特发性中枢性性早熟女童的血清胰岛素样生长因子-1 肌酐 尿酸与黄体生成素 骨龄的关系

目的 探究特发性中枢性性早熟女童血清胰岛素样生长因子-1(IGF-1)、肌酐(Cr)、尿酸(BUA)水平与黄体生成素(LH)、骨龄的关系。方法 根据纳入、排除标准,选取浙江大学医学院附属妇产科医院宁海分院2019年10月—2022年8月期间收治的122例特发性中枢性性早熟女童作为研究对象,将其纳入病例组。并选取80例同期进行体检的健康女童作为对照组。比较两组受试者血清IGF-1、Cr、BUA水平以及LH、骨龄的差异,并观察病例组患儿血清IGF-1、Cr、BUA水平与LH、骨龄的关系。结果 与对照组相比,病例组女童IGF-1(405.66±62.41)μg/L、LH(7.89±1.14)U/L和骨龄(7.22±1.04)岁均明显较高,而BUA水平(253.66±94.36)μmol/L明显较低,差异有统计学意义(P<0.05)。两组间的Cr比较,差异无统计学意义(P>0.05)。采取Pearson分析ICPP女童IGF-1、Cr、BUA与LH、骨龄的关系,发现Cr与LH、骨龄无明显相关性(OR=0.020,P=0.829;OR=0.152,P=0.094),IGF-1与LH、...     

基础血清促性腺激素值在诊断女童性早熟中的临床价值

目的 探讨基础血清促性腺激素(gonadotropin, Gn)值对女童性早熟的诊断作用, 并确定最优界值点。方法 自2012年1月-2013年7月在盛京医院发育儿科确诊为中枢性性早熟(central precocious puberty, CPP)和单纯乳房早发育(premature thelarche, PT)的101例患儿应用化学发光法检测Am 8:00-10:00基础血清促黄体生成素(luteinizing hormone, LH)、卵泡刺激素(follicle stimulating hormone, FSH)水平, 采用受试者工作特征(ROC)曲线分析LH、FSH及LH/FSH曲线下面积、诊断CPP的界值点及所对应的敏感度和特异度。结果 101例患儿 LH、FSH、LH/FSH比值诊断CPP时的ROC曲线下面积分别为0.834、0.742、0.808, 排除4岁以下患儿后的83例, 曲线下面积分别为0.898、0.842、0.854, 排除6岁以下患儿后的60例, 曲线下面积分别为0.895、0.845、0.870;3组曲线LH界值点分别取0.36、0.36、0.38 U/L时, 诊断CPP的敏感度分别为77.6% 、78.7%、75.0%, 特异度分别为81.8%、97.2%、100%;3组曲线FSH界值点分别取2.51、3.63、3.48 U/L时, 诊断CPP的敏感度分别为85.7%、68.1%、69.4%, 特异度分别为57.7%、91.7%、91.7%;3组曲线LH/FSH比值界值点分别取0.09、0.03、0.03时, 诊断CPP敏感度分别为77.6%、85.1%、83.3%, 特异度为75.0%、77.8%、83.3%。结论 基础血清LH在诊断CPP时有较高的特异度, 随着对4岁以下及6岁以下年龄阶段的排除, 诊断CPP的特异度明显增加;4岁以上的女童基础血清LH>0.36 U/L时, 结合临床即可确诊为CPP, 但LH≤0.36 U/L时在各年龄阶段均不能有效排除CPP。     

特发中枢性性早熟女童血清胰岛素样生长因子、维生素D与BMI相关性研究

目的 探讨特发中枢性性早熟女童血清胰岛素样生长因子-1(IGF-1)、维生素D与BMI相关性的研究,以便为临床预防特异中枢性性早熟的发生提供参考依据。方法 选取2022年7月至12月于齐齐哈尔市第一医院完成促性腺激素释放激素(GnRH)激发试验的特发中枢性性早熟女童60例进行前瞻性研究,根据BMI分为正常体质量组(BMI 16～19 kg/m²)和肥胖组(BMI>19 kg/m²),各30例;同期选取30例同龄性发育正常女童作为对照组。比较3组研究对象骨龄、卵巢直径、性激素及维生素D水平;分析血清学指标与BMI的相关性。结果 与对照组比,正常体质量组、肥胖组研究对象骨龄、骨龄-实际年龄及肥胖组左、右卵巢直径均更高,且肥胖组骨龄、骨龄-实际年龄高于正常体质量组;与对照组比,正常体质量组、肥胖组研究对象血清IGF-1、黄体生成素(LH)、黄体生成素峰值/促卵泡生成激素峰值(LH峰值/FSH峰值)均更高,且肥胖组高于正常体质量组;与对照组比,正常体质量组、肥胖组研究对象维生素D降低,且肥胖组低于正常体质量组;经Pearson相关性分析可知,I...     

血清维生素D水平与前列腺癌的相关性研究

目的探索中国南方人群的血清维生素D(VD)水平与前列腺癌的相关性。方法对90例前列腺癌患者和129例年龄匹配的正常对照者的血清25-羟维生素D水平进行分析,比较两组的血清VD水平均数,以及VD正常(≥30 ng/mL)、不足(20 ng/mL≤VD<30 ng/mL)和缺乏(<20 ng/mL)个体所占比例的差异。结果前列腺癌组的血清VD水平为(27.10±8.26)ng/mL,显著低于正常对照组的(30.10±9.08)ng/mL(P<0.05)。前列腺癌组中血清VD水平正常个体所占的比例低于正常对照组(37.78%vs.45.74%),但前列腺癌中VD水平缺乏个体所占的比例高于正常对照组(22.22%vs.13.18%,OR=1.882,P=0.078 9)。结论血清VD水平低下与前列腺癌存在相关性,VD缺乏(<20 ng/mL)可能增加患前列腺癌的风险。     

性早熟女童生长潜能的研究

目的　研究性早熟女童的生长潜能 ,提高GnRHa改善性早熟女童终身高的疗效。方法　对 2 5例正常未发育和 177例不同Tanner期的特发性早熟发童测定血IGF Ⅰ ,比较各组性早熟女童的体重指数、骨龄进展、年龄及骨龄的身高标准差及治疗前后的变化。结果　 (1)血IGF Ⅰ水平 ,TannerⅡ期中枢性(CPP)和乳房早发育 (PT)与同年龄对照组 3组之间比较以及 3组不同Tanner期CPP女童之间比较均有显著性差异 (p <0 0 0 1) ,且其水平上升与Tanner期进展相关。 (2 )骨龄进展和骨龄的身高标准差分值 ,CPP与PT比较有显著性差异 ,不同Tanner期CPP之间的比较也有显著性差异。 (3 ) 18例治疗满 1年的CPP女童 ,骨龄的身高标准差分值和体重指数治疗前后比较有显著性差异。结论　PT不完全是对儿童生长潜能没有影响的自限性疾病 ;骨龄进展的程度和骨龄的身高标准差分值可作为CPP选择GnRHa治疗的重要指标。     

维生素D与多囊卵巢患者胰岛素抵抗相关性及其机制研究

目的:探讨维生素D对多囊卵巢综合征(PCOS)患者胰岛素抵抗(IR)的影响及其机制研究.方法:选取自2013年2月～2014年2月在该院就诊的48例PCOS患者作为PCOS组,另选30例健康育龄期妇女作为对照组,测量研究者身高、体质量参数,计算体质指数(BMI),采用全自动生化分析仪葡萄糖氧化酶检测空腹血糖浓度(FBG)、化学发光法检测血清空腹胰岛素(FI)及胰岛素样生长因子-1(IGF-1)水平、ELISA方法测定血清25-(OH)D3浓度,计算稳态胰岛素评价指数(HOMA-IR)用于评价胰岛素抵抗性,量化胰岛素敏感指数(QUICKI)用于评价胰岛素敏感度,并分析FI、HOMA-IR、QUICKI及IGF-1与血清25-(OH)D3浓度的相关性.结果:PCOS组BMI及FBG与对照组相比,差异无统计学差异(P＞0.05),而FI、HOMA-IR、QUICKI、25-(OH) D3及IGF-1与对照组比较,差异均有统计学差异(P＜0.05);并且PCOS组FI和HOMA-IR与血清25-(OH)D3浓度呈显著负相关,差异有统计学意义(P＜0.05),QUICKI和IGF-1水平与血清25-(OH)D3浓度呈显著正相关,差异有统计学意义(P＜0.05).结论:PCOS患者IR可能与血清中维生素D缺乏有关,而IGF-1分泌减少又可能是导致PCOS患者维生素D缺乏的重要原因.     

更年期妇女血清雌二醇与胰岛素抵抗和卵巢功能衰退的关系研究

目的探讨更年期妇女血清雌二醇(E_2)与胰岛素抵抗和卵巢功能衰退的关联。方法本研究选取2017年5-10月期间该院收治的80例更年期妇女为研究对象,根据血清E_2水平分组,将血清E_2水平80 pmol/L的受试者33例纳入低E_2组,将血清E_2水平≥80 pmol/L的受试者47例纳入高E_2组。比较两组卵巢功能指标、胰岛素抵抗指数、血清单胺氧化酶(MAO)活性以及更年期症状。结果低E_2组受试者E_2水平明显低于高E_2组,卵泡刺激素(FSH)水平明显高于高E_2组、黄体生成素(LH)水平明显高于高E_2组(P0. 05)。低E_2组受试者胰岛素抵抗指数明显高于高E_2组受试者(5. 28±0. 63 vs.4. 02±0. 55,P0. 05)。两组受试者体重、BMI指数、绝经年龄及绝经时间差异均无统计学意义(P0. 05)。低E_2组受试者潮热出汗、失眠、容易疲乏、暴躁易怒、胸闷心悸、性欲减退、外阴不适评分以及更年期症状总评分均明显高于高E_2组(P0. 05)。低E_2组受试者MAO活性明显高于高E_2组(39. 68±6. 17 vs. 28. 42±3. 85,P0. 05)。多因素Logistic回归分析结果显示,更年期妇女血清E_2表达水平与胰岛素抵抗指数、FSH与LH水平及MAO活性相关(P0. 05),与BMI指数、绝经年龄、绝经时间及体重无显著相关性(P0. 05)。结论更年期妇女血清E_2水平与胰岛素抵抗及卵巢功能衰退密切相关。     

男性糖尿病患者血清维生素D与生殖激素间的关系分析

目的 探讨男性糖尿病患者血清 25- 羟基维生素 D₃[25-hydroxy vitamin D₃,25(OH)D₃] 与血清生殖激素水平的关系。方法 选取 2019 年 3 月—2020 年 8 月本院收治的男性糖尿病患者 130 例,将其按血脂水平分为观察组(68 例)及对照组(62例)。根据入组患者年龄将其分为 4 组(25 ～ 35 岁,36 ～ 45岁,46 ～ 55 岁及 56 ～ 65 岁),随后再次将入组患者依据血清25(OH)D₃水平将其分为 Q1、Q2 及 Q3 组。分别比较观察不同组别患者生殖激素及 25(OH)D₃等相关激素水平。结果 年龄段相同观察组患者 25(OH)D₃水平明显低于对照组,差异有统计学意义(P < 0.05)。随着年龄增长,观察组及对照组患者血清 25(OH)D₃水平均逐渐下降,且组间比较差异有统计学意义(P < 0.05)。Q3 组及 Q2 组睾酮水平明显高于 Q1 组,且 Q...     

锰对雄性小鼠血清性激素水平的影响

目的 探讨锰暴露对雄性小鼠血清性激素分泌的影响。 方法 选用健康雄性昆明小鼠48只,随机分为对照组和低、中、高染锰组。各组小鼠分别腹腔注射生理盐水、12.5、25.0、50.0 mg/kg MnCl₂,注射容量5 ml/kg,每天染毒1次,持续14 d,最后一天染毒24 h后处死小鼠,测量体重、睾丸和附睾的重量,腹主动脉采血,离心后取血清用酶联免疫试剂盒检测促性腺激素释放激素(gonadotropin-releasing hormone,GnRH)、卵泡刺激素(folide-stimulating hormone,FSH)、黄体生成素(luteinizing hormone,LH)和睾酮(testosterone,T)的水平。HE染色观察下丘脑神经元细胞组织形态的改变。 结果 与对照组相比,各染锰组小鼠体重、睾丸和附睾脏器系数差异无统计学意义(P>0.05),而高锰组血清中GnRH、FSH和LH含量显著升高至68.22 ng/L、11.43 U/L、2 055.82 pg/ml(P<0.05),T水平明显降低至81.25 nmol/L(P<0.05)。HE染色发现对照组可见结构清楚,排列规整,核膜清晰,染锰组逐渐形态紊乱,胞体皱缩,细胞周围间隙增大。 结论 锰暴露可引起雄性小鼠血清性激素分泌异常以及下丘脑组织形态受损,GnRH、FSH、LH明显升高,睾酮降低。     

单纯乳房早发育和中枢性性早熟女童血清25羟维生素D水平的分析

目的 分析单纯乳房早发育和中枢性性早熟女童血清25羟维生素D[25-(OH)D]水平的临床意义,为预防性早熟进展提供理论依据。方法 选取2015年1月-2017年1月在本院专科门诊就诊的诊断为性早熟女童84例,其中根据诊断标准分为单纯乳房早发育组和中枢性性早熟组;根据国际维生素D营养状况的分类方法,将性早熟组女童分为维生素D正常组、不足组、缺乏组;另选取80例健康女童为对照组。记录并统计年龄、体重、身高、体重指数(BMI)、骨龄(BA);骨龄与生活年龄比值(BA/CA)、用化学发光免疫分析仪检测血清黄体生成素(LH)水平、卵泡刺激素(FSH)、促黄体生成素峰值(P-LH)、促卵泡雌激素峰值(P-FSH)、血清雌二醇(E2)水平,采用25-(OH)D水平评价维生素D水平。结果 性早熟组女童血清25-(OH)D水平为(53.02±20.64)nmol/L,显著低于正常对照组女童[(74.32±14.30)nmol/L],且差异有统计学意义(t=-9.19,P<0.05);中枢性性早熟组女童25-(OH)D水平[(36.09±11.83)nmol/L]低于单纯乳房早发育女童[(55.29±23.08)nmol/L],差异有统计学意义(t=-3.357,P<0.05)。25-(OH)D不足组与25-(OH)D缺乏组骨龄(BA)、实际年龄(CA)、BMI-SDS、身高SDS、体重SDS、LH、FSH基础值、E2、P-LH、P-FSH等差异均无统计学意义(P>0.05);25-(OH)D不足组P-LH[(30.31±13.45)U/L]和P-FSH[(22.66±7.70)U/L]与25-(OH)D正常组P-LH[(10.67±9.34)U/L]和P-FSH[(17.12±9.23)U/L])比较差异有统计学意义(t=3.603、3.127,P<0.05);25-(OH)D缺乏组P-LH[(32.39±14.56)U/L)]和P-FSH[(25.09±10.56) U/L]与25-(OH)D正常组P-LH和P-FSH差异有统计学意义(t=4.825、5.242,P<0.05)。 结论 性早熟女童维生素D水平减低,且维生素D水平与性早熟的发生及进程可能相关。     

The Relationship Between Female Reproductive Functions and Vitamin D

Nonclassical target organs recently defined for vitamin D, a major regulator of calcium phosphorus homeostasis and bone health, include reproductive ones. This compilation study focuses on the potential effects of vitamin D on female reproductive functions. Vitamin D receptor enzymes that metabolize vitamin D are expressed in both central and peripheral reproductive organs. Most studies suggest that vitamin D may be directly or indirectly related to gonadal functions. Vitamin D's effects on reproductive functions may be indirectly related to diseases such as polycystic ovary syndrome (PCOS), uterine leiomyomas, and endometriosis. In case of vitamin D deficiency during infertility treatment, vitamin D supplementation can be recommended especially for women who have PCOS, insulin resistance, or low anti-Mullerian hormone levels. Supplementation, however, should take into account possible toxic effects of high-dose vitamin D. To be able to recommend measuring vitamin D as a routine screening test and to better understand the effects of vitamin D and its supplementation on female reproductive functions, larger randomized controlled prospective studies are needed.     

Optimal Serum 25(OH)D Level and Vitamin D Intake in Young Korean Women

Vitamin D status is essential for preventing bone disease. Young Korean women have the highest vitamin D deficiency prevalence compared with other demographic groups. This study aimed to establish the optimal vitamin D intake level for maintaining an adequate serum 25-hydroxyvitamin D (25[OH]D) level by season in young Korean women (mean age: 23.1 years). Each participant (wintertime, n = 101; summertime, n = 117) completed a lifestyle survey, dietary record, bone mineral density, and biochemical tests. Seasonal factors impacting 25(OH)D were identified, vitamin D intake for sufficient 25(OH)D levels was calculated, and the relationship between 25(OH)D and intact parathyroid hormone (iPTH) was analyzed. During summertime, 25(OH)D levels were higher than in wintertime (17.9 vs. 15.0 ng/mL). A 1 µg/1000 kcal increase in vitamin D intake increased 25(OH)D levels by 0.170 ng/mL in wintertime and 0.149 ng/mL in summertime. iPTH levels reached a theoretical plateau corresponding to an 18.4 ng/mL 25(OH)D level. The vitamin D intake threshold for maintaining 25(OH)D levels at ≥20 and ≥18.4 ng/mL was ≥10.97 μg/day. For a sufficient level of 25(OH)D in young Korean women, increasing summertime UV irradiation time and increasing vitamin D supplements and vitamin D-containing foods throughout the year is beneficial.     

维生素D与骨的生长和矿化

维生素D通过调节肠道和肾脏对钙磷的吸收和重吸收、骨钙的转移来调控矿物质的生理平衡 ,调节骨的矿化和生长。 1,2 5 (OH) 2 D3是活性最强的维生素D代谢产物 ,通过维生素D受体来发挥作用 ,体内还有一种细胞膜相关性快反应类固醇结合蛋白路径 ,通过基因和非基因两条路径维生素D调节和控制着骨的生长和矿化     

赣州地区孕妇血清维生素D水平研究

目的：探讨赣州地区孕妇血清维生素D水平。方法：抽取2134例孕妇空腹静脉血液进行血清25-OH维生素D检查,记录检查结果并统计学分析后,对189例维生素D缺乏孕妇再次实施25（OH）VitD检测,之后将其按抽签方式随机分为A组、B组和c组,A组每Et给予800IU维生素D制剂;B组每日给予400IU维生素D制剂;C组未给予任何药物干预措施。记录三组孕妇妊娠并发症发生率、25（OH）VitD检测结果。结果：2134例孕妇中34．96％孕妇维生素D检测结果正常,8．86％孕妇体内维生素D检测结果缺乏。C组孕妇发生妊娠并发症几率高达46．03％,与A、B组比较差异均有统计学意义（P〈0．05）;C组产妇并发症发生率最高,新生儿Apgar评分小于7分所占比例最高,且上述指标与A、B组比较差异均有统计学意义（P〈0．05）。结论：临床医生应及时有效的监测孕妇各时期体内维生素D含量,给予正确的饮食指导,必要时采用药物补充机体所需维生素D,降低妊娠并发症发生率,保障母婴身心健康。     

Association between Vitamin D Receptor Polymorphism and Serum Vitamin D Levels in Children with Low-Energy Fractures

Objective: Fractures of bones, especially forearm fractures, are very common in children and their number is increasing. This study was designed to determine the impact of vitamin D serum levels and vitamin D receptor (VDR) polymorphisms on the occurrence of low-energy fractures in children.

Methods: The study group consisted of 100 children with clinically relevant bone fractures and a control group consisted of 127 children without fractures. Total vitamin D [25(OH)D3 plus 25(OH)D2] serum concentrations were evaluated in every patient. Genotypes for 4 restriction fragment length polymorphisms of the vitamin D receptor gene (FokI, ApaI, TaqI, and BsmI) were determined by standard polymerase chain reaction–restriction fragment length polymorphism (PCR-RFLP) techniques.

Results: Differences in concentrations of vitamin D were observed between the group with bone fractures (median = 12 ng/ml) and the control group (median = 16 ng/ml; p = 0.000044).

Higher levels of vitamin D reduced the risk of fracture by 1.06 times (p = 0.0005). No impact of particular VDR polymorphism on the occurrence of low-energy fractures in children was detected. However, there were significant differences in the prevalence of FokI polymorphism genotypes between the fracture and control groups (p = 0.05). Furthermore, the recessive “aa” genotype of ApaI polymorphism and the dominant “TT” genotype of TaqI polymorphism were associated with higher levels of vitamin D (p = 0.005 and p = 0.036, respectively).

Conclusions: Vitamin D deficiency is an independent risk factor for fractures in children. ApaI polymorphism recessive “aa” and TaqI polymorphism dominant “TT” genotypes are associated with higher levels of vitamin D in serum.     

Increased Plasma Concentrations of Vitamin D Metabolites and Vitamin D Binding Protein in Women Using Hormonal Contraceptives: A Cross-Sectional Study

Use of hormonal contraceptives (HC) may influence total plasma concentrations of vitamin D metabolites. A likely cause is an increased synthesis of vitamin D binding protein (VDBP). Discrepant results are reported on whether the use of HC affects free concentrations of vitamin D metabolites. Aim: In a cross-sectional study, plasma concentrations of vitamin D metabolites, VDBP, and the calculated free vitamin D index in users and non-users of HC were compared and markers of calcium and bone metabolism investigated. Results: 75 Caucasian women aged 25–35 years were included during winter season. Compared with non-users (n = 23), users of HC (n = 52) had significantly higher plasma concentrations of 25-hydroxyvitamin D (25OHD) (median 84 interquartile range: [67-111] vs. 70 [47-83] nmol/L, p = 0.01), 1,25-dihydroxyvitamin D (1,25(OH)₂D) (198 [163-241] vs. 158 [123-183] pmol/L, p = 0.01) and VDBP (358 [260-432] vs. 271 [179-302] µg/mL, p < 0.001). However, the calculated free indices (FI-25OHD and FI-1,25(OH)₂D) were not significantly different between groups (p > 0.10). There were no significant differences in indices of calcium homeostasis (plasma concentrations of calcium, parathyroid hormone, and calcitonin, p > 0.21) or bone metabolism (plasma bone specific alkaline phosphatase, osteocalcin, and urinary NTX/creatinine ratio) between groups. In conclusion: Use of HC is associated with 13%–25% higher concentrations of total vitamin D metabolites and VDBP. This however is not reflected in indices of calcium or bone metabolism. Use of HC should be considered in the interpretation of plasma concentrations vitamin D metabolites.     

Nutrition Support in Liver Transplantation and Postoperative Recovery: The Effects of Vitamin D Level and Vitamin D Supplementation in Liver Transplantation

Vitamin D plays an important role in the arena of liver transplantation. In addition to affecting skeletal health significantly, it also clinically exerts immune-modulatory properties. Vitamin D deficiency is one of the nutritional issues in the perioperative period of liver transplantation (LT). Although vitamin D deficiency is known to contribute to higher incidences of acute cellular rejection (ACR) and graft failure in other solid organ transplantation, such as kidneys and lungs, its role in LT is not well understood. The aim of this study was to investigate the clinical implication of vitamin D deficiency in LT. LT outcomes were reviewed in a retrospective cohort of 528 recipients during 2014–2019. In the pre-transplant period, 55% of patients were vitamin-D-deficient. The serum vitamin D level was correlated with the model for end-stage liver disease (MELD-Na) score. Vitamin D deficiency in the post-transplant period was associated with lower survival after LT, and the post-transplant supplementation of vitamin D was associated with a lower risk of ACR. The optimal vitamin D status and vitamin D supplementation in the post-transplant period may prolong survival and reduce ACR incidence.     

Vitamin D and bone health: potential mechanisms

Osteoporosis is associated with increased morbidity, mortality and significant economic and health costs. Vitamin D is a secosteriod hormone essential for calcium absorption and bone mineralization which is positively associated with bone mineral density [BMD]. It is well-established that prolonged and severe vitamin D deficiency leads to rickets in children and osteomalacia in adults. Sub-optimal vitamin D status has been reported in many populations but it is a particular concern in older people; thus there is clearly a need for effective strategies to optimise bone health. A number of recent studies have suggested that the role of vitamin D in preventing fractures may be via its mediating effects on muscle function (a defect in muscle function is one of the classical signs of rickets) and inflammation. Studies have demonstrated that vitamin D supplementation can improve muscle strength which in turn contributes to a decrease in incidence of falls, one of the largest contributors to fracture incidence. Osteoporosis is often considered to be an inflammatory condition and pro-inflammatory cytokines have been associated with increased bone metabolism. The immunoregulatory mechanisms of vitamin D may thus modulate the effect of these cytokines on bone health and subsequent fracture risk. Vitamin D, therefore, may influence fracture risk via a number of different mechanisms.     

Vitamin D Level and Risk of Community-Acquired Pneumonia and Sepsis

Previous research has reported reduced serum 25-hydroxyvitamin D (25(OH)D) levels is associated with acute infectious illness. The relationship between vitamin D status, measured prior to acute infectious illness, with risk of community-acquired pneumonia (CAP) and sepsis has not been examined. Community-living individuals hospitalized with CAP or sepsis were age-, sex-, race-, and season-matched with controls. ICD-9 codes identified CAP and sepsis; chest radiograph confirmed CAP. Serum 25(OH)D levels were measured up to 15 months prior to hospitalization. Regression models adjusted for diabetes, renal disease, and peripheral vascular disease evaluated the association of 25(OH)D levels with CAP or sepsis risk. A total of 132 CAP patients and controls were 60 ± 17 years, 71% female, and 86% Caucasian. The 25(OH)D levels <37 nmol/L (adjusted odds ratio (OR) 2.57, 95% CI 1.08–6.08) were strongly associated with increased odds of CAP hospitalization. A total of 422 sepsis patients and controls were 65 ± 14 years, 59% female, and 91% Caucasian. The 25(OH)D levels <37 nmol/L (adjusted OR 1.75, 95% CI 1.11–2.77) were associated with increased odds of sepsis hospitalization. Vitamin D status was inversely associated with risk of CAP and sepsis hospitalization in a community-living adult population. Further clinical trials are needed to evaluate whether vitamin D supplementation can reduce risk of infections, including CAP and sepsis.     

Vitamin D deficiency and hyperparathyroidism in relation to ethnicity: a cross-sectional survey in healthy adults

Background  The study of vitamin D status at population level gained relevance since vitamin D deficiency was recently suggested to trigger chronic disease. Aim of the study  We aimed to describe vitamin D status, its association with bone and mineral metabolism and risk factors for deficiency in adults over 40 years in Belgium. Methods  We conducted a cross-sectional survey in a stratified random sample of 401 subjects aged between 40 and 60 years living in Brussels, and drawn from 4 different ethnic backgrounds: autochthonous Belgian, Moroccan, Turkish and Congolese. 25-Hydroxyvitamin D (25OHD), parathyroid hormone (PTH), osteocalcin, C-telopeptide and bone mineral density was measured. Results  Three-hundred and six subjects (77%) showed 25OHD concentrations below 50 nmol/l,135 (34%) below 25 nmol/l and 18 (5%) below 12.5 nmol/l. The proportion of subjects with vitamin D deficiency was four times greater amongst those of Moroccan or Turkish descent compared with those of Congolese or Belgian descent. Moroccan subjects showed a significant higher PTH and bone marker concentrations compared to Belgian. Ethnicity, season and sex were independently associated with vitamin D deficiency in multivariate analysis. Conclusion  The prevalence of vitamin D deficiency is very high amongst the adult population of Brussels but immigrants are at greater risk. Given the established link between population health and adequate vitamin D status, a policy of vitamin D supplementation should be considered in these risk groups.