OBJECTIVETo explore the predictive value of cord blood 25(OH)D [25(OH)D] for infantile atopic dermatitis (AD), and to provide a reference for primary prevention of early infantile AD.

METHODSThe neonates born from July to September, 2015 were enrolled. The cord blood samples were collected at birth to measure the level of 25(OH)D. Outpatient follow-up was conducted for all the infants at 6 weeks, 3 months, and 6 months after birth. A survey was performed to investigate the incidence of AD.

RESULTSA total of 67 neonates completed a 6-month follow-up. The incidence of AD was 34% (23/67), and 91% (21/23) of these cases occurred in the first month after birth. The 23 AD children had a significantly lower cord 25(OH)D level than those without AD (P<0.05). The children with a cord 25(OH)D level <30 nmol/L showed a significantly higher incidence of AD than those with a cord 25(OH)D level ≥30 nmol/L (P<0.05). The receiver operating characteristic (ROC) analysis showed that the area under the ROC curve of cord 25(OH)D in predicting AD was 0.648 (standard error: 0.075; 95%CI: 0.502-0.795). Its sensitivity, specificity, positive predictive value, and negative predictive value were 52.2%, 79.5%, 57.1%, and 76.1%, respectively. Logistic regression analysis showed that low cord 25(OH)D level, preference for seafood during pregnancy, atopic family history, and mixed feeding were risk factors for infantile AD (P<0.05).

CONCLUSIONSCord 25(OH)D level is inversely associated with the risk of infantile AD, but it has a low diagnostic value for this disease.

Calcifediol ; blood ; Dermatitis, Atopic ; blood ; epidemiology ; etiology ; prevention & control ; Female ; Fetal Blood ; chemistry ; Humans ; Infant, Newborn ; Logistic Models ; Male ; Predictive Value of Tests ; ROC Curve ; Risk Factors

Signaling through the vitamin D receptor has been shown to be biologically active and important in a number of preclinical studies in prostate and other cancers. Epidemiologic data also indicate that vitamin D signaling may be important in the cause and prognosis of prostate and other cancers. These data indicate that perturbation of vitamin D signaling may be a target for the prevention and treatment of prostate cancer. Large studies of vitamin D supplementation will be required to determine whether these observations can be translated into prevention strategies. This paper reviews the available data in the use of vitamin D compounds in the treatment of prostate cancer. Clinical data are limited which support the use of vitamin D compounds in the management of men with prostate cancer. However, clinical trials guided by existing preclinical data are limited.
Antineoplastic Combined Chemotherapy Protocols/therapeutic use* ; Calcifediol/blood* ; Calcitriol/therapeutic use* ; Clinical Trials as Topic ; Ergocalciferols/therapeutic use* ; Humans ; Male ; Prostatic Neoplasms/prevention & control* ; Signal Transduction ; Vitamin D/metabolism* ; Vitamin D Deficiency/epidemiology*

OBJECTIVETo examine the changes in 25-hydroxyvitamin D[25-(OH)D] level in children with Henoch-Schönlein purpura (HSP) and its clinical significance.

METHODSA total of 92 HSP children were included in this study, and were divided into HSP nephritis (HSPN) group (31 cases) and HSP group (61 cases) based on the presence or absence of HSPN. Alternatively, the patients were divided into purpura alone group (22 cases), purpura with joint symptoms group (joint symptom group, 24 cases), purpura with gastrointestinal symptoms group (gastrointestinal symptom group, 20 cases), and purpura with joint and gastrointestinal symptoms (mixed group, 26 cases) based on their clinical symptoms. In addition, 42 healthy children were selected as healthy control group. The level of 25-(OH)Din each group was measured using enzyme-linked immunoassay.

RESULTSThe 25-(OH)Dlevel in the HSP and HSPN groups was significantly lower than that in the healthy control group (P<0.05), and the 25-(OH)Dlevel in the HSPN group was significantly lower than that in the HSP group (P<0.05). Although there was no significant difference in the 25-(OH)Dlevel between the joint symptom, gastrointestinal symptom, and mixed groups (P=0.22), the 25-(OH)Dlevel in the three groups was all significantly lower than that in the purpura alone group (P<0.05).

CONCLUSIONSThe level of 25-(OH)Dis reduced in children with HSP, particularly those with HSPN or with joint and gastrointestinal symptoms. Therefore, the reduction in 25-(OH)Dlevel may serve as a predictor of whether HSP is associated with other impairments.

Adolescent ; Calcifediol ; blood ; Child ; Child, Preschool ; Female ; Humans ; Immunoenzyme Techniques ; Male ; Purpura, Schoenlein-Henoch ; blood

OBJECTIVE: To review cases of adult patients who develop Hungry Bone Syndrome (HBS) after parathyroidectomy for Primary Hyperparathyroidism (PHPT) in a tertiary care center in the Philippines and describe the clinical features, pre-operative preventive measures done and risk factors for HBS.
METHODS:
Design: Retrospective Case Note Review
Setting: Tertiary Private Hospital
Participants: Chart review of adult Filipino patients who underwent parathyroidectomy for PHPT at Makati Medical Center from January 2011 to December 2016 was conducted and evaluated according to the inclusion and exclusion criteria. Medical information obtained included clinical parameters, biochemical results, operation performed, pathology, length of hospital stay and complications if with any.
RESULTS: From among 20 adult Filipino patients (mean age 55 years; 13, 65% female) who underwent parathyroidectomy for PHPT, HBS was found in 7 (35%). Most common pre-operative symptoms of hypercalcemia were musculoskeletal complaints. To prevent HBS, all were hydrated prior to surgery while some were given bisphosphonates and diuretics. The most common parathyroid gland imaging used for pre-procedure localization was Tc 99m Sestamibi scan with single photon emission computed tomography (SPECT) and 19 (95%) had parathyroid adenoma on post-operative histopathologic report. Among biochemical and clinical factors that may be risk factors for HBS, those with HBS had significantly lower pre-operative 25-hydroxyvitamin D, higher BUN, phosphate and alkaline phosphatase (ALP) than those without HBS. Of these, only ALP showed significant association with HBS (OR = 107.17, p = <0.0001). Length of hospital stay was longer among those with HBS although not statistically significant.
CONCLUSION: Knowledge on post-parathyroidectomy HBS for PHPT may aid clinicians on preoperative prevention and post-operative monitoring. Thirty-five percent (7) of our patients presented with HBS post-parathyroidectomy for PHPT from 2011 to 2016. An abnormal ALP level pre-operatively may be a risk factor in developing HBS post-parathyroidectomy for PHPT

Human ; Male ; Female ; Middle Aged ; Adult ; Hyperparathyroidism, Primary ; Parathyroidectomy ; Parathyroid Neoplasms ; Alkaline Phosphatase ; Parathyroid Glands ; Hypercalcemia ; Diphosphonates ; Diuretics ; Blood Urea Nitrogen ; Calcifediol ; 25-hydroxyvitamin D ; Vitamin D

PURPOSE: Despite new treatment strategies, anemia remains the most prevalent complication in patients with end-stage renal disease (ESRD). We investigated whether 25-hydroxyvitamin D [25(OH)D3] deficiency was associated with anemia in ESRD patients. MATERIALS AND METHODS: We reviewed the medical records of 410 ESRD patients who had undergone renal transplantation (RTx) at Yonsei University Health System and who had 25(OH)D3 levels measured at the time of RTx. Patients were divided into two groups based on baseline 25(OH)D3 concentrations: group 1, 25(OH)D3 levels <10 ng/mL; and group 2, 25(OH)D3 levels ≥10 ng/mL. RESULTS: Using multivariate regression models, 25(OH)D3, age, and erythrocyte-stimulating agent (ESA) dose were found to be significantly associated with hemoglobin (Hb) levels [25(OH)D3: β=0.263, p<0.001; age: β=0.122, p=0.010; ESA dose: β=-0.069, p=0.005]. In addition, logistic regression analysis revealed that patients in group 1 had a significantly higher risk for developing anemia (Hb level <10 g/dL) compared to group 2 patients, even after adjusting for potential risk factors for anemia (odds ratio=3.857; confidence interval=1.091-13.632; p=0.036). CONCLUSION: 25(OH)D3 deficiency was significantly associated with anemia in patients with ESRD. Randomized controlled trials are needed to determine whether vitamin D supplementation can improve anemia in these patients.
Adult ; Aged ; Anemia/blood/*etiology ; Calcifediol ; Cross-Sectional Studies ; Female ; Hemoglobin A/analysis ; Humans ; Kidney Failure, Chronic/*complications ; Kidney Transplantation ; Male ; Middle Aged ; Odds Ratio ; Prevalence ; Regression Analysis ; Risk Factors ; Vitamin D/analogs & derivatives/blood ; Vitamin D Deficiency/blood/*complications

OBJECTIVETo investigate the changes in the serum level of 25-hydroxyvitamin D3 [25-(OH)D3] and its significance in children with Kawasaki disease (KD).

METHODSThe clinical data of 242 KD children were collected. According to the presence or absence of coronary artery lesion (CAL), these children were classified into CAL group (63 children) and non-CAL (NCAL) group (179 children). According to the efficacy of intravenous immunoglobulin (IVIG), these children were classified into IVIG-sensitive group (219 children) and no-IVIG-response group (23 children). A total of 40 healthy children (control group) and 40 children with acute upper respiratory tract infection (AURI group) were enrolled as controls. Enzyme-linked immunosorbent assay was applied to measure the serum level of 25-(OH)D3.

RESULTSBefore IVIG treatment, the AURI, NCAL, and CAL groups had significantly lower serum levels of 25-(OH)D3 than the control group (P<0.05); the CAL group had a significantly lower serum level of 25-(OH)D3 than the AURI and NCAL groups (P<0.05); the AURI, IVIG-sensitive, and no-IVIG-response groups had significantly lower serum levels of 25-(OH)D3 than the control group (P<0.05); the no-IVIG-response group had a significantly lower serum level of 25-(OH)D3 than the AURI and IVIG-sensitive groups (P<0.05). After IVIG treatment, the CAL group had a significantly lower serum level of 25-(OH)D3 than the NCAL and control groups (P<0.05); the no-IVIG-response group had a significantly lower serum level of 25-(OH)D3 than the IVIG-sensitive and control groups (P<0.05).

CONCLUSIONSKD children may experience a reduction in the serum level of 25-(OH)D3. With a greater reduction in the serum level of 25-(OH)D3, the possibility of CAL and KD with no response to treatment increases.

Calcifediol ; blood ; Child ; Child, Preschool ; Female ; Humans ; Immunoglobulins, Intravenous ; therapeutic use ; Infant ; Male ; Mucocutaneous Lymph Node Syndrome ; blood ; drug therapy

PURPOSE: The association between excess calcium intake and cardiovascular mortality has already been reported. In the present study, we investigated the relation between dietary calcium intake and Framingham Risk Score (FRS) according to serum 25-hydroxyvitamin D [25(OH)D] status. MATERIALS AND METHODS: A total of 7809 subjects (3452 males and 4357 female) aged over 40 years were selected for this cross-sectional study from data obtained from the Korea National Health and Nutrition Examination Survey (2008-2011). Daily dietary calcium intake was categorized into <300, 300-600, 600-900, 900-1200, and >1200 mg/day and serum 25(OH)D concentration classified into <50, 50-75, >75 mmol/L. The FRS was compared by the daily dietary calcium intake categories according to 25(OH)D concentration after adjustment with relevant variables in both genders. RESULTS: Higher FRS was observed in males with both <300 mg and >1200 mg of dietary calcium intake and females with <300 mg of dietary calcium intake without adjustment. The significantly higher FRS remained in the <300 mg and >1200 mg of dietary calcium intake groups in both genders after adjustments for relevant variables. FRS was significantly higher in the group with >1200 mg of dietary calcium intake and serum 25(OH)D <50 nmol/L, which was the male only vitamin D deficient group. CONCLUSION: Very low (<300 mg/day) and excess (>1200 mg/day) dietary calcium intake were related with higher FRS in both genders. In particular, higher FRS was observed in the excess (>1200 mg/day) dietary calcium intake male group under vitamin D deficiency (<50 nmol/L).
Adult ; Aged ; Calcifediol ; Calcium, Dietary/*administration & dosage ; Cross-Sectional Studies ; Female ; Humans ; Male ; Middle Aged ; Nutrition Surveys ; Republic of Korea ; Risk ; *Risk Assessment ; Vitamin D/*analogs & derivatives/blood ; Vitamin D Deficiency/*blood

OBJECTIVE25-Hydroxyvitamin D3 [25(OH)D3] is the main product of vitamin D and can reflect the absolute concentration of active vitamin D in the body. This study examined serum 25(OH)D3 levels in children with juvenile idiopathic arthritis (JIA) in order to explore the association of vitamin D concentrations with the pathogenesis and disease activity of JIA.

METHODSSerum samples were collected from 53 children confirmed as having JIA between January 2013 and March 2014, as well as 106 healthy children (control group) who underwent physical examination in the same period. Serum concentrations of 25(OH)D3 were measured using ELISA and compared between the cases and healthy controls. The association of serum 25(OH)D3 levels with JIA subtypes, ACR Pediatric 30 Score, peripheral blood C-reactive protein (CRP), and erythrocyte sedimentation rate (ESR) were analyzed in children with JIA.

RESULTSCompared with the control group, the JIA group had significantly reduced serum 25(OH)D3 levels (median: 42.6 nmol/L vs 49.9 nmol/L; P<0.01). The percentage of subjects with severe deficiency of vitamin D in the JIA group was significantly higher than that in the control group (17.0% vs 6.6%; P<0.05). Serum 25(OH)D3 showed no significant correlations with JIA subtypes, ACR Pediatric 30 Score, CRP, and ESR in children with JIA.

CONCLUSIONSVitamin D concentrations are significantly decreased in children with JIA. Decreased vitamin D concentrations may be associated with the pathogenesis of JIA. However, vitamin D concentrations may have no correlations with JIA subtypes, disease severity, and disease activity.

Adolescent ; Arthritis, Juvenile ; blood ; etiology ; Calcifediol ; blood ; Child ; Child, Preschool ; Female ; Humans ; Infant ; Male

PURPOSE: Although interest in the role played by vitamin D in bone health is increasing, little is known about the role of this vitamin in musculoskeletal pain in children. This study aimed to assess the prevalence of vitamin D deficiency in children presenting with nonspecific lower extremity pains. MATERIALS AND METHODS: From 2011 to 2012, 183 children underwent evaluation for nonspecific lower-extremity pains. Patients with valid causes, such as fractures or transient synovitis, were excluded, as were those with underlying medical conditions, such as cerebral palsy and metabolic disease. Ultimately, 140 patients met the inclusion criteria. Levels of serum 25-hydroxy vitamin D [25-(OH)D], the ideal indicator of vitamin D status, were measured in these children. RESULTS: Eighty-seven boys (62.1%) and 53 girls (37.9%) were included. The mean age at presentation was 5.2 years (range, 2-15). Serum 25-(OH)D levels were <10 ng/mL in 5.7% of patients, 10 to <20 ng/mL in 51.4%, 20 to <30 ng/mL in 37.9%, and > or =30 ng/mL in only 5.0%. Most patients visited the hospital in the winter (41.4%) (summer, 12.9%), and serum 25-(OH)D levels were also lowest in the winter (17.2+/-5.5 ng/mL). CONCLUSION: This study found a high prevalence of vitamin D deficiency or insufficiency in Korean children with nonspecific lower-extremity pains, indicating a positive association between vitamin D deficiency and growing pains. More attention should be directed toward vitamin D and its role in the optimization of bone health.
Adolescent ; Asian Continental Ancestry Group/*statistics & numerical data ; Calcifediol/administration & dosage ; Child ; Child, Preschool ; Cross-Sectional Studies ; Female ; Humans ; Male ; Musculoskeletal Pain/drug therapy/etiology ; Prevalence ; Republic of Korea/epidemiology ; Retrospective Studies ; Seasons ; Vitamin D/*analogs & derivatives/blood ; Vitamin D Deficiency/blood/complications/*ethnology ; Vitamins/administration & dosage

OBJECTIVETo explore the changes of serum 25-hydroxyvitamin D3 [25-(OH)D3] and interleukin-6 (IL-6) in children with Kawasaki disease (KD) after treatment with intravenous immunoglobulins (IVIG) and analyze their clinical implications.

METHODSThirty-five children with KD (26 boys and 9 girls) were examined for serum 25-(OH)D3 and IL-6 levels before and after IVIG treatment using enzyme linked immunosorbent assay (ELISA), with 25 febrile children with respiratory tract infections and 25 healthy children as controls.

RESULTSSerum 25-(OH)D3 levels were significantly higher in healthy children than in febrile children (P=0.025), and was even higher in children with KD before IVIG treatment (P=0.023). Serum IL-6 levels were similar between healthy and febrile children (P=0.4), but significantly elevated in KD children (P=0.000). Serum 25-(OH)D3 level was positive correlated with serum IL-6 level in KD children before treatment (r=0.9, P=0.000). In KD children after IVIG treatment, serum 25-(OH)D3 level was significantly increased (P=0.012) and serum IL-6 levels slightly decreased (P=0.325) without showing any correlations (r=0.18, P=0.4).

CONCLUSIONSerum 25-(OH)D3 level is positively correlated with serum IL-6 level in KD children before IVIG treatment but not after the treatment,. 25(OH)D3 may participate in the pathogenesis of KD and potentially serves as the therapeutic target for KD.

Calcifediol ; blood ; Case-Control Studies ; Child ; Female ; Humans ; Immunoglobulins, Intravenous ; therapeutic use ; Interleukin-6 ; blood ; Male ; Mucocutaneous Lymph Node Syndrome ; blood ; drug therapy