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The objective was to provide guidelines to clinicians for the evaluation, treatment, and prevention of vitamin D deficiency with an emphasis on the care of patients who are at risk for deficiency.
The Task Force was composed of a Chair, six additional experts, and a methodologist. The Task Force received no corporate funding or remuneration.
Consen...
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Citations
... We explored chronic conditions of diabetes, stroke, asthma, and congestive heart failure in the medical conditions questionnaire. (29). Depending on exposure to SHS, the participants were categorized into two groups (yes or no). ...
Objectives
To investigate whether exposure to secondhand smoke (SHS) aggravates the detrimental effect of vitamin D deficiency (VDD) on cognitive performance in the elderly.
Methods
Based on National Health and Nutrition Examination Surveys (NHANES) 2011–2014, 1,446 non-smoking participants (≥ 60 years old) with detailed serum 25-hydroxyvitamin D [25(OH)D], concentration of cotinine and tests score of cognitive function were included. Cognitive impairment was defined as having a cognitive score in the lowest quartile. The possible synergistic effect of SHS with VDD on cognitive impairment was evaluated by using a multivariable logistic regression model.
Results
VDD was independently associated with risk of low the Digit Symbol Substitution Test (DSST) scores, increased by nearly 60% [< 34, adjusted odds ratio (aOR) = 1.62, 95% CI: 1.03 ~ 2.53]. Although it only had an association with cognitive impairment indicated by DSST and the Animal Fluency test (AFT) in the crude model, SHS exposure showed significant synergistic effects with VDD on DSST (aOR: 3.03, 95% CI: 1.57 ~ 5.83, P interaction = 0.001) and AFT (aOR: 2.40, 95% CI: 1.34 ~ 4.29, P interaction = 0.003), respectively, after adjusting for the possible confounders. In further stratified analysis, a more obvious synergistic effect of SHS with VDD on DSST (aOR: 4.73, 95%CI:1.77 ~ 12.68, P interaction = 0.002) and AFT (aOR: 5.30, 95%CI: 1.63 ~ 17.24, P interaction = 0.006) was found in obese and overweight subjects, respectively.
Conclusion
SHS exposure had synergistic effect with VDD on cognitive impairment among elderly and the interaction effect was more obvious in overweight and obese individuals.
... Levels below 30 ng/mL (75 nmol/L) are considered insufficient, while levels below 20 ng/mL (50 nmol/L) are considered deficient. Some clinical trials considered > 50 nmol/L or 20 ng/ml of 25(OH)D as the goal of primary treatment or supplementation, although a higher threshold was suggested by others for beneficial use [11,12], to help in preventing or attenuating the SARS-CoV-2 infection and improving the efficacy of its vaccines, especially in immunosuppressed patients [13,14]. Although vitamin D is a hormonal form, the form of 1,25 dihydroxy vitamin D (1,25(OH) 2 D) is not used in monitoring vitamin D status for many reasons; it has a short serum half-life which is only 4 h, it is often converted from 25(OH)D at the tissue level outside the circulation and also its circulatory levels are considered variable (decrease, normal, increased) in patients with low 25(OH) D level, making it unreliable for vitamin D measurement [15]. ...
The SARS-CoV-2 vaccine is an important keystone in fighting against the virus. The vaccination alone could not prevent all SARS-CoV-2 viral infections or even its spread, especially after the emergence of newly mutant strains. The immune response to the SARS-CoV-2 vaccines varies greatly from one person to another. Age, along with adequate micronutrients, especially vitamin D, are major factors influencing immunity. We aimed to analyze SARS-CoV-2 vaccine neutralization potency and the total IgG antibodies along with 25-hydroxy-cholecalciferol concentrations in a cohort of healthy Egyptian vaccinated adults. 196 individuals were included; 145 females and 51 males, with an age range between 22 and 59 years old, from the first time of vaccination and over 16 weeks long. Three blood samples were taken from each individual at three time points; before the 1st dose of vaccination, before the 2nd dose of vaccination, and after 8 weeks of complete vaccination. The samples were analyzed using a chemiluminescent immunoassay to measure vitamin D level and titer of neutralizing and IgG antibodies. A lower level of neutralizing antibodies was detected in deficient and insufficient vitamin D-vaccinated individuals. However, a sufficient titer was detected in individuals with normal vitamin D. Vitamin D deficiency is associated with a suppressed immune response against SARS-CoV-2 despite vaccination. Thus, we made inquiries about using vitamin D as an adjuvant to SARS-CoV-2 vaccination, and its relation with the production of anti-SARS-CoV-2 antibodies.
... One notable finding was that all of the participants demonstrated low vitamin D serum levels (<10 ng/mL). The vitamin D status of the participants was classified according to the recommendations of the Endocrine Society, with sufficiency defined as 30-100 ng/mL, insufficiency as 20-29 ng/mL, and deficiency as <20 ng/mL [32]. This deficiency may be attributed to the timing of the study, which was conducted in March, shortly after the winter season when reduced sunlight exposure often leads to diminished vitamin D synthesis. ...
(1) Background: In recent years, there has been a growing interest in understanding the innate immunity of the mouth, particularly the mechanisms through which vitamin D influences oral health. Researchers have increasingly focused on the association between vitamin D and the antimicrobial peptide LL-37 since the CAMP gene, responsible for encoding the LL-37 peptide, is a direct target of both vitamin D and its receptor (vitamin D receptor, VDR). This study aimed to explore the correlation between the 25-hydroxyvitamin D (25(OH)D) levels and the concentration of the LL-37 peptide in both serum and saliva. The objective was to compare the serum concentrations of 25(OH)D and ll-37 with those in saliva and to access the correlations between the two compounds. (2) Methods: Serum and whole saliva samples were collected from 72 healthy adults (mean age 28.68 ± 8.35). The levels of 25(OH)D and LL-37 were assessed in both the saliva and serum samples using commercially available enzyme-linked immunosorbent assay (ELISA) kits. (3) Results: The 25(OH)D levels in the serum (median 5.92 ng/mL, min–max 2.7–10.4 ng/mL) correlated with the LL-37 serum levels (62 ng/mL, min–max 18–378 ng/mL; Pearson’s r 0.328, p = 0.005). Additionally, the 25(OH)D levels in saliva (median 1.16 ng/mL, min–max 0.54–2.12 ng/mL) strongly correlated with the LL-37 salivary levels (median 44 ng/mL, min–max 6.5–205 ng/mL; Pearson’s r 0.667, p < 0.001). The 25(OH)D salivary levels demonstrated a robust correlation with the LL-37 salivary levels. (4) Conclusions: This discovery emphasizes the complex interplay between vitamin D and LL-37 and lay the groundwork for the further exploration of vitamin D’s role in oral immune function.
... The mentioned assessment is recommended, particularly for those who are vulnerable, immune compromised, or have comorbidities [32,97]. In this regard, the 2024 Endocrine Society guidelines represent a significant error, among other errors [24,27], by recommending against the measurement of 25(OH)D [28]. ...
... Several leading vitamin D research groups refuted this erroneous guidance [27,98]. Demay et al.'s recommendation [28] even failed to advocate the target 25(OH)D level of 30 ng/ mL (75 nmol/L) recommended in the 2011 guideline [97], so it can only harm people. ...
Clinical trials consistently demonstrate an inverse correlation between serum 25-hydroxyvitamin D [25(OH)D; calcifediol] levels and the risk of symptomatic SARS-CoV-2 disease, complications, and mortality. This systematic review (SR), guided by Bradford Hill’s causality criteria, analyzed 294 peer-reviewed manuscripts published between December 2019 and November 2024, focusing on plausibility, consistency, and biological gradient. Evidence confirms that cholecalciferol (D3) and calcifediol significantly reduce symptomatic disease, complications, hospitalizations, and mortality, with optimal effects above 50 ng/mL. While vitamin D requires 3–4 days to act, calcifediol shows effects within 24 h. Among 329 trials, only 11 (3%) showed no benefit due to flawed designs. At USD 2/patient, D3 supplementation is far cheaper than hospitalization costs and more effective than standard interventions. This SR establishes a strong inverse relationship between 25(OH)D levels and SARS-CoV-2 vulnerability, meeting Hill’s criteria. Vitamin D3 and calcifediol reduce infections, complications, hospitalizations, and deaths by ~50%, outperforming all patented, FDA-approved COVID-19 therapies. With over 300 trials confirming these findings, waiting for further studies is unnecessary before incorporating them into clinical protocols. Health agencies and scientific societies must recognize the significance of these results and incorporate D3 and calcifediol for prophylaxis and early treatment protocols of SARS-CoV-2 and similar viral infections. Promoting safe sun exposure and adequate vitamin D3 supplementation within communities to maintain 25(OH)D levels above 40 ng/mL (therapeutic range: 40–80 ng/mL) strengthens immune systems, reduces hospitalizations and deaths, and significantly lowers healthcare costs. When serum 25(OH)D levels exceed 70 ng/mL, taking vitamin K2 (100 µg/day or 800 µg/week) alongside vitamin D helps direct any excess calcium to bones. The recommended vitamin D dosage (approximately 70 IU/kg of body weight for a non-obese adult) to maintain 25(OH)D levels between 50–100 ng/mL is safe and cost-effective for disease prevention, ensuring optimal health outcomes.
... Research has shown that areas with more overweight children also have a higher proportion of children with hypovitaminosis D (25OHD <30 ng/ml) [6]. Extensive research has indicated that human obesity is often accompanied by hypovitaminosis D [9] and elevated expression of the vitamin D receptor (VDR) in subcutaneous adipose tissue [10]. Animal experimentation has revealed that overexpression of the human VDR in the adipose tissue of mice results in augmented fat mass, impaired glucose tolerance, and reduced energy expenditure [11]. ...
Background
As all kown, both hypovitaminosis D and insulin resistance (IR) have been linked to adiposity. However, the extent of adiposity’s mediating influence on the hypovitaminosis D-IR relationship among adolescents remains to be elucidated. Additionally, the intricate effects of obesity and blood lipid profiles on IR are not yet fully understood.
Methods
We conducted a comprehensive analysis of NHANES data from 2011 to 2018, examining the correlation between adiposity indices such as Body Mass Index (BMI), Fat Mass Index (FMI, defined as the ratio of fat mass to height squared), hypovitaminosis D, and IR. We employed the XGBoost algorithm to identify key factors significantly influencing IR, thereby deepening our insight into the link between adiposity and insulin resistance. Furthermore, we applied mediation analysis to precisely assess the mediating role of adiposity indices in the relationship between hypovitaminosis D and IR.
Results
Our study revealing significant correlations between adiposity indices, hypovitaminosis D, and IR after variable adjustment. Notably, subgroup analysis indicated a pronounced hypovitaminosis D -adiposity association in female adolescents, which was not observed in males. The XGBoost algorithm pinpointed obesity and blood lipid indicators significantly affecting IR, with total fat mass, triglyceride, cholesterol, BMI, and FMI ranked by descending importance. Mediation analysis disclosed that adiposity indices mediate a substantial portion of the hypovitaminosis D -IR relationship, with FMI (43.84%, p < 0.001) and BMI (40.87%, p < 0.001) showing significant mediating effects.
Conclusion
The study confirmed significant correlations between adiposity indices, hypovitaminosis D, and IR in adolescents, with gender-specific differences in the hypovitaminosis D -adiposity link. Cholesterol was found to have a more substantial influence on IR than BMI and FMI. Furthermore, FMI was identified as a more potent mediator of the hypovitaminosis D-IR relationship compared to BMI, highlighting its importance in the pathophysiology of insulin resistance in adolescents.
... The biochemical parameters were done on the same day, including blood urea, serum creatinine, ALT, AST, ferritin, LDH, by HITACHI auto analyser. (Japan), according to the manufacture's instruction [27]. The serum samples were stored at −20˚C after careful labelling till the time of 25(OH)D3 level measurement. ...
... It is worth noting that the bone metabolism indexes (25-OHVitD, PTH, calcitonin, bone alkaline phosphatase) of BC patients were measured and reviewed by professional technicians in the Endocrinology Laboratory. In this study, Vitamin D status of deficiency [< 20 ng/ mL (50 nmol/L)], insufficiency [20-30 ng/mL (50-75 nmol/L)] and sufficient [≥ 30 ng/mL (75 nmol/L)] were determined by the criteria set by the International Osteoporosis Foundation 14 and the American Endocrine Association 15 . ...
Bone health problem is one of the important concomitant diseases of breast cancer (BC). This study aimed to investigate the bone health status of newly diagnosed female BC patients in China. A total of 636 newly diagnosed female BC patients and 268 women undergoing routine physical examinations (control group) were included. Bone mineral density and bone metabolism parameters were assessed. The association between BC and abnormal bone mass (ABM) was analyzed by logistic regression. We found that approximately 15.3% of BC patients presented with hypocalcemia after albumin adjustment. 25-OHVitD deficiency or insufficiency was observed in 92.3% of BC patients. ABM was identified in 63.2% of BC patients, comprising 36.4% with osteopenia and 26.8% with osteoporosis. ABM prevalence was significantly higher in BC patients under 40 years old (40.8%) compared to 8% in the age-matched control group. The severity of bone loss correlated with elevated bone turnover markers. Logistic regression analysis showed that a 5.5-fold and 3.4-fold increased risk of ABM and osteoporosis, respectively, in newly diagnosed BC patients versus the control group. All BC subtypes were associated with a markedly higher risk of ABM. Young BC patients (< 45 years) exhibited a nearly 9-fold higher risk of ABM compared to their age-matched counterparts. Vitamin D deficiency/insufficiency, osteopenia, and osteoporosis were highly prevalent among newly diagnosed female BC patients. Regardless of age and BC subtype, BC patients face a higher risk of ABM compared to those physical examination women, especially among the young.
... Low serum vitamin D levels are frequently observed in children with obesity [65,66]; this is probably due to the sequestration of the liposoluble vitamin D by the subcutaneous fat [66]. Supplementation of vitamin D in obese and overweight subjects may require higher doses than in normal-weight individuals [67,68]. This paradox underscores the fragility underlying increased bone mass in obesity. ...
Childhood obesity represents a multifaceted challenge to bone health, influenced by a combination of endocrine, metabolic, and mechanical factors. Excess body fat correlates with an increase in bone mineral density (BMD) yet paradoxically elevates fracture risk due to compromised bone quality and increased mechanical loading on atypical sites. Additionally, subjects with syndromic obesity, as well as individuals with atypical nutritional patterns, including those with eating disorders, show bone fragility through unique genetic and hormonal dysregulations. Emerging evidence underscores the adverse effects of new pharmacological treatments for severe obesity on bone health. Novel drugs, such as glucagon-like peptide-1 (GLP-1) receptor agonists, and bariatric surgery demonstrate potential in achieving weight loss, though limited evidence is available regarding their short- and long-term impacts on skeletal health. This review provides a comprehensive analysis of the mechanisms underlying the impact of childhood obesity on bone health. It critically appraises evidence from in vitro studies, animal models, and clinical research in children with exogenous obesity, syndromic obesity, and eating disorders. It also explores the effects of emerging pharmacological and surgical treatments for severe obesity on skeletal integrity, highlights prevention strategies, and identifies research gaps.
... Fetal vitamin D concentrations are largely dependent on maternal vitamin D status (7). To date, guidelines concerning vitamin D screening in pregnant women have been conflicting (8)(9)(10)(11)(12)(13). The Committee Opinion of the American College of Obstetricians and Gynecologists (8) and Australian Government antenatal care clinical practice guidelines (10) recommend screening only women at increased risk of vitamin D deficiency, including vegetarians, women with limited sun exposure, and women with darker skin (14). ...
Background
Given the ease of access to ambient temperature, it may be a more practical guide than the UVB index. However, the association between gestational temperature and vitamin D level in newborns remains unclear. Our study aims to explore this association and the necessity of maternal vitamin D supplementation when ambient temperature is less than a specific value.
Methods
Based on a birth cohort study, we measured cord blood concentrations of 25(OH)D in 1419 neonates from January to September 2008 in Hefei, a new first-tier city in China. The daily mean temperature of Hefei was obtained from the China Meteorological Data Sharing Service System. Individual information on sociodemographic characteristics, perinatal health status, lifestyle, and birth outcomes was collected prospectively.
Results
The best-fit relationship was observed in the regression model using a quadratic function to describe the association between the ambient temperature of the eighth gestational month (29–32 gestational weeks) and cord blood 25(OH)D concentrations (R² = 0.358, p < 0.001). Ambient temperatures of 10 and 24.5°C were linked to the cutoff of vitamin D inadequacy (<50 nmol/L) and deficiency (<30 nmol/L) in cord blood, respectively. For maternal exposure to an ambient temperature of ≥24.5°C in the eighth gestational month, vitamin D supplementation during pregnancy failed to significantly enhance neonatal vitamin D concentrations. In contrast, for maternal exposure to ambient temperature of <10°C, maternal vitamin D supplementation was significantly associated with elevated 25(OH)D concentrations in cord blood.
Conclusion
Gestational ambient temperature may be an ideal predictor for infant vitamin D status screening. Maternal exposure to an ambient temperature of less than 10°C is a critical index in the eighth gestational month, which may determine the onset of vitamin D supplementation.
... Frontiers in Nutrition 07 frontiersin.org established by the Endocrine Society Task Force on Vitamin D (24). However, the optimal vitamin D levels may vary across different populations and ethnicities (25). ...
Background
Patients with chronic kidney disease (CKD) have an elevated risk of both vitamin D deficiency (VDD) and depression. However, the relationship between VDD and the risk of depression in this population remains unclear.
Methods
Using the TriNetX network database (2010–2019), we conducted a propensity score-matched cohort study of CKD patients aged ≥50 years. Patients were categorized into VDD (≤20 ng/mL) and control (≥30 ng/mL) groups based on measurements within 3 months of CKD diagnosis. The primary outcome was the incidence of major depression within 1 year of follow-up.
Results
Among 17,955 matched pairs, VDD was associated with increased depression risk at 1 year (hazard ratio [HR]: 1.929; 95% confidence interval [CI]: 1.52–2.448; p < 0.0001). This association persisted through 3 years of follow-up. The relationship remained consistent across CKD stages, with similar risks in early (HR:1.977; 95% CI: 1.382–2.829) and CKD stage 3–5 (HR:1.981; 95% CI: 1.533–2.559). Males with VDD showed higher depression risk (HR: 2.264; 95% CI: 1.498–3.421) compared to females (HR:1.761; 95% CI: 1.307–2.374). Even vitamin D insufficiency (20–30 ng/mL) increased depression risk compared to normal levels (HR:1.667; 95% CI: 1.318–2.11). In patients with VDD, cerebrovascular disease, malnutrition, and ischemic heart disease are risk factors for depression.
Conclusion
VDD is independently associated with increased depression risk in patients with CKD, particularly in males. These findings suggest that maintaining adequate vitamin D levels might be important for mental health in patients with CKD, although randomized trials are needed to confirm whether supplementation can prevent depression in this population.