Theobald palm and his remarkable observation: how the sunshine vitamin came to be recognized

The seminal discovery that sunlight was important in the prevention of nutritional rickets was made in 1890 by Theobald A. Palm, a medical missionary who contrasted the prevalence of rickets in northern European urban areas with similar areas in Japan and other tropical countries. He surmised that exposure to sunlight prevented rickets. Over the next 40 years his observation led to an understanding of ultraviolet irradiation and its role in vitamin D synthesis. This opened a new era of appreciation for the curative powers of the sun and "the sunshine vitamin". While Palm's observations were in some ways obscure, they had a potent effect on the development of photobiology.     

COVID-19 Mortality in Europe,by Latitude and Obesity Status: A Geo-Spatial Analysis in 40 Countries

On 30 January 2020, the World Health Organization (WHO) declared the current novel coronavirus disease 2019 (COVID-19) as a public health emergency of international concern and later characterized it as a pandemic. New data show that excess body mass and vitamin D deficiency might be related to the disease severity and mortality. The aim of this study was to evaluate whether latitude, as a proxy of sunlight exposure and Vitamin D synthesis, and prevalent obesity among European populations, is related to COVID-19 spread and severity. European COVID-19 data (incidence and fatality), including information on the prevalence of obesity, social distancing, and others were obtained by the “Our World in Data” website on 17 April 2021. Adjusted analysis showed that higher COVID-19 incidence and fatality were pictured in countries being in higher latitude, both during the whole period, as well as, during the time period 1 November 2020–31 March 2021. Higher incidence and fatality of COVID-19 were observed where the prevalence of overweight/obesity was higher during the whole time period, whereas during the time period 1 November 2020–31 March 2021, only COVID-19 incidence was higher but not a fatality. The present results provide insights for targeted interventions and preventive strategies against COVID-19.     

Public health implications of standardized 25-hydroxyvitamin D levels: A decrease in the prevalence of vitamin D deficiency among older women in Germany

Objective.

To compare the public health implications of using unstandardized immunoassay measurements of serum 25-hydroxyvitamin D [25(OH)D] concentrations versus using measurements standardized by liquid chromatography tandem-mass spectrometry (LC-MS/MS) when assessing the prevalence of 25(OH)D insufficiency and deficiency in various subgroups of individuals.

Method.

We standardized immunoassay-based measurements of 25(OH)D with LC-MS/MS in a population-based sample of 5386 women aged 50-74 recruited in 2000-2002 in Germany. We used multivariate regression to assess 25(OH)D determinants and the association of vitamin D deficiency with health status.

Results.

Prevalences of 25(OH)D levels < 50 nmol/L (insufficiency) and < 30 nmol/L (deficiency) decreased considerably by standardization. The decrease in vitamin D deficiency (from 64.4% to 17.9%) was particularly strong in March-May among women aged ≥ 65. Independent of season of blood draw and standardization, women ≥ 70 years, obese, or currently smoking had an increased risk of having 25(OH)D levels < 30 nmol/L.

Conclusion.

The proportion of older women with vitamin D deficiency in Germany is much lower than previously reported, but prevalence of vitamin D insufficiency is high. Standardization of 25(OH)D values by immunoassay methods to LC-MS/MS equivalent values or direct measurement by LC-MS/MS is indispensable in drawing valid conclusions about the health implications of vitamin D deficiency or insufficiency.     

维生素D受体基因多态性与肺结核易感性的病例对照研究

目的 探讨维生素D受体(VDR)基因多态性与中国汉族人群肺结核发病间的关系。方法 采用病例对照研究设计，用聚合酶链反应—限制性片段长度多态性分析(PCR—RFLP)检测VDR基因中T／C多态性位点，对肺结核相关的环境因素进行问卷调查，并进行单因素分析和多因素1ogistic回归分析。结果 对76例病例和171名对照进行了VDR的基因分型，VDR—FF、VDR—Ff与VDR—ff三种基因型在病例组和对照组中的分布频率分别为38．2％、44．7％、17．1％和52．6％、40．9％、6．4％，其中ff基因型在病例组中的频率显著高于对照组，OR值95％CI：3．668(1．483—9．071)；在多因素分析中调整卡介苗接种史和吸烟状况后，VDR—ff基因型与肺结核发病仍有显著性关联，调整OR值95％CI：3．036(1．117—8．253)。结论 VDR—ff基因型可能是中国汉族人群肺结核病的易感基因型。     

Participant attrition and perinatal outcomes in prenatal vitamin D-supplemented gestational diabetes mellitus patients in Asia: A meta-analysis

BACKGROUNDThe role of vitamin D supplementation in gestational diabetes mellitus (GDM) patients is unclear.AIMTo determine the burden and risk of post-randomization GDM patient attrition from vitamin D-supplemented arms of randomized controlled trials (RCTs). The auxiliary aim was to compare the effects of nutritional supplements on their fasting blood glucose (FPG) levels and perinatal outcomes.METHODSRCTs were searched in the PubMed, Embase, and Scopus databases. Random-effect prevalence and pairwise meta-analysis were performed for the primary objective. The auxiliary aim was to compare the effects of nutritional supplements on their fasting blood glucose (FPG) levels and perinatal outcomes. Fixed-effect network meta-analyses were undertaken for the secondary goals. All analyses were performed using Stata software, and statistical significance was determined at P < 0.05.RESULTSThirteen RCTs from Iran and China were reviewed. The participant attrition burden in vitamin D recipients was 6% [95% confidence interval (CI): 0.03, 0.10], and its risk did not vary from non-recipients. Vitamin D and calcium co-supplementation reduced the cesarean section incidence in GDM patients [risk ratio (RR): 0.37; 95%CI: 0.18, 0.74]. The hyperbilirubinemia or hospitalization risk in their newborns decreased with vitamin D supplementation (RR: 0.47; 95%CI: 0.27, 0.83) and co-supplementation with calcium (RR: 0.35; 95%CI: 0.16, 0.77) or omega-3 fatty acids (RR: 0.25; 95%CI: 0.08, 0.77). Vitamin D and probiotics co-supplementation decreased newborn hyperbilirubinemia risk (RR: 0.28; 95%CI: 0.09, 0.91). FPG levels and macrosomia risk did not vary across interventions.CONCLUSIONIn RCTs, vitamin D supplementation or co-supplementation in GDM patients showed a low participant attrition burden and low risk of cesarean section, newborn hyperbilirubinemia, and newborn hospitalization.     

妊娠期大气二氧化氮暴露与孕妇维生素D缺乏症的关联

目的 孕妇维生素D缺乏症与妊娠期糖尿病、妊娠期高血压、孕妇贫血以及胎儿生长受限和早产等不良妊娠结局密切相关。本研究旨在探讨妊娠期大气二氧化氮（nitrogen dioxide,NO2）暴露与孕妇维生素D缺乏症的关联。方法 选取2013年5月-至2014年５月,在某市妇幼保健院建卡的孕妇作为初始研究对象。按照入选和排除标准最终纳入3244名孕妇进入本研究。通过问卷调查收集孕妇的一般人口学信息;利用环境监测站点的数据模拟孕妇在妊娠期间大气NO2的暴露水平;采用酶联免疫吸附法检测孕晚期孕妇血清中25（OH）D的浓度。结果 孕妇在孕早期、中期、晚期以及整个孕期NO2暴露水平的中位数分别为:39.52、36.84、28.09以及31.90μg/m3。孕晚期血清中25(OH)D浓度的平均值为42.09nmol/L。多元线性回归分析的结果显示,孕中期、孕晚期以及整个孕期NO2的暴露水平每增加10μg / m3,孕妇血清中25（OH）D的水平分别降低2.224nmol/L（95%CI:-2.777,-1.671）,2.240nmol/L（95%CI:-2.665,-1.816）以及5.299 nmol/L（95%CI:-6.481,-4.177）。多元logistic回归分析的结果显示,随着孕中期、孕晚期以及整个孕期NO2的暴露水平的增加,孕妇VD缺乏症发生的风险增加,其OR值分别为1.338（95%CI:1.225,1.461）,1.347（95%CI:1.259,1.442）以及2.049（95%CI:1.709～2.456）。结论 孕期NO2暴露是孕妇维生素D缺乏症发生的一个危险因素。在制订维生素D缺乏症的防控措施时需要考虑孕期NO2的暴露。     

美国儿科学会预防佝偻病和维生素D缺乏2008年指南简介

2008年美国儿科学会重新修订的临床指南推荐所有的婴儿（包括全母乳喂养婴儿）、儿童和青少年自出生后不久起每日至少补充维生素D400IU。本文简单介绍该指南,并与2008年中华医学会儿科学分会等的建议比较,提议中华医学会儿科学分会,参照2008年美国儿科学会指南,修订其2008年3月的建议。