Vitamin D and Major Chronic Illness

Quraishi, Sadeq A.; Camargo, Carlos A.

doi:10.14200/jrm.2012.1.1001

Cited by 5 publications

(6 citation statements)

References 122 publications

(151 reference statements)

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“…38 Although this traditional delineation is based on bone health–related studies demonstrating maximal parathyroid hormone suppression at 25(OH)D levels around 30 ng/mL, 39 some immunomodulatory effects of vitamin D are also maximized at this threshold. 40,41 Moreover, to address any possible concerns about our chosen threshold, we also set thresholds at less than 20 ng/mL and less than 10 ng/mL, and the results were not materially different from what we reported for levels less than 30 ng/mL (data not shown). This relationship was further confirmed on the LOWESS analysis, which graphically represented a well-defined change in the relationship between vitamin D status and the risk for HAIs or SSIs at 25(OH)D levels less than 30 ng/mL vs 30 ng/mL or greater.…”

Section: Discussionmentioning

confidence: 91%

Association Between Preoperative 25-Hydroxyvitamin D Level and Hospital-Acquired Infections Following Roux-en-Y Gastric Bypass Surgery

et al. 2014

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IMPORTANCE Postoperative hospital-acquired infections (HAIs) may result from disruption of natural barrier sites. Recent studies have linked vitamin D status and barrier site integrity. OBJECTIVE To investigate the association between preoperative vitamin D status and the risk for HAIs. DESIGN, SETTING, AND PARTICIPANTS A retrospective analysis was performed using propensity score methods to construct a matched-pairs cohort to reduce baseline differences between patients with 25-hydroxyvitamin D (25[OH]D) levels less than 30 ng/mL vs 30 ng/mL or greater. Multivariable logistic regression analysis was then performed to examine the association between 25(OH)D levels and HAIs while adjusting for additional perioperative factors. Locally weighted scatterplot smoothing was used to depict the relationship between increasing 25(OH)D levels and the risk for HAIs. This study was conducted in a single, teaching hospital in Boston, Massachusetts, and involved 770 gastric bypass surgery patients between January 1, 2007, and December 31, 2011. EXPOSURES Preoperative 25(OH)D levels. MAIN OUTCOMES AND MEASURES Association between preoperative 25(OH)D levels and the risk for postoperative HAIs. RESULTS The risk for HAIs was 3-fold greater (adjusted odds ratio, 3.05; 95%CI, 1.34–6.94) in patients with 25(OH)D levels less than 30 ng/mL vs 30 ng/mL or greater. Further adjustment for additional perioperative factors did not materially change this association. Locally weighted scatterplot smoothing analysis depicted a near inverse linear relationship between vitamin D status and the risk for HAIs for 25(OH)D levels around 30 ng/mL. CONCLUSIONS AND RELEVANCE In our patient cohort, a significant inverse association was observed between preoperative 25(OH)D levels and the risk for HAIs. These results suggest that preoperative 25(OH)D levels may be a modifiable risk factor for postoperative nosocomial infections. Prospective studies must determine whether there is a potential benefit to preoperative optimization of vitamin D status.

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Section: Discussionmentioning

confidence: 91%

Association Between Preoperative 25-Hydroxyvitamin D Level and Hospital-Acquired Infections Following Roux-en-Y Gastric Bypass Surgery

et al. 2014

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“…In humans, cholecalciferol is either obtained through the diet or synthesized by skin upon exposure to ultraviolet B radiation [17]. Cholecalciferol is converted to 25OHD in the liver and then to 1,25OH2D by the kidneys and by cells of the immune system (amongst others) for paracrine use [37].…”

Section: Discussionmentioning

confidence: 99%

“…In humans, circulating 25-hydroxyvitamin D (25OHD) is the most abundant vitamin D metabolite [17]. As such, it is often used as a proxy for total body vitamin D status [18].…”

Section: Introductionmentioning

confidence: 99%

Effect of Cholecalciferol Supplementation on Vitamin D Status and Cathelicidin Levels in Sepsis

Quraishi

Pascale

Needleman

et al. 2015

Critical Care Medicine

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Objectives To compare changes in vitamin D status and cathelicidin (LL-37) levels in septic ICU patients treated with placebo versus cholecalciferol. Design Randomized, placebo-controlled, trial. Setting Medical and surgical ICUs of a single teaching hospital in Boston, MA. Patients 30 adult ICU patients. Interventions Placebo (n=10) versus 200,000 IU cholecalciferol (n=10) versus 400,000 IU cholecalciferol (n=10), within 24 hours of new-onset severe sepsis or septic shock. Measurements and Main Results Blood samples were obtained at baseline (day 1) and on days 3, 5, and 7, to assess total 25-hydroxyvitamin D (25OHD), as well as vitamin D binding protein and albumin to calculate bioavailable 25OHD. Plasma LL-37 and high sensitivity C-reactive protein (hsCRP) levels were also measured. At baseline, median (IQR) plasma 25OHD was 17 (13 to 22) ng/mL and peaked by day 5 in both intervention groups. Groups were compared using Kruskal-Wallis tests. Relative to baseline, on day 5, median change in biomarkers for placebo, 200,000 IU cholecalciferol, and 400,000 IU cholecalciferol groups, respectively, were: 1) total 25OHD: 3 (-3 to 8)%, 49 (30 to 82)%, and 69 (55 to 106)%, (P<0.001); 2) bioavailable 25OHD: 4 (-8 to 7)%, 45 (40 to 70)%, and 96 (58 to 136)%, (P<0.01); and 3) LL-37: -17 (-9 to -23)%, 4 (-10 to 14)%, and 30 (23 to 48)%, (P=0.04). Change in hsCRP levels did not differ between groups. A positive correlation was observed between bioavailable 25OHD and LL-37 (Spearman's rho=0.44, P=0.03), but not for total 25OHD and LL-37. Conclusions High-dose cholecalciferol supplementation rapidly and safely improves 25OHD and bioavailable 25OHD levels in patients with severe sepsis or septic shock. Changes in bioavailable 25OHD are associated with concomitant increases in circulating LL-37 levels. Larger trials are needed to verify these findings and to assess whether optimizing vitamin D status improves sepsis-related clinical outcomes.

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“…In order to maximize potential benefits and mitigate potential risks, supplementation of vitamin D to restore 25(OH) D levels within a range of 30-50 ng/ml is appropriate. This, of course, should be taken into account in the sense of the patient’s individual needs and co-morbidities [ 9 ] and the potential association between decreased mortality and post-fracture use of prescribed supplementation of calcium plus vitamin D and concomitant use of anti-osteoporotic drugs in females. Further investigations are required, however, in order to understand the reasons behind the reduction in the risk of death [ 10 ].…”

Section: Discussionmentioning

confidence: 99%

Assessment of Vitamin D Levels and Its Correlation With Osteoporosis and Fracture Site Comminution in Osteoporotic Hip Fractures in Tertiary Care Hospital

Vellingiri¹,

Ethiraj²,

Nagakumar³

et al. 2021

Cureus

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Introduction: A global concern is vitamin D deficiency and insufficiency. There is a particularly high risk for pregnant women, people of color (Blacks, Hispanics, and those with increased skin melanin pigmentation), obese children and adults, and children and adults who are abstinent from direct sun exposure. The goal of this study was to understand the incidence of vitamin D deficiency in patients with osteoporotic hip fractures in our rural population and also to know its association with osteoporosis and osteoporotic hip fractures in a tertiary care trauma center. Methods: This prospective research was performed at our tertiary trauma treatment center in Kolar, Karnataka, India by the Department of Orthopedics from September 2019 and July 2020. The age category was 45-90 years, intertrochanteric fractures were graded using the Boyd and Griffin classification and femoral neck fractures the Garden's staging. The research included all patients with fractures after a trivial trauma such as slip and fall while standing/walking and excluded patients with a serious history of trauma such as road traffic accidents/falls from height and pathological fractures. This study involved 30 patients. Age and gender, type of fracture, vitamin D levels, Singh’s index, and comminution of fracture site were reported in patient demographics. Results: Thirty patients comprised the study population. Most of them were female. Females comprised 18 out of the 30. There were twelve, thirteen, and five persons in our sample population between the ages of 45-60, 61-75, and >75 years. The Singh's index was tabulated. Mean vitamin D levels were 9.64+/-3.23 in the femur fracture group and 13.42+/-5.31 in the intertrochanteric fracture group. Mean levels of vitamin D are included as a graphical representation. The comminution of the fracture site in groups of the femur and intertrochanteric fractures was eight and six, respectively. Conclusion: Early diagnosis and treatment of these patients with vitamin D for osteomalacia and anti-osteoporotic osteoporosis regimens will hopefully enhance bone, muscle, and general health, minimizing falls and fractures.

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Vitamin D and Major Chronic Illness

Cited by 5 publications

References 122 publications

Association Between Preoperative 25-Hydroxyvitamin D Level and Hospital-Acquired Infections Following Roux-en-Y Gastric Bypass Surgery

Association Between Preoperative 25-Hydroxyvitamin D Level and Hospital-Acquired Infections Following Roux-en-Y Gastric Bypass Surgery

Effect of Cholecalciferol Supplementation on Vitamin D Status and Cathelicidin Levels in Sepsis

Assessment of Vitamin D Levels and Its Correlation With Osteoporosis and Fracture Site Comminution in Osteoporotic Hip Fractures in Tertiary Care Hospital

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