Abstract:Vitamin D deficiency is a common health concern worldwide. We aim to compare the prevalence of vitamin D deficiency among older adults (65+) in China and the United States (US). We used data from the 2011 wave of Chinese Longitudinal Healthy Longevity Survey (CLHLS) in China (n = 2180), and 2011–2014 National Health and Nutrition Examination Survey (NHANES) in the US (n = 2283). Serum 25-hydroxyvitamin D [25(OH)D] was measured and a level of under 30/50 nmol/L was defined as vitamin D severe deficiency/deficie… Show more
“… Fig. 4 a Mean 25(OH)D in the elderly population in the US [ 61 ], Iran [ 62 ], France [ 63 ] and the UK [ 64 ]. Estimated 25(OH)D concentration of elderly in Italy [ 49 – 51 , 65 ], and Spain [ 52 ].…”
Section: Results and Interpretationmentioning
confidence: 99%
“…The concentration of 25-hydroxyvitamin D (25(OH)D) among the elderly population in each country was obtained from prior studies [49][50][51][52][53][54][61][62][63][64][65]. CRP, VitD, and demographic variables data of the subjects were pooled from the cross-sectional data from 2009-2010 NHANES, conducted by the National Center for Health Statistics (NCHS), Centers for Disease Control and Prevention (CDC) [55].…”
Objectives
We present evidence for a possible role of Vitamin D (VitD) deficiency in unregulated cytokine production and inflammation leading to complications in COVID-19 patients.
Design
The time-adjusted case mortality ratio (T-CMR) was estimated as the ratio of deceased patients on day N to the confirmed cases on day N-8. The adaptive average of T-CMR (A-CMR) was calculated as a metric of COVID-19 associated mortality. A model based on positivity change (PC) and an estimated prevalence of COVID-19 was used to determine countries with similar screening strategies. A possible association of A-CMR with the mean concentration of 25-hydroxyvitamin D (25(OH)D) in elderly individuals in countries with similar screening strategy was investigated. We considered high C-reactive protein (CRP) in severe COVID-19 patients (CRP ≥ 1 mg/dL) as a surrogate of a cytokine storm. We considered high-sensitivity CRP (hs-CRP) in healthy subjects as hs-CRP ≥ 0.2 mg/dL.
Results
A link between 25(OH)D and A-CMR in countries with similar screening strategy is evidence for VitD’s possible role in reducing unregulated cytokine production and inflammation among patients with severe COVID-19. We observed an odds ratio (OR) of 1.8 with 95% confidence interval (95% CI) (1.2 to 2.6) and an OR of 1.9 with 95% CI (1.4 to 2.7) for hs-CRP in VitD deficient elderly from low-income families and high-income families, respectively. COVID-19 patient-level data show an OR of 3.4 with 95% CI (2.15 to 5.4) for high CRP in severe COVID-19 patients.
Conclusion
We conclude that future studies on VitD’s role in reducing cytokine storm and COVID-19 mortality are warranted.
“… Fig. 4 a Mean 25(OH)D in the elderly population in the US [ 61 ], Iran [ 62 ], France [ 63 ] and the UK [ 64 ]. Estimated 25(OH)D concentration of elderly in Italy [ 49 – 51 , 65 ], and Spain [ 52 ].…”
Section: Results and Interpretationmentioning
confidence: 99%
“…The concentration of 25-hydroxyvitamin D (25(OH)D) among the elderly population in each country was obtained from prior studies [49][50][51][52][53][54][61][62][63][64][65]. CRP, VitD, and demographic variables data of the subjects were pooled from the cross-sectional data from 2009-2010 NHANES, conducted by the National Center for Health Statistics (NCHS), Centers for Disease Control and Prevention (CDC) [55].…”
Objectives
We present evidence for a possible role of Vitamin D (VitD) deficiency in unregulated cytokine production and inflammation leading to complications in COVID-19 patients.
Design
The time-adjusted case mortality ratio (T-CMR) was estimated as the ratio of deceased patients on day N to the confirmed cases on day N-8. The adaptive average of T-CMR (A-CMR) was calculated as a metric of COVID-19 associated mortality. A model based on positivity change (PC) and an estimated prevalence of COVID-19 was used to determine countries with similar screening strategies. A possible association of A-CMR with the mean concentration of 25-hydroxyvitamin D (25(OH)D) in elderly individuals in countries with similar screening strategy was investigated. We considered high C-reactive protein (CRP) in severe COVID-19 patients (CRP ≥ 1 mg/dL) as a surrogate of a cytokine storm. We considered high-sensitivity CRP (hs-CRP) in healthy subjects as hs-CRP ≥ 0.2 mg/dL.
Results
A link between 25(OH)D and A-CMR in countries with similar screening strategy is evidence for VitD’s possible role in reducing unregulated cytokine production and inflammation among patients with severe COVID-19. We observed an odds ratio (OR) of 1.8 with 95% confidence interval (95% CI) (1.2 to 2.6) and an OR of 1.9 with 95% CI (1.4 to 2.7) for hs-CRP in VitD deficient elderly from low-income families and high-income families, respectively. COVID-19 patient-level data show an OR of 3.4 with 95% CI (2.15 to 5.4) for high CRP in severe COVID-19 patients.
Conclusion
We conclude that future studies on VitD’s role in reducing cytokine storm and COVID-19 mortality are warranted.
“…Despite these limitations, the present study also has a number of strengths. First, the data was based on a broad age range sample taken from the Korean general population, which represents an ethnically homogeneous group and a geographically homogeneous region; both of these factors are known to affect vitamin D concentrations (45). Second, the analysis was stratified by sex and assessed specific domains of depressive symptoms, extending our understanding of these associations.…”
Objective: There is increasing evidence of an inverse association between serum vitamin D concentrations and depression, but whether there are sex-specific differences remains controversial. Thus, the aim of this study was to investigate the association between serum vitamin D concentrations and specific domains of depressive symptoms by each sex in the Korean general population. Methods: The study sample comprised 820 men and 916 women, aged from 19 to 76, who participated in the Korea National Health and Nutrition Examination Survey 2014. Participants completed health interviews and health examinations providing data of serum 25-hydroxyvitamin [25(OH)D] concentrations, the Patient Health Questionnaire-9 (PHQ-9), and certain covariates. Associations were analyzed using negative binomial regression. Results: After adjusting for various covariates, the association between log-transformed serum 25(OH)D concentrations and total PHQ-9 scores was statistically significant {incidence rate ratio [IRR] = 0.74 [95% confidence interval (CI) = 0.59-0.93]} only in men. Additionally, the association between log-transformed serum 25(OH)D concentrations and the PHQ-9 cognitive/affective subscore was statistically significant [IRR = 0.56 (95% CI = 0.40-0.80)] only in men. There was no association for the somatic subscore. Conclusions: Serum vitamin D levels were inversely associated with cognitive/affective depressive symptoms only in men.
“…One study conducted in Europe showed that 13.0% of 55,844 European individuals showed average serum 25(OH)D concentrations of < 30 nmol/L 9 . In China, 30.6% of elderly people have vitamin D deficiency 10 .…”
this meta-analysis assessed the association between vitamin D supplementation and the outcomes of critically ill adult patients. A literature search was conducted using the PubMed, Web of Science, EBSCO, Cochrane Library, Ovid MEDLINE, and Embase databases until March 21, 2020. We only included randomized controlled trials (RCTs) comparing the efficacy of vitamin D supplementation with placebo in critically ill adult patients. The primary outcome was their 28-day mortality. Overall, 9 RCTs with 1867 patients were included. In the pooled analysis of the 9 RCTs, no significant difference was observed in 28-day mortality between the vitamin D supplementation and placebo groups (20.4% vs 21.7%, OR, 0.73; 95% CI, 0.46-1.15; I 2 = 51%). This result did not change as per the method of vitamin D supplementation (enteral route only: 19.9% vs 18.2%, OR, 1.19; 95% CI, 0.88-1.57; I 2 = 10%; intramuscular or intravenous injection route: 25.6% vs 40.8%, OR, 0.48; 95% CI, 0.21-1.06; I 2 = 19%) or daily dose (high dose: 20.9% vs 19.8%, OR, 0.83; 95% CI, 0.51-1.36; I 2 = 53%; low dose: 15.6% vs 21.3%, OR, 0.74; 95% CI, 0.32-1.68; I 2 = 0%). No significant difference was observed between the vitamin D supplementation and placebo groups regarding the length of ICU stay (standard mean difference [SMD], − 0.30; 95% CI, − 0.61 to 0.01; I 2 = 60%), length of hospital stay (SMD, − 0.17; 95% CI, − 041 to 0.08; I 2 = 65%), and duration of mechanical ventilation (SMD, − 0.41; 95% CI, − 081 to 0.00; I 2 = 72%). In conclusion, this meta-analysis suggested that the administration of vitamin D did not provide additional advantages over placebo for critically ill patients. However, additional studies are needed to confirm our findings. Vitamin D, a fat-soluble vitamin, is an essential nutrient in bone metabolism and calcium and phosphorus homeostasis. However, the system of vitamin D is complex, in which some novel pathways have been found for host response to vitamin D treatment including non-canonical pathways of vitamin D activation 1,2 leading to production of non-or low-calcemic analogs 3 and of lumisterol activation 4. In clinical practice, vitamin D is used for the treatment of hyperproliferative skin diseases, hyperparathyroidism, and osteoporosis. Vitamin D also exhibits other non-skeletal pleiotropic properties, such as immunomodulatory, antimicrobial, cardiovascular, and muscular effects. Therefore, vitamin D deficiency is associated with many diseases including tuberculosis, nonalcoholic fatty liver disease, cardiovascular disease, and metabolic syndrome 5-7. In the United States, adults aged 20-39 years are at the highest risk of vitamin D deficiency
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