The impact of dietary factors and metabolic traits on the risk of myasthenia gravis (MG) is not well understood. This study utilized two-sample Mendelian randomization (MR) to investigate the causal relationships between 16 dietary factors and 10 metabolic traits with MG risk. Using the inverse variance weighted (IVW) method, we identified significant causal associations and tested for heterogeneity using Cochran's Q test. The MR-Egger intercept was used to assess horizontal pleiotropy, and the Mendelian Randomization Pleiotropy RESidual Sum and Outlier (MR-PRESSO) framework was applied to detect and correct for potential outliers. Our analysis revealed that increased fresh fruit intake was associated with a reduced risk of MG (odds ratio [OR] = 0.023, 95% confidence interval [CI] = 0.001-0.683, p = 0.029). In contrast, higher body mass index (BMI) (OR = 2.696; 95% CI = 1.524-4.770; p < 0.001), waist circumference (OR = 2.995, 95% CI = 1.457-6.156, p = 0.003), hypothyroidism (OR = 1.337, 95% CI = 1.033-1.730, p = 0.027), and hyperthyroidism (OR = 2.240, 95% CI = 1.001-4.683, p < 0.001) were positively associated with MG risk. After adjusting for the false discovery rate (FDR), BMI and hyperthyroidism remained significantly linked to MG. No significant associations were found between MG and the other 15 dietary factors or 6 metabolic traits. These findings highlight the potential nutritional and metabolic pathways that may contribute to MG risk, suggesting that dietary interventions, particularly increasing fruit intake, and managing metabolic factors like BMI and thyroid health could play a role in the prevention and management of MG.

Background: High rates of vitamin D deficiency have been reported in population-based studies, including those conducted in Germany. The goal of this study was to evaluate vitamin D levels and associated factors in a clinical cohort of German patients presenting to a rheumatology clinic. Methods: We conducted a retrospective observational study of electronic health record data from patients presenting to a rheumatology clinic in southern Germany. Data included demographic characteristics and vitamin D levels as measured by the Elecsys® Vitamin D total III assay (Roche). Associations between vitamin D levels and patient characteristics were evaluated by Pearson correlation analyses, t-tests, and multiple regression analyses. We also explored seasonal changes. Results: A total of 4979 patients were included; 3230 (64.9%) were female and the mean (standard deviation [SD]) age was 53.6 (15.2) years. The mean (SD) vitamin D level was 27.4 (14.0) ng/mL (range, 3-240 ng/mL). Overall, 1540 (30.9%) had vitamin D levels in the deficient range (<20 ng/mL), 1774 (35.6%) had sufficient vitamin D (20 to 30 ng/mL), 1597 (32.1%) had optimal vitamin D levels (>30 to 70 ng/mL), and 68 (1.4%) had levels >70 ng/mL. Lower vitamin D levels were significantly associated with younger age, male sex, and higher body mass index. Mean levels were significantly lower during winter months and the percentages of patients with vitamin D deficiency were higher. Conclusions: Our data indicate that low levels of vitamin D are common in clinical cohorts, particularly in men, younger adults, overweight individuals, and during winter months. Patient education and/or supplementation may help to address this issue and potentially improve patient health.

Vitamin D plays a vital role in human physiology, including a crucial role in regulating bone metabolism and various extra-skeletal effects. Calcitriol exerts anti-inflammatory effects on monocytes and macrophages by increasing IL-10 production and decreasing the production of proinflammatory IL-1β, IL-6, tumor necrosis factor-α (TNF-α), receptor activator of nuclear factor kappa-Β ligand (RANKL), and cyclo-oxygenase-2 (COX-2). In addition, calcitriol also exerts important effects on adaptive immunity by downregulating MHC-II class and co-stimulatory molecules on antigen-presenting cells, but it also directly affects T lymphocytes. In multiple studies, the influence of vitamin D on eye diseases, including corneal diseases, has been demonstrated. Adequate vitamin D supplementation in patients with dry eye significantly improves tear quality and consequently heals the epithelial cells of the ocular surface. Pterygium is a fibrovascular growth of conjunctival tissue that histologically consists of superficial conjunctival epithelium and an underlying fibrovascular layer. The prevalence of pterygium depends on the region. In zones closer to the equator-"pterygium zone", it is up to 22%, and outside of them it can be even less than 2%. While UV radiation is recognized as a primary risk factor, other factors, including vitamin D, may influence its development. This review aims to summarize the effects of vitamin D on the pathophysiological mechanism of pterygium and its possible therapeutic impact. Current research suggests that vitamin D is protective through its immunomodulatory and anti-inflammatory properties. Finally, there is still insufficient evidence of the therapeutic benefit of vitamin D in pterygium, and future large-scale randomized controlled studies are needed to elucidate the exact role of vitamin D in pterygium onset and recurrence as well as its potential therapeutic benefit.

Recent years have seen a search for more effective forms of asthma therapy, with one possible option being vitamin D supplementation. The main objective of this study was to present the current state of knowledge on the effect of vitamin D supplementation on the course of asthma in children and adults; it also reviews the existing literature on prenatal vitamin D supplementation and asthma status. The search comprised articles, mostly randomized controlled trials (RCTs), included in the PubMed database and published after 2018. Most RCTs conducted on children indicate that vitamin supplementation did not affect the course of the disease, its control, or exacerbations; however, several trials in adults confirm it to have beneficial effects, with an important role being played by vitamin D deficiency. Unfortunately, the studies demonstrated considerable heterogeneity concerning the age and number of participants, dose, duration, and use of guidelines for pharmaceutical drugs, making it difficult to draw clear conclusions. Further, properly designed, large-scale studies with long-term follow-ups are needed.

The increasing global burden of allergic diseases and multimorbidity underscores the urgent need for innovative strategies to strengthen immune health. This review explores the complex relationships among nutrition, gut microbiota, immune regulation, allergic diseases, and multimorbidity. It highlights how targeted nutritional and microbial interventions may influence disease outcomes. Dietary components and microbial metabolites dynamically modulated immune function, highlighting the critical role of the gut-immune-metabolism axis in disease pathogenesis and management. Personalized nutrition, guided by advances in diagnostics such as component-resolved diagnostics, basophil activation tests, and epigenetic biomarkers, allows for precise dietary interventions tailored to individual allergy phenotypes and multimorbidity profiles. The Mediterranean diet, breastfeeding, and microbiota-targeted therapies have emerged as effective strategies to enhance immune resilience, reduce inflammation, and manage allergic reactions. Technological advancements, including artificial intelligence-driven dietary assessments, wearable devices, and mobile applications, have further revolutionized personalized dietary management, enabling real-time, precise nutritional monitoring and intervention. Despite these advances, challenges in implementing personalized nutrition persist, including variability in dietary patterns, cultural and socioeconomic factors, and accessibility concerns. Future research should focus on long-term interventional and longitudinal studies to validate precision nutrition strategies and enhance clinical applicability. This integrative approach, combining nutrition, microbiome science, technology, and personalized healthcare, holds substantial promises for sustainable disease prevention and enhanced immune resilience across diverse populations.

Objectives Depression is characterized by a lack of energy, social withdrawal, and fatigue, and it is also associated with increased inflammation in the brain. Some studies suggest that adropin may have anti-inflammatory effects and could reduce the inflammatory processes contributing to depression.

We included 54 newly diagnosed patients experiencing their first episode of depression and 56 healthy volunteers in this study. The participants with depression were divided into three subgroups based on DSM-5 and BDI-II criteria. The focus of the study was to compare adropin levels between depressive patients and healthy volunteers, as well as to monitor changes in adropin levels after six months of treatment for depressive patients.

Initial measurements showed no significant differences in standard laboratory parameters or adropin levels between the depression and control groups. However, adropin and vitamin D levels increased in the group of depressive patients during the six-month follow-up.

Our research indicates that adropin plays a significant role in the development of depression and may influence the effectiveness of depression treatments.

Vitamin D and magnesium are essential nutrients that play key roles in an athlete's performance, recovery, and overall health. Vitamin D is crucial for bone health (aiding calcium absorption and preventing stress fractures), muscle function (preventing weakness and injury), and reducing respiratory infections. Magnesium is fundamental in muscle function, adenosine triphosphate production for muscle contraction, electrolyte balance, bone strength, and cardiovascular health. The magnesium requirement of healthy adults is estimated at 300-400 mg/day, but there is evidence that athletes may have higher magnesium needs compared to sedentary persons. Magnesium and vitamin D are closely linked-vitamin D aids magnesium absorption, while magnesium is vital for vitamin D synthesis, transport, and activation. Given their importance in athletes, this article explores their functions, interactions, and the effects of deficiencies and supplementation in athletic populations.

Perfluoroalkyl and polyfluoroalkyl substances (PFAS) are a class of synthetic chemicals characterized by exceptional stability and potential for bioaccumulation. Ubiquitous in the environment, PFAS can enter the human body through water, air, and dietary sources. Exposure to PFAS has been linked to various adverse health effects, including cancer, endocrine disruption, and reproductive and developmental toxicities. Emerging evidence suggests potential interactions between PFAS exposure and vitamin levels in the human body. This review provides a comprehensive understanding of the associations between PFAS and various vitamins, elucidates potential underlying mechanisms, and offers insights for the development of targeted nutritional interventions.

Coronavirus disease 2019 (COVID-19) presents with various symptoms, and some patients develop post-COVID-19 condition (PCC). Vitamin D has shown therapeutic potential in COVID-19 and may offer benefits for PCC. The aim of this study was to evaluate the differences associated with two supplementation strategies (bolus and daily) on interleukin-6 (IL-6) levels, glutathione peroxidase (GPx) activity, and clinical outcomes in PCC patients, regardless of whether target 25 (OH) D levels reached the ideal range. We conducted a self-controlled study in which 54 participants with PCC were supplemented with vitamin D3 (n = 28 bolus and n = 26 daily) for 2 months. Blood samples were collected to measure IL-6 levels and GPx activity using spectrophotometric methods. The Hospital Anxiety and Depression Scale (HADS) was used to assess mental function. Both bolus and daily vitamin D supplementation were significantly associated with increased GPx activity and decreased IL-6 levels. Daily supplementation was additionally associated with a significant reduction in anxiety and depression scores. However, neither regimen was associated with improvements in cough, dyspnea, or fatigue. These findings suggest a potential association between vitamin D supplementation and improvements in antioxidant and neuropsychiatric parameters in PCC, possibly mediated by its immunomodulatory and antioxidant properties. Further placebo-controlled trials are warranted to determine whether these observed associations reflect causal relationships.

The pandemic crisis is now a memorable milestone in the history of science, not only for the impacts on the population's health but also for the effort of the medical community to find immediate solutions amid the pandemic so that appropriate therapeutic means can be provided. Diet and nutrition could not fail to be studied in the context of combating the side effects of COVID-19. This study attempts to detect the relationship between dietary patterns and the disease of COVID-19 and emphasizes research on probiotics by mapping the knowledge produced during the pandemic until 2024.

In addition to bibliometrics, a machine-learning framework, ASReview, was used to structure the literature search. With this method, 2,309 articles were collected from the PubMed database, with 599 constituting inputs into bibliometric software and further analysis.

Food choices, dietary patterns, vitamins and their role (vitamin D), obesity, and probiotics were keywords that attracted global research attention. Dietary supplements also constituted a field of study regarding the evolution of the disease and the impact they could have after the first pandemic wave.

Probiotics were considered an adjunct therapeutic intervention not only during the period before the development of vaccines but also alongside other therapeutic solutions. Whether used preventively or during the treatment phase, probiotics were studied to combat COVID-19 due to their potential role in immunomodulation and ability to regulate gut microbiota during respiratory infections.

Vitamin D deficiency is prevalent and linked to chronic diseases; its association with advanced liver disease progression requires clarification.

To investigate the association between vitamin D levels and risks of liver cirrhosis, hepatocellular carcinoma (HCC), and mortality, and assess risk changes after achieving sufficiency post-supplementation.

This was a retrospective cohort study.

Utilized TriNetX US data (3,905,594 patients, 2000-2024). Adults with vitamin D deficiency (20.00-30.00 ng/mL) were compared with those with sufficient levels (30.01-80.00 ng/mL). Follow-up was initiated from the first vitamin D test or start of supplementation to minimize immortal time bias. Propensity score matching (1:1) balanced >20 baseline confounders.

After matching, 1,204,760 patients with vitamin D deficiency and 1,204,760 with sufficient vitamin D levels were included. Vitamin D deficiency was associated with an increased risk of liver cirrhosis (hazard ratio (HR), 1.30; 95% confidence interval (CI), 1.25-1.36), HCC (HR, 1.22; 95% CI, 1.08-1.37), and all-cause mortality (HR, 1.14; 95% CI, 1.13-1.16). Achieving sufficient vitamin D levels reduced the risk of all-cause mortality (HR, 0.93; 95% CI, 0.88-0.99) and aligned HCC outcomes (HR, 1.16; 95% CI, 0.68-2.00). However, it did not significantly reduce the risk of liver cirrhosis (HR, 2.05; 95% CI, 1.69-2.50). Dose-response analysis showed a U-shaped relationship for liver cirrhosis and HCC, with the lowest risks at 40-60 ng/mL.

Serum vitamin D levels showed a nonlinear association with liver cirrhosis and HCC risk; deficiency independently increased the risks for cirrhosis, HCC, and mortality. Supplementation achieving sufficiency reduced mortality and normalized HCC risk but not cirrhosis risk, potentially reflecting limitations in reversing established disease. The lowest liver disease risk was associated with vitamin D levels of 40-60 ng/mL in this cohort, although causality and the clinical benefit of targeting this specific range require confirmation.

Cadmium (Cd) is a toxic heavy metal with a long biological half-life, exerting adverse effects on most tissues and organs in the human body. Inhalation, ingestion, and skin contact are the main ways of exposure to Cd. Bone is one of the target organs of Cd. The aging of the population has been considered as the reason for the high incidence rate of osteoporosis, but recent studies have emphasized that the risk of osteoporosis is related to Cd exposure. With the widespread use of Cd-containing materials in industrial and agricultural activities, the risk of Cd exposure is worrying. This review covers the epidemiological, in vivo, and in vitro studies on Cd exposure and osteoporosis. Epidemiological evidence has emphasized a positive association between Cd exposure and the occurrence rates of osteoporosis and fractures. Experimental studies have demonstrated that Cd induces osteoporosis through both direct and indirect pathways. The indirect pathway encompasses inducing renal dysfunction to impair calcium and phosphorus metabolism, whereas the direct pathway consists of directly influencing bone cells. This review aims to emphasize that Cd exposure may be an overlooked risk factor for osteoporosis and to elucidate the direct and indirect molecular mechanisms by which Cd induces osteoporosis. Understanding the pathogenesis of Cd-induced osteoporosis is crucial for the development of preventive and therapeutic strategies.

Chronic cold exposure is a stressor that may adversely affect the hippocampal structure and cognitive function. Critical for memory formation and learning processes, the hippocampus is particularly susceptible to hypothalamic-pituitary-adrenal (HPA) axis activity and elevated glucocorticoid levels. Vitamin D plays a complex role in regulating mitochondrial function and may provide neuroprotection. This study aimed to investigate the effects of chronic cold exposure on proteins associated with signaling pathways, mitochondrial function, and oxidative stress in the hippocampus of rats and to evaluate the neuroprotective potential of vitamin D3 supplementation. Male Wistar rats (n = 26) were assigned to four groups: control (CON; n = 4), sham stress (WW; n = 6), chronic cold water immersion (CCWI) (CW group; n = 8), and CCWI with 600 IU/kg/day vitamin D3 (VD3) supplementation (CW + D group; n = 8). Exposure to CCWI significantly reduced the hippocampal mass of rats, an effect not reversed by vitamin D3 supplementation. However, vitamin D3 improved mitochondrial function and exhibited antioxidant effects, partially reducing markers of protein and lipid free radicals damage in neural tissue. Our findings demonstrate the antioxidant properties of VD3 and its potential role in mitigating hippocampal damage during prolonged cold exposure, although its neuroprotective effects remain limited.

Polycystic ovary syndrome (PCOS) is a common endocrine disorder among fertile women, which is influenced by genetics and environment. A recent study revealed that PCOS patients were in a chronic inflammatory state, and they had abnormally activated macrophages. This paper introduces the relationship between PCOS and macrophages. The forkhead box protein O1 (FOXO-1), migration inhibitory factor, sympathetic conservation disorder, and vitamin D are believed to influence macrophages in PCOS. There is evidence that PCOS-associated abnormalities are associated with macrophages, including insulin resistance, obesity, hyperandrogenism (HA), hyperhomocysteinemia (HHcy), cardiometabolic disorder and gut microbiota dysbiosis. This review summarizes the research status of macrophages in PCOS. Macrophages might be a potential PCOS treatment candidate.

The causal association and biological mechanism linking serum 25-hydroxyvitamin D (25(OH)D) to stroke risk lacks epidemiological evidence.

This study aimed to investigate the association between 25(OH)D concentration and stroke risk as well as the potential mediating factors.

The community-based prospective community-based cohort study, the Chin-Shan Community Cardiovascular Cohort, was conducted from 1990 to December 2011, with external validation using a 2-sample Mendelian randomization (MR) study.

A total of 1778 participants with serum 25(OH)D data were enrolled.

In the Chin-Shan Community Cardiovascular Cohort observational study, the outcome was ascertained as stroke, while in the 2-sample MR study, it was defined as ischemic stroke. Causal effects were estimated using restricted cubic spline analysis, COX proportional hazard ratios, mediation analysis, and 2-sample MR.

Over 12 years (21 598 person-years) of follow-up, 163 participants (9.17%) developed stroke. Higher 25(OH)D concentrations were associated with lower stroke risk (hazard ratio: 0.64; 95% confidence interval, 0.43-0.96) after full-model adjustments. Mediation analysis showed a significant association between 25(OH)D concentration and stroke risk mediated by hypertension in unadjusted models (mediation percentage 23.3%, P = .008) that became nonsignificant in full models (mediation percentage, 15.5%; P = .072). Two-sample MR confirmed a significant inverse association between genetically determined 25(OH)D and stroke risk (inverse variance weighted method odds ratio 0.92; 95% confidence interval: 0.85-0.99; P = .036). However, hypertension had an insignificant mediating role in the MR study.

Higher 25(OH)D levels are linked to reduced stroke risk, potentially mediated by hypertension. Prioritizing blood pressure management may improve stroke prevention in 25(OH)D-deficient patients.

Vitamin D deficiency and sleep disorders may independently contribute to increased mortality, but the combined effects of these two factors on mortality remain unknown. This study aimed to investigate both the separate and joint effects of vitamin D deficiency and sleep disorders on cardiovascular disease mortality, as well as all-cause mortality and cancer mortality.

We analyzed data from 24,566 adults in the National Health and Nutrition Examination Survey (NHANES) from 2005 to 2018. Sleep disorders were assessed using self-report questionnaires, and vitamin D levels were measured through serum total 25-hydroxyvitamin D [25(OH)D]. Cox proportional hazards models were employed to evaluate the associations between separate and joint effects of vitamin D deficiency and sleep disorders with mortality outcomes.

Over a median follow-up of 9.08 years, we included a total of 24,566 individuals, in this study. Among them, 2,776 cases were all-cause deaths, 858 were cardiovascular disease deaths, and 644 were cancer deaths. We found that Vitamin D deficiency was independently associated with an increased risk of all-cause mortality, while sleep disorders were similarly associated with a higher risk of all-cause mortality. Notably, participants with both vitamin D deficiency and sleep disorders exhibited a significantly higher risk of all-cause mortality (HR, 2.31; 95% CI: 1.36-3.91) and cardiovascular mortality (HR, 2.39; 95% CI, 1.03-5.58) compared to those with only one or neither risk factor, even after adjusting for potential confounders.

Our study highlights that the combination of vitamin D deficiency and sleep disorders was associated with an increased risk of all-cause and cardiovascular mortality in adults. These findings might help to refine dietary and lifestyle intervention strategies for this population.

Since the beginning of COVID-19 pandemic, there has been a noticeable increase in the consumption of vitamin D. Evidence accentuates the generation of a pro-tolerogenic T helper 2 cell state with vitamin D, suppressing T helper 1 inflammatory response. T helper 2 cell polarization is characteristic of atopy. However, although the literature on vitamin D and atopy has yielded controversial results, multiple studies have described an inverse relationship between vitamin D levels and the severity of atopy, as well as an improvement of the pathology with vitamin D supplementation. A different approach is offered in the analysis of the immunological mechanisms by which vitamin D acts in the human body, supporting its use as a promoter of homeostasis. In this sense, vitamin D promotes a balanced state through the action of regulatory T cells, controlling cytokines, both pro- and anti-inflammatory, and by reducing B cell prolif eration and differentiation, thus preventing the possible development of atopy.

Musculoskeletal disorders (MSDs) represent a significant global health burden. While physical activity (PA) and physical fitness are both thought to reduce MSD risk, their independent and joint associations with MSD incidence have not been fully explored. This study investigated the independent and combined effects of PA, cardiorespiratory fitness (CRF), grip strength (GS), and GS asymmetry on MSD incidence in a large prospective cohort.

We analyzed data from the UK Biobank cohort (2006-2023), including 406,080 participants aged 37-73 years (age = 55.7 ± 8.2 years, mean ± SD; 53.0% female) who were free of MSD at baseline and during the first 2 years of follow-up. PA, derived from self-reported data and expressed in total metabolic equivalent hours per week (MET-h/week); CRF (watts (W)/kilogram (kg)), measured using a cycling exercise test; and GS (kg), measured by hydraulic hand dynamometer, were included as exposures. GS asymmetry was defined by the left-to-right hand strength ratio. MSD incidence was determined via hospital records. Time-to-event associations were analyzed using Cox proportional hazards regression models with restricted cubic splines to account for non-linear relationships. The analysis was conducted in April 2024.

Over a median follow-up of 14.7 years, a total of 73,002 incident cases of MSDs were recorded (rheumatoid arthritis: 2923; osteoarthritis: 54,955; degenerative spinal diseases: 15,124). Lower self-reported PA (<4.8 MET-h/week) was associated with increased MSD risk (hazard ratio (HR) = 1.07, 95% confidence interval (95% CI), 1.07-1.08). Low CRF (<1.7 W/kg; HR = 1.09, 95% CI, 1.06-1.13), low GS (<30.0 kg mean GS; HR = 1.11, 95% CI, 1.10-1.13), and GS asymmetry (HR = 1.11, 95% CI, 1.08-1.13) were also significantly associated with increased MSD risk. Good CRF and GS, and lower GS asymmetry mitigated the higher MSD risk associated with low PA levels.

Low levels of PA, CRF, GS, and GS asymmetry were associated with a higher risk of incident MSD. Meanwhile, improvements in CRF, GS, and GS balance could help offset the risk of MSD incidence in populations with insufficient PA.

Background: Orthopedic surgery and the corresponding events (i.e., immobilization and muscle disuse) result in a cascade of biological events to promote healing but can come with the loss of skeletal muscle mass and strength. A good nutritional status of patients is associated with positive post-surgical outcomes, with macronutrients receiving the majority of emphasis in the research literature. However, beyond the surgical literature, there are other nutrients and nutritional supplements that have been established or postulated to improve skeletal muscle mass and strength. Objective: The purpose of this narrative review is to provide evidence for the utility of using creatine, vitamin D, omega-3 fatty acids, glutamine, essential amino acids-branched chain amino acids (EAA-BCAA) and beta-hydroxy-beta-methylbutyrate (HMB) supplementation and the role they may play in minimizing muscle atrophy and strength loss following orthopedic surgery. The review will also highlight areas of future research to support a better understanding of the efficacy of supplementing with these substances pre- and/or post-surgery.

Vitamin D fortification of bakery's wheat flour, which excludes flours used for confectionaries and bulky breads, can be a suitable strategy to improve vitamin D status of the general population.

This study aimed to generate a predictive model to anticipate the effectiveness and potential risk of vitamin D-fortified bread in different fortification doses in general population.

To gather baseline data before implementation of flour fortification, a cross-sectional descriptive study was conducted on a representative sample comprising 1051 subjects aged 7-65 y from 2 cities Birjand and Yazd. Demographic, anthropometric, and laboratory assessments were performed for all subjects. The amount of bread consumption was estimated using a 24-h recall questionnaire. A simulation model was used to examine the impact of various fortification doses of vitamin D in bread on the proportion of both adults and children achieving sufficient circulating 25-hydroxycalciferol [25(OH)D] concentrations (>50 nmol/L) and potential harm thresholds (>375 nmol/L). The baseline serum 25(OH)D concentration data were used as a reference for comparison at each fortification dose. Circulating 25(OH)D between 27.5 and 50 nmol/L and below 27.5 nmol/L was considered as insufficiency and deficiency, respectively.

Substantial proportions of both children and adults fell into the insufficient (37.5% and 37.4%, respectively) and deficient (34.7% and 31.8%, respectively) categories. Our model showed that the fortification dose of 250 IU/100g bread could be an effective strategy for significantly improving vitamin D status in the general population. Higher doses, such as 500 IU/100g, results in >70% of the population achieving sufficient 25(OH)D concentrations. However, starting at 400 IU/100 g bread, a very small percentage (0.1%) of the population could reach potentially harmful concentrations.

By adding 250-350 IU vitamin D per 100 g bread, over half of the general population can reach to sufficient vitamin D status with no potential risk of toxicity.

Canine sinonasal aspergillosis (SNA) is a poorly understood disease and remains a challenge to treat. Hypovitaminosis D is associated with many infectious diseases in humans and Vitamin D (VitD) deficiency in experimental mice decreases resistance to Aspergillus fumigatus. The objective of this study was to determine whether dogs with SNA have different VitD metabolite concentrations compared to healthy dogs (HD) and dogs with other nasal conditions and if those concentrations change after cure for SNA dogs. Twenty-two dogs with SNA, 12 HD, 9 dogs with lymphoplasmacytic rhinitis (LPR) and 10 dogs with nasal neoplasia (NN) were included. Serum 25-hydroxyvitamin D2 (25(OH)D2), 25-hydroxyvitamin D3 (25(OH)D3), 24,25-dihydroxyvitamin D3 (24,25(OH)2D3), 3-epimer-25-hydroxyvitamin D3 (3-epi-25(OH)D3) concentrations were measured by a certified liquid chromatography tandem mass spectrometry method at time of diagnosis or revisit. Twelve SNA dogs were available for serial blood collection until cure. Serum 25(OH)D and 24,25(OH)2D3 were lower in dogs with SNA (mean ± standard deviation; 23 ng/ml ± 7.3 and 10.2 ng/ml ± 4.2, respectively) than in HD (34.1 ng/ml ± 7.5; P = 0.007 and 18.2 ng/ml ± 5.4; P = 0.002) while there was no difference among the other groups. Cured SNA dogs had higher serum 25(OH)D concentrations (27.7 ng/ml ± 9.4) compared to before treatment (23.1 ng/ml ± 7.7; P = 0.0002). These results further support the rationale that VitD may play a role in the complex SNA pathophysiology. Whether lower VitD status contributes to the development of the disease or is a consequence of it is unknown.

Deficiency in vitamin D is widely prevalent around the world. Oral vitamin D supplementation is suggested for older adults to sustain appropriate 25-hydroxyvitamin D (25(OH)D) levels throughout the year. At present, cholecalciferol (vitamin D3) and ergocalciferol (vitamin D2) are the most commonly used compounds. Supplementation with calcifediol (25OHD3) rather than vitamin D itself should also be considered for the treatment. We performed a systematic review of the literature with a meta-analysis to assess the effects of cholecalciferol (vitamin D3) compared to calcifediol (25OHD3) on increasing serum 25(OH)D levels.

A search of online databases was performed electronically for all relevant observational published population-based studies until November 2023, without geographical restrictions. We included studies that directly compared the effects of cholecalciferol and calcifediol on increasing concentrations of serum 25(OH)D. Only papers in English or French languages were considered. Records were screened and data were retrieved through a standardized extraction process.

Seventeen studies including 1575 participants were reviewed. Twelve intervention trials showed that, in spite of the dosage or the frequency of administration, calcifediol supplementation was more efficacious in raising serum 25(OH)D concentrations compared with cholecalciferol. Two studies showed that calcifediol and cholecalciferol were identically potent. According to three studies, cholecalciferol was more effective than calcifediol in raising 25(OH)D concentrations. A meta-analysis including randomized controlled trials (RCTs) and non-randomized trials revealed that calcifediol supplementation had a better impact on elevating serum 25(OH)D concentrations compared with the effect of cholecalciferol.

This meta-analysis suggests that calcifediol is more effective in increasing serum 25(OH)D concentrations compared to cholecalciferol. Consequently, calcifediol may emerge as the preferred option for supplementation.

Objectives: Vitamin D plays a crucial role in maintaining bone and muscle health and is associated with various health conditions. Risk factors for reduced vitamin D levels include occupation. The aim of this study was to explore the association between shift work and vitamin D levels among female workers. Methods: This cross-sectional study was conducted among 304 women from an industrial group located in southern Brazil. Vitamin D deficiency was defined as serum 25(OH)D levels < 20 ng/mL, and deficiency/insufficiency was defined as serum levels < 30 ng/mL. Work shift data were collected through interviews using the start and end times of work shifts, classified as "day shift" (6:00 AM ≤ hh:hh < 10:00 PM) and "night shift" (10:00 PM ≤ hh:hh < 6:00 AM), respectively. The association between vitamin D deficiency and shift work was expressed as prevalence ratio (PR), using Poisson regression adjusted for confounding variables. Results: The prevalence of vitamin D deficiency was 36.5% (95% CI: 31.1-41.9), while the prevalence of insufficiency was 75.7% (95% CI: 70.8-80.5). After adjustment, a significant association was found, with 65% and 17% higher probabilities of having vitamin D deficiency (PR = 1.65; 95% CI: 1.23-2.22; p = 0.001) and vitamin D deficiency/insufficiency (PR = 1.17; 95% CI: 1.02-1.35; p = 0.030) among nightshift workers compared with dayshift workers. Conclusions: The findings of this study indicate a high prevalence of hypovitaminosis D among Brazilian female fixed-shift workers as well as a higher probability of vitamin D deficiency and deficiency/insufficiency among nightshift workers compared with dayshift workers.

Individual variations in the active form of vitamin D (Vit.D) arise from a combination of dietary intake, sun exposure, and genetic factors, making it complex and challenging to maintain optimal levels. Among Vit.D-related genes, variations in CYP2R1 and CYP27B1 influence Vit.D synthesis, CYP24A1 regulates its inactivation, and the Vit.D receptor (VDR) mediates Vit.D signaling. These genetic variations contribute to substantial differences in Vit.D concentrations and associated clinical effects. However, there has been a lack of comprehensive, simultaneous exploration of these key genes and their clinical implications. This review provides a systematic analysis of genetic variants in Vit.D-related P450 genes identified in human clinical studies, along with in silico predictions of their functional consequences. Since multiple genes seem to influence the body's response to Vit.D, studying just one genetic variant may not fully explain Vit.D deficiency. A comprehensive evaluation of all Vit.D-related genes could offer valuable insights for advancing personalized medicine in Vit.D management. This study provides a foundation for developing a more personalized approach to Vit.D supplementation and regulation, guided by genetic information.

Attention deficit hyperactivity disorder (ADHD) is a common neurodevelopmental disorders often co-occurring with sleep problems and other physical disorders. Vitamin D regulates sleep and supports normal brain function. Regrettably, no studies have looked at whether vitamin D insufficiency exacerbates sleep problems in ADHD children and further affects ADHD symptoms.

This study aimed to examine whether vitamin D insufficiency exacerbates sleep problems and ADHD symptoms in children aged 6-14 years.

This is a case-control study, 260 ADHD children (aged 6-14 years) were enrolled in, of whom 95 had vitamin D insufficiency and 165 had sufficiency. Collected all ADHD symptom severity and functional impairment scales, including Swanson, Nolan and Pelham (SNAP) scale, Integrated Visual and Auditory Continuous Performance Test (IVA-CPT), Conners parents symptom questionnaire (PSQ) and Weiss Functional Impairment Rating Scale-Parent Form (WFIRS-P). All guardians of children with ADHD complete the Children's Sleep Habits Questionnaire (CSHQ).

The CSHQ total scores of the ADHD children in both groups were significantly higher than 41, which means that ADHD children overall have sleep problems. Compared to ADHD children with vitamin D sufficiency group, we observed significantly higher sleep duration and sleep disordered breathing scores in ADHD children with vitamin D insufficiency group (all p< 0.05). However, there was no direct effect of vitamin D insufficiency on the type of ADHD, symptoms or functional impairment (all p> 0.05). Further analyses showed a correlation between the CSHQ and symptoms, functional impairment scores in children with ADHD.

Sleep problems are highly prevalent in children with ADHD. Vitamin D insufficiency has a significant impact on both sleep duration and sleep disordered breathing, but no notable direct effects on ADHD symptoms or functional impairment. Our findings underscore the importance of screening for vitamin D insufficiency in children with ADHD, particularly given its association with sleep disturbances, which may indirectly affect symptom severity.

Vitamin D is an open-cyclic steroidal trace organic compound that plays a crucial role in human metabolism and nutritional health. In recent years, Mendelian randomization (MR) has emerged as a widely adopted method for analyzing causal relationships, particularly in studying the association between Vitamin D and related diseases. However, no bibliometric analyses have been conducted to explore the research hotspots and trends regarding Vitamin D status in MR studies. This study utilized the Web of Science Core Collection as a source database and retrieved articles on Vitamin D status in MR published from 2014 to 2024. Bibliometric and visualization analyses utilized VOSviewer, Microsoft Excel 2021, and Scimago Graphica. An in-depth analysis of country or region, authors, journals, keywords, and references were performed to provide insights into the content related to the field. A total of 186 documents authored by 1122 contributors across 30 countries were identified. China and the University of Bristol had the highest publication counts, with 94 and 19 articles, respectively. The nutrients published the largest number of articles, and J Brent Richards was the largest contributors. The most frequently used keywords included "Mendelian randomization," "Vitamin D," "25-hydroxyVitamin D," "obesity," and "Type 2 Diabetes." The current research focuses on using MR methods to explore the associations between Vitamin D status and metabolic, cardiovascular, immune skin, psychiatric and neurological diseases. The related research in this field will continue to increase in the next few years, which is a promising research prospect in this field. This study systematically reviews the literature from the past decade, revealing research hotspots and trends in the field of Vitamin D status within MR studies. This information will provide a strong reference for readers and researchers.

Cardiovascular diseases (CVDs) cause about 30% of deaths worldwide, increasing social and economic burden in our societies. Although the treatment of the canonical cardiovascular risk factors has reduced the impact of CVDs on morbidity and mortality in the past few years, they continue to represent a major health problem. The definition of the biological properties of the bone-heart axis has led to new insights in the pathogenesis of CVDs; hence, the aim of this review is to try to elucidate the role of this axis on the susceptibility to CVDs. There is evidence that the bone interacts with extra-skeletal organs, including the cardiovascular system, through its endocrine functions. Clinical and experimental data strongly indicate that the interplay between the bone and the cardiovascular system represents a future tool for the prevention, diagnosis and treatment of CVDs. The identification of these non-canonical cardiovascular risk factors could prompt pharmacological research towards new target therapy aimed at precision medicine.

Obesity is a risk factor for thrombosis-related diseases and a condition that leads to vitamin D deficiency. Furthermore, orthopedic conditions are also at risk for diseases associated with coagulation and endothelial function. This study aimed to assess whether vitamin D supplementation in patients with acute (AOCs) and chronic orthopedic conditions (COCs) and coexisting obesity could affect coagulation and endothelial function. Thirty-three obese individuals with AOCs or COCs were included in the study. Patients were supplemented with vitamin D at 4000 IU/day for 3 months. An enzyme-linked immunosorbent assay (ELISA) was used to measure the concentrations of alpha 2-antiplasmin (α2AP), vascular cell adhesion molecule 1 (VCAM-1), plasminogen activator inhibitor-1 (PAI-1), tissue factor pathway inhibitor (TFPI), and vitamin D, which were examined at two time points-before and after supplementation. Regardless of the increase in serum vitamin D levels in both groups after supplementation, there was a statistically significant increase in VCAM-1 and PAI-1 levels in the group with AOCs, whereas only VCAM-1 increased statistically significantly in the second group. For obese patients with COCs, vitamin D does not appear to have a potentially beneficial effect on coagulation and the endothelium.

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.

Malnutrition is a clinical condition that leads to unfavourable changes in health. It affects 35-55% of hospitalized patients, and in the case of cancer, this prevalence rises to 40-90% of patients. Screening nutritional status is essential for preventing undernutrition, which is crucial as its treatment. Undernutrition in patients after severe injuries significantly increases catabolic changes. Cytokines and hormones, such as epinephrine, glucagon, and cortisol, are released, which can increase energy expenditure by 50%. Properly conducted nutritional treatment aims to maintain or improve the nutritional status of patients whose nutrition with a natural diet is insufficient, moreover, in some cases, treatment of the underlying disease.

This study is a narrative review focused on immunonutrition. The search for source articles, mainly from the last 10 years, was conducted in the PubMed and Google Schoolar databases, as well as in printed books. The key words used were "malnutrition", "inflammation", "clinical nutrition", "immunomodulatory components", "nutritional status assessment", "enteral nutrition", "parenteral nutrition", and their combinations.

Providing substances such as omega-3 fatty acids, glutamine, arginine, nucleotides, antioxidants, and prebiotic fiber has a beneficial impact on immunological and anti-inflammatory pathways. The above-mentioned ingredients may inhibit the secretion of pro-inflammatory cytokines, activate anti-inflammatory cytokines, stimulate immune cells, and have a beneficial effect in allergic diseases, respiratory infections, or wound healing.

Immunonutrition can be administrated via oral, enteral, and parenteral routes. It is crucial to highlight the importance of proper nutritional status in patients. The relationship between inflammation and malnutrition creates a vicious cycle, where one negatively affects the other due to increased metabolic demand, loss of appetite, weakened immune system, and gut dysbiosis.

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.

To evaluate the association between sun-protective behaviours and psoriasis in a nationally representative sample of US adults.

Analysis of cross-sectional data.

National Health and Nutrition Examination Survey (NHANES), 2009-2014.

A total of 9735 participants aged 20-59 years with available data on psoriasis, sun-protective behaviours and covariates were included in the analysis.

Information on sun-protective behaviours (staying in the shade, wearing long sleeves and using sunscreen) and psoriasis was obtained from questionnaires in the NHANES database. Logistic regression models and subgroup analyses were employed to investigate the association between sun-protective behaviours and psoriasis.

After adjusting for sociodemographic variables, body mass index (BMI), alcohol drinking status, smoking status, sun sensitivity and time spent outdoors in the multivariable logistic regression model, moderate wearing of long sleeves was negatively associated with psoriasis (OR, 0.55; 95% CI 0.33 to 0.90, p=0.02), while frequent wearing showed no significant relationship. There was no significant association between staying in the shade and psoriasis, regardless of frequency. Subgroup analyses stratified by age, gender, race/ethnicity and smoking status revealed no significant associations in most groups, but moderate wearing of long sleeves was found to be negatively associated with psoriasis among those aged 20-39 years (OR, 0.42; 95% CI 0.18 to 0.98, p=0.04), among non-Hispanic white individuals (OR, 0.52; 95% CI 0.28 to 0.97, p=0.04) and among non-smokers (OR, 0.49; 95% CI 0.25 to 0.95, p=0.04), as it was among women in terms of overall sun protection (OR, 0.58; 95% CI 0.35 to 0.97, p=0.04). However, among non-Hispanic white individuals (staying in the shade: OR, 1.69; 95% CI 1.00 to 2.84, p=0.049) and former/current smokers (overall: OR, 3.28; 95% CI 1.41 to 7.63, p=0.009), frequent sun protection was positively associated with psoriasis.

Moderate sun-protective behaviours among US adults were found to be negatively associated with psoriasis. However, among non-Hispanic white individuals and former/current smokers, frequent sun protection was positively associated with psoriasis. Future studies with rigorous study design could further explore and validate the potential reasons for these associations to better inform evidence-based behavioural recommendations that protect human health.

Clinical trials consistently demonstrate an inverse correlation between serum 25-hydroxyvitamin D [25(OH)D; calcifediol] levels and the risk of symptomatic SARS-CoV-2 disease, complications, and mortality. This systematic review (SR), guided by Bradford Hill's causality criteria, analyzed 294 peer-reviewed manuscripts published between December 2019 and November 2024, focusing on plausibility, consistency, and biological gradient. Evidence confirms that cholecalciferol (D3) and calcifediol significantly reduce symptomatic disease, complications, hospitalizations, and mortality, with optimal effects above 50 ng/mL. While vitamin D requires 3-4 days to act, calcifediol shows effects within 24 h. Among 329 trials, only 11 (3%) showed no benefit due to flawed designs. At USD 2/patient, D3 supplementation is far cheaper than hospitalization costs and more effective than standard interventions. This SR establishes a strong inverse relationship between 25(OH)D levels and SARS-CoV-2 vulnerability, meeting Hill's criteria. Vitamin D3 and calcifediol reduce infections, complications, hospitalizations, and deaths by ~50%, outperforming all patented, FDA-approved COVID-19 therapies. With over 300 trials confirming these findings, waiting for further studies is unnecessary before incorporating them into clinical protocols. Health agencies and scientific societies must recognize the significance of these results and incorporate D3 and calcifediol for prophylaxis and early treatment protocols of SARS-CoV-2 and similar viral infections. Promoting safe sun exposure and adequate vitamin D3 supplementation within communities to maintain 25(OH)D levels above 40 ng/mL (therapeutic range: 40-80 ng/mL) strengthens immune systems, reduces hospitalizations and deaths, and significantly lowers healthcare costs. When serum 25(OH)D levels exceed 70 ng/mL, taking vitamin K2 (100 µg/day or 800 µg/week) alongside vitamin D helps direct any excess calcium to bones. The recommended vitamin D dosage (approximately 70 IU/kg of body weight for a non-obese adult) to maintain 25(OH)D levels between 50-100 ng/mL is safe and cost-effective for disease prevention, ensuring optimal health outcomes.

Numerous physiological systems, such as the functioning of the immune system, bone health, and the regulation of expression of genes, depend critically on vitamin D. Considering the significance of vitamin D for health, it is critical to understand how it is metabolized and the factors that affect its levels.

The objective of this study was to develop and validate an LC-MS/MS method to examine the effects of light exposure and dietary vitamin D consumption on the levels of vitamin D and its metabolites in a mouse model under consistent growth conditions throughout the year. Serum and hair samples from mice were analyzed under various experimental conditions for vitamin D and its metabolites using liquid chromatography-tandem mass spectrometry (LC-MS/MS). The experimental conditions included a vitamin D-deficient diet, a vitamin D-standard diet, and changes in ambient light exposure ranging from complete darkness to a regular light-dark cycle.

Mice fed a standard vitamin D diet and exposed to a regular light-dark cycle exhibited significantly higher levels of 25OHD3 in both serum and hair, indicating the synergistic effect of dietary vitamin D intake and light exposure. Mice fed a standard vitamin D diet but kept in continuous darkness showed moderately elevated 25OHD3 levels, demonstrating the efficacy of dietary vitamin D in maintaining adequate levels despite the absence of light. Conversely, mice fed a vitamin D-deficient diet and housed in darkness displayed 25OHD3 levels below the limit of quantification, highlighting the combined detrimental effects of dietary deficiency and lack of light exposure.

This study provides valuable insights into the complex interplay between dietary vitamin D intake, light exposure, and the regulation of vitamin D metabolism in mice. Moreover, our results underscore the potential implications for human health, suggesting the importance of adequate vitamin D intake and sunlight exposure in maintaining optimal vitamin D levels. Further research in this area has the potential to unveil additional factors influencing vitamin D metabolism, offering valuable insights into strategies for optimizing vitamin D levels in both animal models and human subjects.

Nuclear transcription factor-κB (NF-κB) activation is a pivotal event in the pathogenesis of osteoarthritis (OA). OA patients frequently exhibit vitamin D (VD) deficiency, which is commonly associated with NF-κB activation. Our study aimed to investigate whether VD could protect against OA by modulating NF-κB pathway and to explore the underlying mechanisms.

Proteins levels were assessed by western blot analysis, gene expression was quantified by quantitative real-time polymerase chain reaction (qRT‒PCR) in vivo and in vitro. The expression of phosphorylated-p65 (p-p65) in knee OA rats was detected by immunohistochemistry, and an NF-κB nuclear translocation assay was validated in chondrocytes. Immunoprecipitation was employed to detect the interaction between NF-κB and vitamin D receptor (VDR) in vivo and in vitro. Small interfering RNA (Si-NF-κB and Si-VDR) transfection was used to investigate the role of NF-κB and VDR signaling pathway in knee OA rats under VD influence. Cartilage changes were visualized of knee OA rats using hematoxylin and eosin as well as safranin-O/fast green of staining.

Our findings indicated that VD alleviates OA by inhibiting NF-κB pathway, which in turn reduces chondrocyte apoptosis and extracellular matrix (ECM) degradation. Further analysis revealed that VD primarily stabilizes NF-κB through the interaction of VDR and NF-κB, modulating the AMPK/mTOR signaling pathway to enhance autophagy and delay the progression of OA.

This study highlights the protective role of VD in OA by stabilization of NF-κB, mainly through the interaction between VDR and NF-κB. This interaction regulates the AMPK/mTOR signaling pathway, promoting autophagy and suggesting a potential therapeutic strategy for OA management. Key Points • VD confers a protective effect on OA by primarily stabilizing NF-κB through the interaction between VDR and NF-κB, which in turn inhibits NF-κB phosphorylation and nuclear translocation. • In chondrocytes, VD helps shield against OA by blocking NF-κB's entry into the nucleus, subsequently regulating autophagy via the AMPK/mTOR signaling pathway.

Sepsis and septic shock are major complications of febrile neutropenia (FN) in pediatric patients with cancer (PPCs). The aim of the present study was to determine the association of vitamin D (VD) and cathelicidin levels with sepsis and septic shock in PPCs with FN. A prospective cohort of PPCs with FN who had previously received cytotoxic chemotherapy was analyzed. At baseline, the plasma levels of VD and cathelicidin were quantified. Patients with sepsis and septic shock were compared with patients with FN without complications. Relative risks (RRs) were calculated with 95% confidence intervals (95% CIs) to determine associations. Multiple logistic regression analysis was performed to adjust the results for the identified confounders. A total of 78 episodes of FN were included; 35 (44.8%) completed their FN treatment without complications, 19 (24.4%) presented with sepsis and 24 (30.8%) progressed to septic shock. The median plasma VD level was 15.2 ng/ml, while the median plasma cathelicidin level was 27.9 ng/ml. Patients with severe VD deficiency (RR, 2.34; 95% CI, 1.17-4.70) and patients with cathelicidin levels >41.5 ng/ml (RR, 2.44; 95% CI, 1.07-5.56) exhibited a higher risk of developing sepsis compared with the control group. Patients with severe VD deficiency had a higher risk of septic shock (RR, 1.96; 95% CI, 1.02-3.79) compared with patients without complications, while cathelicidin levels were not associated with septic shock. After adjusting for confounders, cathelicidin levels >41.5 ng/ml (odds ratio, 5.52; 95% CI, 1.17-26.06) remained as an independent risk factor for progressing to sepsis. In patients who developed septic shock, the multivariate model revealed <700 leukocytes/mm3 and glucose levels >100 mg/dl as independent risk factors. In conclusion, higher plasma cathelicidin levels were independently associated with progression to sepsis in PPCs with FN.

Sunlight exposure plays an important role in human health, impacting processes such as mood, blood pressure regulation, and vitamin D3 production. Solar ultraviolet B radiation initiates vitamin D3 synthesis in the skin, which is subsequently metabolized into its biologically active form. UVB exposure plays a key role in enabling vitamin D3 synthesis, but it can also contribute to skin carcinogenesis, creating a complex interplay between its beneficial and harmful effects. Vitamin D deficiency, affecting over half the global population, is linked to a range of chronic diseases, including cancers, cardiovascular conditions, and autoimmune disorders. Simultaneously, excessive solar UVB exposure increases the risk of non-melanoma and melanoma skin cancers through mechanisms involving DNA damage and oxidative stress. This review examines the dual role of UVB radiation in health and disease, focusing on the mechanisms of cutaneous vitamin D3 synthesis, the epidemiology of skin cancer, and the protective roles of vitamin D3's photoproducts and its active metabolite, 1,25-dihydroxyvitamin D3. Understanding these interconnections is critical for developing strategies that balance adequate sun-induced vitamin D3 production with skin cancer prevention.