There is still uncertainty regarding the optimal serum levels 25-Hydroxy-vitamin D [25(OH)D] and the most effective supplementation strategies, including the choice of molecule and its dosing frequency. The aim of the study is to compare the effects of calcifediol versus two different frequencies of cholecalciferol administration on vitamin D supplementation, and to identity the key parameters that predict response to treatment.

This retrospective, real-world cohort study included 105 patients, who were divided into three groups. Group 1 (n = 21) received cholecalciferol 50,000 international units (UI) once a month, Group 2 (n = 27) received cholecalciferol 25,000 UI every two weeks, and Group 3 (n = 57) received calcifediol 0.266 mg (mg) once a month. The primary outcome measured was the delta increase in 25(OH)D levels after 6 months of treatment, compared to pre-treatment levels.

The study revealed a significant greater delta increase in 25(OH)D levels in Group 1, which received cholecalciferol 50,000 IU once a month, compared to the other two groups. However, multiple regression analysis indicated that neither the type of molecule nor the frequency of administration independently influenced the treatment outcome. Only pre-treatment serum 25(OH)D levels were found to significantly affect the outcome. Based on the receiver operating characteristic curve, serum 25(OH)D levels below 19.5 ng/dL were predictive of a doubling of pre-treatment values, with high sensitivity and specificity.

Pre-treatment serum 25(OH)D levels are valuable for selecting patients who should undergo supplementation. This finding suggests the importance of tailoring therapy according to the degree of vitamin D deficiency.

25-hydroxyvitamin D (25OHD) is the principal biomarker of vitamin D status. Values below the assay detection limit (<10 nmol/L) are often reported as missing. Thus the most severely deficient participants are excluded from research which can lead to inaccurate findings such as underestimated prevalence of deficiency, overlooked risk factors, and biased evaluation of disease associations.

In total 369,626 individuals from the UK Biobank cohort were included in this study. Data on 25OHD concentration and relevant demographic and lifestyle factors such as age, supplement intake, diet, and time spent outdoors were used in the analyses. Ambient UVB radiation was approximated for each participant. 25OHD was evaluated as a categorical outcome and we reintroduced participants with 25OHD values < 10 nmol/L (conventionally reported as missing values) back to the dataset. Adjusted regression models were used to investigate the determinants of profound (25OHD <10 nmol/L) and severe (10-25 nmol/L) vitamin D deficiency and to assess disease associations (with 25-50 nmol/L as the reference category).

1,784 (0.48 %) individuals were profoundly deficient and a further 47,226 (12.78 %) individuals were severely vitamin D deficient. The proportions of profoundly and severely deficient were highest among Asians, 9 % and 47 %, respectively. Ambient UVB radiation was the second strongest predictor: comparing the lowest vs. highest quartile, the risk of profound deficiency was 17-fold increased and that of severe deficiency 7.5-fold increased. Use of vitamin D supplements substantially reduced risk of profound (4.4-fold) and severe (2.5-fold) deficiency, as did fish intake (5- and 1.9-fold, respectively). Profound deficiency was more strongly associated with chronic illness, diabetes, and emphysema compared to severe deficiency.

The prevalence of profound and severe vitamin D deficiency among Asian and Black ethnicities in the UK is high and requires targeted action. Solar radiation is potent in protecting against profound and severe vitamin D deficiency. Studies evaluating the relationship between vitamin D status and other health outcomes may be biased if profoundly deficient participants are excluded.

Vitamin D deficiency (VDD) is prevalent globally and in pediatric intensive care units, where it represents a modifiable risk factor that may impact patient recovery during hospitalization. Herein, we performed a retrospective analysis of serum samples from a phase-II randomized placebo-controlled trial involving a single large bolus of 10,000 IU/kg vitamin D3 ingested by critically ill children with VDD (25-OH-D < 50 nmol/L). Targeted and untargeted methods were used to comprehensively measure 6 vitamin D metabolites, 239 lipids, 68 polar metabolites, and 4 electrolytes using a multi-step data workflow for compound authentication. Complementary statistical methods classified circulating metabolites/lipids associated with vitamin D repletion following high-dose vitamin D3 intake (n = 20) versus placebo (n = 11) comprising an optional standard of care maintenance dose (< 1000 IU/day). There was a striking increase in median serum concentrations of 25-OH-D3 (4.7-fold), 3-epi-25-OH-D3 (24-fold) and their C3-epimer ratio (6.7-fold) in treated patients on day 3, whereas serum vitamin D3 peaked on day 1 (128-fold) unlike placebo. Treatment response differences were attributed to D3 bioavailability and C3-epimerase activity without evidence of hypercalcemia. For the first time, we report the detection of circulating 3-epi-D3 that was strongly correlated with vitamin D3 uptake (r = 0.898). Metabolomic studies revealed that vitamin D sufficiency (serum 25-OH-D >75 nmol/L) coincided with lower circulating levels of 3-methylhistidine, cystine, S-methylcysteine, uric acid, and two lysophosphatidylcholines 7 days after treatment. Rapid correction of VDD was associated with indicators of lower oxidative stress, inflammation, and muscle protein turn-over that may contribute clinical benefits in high-risk critically ill children.

We aimed to estimate the prevalence of vitamin D deficiency in Mongolian men aged from 15 to 49 years at the National level as part of the Fifth National Nutrition Survey in 2016. This was a cross-sectional survey, conducted between September and November in 21 aimags of 4 economic regions of the country, and also in Ulaanbaatar. Given the regional differences in lifestyle and nutritional status, the target populations were stratified into 5 strata based on their economic region and in Ulaanbaatar, with equal samples drawn from each stratum using a cluster-randomized sampling design. A representative sample of 30 clusters [villages] was randomly selected using Probability Proportional to Size [PPS] methodology in each of the 4 regions and in Ulaanbaatar for a total of 150 cluster units. The selection of survey participants differed for the three sampling regions. Household eligibility was based on having a child 0-59 months of age, living in the household which was randomly selected from each cluster for a total of 450 households in each region. Households with a child 0-59 months of age were selected from household lists available at the kheseg or bagh level. All men 15-49 years of age who resided in the selected households were also eligible to participate in the survey. Serum concentration of 25-hydroxyvitamin D [25(OH)D] were measured using an enzyme-linked fluorescence assay in 377 men aged 15-49 years. The overall mean serum level of 25(OH)D concentration was 22.26 ± 0.48 ng/mL (95 % CI 21.31-23.21). The mean serum 25(OH)D concentrations were 19.65 ± 0.32 ng/mL (95 % CI19.01-19.82), and 33.68 ± 0.49 ng/mL (95 % CI 32.72-34.64) in vitamin D deficient, and in vitamin D sufficient subjects, respectively. The prevalence of vitamin D deficiency was 83.5 % with no significant difference in the prevalence of vitamin D deficiency by age group, economic region, area, location, education, and wealth index quintile. The prevalence of men in this study who were overweight or obese was 48.8 % and 14.6 % respectively. Although no significant difference was found between vitamin D deficiency and obesity, vitamin D deficiency was higher among men aged 30-39 and 40-49 years old by age specific analyses. The men did not take vitamin D supplements, and there is currently no vitamin D food fortification in Mongolia. The findings of this survey showed that vitamin D deficiency in men is a public health problem in Mongolia. In conclusion, vitamin D deficiency are common in Mongolian men, which indicates the need for vitamin D screening and treatment, as well as for an increased use of vitamin D supplements and for implementing vitamin D food fortification programs.

Vitamin D was discovered as the cure for nutritional rickets, a disease of bone growth arising from inadequate intestinal calcium absorption, and for much of the 20th century, it was studied for its critical role in calcium homeostasis. However, we now recognize that the vitamin D receptor and vitamin D metabolic enzymes are expressed in numerous tissues unrelated to calcium homeostasis. Notably, vitamin D signaling can induce cellular differentiation and cell cycle arrest. Moreover, the vitamin D receptor and the enzyme CYP27B1, which produces the hormonal form of vitamin D, 1,25-dihydroxyvitamin D (1,25D), are expressed throughout the immune system. In addition, CYP27B1 expression in immune cells is regulated by physiological inputs independent of those controlling its expression in calcium homeostatic tissues. These observations have driven the development of 1,25D-like secosteroidal analogs and nonsecosteroidal analogs to separate the effects of vitamin D on cell differentiation and function from its calcemic activities. Notably, some of these analogs have had considerable success in the clinic in the treatment of inflammatory and immune-related disorders. In this review, we described in detail the mechanisms of vitamin D signaling and the physiological signals controlling 1,25D synthesis and catabolism, with a focus on the immune system. We also surveyed the effects of 1,25D and its analogs on the regulation of immune system function and their implications for human immune-related disorders. Finally, we described the potential of vitamin D analogs as anticancer therapeutics, in particular, their use as adjuncts to cancer immunotherapy. SIGNIFICANCE STATEMENT: Vitamin D signaling is active in both the innate and adaptive arms of the immune system. Numerous vitamin D analogs, developed primarily to minimize the dose-limiting hypercalcemia of the active form of vitamin D, have been used widely in preclinical and clinical studies of immune system regulation. This review presents a description of the mechanisms of action of vitamin D signaling, an overview of analog development, and an in-depth discussion of the immunoregulatory roles of vitamin D analogs.

To establish accurate population-based reference intervals (RIs) for serum 25-hydroxyvitamin D [25(OH)D] using the refineR indirect method and real-world data (RWD), accounting for demographic, methodological, and seasonal factors.

A retrospective analysis of 130,030 serum 25(OH)D samples collected from 2018 to 2022 at a tertiary hospital in Barcelona was performed. Samples were measured using VDSP-certified Liaison and Atellica immunoassays. The refineR algorithm was employed to establish RIs, utilizing Box-Cox transformations to adjust for data distribution. Demographic variables (sex and age), assay differences, medical department and seasonal variations were analysed. RIs were verified using a subset of healthy individuals.

The median serum 25(OH)D level was 25 ng/mL (62.5 nmol/L). Vitamin D deficiency (≤20 ng/mL, ≤50 nmol/L) was observed in 34.2% of samples, and severe deficiency (≤12 ng/mL, ≤30 nmol/L) in 12.6%. The default Box-Cox transformation estimated RIs of 11.5-64.5 ng/mL (28.7-161.2 nmol/L), while the modified Box-Cox transformation yielded RIs of 14.2-65.9 ng/mL (35.5-164.7 nmol/L). Women exhibited wider RIs (14.5-68.6 ng/mL, 36.2-171.5 nmol/L) compared to men (11.6-57.3 ng/mL, 29-143.2 nmol/L). Method-specific RIs were 10.2-58.6 ng/mL (25.5-146.5 nmol/L) for the Liaison assay and 9.9-59.3 ng/mL (24.7-133.2 nmol/L) for the Atellica assay. The lowest RIs were observed in outpatients (4.3-46.4 ng/mL, 10.7-116 nmol/L) and endocrinology patients (5.5-43.9 ng/mL, 13.7-109.7 nmol/L). Seasonal variation significantly impacted RIs, with higher levels during summer months.

The refineR algorithm effectively established population-based RIs for serum 25(OH)D in Barcelona, revealing significant demographic and seasonal variations. Redefining 25-hydroxyvitamin D thresholds based on population-specific data may reduce unnecessary screening and supplementation, minimizing associated risks. This study highlights the need for population-, seasonal-, and method-specific RIs to improve vitamin D assessment and management.

Vitamin D deficiency is common in Paediatric Inflammatory Bowel Disease (PIBD) and has been implicated in disease pathogenesis and disease exacerbation. Current guidelines recommend oral vitamin D supplementation when 25OHD levels are below 50 nmol/L. Supplementation comes in two forms: either a daily supplement of a low dose of vitamin D3 (2000 IU) for several months or a single high dose of oral vitamin D3-termed 'stoss' therapy, with no consensus regarding optimum treatment.

A randomised controlled trial was conducted in children with a prior diagnosis of PIBD with 25OHD deficiency (< 50 nmol/L), comparing 2000 IU oral D3 daily to a stoss protocol (oral D3 dosage 400,000 IU for 3-12 years of age or 800,000 IU for > 12 years). Children were followed for 12 months, with biochemistry (25OHD, calcium, magnesium, phosphate, parathyroid hormone, haemoglobin, haematocrit, platelets, albumin), stool markers (calprotectin, S100A12), anthropometrics (weight, height, body mass index) as well as clinical disease indices (Paediatric Crohn's Disease Activity Index, Paediatric Ulcerative Colitis Activity Index) and medication use collected at 3, 6, 9 and 12 months.

74 children aged 5-18 years completed the study. Both 2000 IU daily and stoss protocol significantly increased 25OHD from baseline values at 3, 6, 9 and 12 months. One patient randomised to stoss protocol had a 25OHD level of 263 nmol/L with normal serum calcium. There was no difference in biochemical, stool or clinical markers between groups at any time point, nor was there any correlation between 25OHD level and calprotectin or 25OHD level and clinical disease activity scores.

Stoss protocol was non-inferior to 2000 IU daily vitamin D3 in raising 25OHD levels at 12 months. There was also no difference between 25OHD levels at 3, 6 and 9 months between groups.

Background/Objectives: Vitamin D-crucial for bone health, immune function, and hormone regulation-is deficient worldwide, affecting around half the population, particularly women. The study aims to determine the prevalence and risk factors of vitamin D deficiency and hypovitaminosis D in non-pregnant women in Lebanon. Methods: A national cross-sectional survey sampled households across Lebanon, covering 2803 non-pregnant women aged 15 to 49. Demographic information and dietary habits were collected, and anthropometric measurements and serum analyses, including 25-hydroxyvitamin D (25(OH)D) concentrations, were conducted. Multivariable Poisson regressions were constructed to calculate the adjusted prevalence ratio (aPR) for vitamin D deficiency and hypovitaminosis D of variables. Results: The prevalence of vitamin D deficiency (<30 nmol/L) among non-pregnant women in Lebanon was 37.9%, while 69.2% had hypovitaminosis D (<50 nmol/L). Wearing a veil (hijab) was identified as the most significant risk factor for both vitamin D deficiency (aPR = 3.76) and hypovitaminosis D (aPR = 1.47). Additionally, olive skin and dark skin were both associated with an increased prevalence of vitamin D deficiency (olive skin: aPR = 1.14; dark skin: aPR = 1.28), while only dark skin color was associated with hypovitaminosis D (aPR = 1.10). In contrast, protective factors against vitamin D deficiency and hypovitaminosis D included daily sun exposure exceeding one hour (aPR = 0.83-0.91) and vitamin D supplementation (aPR = 0.30-0.55). Anemia, folate deficiency, and vitamin B12 deficiency were significantly associated with a higher prevalence of vitamin D deficiency, hypovitaminosis D, or both. BMI was not significantly associated with vitamin D deficiency; however, women with underweight (aPR = 1.13) and obesity (aPR = 1.12) exhibited a higher prevalence of hypovitaminosis D. Conclusions: Vitamin D deficiency and hypovitaminosis D affect a significant portion of non-pregnant women in Lebanon, with veiling (hijab wearing), limited sun exposure, and lack of supplementation as primary risk factors. Future work should focus on tailoring recommendations for vitamin D supplementation, sun exposure, and food fortification to effectively address the diverse risk factors in the population.

Background and Objectives: Adequate levels of vitamin D are vital for both growth and immunomodulation in children. To evaluate the levels of vitamin D in children from Western Romania and to identify significant age, seasonal, and geographical disparities. Materials and Methods: This study evaluates the level of 25-hydroxyvitamin D levels assessed on Cobas 6000's module e601 in 1698 children aged 1-18 years between 1 January 2018 and 31 December 2021 from Western Romania. Results: Children aged 1-6 years predominantly present sufficient levels (>30 ng/mL), while older age groups showed a marked decline. Adolescents aged 13-18 years were most affected, with over half displaying insufficient levels (20-30 ng/mL). Rural children were more likely to achieve sufficiency compared to urban peers. Males demonstrated significantly higher vitamin D levels when compared to females. Seasonal variations showed the highest vitamin D levels during late summer and early autumn (September: aOR = 5.47; 95% CI: 3.17-9.42, p < 0.001). Multivariate analysis revealed a significant improvement in vitamin D levels during 2019-2020. Conclusions: Our findings suggest the need for targeted screening programs and health policies to address vitamin D deficiency, particularly among older children, urban residents and during winter months.

Patients with end-stage chronic diseases, especially those undergoing hemodialysis (HD), often experience mineral bone disease (MBD), leading to hypocalcemia, hyperphosphatemia, and elevated parathyroid hormone (PTH). Vitamin D deficiency and metabolism disorders are also common, resulting from impaired conversion of 25(OH)D3 to its active form, 1,25(OH)2D3, and reduced inactivation to 24,25(OH)2D3. This study aimed to assess the levels of 25(OH)D2, 25(OH)D3, 24,25(OH)2D3, 3-epi-25(OH)D3, and the vitamin D metabolism ratio (VMR) in patients with maintenance HD.

A cross-sectional study was conducted on 66 HD patients (22-90 years, average 61.3 ± 16.4), with a control group of 206 adults without chronic kidney disease (CKD), both without cholecalciferol supplementation.

the HD patients had significantly lower 25(OH)D3 levels (15 ng/mL vs. 22 ng/mL) and higher deficiency rates (69% vs. 39%) compared to the controls. However, both groups showed similarly low levels of optimal vitamin D3. The HD patients had lower 24,25(OH)D3 levels (0.1 vs. 2.1 ng/mL) and a lower VMR (0.9% vs. 9%). 3-epi-25(OH)D3 levels and its ratio to 25(OH)D3 were significantly lower in the HD group. Alphacalcidol supplementation raised 1,25(OH)2D3 levels (30.4 vs. 16.2 pg/mL) without affecting other vitamin D metabolites. The HD patients had higher levels of 25(OH)D2 compared to the controls (0.61 vs. 0.31 ng/mL).

Vitamin D3 reserves are lower, and both functional deficiency and impaired catabolism of vitamin D3 are present in HD patients compared to the general population. The VMR index is the most sensitive parameter for vitamin D3 deficiency assessment, highlighting the importance of measuring 24,25(OH)D3. Alphacalcidol supplementation increases 1,25(OH)2D3 levels without affecting other vitamin D metabolites. 25(OH)D2 is the only metabolite that was higher in HD patients than the controls.

In addition to its classical role in calcium and phosphate metabolism regulation, vitamin D also has an important impact on immunity modulation. Vitamin D regulates the immune response, shifting from a proinflammatory state to a more tolerogenic one by increasing the release of anti-inflammatory cytokines while downregulating proinflammatory cytokines. Thus, low levels of vitamin D have been associated with an increased risk of developing autoimmune diseases like multiple sclerosis and type 1 diabetes. Furthermore, this prohormone also enhances the release of well-known antimicrobial peptides, like cathelicidin LL-37 and β-defensins; therefore, it has been proposed that vitamin D serum levels might be related to the risk of well-known pathogen infections, including herpesviruses. These are a group of widely spread viral pathogens that can cause severe encephalitis or tumors like Kaposi's sarcoma and Burkitt lymphoma. However, there is no consensus on the minimum levels of vitamin D or the recommended daily dose, making it difficult to establish a possible association between these two factors. This narrative non-systematic review will analyze the mechanisms by which vitamin D regulates the immune system and recent studies about whether there is an association between vitamin D serum levels and herpesvirus infections.

Background/Objectives: Vitamin D deficiency (VDD) is a global health concern associated with metabolic disease and immune dysfunction. Despite known risk factors like limited sun exposure, diet, and lifestyle, few studies have explored these factors comprehensively on a large scale. This cross-sectional study aimed to identify VDD-associated factors in South Korea via an integrative approach of machine learning and statistical analyses using Korea National Health and Nutrition Examination Survey (KNHANES) IX-1 data. Methods: Using the KNHANES dataset, six machine learning algorithms were applied to evaluate VDD (serum 25[OH]D3 < 20 ng/mL)-associated factors through feature importance scores. Thereafter, multivariate linear and logistic regression models were applied to the dataset-stratified by sex and age. Results: Among 583 variables, 17 VDD-associated factors were identified using the CatBoost model, which achieved the highest F1 score. When these factors were assessed through statistical analysis, dietary supplement use emerged as a consistent factor associated with VDD across all subgroups (younger men, younger women, older men, and older women). In younger adults, HDL cholesterol, blood and urinary creatinine, water intake, urban residence, and breakfast frequency were significantly associated with VDD. Additionally, blood urea nitrogen and fasting plasma glucose in men and urinary sodium in women showed sex-specific associations with serum 25(OH)D levels. Conclusions: This study identified key VDD-associated factors in the South Korean population, which varied by age or sex. These findings highlight the multifaceted nature of VDD, influenced by dietary, lifestyle, and biochemical factors and underscore the need for strategies integrating machine learning and statistical analysis.

Vitamin D is activated into 1α,25(OH)2D through two hydroxylation steps that are primarily catalyzed by 25-hydroxylase in the liver and 1α-hydroxylase in the kidneys. The active form of vitamin D regulates myriads of cellular functions through its nuclear receptor, vitamin D receptor (VDR). Vitamin D metabolizing enzymes and VDR are expressed in adipose tissues and vitamin D regulates multiple aspects of adipose biology including the recruitment and differentiation of adipose stem cells into adipocytes and metabolic, endocrine, and immune properties. Obesity is associated with low vitamin D status, which is thought to be explained by its sequestration in large mass of adipose tissues as well as dysregulated vitamin D metabolism. Low vitamin D status in obesity may negatively impact adipose biology leading to adipose tissue dysfunctions, the major pathological factors for cardiometabolic diseases in obesity. In this review, the current understanding of vitamin D metabolism and its molecular mechanisms of actions, focusing on vitamin D-VDR regulation of adipose biology with their implications on obesity-associated diseases, is discussed. Whether improving vitamin D status leads to reductions in adiposity and risks for cardiometabolic diseases is also discussed.

Vitamin D is an essential fat-soluble vitamin for humans and vitamin D deficiency (VDD) affects all age groups, with older adults being at high risk of VDD. A deficiency in vitamin D has been associated with a range of health concerns in older adults, including osteomalacia and osteoporosis. Additionally, there is limited evidence suggesting that VDD may be associated with increased risk of developing cognitive impairment, muscle-wasting disorders, cardiovascular disease, type 2 diabetes mellitus, and mortality. This review synthesizes the latest research advances in China and abroad to provide detailed information on the current status of vitamin D nutritional monitoring, causes of deficiency, health risks, and proposed intake for reducing risk of diet-related noncommunicable diseases in the Chinese older adults.

This paper aimed to determine the prevalence of 25-hydroxy vitamin D (25(OH)D) deficiency in healthy adult patients who presented to our hospital in Istanbul province and to present the difference between vitamin 25(OH)D levels by gender, age group, season, and month.

The vitamin 25(OH)D levels of 9,778 adults who presented to our hospital's internal medicine checkup outpatient clinic between January 2022 and December 2023 were analyzed retrospectively. Individuals with chronic disorders were excluded from the study. The adult patients included in the study were divided into two groups by age (18-50 and 51-65 years). Serum 25(OH)D levels were measured using the electrochemiluminescence immunoassay method. A serum 25(OH)D level was considered deficient if below 20 ng/mL, insufficient if 20-30 ng/mL, and sufficient if above 30 ng/mL. The patients' 25(OH)D levels were investigated by age, gender, season, and month.

After measurement, vitamin D levels were deficient in 57.2% of the patients (n=5,592), insufficient in 28.2% (n=2,756), and sufficient in 14.6% (n=1,430). The mean vitamin D level of the 18-50 age group was significantly lower than that of the group 51-65 age group (p=0.001; p<0.01). The vitamin D levels did not statistically significantly differ by gender (p=0.085, p>0.05). The mean vitamin D levels were 17.99±10.88 ng/mL in winter, 18.11±12.69 ng/mL in spring, 22.08±11.58 ng/mL in summer, and 21.67±10.82 ng/mL in fall. There were statistically significant differences according to the season and month of hospital presentation (p=0.001; p<0.01).

The prevalence of vitamin D deficiency (below 20 ng/mL) in healthy adults aged 18-65 years in Istanbul was 57.2%. That prevalence varied across seasons and months, indicating that sunlight was not used sufficiently. Vitamin D deficiency in Istanbul presents a major problem that needs to be remedied.

Vitamins D and B12 play a crucial role in maintaining bone health, immune function, and neurological integrity. Combined deficiencies in these vitamins can lead to severe health consequences. Current treatment approaches, such as dietary changes and single-vitamin supplementation, often fail to address these deficiencies comprehensively. This study evaluates the effectiveness of concurrent vitamin D and B12 supplementation to correct these insufficiencies.

A prospective, multicenter, randomized controlled trial was conducted in Greece from October 2024 to December 2024. Participants aged 20 to 80 years, with insufficient levels of 25-hydroxyvitamin D (serum < 20 ng/mL) and B12 (serum < 250 ng/L), were eligible for inclusion.

A total of 124 patients were randomized into three groups: one receiving vitamins B12 and D in a single supplement (2500 IU + 1000 mcg), one receiving separate doses of each vitamin (2000 IU + 1000 mcg), and a control group receiving no supplementation. The results demonstrated a significant increase in B12 and 25-hydroxyvitamin D levels among the supplemented groups. Particularly, participants in the combined supplementation group showed higher average serum levels of both vitamins. By the end of this study, 37.1% of those in the combined supplement group achieved adequate vitamin levels, compared to 29.4% in the separate supplementation group.

In conclusion, combined supplementation may improve patient adherence and compliance, leading to better health outcomes for individuals with combined vitamins D and B12 deficiencies.

Patients with vitamin D deficiency are susceptible to increased microbial infection and increased risk of mortality. However, whether vitamin D supplementation would improve their prognosis remains uncertain.

We conducted a retrospective cohort study using data from MIMIC-IV database, a publicly available database containing clinical information on patients admitted to the ICU at Beth Israel Deaconess Medical Center (BIDMC) from 2008 to 2019. Adult patients with sepsis were included in the analysis. The exposure factor was vitamin D supplementation during the ICU stay. The primary outcome was 28-day all-cause mortality. Both propensity score matching (PSM) and stepwise regression analyses were employed to adjust for potential confounders.

A total of 20230 eligible patients were enrolled in the entire unmatched cohort, and 8710 patients were included in the matched cohort. In PSM analysis, the 28-day all-cause mortality rate was 14.04% (250/1780) in the vitamin D group and 22.31% (1546/6930) in the no vitamin D group. Vitamin D supplementation was associated with decreased 28-day all-cause mortality (HR, 0.56; 95% CI, 0.49-0.64; p < 0.001). Subgroup analyses showed consistent benefits regardless of the baseline vitamin D status (deficiency: HR, 0.70; 95% CI, 0.33-1.50; p = 0.36; insufficiency: HR, 0.10; 95% CI, 0.03-0.34; p < 0.001; sufficiency: HR, 0.33; 95% CI, 0.12-0.88; p = 0.03). Additionally, vitamin D supplementation was associated with decreased ICU mortality (OR, 0.37; 95% CI, 0.29-0.48; p < 0.001) and reduced in-hospital mortality (OR, 0.57; 95% CI, 0.48-0.68; p < 0.001). Sensitivity analysis using the unmatched cohort confirmed these findings (HR, 0.57; 95% CI, 0.43-0.76; p < 0.001).

Vitamin D supplementation may reduce mortality in critically ill patients with sepsis. However, further high-quality prospective studies are still needed to validate these findings.

Objectives: To investigate the correlation between baseline serum concentrations of 25-hydroxyvitamin D (25-OHD) and quality of life (QoL), as well as pain perception in patients with chronic pain with long-term prescription opioid usage before opioid detoxification. Methods: We prospectively studied 45 patients with chronic pain with long-term prescription opioid usage who were selected for elective detoxification. Baseline serum 25-OHD levels were measured prior to detoxification, classifying patients as either vitamin D deficient (<75 nmol/L) or sufficient (≥75 nmol/L). QoL was assessed using the SF-36v2TM questionnaire, while pain levels were assessed using Visual Analogue Scale (VAS) scores before treatment. Results: Mean pain scores before detoxification of the patients with sufficient baseline 25-OHD levels vs. those with deficient levels were, respectively, 6.06 ± 2.32 vs. 6.86 ± 2.10 (normalized scores 1.22 ± 0.571 vs. 0.950 ± 0.632; p = 0.164). The analysis of SF-36v2™ questionnaire scores revealed minimal variation between groups (35.00 ± 14.198 vs. 34.97 ± 13.52), indicating no significant association between Vitamin D levels and QoL (p = 0.913). Conclusions: The analysis of baseline 25-OHD levels in relation to QoL assessments and pain scores did not reveal a statistically significant association, indicating that variations in baseline vitamin D levels may not substantially impact QoL or pain perception. Further studies may help determine how to assess and optimize vitamin D levels in patients with chronic pain on long-term prescription opioids.

Serum vitamin D deficiency is intricately linked to metabolic disorders, however, evidence on its association with continuous metabolic risk in children and adolescents remains insufficient. This study aims to elucidate the relationship between serum vitamin D levels and continuous metabolic risk.

The cross-sectional analysis involved 4490 participants aged 6 ~ 18, and the longitudinal investigation included 1398 individuals aged 6 ~ 12 years. Serum 25(OH)D concentrations were quantified using liquid chromatography-mass spectrometry. Continuous Metabolic syndrome risk score (CMSRS), incorporating waist, blood pressure, blood lipid levels, and glucose metabolism as four components, utilizes age- and gender-specific Z scores to evaluate metabolic risk. Restricted cubic splines (RCS) were used to visualize dose-response relationships and generalized linear models (GLM) were used to estimate potential associations. Mediation analysis was used to evaluate the mediating role of levels of Neutrophil-to-lymphocyte ratio (NLR).

The RCS indicated a negative linear association between serum 25(OH)D levels and CMSRS (P-overall = 0.0066, P-nonlinear = 0.1393). GLM revealed that compared to Q1, with the quartiles of serum 25(OH)D concentrations increase, the β value ranged from 0.028 (95% CI: - 0.093, 0.037) to 0.001(95%CI: - 0.067, 0.069), and then to -0.074 (95%CI: -0.146, -0.003, P for trend = 0.0659). For every 10 ng/mL increase in serum 25(OH)D concentration corresponded to the β value change -0.058 (95%CI: -0.098, -0.017). This association was more pronounced in younger or overweight/obese individuals. Furthermore, in the longitudinal study, as the baseline quartile of serum 25(OH)D concentration increased, the estimated change of subsequent CMSRS indicated a decreasing trend, ranging from -0.085 (95%CI: -0.203, 0.032) to -0.166 (95%CI: - 0.285, - 0.046), and then to - 0.174 (95%CI: - 0.296, -0.053, P for trend = 0.0031). The mediating proportion of levels of NLR was 7.2%.

Higher serum 25(OH)D concentration is significantly associated with reduced CMSRS in children and adolescents, and adequate serum vitamin D levels play a prominent role in preventing long-term metabolic disorders, partly meditating by inflammation in peripheral blood.

To investigate the prevalence of vitamin D deficiency (VDD) in children/adolescents in extreme southern China.

This multicenter, cross-sectional study included 21,811 children aged 0-18 years from 18 districts in Hainan Province, using a multistage stratified random sampling method from January 2021 to March 2022.

Serum 25(OH)D levels decreased with age (p trend <0.001). VDD prevalence increased significantly from 3.7% (95% CI: 3.2, 4.3) in children aged 0-3 years to 43.5% (95% CI: 42.1, 45.0) in those aged 13-18 years. Girls and urban residents showed higher deficiency rates. Adolescents (13-18 years) had the highest prevalence of VDD (43.5%), while toddlers (0-3 years) had the lowest (3.7%). Factors influencing vitamin D status included gender, urban residency, and breastfeeding duration. Seasonal variations showed higher deficiency rates in autumn, particularly among preschoolers. Regional differences were noted, with the highest deficiency in semiarid and subhumid zones for various age groups.

A significant increase in VDD with age, particularly among adolescents, urban girls, and during autumn, emphasizing the need for targeted strategies.

Several nutrients are crucial in enhancing the immune system and preserving the structural integrity of bodily tissue barriers. Vitamin D (VD) and zinc (Zn) have received considerable interest due to their immunomodulatory properties and ability to enhance the body's immune defenses. Due to their antiviral, anti-inflammatory, antioxidative, and immunomodulatory properties, the two nutritional powerhouses VD and Zn are crucial for innate and adaptive immunity. As observed with COVID-19, deficiencies in these micronutrients impair immune responses, increasing susceptibility to viral infections and severe disease. Ensuring an adequate intake of VD and Zn emerges as a promising strategy for fortifying the immune system. Ongoing clinical trials are actively investigating their potential therapeutic advantages. Beyond the immediate context of the pandemic, these micronutrients offer valuable tools for enhancing immunity and overall well-being, especially in the face of future viral threats. This analysis emphasizes the enduring significance of VD and Zn as both treatment and preventive measures against potential viral challenges beyond the current health crisis. The overview delves into the immunomodulatory potential of VD and Zn in combating viral infections, with particular attention to their effects on animals. It provides a comprehensive summary of current research findings regarding their individual and synergistic impacts on immune function, underlining their potential in treating and preventing viral infections. Overall, this overview underscores the need for further research to understand how VD and Zn can modulate the immune response in combatting viral diseases in animals.

The role of the vitamin D receptor (VDR) in inflammatory bowel disease (IBD) is poorly described. The aim of this study was to examine the relationship between immunohistochemical VDR expression and IBD activity. The immunohistochemical expression of VDR was analysed in biopsies from active and inactive IBD in 28 patients (ulcerative colitis: 21, Crohn's disease: 7) and 12 non-IBD controls. VDR expression did not change in active compared to inactive disease (p = 0.40 in epithelium and p = 0.29 in stroma). There was a trend for higher VDR expression in controls compared to IBD patients. No relationship was found between VDR expression and histologic inflammation (r = -0.19, p = 0.89 for epithelium and r = 0.13, p = 0.35 for stroma), colonoscopic picture and clinical and laboratory measures including serum 25(OH) vitamin D status (r = -0.91, p = 0.82). IBD disease activity did not correlate to VDR immunohistochemical expression, nor did it differ compared to controls. These results partly conflict with prior studies, but these have only shown modest correlations. Prospective studies investigating VDR activity between IBD and controls should be contemplated.

This study examines the causal effects of sunlight exposure on suicide rates. Leveraging county-month-year data on solar insolation and suicide rates in the U.S. from 1979 to 2004, we provide first robust evidence that insufficient sunlight increases suicide rates. We also find that insufficient sunlight increases Google searches containing depressive language, suggesting a potential adverse impact on mental well-being. Importantly, our findings favor a biological pathway over alternative mechanisms. The estimated effect of sunlight on suicide, often exceeding other interventions in magnitude, sheds new light on sunlight as a significant risk factor in suicide incidence.

Studies have shown a high prevalence of vitamin D deficiency in critically ill patients, and these patients are at higher risk for pneumonia and have increased incidence of sepsis and mortality. In this study, we reviewed available literature from randomized controlled trials (RCTs) on vitamin D supplementation in critically ill patients and summarized the evidence in this narrative review.

Randomized controlled trials that included vitamin D supplementation as an intervention were eligible for inclusion. No limits were set regarding vitamin D dosage or route of administration, as well as for primary and secondary outcomes. A search was conducted in MEDLINE via PubMed for eligible RCTs. References from systematic reviews (SRs) and meta-analyses (MAs) were screened, and Clinicaltrials.gov was searched for ongoing studies.

A total of 21 RCTs involving 3166 patients were analyzed. There was a large heterogeneity in terms of patients' characteristics and inclusion criteria. Only six studies included patients with vitamin D levels < 50 nmol/L. Regarding clinically important outcomes, most of the studies did not show differences between the intervention and control group in terms of mortality, intensive care unit (ICU) or hospital length of stay (LoS).

There is great variability in trial designs regarding the selection of patients, dosage, dosing intervals and routes of administration of vitamin D supplements. Better study designs are mandatory for future clinical research, with measuring and reporting basal vitamin D levels before randomization. Since variability in supplementation regimes limits the possibility of data synthesis, standardized protocols for vitamin D supplementation should be used in clinical trial settings.

the COVID-19 pandemic underscored the necessity of understanding the factors influencing susceptibility and disease severity, as well as a better recovery of functional status, especially in postcritical patients. evidence regarding the efficacy of vitamin D supplementation in reducing the severity of COVID-19 is still insufficient due to the lack of primary robust trial-based data and heterogeneous study designs. the principal aims of our study were to determine the impact of vitamin D deficiency or insufficiency on complications during intensive care unit (icu) stay, as well as its role in muscle mass and strength improvement as well as morphofunctional recovery during a multispecialty 6-month follow-up program based on adapted nutritional support and specific physical rehabilitation. as a secondary objective, we compared the association mentioned above between patients with sarcopenic obesity and non- sarcopenic obesity.

this prospective observational study included 94 outpatients postcritical COVID-19. two weeks after hospital discharge, patients were divided into sufficient (≥30 ng/mL), insufficient (20.01-29.99 ng/mL), or deficient (≤20 ng/mL) vitamin D levels. the differences in in-hospital complications and morphofunctional parameters including phase angle (PhA), body cell mass (BCM), handgrip strength (HGS), timed get-up-and-go (UAG), 6 min walk test (6MWT), and proinflammatory biochemical variables were analyzed. Incremental (Δ) changes in these parameters were also analyzed at the end of follow-up according to vitamin D levels and the presence vs. absence of sarcopenic obesity. A multivariate linear regression analysis was performed to detect possible confounding factors in the impact analysis of vitamin D changes on functional recovery in patients with obesity.

A total of 36.2% of patients exhibited vitamin D deficiency, 29.8% vitamin D insufficiency, and only 32.9% showed sufficient levels at hospital discharge. A total of 46.8% of patients had obesity, and 36.1% had sarcopenic obesity. Vitamin D deficiency was associated with longer hospital stays (p = 0.04), longer ICU stays (p = 0.04), more days of invasive mechanical ventilation (IMV) (p = 0.04), lower skeletal muscle mass/weight (SMM/w) (p = 0.04) and skeletal muscle index (SMI) (p = 0.047), higher fat mass percentage (FM%) (p = 0.04), C-reactive-protein (CRP) (p = 0.04), and glycated hemoglobin (HbA1c) (p = 0.03), and better performance in R-HGS (p = 0.04), UAG (p = 0.03), and 6MWT (p = 0.034) when compared with those with normal vitamin D levels. At six months, Δvitamin D significantly correlated with ΔHbA1c (p = 0.002) and CRP (p = 0.049). Patients with normal vitamin D values showed better recovery of ΔSMI (p = 0.046), ΔSMM/w (p = 0.04), ΔR-HGS (p = 0.04), and ΔUAG (p = 0.04) compared to those with abnormal vitamin D levels, and these improvements in ΔR-HGS and ΔUAG were greater in the subgroup of sarcopenic obesity compared than in nonsarcopenic obesity (p = 0.04 and p = 0.04, respectively). Multivariate regression analysis detected that these results were also attributable to a longer hospital stay and lower ΔCRP in the subgroup of patients with sarcopenic obesity.

Vitamin D deficiency was associated with longer hospital stays, longer VMI requirement, worse muscle health, and a higher degree of systemic inflammation. Furthermore, normal vitamin D levels at the end of the follow-up were associated with better morphofunctional recovery in postcritical COVID-19, particularly in patients with sarcopenic obesity partly due to a higher degree of inflammation as a result of a longer hospital stay.

The Roma are a socioeconomically disadvantaged, marginalized community with reduced access to education, social services, and healthcare. Despite the known health risks they are exposed to, we have limited data about a wide range of health outcomes in this population, including vitamin D deficiency. The aim of this study was to investigate prevalence of vitamin D deficiency and its impact on the anthropometric outcomes of newborns in a group of Roma mothers and their infants in Romania.

In total, 131 Roma women and 131 newborns were included in the study. Vitamin D levels in both mothers and newborns, as well as the birth weight, length, and head circumference of newborns, were recorded at birth. We also assessed socioeconomic factors, including education, employment status, income, and living conditions, as well as factors that influence vitamin D status, including sun exposure, use of sunscreen, fish consumption, and skin type.

All mothers and almost all newborns had vitamin D insufficiency or deficiency, with 25-hydroxivitamin D levels below 30 ng/mL. Maternal vitamin D status was significantly correlated with neonatal vitamin D levels (p < 0.01) but not with anthropometric outcomes such as birth weight (p = 0.57), birth length (p = 0.53), or head circumference (p = 0.96). Most study participants had a low socioeconomic status, reporting severe deficiencies in education, employment status, household income, and living conditions.

Vitamin D deficiency is a significant public health issue among Roma women and their newborns, which may be compounded by the socioeconomic challenges of this vulnerable population.

It has been assumed that magnesium (Mg) status may interact with vitamin D status. We therefore aimed at investigating the association between Mg and vitamin D status in a large cohort of adult individuals with a high prevalence of deficient/insufficient vitamin D and Mg status.

We used data from the Ludwigshafen Risk and Cardiovascular Health Study (n = 2,286) to analyze differences according to serum Mg status in circulating 25-hydroxyvitamin D [25(OH)D] (primary endpoint), 24,25-dihydroxyvitamin D3 [24,25(OH)2D3], vitamin D metabolite ratio and calcitriol, and odds ratios for deficient or insufficient 25(OH)D (secondary endpoints). We performed unadjusted and risk score (RS) adjusted and matched analyses.

Of the study cohort (average age > 60 years), one third was 25(OH)D deficient (< 12 ng/mL), one third 25(OH)D insufficient (12 to < 20 ng/mL), about 10% Mg deficient (< 0.75 mmol/L) and additional 40% potentially Mg deficient (0.75 to 0.85 mmol/L). In adjusted/matched analyses, 25(OH)D was only non-significantly lower in Mg deficient or insufficient groups versus their respective control group (P > 0.05). Only the RS-adjusted, but not the RS-matched odds ratio of 25(OH)D deficiency was significantly lower for the group with adequate versus deficient/potentially deficient Mg status (0.83; 95%CI: 0.69-0.99), and only the RS-matched, but not the RS-adjusted odds ratio of 25(OH)D insufficiency was significantly lower for non-deficient versus deficient Mg status (0.69; 95%CI: 0.48-0.99). Other adjusted or matched secondary endpoints did not differ significantly between subgroups of Mg status.

Our data indicate only little effect between Mg and vitamin D status in adults with high prevalence of vitamin D deficiency and insufficiency.

Knee osteoarthritis (KOA) is a major cause of disability in the elderly, with its pain primarily driving medical consultations. Despite numerous studies, the role of Vitamin D in managing KOA pain remains inconclusive. This study seeks to explore the association between serum Vitamin D levels and WOMAC pain scores, providing new insights into potential treatment strategies for KOA. Utilizing data from the Osteoarthritis Initiative (OAI) database, we conducted a cross-sectional analysis involving 524 participants. Serum levels of 25-hydroxyvitamin D were measured using liquid chromatography-tandem mass spectrometry. WOMAC pain scores served as the dependent variable. Multivariable linear regression models and restricted cubic splines were employed to assess the relationship between Vitamin D levels and KOA pain, with subgroup analyses stratified by sex. Higher Vitamin D levels were significantly associated with lower WOMAC pain scores in males across all models. For females, no significant associations were observed. The analysis suggests a nonlinear relationship between Vitamin D levels and KOA pain in the general cohort, which becomes non-significant after adjustment for covariates. Our findings indicate that Vitamin D is associated with reduced pain in male patients with KOA, highlighting a potential sex-specific therapeutic approach. The results warrant further investigation through longitudinal studies and randomized controlled trials to substantiate Vitamin D supplementation as a viable treatment for reducing KOA pain in males.

The aims were to assess whether vitamin D deficiency influenced mortality risk and length of acute hospital stay in patients presenting with a hip fracture.

A retrospective study was undertaken including all patients aged over 50 years that were admitted with a hip fracture to a single centre during a 24-month period. Serum vitamin D levels on admission, patient demographics, perioperative variables and mortality were collected. Cox regression analysis was utilised to determine the independent association between serum vitamin D levels and patient mortality.

The cohort consisted of 1510 patients with a mean age of 81.3 years and 1107 (71.4%) were female. 876 (58.0%) were vitamin D deficient (< 50 nmol/l). The median follow up was 405 (IQR 249 to 610) days. During follow-up there were 464 deaths (30.7%). Vitamin D deficiency was independently associated with higher mortality risk (hazard ratio [HR] 1.26, 95% confidence interval (CI) 1.03 to 1.53, P = 0.022). Male sex (HR 1.64, 95% CI 1.34 to 2.01, P < 0.001) was also associated with a higher mortality risk. Vitamin D deficiency was not associated with length of hospital stay (median difference 0 days, P = 0.207).

Vitamin D deficiency was independently associated with increased mortality in hip fracture patients, though this finding may be influenced by lack of comprehensive adjustment for comorbidity. While the value of routine serum vitamin D measurement is debated, supplementation during hospital stays is important to reduce falls and fracture risks associated with deficiency.

Vitamin D plays a crucial role in bone, immunology, and neurophysiological functions but has inadequate bioavailability in the human body. In this paper, six different liquid beverages were used for vitamin D3 fortification, investigating the effect of different food matrices on the bioaccessibility of vitamin D. Not from concentrate (NFC) apple juice (9.34%) and NFC orange juice (8.12%) presented about 20% higher bioaccessibility of vitamin D3 than soybean and skim milk, and achieved a similar value of whole milk (8.04%). Meanwhile, the bioaccessibility of NFC apple and orange juice was markedly about 120% higher than that of apple clear juice. From the correlation analysis, the bioaccessibility of VD3 indicated significant correlations with small intestine retention (0.82) and viscosity (0.66). But small intestinal particle size showed a negative effect on bioaccessibility (-0.78). Therefore, food components, delivery matrices, and physicochemical properties of digesta were key factors to achieve higher bioaccessibility for guiding formulation design.

Consumption of diets from sustainable sources is required for planetary health, however, large sections of the population, including females of reproductive age and children, will be at risk of not meeting their micronutrient (MN) requirements in a complete transition to plant-based foods. Constrained diet optimization methods use mathematical programming to construct diets that meet predefined parameters and may contribute towards modelling dietary solutions that meet nutritional and planetary targets.

Review the evidence from diet optimization studies proposing solutions to ensure MN availability in the context of a transition to diets from sustainable sources.

Narrative review focusing on literature published over the last five years.

Dietary modelling using diet optimization can design a range of omnivorous and plant-based diets that meet individual MN requirements, have reduced environmental impacts, and minimize deviation from culturally acceptable dietary practices. Using data from large-scale dietary surveys, diet optimization can support development of food-based dietary guidelines; identify limiting MNs in a particular context or a conflict between constraints e.g. nutrition and environment; explore food-based strategies to increase nutrient supply, such as fortification; and support trial design. Methods used and outcomes reported are sources of variability. Individual-level dietary data and MN requirements for population sub-groups such as females of reproductive age and children are important requirements. Although maintaining iron and zinc intakes are regularly reported to present challenges in diets from sustainable sources, few studies have considered bioavailability, which reduces with increased dietary phytate. These and other data gaps including acceptability and affordability must be addressed to improve the applicability of modelling outcomes in population recommendations.

Dietary modelling using diet optimization can be useful in the design of more sustainable diets that meet MN requirements, however, translation of outcomes into dietary intervention studies is required to test real-world application and adoption into dietary guidelines.

Insulin resistance (IR) is a common pathology in women with polycystic ovarian syndrome (PCOS) involved in increased rates of cardiometabolic disease such as diabetes and cardiovascular disease. Low serum vitamin D is often associated with insulin resistance but there is no consensus on whether vitamin D supplementation can ameliorate markers of IR in PCOS.

We assessed evidence on the effects of vitamin D supplementation (≥ 1000 IU/day), without the use of additional supplements or other pharmacological treatments known to affect IR, on markers of IR and glycemic control in women with PCOS.

A systematic search was conducted using PubMed, Medline and Web of Science databases from January 2000 up to November 2023. Randomized controlled trials that assessed the effects of vitamin D supplementation in women with PCOS, on fasting glucose, fasting insulin, glycated haemoglobin (HbA1c) or homeostatic model assessment for insulin resistance (HOMA-IR) were included.

9 studies were identified. Study populations ranged from 28 to 180 participants, with mean ages ranging from 22 to 30 years. Daily vitamin D doses ranged from 1714-12,000 IU. Of the included studies, 3 reported statistically significant reductions in fasting glucose, 2 reported reductions in fasting insulin, 2 reported reductions in HOMA-IR, none reported reductions in HbA1c and 5 reported no differences in any of the relevant outcomes.

In conclusion, in RCTs of vitamin D supplementation in women with PCOS, the majority of studies do not report statistically significant improvements in fasting glucose, fasting insulin, HbA1c or HOMA-IR. However, as a minority of studies report some statistically significant results, further investigation may be warranted.

PROSPERO ID: CRD42023486144.

Introduction: This study investigated the health effects of two different architectural glass types: A two-layered low-iron high transmittance glass and a three-layered low energy glass with lower transmittance. The study investigated how these glass types affected daylight conditions in 72 residential apartments, as well as health and satisfaction of the residents.Methods: The study installed high transmittance glass (light transmittance LT:0.82) in 36 apartments and low transmittance (LT:0.74) in 36 identical apartments. The study then analyzed the light transmittance of each glass type in the laboratory and analyzed the indoor environmental quality (IEQ) in eight representative apartments before and after renovation. Self-reported questionnaires were handed out and collected before and after renovation.Results: The results showed that the glass types differed significantly in measured daylight transmittance. The two-layered high transmittance glass transmitted 15% more visual light (380-750 nm) and 20% more light in the spectral range (460-480 nm), stimulating ipRGCs and circadian rhythm, when compared to three-layered low energy glass. In addition, significant differences were observed in the UV-B spectrum (280-315 nm). While two-layered high transmittance glass transmitted UV-B, three-layered low transmittance glass did not. During the 12-month study period, residents in apartments with three-layered low energy glass reported more difficulties sleeping (p = 0.05), higher satisfaction with daylight (p = 0.03) and higher satisfaction with ventilation (p = 0.04). Residents in apartments with three-layered low energy glass experienced fewer days with too cold indoor temperatures (p = 0.02), compared to residents with two-layered low-iron glass. The results of energy consumption for heating showed that two-layered low-iron glass reduced the energy consumption by 11.0%, while three-layered low energy glass reduced the energy consumption by 9.4%, compared to the year prior to renovation.Conclusion: The results contribute to a discussion about potential energy savings on one hand and potential non-energy benefits, such as daylight quality, overall health, and total economy/life cycle assessment of the built environment on the other hand. The results suggest further research performed in randomized large-scale studies.

Insufficient 25-hydroxyvitamin D [25(OH)D] levels are associated with falls, fractures, and worse overall health outcomes. We evaluated 25(OH)D levels in individuals with spinal cord injury or disorder (SCI/D) during postacute rehabilitation who received vitamin D3 supplementation according to routine clinical practice. Associations with clinical outcomes were also assessed.

This prospective observational cohort study included individuals aged 18 to 85 years with newly acquired SCI/D admitted for inpatient rehabilitation to a specialized center. The following parameters were collected monthly from admission to discharge as part of the clinical routine: serum 25(OH)D, vitamin D3 supplementation, pressure injuries, bed rest, and falls. 25(OH)D levels were categorized as insufficient (≤75 nmol/L) or sufficient (>75 nmol/L). Descriptive statistics and group comparisons were performed.

Eighty-seven patients (25 [29%] females, median age 53 [IQR 39-67] years) were included and followed for 186 (163-205) days. The proportion of patients with a sufficient 25(OH)D level increased from 8% (95% CI, 3-16) to 61% (95% CI, 50-71) (p < .001). Ninety-two percent of patients received vitamin D3 (1100 [1000-2000] IU/day). No differences in 25(OH)D levels or supplementation doses were found for the occurrence of pressure injuries, bed rest, or falls.

This is the first study to examine 25(OH)D levels and vitamin D3 supplementation during postacute SCI/D rehabilitation. Insufficient 25(OH)D levels were prevalent throughout rehabilitation. For some patients, the doses of vitamin D3 used in current clinical practice may be too low to achieve sufficient 25(OH)D levels. Regular monitoring of 25(OH)D levels and individualized supplementation strategies are warranted.

Objective: Chronic rhinosinusitis with nasal polyposis (CRSwNP) is characterized by type 2 inflammation, and studies have shown that conventional therapy usually yields unsatisfactory results. While recent studies have indicated the potential effect of vitamin D on allergic and inflammatory diseases, including CRSwNP. Therefore, this study aimed to investigate the relationship between serum vitamin D levels and the severity of CRSwNP using endoscopic evaluations, imaging, patient-reported outcome measures, absolute eosinophilic count, and serum vitamin D levels and determine the prevalence of vitamin D deficiency in patients with CRSwNP. Methods: Serum vitamin D levels were measured in 104 patients with uncontrolled CRSwNP, who failed maximum medical management and were scheduled for functional endoscopic sinus surgery. Vitamin D levels were compared between patients using the Lund- Mackay (LM) score, Sinonasal Outcome Test-22 (SNOT-22), total nasal polyp scores, and absolute eosinophil counts. Results: The 104 included patients had an average age of 42.09 ± 13.3 years, and 63.5% of them were male. Mean value of vitamin D was 57.9 ± 31.2 nmol/L. The average SNOT-22 score was 65.49 ± 21.3. The mean LM score was 14.48 ± 6.64. The total nasal polyp score was 4.3 ± 2.08. Vitamin D levels were negatively correlated with LM score (r = -.210, P = .032) and polyp grade (r = -.264, P = .007), but did not correlate with other variables. Conclusions: Our study indicates that vitamin D deficiency or insufficiency is common in patients with CRSwNP. We found that low serum vitamin D levels were negatively correlated with the Lund-Mackay score and the total nasal polyp score, providing additional support for an association between low vitamin D levels and a greater severity of CRSwNP.

The aim of the study was to establish whether the level of 25 hydroxyvitamin D (25(OH)D) in serum has an influence on speed (m/s) and change of direction (COD, s) performance. Twenty male soccer players from the top league participated in the study. All subjects were evaluated for the serum concentration of 25(OH)D at the beginning of the preseason. The linear sprint test was performed at 5 m and 30 m, and COD (time and deficit) at the beginning (BPP) and after (APP) 6 weeks of the preparatory period. The results revealed that 20% of soccer players had a significant deficiency of 25(OH)D (<20 ng/mL) and 30% had insufficient 25(OH)D levels (between 20 and 30 ng/mL). Positive correlations were found between the training effect for the ∆COD (BPP-APP) (p = 0.003) and ∆deficit (BPP-APP) (p = 0.039). Significant differences were noticed for the ∆COD (m = 0.60 [s]) and ∆deficit (m = 0.56[s]) in the soccer players whose 25(OH)D concentration was <=30 ng/mL, and for the ∆COD (p = 0.002) and ∆deficit (p = 0.017) in the soccer players whose 25(OH)D concentration was >30 ng/mL. The training effect was significantly higher for the soccer players whose 25(OH)D concentration was above 30 ng/mL. Soccer players with higher 25(OH)D levels achieved superior results in the COD test and demonstrated better deficit outcomes, affirming the positive influence of 25(OH)D on muscle metabolism.

Vitamin D plays a critical role in the prevention and management of osteoporosis. However, there is an ongoing debate regarding the most effective vitamin D supplementation strategies for maintaining optimal bone mineral density (BMD) levels in adults. This study sought to establish the correlation between serum 25-hydroxyvitamin D [25(OH)D] levels and total BMD in a substantial population sample.

Data from the National Health and Nutrition Examination Survey (NHANES) for the 2011-2018 cycles, encompassing 11,375 adult participants, were analyzed. The primary variables of interest were serum 25(OH)D levels and BMD. A multivariable logistic regression model was utilized to account for relevant variables associated with these correlations.

A U-shaped relationship between serum 25(OH)D levels and BMD was observed. In males, a significant positive association was identified for 25(OH)D levels below 84.8 nmol/L (p < 0.0001), while levels above this threshold showed no significant correlation (p = 0.3377). In females, those with 25(OH)D levels below 31.4 nmol/L exhibited a significant positive association with BMD (p = 0.0010), but this association weakened and became marginally significant above this threshold (p = 0.0650).

For adult males, the optimal serum 25(OH)D level is 84.8 nmol/L, beyond which higher levels do not lead to increased BMD. A deficiency threshold for adult females should be above 31.4 nmol/L, as lower 25(OH)D levels are not conducive to BMD. These findings underscore the importance of maintaining appropriate vitamin D levels for bone health in both genders.

Vitamin D deficiency is common in many societies and causes rickets and non-skeletal disorders in children. There are no published data on vitamin D deficiency in Afghanistan. We, therefore, investigated the prevalence and associated factors of vitamin D deficiency in Afghan school children in Kandahar City, Afghanistan. This cross-sectional analytical study was conducted from September 2022 to April 2023 in 510 primary school students aged 6-15 years from six randomly selected schools. Data were analyzed by using descriptive statistics, Chi-square test, and multivariate logistic regression. Of the 510 enrolled children, 54.3% were boys and 91.8% were poor. The mean serum 25(OH)D concentration was 9.3 ng/mL. Vitamin D deficiency (< 20 ng/mL) was detected in 436/510 (85.5%) children that was severe in 267/510 (52.4%). By logistic regression analysis, independent factors for vitamin D deficiency were: (i) older age group 11-15 vs. 6 - 10 years, adjusted odds ratio (AOR) 2.8 (95% confidence interval 1.2-6.2), (ii) poverty AOR 2.0 (1.0-4.3), (iii) not doing outdoor physical activity AOR 4.8 (2.8-8.1), and (iv) daily sunlight exposure < 60 min AOR 2.2 (1.3-3.7). Although Kandahar is very sunny throughout the year, vitamin D deficiency is highly prevalent among school boys and girls, placing them at great risk of vitamin D-deficient rickets. More work is needed to define the country-wide prevalence of vitamin D deficiency to inform robust strategies of vitamin D supplementation, the provision of vitamin D-fortified food to the school children in Kandahar City and health education programs that can be conducted with the help of international organizations.

The current study aimed to investigate the association between predicted vitamin D status and depression in a prospective Spanish cohort of university graduates. The SUN Project is a dynamic cohort study designed to investigate multiple aspects of health and lifestyle. Participants were asked to complete a comprehensive questionnaire consisting of 556 items, that included a validated food-frequency questionnaire. Participants initially free of depression were classified as incident cases if they reported a medical diagnosis of depression during follow-up. Serum vitamin D levels were predicted by a previously validated equation. Vitamin D deficiency was defined as vitamin D levels below 20 ng/mL. Cox models were used to estimate adjusted hazard ratios (HR) and 95% confidence intervals (95% CI). We included 15,175 Spanish university graduates [mean (SD) age: 36.9 year (11.5)] followed-up for a median of 12.7 years. Among 192,976 person-years of follow-up, we identified 753 incident cases of depression. Participants with vitamin D deficiency had a 27% higher risk of depression as compared to those with vitamin D sufficiency (HR: 1.27, 95% CI: 1.09-1.48; p = 0.002) after adjusting for potential confounders. Furthermore, a significant effect modification by female sex was observed with higher depression risks associated with vitamin D deficiency in women than in men (p for interaction = 0.034). In educated middle-aged Spanish adults, we observed a direct association between vitamin D deficiency and the risk of depression, that was stronger among women.