• Clinical and Experimental Pediatrics
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• v.62 no.5
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• pp.166-172
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• 2019

Purpose: This study aimed to evaluate vitamin D status at birth in very-low-birth-weight infants (VLBWIs: <1,500 g) and to determine the association between vitamin D level and respiratory morbidity. Methods: A retrospective study was conducted at Soonchunhyang University Bucheon Hospital between November 2013 and November 2017. We collected blood samples and data on respiratory morbidity from 230 VLBWIs on the first day of life. Patients who were transferred to other hospitals (n=19), died before 36 weeks of gestational age (n=18), or whose blood samples were not collected immediately after birth (n=5) were excluded. Finally, 188 patients were enrolled. VLBWIs with different vitamin D levels were compared with respect to demographic features, maternal diseases, respiratory morbidities, and other neonatal diseases. Results: The mean serum vitamin D level, as measured by 25-hydroxyvitamin D (25(OH)D), was $13.4{\pm}9.3ng/mL$. The incidence of vitamin D deficiency (<20 ng/mL) was 79.8%, and 44.1% of preterm infants had severe vitamin D deficiency (<10 ng/mL). Logistic analysis shows that a low serum 25(OH)D level (<20 ng/mL) was a risk factor for respiratory distress syndrome (odds ratio [OR], 4.32; P=0.010) and bronchopulmonary dysplasia (OR, 4.11; P=0.035). Conclusion: The results showed that 79.8% of preterm infants in this study had vitamin D deficiency at birth. Low vitamin D status was associated with respiratory morbidity, but the exact mechanism was unknown. Additional studies on the association between vitamin D level and neonatal morbidity are required.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.19 no.5
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• pp.303-311
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• 2018

The aim of this study was to investigate vitamin D status and factors associated with vitamin D deficiency among Koreans in their using Korean National Health and Nutrition Examination Survey (KNHANES) V. The subjects were 1,837 people who were 20-29 years old. The data were analyzed by ${\chi}^2$ test and multiple logistic regression analysis using weighted composite sample analysis. Vitamin D deficiency was reveled in 84.2% of subjects; 88.6% of women and 79.4% of men showed deficiency. In the multiple logistic regression analysis, the risk for vitamin D deficiency was higher in women (OR 1.84; 95% CI 1.31-2.56), non-married (OR 2.12; 95% CI 1.41-3.19), poor subjective health status (OR 1.94; 95% CI 1.16-3.25), and in the absence of moderate to vigorous physical activity (OR 3.38; 95% CI 1.85-6.16). Continued research on vitamin D levels at this time is needed since vitamin D deficiency among Koreans in their twenties will exacerbate health problems, both individually and socially. In addition, vitamin D has been shown to be closely related to time of exposure to sunlight and physical activity. Therefore, it is thought that long-term and planned efforts should be made at the national level, such as establishing schools and workplaces in which those in their twenties can perform outdoor activities and moderate to vigorous physical activity.

• Clinical and Experimental Reproductive Medicine
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• v.41 no.2
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• pp.80-85
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• 2014

Objective: To investigate: the prevalence of vitamin D deficiency in Korean women with polycystic ovary syndrome (PCOS), and the relationship between vitamin D status and clinical or metabolic features in this group. Methods: We recruited 38 women with PCOS using the Rotterdam criteria. A total of 109 premenopausal control women were matched with patients based on age and body mass index. Serum 25-hydroxy vitamin D concentrations less than 20 ng/mL were classified as frank vitamin D deficiency. Since vitamin D may play a significant role in metabolic disturbances in women with PCOS, correlations between clinical or metabolic parameters and vitamin D status were analyzed separately in patients and controls. Results: Women with PCOS showed no differences in the level of 25-hydroxy vitamin D ($19.6{\pm}6.6ng/mL$ in patients vs. $20.1{\pm}7.4ng/mL$ in controls, respectively, p=0.696) or prevalence of vitamin D deficiency (57.9% in patients vs. 56.5% in controls, respectively, p=0.880). In addition, we did not find any correlations between serum vitamin D level and clinical or metabolic profiles in either PCOS patients or controls. Conclusion: Our study found no differences in the absolute level of serum vitamin D between PCOS patients and matched controls. Prevalence of vitamin D deficiency was equally common among both patients and controls. Additionally, we did not find any correlations between serum vitamin D level and clinical or metabolic profiles, suggesting that the role of vitamin D in the pathogenesis of PCOS is not yet clear.

• The Korean journal of internal medicine
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• v.33 no.6
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• pp.1129-1136
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• 2018

Background/Aims: Vitamin D modulates innate and adaptive immune responses, and vitamin D deficiency is associated with increased mortality in hospitalized patients with pneumonia. We evaluated the prevalence of vitamin D deficiency in Korean patients with acute respiratory distress syndrome (ARDS) and its effect on the clinical outcomes of ARDS. Methods: We retrospectively analyzed the data of 108 patients who had a measured serum level of 25-hydroxy vitamin D3 ($25(OH)D_3$) at the time of diagnosis with ARDS. The clinical outcomes were evaluated based on $25(OH)D_3$ levels of 20 ng/mL and stratified by quartiles of $25(OH)D_3$ levels. Results: The mean age of patients was 59.4 years old; 77 (71.3%) were male. Vitamin D deficiency was found in 103 patients (95.4%). The mean $25(OH)D_3$ level was $8.3{\pm}7.0ng/mL$. Neither in-hospital mortality (40.0% vs. 68.0%) nor 6-month mortality (40.0% vs. 71.8%) significantly differed between groups. There were no significant differences in $25(OH)D_3$ level between survivors ($8.1{\pm}7.6ng/mL$) and non-survivors ($8.5{\pm}6.8ng/mL$, p = 0.765). There were no trends toward a difference in mortality among quartiles of $25(OH)D_3$ levels. However, $25(OH)D_3$ levels were inversely related with length of hospital stay and intensive care unit stay among in-hospital survivors. Conclusions: Vitamin D deficiency was prevalent in Korean patients with ARDS. However, levels of vitamin D were not associated with mortality. A large, prospective study is needed to evaluate the effects of vitamin D deficiency on clinical outcomes of ARDS.

• Journal of the Korean Orthopaedic Association
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• v.53 no.6
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• pp.552-557
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• 2018

Vitamin D plays a major role in bone metabolism, and its deficiency has an impact on fracture risk and healing. Low vitamin D levels are a cause of poor bone mineralization and have been associated with a significantly higher risk of physeal injury in children. This paper presents a case of a 13-year-old boy with a vitamin D deficiency, who sustained multiple sequential epiphyseal injuries at various areas. This report suggests that vitamin D deficiency is not only a significant cause of the clinical disease itself, but also an important factor affecting the successful recovery of injuries.

• Clinical and Experimental Pediatrics
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• v.53 no.2
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• pp.152-157
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• 2010

Purpose : Vitamin D deficiency rickets is a significant public health problem that results from insufficient exposure to sunlight and inadequate vitamin D supplementation. The purpose of this study is to identify the clinical characteristics of vitamin D deficiency rickets in infants. Methods : Data of 35 infants diagnosed as vitamin D deficiency rickets at Sanggye-Paik Hospital, Seoul, Korea, from March 2007 to May 2009 were reviewed. Children with plasma 25-hydroxyvitamin D levels <15 ng/mL and 15-30 ng/mL were considered to have vitamin D deficiency and vitamin D insufficiency, respectively. Results : Thirty-five infants (22 boys, 13 girls) were diagnosed with rickets. Mean age at diagnosis was $7.4{\pm}7.1$ months (range: 0.1-29.8 months). Eighteen infants (51%) were vitamin D deficient and seventeen infants (49%) were insufficient. Twenty-eight of all (80%) diagnosed as subclinical rickets. Twenty-nine infants (83%) were below the age of 12months. Twenty infants (57%) had breastfed and ten infants (29%) had iron deficiency anemia. Nine of breastfed infants (45%) were vitamin D deficient and ten of their mothers were vitamin D insufficient. Overall, radiographic evidence of rickets was present in 93% of the cases. Radiographic sign of rickets was evident even in vitamin D insufficient state. Conclusion : It is important for the clinician to screen for subclinical vitamin D deficiency rickets in inadequately supplemented infants by pairing 25-hydroxyvitamin D levels with wrist radiographs. A nationwide epidemiological study of vitamin D deficiency rickets must be conducted and evidence-based national guidelines must be defined to prevent rickets.

• Osteoporosis and Sarcopenia
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• v.2 no.4
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• pp.228-237
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• 2016

Objective: There has been no prospective study that examined intramuscular injection of high-dose vitamin D in Korean adults. The aim of this study was to assess the efficacy and safety of high-dose vitamin $D_3$ after intramuscular injection in Korean adults with vitamin D deficiency. Method: This study was a 24-week, prospective, multicenter, randomized, double-blind, placebo-controlled trial. A total of 84 subjects ${\geq}19$ and <65 years of age were randomly allocated to either the vitamin $D_3$ or placebo group in a 2:1 ratio. After randomization, a single injection of plain vitamin $D_3$ 200,000 IU or placebo was intramuscularly administered. If serum 25-hydroxyvitamin D (25[OH]D) concentrations were <30 ng/mLon week 12 or thereafter, a repeat injection was administered. Results: After a single intramuscular injection of vitamin $D_3$ to adults with vitamin D deficiency, the proportion of subjects with serum 25(OH)D concentrations ${\geq}30ng/mL$ within 12 weeks was 46.4% in the vitamin $D_3$ group and 3.6% in the placebo group (p<0.0001). The proportion of subjects with serum 25(OH)D concentrations ${\geq}30ng/mL$ within 24 weeks was 73.2% in the vitamin $D_3$ group and 3.6% in the placebo group (p<0.0001). Mean change in serum 25(OH)D concentrations at weeks 12 and 24 after vitamin $D_3$ injection was $12.8{\pm}8.1$ and $21.5{\pm}8.1ng/mL$, respectively, in the vitamin $D_3$ group, with no significant changes in the placebo group. Serum parathyroid hormone concentrations showed a significant decrease in the vitamin $D_3$ group but no change in the placebo group. Conclusion: Intramuscular injection of vitamin $D_3$ 200,000 IU was superior to placebo in terms of its impact on serum 25(OH)D concentrations, and is considered to be safe and effective in Korean adults with vitamin D deficiency.

• Allergy, Asthma & Respiratory Disease
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• v.6 no.6
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• pp.284-289
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• 2018

Purpose: Vitamin D plays an important role in calcium homeostasis and bone metabolism. It is associated with various diseases such as cardiovascular, immune, allergic and infectious disease. The aim of this study was to investigate the difference in clinical manifestations according to the concentration of vitamin D in mild bronchiolitis. Methods: We performed a retrospective review of medical records of patients with mild bronchiolitis from November 2016 to April 2017 in Daegu Fatima Hospital. Mild bronchiolitis was classified by the modified Tal's score method. Patients were divided into 2 groups according to a 25-hydroxyvitamin D level of 20 ng/mL. We analyzed the clinical characteristics and laboratory data from the 2 groups. Results: Of the 64 patients, 19 were included in the deficiency group and 45 in the normal group. Vitamin D levels were $11.7{\pm}4.9ng/mL$ in the deficiency group and $28.8{\pm}5.0ng/mL$ in the normal group. There were no differences in clinical features between both groups. However, the vitamin D deficiency group had significantly longer hospitalization than the normal group ($6.78{\pm}2.74$ days vs. $5.3{\pm}1.7$ days, P=0.045). In the deficiency group, the incidence of previous respiratory diseases was significantly higher (P=0.001). No significant difference in blood and respiratory virus tests was observed. Conclusion: Low vitamin D levels in mild bronchiolitis were associated with longer hospitalization and prior respiratory disease. Vitamin D may affect the course of mild bronchiolitis.

• Clinical and Experimental Pediatrics
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• v.54 no.2
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• pp.51-54
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• 2011

Vitamin D is present in two forms, ergocalciferol (vitamin $D_2$) produced by plants and cholecalciferol (vitamin $D_3$) produced by animal tissues or by the action of ultraviolet light on 7-dehydrocholesterol in human skin. Both forms of vitamin D are biologically inactive pro-hormones that must undergo sequential hydroxylations in the liver and the kidney before they can bind to and activate the vitamin D receptor. The hormonally active form of vitamin D, 1,25-dihydroxyvitamin D3 $[1,25(OH)_2D]$, plays an essential role in calcium and phosphate metabolism, bone growth, and cellular differentiation. Renal synthesis of $1,25(OH)_2D$ from its endogenous precursor, 25-hydroxyvitamin D (25OHD), is the rate-limiting and is catalyzed by the $1{\alpha}$-hydroxylase. Vitamin D dependent rickets type I (VDDR-I), also referred to as vitamin D $1{\alpha}$-hydroxylase deficiency or pseudovitamin D deficiency rickets, is an autosomal recessive disorder characterized clinically by hypotonia, muscle weakness, growth failure, hypocalcemic seizures in early infancy, and radiographic findings of rickets. Characteristic laboratory features are hypocalcemia, increased serum concentrations of parathyroid hormone (PTH), and low or undetectable serum concentrations of $1,25(OH)_2D$ despite normal or increased concentrations of 25OHD. Recent advances have showed in the cloning of the human $1{\alpha}$-hydroxylase and revealed mutations in its gene that cause VDDR-I. This review presents the biology of vitamin D, and $1{\alpha}$-hydroxylase mutations with clinical findings.

• Journal of Hospice and Palliative Care
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• v.17 no.1
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• pp.27-33
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• 2014

Purpose: Although vitamin D deficiency is more commonly found in cancer patient than in non-cancer patients, there have been little data regarding the prevalence of vitamin D deficiency in cancer patients at the very end of life. We examined vitamin D deficiency in terminally ill cancer patients and related factors. Methods: This study was based on a retrospective chart review of 133 patients in a hospice ward. We collected data regarding age, sex, serum 25-hydroxyvitamin D level, cancer type, physical performance, current medications and various laboratory findings. We investigated factors related to serum vitamin D levels after multivariate adjustment for potential confounders. Serum 25-hydroxyvitamin D<20 ng/mL was considered deficient and <10 ng/mL severely deficient. Results: Ninety-five percent of the patients were serum vitamin D deficient. Severe vitamin D deficiency was more common in male patients, non-lung cancer patients, $H_2$ blocker users and non-anticonvulsant users. Elevated levels of serum alanine aminotransferase (ALT) were also associated with low serum vitamin D levels. Multiple regression analysis showed that severe vitamin D deficiency was associated with male gender (aOR 3.82, 95% CI: 1.50~9.72, P=0.005), $H_2$ blocker users (aOR 3.94, 95% CI: 1.61~9.65, P=0.003) and elevated serum ALT levels (aOR 4.52, 95% CI: 1.35~15.19, P=0.015). Conclusion: Vitamin D deficiency was highly prevalent among terminally ill cancer patients. Severe vitamin D deficiency was more common in male patients, $H_2$ blocker users, and patients with elevated ALT levels.