Pilot Study Evaluating Efficacy of 2 Regimens for Hypovitaminosis D Repletion in Pediatric Inflammatory Bowel Disease Impact of dietary and lifestyle on vitamin D in healthy student girls aged 11-15 years. Higher serum 25-hydroxyvitamin D concentrations are associated with active pulmonary tuberculosis in hospitalised HIV infected patients in a low income tropical setting: a cross sectional study Association of low serum 25-hydroxyvitamin D levels and high arterial blood pressure in the elderly. Vitamin D status in healthy Moroccan men and women aged 50 years and older: a cross-sectional study Treatment of hypovitaminosis D in infants and toddlers. Optimal vitamin D status: a critical analysis on the basis of evidence-based medicine. Hypovitaminosis D in the Middle East and North Africa Effectiveness of Prenatal Vitamin D Deficiency Screening and Treatment Program: A Stratified Randomized Field Trial Impact of cholecalciferol treatment on biomarkers of inflammation and myocardial structure in hemodialysis patients without hyperparathyroidism. Patients with Nonalcoholic Fatty Liver Disease Have a Low Response Rate to Vitamin D Supplementation. Effect of vitamin D supplementation on bone health parameters of healthy young Indian women EFFECT OF HIGH-DOSE VITAMIN D REPLETION ON GLYCEMIC CONTROL IN AFRICAN-AMERICAN MALES WITH PREDIABETES AND HYPOVITAMINOSIS D. Between-meal risedronate does not alter bone turnover in nursing home residents. The response of elderly veterans to daily vitamin D3 supplementation of 2,000 IU: a pilot efficacy study. Low vitamin D status is an independent predictor of increased frailty and all-cause mortality in older men: the Health in Men Study. Vitamin D levels in Hispanics with multiple sclerosis Effect of vitamin D supplementation alone on muscle function in postmenopausal women: a randomized, double-blind, placebo-controlled clinical trial Prevalence of vitamin d insufficiency in patients with Parkinson disease and Alzheimer disease. Chronic kidney disease, hypovitaminosis D, and mortality in the United States. Impact of Hypovitaminosis D and Alfacalcidol Therapy on Survival of Hemodialysis Patients: Results from the French ARNOS Study Influence of a single oral dose of vitamin D(2) on serum 25-hydroxyvitamin D concentrations in tuberculosis patients. Vitamin D intake is low and hypovitaminosis D common in healthy 9− to 15-year-old Finnish girls
Objectives : Vitamin D is critical for skeletal health ; hypovitaminosis D is common in pediatric inflammatory bowel disease ( IBD ) , yet optimal repletion therapy is not well studied . We aim ed to conduct a pilot trial comparing the efficacy of 2 vitamin D regimens of weekly dosing for the repletion of hypovitaminosis D in pediatric IBD . Methods : Subjects identified from our IBD clinic with 25-hydroxyvitamin D ( 25[OH]D ) concentrations < 30 ng/mL were r and omized to 10,000 ( n = 18 ) or 5000 ( n = 14 ) IU of oral vitamin D3/10 kg body weight per week for 6 weeks  . Serum 25(OH)D , Ca , and parathyroid hormone concentrations were measured at baseline , week 8 , and week 12 . Results : In the higher dosing group , serum 25(OH)D increased from 23.7 ± 8.5 ng/mL at baseline to 49.2 ± 13.6 ng/mL at 8 weeks ; P < 0.001 . In the lower dosing group , serum 25(OH)D increased from 24.0 ± 7.0 ng/mL at baseline to 41.5 ± 9.6 ng/mL at 8 weeks ; P < 0.001 . At 12 weeks , serum 25(OH)D concentrations were 35.1 ± 8.4 and 30.8 ± 4.2 ng/mL for the higher and lower dose regimens , respectively . Mean serum Ca and parathyroid hormone concentrations did not significantly change during the study . No patient exhibited hypercalcemia , and no serious adverse events occurred . Conclusions : Both treatment arms were safe and effective at normalizing vitamin D nutriture in pediatric IBD . Although significant repletion of 25(OH)D concentration was achieved in both dosing groups at 8 weeks , this effect was lost by the 12-week follow-up . Maintenance vitamin D therapy following initial repletion is likely required to maintain long-term normalized vitamin D status OBJECTIVE To study daily intake of calcium , phosphorus and vitamin D , to determine the biochemical findings of rickets and the effect of sunlight exposure and vitamin D supplementation in school girls with hypovitaminosis D. METHODS A cross-sectional study was conducted on school girls aged 11 - 15 years selected r and omly from various areas of Tehran , Iran .  Dietary information and amount of sunlight exposure were estimated by a 7 day recalling method using self-reported question naire . Hypovitaminosis D defined as low serum 25-hydroxyvitamin D concentration with two or more others abnormal biochemical findings . Girls with hypovitaminoses D were r and omly divided into two groups . The faces and h and s of girls in group 1 were exposed to sunlight for one hour per day for twenty days , while those in group 2 were administered vitamin D capsules , 50,000 IU per day for the same period . RESULTS four-hundred fourteen girls evaluated , mean daily calcium intake , sunlight exposure and vitamin D acquirement were 360 mg , 10 minutes and 119 IU , respectively . Mean serum 25-hydroxyvitamin D concentration was 30 ng/ml among all girls whereas in 15 ( 3.63 % ) of 414 girls was 7.8 ng/ml . Abnormal biochemical findings in these girls included hypocalcemia ( n=4 ) , hypophosphatemia ( n=5 ) , raised serum alkaline phosphatase ( n=13 ) , and parathyroid hormone ( n=15 ) . After intervention , mean serum 25-hydroxyvitamin D concentration  in sunlight exposure ( n=8 ) and vitamin D ( n=7 ) supplementation increased to 14.4+/-4 ng/ml and 23+/-4 ng/ml respectively . There was a significant difference between the two groups ( p<0.05 ) . CONCLUSION Vitamin D deficiency developed in rapid growth period of girls without clear clinical rickets in sunny temperate climate city in Iran which vitamin D supplementation improved biochemical findings better than sunlight exposure Background The inherent risk of developing tuberculosis ( TB ) in HIV- infected individuals is further enhanced by hypovitaminosis D. Interventions that offset HIV-associated immune deterioration potentially arrest disease progression and incidence of opportunistic infections including TB . Despite conflicting reports on association between vitamin D deficiency ( VDD ) and risk of TB , vitamin D ( VD ) supplementation remains a promising intervention . Methods We conducted a comparative cross-sectional study on 145 HIV+/pulmonary TB+ ( PTB ) and 139 HIV+/PTB− hospitalised patients to investigate association of vitamin D status and risk of PTB . Stratified r and om sampling was used to select archived serum specimens from participants enrolled in a r and omised controlled trial ( RCT ) conducted to investigate the impact of using a point-of-care urine lipoarabinomannan strip test for TB diagnosis . PTB status was confirmed using sputum smear microscopy , culture or GeneXpert MTB/RIF .  Serum 25-hydroxyvitamin D [ 25(OH ) D ] concentrations  were assayed by competitive chemiluminescent immunoassay prior to commencement of anti-TB treatment . Effect of VD status on duration of hospital stay and patient outcomes on follow up at 8 weeks were also investigated . Median serum 25(OH ) D concentrations were compared using Mann-Whitney test and covariates of serum VD status were assessed using logistic regression analysis . Results Overall VDD prevalence in the cohort was 40.9 % ( 95 % CI : 35.1–46.8 ) . Median serum 25(OH)D concentrations were significantly higher in HIV+/PTB+ group ( 25.3 ng/ml , IQR:18.0–33.7 ) compared to the HIV+/PTB− group ( 20.4 ng/ml , IQR:14.6–26.9 ) , p = 0.0003 . Patients with serum 25(OH ) D concentration ≥ 30 ng/ml were 1.9 times more likely to be PTB+ compared to those with serum 25(OH ) D concentrations < 30 ng/ml ( odds ratio ( OR ) 1.91 ; 95 % CI 1.1–3.2 ) . PTB-related death was associated with higher odds of having 25(OH ) D levels≥30 ng/ml . Age , gender , CD4 + count , combination antiretroviral therapy ( cART ) status , efavirenz based cART regimen and length of hospital stay were not associated with vitamin D status . Conclusions The finding of an association between higher serum 25(OH ) D concentrations and active PTB and TB-related mortality among hospitalised HIV-infected patients in the present study is at variance with the commonly reported association of hypovitaminosis and susceptibility to TB . Our findings though , are in concordance with a small pool of reports from other setting BACKGROUND Vitamin D and calcium metabolism are involved in vascular smooth muscle cell proliferation , endothelial function and blood pressure ( BP ) regulation . Their physiopathology has been a matter of intensive clinical investigation with variable and sometimes contradictory results . Vitamin D insufficiency is highly prevalent in the general population , particularly among the elderly . We evaluated the association between serum 25(OH)-D levels and arterial BP in this population . METHODS An epidemiological cross-sectional study was design ed to analyse the prevalence of hypovitaminosis D ( ' D'AVIS ' study ) in our reference area . The study was performed on a representative r and om sample of the population over 64 years of age obtained from five primary health care areas . A medical record , arterial BP and biological analysis : serum 25(OH)-D , iPTH , creatinine , urea , calcium , albumin were obtained . RESULTS A total of 237 subjects ( 53 % women ) , aged between 64 and 93 ( mean 71.7 + /- 5.3 ) , were evaluated . The mean serum 25(OH)-D levels were 17.21 + /- 7.57 ng/ml ( interval 5 - 54 ; 86 % had < 25 ng/ml ) . The mean BP was 138.8 + /- 14/80 + /- 7.4 mmHg , and 46 % were on antihypertensive treatment . A significant negative association was observed between serum 25(OH)-D levels and systolic ( r = -0.153 , P = 0.018 ) and diastolic BP ( r = -0.152 , P = 0.019 ) . This association persisted after controlling for possible confounders in the multivariate analyses . CONCLUSIONS Low serum 25(OH)-D levels were inversely and independently associated with BP . Supplemental measures to prevent hypovitaminosis D in this population would be important , not only to protect the skeletal system but also for the possible beneficial effects on the cardiovascular system and the BP regulation Summary This study aim ed to compare the  vitamin D status  in healthy Moroccan men and women aged 50 years and older . A total of 186 Moroccan women and 68 men , who had no previous diagnosis of osteoporosis , were recruited prospect ively . We found in this study a high prevalence of hypovitaminosis D with no difference between men and women . Purpose The main purpose of this study was to describe and compare the  vitamin D status , parathormone , calcium , and phosphate  of healthy Moroccan men and women aged 50 years and older . Methods We conducted two cross-sectional studies , in postmenopausal women from October 2008 to November 2009 and in men over 50 years old , from December 2009 to August 2010 . A total of 186 Moroccan women and 68 men , who had no previous diagnosis of osteoporosis , were recruited prospect ively . For the definition of hypovitaminosis D , the preferred level for 25-hydroxyvitamin D ( 25(OH)D ) insufficiency , which is now recommended by many experts , is 30 ng/mL ( 75 nmol/L ) , and the levels below 10 ng/ml ( 25 nmol/L ) indicate deficiency . Results The prevalence of vitamin D deficiency in men and women was 4.4 and 8.6 % , respectively , and the prevalence of vitamin D(25(OH ) D ) insufficiency in men and women were 85.2 and 77.4 % , respectively . In men and women , no correlations were found between intact parathormone ( PTHi ) and 25(OH ) D ( r = 0.056 ) . Conclusions Despite a sunny environment , we found in this study a high prevalence of hypovitaminosis D ( insufficiency + deficiency ) in Moroccan men over 50 years old and postmenopausal women CONTEXT Hypovitaminosis D appears to be on the rise in young children , with implication s for skeletal and overall health . OBJECTIVE The objective of the study was to compare the safety and efficacy of vitamin D2 daily , vitamin D2 weekly , and vitamin D3 daily , combined with supplemental calcium , in raising serum 25-hydroxyvitamin D [ 25(OH)D ] and lowering PTH concentrations . DESIGN This was a 6-wk r and omized controlled trial . SETTING The study was conducted at an urban pediatric clinic in Boston . SUBJECTS Forty otherwise healthy infants and toddlers with hypovitaminosis D [ 25(OH)D < 20 ng/ml ] participated in the study . INTERVENTIONS Participants were assigned to one of three regimens : 2,000 IU oral vitamin D2 daily , 50,000 IU vitamin D2 weekly , or 2,000 IU vitamin D3 daily . Each was also prescribed elemental calcium ( 50 mg/kg.d ) . Infants received treatment for 6 wk . MAIN OUTCOME MEASURES Before and after treatment , serum measurements of 25(OH)D , PTH , calcium , and alkaline phosphatase were taken . RESULTS All treatments approximately tripled the 25(OH)D concentration . Preplanned comparisons were nonsignificant : daily vitamin D2 vs. weekly vitamin D2 ( 12 % difference in effect , P = 0.66 ) and daily D2 vs. daily D3 ( 7 % , P = 0.82 ) . The mean serum calcium change was small and similar in the three groups . There was no significant difference in PTH suppression . CONCLUSIONS Short-term vitamin D2 2,000 IU daily , vitamin D2 50,000 IU weekly , or vitamin D3 2,000 IU daily yield equivalent outcomes in the treatment of hypovitaminosis D among young children . Therefore , pediatric providers can individualize the treatment regimen for a given patient to ensure compliance , given that no difference in efficacy or safety was noted among these three common treatment regimens CONTEXT Public health authorities around the world recommend widely variable supplementation strategies for adults , whereas several professional organizations , including The Endocrine Society , recommend higher supplementation . METHODS We analyzed published r and omized controlled clinical trials to define the optimal intake or vitamin D status for bone and extraskeletal health . CONCLUSIONS The extraskeletal effects of vitamin D are plausible as based on pre clinical data and observational studies . However , apart from the beneficial effects of 800 IU/d of vitamin D3 for reduction of falls in the elderly , causality remains yet unproven in r and omized controlled trials ( RCTs ) . The greatest risk for cancer , infections , cardiovascular and metabolic diseases is associated with 25-hydroxyvitamin D ( 25OHD ) levels below 20 ng/mL. There is ample evidence from RCTs that calcium and bone homeostasis , estimated from serum 1,25-dihydroxyvitamin D and PTH , calcium absorption , or bone mass , can be normalized by 25OHD levels above 20 ng/mL. Moreover , vitamin D supplementation ( 800 IU/d ) in combination with calcium can reduce fracture incidence by about 20 % . Such a dose will bring serum levels of 25OHD above 20 ng/mL in nearly all postmenopausal women . Based on calculations of the metabolic clearance of 25OHD , a daily intake of 500 - 700 IU of vitamin D3 is sufficient to maintain serum 25OHD levels of 20 ng/mL. Therefore , the recommendations for a daily intake of 1500 - 2000 IU/d or serum 25OHD levels of 30 ng or higher for all adults or elderly subjects , as suggested by The Endocrine Society Task Force , are premature . Fortunately , ongoing RCTs will help to guide us to solve this important public health question Background : The Middle East and North Africa ( MENA ) region registers some of the highest rates of hypovitaminosis D worldwide . Aim : We systematic ally review ed the prevalence of hypovitaminosis D , rickets and osteomalacia , their predictors and impact on major outcomes , in the region . Methods : Medline , Pubmed and Embase search engines , entering keywords and concepts , combined with individual countries of interest , were used . Search was limited years 2000–2012 ; and review articles were used for the period preceding year 2000 . Results : Rickets and osteomalacia still occur in this sunny region . Hypovitaminosis D prevails , with rates varying 30–90 % , considering a desirable serum 25 hydroxy-vitamin D [ 25(OH)D ] of 20 ng/ml . Advancing age , female gender , multi-parity , clothing style , season , socio-economic status and urban living are recognized predictors of hypovitaminosis D in adults . Prolonged breastfeeding without vitamin D supplementation and low dietary calcium intake are the recognized risk factors for rickets and hypovitaminosis D in children .. Associations with pain score and disease activity in rheumatologic disorders , viral load and interleukins in hepatitis C , BMI , lipids and insulin sensitivity , blood pressure , heart failure and mortality are described . Sun exposure in adults decreased prevalence of metabolic syndrome in one study . Few r and omized vitamin D trials revealed that the majority of mothers or children failed to achieve a desirable 25(OH)D level , even with doses by far exceeding current recommendations . A trial in adolescent girls reveals substantial bone and lean mass increments . Conclusion : Hypovitaminosis D is prevalent in MENA . The lack of population s based studies , gaps in studies in infants , pre-pubertal children and pregnant women , hinder the development of region specific guidelines and constitute a major obstacle to impact this chronic and most often sub clinical disease Context Despite evidence on the association between hypovitaminosis D and adverse pregnancy outcomes and the positive impact of vitamin D supplementation , no evidence exists supporting a universal screening program in pregnancy as part of routine prenatal care . Objective We sought to determine the effectiveness of a prenatal screening program on optimizing 25-hydroxyvitamin D [ 25(OH)D ] levels and preventing pregnancy complications . Also , to identify a safe regimen , we compared several regimens in a subgroup of vitamin D-deficient pregnant women . Design Two cities of Masjed-Soleyman and Shushtar from Khuzestan province , Iran , were selected as the screening and nonscreening arms , respectively . Within the screening arm , a r and omized controlled trial was conducted on 800 pregnant women . Setting Health centers of Masjed-Soleyman and Shushtar cities . Patients or Participants Pregnant women aged 18 to 40 years . Intervention Women with moderate [ 25(OH)D , 10 to 20 ng/mL ] and severe [ 25(OH)D , < 10 ng/mL ] deficiency were r and omly divided into four subgroups and received vitamin D3 ( D3 ) until delivery . Main Outcome Measure Maternal concentration of 25(OH)D at delivery and rate of pregnancy complications . Results After supplementation , only 2 % of the women in the nonscreening site met the sufficiency level ( > 20 ng/mL ) vs 53 % of the women in the screening site . Adverse pregnancy outcomes , including preeclampsia , gestational diabetes mellitus , and preterm delivery , were decreased by 60 % , 50 % , and 40 % , respectively , in the screening site . A D3 injection in addition to monthly 50,000 IU maintenance therapy contributed the most to achievement of sufficient levels at delivery . Conclusions A prenatal vitamin D screening and treatment program is an effective approach in detecting deficient women , improving 25(OH)D levels , and decreasing pregnancy adverse outcomes INTRODUCTION Vitamin D ( 25-hydroxyvitamin D , 25(OH)D ) deficiency , hypovitaminosis D , is highly prevalent in chronic kidney disease patients and is potentially involved with complications in the hemodialysis ( HD ) population . The aim of this study was to evaluate the impact of cholecalciferol supplementation on biomarkers of mineral metabolism , inflammation , and cardiac function in a group of HD patients presenting with hypovitaminosis D and low intact parathyroid hormone ( iPTH ) levels . MATERIAL AND METHODS HD patients with iPTH levels of < 300 pg/mL , not receiving vitamin D therapy , and presenting with 25(OH)D levels of < 30 ng/mL were enrolled in this prospect i ve study . Oral cholecalciferol was prescribed once a week in the first 12 weeks ( 50,000 IU ) and in the last 12 weeks ( 20,000 IU ) of the study . High-sensitivity C-reactive protein , interleukin-6 , and serum albumin were used as inflammatory markers .  Echocardiograms were performed on a midweek interdialytic day at baseline and after 6 months of cholecalciferol supplementation . RESULTS In all , 30 patients were included in the final analysis . We observed a significant increase in serum 25(OH)D levels after 3 months ( 46.2 ± 14.4 ng/mL vs. 18.1 ± 6.6 ng/mL ; P < .001 ) and after 6 months ( 40.4 ± 10.4 ng/mL vs. 18.1 ± 6.6 ng/mL ; P < .001 ) of cholecalciferol supplementation . There were no significant changes in alkaline phosphatase , iPTH , phosphorus , and serum albumin levels , but there was a slight but significant increase in calcium levels after 6 months of cholecalciferol supplementation ( 9.4 ± 0.6 mg/dL vs. 9.0 ± 0.6 mg/dL ; P = .02 ) . Additionally , we observed a significant reduction in high-sensitivity C-reactive protein levels after 3 months ( median : 0.62 [ 0.05 to 29.6 ] mg/L vs. 0.32 [ 0.02 to 3.13 ] mg/L ; P = .02 ) and after 6 months ( median : 0.62 [ 0.05 to 29.6 ] mg/L vs. 0.50 [ 0.02 to 5.66 ] mg/L ; P = .04 ) of cholecalciferol supplementation , as well as a significant reduction in interleukin-6 levels ( median : 6.44 pg/mL vs. 3.83 pg/mL ; P = .018 ) after 6 months of supplementation . Left ventricular mass index was significantly reduced at the end of supplementation ( 159 ± 55 g/m(2 ) vs. 175 ± 63 g/m(2 ) ; P = .03 ) . CONCLUSIONS Cholecalciferol supplementation in HD patients was found to be safe and efficient to correct hypovitaminosis D and established little impact on mineral metabolism markers . Additionally , we observed a reduction in important surrogate markers of cardiovascular risk , namely systemic inflammation and left ventricular hypertrophy , suggesting an anti-inflammatory action and possibly an improvement of cardiac dysfunction Background : Hypovitaminosis D is associated with an increased severity of nonalcoholic fatty liver disease ( NAFLD ) , but reports on the response to cholecalciferol ( vitamin D3 ) supplementation are conflicting . Objective : The objective of this study was to determine if st and ard vitamin D3 supplementation is effective in NAFLD with hypovitaminosis D. Methods : Sixty-five well-characterized adults [ age ( mean ± SD ) : 51.6 ± 12.3 y ] with biopsy-proven NAFLD were screened . Forty-two patients ( the ratio of men to women was 13:29 ) had hypovitaminosis D ( plasma 25-hydroxyvitamin D [ 25(OH)D ] < 30 ng/mL ) . An observational study was performed in NAFLD patients with hypovitaminosis D treated with 2000 IU cholecalciferol ( vitamin D3 ) daily for 6 mo per clinical practice . Plasma 25(OH)D , hepatic and metabolic panels , and metabolic syndrome components were assessed before and after cholecalciferol supplementation . Body composition was measured by using bioelectrical impedance analysis . The primary outcome measure was plasma 25(OH)D ≥30 ng/mL at the end of the study . Secondary outcomes included change in serum transaminases , fasting plasma glucose , and insulin and homeostasis model assessment of insulin resistance ( HOMA-IR ) . Chi-square , Student 's t tests , correlation coefficient , and multivariate analysis were performed . Results : Twenty-six ( 61.9 % ) patients had nonalcoholic steatohepatitis ( NASH ) , and 16 ( 38.1 % ) had hepatic steatosis . After 6 mo of cholecalciferol supplementation  , plasma 25(OH)D ≥30 ng/mL was observed in 16 subjects ( 38.1 % ; responders ) whereas the remaining 26 patients ( 61.9 % ) were nonresponders with plasma 25(OH)D < 30 ng/mL. Significantly fewer ( P < 0.01 ) patients with NASH were responders ( 4 of 26 , 15.4 % ) than those with hepatic steatosis ( 12 of 16 , 75 % ) . Baseline fasting serum alanine aminotransferase , plasma glucose , and HOMA-IR were similar in the responders and nonresponders , but the NASH score on the liver biopsy was lower ( 16.5 % ) in the responders ( P < 0.001 ) . Nonresponders had a higher fat mass ( 10.5 % ) and lower fat-free mass ( 10.4 % ) than responders did . End-of-treatment alanine aminotransferase and HOMA-IR improved only in responders . The baseline HOMA-IR and histological NASH score were independent predictors of nonresponse to cholecalciferol supplementation . Conclusions : Daily supplementation with 2000 IU cholecalciferol for 6 mo did not correct hypovitaminosis D in the majority of patients with NASH . Further studies are needed to determine if higher doses are effective . This trial was registered at clinical trials.gov as 13 - 00153 Summary There is a huge prevalence of hypovitaminosis D in the Indian population . We studied the efficacy and safety of oral vitamin D supplementation in apparently healthy adult women . Monthly cholecalciferol given orally , 60,000 IU/month during summers and 120,000 IU/month during winters , safely increases 25-hydroxyvitamin D ( 25(OH)D ) levels to near normal levels . Introduction There is a huge burden of hypovitaminosis D in the Indian population . The current recommendation for vitamin D supplementation is not supported by sufficient evidence . Methods Study subjects included 100 healthy adult women of reproductive age group from hospital staff . They were r and omized into group A ( control ) and group B ( supplement ) by simple r and omization . Group B received 60,000 IU of cholecalciferol/month administered orally for 3 months , and then group A received 60,000 IU and group B 120,000 IU/month for 6 months . Results Mean baseline 25(OH)D level was 4.5 ± 3.1 ng/ml and parathyroid hormone level was 50 ± 25 pg/ml . In group B , 25(OH)D levels increased from 4.8 ± 3.5 to 31.6 ± 15.5 ng/ml ( P < 0.001 ) in 3 months . Interestingly , the increase , although of lower magnitude , was also observed in control group A , from 4.5 ± 3.4 ng/ml ( in spring ) to 10.8 ± 7.2 ng/ml ( in summer ; P < 0.001 ) . In group A ( 60,000 IU/month ) , mean 25(OH)D level had increased to 22.3 ± 12.4 ng/ml ( P < 0.001 ) at 9 months ( winter ) . In group B ( 120,000 IU/month ) , 25(OH)D levels were maintained at 30.7 ± 12.8 ng/ml at 9 months ( winter ) . Conclusion Our data show that monthly administration of 60,000 IU cholecalciferol in healthy subjects with hypovitaminosis D may suffice in summer months , but higher doses may be more appropriate during winter months OBJECTIVE This double-blind , r and omized , controlled trial evaluated whether 12 months of high-dose vitamin D2 supplementation improved insulin sensitivity and secretion and glycemic status . METHODS African-American males ( AAM ) with prediabetes ( glycosylated hemoglobin [ A1C ] 5.7 - 6.4 % ) , hypovitaminosis D ( 25-hydroxyvitamin D [ 25OHD ] 5 - 29 ng/mL ) , and prevalent medical problems were supplemented with vitamin D3 ( 400 IU/day ) and then r and omized to weekly placebo or vitamin D2 ( 50,000 IU ) . The primary outcome was the change in oral glucose insulin sensitivity ( OGIS , from an oral glucose tolerance test [ OGTT ] ) after 12 months of treatment . Secondary outcomes included other glycemic indices , A1C , and incident diabetes . RESULTS Baseline characteristics were similar in vitamin D-supplemented ( n = 87 ) and placebo ( n = 86 ) subjects completing the trial with average concentrations 14.4 ng/mL , 362 mL × min(-1 ) × m(-2 ) , and 6.1 % for 25OHD , OGIS and A1C , respectively . After 12 months , the vitamin D-supplemented group had a change in serum 25OHD + 35 versus + 6 ng/mL for placebo , P<.001 ; OGIS + 7.8 versus -16.0 mL × min(-1 ) × m(-2 ) for placebo , P = .026 ; and A1C -0.01 versus + 0.01 % for placebo , P = .66 . Ten percent of subjects in both groups progressed to diabetes . A posthoc analysis of participants with baseline impaired fasting glucose ( IFG ) showed that more subjects in the vitamin D subgroup ( 31.6 % ) than placebo ( 8.3 % ) returned to normal glucose tolerance , but the difference did not reach significance ( P = .13 ) . CONCLUSION The trial does not provide evidence that 12 months of high-dose D2 repletion improves clinical ly relevant glycemic outcomes in subjects with prediabetes and hypovitaminosis D ( NCT01375660 ) OBJECTIVES To assess the effect of between-meal weekly risedronate and daily calcium 630 mg and vitamin D 400 IU on bone turnover markers . DESIGN R and omized , double-blind , placebo-controlled trial . SETTING Skilled nursing home ( NH ) . PARTICIPANTS Sixty skilled-NH residents ( 46 men , 14 women ) , mean age+/-st and ard deviation of 76+/-6 , were r and omized to receive risedronate 30 mg ( n=31 ) or matching placebo ( n=29 ) once weekly for 12 weeks . All received 315 mg calcium with 200 IU vitamin D twice daily . MEASUREMENTS Bone-specific alkaline phosphatase ( BSAP ) , N-telopeptide of type 1 collagen ( NTx ) , 25-hydroxyvitamin D ( 25OHD ) , and parathyroid hormone were measured at baseline and 6 and 12 weeks . RESULTS Risedronate reduced BSAP significantly more than placebo ( P<.05 ) at 6 weeks but not at 12 weeks ; no treatment effect on serum NTx was observed . Defining hypovitaminosis D as a serum 25OHD concentration below 32 ng/mL , 50 of 53 ( 94 % ) study participants were low at baseline ( mean 25OHD 19 ng/mL ) . Vitamin D levels remained insufficient in 74 % of participants after 12 weeks . CONCLUSION In this NH population , weekly risedronate administered using a between-meal dosing schedule reduced serum BSAP at 6 weeks of treatment ; this effect was not observed at 12 weeks . The overall lack of change in bone turnover markers suggests that this risedronate dose and schedule would not be expected to increase bone density or reduce fracture risk in this population . Hypovitaminosis D was common and not reliably corrected by 400 IU of vitamin D daily . Despite an extremely high osteoporotic fracture risk in NH residents , additional study is required to determine under which conditions pharmacological treatment is efficacious in this population and define approaches that assure vitamin D repletion OBJECTIVES To determine the prevalence of hypovitaminosis D ( serum 25-hydroxyvitamin D<32 ng/mL ; HVD ) in a population of elderly veterans and conduct a preliminary assessment of the efficacy of supplementation with cholecalciferol in correcting HVD . DESIGN R and omized , double-blind , placebo-controlled clinical trial . SETTING Geriatric clinic at the Bruce W. Carter Veterans Affairs Medical Center , Miami , Florida . PARTICIPANTS Veterans aged 70 and older . INTERVENTION Oral cholecalciferol 2,000 IU daily or placebo for 6 months . MEASUREMENTS Serum calcium , 25-hydroxyvitamin D , parathyroid hormone , and 24-hour urinary calcium . RESULTS Of the 34 participants who completed the study , 62 % had HVD at baseline . In the treatment group , mean serum 25-hydroxyvitamin D level rose from 28.4±7.9 ng/mL at baseline to 42.7±10.5 ng/mL at the end of the trial , but levels remained less than 32 ng/mL in three of 17 ( 18 % ) of the participants . In the placebo group , the baseline level of 27.7±8.3 ng/mL remained unchanged ( 28.8±8.7 ng/mL ) . Supplementation did not alter serum or urinary calcium levels and did not result in any adverse events . CONCLUSION These initial observations suggest that , in older veterans  , cholecalciferol 2,000 IU daily for 6 months is generally safe and corrects HVD in most but not all individuals CONTEXT AND OBJECTIVE Hypovitaminosis D and frailty are common in the older population . We aim ed to determine whether 25-hydroxyvitamin D [ 25(OH)D ] concentrations are associated with frailty and mortality . DESIGN We conducted a prospect i ve cohort study . SETTING AND PARTICIPANTS Participants included 4203 older men aged 70 - 88 years in Perth , Western Australia . MAIN OUTCOME MEASURES 25(OH)D was measured by immunoassay  . Frailty was assessed with the 5-point FRAIL ( fatigue , resistance , ambulation , illness , and loss of weight ) scale . Mortality was determined from the death registry via the Western Australian Data Linkage System . RESULTS At baseline , 676 ( 16.1 % ) men were frail , as defined by having ≥3 deficits ( FRAIL scale ≥ 3 ) . In multivariate cross-sectional analysis , low vitamin D status , defined by the lowest quartile of 25(OH)D values ( < 52.9 nmol/L ) , was associated with increased prevalent frailty ( odds ratio , 1.96 ; 95 % confidence interval [ CI ] , 1.52 to 2.52 ) in comparison to the highest quartile of 25(OH)D values ( > 81.6 nmol/L ) . After a mean period of 5.3 years , the adjusted odds ratio of being frail at follow-up for men with low vitamin D and having zero deficit at baseline ( FRAIL scale = 0 ) was 1.56 ( 95 % CI , 1.07 to 2.27 ) . Low vitamin D also predicted all-cause mortality over a period of up to 9.2 years ( hazard ratio , 1.20 ; 95 % CI , 1.02 to 1.42 ) , independent of baseline frailty and other covariates . CONCLUSION Hypovitaminosis D is associated with prevalent and incident frailty in older men . Hypovitaminosis D also predicts all-cause mortality , independent of frailty . The association between vitamin D and mortality is not solely dependent on the occurrence of frailty Vitamin D has been associated with multiple sclerosis ( MS ) and several markers of disease state in whites . There are limited reports of vitamin D ’s influence in MS in ethnic groups , such as in Hispanics . In this study , we compared vitamin D levels in  Hispanics and whites with MS and tried to determine whether season or increasing disability influence hypovitaminosis D in Hispanics with MS .  Serum 25-hydroxyvitamin D [ 25(OH)D ] levels and clinical characteristics were compared in a cross-sectional sample of Hispanics ( n = 80 ) and whites ( n = 80 ) with MS recruited from the University of Southern California . Serum 25(OH)D levels were significantly lower in Hispanics than whites with MS ( mean and st and ard deviation 25.1 ± 9.4 and 37.3 ± 19.8 ng/ml , respectively ; p < 0.001 ) . Hispanics were significantly more likely than whites to be  vitamin D insufficient ( ≤30 ng/ml ; 70 vs. 41 % , respectively ; p < 0.001 ) and deficient ( ≤20 ng/ml ; 40 vs. 14 % , respectively , p < 0.001 ) . In Hispanics , serum 25(OH)D levels were not influenced by season ( p = 0.8 ) or higher physical disability ( EDSS ≥6 , p = 0.7 ) . We found that the relationship between vitamin D and MS differs by Hispanic ethnicity . Hypovitaminosis D was significantly more common among Hispanics than among whites with MS , and the majority of Hispanics were vitamin D insufficient . Interestingly , there was no association between vitamin D levels and season or increasing disability in the Hispanics . Our findings imply that factors influencing vitamin D levels and possibly vitamin D  requirements may vary by ethnicity in patients with MS . These results should be confirmed in larger , prospect i ve multi-ethnic cohort studies Summary The present study investigates the effects of vitamin D on muscle function in postmenopausal women . It has been shown that vitamin D supplementation in postmenopausal women with hypovitaminosis D provides significant protective factor against sarcopenia , with significant increases in muscle strength and control of progressive loss of lean mass . Introduction We aim ed to evaluate the effect of supplementation of vitamin D ( VITD ) alone on muscle function in younger postmenopausal women . Methods In this double-blind , placebo-controlled clinical trial , 160 Brazilian postmenopausal women were r and omized into two groups : VITD group consisting of patients receiving vitamin D3 1000 IU/day orally ( n = 80 ) or placebo group ( n = 80 ) . Women with amenorrhea for more than 12 months and age 50–65 years , with a history of falls ( previous 12 months ) , were included . The intervention time was 9 months , with assessment s at two points , start and end . Lean mass was estimated by total-body dual-energy X-ray absorptiometry ( DXA ) and muscle strength by h and grip strength and chair rising test . The plasma concentrations of 25-hydroxyvitamin D [ 25(OH)D ] were measured by high-performance liquid chromatography ( HPLC ) . Statistical analysis was by intention to treat ( ITT ) , using ANOVA , Student ’s t test , and Tukey ’s test . Results After 9 months , average values of 25(OH)D increased from 15.0 ± 7.5 to 27.5 ± 10.4 ng/ml ( + 45.4 % ) in the VITD group and decreased from 16.9 ± 6.7 to 13.8 ± 6.0 ng/ml ( −18.5 % ) in the placebo group ( p < 0.001 ) . In the VITD group , there was significant increase in muscle strength ( + 25.3 % ) of the lower limbs by chair rising test ( p = 0.036 ) . In women in the placebo group , there was considerable loss ( −6.8 % ) in the lean mass ( p = 0.030 ) . Conclusion The supplementation of vitamin D alone in postmenopausal women provided significant protective factor against the occurrence of sarcopenia , with significant increases in muscle strength and control of progressive loss of lean mass BACKGROUND A role for vitamin D deficiency in Parkinson disease ( PD ) has recently been proposed . OBJECTIVE To compare the prevalence of vitamin D deficiency in a research data base cohort of patients with PD with the prevalence in age-matched healthy controls and patients with Alzheimer disease ( AD ) . DESIGN Survey study and blinded comparison of plasma 25-hydroxyvitamin D ( 25[OH]D ) concentrations of stored sample s in a clinical research data base at Emory University School of Medicine . SETTING Referral center ( PD and AD patients ) , primary care clinics , and community setting ( controls ) . PARTICIPANTS Participants were recruited into the study between May 1992 and March 2007 . Every fifth consecutively enrolled PD patient was selected from the clinical research data base . Unrelated AD ( n = 97 ) and control ( n = 99 ) participants were r and omly selected from the data base after matching for age , sex , race , APOE genotype , and geographic location . MAIN OUTCOME MEASURES Prevalence of suboptimal vitamin D and mean 25(OH)D concentrations . RESULTS Significantly more patients with PD ( 55 % ) had insufficient vitamin D than did controls ( 36 % ) or patients with AD ( 41 % ; P = .02 , chi(2)test ) . The mean ( SD ) 25(OH)D concentration in the PD cohort was significantly lower than in the AD and control cohorts ( 31.9 [ 13.6 ] ng/mL vs 34.8 [ 15.4 ] ng/mL and 37.0 [ 14.5 ] ng/mL , respectively ; P = .03 ) . CONCLUSIONS This report of 25(OH)D concentrations in a predominantly white PD cohort demonstrates a significantly higher prevalence of hypovitaminosis in PD vs both healthy controls and patients with AD . These data support a possible role of vitamin D insufficiency in PD . Further studies are needed to determine the factors contributing to these differences and eluci date the potential role of vitamin D in pathogenesis and clinical course of PD Low serum 25-hydroxy vitamin D ( 25OHD ) predicts a higher cardiovascular risk in the general population . Because patients with chronic kidney disease are more likely to have low serum 25OHD , we determined the relationship between hypovitaminosis D and death in this group . Analysis was done using a cohort composed of 3011 patients from the Third National Health and Nutrition Examination Survey who had chronic kidney disease but were not on dialysis and who had a mean follow-up of 9 years . In analyses adjusted for demographics , cardiovascular risk factors , serum phosphorus , albumin , hemoglobin , stage of chronic kidney disease , albuminuria , and socioeconomic status , individuals with serum 25OHD levels less than 15 ng/ml had an increased risk for all-cause mortality when compared to those with levels over 30 ng/ml . This significantly higher risk for death with low serum 25OHD was evident in 15 of the 23 subgroups . The higher risk for cardiovascular and non-cardiovascular mortality became statistically nonsignificant on multivariable adjustment . The trend for higher mortality in patients with 25OHD levels 15 - 30 ng/ml was not statistically significant . Our results indicate there is a grade d relationship between serum 25OHD and the risk for death among subjects with chronic kidney disease who are not undergoing dialysis . R and omized , controlled trials are needed to conclusively determine whether vitamin D supplementation reduces mortality Background : In chronic kidney disease and dialysis patients , vitamin D deficiency is associated with mortality . In some observational studies , calcitriol analogue therapy was associated with a better survival rate in hemodialysis ( HD ) patients . The aim of this study was to determine the relationship between serum 25-hydroxyvitamin D ( 25-OHD ) levels and alfacalcidol therapy with HD patients ’ outcomes . Methods : We measured baseline 25-OHD levels using a cross-sectional analysis in 648 HD prevalent patients from the regional ARNOS French cohort . A 42-month survival analysis was applied according to serum 25-OHD level and calcitriol analogue therapy . Results : The prevalence of 25-OHD insufficiency < 30 ng/ml was high ( 73 % ) , with only 22 % taking native vitamin D supplementation . A baseline 25-OHD level above the median value ( 18 ng/ml ) was associated with lower all-cause mortality [ hazard ratio ( HR ) , 0.73 ( 0.5–0.96 ) ; p = 0.02 ] after adjustment for age , gender , dialysis vintage , calcemia , phosphatemia , cardiovascular disease , and diabetes . Only in monovariate analysis was low-dose oral alfacalcidol therapy associated with a better survival rate in patients with and without 25-OHD deficiency [ HR , 0.7 ( 0.5–0.92 ) ; p = 0.05 ] . Conclusions : Our study shows that , among prevalent HD patients , low 25-OHD levels affect  mortality .  Alfacalcidol therapy , especially in small doses , may provide compensation , but this needs to be further confirmed using prospect i ve controlled studies comparing native and active vitamin D compounds SETTING Newham Chest Clinic , London , UK . OBJECTIVE To determine the safety and efficacy of the administration of bolus-dose vitamin D(2 ) in elevating serum 25-hydroxyvitamin D ( 25[OH]D ) concentrations in tuberculosis ( TB ) patients . DESIGN A multi-ethnic cohort of TB patients was r and omised to receive a single oral dose of 2.5 mg vitamin D(2 ) ( n = 11 ) or  placebo ( n = 14 ) . Serum 25(OH)D and corrected calcium concentrations were determined at baseline and 1 week and 8 weeks post-dose , and compared to those of a multi-ethnic cohort of 56 healthy adults receiving an identical dose of vitamin D(2 ) . RESULTS Hypovitaminosis D ( serum 25[OH]D < 75 nmol/l ) was present in all patients at baseline . A single oral dose of 2.5 mg vitamin D2 corrected hypovitaminosis D in all patients in the intervention arm of the study at 1 week post-dose , and induced a 109.5 nmol/l mean increase in their serum 25(OH)D concentration . Hypovitaminosis D recurred in 10/11 patients at 8 weeks post-dose . No patient receiving vitamin D(2 ) experienced hypercalcaemia . Patients receiving 2.5 mg vitamin D(2 ) experienced a greater mean increase in serum 25(OH)D at 1 week post-dose than healthy adults receiving 2.5 mg vitamin D(2 ) . CONCLUSION A single oral dose of 2.5 mg vitamin D(2 ) corrects hypovitaminosis D at 1 week but not at 8 weeks post-dose in TB patients Objectives : To study the prevalence of hypovitaminosis D , the effect of vitamin D supplementation on serum 25-hydroxyvitamin D [ S-25(OH)D ] , and the intakes of vitamin D and calcium in Finnish 9− to 15-year-old athletic and nonathletic girls . Design : 1-year follow-up study ( February 1997-March 1998 ) with three months of vitamin D supplementation ( 10 μg/d ) from October to January . Setting : Turku University Central Hospital , Finl and .Subjects : 191 female volunteers aged 9–15 y ( 131 athletes and 60 controls ) . Methods :  Vitamin D and calcium intakes were estimated by a four-day food recording and a semi-quantitative food frequency question naire ( FFQ ) . S-25(OH)D was followed by radioimmunoassay ( RIA ) . Results : At baseline the mean S-25(OH)D concentration was 33.9 nmol/l among all girls . In winter severe hypovitaminosis D ( S-25(OH)D<20 nmol/l ) occurred in 13.4 % of the participants and in 67.7 % S-25(OH)D was below 37.5 nmol/l . By the next summer the mean S-25(OH)D concentration was 62.9 nmol/l and in 1.6 % of the subjects it was below 37.5 nmol/l . The prevalence of severe hypovitaminosis D was not significantly reduced by three months of vitamin D ( 10 μg/d ) supplementation . At baseline , the mean intake of vitamin  D was 2.9 μg/d by food recording and 4.3 μg/d by FFQ . The mean calcium intake was 1256 mg/d and 1580 mg/d , respectively . The intakes of vitamin D and calcium remained unchanged during the follow-up period . The athletes consumed more calcium than nonathletic controls , whereas the intake of vitamin D was quite similar among both groups . The vitamin D intake by FFQ correlated with the S-25(OH)D concentration in wintertime ( r=0.28 , P<0.01 ) . Conclusion : Hypovitaminosis D is fairly common in growing Finnish girls in the wintertime , and three months of vitamin D supplementation with 10 μg/d was insufficient in preventing hypovitaminosis D. The daily dietary vitamin D intake was insufficient ( < 5 μg/d ) in the majority of participants , while the calcium intake was usually sufficient . Sponsorship : Supported by the Yrjö Jahnsson Foundation , The Turku University Foundation , and the Medical Research Foundation of the Turku University Central Hospital
Neither latitude , region of the world , nor laboratory methodology were found to be associated with the prevalence of hypovitaminosis
BACKGROUND Hypovitaminosis D is considered a global public health issue .
Knowledge of its true dimensions will allow us to design interventions and plan preventive measures that can have a significant impact on human health .
OBJECTIVES The aim of this study was to evaluate the prevalence of hypovitaminosis D , defined as a serum 25-hydroxyvitamin D concentration < 30 ng/ml , in postmenopausal women around the world , as well as to identify the potential associated factors .