Vitamin D has been the focus of much scientific literature in recent years owing to various studies showing its association with a wide variety of pathological conditions 1,2 . Sun exposure, diet and fortified supplementation account for a bulk of Vitamin D intake in humans. Activation of vitamin D is sequential and requires sun exposure for conversion of 7- dehydrocholesterol to Vitamin D3. Further metabolism in the liver converts Vitamin D3 to 25 –hydroxyvitamin D3. Conversion to its active form 1,25 dihydroxyvitamin D3 (Calcitriol) occurs in the kidneys 2 . The importance of Vitamin D in calcium metabolism and bone health is well known and documented. Controversies exist regarding the true prevalence of hypovitaminosis, however in developing countries the prevalence of vitamin D deficiency in all age groups is probably higher 3 . Adding to this the burden and morbidity of skeletal trauma, persistent deficiency may have a deleterious effect in the injured 4, 5 . Vitamin D, with its positive effect on bone health does play a role in the biology of fracture repair and remodelling 6 . The role of Vitamin D replacement as sole biological effectors in fracture repair may be difficult to quantify and confounded by other variables at play in bone healing. Studies looking at vitamin D levels in orthopaedic patients have also shown significant levels of deficiency and have put forward recommendations for evaluation and supplementation
Vitamin D Deficiency

Introduction: Derangement in calcium homeostasis is common in nephrotic syndrome (NS). It is postulated that low serum total calcium and vitamin D levels are due to loss of protein-bound calcium and vitamin D. It is unclear if free calcium and free vitamin D levels are truly low. The guideline is lacking with regards to calcium and vitamin D supplementation in NS. This study aims to examine calcium and vitamin D homeostasis and bone turnover in NS to guide practice in calcium and vitamin D levels supplementation. Methodology: This is a prospective pilot study of ten patients diagnosed with NS, and eight healthy controls. Calcium, vitamin D, and bone turnover-related analytes were assessed at baseline, partial and complete remission in NS patients and in healthy controls. Results: NS patients had low free and total serum calcium, low total 25(OH)D, normal total 1,25(OH)D levels and lack of parathyroid hormone response. With remission of disease, serum calcium and vitamin D metabolites improved. However, nephrotic patients who do not attain complete disease remission continue to have low 25(OH)D level. Conclusion In this study, the vitamin D and calcium derangement observed at nephrotic syndrome presentation trended towards normalisation in remission. This suggested calcium and vitamin D replacement may not be indicated in early-phase nephrotic syndrome but may be considered in prolonged nephrotic syndrome.
Vitamin D Deficiency

Background: Apart from its role in bone health, recent developments have shown that vitamin D also has anti-inflammatory properties, and therefore may have a role in inflammatory bowel disease (IBD) in children. Objectives: To determine the effect of vitamin D supplementation on the disease activity of pediatric patients with IBD. Design: Random-effects meta-analysis Data Sources: : Studies were searched at Cochrane Library, PubMed, EBSCO Host, ScienceDirect, Google Scholar, and Wiley Online. Review Methods: Experimental studies measuring the effect of vitamin D on the disease activity of pediatric patients with IBD were included. The proportion of disease activity, measured as remission rate or inactivity using Pediatric Crohn’s Disease Activity Index (PCDAI) or Pediatric Ulcerative Colitis Activity Index (PUCAI), and the mean and standard deviation of mean serum vitamin D [25(OH)D] level, change in 25(OH)D, and different inflammatory markers [erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP)] were extracted or estimated and recorded in an abstraction form. Standardized mean difference and odds ratio were used as summary effect measures and estimated using Stata/Multiprocessor. Results: The serum 25(OH)D (SMD = 1.75, z = 2.33, p = 0.001) and change in 25(OH)D (SMD = 3.37, z = 2.34, p = 0.019) was significantly higher among those who received a high dose of vitamin D. However, a significantly high heterogeneity was estimated (I2 >50%). For the disease activity of IBD, the standard mean difference of mean ESR (SMD = –1.10, z = 5.35, p = 0.001) was significantly lower with high-dose vitamin D. The likelihood of remission rate using the Pediatric Crohn’s Disease Activity Index (PCDAI) or Pediatric Ulcerative Colitis Activity Index (PUCAI), and standardized mean difference of CRP were not significantly different among those who received high-dose and low-dose vitamin D. Conclusion Cognizant of the functions of vitamin D in enhancing intestinal flora balance, regulating immunologic response, and improving intestinal mucosal barrier, vitamin D can be recommended as a supplementary treatment for IBD among the pediatric population. Nevertheless, there is still insufficient evidence for the cut-off level of adequate levels of serum 25(OH)D among pediatric patients with IBD, thus necessitating further studies.
Vitamin D Deficiency

Humans ; Vitamin D ; Vitamin D Deficiency

Humans ; Vitamin D ; Vitamin D Deficiency

Objectives: This study aimed to compare the severity of COVID-19, inflammatory parameters and clinical outcomes among patients with normal and subnormal levels of Vitamin D. Methodology: This is a retrospective cohort study of 135 patients admitted in a tertiary hospital for COVID-19. Patients were grouped according to their Vitamin D level. Primary outcome measure was the composite of all-cause mortality and morbidity. Other outcome measures determined were the comparison among the groups on the severity of COVID-19 infection, changes in inflammatory parameters, length of hospital stay and duration of respiratory support. Results: There was a significant trend of higher ICU admission (p=0.024), mortality (p=0.006) and poor clinical outcome (p=0.009) among the Vitamin D deficient group. No significant difference was found for most of the inflammatory parameters, duration of hospital stay and respiratory support. Overall, patients with deficient, but not insufficient Vitamin D level had 6 times higher odds of composite poor outcome than those with normal Vitamin D (crude OR=5.18, p=0.003; adjusted OR=6.3, p=0.043). Conclusion The inverse relationship between Vitamin D level and poor composite outcome observed in our study suggests that low Vitamin D may be a risk factor for poor prognosis among patients admitted for COVID-19.
Vitamin D ; Vitamin D Deficiency ; COVID-19

Objectives. To determine the association between low maternal serum vitamin D and gestational diabetes mellitus (GDM) among Filipino women in St. Luke’s Medical Center, Quezon City. Methodology. A cross-sectional study involving pregnant women at outpatient clinics in a tertiary hospital in the Philippines. Simultaneous testing for fasting blood sugar, 75g oral glucose tolerance test and serum vitamin D was done. Participants were classified as GDM versus non-GDM, and normal versus low serum vitamin D. Univariate and multivariate statistics were done to determine relationship between vitamin D and GDM. Results. Of 211 included women, 198 (93.8%) had low vitamin D levels, and 56 (26.5%) had GDM. Vitamin D was significantly higher in the GDM group (21.0±8.1 vs 18.8±5.3 ng/mL, p=0.0189). The proportion of women with low vitamin D levels was significantly higher among those without GDM (96.1% vs 87.5%, OR=0.28, p=0.029]. After adjusting for age, parity, history of GDM and pre-pregnancy BMI, no significant association was observed (adjusted OR=0.66, p=0.522). No correlation was seen between vitamin D and FBS (r=0.28, p=0.095), 1-hour post-75 g OGTT (r=0.26, p=0.643), and 2-hour post-75 g OGTT (r=0.28, p=0.113). Conclusion. There was an association found between maternal serum vitamin D level and GDM in the univariate analysis, but none was evident after adjusting for possible confounders. The unanticipated high prevalence of low vitamin D levels among pregnant Filipinos needs to be verified in future studies.
vitamin D deficiency ; Diabetes, Gestational

Objective. We aim to study the prevalence and risk factors of hypovitaminosis D among healthy adolescents in Kota Bharu, Kelantan based on the most recent Paediatric Consensus guideline. Methodology. Ten public schools were selected from Kota Bharu, Kelantan. We analysed their demography (age, gender, ethnicity, income), measured their anthropometry (height, weight, BMI) and finally analysed their vitamin D and intact- Parathyroid hormone levels. Results. The prevalence of hypovitaminosis D was 16.9% among healthy teenagers with mean age of 15.9±1.39 years. Multivariate analysis showed female gender (adjusted OR, 95% CI): 23.7 (5.64, 100.3) and Chinese 0.24 (0.07, 0.84) were the significant predictors for hypovitaminosis D. Conclusion. The prevalence of healthy adolescents with hypovitaminosis D in Kota Bharu, Kelantan was 16.9% using the most recent cut off value of 30 nmol/L from the global consensus 2016. Female and Malay were the significant risk factors associated with hypovitaminosis D. Higher cut off value would result in overestimation of prevalence rate of hypovitaminosis D.
Vitamin D Deficiency ; Rickets ; adolescents

Introduction: Seborrheic dermatitis is a chronic and recurrent inflammatory dermatosis affecting different age groups with a prevalence rate of 1–5% among Asian adults. Due to its immune-modulatory and anti-inflammatory properties, vitamin D has been correlated with inflammatory dermatoses such as seborrheic dermatitis. Objectives: To determine the prevalence of vitamin D insufficiency, deficiency and severe deficiency among Filipino adult pa- tients with moderate to severe seborrheic dermatitis. Methods: A single-center, analytical, cross-sectional study at Makati Medical Center, which included Filipino patients aged 18– 60 years, diagnosed with moderate-to-severe seborrheic dermatitis based on Investigator's Static Global Assessment (ISGA) with serum vitamin D levels classified as normal, insufficient, deficient and severely deficient. Results: We included 61 patients, 5 patients (8%) of whom presented with normal Vitamin D levels. Twenty-one patients (34%) pre- sented with vitamin D insufficiency, 32 patients (52%) presented with vitamin D deficiency, while 3 patients (5%) presented with se- vere deficiency. Vitamin D insufficiency and deficiency were more prevalent among patients in the younger age group (p = 0.001), with predominant scalp lesions (p = 0.006), and those who are single (p = 0.015). There was no statistically significant difference in the prevalence of vitamin D insufficiency and/or deficiency based on seborrheic dermatitis severity as per ISGA scale (p = 0.126). Conclusion Seborrheic dermatitis in Filipinos has been associated with vitamin D insufficiency, deficiency and severe defi- ciency. The prevalence of vitamin D deficiency is seen in almost half of patients while vitamin D insufficiency is seen in almost one-third of patients with seborrheic dermatitis. While topical and oral medications have been the treatment of choice for seb- orrheic dermatitis, the role of oral vitamin D supplementation as adjunct treatment may be studied.
Dermatitis, Seborrheic ; Vitamin D Deficiency

OBJECTIVE: To investigate the correlation between depressive symptoms and serum vitamin D levels in stroke patients. METHODS: In total, 126 stroke patients were analyzed. The 25-hydroxyvitamin D (25-OHD) concentration of each patient was used to determine their vitamin D status. Depressive symptoms were assessed using the Beck Depression Inventory II (BDI-II) and the Patient Health Questionnaire 9 (PHQ-9). Functional status was evaluated with the Korean version of the Modified Barthel Index (K-MBI). We compared the clinical questionnaires of a vitamin D-deficient group and a normal group, and evaluated the correlations between BDI-II, PHQ-9, K-MBI, and serum 25-OHD levels. RESULTS: In the vitamin D-deficient group, BDI-II (16.0±12.1) and PHQ-9 (7.4±4.2) scores were significantly higher than those of the normal group (BDI-II, 9.1±7.2; PHQ-9, 4.2±2.9; p<0.01). In a Spearman correlation analysis, a significant negative correlation was found between serum 25-OHD levels and BDI-II (Spearman r=0.177, p=0.048), but there were no significant correlations between serum 25-OHD levels and PHQ-9 or K-MBI. CONCLUSION: Vitamin D deficiency was correlated with the symptoms of depression in stroke patients.
Depression* ; Humans ; Stroke* ; Vitamin D Deficiency ; Vitamin D* ; Vitamins*