, located primarily in the nuclei of target cells. VDR is present in most tissues and cells in the body such as in the: digestive system, cardiovascular system, immune system. This receptor represents the key to the understanding of vitamin D non-skeletal effects. Recently, some data were published on the correlation between vitamin D levels and sepsis, indicating a prevalence of vitamin D deficiency of approximately 61.6% in sepsis patients and of 74% in patients admitted to intensive care units (ICU). Vitamin D deficiency in critically ill patients is associated with infection and sepsis, and this association is based on the relation between vitamin D and inflammatory cytokine. Vitamin D, via VDR influences the secretion of cytokines and antimicrobial peptides. Practically, vitamin D acts as an immunomodulator stimulating the differentiation of cells of the innate immune system and, regulating T and B cell proliferation. The data clearly show predominant effects of vitamin D on the adaptive immune function. Vitamin D modulates the T cell phenotype specially that of CD4+ helper T cells (Th1, Th2, as well as Th17 sub-grups). The amplitude of the response to vitamin D depends on a cell’s state of activation, as the number of VDR in inactive cells is low, but may increase five times after activation It was found that the intestinal expression of VDR regulates the host’s microbiome and mediates the anti-inflammatory effects of probiotics. A low level of vitamin D in ICU patients is demonstrated and has many causes. The rapid correction of this deficiency by administering very high doses of vitamin D is possible without causing adverse effects like hypercalcemia or hypercalciuria. Vitamin D is more than just a vitamin. It has clear effects on the immune system, in particular in patients with autoimmune diseases and critically ill. Currently, the majority of data strongly support the association, between low vitamin D levels and sepsis rather than a causal relation. Vitamin D is emerging as a promising and relatively safe nutrient for developing new preventive strategies and adjuvant treatments of diseases, caused by impaired immune-homeostasis. In addition, its supplmentation is very easy and safe.

scholarly journals Relation of serum 25(OH) D with variables of thyroid and lipid profile in perimenopausal women

2017 ◽  
Vol 6 (3) ◽  
pp. 1087
Author(s):  
Poonam Rani ◽  
Seema Gupta ◽  
Gaurav Gupta
Keyword(s):  
Cardiovascular Disease ◽  
Vitamin D ◽  
Lipid Profile ◽  
Vitamin D Deficiency ◽  
Serum Levels ◽  
The Body ◽  
P Value ◽  
Thyroid Disorder ◽  
Vitamin D Levels ◽  
Perimenopausal Women

Background: Deficiency of vitamin D is quite prevalent among elderly population or postmenopausal women worldwide and may affect various function of the body. The status of its deficiency with their relation with other variables are not well explored in perimenopausal women.Methods: 100 perimenopausal women from the department of obstetrics and gynaecology were selected without having known risk of thyroid disorder and cardiovascular disease. The age group criteria for these women were 40 to 50 years. Thyroid profile including TSH, T3, and T4 were estimated by using enzyme linked immunesorbent assay. Serum levels of 25(OH) D3 was estimated by using spectrophotometric method. Lipid profile including TC, TG and HDL-C were estimated CHOD-POD method, GPO-PAP method, and CHOD-POD/Phosphotungustate method. LDL-C was calculated by friedewald formula.Results: There 58 women were presented with insufficient amount of vitamin D. They were characterised with increased BMI, elevated thyrotropin alongwith lower concentrations of T3 and T4. Increased levels of TC, TG and LDL-cholesterol alongwith lower concentration of HDL-C were also observed in women with vitamin d deficiency. Women having vitamin D deficiency were presented with overweight (OR-18.0, p-value=<0.001) and dyslipidemia (OR-12.13, p-value≤0.001). Vitamin D was negatively correlated with variable i.e. BMI, TSH, TC, TG and LDL-C. This negative association was significant (<0.001) while HDL-C and T4 were positively correlated with vitamin D levels in this study population.Conclusions: Vitamin D deficiency frequently occurs in middle aged perimenopausal women. Negative correlation of it with BMI, TSH and lipid variables may suggest the development of cardiovascular disease and hypothyroidism in coming years. Vitamin D supplements or vitamin D containing diet and regular exposure to sun is highly recommended to perimenopausal women.

scholarly journals Role of Vitamin D in Cardiometabolic Diseases

2013 ◽  
Vol 2013 ◽  
pp. 1-10 ◽  
Author(s):  
Chaoxun Wang
Keyword(s):  
Metabolic Syndrome ◽  
Vitamin D ◽  
Vitamin D Deficiency ◽  
Vascular Inflammation ◽  
Left Ventricular ◽  
Bone Diseases ◽  
The Body ◽  
Cvd Risk ◽  
Increased Risk ◽  
Vitamin D Levels

Vitamin D deficiency is a highly prevalent condition. Low vitamin D levels have long been associated with bone diseases, such as rickets in children and osteomalacia and osteoporosis in adults. However, it has become apparent in recent years that adequate vitamin D levels are also important for optimal functioning of many organs and tissues throughout the body, including the cardiovascular system. Evolving data indicate that vitamin D deficiency is associated with an increased risk of cardiovascular disease (CVD). Studies have shown that low vitamin D levels are associated with hypertension, diabetes, metabolic syndrome, left ventricular hypertrophy, and chronic vascular inflammation, all of which are risk factors for CVD. This paper reviews the definition and pathophysiology of vitamin D deficiency, clinical evidence linking vitamin D and CVD risk, diabetes and its complications, and metabolic syndrome.

scholarly journals Body composition and metabolic profile in adults with vitamin D deficiency

2017 ◽  
Vol 30 (4) ◽  
pp. 419-430 ◽  
Author(s):  
Liane Murari ROCHA ◽  
Daniela Cristina da Silva BALDAN ◽  
Aglécio Luiz SOUZA ◽  
Elinton Adami CHAIM ◽  
Elizabeth João PAVIN ◽  
...  
Keyword(s):  
Vitamin D ◽  
Body Composition ◽  
Vitamin D Deficiency ◽  
Lean Mass ◽  
Metabolic Profile ◽  
The Body ◽  
Impedance Method ◽  
Model Assessment ◽  
Homeostasis Model Assessment ◽  
Vitamin D Levels

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

scholarly journals Expression of Vitamin D Receptor Pathway Genes in Subcutaneous Adipose Tissue of Obese Individuals

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. A658-A658
Author(s):  
Olivia Z B Ginnard ◽  
Stephanie Sisley
Keyword(s):  
Gene Expression ◽  
Vitamin D ◽  
Vitamin D Deficiency ◽  
Subcutaneous Adipose Tissue ◽  
Target Gene ◽  
The Body ◽  
Target Gene Expression ◽  
Vitamin D Levels ◽  
Subcutaneous Adipose ◽  
Gene Expression Levels

Abstract Introduction: Vitamin D deficiency is a substantial comorbidity in 50% of pediatric patients and is linked with poorer health outcomes in children. Vitamin D levels are also shown to be inversely related to BMI. Therefore, there are many more children with low vitamin D levels due to the increasing prevalence of pediatric obesity. Pediatric patients with obesity and vitamin D deficiency also have a uniquely increased risk of metabolic syndrome, as compared to their lean peers. Measured levels of vitamin D correlate with other physiological markers of vitamin D effects in lean individuals but not obese individuals. It is possible that vitamin D levels reflect a storage form of vitamin D rather than a true reflection of vitamin D action in the body in this particular population. The aim of this study was to provide foundational knowledge to understand if expression of vitamin D receptor (VDR)-target genes may be used as a reference standard for vitamin D status in the body. Methods: We performed a secondary analysis of samples obtained from 33 obese adolescents that were consented under a past IRB-approved protocol. They were between the ages of 13 to 18 years that underwent bariatric surgery between 2004 and 2019. Data comprised of age, gender, race/ethnicity, and BMI. Samples collected included blood and subcutaneous adipose tissue. The tissue was analyzed via Real Time-PCR to obtain quantitative levels of VDR-target gene expression, which included PPARg, TLR4, THBD, CYP24A1, and VDR. Gene expression levels were normalized to the average of two housekeeping genes, GAPDH and RPLPO. Blood samples provided vitamin D levels (serum 25(OH)D). Results: VDR-target gene expression was significantly correlated between THBD, VDR, and TLR4 (p &lt;0.05), and PPARg with THBD and TLR4 (p &lt;0.05). There was no correlation observed between CYP24A1 gene expression and the other genes that were evaluated (p &gt;0.05). PPARg, THBD, TLR4, CYP24A1, and VDR gene expression levels did not correlate with circulating serum 25(OH)D levels (p &gt;0.05). Conclusion: These preliminary findings suggest that VDR-target gene expression correlates with each other but not with circulating serum 25(OH)D levels. This discrepancy supports that 25(OH)D levels do not indicate levels of vitamin D action and may not be an appropriate indicator of vitamin D deficiency in the obese population. Also, the observed CYP24A1 gene expression was limited in subcutaneous adipose tissue yet expression was seen in multiple other VDR-target genes. This emphasizes the tissue-specific nature of gene regulation of vitamin D. Further work should investigate VDR-target gene expression levels across multiple tissues of obese individuals to determine if markers of vitamin D action in one tissue are reflective of action across the body. This study may provide the first step in determining a new and more accurate biomarker for vitamin D deficiency and treatment in obesity.

scholarly journals Vitamin D Levels among Hospitalized and Non-Hospitalized COVID-19 Patients in Dr. M. Djamil General Hospital Padang

2021 ◽  
Vol 3 (6) ◽  
pp. 78-81
Author(s):  
Harika Putra ◽  
Efrida ◽  
Rismawati Yaswir
Keyword(s):  
Vitamin D ◽  
Immune System ◽  
Vitamin D Deficiency ◽  
Serum Vitamin ◽  
Study Groups ◽  
P Value ◽  
Chi Square ◽  
Serum Vitamin D ◽  
Vitamin D Levels ◽  
Chemiluminescent Microparticle Immunoassay

Coronavirus Disease 2019 (COVID-19) causes immune system dysregulation and an exaggerated systemic inflammatory response. Vitamin D acts as an immunomodulator that enhances the immunity defense. Low levels of vitamin D affect the severity of COVID-19 infection. This study aims to determine vitamin D levels in hospitalized and non-hospitalized COVID-19 patients. A case-control study was conducted involving 62 COVID-19 patients, equally divided into hospitalized and non-hospitalized groups at RSUP dr. M. Djamil, Padang from February to September 2020. Serum vitamin D levels were measured using the Chemiluminescent Microparticle Immunoassay. Vitamin D deficiency was defined as a level less than 20 ng/mL. The hospitalized group consisted of moderate to critical COVID-19 patients, whereas the non-hospitalized group consisted of the asymptomatic and mild COVID-19 patients according to the Indonesian Ministry of Health Guidelines. All data were analyzed using a T-test and Chi-square with a significant p-value of 0.05. The results showed that most subjects were women between 21–60 years. The mean level of vitamin D (ng/mL) in the hospitalized group was lower than in the non-hospitalized group (15.5 ± 7.72 vs. 19.2 ± 14.30; 95% CI -9.509–2.167; p=0.213). Vitamin D deficiency affected hospitalized group more than the non-hospitalized group, but not statistically significant (71% vs. 64.5%, p=0.566). It indicated the role of vitamin D in preventing immune system hyperactivation causing COVID-19 cytokine storm. This study concluded no difference in vitamin D levels among the study groups. Nevertheless, further research on vitamin D is needed to determine its role and benefits against COVID-19 infection.

scholarly journals Are Vitamin D Levels Associated With Risk of Deep Neck Infection?

2019 ◽  
pp. 014556131986549
Author(s):  
Mustafa Sıtkı Gozeler ◽  
Muhammed Sedat Sakat ◽  
Korhan Kilic ◽  
Abdulkadir Sahin ◽  
Arzu Tatar ◽  
...  
Keyword(s):  
Vitamin D ◽  
Immune System ◽  
Vitamin D Deficiency ◽  
Serum Levels ◽  
Control Group ◽  
Deep Neck Infection ◽  
Neck Infection ◽  
Vitamin D Receptors ◽  
Vitamin D Levels ◽  
25 Hydroxy Vitamin D

Deep neck infection (DNI) refers to infections in spaces created by superficial and deep cervical fascia around the muscles and organs in the neck. Vitamin D is highly important for an effective immune system. Vitamin D receptors (VDR) have been identified in immune system cells, and particularly in T and B lymphocytes, macrophages, and dendritic cells. Vitamin D deficiency is thought to result in impaired immune response, decreased leukocyte chemotaxis, and an increased disposition to infection. The purpose of this study was to investigate whether vitamin D deficiency is an underlying occult factor in the development of DNI. Sixty-five patients aged 6 to 90, diagnosed with DNI, and 70 healthy age- and sex-compatible cases were included in the study. Serum levels of calcium, phosphorus, parathyroid hormone, and 25-hydroxy vitamin D (25(OH)D) were determined in each case. 25-hydroxy vitamin D levels above 20 ng/mL were regarded as normal, 12 to 20 ng/mL as insufficient, 5 to 12 ng/mL as deficient, and less than 5 ng/mL as severely deficient. Mean serum 25(OH)D levels were 10.4 (6.2) ng/mL in the patient group and 15.5 (6.4) ng/mL in the control group ( P < .01). This difference was statistically significant ( P < .01). Vitamin D was within normal limits in 9.2% (n = 6) of cases in the study group, insufficient in 29.2% (n = 19), deficient in 35.3% (n = 23), and severely deficient in 26.2% (n = 17). The equivalent values in the control group were 21.4% (n = 15), 48.5% (n = 34), 30% (n = 21), and 0% (n = 0). Serum 25(OH)D levels were significantly lower in patients with DNI compared to the healthy cases; 25(OH)D levels may be a factor in the development of DNI.

Vitamin D deficiency and mortality among critically ill surgical patients in an urban Korean hospital

2020 ◽  
pp. 1-8 ◽  
Author(s):  
Ji-hyun Lee ◽  
Seo-rin Doo ◽  
Dongha Kim ◽  
Yoo-kyoung Park ◽  
Eun-jeong Park ◽  
...  
Keyword(s):  
Vitamin D ◽  
Vitamin D Deficiency ◽  
Critically Ill ◽  
Serum Vitamin ◽  
Surgical Patients ◽  
Serum Vitamin D ◽  
Vitamin D Levels ◽  
Significant Difference ◽  
Deficiency Group ◽  
Critically Ill Surgical Patients

Abstract. Critically ill patients in intensive care units (ICUs) are exposed to various risk factors for vitamin D deficiency. Vitamin D deficiency in extended-stay patients may result in decreased muscle mass and increased fat tissue, which may impair rehabilitation and recovery. Our study aimed to evaluate the degree of serum vitamin D deficiency in critically ill surgical patients and its association with clinical outcomes. Clinical data from 186 adult male (n = 121; 65.1%) and female (n = 65; 34.9%) patients hospitalized in surgical ICUs at Ajou University Hospital from April 2015 to September 2016 were retrospectively analyzed. All adult surgical patients between the age of 18 and 88 years were enrolled. The mean serum 25-hydroxyvitamin D (25[OH]D) level of all patients was 17.8 ng/mL. A total of 120 patients (64.5%) with serum 25(OH)D levels < 20 ng/mL were classified as the deficiency group. A prolonged hospital stay was observed among the deficiency group but was not statistically significant ( p = 0.824). Serum 25(OH)D levels were significantly correlated with age but inversely correlated with Sequential Organ Failure Assessment (SOFA) score, selenium, triglyceride, and C-reactive protein levels. There was no significant difference in mortality rates between the group with a vitamin D injection and the group without a vitamin D injection (14.6% vs. 16.9%, p = 0.074). Vitamin D deficiency was common in surgical ICU patients; however, vitamin D levels were higher in older patients. In conclusion, vitamin D deficiency was inversely associated with the SOFA severity score (Correlation Coefficient –0.165, p = 0.024) but was not associated with the length of hospital or ICU stay and mortality.

scholarly journals Factors affecting vitamin D status in Moscow adolescents

2019 ◽  
pp. 50-57
Author(s):  
I. N. Zakharova ◽  
E. A. Solov’yeva ◽  
T. M. Tvorogova ◽  
S. I. Lazareva ◽  
T. Yu. Vil’ken ◽  
...  
Keyword(s):  
Risk Factors ◽  
Vitamin D ◽  
Vitamin D Deficiency ◽  
Respiratory Infections ◽  
Endocrine System ◽  
Risk Groups ◽  
The Body ◽  
Gastrointestinal Pathology ◽  
Vitamin D Levels ◽  
The Impact

Justification of the study. The normalization of vitamin D levels in both children and adults is the goal of numerous studies around the world, and the setting of a number of objectives related to this vector of preventive medicine, dictates the need for a more detailed study of regional features of the status of calcidiol and the identification of both risk factors and risk groups. Aim of the study: to analyze the impact of risk factors on the provision of vitamin D to adolescents in the Moscow region. Methods: 360 children over 11 years of age (average age was 14.74 ± 1.92 years) who attended a children’s polyclinic for preventive check-ups or are under observation in a day-care centre. After the examination, all schoolchildren were determined to have serum content of calcidiol – active metabolite of vitamin D. Results: the analysis revealed low vitamin D levels in children, with a median of 16.1 ng/ml. Normal vitamin D levels were found in only 6.7% of cases. The following risk factors for vitamin D deficiency were identified in Moscow schoolchildren: time of year (p < 0.001), inclusion of such foods as fish (p = 0.021) and liver (p = 0.036), gastrointestinal pathology (p < 0.001), endocrine system pathology (p < 0.001), musculoskeletal system pathology (p = 0.045): course of chronic inflammatory process (p = 0.01) in the body. The correlation between acute respiratory diseases and calcidiol supply was analyzed: at low frequency of acute respiratory infections during the year, the median level of vitamin D was 17.1 ng/ml (Q1-Q3: 12.6-22.1 ng/ml), at an average frequency – 11.4 ng/ml (Q1-Q3: 8.45-16.05 ng/ml), at high frequency – decreased to 7.94 ng/ml (Q1-Q3: 5.89-9.06 ng/ml). Conclusion: Vitamin D deficiency prophylaxis should be provided to children all year round, without a break for the summer months. If a child has a risk factor for vitamin D deficiency, the metabolite correction should be controlled by the calcidiol serum content.

scholarly journals Up to 40% of COVID-19 Critically Ill Patients Have Vitamin D Deficiency

2020 ◽  
Author(s):  
Teresa-Maria Tomasa-Irriguible ◽  
Lara Bielsa-Berrocal
Keyword(s):  
Vitamin D ◽  
Vitamin D Deficiency ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Statistical Significance ◽  
Vitamin D Status ◽  
Reactive Protein ◽  
Vitamin D Levels ◽  
Polymerase Chain ◽  
Potential Strategy

Background: Coronavirus disease (COVID-19) has caused more than 745,000 deaths worldwide. Vitamin D has been identified as a potential strategy to prevent or treat this disease. The purpose of the study was to measure vitamin D at hospital admission of COVID-19; Methods: We included critically ill patients with the polymerase chain reaction positive test for COVID-19, from March to April, 2020. Statistical significance was defined as P &amp;lt; .05. All tests were 2-tailed; Results: A total of 35 patients (median age, 60 years; 26 [74.3%] male) were included. Vitamin D levels were categorized as deficient for 14 participants (40%). Vitamin D deficiency was associated with vitamin A (P= 0.003) and Zinc (P= 0.019) deficiency and lower levels of albumin (P= 0.026) and prealbumin (P= 0.009). Overall, none of the studied variables were associated with vitamin D status: mortality, intensive care unit (ICU) or hospital stay, necessity of vasoactive agents, intubation, prone position, C reactive protein (CRP), Dimer-D, Interleukin 6 levels (IL-6), ferritin levels, or bacterial superinfection; Conclusions: In this single-center, retrospective cohort study, deficient vitamin D status was found in 40% in COVID-19 critically ill patients. However, deficient vitamin D status was not associated with inflammation or outcome.

663 Effect of Admission Vitamin D Levels on Outcomes in Pediatric Burn Patients

2020 ◽  
Vol 41 (Supplement_1) ◽  
pp. S176-S177
Author(s):  
Kate Pape ◽  
Colette Galet
Keyword(s):  
Vitamin D ◽  
Vitamin D Deficiency ◽  
Critically Ill ◽  
Pediatric Patients ◽  
Graft Loss ◽  
Small Sample ◽  
Hospital Length Of Stay ◽  
Burn Patients ◽  
Poverty Level ◽  
Vitamin D Levels

Abstract Introduction The effect of vitamin D levels on clinical outcomes has been studied in critically ill non-burn patients and adult burn patients. Low vitamin D levels predicted sepsis and were associated with in-hospital mortality in critically ill non-burn patients. Vitamin D deficiency and insufficiency in adult burn patients correlated with higher rates of complications and longer ICU and hospital length of stay (LOS). Vitamin D levels in pediatric patients have been studied during the post-burn period, showing that low vitamin D levels post-burn may play a role in post-burn osteopenia. However, the effects of admission vitamin D levels on outcomes have not been evaluated in the pediatric burn population. Methods This is a retrospective study of pediatric burn patients admitted to an American Burn Association verified burn center over a 3-year period. Patients were included if they were under the age of 18 years and had a vitamin D level measured within 7 days of admission. Vitamin D deficiency was defined as vitamin D level less than 12 ng/mL; insufficiency as vitamin D level 12–20 ng/mL; sufficiency greater than 20 ng/mL. Basic demographics were collected. Outcome data collected included infection, graft loss, renal failure requiring renal replacement therapy, LOS, number of days requiring the ventilator, and need for vasopressors. Univariate and multivariate analyses were performed using SPSS 25.0. P &lt; 0.05 was considered significant. Results A total of 249 pediatric patients were admitted during the study period. Of those, 38 patients had vitamin D levels measured within the first 7 days of admission and were included in the study. No patients were vitamin D deficient, and 7 (18%) patients were vitamin D insufficient. No significant differences were observed between patients who were vitamin D sufficient or insufficient with regards to sex, race, or mechanism of burn injury. Patients who were vitamin D insufficient had a longer LOS (15 days vs. 3.34 days; p = 0.023), a larger total body surface area burn size (16.75% vs. 7.23%; p = 0.027), and required more surgeries (1.14 vs. 0.06; p = 0.037). After adjustment for age and gender, higher vitamin D levels were associated with an increased chance of not having surgery (OR = 1.29, 95%CI[1.06–1.58]; p = 0.013). Conclusions Despite its retrospective nature and small sample size, our study suggests that pediatric patients who present with vitamin D insufficiency may be at risk for increased LOS and need for surgery. Applicability of Research to Practice Larger studies are warranted to identify outcomes affected by low vitamin D levels on admission as well as socioeconomic factors, such poverty level and food insecurity, that may affect vitamin D levels on admission.

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