ObjectiveTo investigate the correlation between serum level of 25(OH)D3 and peripheral neuropathy in patients with impaired glucose tolerance. MethodsA total of 108 patients with impaired glucose tolerance treated or examined between January 2012 and July 2014 were recruited in this study. According to whether peripheral neuropathy was combined, the patients were divided into neuropathy group (n=50) and non-neuropathy group (n=58). The level of 25(OH)D3 was measured and compared between the two groups, and the correlation of 25(OH)D3 with the clinical indexes of impaired glucose tolerance was analyzed. ResultsThe level of 25(OH)D3 in the neuropathy group and non-neuropathy group was respectively (16.1±4.2) and (19.6±4.7) ng/mL with a significant difference (P<0.05). The 25(OH)D3 deficiency rate of the above two groups was respectively 80.0% and 41.38%, also with a significant difference (P<0.05). The 25(OH)D3 level had a negative correlation with body mass index (BMI) and glycosylated hemoglobin (P<0.05). Conclusions There is a significant relationship between impaired glucose tolerance and 25(OH)D3 level. The 25(OH)D3 level has a negative correlation with BMI and glycosylated hemoglobin.
Objective To observe the level of vitamin D in patients with steroid resistant (SR) asthma, and investigate the effect of 1,25-(OH)2D3 on JNK/AP-1 and glucocorticoid receptor of T lymphocytes in SR asthmatics. Methods Sixty-two outpatients and inpatients with asthma with acute exacerbation between 2014 and 2015 were recruited in the study, including 26 cases of steroid sensitive (SS) asthmatics and 36 cases of SR asthmatics. Meanwhile 25 healthy volunteers were recruited as control. Clinical data were collected and peripheral venous blood was sampled for measuring the level of 25-(OH)D and separating the T lymphocytes. T lymphocytes were assigned to six groups, ie. a healthy control group (Group A), a SS asthmatics control group (Group B), a SR asthmatics control group (Group C), a SR asthmatics with JNK inhibitor (SP600125)+1,25-(OH)2D3 group (Group D), a SR asthmatics with JNK inhibitor (SP600125) group (Group E), and a SR asthmatics with 1,25-(OH)2D3 group (Group F). T lymphocytes were cultured for 48 hours. By the end of culture, the expression of phospho-JNK (p-JNK) and phospho-glucocorticoid receptor (p-GR) of T lymphocytes were detected by Western blot method, and the expression of c-Jun mRNA was detected by RT-PCR method. Results The level of 25-(OH) D was lower in Group B and Group C than Group A (P<0.05), and lower in Group C than Group B (P<0.05). The level of p-JNK was higher in Group B and Group C than Group A (P<0.05), higher in Group C than Group B (P<0.05), lower in Group E and Group F than Group C (P<0.05), lower in Group D than Group F (P<0.05). The level of p-GR was lower in Group C than Group A and Group B (P<0.05), higher in Group E and Group F than Group C (P<0.05), higher in Group D than Group F (P<0.05). The level of c-Jun mRNA was higher in Group B and Group C than Group A (P<0.05), higher in Group C than Group B (P<0.05), lower in Group E and Group F than Group C (P<0.05), and lower in Group D than Group F (P<0.05). The 25-(OH) D level was negatively correlated with the expression of p-JNK and c-Jun mRNA in Group C (r=–0.69, r=–0.65, P<0.05). However, there was a positive correlation between the 25-(OH) D level and p-GR (r=0.72, P<0.05). Conclusions There is a high prevalence of vitamin D deficiency or lack in SR asthmatics. 1,25-(OH)2D3 can promote the expression of p-GR by inhibiting the JNK/AP-1 signaling pathway of T lymphocytes in SR asthmatics, which may be one of the mechanisms of vitamin D to improve glucocorticoid resistance in SR asthmatics.
Objective To explore the relationship between 25-hydroxy vitamin D [25(OH)D] and metabolic syndrome (MS) in non-dialysis patients with stage 3–5 chronic kidney disease (CKD). Methods Between January 2014 and May 2015, a total of 61 non-dialysis patients with stage 3–5 CKD were included. The patients’ height, weight, blood lipid, levels of 25(OH)D and serum creatinine were conducted. The relationship between 25(OH)D and MS was analyzed. Results The average level of 25(OH)D was (39.99±17.66) nmol/L. Normal level (≥75 mmol/L) of 25(OH)D was observed in 3.3% (2/61) of the patients, insufficiency of 25(OH)D (≥37.5 nmol/L and <75 nmol/L) was observed in 50.8% (31/61), and deficiency (<37.5 nmol/L) was observed in 45.9% (28/61). The prevalence of MS was 67.2% ( 41/61). The body mass index (BMI), proportion of hypertension, proportion of diabetes mellitus, level of triglyceride in the MS group were higher than those in the non-MS group, while the levels of high-density lipoprotein and 25(OH)D were lower in the MS group than those in the non-MS group, and the differences were statistically significant (P<0.05). The patients’ BMI, proportion of hypertension, level of triglyceride and proportion of MS in the 25(OH)D deficiency group were higher than those in the 25(OH)D non-deficiency group, meanwhile, the level of high-density lopoprotein was lower in the 25(OH)D deficiency group than that in the 25(OH)D non-deficiency group, and the differences were statistically significant (P<0.05). Serum 25(OH)D level was correlated negatively with BMI (r=–0.35, P=0.006) and the level of triglyceride (r=–0.16, P=0.039), and correlated positively with the level of high-density lipoprotein (r=0.18, P=0.026). Conclusions Low level of 25(OH)D and MS are both of high incidence rate in non-dialysis patients with stage 3–5 CKD. 25(OH)D is associated with MS.
Objective To explore the association between 25-hydroxyvitamin D (25OHD) level and risk of the onset of metabolic syndrome (MS) in people in Chengdu. Methods In total, 474 participants were selected randomly by cluster sampling from one urban district and two rural villages in Longquanyi district of Chengdu. The data of sociodemographic information, lifestyle and family history were collected by questionnaires. Binary logistic regression was performed to assess the relationship between baseline 25OHD level and incident of MS, while multiple linear regression was conducted to analyze the relationship between baseline 25OHD level and insulin resistance. Results Four hundred seventy-four people were enrolled in the cohort study, 39 of them developed MS, with the incidences of 20.8 events per 1 000 person years. Among women, low 25OHD status was significantly associated with the risk of developing MS (OR=4.29, 95%CI 1.05 to 29.50, P=0.044) after adjustment for multiple potential confounders. In a multiple linear regression analysis, low 25OHD level of baseline was independently associated with the increased HOMA-IR over a 4-year period among Chengdu individuals (P<0.05) and was independently related to the decreased ISIcomp over a 4-year period in female (P<0.05). Conclusions The current prospective study suggests that low 25OHD level may contribute to increase insulin resistance in Chengdu population. Furthermore, low 25OHD level may increase the risk of MS among women in Chengdu.
ObjectiveTo investigate the clinical value of peripheral blood vitamin D level in predicting the outcome of weaning from mechanical ventilation in critically ill patients.MethodsA total of 130 critically ill patients who undergoing mechanical ventilation for more than 48 hours in our hospital were recruited from June 2014 to June 2017. Serum 25(OH)D3 was detected on admission and before spontaneous breathing test (SBT) meanwhile general clinical data and laboratory examination indexes were recorded. The cases were divided into a successful weaning group and a failure weaning group according to the outcome of weaning from mechanical ventilation. Logistic regression equation was used to analyze the relationship between vitamin D level and failure weaning, and a receiver operating characteristic (ROC) curve was used to analyze the predictive value for failure weaning.ResultsThere were 46 patients with failure weaning among 130 patients (35.38%). Compared with the successful weaning group, the failure weaning group had significantly higher Acute Physiology and Chronic Health EvaluationⅡ score, longer duration in intensive care unit, higher respiratory rate, higher rapid shallow breathing index, higher C-reactive protein, higher N-terminal prohormone of brain natriuretic peptide, higher serum creatinine, and significantly lower albumin (all P<0.05). 25(OH)D3 level classifications on admission and before SBT in the failure weaning group were worse than those in the successful weaning group (P<0.05). 25(OH)D3 levels of the failure weaning group were lower than those of the successful weaning group [on admission: (18.16±4.33) ng/ml vs. (21.60±5.25) ng/ml, P<0.05; before SBT: (13.50±3.52) ng/mlvs. (18.61±4.30) ng/ml, P<0.05]. Multivariate logistic regression analysis showed that 25(OH)D3 levels on admission and before SBT were independent risk factors for failure weaning (OR values were 2.257 and 2.613, respectively, both P<0.05). ROC curve analysis showed that areas under ROC curve were 0.772 and 0.836, respectively, with sensitivities of 80.3% and 85.2%, specificities of 69.0% and 71.0%, respectively.Conclusions25(OH)D3 deficiency or insufficiency is common in critically ill patients. The lower the level of vitamin D, the higher the risk of failure weaning. So it may be an independent predictor of failure weaning.
ObjectiveTo systematically review the efficacy of vitamin D supplementation on patients with polycystic ovary syndrome (PCOS).MethodsPubMed, EMbase, The Cochrane Library, Web of Science, EBSCO, CBM, WanFang Data, CNKI and VIP databases were electronically searched to collect randomized controlled trials (RCTs) on the efficacy of vitamin D supplementation for PCOS from inception to July 2019. Two reviewers independently screened literature, extracted data and assessed risk of bias of included studies, then, meta-analysis was performed by using RevMan 5.3 software.ResultsA total of 11 RCTs involving 692 patients were included. The results of meta-analysis showed that compared with placebo, vitamin D could reduce the level of hypersensitive C-reactive protein (hs-CRP) (MD=−0.54, 95%CI −1.00 to −0.08, P=0.02) and total testosterone (MD=−0.17, 95%CI −0.29 to −0.05, P=0.004), and increase endometrial thickness (MD=1.78, 95%CI 0.49 to 3.06, P=0.007). However, there were no significant differences between two groups in the incidence of sex hormone binding globulin (SHBG) level and hypertrichosis’s score (mF-G) (P>0.05).ConclusionsCurrent evidence indicates that vitamin D supplementation can significantly reduce the level of total testosterone and hs-CRP, and increase endometrial thickness of PCOS. Due to the limited quality and quantity of the included studies, more high quality studies are required to verify the above conclusions.
ObjectiveTo summarize the current research progress of the relationship between vitamin D and the development and progression of hepatocellular carcinoma (HCC), and relevant clinical translational application researches.MethodsThe related literatures at home and abroad were searched to review the studies on the synthesis and metabolism of vitamin D, classic and non-classical effects of vitamin D, and the relationship between vitamin D and the development and progression of HCC, as well as relevant clinical translational application.ResultsVitamin D was an important cytokine that regulated the body’s mineral and bone metabolism, and its anti-proliferation, pro-differentiation, pro-apoptosis, anti-inflammation, immune regulation, and other non-classical effects, had received more and more attentions in recent years. The existing studies had found that vitamin D was closely associated with HCC, which affected the development and progression of HCC through various mechanisms. Epidemiology showed that vitamin D levels were closely related to the prognosis of HCC patients. Whether vitamin D could be used as a clinical prognostic indicator and treatment plan for HCC still needed further clinical evidence to confirm.ConclusionVitamin D plays an important role in the regulation of the development and progression of HCC, and exploration of the association between vitamin D and HCC and related clinical translation problems are expected to provide a new approach for the prevention and treatment of HCC.
ObjectiveTo understand the nutritional status of vitamin D in some children aged 0-14 in Mianyang during the past 3 years and the changes of vitamin D nutritional status under home protection during the coronavirus disease 2019 (COVID-19) epidemic, so as to provide a theoretical basis for the monitoring and reasonable supplementation of vitamin D in children in this area after the epidemic.MethodsThe clinical data of children aged 0-14 who underwent physical examination in the Children’s Health Department of Mianyang Central Hospital from January to April 2018, from January to April 2019 and from January to April 2020 were analyzed retrospectively. High performance liquid chromatography tandem mass spectrometry was used to detect vitamin D, including vitamin D2, vitamin D3 and 25-hydroxyvitamin D [25(OH)D] in children’s serum. The differences in vitamin D components and 25(OH)D between different genders, different age groups, and different years were analyzed.ResultsA total of 12 348 children were included. The average vitamin D2 was (4.89±6.02) ng/mL, the average vitamin D3 was (22.91±9.29) ng/mL, the average 25(OH)D was (27.81±10.53) ng/mL, and 9 434 cases had sufficient 25(OH)D. The differences in vitamin D2, vitamin D3, 25(OH)D and 25(OH)D nutritional status in 2018, vitamin D2 and 25(OH)D in 2019, and vitamin D2 in 2020 between different genders were not statistically significant (P>0.05). There were statistically significant differences in vitamin D3 and 25(OH)D nutritional status in 2019, vitamin D3, 25(OH)D and 25(OH)D nutritional status in 2020 between different genders (P<0.05). From 2018 to 2020, vitamin D2 was the highest in infant group (P<0.05), while vitamin D3, 25(OH)D and 25(OH)D nutritional status were the highest in children group (P<0.05); vitamin D2 (χ2=143.106, P<0.001) showed an overall downward trend, vitamin D3 (F=400.178, P<0.001) and 25(OH)D (F=447.384, P<0.001) showed an overall upward trend; 25(OH)D nutritional status (χ2=103.566, P<0.001) was the highest in 2019.ConclusionsThe overall vitamin D nutritional status of children in Mianyang area is acceptable. Under the home protection, the average level of children’s serum 25(OH)D has little change, while the nutritional status of 25(OH)D has decreased significantly. After the outbreak of COVID-19, more attention should be paid to the monitoring and supplementation of vitamin D in school-age female children.
Objective The research was performed to investigate the relationship between serum 25-hydroxyvitamin D (25(OH)D) levels and the risk of adverse pregnancy outcomes. Methods We enrolled females who were in the first trimester of pregnancy and had arranged antenatal care at the Weifang Maternal and Child Health Hospital between January 2017 and December 2019. The liquid chromatography-tandem mass spectrometry (LC-MS/MS) method was used to detect serum concentrations of 25(OH)D. The health status of the expectant mothers and fetuses and the incidence of adverse pregnancy outcomes of newborns were monitored through the outpatient, prenatal, and delivery stages in the hospital. Results An initial total of 6 770 females were signed up, while 4 997 females were eventually included. The median value of 25(OH)D concentration was 15.40 ng/mL, and the incidence rate of vitamin D deficiency [25(OH)D < 20 ng/mL] was 71.26%. The occurrence rates of gestational diabetes mellitus (GDM), pre-eclampsia, premature rupture of membranes (PROM), oligohydramnios, polyhydramnios, cesarean delivery, spontaneous abortion or stillborn fetus, fetal malformation, premature delivery, fetal macrosomia, low birth weight, small for gestational age infant, and asphyxia of newborn were 28.31%, 2.27%, 23.47%, 12.68%, 0.51%, 45.71%, 1.44%, 0.93%, 9.26%, 5.05%, 11.68%, 2.68%, 3.18%, and 1.16%, respectively. After adjusting for age, parity, season, pre-existing hypertension, pre-existing diabetes, and vitamin D supplementation, no relationship between 25(OH)D levels and adverse pregnancy outcomes was found (P>0.05). Conclusions Levels of 25(OH)D do not affect the risk of adverse pregnancy outcomes in females during the first trimester of pregnancy.