Purpose: Vitamin D status is associated with several chronic diseases related to obesity. In this study, we evaluate the nutritional status of vitamin D and its relation to obesity indices in Korean women. Methods: A total of 156 healthy women participated. Vitamin D status (serum $25-OH-vitamin\;D_3$ level) and obesity indices (body mass index, body fat mass, waisthip ratio, and body fat percentage etc.) and serum lipid profiles and serum adipokine (leptin and adiponectin) levels were analyzed. Results: The $25(OH)D_3$ level showed an extremely skewed distribution from 4.1 ng/ml to 24.4 ng/ml and mean $25(OH)D_3$ level was $9.0{\pm}4.0ng/ml$. With cut-off level for vitamin D deficiency (< 12.0 ng/ml), insufficiency (12-19.9 ng/ml) and sufficiency (${\geq}20ng/ml$), 77.6%, 19.2%, and 3.2% of subjects showed vitamin D deficiency, insufficiency, and sufficiency status, respectively. The $25(OH)D_3$ level showed positive correlation with weight (r = 0.2461, p < 0.01), body mass index (r = 0.2913, p < 0.001), body fat contents (r = 0.1691, p < 0.05), fat free mass (r = 0.2330, p < 0.01), and waist hip ratio (r = 0.1749, p < 0.05) after adjusted by age. The $25(OH)D_3$ level showed no significant correlation with serum lipid profiles and adipokine levels. Conclusion: Most subjects (76.6%) in this study, who had a vitamin D deficient status and serum $25(OH)D_3$ level, showed positive correlation with several obesity indices, however further research based on a large Korean population is needed to confirm the relationship.
"Rickets" is the term applied to impaired mineralization at epiphyseal growth plate, resulting in deformity and impaired linear growth of long bones. Rickets may arise as a result of vitamin D deficiency or abnormality in metabolism. Vitamin D-dependent rickets(VDDR) is rare autosomal recessive disorder in which affected individuals have clinical features of vitamin D deficiency. In 1961, Prader first described this disorder including severe clinical features of rickets, such as hypophosphatemia, hypocalcemia, muscle weakness and seizure. Two distinctive hereditary defects, type I VDDR and type II VDDR have been recognized in vitamin D metabolism. Type I VDDR may be due to congenital defects of renal 1 ${\alpha}$-hydroxylase, the enzyme responsible for conversion of $25(OH)D_3$. These patients have low to detectable $1,25(OH)_2D_3$ in presence of normal to raised $25(OH)D_3$. In type II VDDR, renal production of $1,25(OH)_2D_3$ is intact but $1,25(OH)_2D_3$ is not used effectively and target organ resistant to $1,25(OH)_2D_3$ is respectively derived from the abnormality in the vitamin D receptor. We report a case of a 25 month-old girl with typical clinical features of VDDR type I rickets, hypocalcemia, increased alkaline phosphatase and secondary hyperparathyroidism.
Since 2006, type 1 diabetes in Finland has plateaued and then decreased after the authorities' decision to fortify dietary milk products with cholecalciferol. The role of vitamin D in innate and adaptive immunity is critical. A statistical error in the estimation of the recommended dietary allowance (RDA) for vitamin D was recently discovered; in a correct analysis of the data used by the Institute of Medicine, it was found that 8895 IU/d was needed for 97.5% of individuals to achieve values ${\geq}50nmol/L$. Another study confirmed that 6201 IU/d was needed to achieve 75 nmol/L and 9122 IU/d was needed to reach 100 nmol/L. The largest meta-analysis ever conducted of studies published between 1966 and 2013 showed that 25-hydroxyvitamin D levels <75 nmol/L may be too low for safety and associated with higher all-cause mortality, demolishing the previously presumed U-shape curve of mortality associated with vitamin D levels. Since all-disease mortality is reduced to 1.0 with serum vitamin D levels ${\geq}100nmol/L$, we call public health authorities to consider designating as the RDA at least three-fourths of the levels proposed by the Endocrine Society Expert Committee as safe upper tolerable daily intake doses. This could lead to a recommendation of 1000 IU for children <1 year on enriched formula and 1500 IU for breastfed children older than 6 months, 3000 IU for children >1 year of age, and around 8000 IU for young adults and thereafter. Actions are urgently needed to protect the global population from vitamin D deficiency.
Parra-Ortega, Israel;Alcara-Ramirez, Diana Guadalupe;Ronzon-Ronzon, Alma Angelica;Elias-Garcia, Fermin;Mata-Chapol, Jose Agustin;Cervantes-Cote, Alejandro Daniel;Lopez-Martinez, Briceida;Villasis-Keever, Miguel Angel;Zurita-Cruz, Jessie Nallely
Nutrition Research and Practice
/
v.15
no.sup1
/
pp.32-40
/
2021
BACKGROUND/OBJECTIVES: Considering the high number of deaths from coronavirus disease 2019 (COVID-19) in Latin American countries, together with multiple factors that increase the prevalence of vitamin D deficiency, we aimed to determine 25-hydroxyvitamin D (25[OH]D) levels and its association with mortality in patients with critical COVID-19. SUBJECTS/METHODS: This was a prospective observational study including adult patients with critical COVID-19. Data, including clinical characteristics and 25(OH)D levels measured at the time of intensive care unit admission, were collected. All patients were followed until hospital discharge or in-hospital death. The patients were divided into those surviving and deceased patient groups, and univariate and multivariate logistic regression analyses were performed to determine independent predictors of in hospital mortality. RESULTS: The entire cohort comprised 94 patients with critical COVID-19 (males, 59.6%; median age, 61.5 years). The median 25(OH)D level was 12.7 ng/mL, and 15 (16%) and 79 (84%) patients had vitamin D insufficiency and vitamin D deficiency, respectively. The median serum 25(OH)D level was significantly lower in deceased patients compared with surviving (12.1 vs. 18.7 ng/mL, P < 0.001). Vitamin D deficiency was present in 100% of the deceased patients. Multivariate logistic regression analysis revealed that age, body mass index, other risk factors, and 25(OH)D level were independent predictors of mortality. CONCLUSIONS: Vitamin D deficiency was present in 84% of critical COVID-19 patients. Serum 25(OH)D was independently associated with mortality in critical patients with COVID-19.
Purpose: Vitamin D deficiency is common in Crohn disease (CD). The aim of the study was to examine the prevalence of vitamin D deficiency and evaluate the association between vitamin D status and growth outcome in Korean pediatric CD patients. Methods: In this retrospective study, 17 children younger than 18 years old diagnosed with CD were enrolled and their serum 25-hydroxy vitamin D (25[OH]D) was checked between 2011 and 2015. We categorized the patients into two groups, Group 1 and Group 2. Group 1 included patients with serum 25(OH)D levels below 10 ng/mL, and Group 2 was for patients with a 25(OH)D serum levels between 10 ng/mL and 30 ng/mL. The z-scores for height (Htz), weight (Wtz), and body mass index (BMIz) were measured at baseline, 6 months, and 12 months. Results: The mean serum 25(OH)D levels of the total 65 CD patients and 17 enrolled patients were $15.64{\pm}6.9ng/mL$ and $13.1{\pm}5.1ng/mL$, respectively. There was no correlation at the beginning of the study between vitamin D level and growth parameters (Htz, Wtz, BMIz) or other variables including laboratory data and Pediatric Crohn Disease Activity Index. The Htz, Wtz, and BMIz in Group 1 showed no significant improvement at 6 months and 12 months follow-up. In Group 2, Wtz and BMIz showed significant improvements sustained until 12 months of follow-up. Htz showed no significant improvement at 6 months but there was significant improvement at 12 months. Conclusion: It seems that baseline vitamin D status affects growth outcome in pediatric CD.
The purpose of this study was to determine whether vitamin {TEX}$B_{6}${/TEX} deficiency and age affect the blood cho-lesterol profile in exercising rats. Fifty four rats were fed either a viramin {TEX}$B_{6}${/TEX} deficient dief(-{TEX}$B_{6}${/TEX}) of a control diet(+{TEX}$B_{6}${/TEX}) for 6 weeks, then subdivided into 3 groups:non-exercise group(NE), exercise and sacrifice group(ES), exercise and recuperation group(ER). ES group was exercised in treadmill({TEX}$10^{o}${/TEX}, 0.5~0.8km/h) for 2 hours and sacrifice. ER group was recuperated three days with respective diet after exercise. At week 3 and 6, and level of plasma total cholesterol(TC), high density lipoprotein cholesterol(HDL_C) and low density lipoprotein cholesterol(LDL_C) were compared. In NE group, there was no difference in the levels of TC, HDL_C and LDL_C between +{TEX}$B_{6}${/TEX} rats and -{TEX}$B_{6}${/TEX} rats. The plasma levels of TC and LDL_C of 6 weeks were higher than those of 3 weeks and on difference in HDL_V between 3 weeks rats and 6 weeks rats. In ES group, there was also no difference in the levels of TC, HDL_C and LDL_C between +{TEX}$B_{6}${/TEX} rats and -{TEX}$B_{6}${/TEX} rats and there was no difference in TC, LDL-cholesterol between 3 weeks rats and 6 weeks rats. The level of HDL_C pf 6 weeks was lower than that of 3 weeks rats. In ER group, there was no difference in the levels of TC and LDL_C not only between +{TEX}$B_{6}${/TEX} rats and-{TEX}$B_{6}${/TEX} rats but also between 3 weeks rats and 6 weeks rats. The level of HDL_C was lower in -{TEX}$B_{6}${/TEX} rats than in +{TEX}$B_{6}${/TEX} rats and higher in 6 weeks rats than in 3 weeks rats. These results suggest that vitamin {TEX}$B_{6}${/TEX} deficiency may affect the HDL_C during exercise and after recuperation. The desirable effect of exercise on plasma Cholesterol profile is strengthened in adult age than young age.
BACKGROUND/OBJECTIVES: Vitamin E is a fat-soluble vitamin and functions primarily as a lipid antioxidant. Inadequate vitamin E status may increase risk of several chronic diseases. Thus, the objectives of this study were to estimate intake and plasma concentration of each tocopherol and to evaluate vitamin E status of Korean adults. SUBJECTS/METHODS: Three consecutive 24-h food recalls and fasting blood samples were collected from healthy 20- to 59-y-old adults (33 males and 73 females) living in the Seoul metropolitan area, South Korea. ${\alpha}$-, ${\beta}$-, ${\delta}$-, and ${\gamma}$-tocopherol intakes and plasma concentrations of tocopherols (${\alpha}$-, ${\delta}$-, and ${\gamma}$- tocopherol) were analyzed by gender. RESULTS: Dietary vitamin E and total vitamin E intake (dietary plus supplemental vitamin E) was $17.68{\pm}14.34$ and $19.55{\pm}15.78mg$${\alpha}$-tocopherol equivalents, respectively. The mean daily ${\alpha}$-tocopherol, and ${\gamma}$-tocopherol intakes were $3.07{\pm}2.27mg$ and $5.98{\pm}3.74mg$, respectively. Intakes of total vitamin E and each tocopherol of males were significantly higher than those of females (P < 0.05). Plasma ${\alpha}$-tocopherol concentration was $15.45{\pm}10.16$ of males and $15.00{\pm}4.54{\mu}mol/L$ of females, respectively. There were no significant differences in plasma tocopherol concentrations by gender ($P{\geq}0.05$). Plasma ${\alpha}$-tocopherol was negatively correlated with ${\gamma}$-tocopherol intake (P < 0.05). Twenty-three percent of the subjects had plasma ${\alpha}$-tocopherol concentrations < $12{\mu}mol/L$ indicating a biochemical deficiency of vitamin E. Approximately 8% and 9% of these participants had plasma ${\alpha}$-tocopherol:total lipid ratio less than $1.59{\mu}mol/mmol$ and plasma ${\alpha}$-tocopherol:total cholesterol ratio less than $2.22{\mu}mol/mmol$, respectively, which are also indicative of vitamin E deficiency. CONCLUSIONS: Vitamin E intakes of Korean adults were generally adequate with the Korean Dietary Reference Intakes for vitamin E. However, ${\alpha}$-tocopherol intake was lower than that reported in other countries, and 23% of the subjects in the current study were vitamin E deficient based on plasma ${\alpha}$-tocopherol concentrations.
Purpose: This study aimed to determine the serum 25-hydroxy-vitamin D (25(OH)D) status of breastfed infants less than six months old and their mothers, and factors affecting the status. Methods: This cross-sectional study was done on breastfed, term, Filipino infants less than six months old who were seen at local health centers and clinics in an urban area. The serum 25(OH)D levels of these infants and their mothers were determined, and their demographic data, nutritional status, sun exposure behavior, and maternal vitamin D intake were analyzed for correlation using regression models. Results: Among the 131 infants, 101 (77%) had vitamin D deficiency (VDD), which was defined as having 25(OH)D levels <37.5 nmol/L, and 13 (10%) had vitamin D insufficiency (VDI), with levels >37.5-50 nmol/L. Conversely, maternal VDD with levels <50 nmol/L was seen in 31 (24%) mothers and maternal VDI with levels 50-75 nmol/L, in 63 (48%) mothers. Infant age and maternal 25(OH)D status were independent predictors of infant VDD. Infants less than three months old were found to have a six-time increased risk of infant VDD (p=0.004). Infants who had mothers with VDD had a six-time increased risk, whereas those with maternal VDI had a four-time increased risk of infant VDD (p=0.049 and p=0.020, respectively). Conclusion: Both infant and maternal VDD and VDI were seen to be highly prevalent in this tropical, urban community. Young infants and maternal VDD/VDI independently increased the risk of infant VDD, whereas lack of sun exposure of the mothers increased the risk for maternal VDI.
Objectives: This study aimed to investigate the association between vitamin D deficiency and the risk of diabetes mellitus, and also examined whether their association is differed by sex and age. Methods: We analyzed the data from 28,135 subjects ${\geq}20years$ old who were registered for the Korea National Health and Nutrition Examination Survey (KNHANES) 2008-2014. Vitamin D was measured using serum 25-hydroxyvitamin D (25(OH)D) concentrations. Results: After adjusting for potential confounders (age, sex, education, income, total energy intake, smoking, physical activity, body mass index, and waist circumference), lower vitamin D was dose-dependently associated with a higher risk of diabetes mellitus (p-trend=0.004). When compared with the sufficient group (25(OH)D ${\geq}30ng/mL$), the severe deficient group (25(OH)D <10 ng/mL) had 1.46 (95% CI 1.11-1.94) odds ratio for the risk of diabetes mellitus. This association was markedly strong in men and adults aged ${\geq}40$, whereas no significant association was observed in women and adults aged <40. Conclusions: We found that vitamin D deficiency may be associated with an increased risk for diabetes mellitus in Korean adults. Our findings suggest that intake of higher vitamin D may help reduce the risk of diabetes mellitus.
Thiamine (vitamin $B_1$) is a water-soluble vitamin that is not endogenously synthesized in humans. It is absorbed by the small intestine, where it is activated. Its active form acts as a coenzyme in many energy pathways. We report a rare case of thiamine deficiency in a 3.5-year old boy with short bowel syndrome secondary to extensive bowel resection due to necrotizing enterocolitis during his neonatal age. The patient was parenteral nutrition-dependent since birth and had suffered from recurrent central catheter-related bloodstream infections. He developed confusion with disorientation and unsteady gait as well as profound strabismus due to bilateral paresis of the abductor muscle. Based on these and a very low thiamine level he was diagnosed and treated for Wernicke encephalopathy due to incomplete thiamine acquisition despite adequate administration. He fully recovered after thiamine administration. After 1999 eight more cases have been reported in the PubMed mostly of iatrogenic origin.
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