PURPOSE: Routine supplementation of high-dose calcium significantly decreased the risk of postoperative symptomatic hypocalcemia after thyroidectomy. However, there is an ongoing debate about whether the same results can be achieved with low-dose calcium supplementation. METHODS: Patients (n = 138) who underwent total thyroidectomy for thyroid cancer were 1:1 randomly assigned to receive oral supplements of 1,500 mg/day elemental calcium and 1,000 IU/day cholecalciferol for 2 weeks or no supplementation. Primary objective was to compare the incidence of symptomatic hypocalcemia for 3 days after total thyroidectomy. Secondary objective was to find the predictors for postoperative hypocalcemia in patients with thyroid cancer. RESULTS: Sixty-five patients in the calcium group and 69 patients in the control group were finally analyzed. The incidence of symptomatic hypocalcemia showed no difference between the calcium and control group (32.3% vs. 21.7%, P = 0.168). The total dosage of intravenous calcium (593.4 ± 267.1 mg vs. 731.6 ± 622.7 mg, P = 0.430) administered to patients with symptomatic hypocalcemia was also comparable between groups. In a multivariate analysis, parathyroid hormone level of 13 pg/mL at postoperative day 1 was only predictive for symptomatic hypocalcemia, and its incidence was 20.9 times (95% confidence interval, 6.8–64.5) higher in patients with parathyroid hormone <13 pg/mL. Other factors did not predict the development of hypocalcemia, including clinicopathological features and routine supplementation of low-dose calcium. CONCLUSION: Routine low-dose calcium supplementation did not reduce the risk of postoperative hypocalcemia. Patients who may benefit from calcium supplementation should be carefully selected.
Calcium ; Cholecalciferol ; Humans ; Hypocalcemia ; Hypoparathyroidism ; Incidence ; Multivariate Analysis ; Parathyroid Hormone ; Prospective Studies ; Thyroid Neoplasms ; Thyroidectomy

No abstract available.
Adult ; Aged ; Asian Continental Ancestry Group/ethnology ; China ; Cholecalciferol/*analysis ; Ergocalciferols/*analysis ; Female ; Humans ; Immunoassay ; India ; Malaysia ; Male ; Middle Aged ; Reagent Kits, Diagnostic ; Young Adult

PURPOSE: Asthma and other allergic disorders have increased over the past decades in nearly all nations. Many studies have suggested the role of vitamin D deficiency in both T-helper1 and T-helper2 diseases; however, the association between vitamin D, allergy, and asthma remains uncertain. In this study, the associations of 25-hydroxy vitamin D3 levels with asthma and with the severity of asthma were evaluated. METHODS: This cross-sectional study was conducted on 50 asthmatic children and 50 healthy controls aged 6-18 years. Serum 25-hydroxy vitamin D3 levels were determined and compared between the two groups. The relationship between serum vitamin D levels and pulmonary function test outcomes and eosinophil counts were examined in asthmatic patients. RESULTS: Univariate analysis of the relationship between asthma and vitamin D showed that decreased vitamin D levels were associated with significantly increased odds of asthmatic state (P=0.002). In a multivariate analysis after adjustment for age, body mass index, and sex, the relationship between vitamin D and asthma increased. In asthmatic patients, 25-hydroxy vitamin D levels had direct and significant correlations with both predicted FEV1 (R2=0.318; P=0.024) and FEV1/FVC (R2=0.315; P=0.026). There were no associations between vitamin D level and eosinophil counts, duration of disease, and the number of hospitalization or unscheduled visits in the previous year (P>0.05). CONCLUSIONS: These results showed that serum 25-hydroxy vitamin D levels were inversely associated with asthma, and there was a direct and significant relationship between vitamin D levels and pulmonary function test outcomes in asthmatic children. An interventional study in asthmatic patients with low serum vitamin D concentration may establish a causal relationship between asthma and vitamin D.
Aged ; Asthma ; Body Mass Index ; Child ; Cholecalciferol ; Cross-Sectional Studies ; Eosinophils ; Hospitalization ; Humans ; Hypersensitivity ; Multivariate Analysis ; Respiratory Function Tests ; Vitamin D ; Vitamin D Deficiency ; Vitamins

OBJECTIVE: to investigate whether vitamin D receptor (VDR) gene polymorphisms are associated with the effect of hormone replacement therapy (HRT) on bone mineral density (BMD) in postmenopausal Korean women. METHODS: The BsmI, ApaI, and TaqI polymorphisms were analyzed by restriction fragment length polymorphism (RFLP) and poly (A) polymorphism by GeneScan and direct DNA sequencing in 304 postmenopausal Korean women who received sequential HRT for 1 year. Serum bone alkaline phosphatase, CrossLaps, osteocalcin and 1,25 (OH)2 vitamin D3 levels were measured by immunoassay and BMD at the lumbar spine and femoral neck by dual energy X-ray absorptiometry before and after HRT of 1 year. RESULTS: The BsmI and TaqI polymorphisms were significantly associated with annual percentage changes in BMD at the lumbar spine. The bb and TT genotype showed a significantly lower percentage changes in BMD of lumbar spine than the Bb and Tt genotype. Annual percentage change in BMD at the lumbar spine was significantly lower in the bT haplotype homozygote women than in women who did not bT haplotype allele, but the bT haplotype genotypes were not distributed differently among HRT-responders and HRT-nonresponders (women who lose more than 3% of bone mass per year). No significant association between annual BMD changes in at all skeletal site and the ApaI or poly (A) polymorphism was observed. There were no significant differences in the 6 month percentage changes in 1,25 (OH)2 vitamin D3 or bone turnover markers among any of the genotypes analyzed. CONCLUSIONS: The VDR bT haplotype allele is associated with the effect of HRT on BMD at the lumbar spine in Korean women.
Absorptiometry, Photon ; Alkaline Phosphatase ; Alleles ; Bone Density* ; Cholecalciferol ; Female ; Femur Neck ; Genotype ; Haplotypes ; Homozygote ; Hormone Replacement Therapy* ; Humans ; Immunoassay ; Osteocalcin ; Polymorphism, Restriction Fragment Length ; Receptors, Calcitriol* ; Sequence Analysis, DNA ; Spine ; Vitamin D* ; Vitamins*

OBJECTIVETo study the effect of 1,25-(OH)2D3 supplementation during gestation and lactation on TGF-β1 and Smad3 expression in lungs of rat offspring with asthma.

METHODSThirty-two female Wistar rats were randomly divided into four groups: low-, medium- and high-dose 1,25-(OH)2D3 supplementation and control groups (n=8 each). From the 7th day of gestation, the three 1,25-(OH)2D3 supplementation groups were administered with 2,10 and 20 μg/mL of 1,25-(OH)2D3 respectively every other day until weaning (rat offspring: 21 days old). The control group received normal saline instead. Then, bronchial asthma was induced in rat offspring from the 4 groups. The protein and mRNA expression of TGF-β1 and Smad3 in the lung tissue was measured by immunochemistry and RT-PCR.

RESULTSEosinophil cell infiltration and airway inflammation decreased in rat offspring from the low- and medium-dose 1,25-(OH)2D3 groups, but increased in rat offspring of the high-dose 1,25-(OH)2D3 group compared with the control group. Immunohistochemistry of lung tissues showed that the expression of TGF-β1 protein and pSmad3 decreased in rat offspring from the low- and medium-dose 1,25-(OH)2D3 groups (P<0.05), but increased significantly in rat offspring from the high-dose 1,25-(OH)2D3 group compared with the control group (P<0.05). PCR showed that the expression of TGF-β1 and Smad3 mRNA in the lung tissue decreased in rat offspring from the low- and medium-dose 1,25-(OH)2D3 groups (P<0.05), but increased significantly in rat offspring from the high-dose 1,25-(OH)2D3 group compared with the control group (P<0.05).

CONCLUSIONS1,25-(OH)2D3 supplementation plays a role in regulating the immune system in asthmatic rats. Its mechanism may be associated with regulation of the expression of TGF-β/Smad signal pathway-related proteins through the vitamin D receptor signal pathway.

Animals ; Asthma ; metabolism ; Cholecalciferol ; administration & dosage ; analogs & derivatives ; Dietary Supplements ; Female ; Lactation ; metabolism ; Lung ; metabolism ; pathology ; Male ; Pregnancy ; RNA, Messenger ; analysis ; Rats ; Rats, Wistar ; Signal Transduction ; Smad3 Protein ; genetics ; physiology ; Transforming Growth Factor beta1 ; genetics ; physiology