vitamin-b-12 and Vitamin-D-Deficiency

The purpose of this study was to conduct a literature review to examine micronutrient deficiencies in laparoscopic sleeve gastrectomy. We conducted a literature review using PubMed and Cochrane databases to examine micronutrient deficiencies in SG patients in order to identify trends and find consistency in recommendations. Seventeen articles were identified that met the defined criteria. Iron, vitamin B12 and vitamin D were the primary micronutrients evaluated. Results demonstrate the need for consistent iron and B12 supplementation, in addition to a multivitamin, while vitamin D supplementation may not be necessary. Additional prospective studies to establish a clearer picture of micronutrient deficiencies post-SG are needed.

Topics: Calcium; Dietary Supplements; Ferritins; Folic Acid; Gastrectomy; Humans; Iron; Iron Deficiencies; Laparoscopy; Micronutrients; Obesity; Prospective Studies; Retrospective Studies; Vitamin B 12; Vitamin B 12 Deficiency; Vitamin D; Vitamin D Deficiency

Nutritional requirements need to be met in order to adapt to pre- and postnatal changes. Our aim was to systematically review the evidence of associations between nutritional biomarkers and psychological distress during pregnancy and in the first postnatal year.. MEDLINE, EMBASE, PsycINFO, Scielo, LILACS, clinicaltrials.gov, International Clinical Trials Registry, Cochrane Library, Scopus and Web of Science databases were searched for articles from inception to 4/15/2016. Studies of maternal nutritional biomarkers in blood (fatty acids/micronutrients/amino acids) and associations with psychological distress (depression/anxiety/stress) were included. Two independent reviewers extracted data based on study designs, participants, outcomes, exposures, and association measures.. There was higher variability between association measures, time and scales of depression and anxiety assessments.. The majority of high-quality studies suggest that lower vitamin D levels may be associated with postpartum depression. However, further evidence is needed for guiding clinical practice on nutritional biomarkers.

Topics: Adult; Anxiety Disorders; Biomarkers; Depression, Postpartum; Depressive Disorder; Female; Folic Acid; Humans; Maternal Nutritional Physiological Phenomena; Micronutrients; Postpartum Period; Pregnancy; Pregnancy Complications; Vitamin B 12; Vitamin D; Vitamin D Deficiency

Micronutrient deficiencies are common in pregnant women due to low dietary intake and increased requirements for fetal development. Low maternal micronutrient status is associated with a range of pregnancy pathologies involving placental dysfunction, including fetal growth restriction (FGR), small-for-gestational age (SGA), pre-eclampsia and preterm birth. However, clinical trials commonly fail to convincingly demonstrate beneficial effects of supplementation of individual micronutrients, attributed to heterogeneity and insufficient power, potential interactions and lack of mechanistic knowledge of effects on the placenta. We aimed to provide current evidence of relationships between selected micronutrients (vitamin D, vitamin A, iron, folate, vitamin B12) and adverse pregnancy outcomes, combined with understanding of actions on the placenta. Following a systematic literature search, we reviewed data from clinical,

Topics: Animals; Dietary Supplements; Female; Fetal Development; Folic Acid; Folic Acid Deficiency; Humans; Infant, Newborn; Iron; Iron Deficiencies; Iron, Dietary; Micronutrients; Models, Animal; Placenta; Pregnancy; Pregnancy Complications; Pregnancy Outcome; Randomized Controlled Trials as Topic; Trophoblasts; Vitamin A; Vitamin A Deficiency; Vitamin B 12; Vitamin B 12 Deficiency; Vitamin D; Vitamin D Deficiency

Nutrition is considered to be a possible factor in the pathogenesis of the neurological disease multiple sclerosis (MS). Nutrition intervention studies suggest that diet may be considered as a complementary treatment to control the progression of the disease; a systematic review of the literature on the influence of diet on MS was therefore conducted. The literature search was conducted by using Medlars Online International Literature (MEDLINE) via PubMed and Scopus. Forty-seven articles met the inclusion criteria. The reviewed articles assessed the relations between macro- and micronutrient intakes and MS incidence. The patients involved used alternative therapies (homeopathy), protocolized diets that included particular foods (herbal products such as grape seed extract, ginseng, blueberries, green tea, etc.), or dietary supplements such as vitamin D, carnitine, melatonin, or coenzyme Q10. Current studies suggest that high serum concentrations of vitamin D, a potent immunomodulator, may decrease the risk of MS and the risk of relapse and new lesions, while improving brain lesions and timed tandem walking. Experimental evidence suggests that serum vitamin D concentration is lower during MS relapses than in remission and is associated with a greater degree of disability [Expanded Disability Status Scale (EDSS) score >3]. The findings suggest that circulating vitamin D concentrations can be considered a biomarker of MS and supplemental vitamin D can be used therapeutically. Other studies point to a negative correlation between serum vitamin B-12 concentrations and EDSS score. Vitamin B-12 has fundamental roles in central nervous system function, especially in the methionine synthase-mediated conversion of homocysteine to methionine, which is essential for DNA and RNA synthesis. Therefore, vitamin B-12 deficiency may lead to an increase in the concentration of homocysteine. Further research is clearly necessary to determine whether treatment with vitamin B-12 supplements delays MS progression.

Topics: Diet; Dietary Supplements; Disease Progression; Humans; Multiple Sclerosis; Nutritional Status; Vitamin B 12; Vitamin B 12 Deficiency; Vitamin D; Vitamin D Deficiency; Vitamins

To consolidate information available on the effect of vitamin B12 on bone mineral density and fracture risk, with emphasis on clinical trials, observational and longitudinal data conducted in humans.. A systematic review of the literature of the past decade on the role of vitamin B12 in bone mineral density and fracture risk in subjects of all ages and both sexes was performed by means of a PubMed, Science Direct, Medline and SciELO database search. Articles included in this review were identified using the search terms: B12 Vitamin and Bone Mineral Density and Vitamin B12 and Risk of Fractures. Evidence quality of the included articles was evaluated by GRADE system.. A total of 25 original studies were identified. After reviewing the titles and abstracts of articles, only 17 articles met the inclusion criteria. The present review provides evidence that the role of vitamin B12 on bone mineral density or fracture risk should be further elucidated. Controversies are explained by heterogeneity of methodologies used for the diagnosis of vitamin B12 and also by differences among populations investigated on the studies.. A real effect of vitamin B12 deficiency in bone health and the mechanisms associated with bone metabolism is not well established yet. It is extremely important to carry out more clarifying studies about this theme, especially with vulnerable groups such as postmenopausal and elderly women, as is well-known that they are greatly affected by deficiency of this vitamin.

Topics: Adult; Bone Density; Clinical Trials as Topic; Dietary Supplements; Female; Fractures, Bone; Humans; Male; Risk Factors; Vitamin B 12; Vitamin D Deficiency

The objective of this review was to evaluate the evidence from human studies on the intake of vitamins, either as monotherapies or in combination with other vitamins, as neuroprotective agents that may delay the onset of cognitive decline in older adults.. Evidence-based methodologies were used to capture and evaluate the highest levels of evidence.. The current evidence available showed no association for cognitive benefits of vitamins B6 or B12 as a monotherapy, and recent systematic reviews provide no clear evidence that supplementation with vitamin B6, B12 and/or folic acid improves dementia outcomes or slows cognitive decline, even though it may normalise homocysteine levels. Meta-analyses from systematic reviews have shown an association between low vitamin D levels and diminished cognitive function, although causality cannot be confirmed from the available evidence. There is no convincing evidence for an association of vitamin A, vitamin C or vitamin E either as a monotherapy or in combination with other antioxidant vitamins such as β-carotene and the prevention of cognitive decline. The appraisal of nineteen systematic reviews and meta-analyses has highlighted the heterogeneity between studies, and the need for better consensus on definitions of cognitive decline, duration of testing and agreement on which specific endpoints are clinically relevant.. Evaluation of the totality of the currently available evidence indicates that intake of the above vitamins, either as a monotherapy, or in combination with other vitamins, has no clinically-relevant effect on delaying cognitive decline or delaying the onset of dementia in older adults.

Topics: Aged; Antioxidants; Ascorbic Acid; beta Carotene; Cognition; Cognition Disorders; Dementia; Dietary Supplements; Folic Acid; Homocysteine; Humans; Meta-Analysis as Topic; Vitamin A; Vitamin B 12; Vitamin B 6; Vitamin D; Vitamin D Deficiency; Vitamin E; Vitamins

Bariatric surgery aims at weight reduction of severely obese patients. The Roux-en-Y technique is one of the most common bariatric procedures and is occasionally accompanied by nutrient insufficiencies and metabolic changes. According to the literature, skin architecture and immunity change after bariatric surgery and may lead to inflammation and increased susceptibility to pathogens. Additionally, vitamin and mineral deficiencies frequently develop in these patients and affect the skin's defense mechanisms, possibly contributing to dermatological complications. Knowledge and recognition of skin changes after bariatric surgery make an important asset for the dermatologist and help in the proper treatment of these patients. We report 2 cases of infectious skin lesions where vitamin and trace element deficiencies have possibly contributed to their persistence and resistance to traditional treatments.

Topics: Abscess; Acinetobacter baumannii; Acinetobacter Infections; Anti-Bacterial Agents; Calcium; Female; Gastric Bypass; Humans; Leg Ulcer; Middle Aged; Obesity, Morbid; Pseudomonas aeruginosa; Pseudomonas Infections; Recurrence; Skin Diseases, Bacterial; Vitamin B 12; Vitamin B 12 Deficiency; Vitamin D; Vitamin D Deficiency; Zinc

Topics: Abnormalities, Drug-Induced; Anticonvulsants; Blood Coagulation; Epilepsy; Female; Fetal Death; Fetus; Folic Acid Deficiency; Humans; Infant, Newborn; Maternal-Fetal Exchange; Obstetric Labor Complications; Pregnancy; Pregnancy Complications; Vitamin B 12; Vitamin D; Vitamin D Deficiency; Vitamin K

To evaluate the efficacy of stoss therapy using fortified biscuit for vitamin D-deficient children.. A total of 108 children aged 30-72 months with vitamin D deficiency were studied in a randomized single-blind clinical trial. The deficient children were assigned to three groups, namely, vitamin D-fortified biscuit (BG), capsule vitamin D (CG), and ampoule vitamin D (AG). Capsules and biscuits containing 50,000 IU of cholecalciferol were consumed twice per week for 3 consecutive weeks. Ampoules with 300,000 IU of cholecalciferol were injected intramuscularly in a single dose. Three weeks after treatment, serum 25(OH)D concentrations were measured, and the three groups were compared.. Each method of treatment could increase the mean serum 25(OH)D concentration to optimal level. Serum 25(OH)D concentrations ≥100 ng/mL were observed in six children, including four from AG and two from CG (P = 0.09). The comparison of the mean serum 25(OH)D concentrations after treatment showed between ampoule and capsule (P = 0.3) and capsule and biscuit (P = 0.62) were insignificant; however, the ampoule and biscuit groups differed significantly (P = 0.012).. Stoss therapy using fortified biscuit may be an effective way to improve compliance in children who cannot take capsules without adverse effects and may also be recommended for prevention purposes.

Topics: Child; Child, Preschool; Cholecalciferol; Cross-Sectional Studies; Female; Food, Fortified; Humans; Male; Single-Blind Method; Vitamin B 12; Vitamin D; Vitamin D Deficiency

Patients with small intestinal neuroendocrine tumours (SI-NET) often have diarrhoea from hormonal overproduction, surgery and medical treatment, leading to malabsorption of bile salts, fats, vitamin B12 and fat-souble vitamins. This could lead to malnutrition.. We assessed nutritional status in 50 consecutive out patients with disseminated SI-NET, 25 patients in each cohort. The first cohort was descriptive and the second cohort supplemented with vitamin D, B12 and calcium. Vitamin D deficiency was defined as <50 nmol/l. All patients were assessed by clinical chemistry and dual-energy X-ray absorptiometry (DXA) and interviewed about weight changes, appetite, gastrointestinal disorders, sunhabits and the use of supplements.. In the first cohort, 29% of the patients were severely and 17% moderately vitamin D deficient. In patients without prior substitution, 32% had subnormal vitamin B12 levels. Seventy-six percent had low bone density. In the second cohort with vitamin and mineral supplementation, none had severe vitamin D deficiency, but 28% had moderate deficiency. No patient had subnormal vitamin B12 levels. Sixty percent had low bone density. The serum levels of vitamin D and B12 were higher and parathyroid hormone (PTH) lower in the second cohort compared with the first cohort (P⩽0,022). Vitamin D and PTH were negatively correlated, r=-30, P=⩽0.036.. Low serum levels of vitamin D and vitamin B12, and low bone density are common in patients with disseminated SI-NET. Supplementation of vitamin D, B12 and calcium resulted in higher serum levels of vitamins, lower PTH levels and diminished severe vitamin D deficiency and is thus recommended as standard care.

Topics: Absorptiometry, Photon; Aged; Aged, 80 and over; Bone Density; Carcinoid Tumor; Diarrhea; Dietary Supplements; Female; Humans; Intestinal Absorption; Intestinal Neoplasms; Intestine, Small; Male; Middle Aged; Nutritional Status; Parathyroid Hormone; Vitamin B 12; Vitamin B 12 Deficiency; Vitamin D; Vitamin D Deficiency; Vitamins

Both vitamin D and iron deficiencies are widespread globally, and a relationship between these deficiencies has been suggested. However, there is a paucity of randomised controlled trials assessing the effect of vitamin D supplementation on iron status.. We aimed to investigate whether 16 weeks of daily vitamin D3 supplementation had an effect on serum ferritin, haemoglobin, serum iron and transferrin saturation.. Overall, 251 participants from South Asia, Middle East and Africa aged 18-50 years who were living in Norway were randomised to receive daily oral supplementation of 10 μg vitamin D3, 25 μg vitamin D3, or placebo for 16 weeks during the late winter. Blood samples from baseline and after 16 weeks were analysed for serum 25-hydroxyvitamin D (s-25(OH) D), serum ferritin, haemoglobin and serum iron. In total, 214 eligible participants completed the intervention (86 % of those randomised). Linear regression analysis were used to test the effect of vitamin D3 supplementation combined (10 or 25 μg) and separate doses 10 or 25 μg compared to placebo on change (T2-T1) in each outcome variable adjusted for baseline s-25(OH)D values.. There was no difference in change in the levels of s-ferritin (1.9 μg/L, 95 % CI: -3.2, 7.0), haemoglobin (-0.02 g/dL, 95 % CI: -0.12, 0.09), s-iron (0.4 μg/L, 95 % CI: -0.5, 1.3) or transferrin saturation (0.7 %, 95 % CI: -0.6.1, 2.0) between those receiving vitamin D3 or those receiving placebo. Serum 25-hydroxyvitamin D increased from 29 nmol/L at baseline to 49 nmol/L after the intervention, with little change in the placebo group.. In this population of healthy ethnic minorities from South Asia, the Middle East and Africa who had low vitamin D status, 16 weeks of daily supplementation with 10 or 25 μg of vitamin D3 did not significantly affect the haemoglobin levels or other markers of iron status.

Topics: Adolescent; Adult; Anemia, Iron-Deficiency; Asia; C-Reactive Protein; Cholecalciferol; Dietary Supplements; Dose-Response Relationship, Drug; Double-Blind Method; Ethnicity; Female; Ferritins; Folic Acid; Hemoglobins; Humans; Iron; Linear Models; Male; Middle Aged; Middle East; Norway; Nutritional Status; Transferrin; Vitamin B 12; Vitamin D Deficiency; Young Adult

The MAINTAIN study is an on-going RCT comparing high-dose micronutrient and anti-oxidant supplementation versus recommended daily allowance (RDA) vitamins in slowing HIV immune deficiency progression in ART-naïve people with HIV infection.. We planned analysis of the first 127 participants to determine the baseline prevalence of serum micronutrient deficiencies and correlates, as well as tolerance and adherence to study interventions.. Participants receive eight capsules twice daily of 1) high-dose or 2) RDA supplements for two years and are followed-up quarterly for measures of immune deficiency progression, safety and tolerability. Regression analysis was used to identify correlates of micronutrient levels at baseline. Adherence was measured by residual pill count, self-report using the General Treatment Scale (GTS) and short-term recall HIV Adherence Treatment Scale (HATS).. Prior micronutrient supplementation (within 30 days) was 27% at screening and 10% of study population, and was not correlated with baseline micronutrient levels. Low levels were frequent for carotene (24%<1 nmol/L), vitamin D (24%<40 nmol/L) and serum folate (20%<15 nmol/L). The proportion with B12 deficiency (<133 pmol/L) was 2.4%. Lower baseline levels of B12 correlated lower baseline CD4 count (r = 0.21, p = 0.02) with a 21 pmol/L reduction in B12 per 100 cells/µL CD4. Vitamin D levels were higher in men (p<0.001). After a median follow-up of 1.63 years, there were 19 (15%) early withdrawals from the study treatment. Mean treatment adherence using pill count was 88%. Subjective adherence by the GTS was 81% and was moderately but significantly correlated with pill count (r = 0.29, p<0.001). Adherence based on short-term recall (HATS) was >80% in 75% of participants.. Micronutrient levels in asymptomatic HIV+ persons are in keeping with population norms, but micronutrient deficiencies are frequent. Adherence levels are high, and will permit a valid evaluation of treatment effects.. ClinicalTrials.gov NCT00798772.

Topics: Adult; Anti-HIV Agents; Carotenoids; CD4 Lymphocyte Count; Diet; Dietary Supplements; Disease Progression; Female; Folic Acid; HIV Infections; Humans; Male; Micronutrients; Middle Aged; Patient Compliance; Recommended Dietary Allowances; Self Report; Vitamin B 12; Vitamin B 12 Deficiency; Vitamin D; Vitamin D Deficiency

Iron, vitamin B12, and folic acid deficiencies are among the most common deficiencies occurring after laparoscopic Roux-en-Y gastric bypass (LRYGB). The present study evaluates the effectiveness of a specially designed multivitamin supplement (WLS Forte, FitForMe, Rotterdam, the Netherlands) specifically developed for LRYGB patients.A triple-blind, randomized, 12-month study was conducted comparing WLS forte with a standard multivitamin supplement (sMVS) containing approximately 100% of the recommended daily allowance (RDA) for iron, vitamin B12, and folic acid. WLS Forte contains vitamin B12 14000% RDA, iron 500% RDA, and folic acid 300% RDA.In total, 148 patients (74 in each group) underwent a LRYGB procedure. Baseline characteristics were similar for both groups. Per protocol analysis demonstrated that sMVS treatment was associated with a decline in ferritin (-24.4 ± 70.1 μg/L) and vitamin B12 (-45.9 ± 150.3 pmol/L) over 12 months, whereas in WLS Forte patients, ferritin remained stable (+3.2 ± 93.2 μg/L) and vitamin B12 increased significantly (+55.1 ± 144.2 pmol/L). The number of patients developing ferritin or vitamin B12 deficiency was significantly lower with WLS Forte compared with sMVS (P < 0.05). Iron deficiency (ID) was reduced by 88% after WLS Forte compared with sMVS. Adverse events related to supplement use did not occur.An optimized multivitamin supplement is safe and reduces the development of iron and vitamin B12 deficiencies after LRYGB.

Topics: Avitaminosis; Dietary Supplements; Folic Acid; Folic Acid Deficiency; Gastric Bypass; Hematologic Tests; Humans; Iron; Netherlands; Vitamin B 12; Vitamin B 12 Deficiency; Vitamin D Deficiency

It was tested if a healthy school meal would result in significant changes in selected blood parameters and if such parameters would lie within generally accepted optimal values.. The study was a block-randomized, controlled trial in which 145 pupils delivered blood before (week 39) and after the intervention (week 49). The intervention group received a healthy meal for two months (25-30% of the daily intake of calories). Blood samples were analyzed for 17 parameters related to carbohydrate, fat and protein metabolism as well as vitamins and minerals.. During the intervention period, the intervention group showed a significant change in mean values for thyroid-stimulating hormone (TSH), calcium (CA) haemoglobin (HB), cobalamin (COBA) and creatinine (CREA) compared with the control group (p < 0.025). The optimal value for vitamin D in serum is about 80 nmol/l. In week 49, more than 94% of the pupils were lower than 80 nmol/l, and they generally had low calcium values.. The intervention group showed significant alterations in TSH, CA, HB, COBA and CREA values from the start to the end of the intervention period compared with the control group. The results should be confirmed in a study with more participants over a longer period of time. The teenagers in the study did not have sufficient vitamin D. Treating adolescents with a daily dose of vitamin D should be considered .

Topics: Adolescent; Blood Specimen Collection; Calcium; Child; Creatinine; Denmark; Diet; Energy Intake; Female; Food; Food Services; Hemoglobins; Humans; Male; Nutrition Surveys; Reference Values; Schools; Thyrotropin; Vitamin B 12; Vitamin D Deficiency

Vitamin B12 (vit B12) or cobalamin is a water-soluble vitamin that acts as a coenzyme and is effective in the formation of a healthy nervous system and erythrocytes. In its deficiency, except fatigue and weakness, may cause serious signs and symptoms such as macrocytic anemia, cognitive-developmental delay, irreversible neurological damage. In this study, hemoglobin, leukocyte, thrombocyte, iron, iron-binding, ferritin, and vit B12 levels were evaluated retrospectively during the routine controls of 689 children 5 to 18 years old without any complaints. In addition, the relationship between serum 25-Hydroxyvitamin D (vit D) levels and vit B12 levels, which were evaluated in 487 of the cases, was investigated. Vit B12 deficiency was diagnosed in a total of 160 (23.2%) cases, 99 (24.4%) girls and 61 (21.4%) boys. Vit B12 level was significantly lower in children over 12 years old. Vitamin D deficiency was found to be 49.3% in 487 cases and was significantly higher in the group under 12 years and girls. The frequency of anemia was 7.2% in this group. There was a significant relationship between vit D deficiency and vit B12 deficiency. In conclusion, vit B12 deficiency is common in school-age children, especially in the adolescent age group. It should be known that vit D deficiency may also be present in vit B12 deficiency cases. More comprehensive studies are needed to reveal the relationship between B12 and vit D deficiency.

Topics: Adolescent; Child; Child, Preschool; Female; Humans; Iron; Male; Retrospective Studies; Vitamin B 12; Vitamin B 12 Deficiency; Vitamin D; Vitamin D Deficiency; Vitamins

The goal of this study was to assess the anthropometric and biochemical parameters of children and adolescents with phenylketonuria (PKU).. The participants in this cross-sectional study ranged in age from four to 18 years old. Biochemical markers such as vitamin B12, folic acid, iron, ferritin, calcium, 25-hydroxy vitamin D3, zinc, plasma phenylalanine (Phe) and tyrosine (Tyr) levels in blood were evaluated, as well as demographics and anthropometric measurements. A three-day dietary recall questionnaire was completed by all individuals.. 80% (64) of the 80 patients (42 females, 52.5%) had typical PKU. Consanguineous marriages were found in 57.5% (46) of the patients' parents. According to the height for age index, 17.5% of the study group (n = 14) were short or very short. According to age-related weight and body mass index (BMI), 37.5% (n = 30) and 43.8% (n = 35) of people are obese or overweight, respectively. Biochemical tests revealed increased vitamin B12 levels and 25-hydroxy vitamin D3 deficiency in 35% (n = 28) of the patients, insufficient folic acid in 12.5% (n = 10), and elevated phenylalanine levels in 70.3% (n = 45) of children under 12 years old, and adolescents 62.5% (n = 10). A high Phe intake (OR = 4.44, CI %95 = 1.27-15.57) is a risk factor for obesity and overweight.. Patients with PKU had a high rate of overweight and obesity. PKU patients who are overweight or obese do not differ from normal-weight patients in terms of dietary intake or laboratory findings (except for serum iron levels). One-third of patients with phenylketonuria were vitamin D deficient and had a BMI/A index of overweight/obese. It is recommended to use special medical food to help solve energy and nutrient deficiencies.

Topics: Adolescent; Child; Child, Preschool; Cholecalciferol; Cross-Sectional Studies; Female; Folic Acid; Humans; Iron; Nutritional Status; Obesity; Overweight; Phenylalanine; Phenylketonurias; Vitamin B 12; Vitamin D Deficiency

The cholesterol-oxidized metabolite 27-hydroxycholesterol (27-OHC) is synthesized by CYP27A1, which is a key factor in vitamin D and oxysterol metabolism. Both vitamin D and 27-OHC are considered to play important roles in Alzheimer’s disease (AD). The study aims to research the effects of co-supplementation of vitamin D, folic acid, and vitamin B12 on learning and memory ability in vitamin D-deficient mice, and to explore the underlying mechanism. In this study, C57BL/6J mice were fed a vitamin D-deficient diet for 13 weeks to establish a vitamin D-deficient mice model. The vitamin D-deficient mice were then orally gavaged with vitamin D (VD), folic acid (FA), and vitamin B12 (VB12) alone or together for eight weeks. Following the gavage, the learning and memory ability of the mice were evaluated by Morris Water Maze and Novel object recognition test. The CYP27A1-related gene and protein expressions in the liver and brain were determined by qRT-PCR. The serum level of 27-OHC was detected by HPLC-MS. Serum levels of 25(OH)D, homocysteine (Hcy), and S-Adenosylmethionine (SAM) were measured by ELISA. After feeding with the vitamin D-deficient diet, the mice performed longer latency to a platform (p < 0.001), lower average speed (p = 0.026) in the Morris Water Maze, a lower time discrimination index (p = 0.009) in Novel object recognition, and performances were reversed after vitamin D, folic acid and vitamin B12 supplementation alone or together (p < 0.05). The gene expressions of CYP27A1 in the liver and brain were upregulated in the vitamin D-deficiency (VDD) group compared with the control (CON) group (p = 0.015), while it was downregulated in VDD + VD and VDD + VD-FA/VB12 groups compared with the VDD group (p < 0.05), with a similar trend in the protein expression of CYP27A1. The serum levels of 27-OHC were higher in the VDD group, compared with CON, VDD + VD, and VDD + VD-FA/VB12 group (p < 0.05), and a similar trend was found in the brain. The serum 25(OH)D levels were significantly decreased in the vitamin D-deficiency group (p = 0.008), and increased in the vitamin D-supplemented group (p < 0.001). The serum levels of SAM were higher in the B vitamins-supplemented group, compared with CON and VDD groups (p < 0.05). This study suggests that CYP27A1 expression may be involved in the mechanism of learning and memory impairment induced by vitamin D deficiency. Co-supplementation with vitamin D, folic acid, and vitamin B12 significantly reverses this eff

Topics: Animals; Folic Acid; Memory Disorders; Mice; Mice, Inbred C57BL; S-Adenosylmethionine; Vitamin B 12; Vitamin B Complex; Vitamin D; Vitamin D Deficiency

The interplay between female fertility and autoimmune diseases (AIDs) can involve HLA haplotypes and micronutrients. We analyzed the distribution of HLA-DQ2/-DQ8 in women with infertility or recurrent spontaneous abortion (RSA) and possible associations with AIDs and micronutrient status.. Consecutive women (. DQA1*05/B1*02 and the occurrence of at least one DQ2 allele were more prevalent among RSA and infertile women than controls. Infertile women showed lower 25(OH)D and higher prevalence of AIDs than RSA women. In the multivariate analysis, DQA1*05/B1*02 was associated with a significantly higher risk of AIDs in infertile women, and DQA1*05 was independently associated with both 25(OH)D deficiency and AIDs. In RSA women, the presence of AIDs was associated with a significantly higher risk of 25(OH)D deficiency.. Our findings showed, for the first time, a higher proportion of DQ2 alleles in infertile and RSA women as compared to controls. Predisposing DQ2 alleles are independent risk factors for AIDs and 25(OH)D deficiency in infertile women and could represent biomarkers for performing early detection of women requiring individually tailored management.

Topics: Abortion, Habitual; Adult; Alleles; Autoimmune Diseases; Autoimmunity; Biomarkers; Female; Ferritins; Folic Acid; Genetic Predisposition to Disease; Genotype; Haplotypes; HLA-DQ Antigens; Humans; Infertility, Female; Micronutrients; Nutritional Status; Pregnancy; Risk Factors; Vitamin B 12; Vitamin D; Vitamin D Deficiency

The use of vitamin D to reduce the severity of COVID-19 complications is receiving considerable attention, backed by encouraging data. Its purported mode of action is as an immune modulator. Vitamin D, however, also affects the metabolism of phosphate and Mg, which may well play a critical role in SARS-CoV-2 pathogenesis. SARS-CoV-2 may induce a cytokine storm that drains ATP whose regeneration requires phosphate and Mg. These minerals, however, are often deficient in conditions that predispose people to severe COVID-19, including older age (especially males), diabetes, obesity, and usage of diuretics. Symptoms observed in severe COVID-19 also fit well with those seen in classical hypophosphatemia and hypomagnesemia, such as thrombocytopenia, coagulopathy, dysfunction of liver and kidneys, neurologic disturbances, immunodeficiency, failure of heart and lungs, delayed weaning from a respirator, cardiac arrhythmia, seizures, and, finally, multiorgan failure. Deficiencies of phosphate and Mg can be amplified by kidney problems commonly observed in patients with COVID-19 resulting in their wastage into urine. Available data show that phosphate and Mg are deficient in COVID-19, with phosphate showing a remarkable correlation with its severity. In one experiment, patients with COVID-19 were supplemented with a cocktail of vitamin D

Topics: COVID-19; COVID-19 Drug Treatment; Dietary Supplements; Humans; Magnesium; Magnesium Deficiency; Vitamin B 12; Vitamin B 12 Deficiency; Vitamin D; Vitamin D Deficiency; Vitamins

Patients with inflammatory bowel disease (IBD) and intestinal Behçet's disease (BD) are vulnerable to micronutrient deficiencies due to diarrhea-related gastrointestinal loss and poor dietary intake caused by disease-related anorexia. However, few studies have investigated the incidence and risk factors for micronutrient deficiency.. We retrospectively analyzed 205 patients with IBD who underwent micronutrient examination, including folate, vitamin B12, 25-OH-vitamin D, and/or ferritin level quantification, with follow-up blood tests conducted 6 months later.. Eighty patients (39.0%), who were deficient in any of the four micronutrients, were classified as the deficiency group, and the remaining 125 (61.0%) were classified as the non-deficient group. Compared to those in the non-deficiency group, patients in the deficiency group were much younger, had more Crohn's disease (CD) patients, more patients with a history of bowel operation, and significantly less 5-amino salicylic acid usage. Multivariate analysis revealed that CD and bowel operation were significant independent factors associated with micronutrient deficiency.. The incidence of micronutrient deficiency was high (39.0%). Factors including CD, bowel operation, and younger ages were found to be associated with higher risks of deficiency. Therefore, patients with IBD, especially young patients with CD who have undergone bowel resection surgery, need more attention paid to micronutrition.

Topics: Behcet Syndrome; Ferritins; Folic Acid; Humans; Incidence; Inflammatory Bowel Diseases; Micronutrients; Retrospective Studies; Risk Factors; Vitamin B 12; Vitamin D; Vitamin D Deficiency

This study was designed to investigate the vitamin D (vit-D) and vitamin B12 (vit-B12) levels and their correlation with anti-thyroid peroxidase (anti-TPO) antibodies in patients with autoimmune hypothyroidism.. A total of 130 patients diagnosed with autoimmune hypothyroidism were included in the study retrospectively. The patients were divided into two groups as those having vit-B12 levels below 200 pg/mL (n = 60) and vit-B12 levels equal to or above 200 pg/mL (n = 70). These two groups were compared in terms of age, sex, thyroid-stimulating hormone (TSH), free-T4 (FT4), vit-D, and anti-TPO. The correlation between vit-B12 and anti-TPO levels was also investigated in these groups. Patients were then divided into four groups according to their vit-D levels. Patients with normal vit-D levels (25[OH]D >30 ng/mL; n = 5), those with vit-D insufficiency (20-30 mg/mL; n = 9), those with vit-D deficiency (10-20 ng/mL; n = 43), and those with severe vit-D deficiency (<10 ng/mL; n = 73). These four groups were compared in terms of age, gender, TSH, FT4, vit-B12, and anti-TPO levels. In addition, the correlation between levels of vit-D and anti-TPO was also investigated.. We found that vit-B12 deficiency and vit-D deficiency were associated with autoimmune hypothyroidism, and that there was a negative correlation between vit-B12 and vit-D levels and anti-TPO antibodies in these patients.. In patients with autoimmune hypothyroidism, vit-D and vit-B12 deficiency should be investigated at the time of diagnosis and periodically on follow-ups.

Topics: Adolescent; Adult; Aged; Female; Hashimoto Disease; Humans; Iodide Peroxidase; Male; Middle Aged; Retrospective Studies; Thyroiditis, Autoimmune; Thyrotropin; Vitamin B 12; Vitamin B 12 Deficiency; Vitamin D; Vitamin D Deficiency; Vitamins; Young Adult

Deficiencies in vitamin D, folate and cobalamin are common in Inflammatory Bowel Disease (IBD). The aim of the present study was to assess serum levels of these vitamins in IBD adults based on the respective serum cut off values for vitamin deficiencies, and to explore possible associations with IBD-related biomarkers and nutritional intake. A cross-sectional study was carried out and patients with Crohn's disease (CD) or ulcerative colitis (UC) from Attica-Greece were enrolled. Medical and dietary history, clinical examination and blood/stool biomarkers were evaluated. In total, 87 patients participated in the study. Serum levels of 25(OH)D, folate and cobalamin were deficient in 36.8%, 18.4% and 5.7% of patients, respectively. Linear regression analysis in the overall patients showed positive associations between (a) serum 25(OH)D with serum iron (beta = 0.083,

Topics: Adult; Bilirubin; Biomarkers; Colitis, Ulcerative; Crohn Disease; Cross-Sectional Studies; Female; Folic Acid; Folic Acid Deficiency; Greece; Humans; Inflammatory Bowel Diseases; Male; Middle Aged; Nutritional Status; Oxidative Stress; Seasons; Vitamin B 12; Vitamin B 12 Deficiency; Vitamin D; Vitamin D Deficiency

The correlation among high levels of total homocysteine, low levels of B. In this study serum homocysteine, B

Topics: Adult; Cognition; Cognition Disorders; Cross-Sectional Studies; Female; HIV; HIV Seropositivity; Homocysteine; Humans; Male; Middle Aged; Vitamin B 12; Vitamin D; Vitamin D Deficiency; Vitamins

The present study aimed to assess the association of vitamin D and vitamin B. The data were obtained from a cross-sectional study that included individuals aged 80 years or older living in the urban and rural areas of the cities of Siderópolis and Treviso in the state of Santa Catarina, Brazil. In total, 165 elderly people were included in the analysis. The outcome of cognitive decline was assessed by the Mini-Mental State Examination. Vitamin D and vitamin B. The present study showed that individuals aged ≥80 years who had vitamin D levels of ≤18 ng mL

Topics: Aged, 80 and over; Brazil; Cognitive Dysfunction; Cross-Sectional Studies; Female; Humans; Male; Mental Status and Dementia Tests; Poisson Distribution; Prevalence; Regression Analysis; Vitamin B 12; Vitamin B 12 Deficiency; Vitamin D; Vitamin D Deficiency

This study aims to test the hypothesis that vitamin D deficiency can influence long-chain polyunsaturated fatty acid metabolism through alterations in the one-carbon cycle. Wistar rats (n = 8 per group) were given either a control (1,000 IU D3/kg diet) or a vitamin D deficient (VDD) (0 IU D3/kg diet) diet from pre-pregnancy to delivery. On day 20 of gestation, pregnant female rats were delivered by C-section to collect placenta and blood. VDD group demonstrated high serum parathyroid hormone, low serum phosphate, low plasma folate, higher plasma homocysteine, and higher plasma malondialdehyde levels (P < 0.05 for all) as compared to control. Lower protein levels of placental cystathionine-β-synthase enzyme (P < 0.05) were observed in the VDD group as compared to control. VDD group demonstrated higher placental mRNA levels of the enzymes phospholipase A

Topics: 6-Ketoprostaglandin F1 alpha; Animals; Calcium; Cyclooxygenase 2; Cystathionine beta-Synthase; Disease Models, Animal; Female; Folic Acid; Gene Expression Regulation; Group II Phospholipases A2; Homocysteine; Humans; Malondialdehyde; Parathyroid Hormone; Phosphates; Placenta; Pregnancy; Rats; Rats, Wistar; Signal Transduction; Thromboxane B2; Vitamin B 12; Vitamin D Deficiency

Schizophrenia (SCH) and drug addiction are chronic disorders that are frequently accompanied by physical diseases, poor nutrition and reduced self-care, all of which are likely to result in vitamin deficiencies. The objective of this study was to compare vitamin levels in SCH patients, substance use disorder (SUD) patients and healthy controls (HCs). The study included 189 SCH patients, 119 SUD patients and 109 HCs. Information on vitamin B12, folic acid and vitamin D levels were retrieved from the hospital's database, and mean values and deficiency/insufficiency were evaluated. Vitamin D deficiency (<30 ng/ml) was more common in the SCH group than in the SUD and HC groups (88.4%, 74.8% and 86.4%, respectively). Although there were no significant differences in folic acid deficiency (<3.0 ng/ml) in the SUD and SCH groups (15.1% and 8.5%, respectively), the incidence of folic acid deficiency was significantly higher in both groups as compared with that in the HC group (5.8%). Significantly higher numbers of patients in the SCH group than in the SUD group had vitamin B12 deficiency (45.5% vs. 28.3%). The prevalence of vitamin B12 deficiency in the SUD group was significantly higher than that the HC group (28.3% vs.11.5%). As compared with the HC group, vitamin D and B12 levels were significantly lower in SCH group, and folic acid and B12 levels were significantly lower in the SUD group. Several vitamin deficiencies appear to be common in both SCH and SUD. Possible reasons should be investigated.

Topics: Adult; Female; Folic Acid; Folic Acid Deficiency; Humans; Incidence; Male; Middle Aged; Prevalence; Schizophrenia; Substance-Related Disorders; Vitamin B 12; Vitamin B 12 Deficiency; Vitamin D; Vitamin D Deficiency

The aim of this study was to evaluate the prevalence of anemia and other vitamin deficiencies among elderly home care patients and to evaluate the causes of anemia and effect of malnutrition as a contributing factor.. Anemia was defined according to the World Health Organization. Hemogram, serum iron, iron binding capacity, ferritin and transferrin saturation values, serum vitamin B12, folic acid and vitamin D levels were evaluated. It was tried to differentiate as absolute iron deficiency anemia, anemia of chronic disease, anemia of unknown cause and vitamin B12 deficiency anemia. Malnutrition was evaluated by Mini Nutritional Assessment test.. Total of 472 patients (mean age 81,4±7,4 years) were included in the study. Anemia was detected in 179 (%37,9) patients, 22,7% of males and 45,5 % of female. Prevalence of iron deficiency anemia, vitamin B12, folic acid and vitamin D deficiencies were found 43%, 46%, 19% and 91% respectively. 22,8% of all patients were malnourished, 17,5% were under malnutrition risk. In patients with anemia 16,2% chronic disease anemia and 37,4% unknown anemia were detected.. With or without malnutrition, iron deficiency anemia, vitamin B12 deficiency and vitamin D deficiency were common in the home care elderly patients.

Topics: Aged; Anemia; Anemia, Iron-Deficiency; Chronic Disease; Female; Ferritins; Folic Acid; Folic Acid Deficiency; Home Care Services; Homes for the Aged; Humans; Male; Malnutrition; Nutrition Assessment; Nutritional Status; Prevalence; Vitamin B 12; Vitamin B 12 Deficiency; Vitamin D Deficiency

Topics: Aged; Anemia, Pernicious; Brain; Cognitive Dysfunction; Diagnosis, Differential; Humans; Injections, Intramuscular; Magnetic Resonance Angiography; Magnetic Resonance Imaging; Male; Methylmalonic Acid; Neurologic Examination; Postural Balance; Sensation Disorders; Syphilis Serodiagnosis; Treponema pallidum; Vitamin B 12; Vitamin D Deficiency

Endobarrier® is a minimally invasive, reversible endoscopic treatment for obesity. It provokes malabsorption along 60 cm of the small intestine, which can contribute to the development of vitamin deficiencies and to changes in bone mineral density (BMD). To determine the prevalence of nutrient deficiencies, changes in body composition and BMD during the first year after Endobarrier® placement. Twenty-one patients with type 2 diabetes met inclusion criteria. Levels of vitamins, micro and macronutrients were assessed prior and at 1, 3 and 12 months post-operatively. DEXA was performed before and 12 months after implant. Nineteen patients completed the 12 months follow-up. Vitamin D deficiency was the most prevalent finding before Endobarrier® implant. The percentage of patients with severe deficiency decreased from 19 to 5% at 12 months after supplementation. Microcytic anaemia was initially present in 9.5% of patients and increased to 26.3% at 12 months. Low ferritin and vitamin B12 levels were observed in 14.2 and 4.8% of patients before the implant and worsened to 42 and 10.5%. Low concentrations of magnesium and phosphorus were also common but improved along the study. A significant but not clinically relevant decrease in BMD of 4.14 ± 4.0% at the femoral neck was observed at 12 months without changes in osteocalcin levels. Vitamin deficiencies are common after Endobarrier® implant. It is therefore important to screen patients prior to and at regular intervals after the implant, and to encourage adherence to diet counselling and supplementation.

Topics: Anemia; Avitaminosis; Bone Density; Deficiency Diseases; Diabetes Mellitus, Type 2; Female; Femur Neck; Ferritins; Humans; Intestinal Absorption; Intestine, Small; Magnesium; Male; Middle Aged; Obesity; Phosphorus; Prostheses and Implants; Vitamin B 12; Vitamin B 12 Deficiency; Vitamin D Deficiency

Chronic autoimmune atrophic gastritis (CAAG) is an autoimmune disease characterized by hypo/achlorhydria. A role of CAAG in the pathogenesis of nutritional deficiencies has been reported, therefore we hypothesized a possible association between CAAG and 25-OH-Vitamin D [25(OH)D] deficiency. Aim of the present study is to evaluate the prevalence of 25(OH)D deficiency in CAAG patients.. 87 CAAG patients (71 females; mean age 63.5 ± 12.8 years) followed at our Centre from January 2012 to July 2015 were consecutively evaluated. 25(OH)D, vitamin B. Data from the present study showed a significant reduction of 25(OH)D levels in CAAG patients and a possible impairment of vitamin D absorption in CAAG may be postulated. Any implication to the genesis of gastric carcinoids remains to be elucidated.

Topics: 25-Hydroxyvitamin D 2; Aged; Autoimmune Diseases; Calcium; Chronic Disease; Female; Gastritis, Atrophic; Humans; Intestinal Absorption; Male; Middle Aged; Parathyroid Hormone; Prospective Studies; Vitamin B 12; Vitamin D Deficiency

Micronutrient deficiencies can compromise the development potential of school-aged children, and their later health and productivity as adults. School feeding and school-based fortification approaches have been utilized globally to redress nutritional deficiencies in this age group.. We explored the acceptability and micronutrient impact of a Bangladesh Government supported school-based micronutrient fortification program for children attending rural primary schools in 10 disadvantaged sub-districts.. We applied a mixed methods approach. The quantitative component assessed the impact of micronutrient fortification on 351 children aged 6-11 years using a cohort pre-post research design with a control group. The qualitative component explored the acceptability of the intervention using focus group discussions, body mapping and semi-structured interviews with teachers, school-going children and school authorities.. Daily consumption of fortified biscuits by primary school children had a significant positive impact on mean levels of iron, folic acid, vitamin B12, retinol and vitamin D controlling for sex, baseline deficiency status, CRP, and H. pylori. Levels of anemia and vitamin D deficiency were also significantly reduced. Qualitative findings indicated the widespread acceptability of the daily biscuit. Teachers perceived students to be more attentive in class, less tired, and some attributed better school performance to biscuit consumption. Children reported similar improvements in concentration and energy levels.. This study is among the first in Bangladesh to comprehensively assess a school-based fortification program in terms of its acceptability and impact on micronutrient status of children aged 6-11 years of age. While results strongly support this modality of school feeding, research on the cognitive impacts of micronutrient fortified biscuits will help clarify the case for scaled-up investments in school- based feeding program in Bangladesh and other low and middle income countries.

Topics: Anemia; Bangladesh; Child; Child Nutrition Disorders; Female; Folic Acid; Food, Fortified; Humans; Iron; Male; Micronutrients; Vitamin A; Vitamin B 12; Vitamin D; Vitamin D Deficiency; Vitamins

Obsessive compulsive disorder (OCD) is a complex disorder with a poorly understood aetiopathogenesis. One carbon metabolism that includes vitamin B12, folic acid and homocysteine has been investigated in many psychiatric disorders like OCD. In recent years, vitamin D has also been considered to contribute to many of these psychiatric disorders. In this study we investigated whether vitamin B12, homocysteine and vitamin D play a role in the aetiology of paediatric OCD. With this aim we compared 52 children and adolescent OCD patients with 30 healthy controls. The participants were tested for vitamin B12, folic acid, homocysteine and vitamin D levels and were evaluated with a sociodemographic form, state-trait anxiety inventory 1 and 2, Kovacs Depression Inventory and Yale-Brown Obsessive Compulsive Scale (Y-BOCS). As a result we found significantly lower levels of vitamin B12 and vitamin D and higher levels of homocysteine in the patient group compared to control group (p values for all three scores were <0.001), whereas there was no significant difference between groups in terms of folate levels (p=0.083). This demonstrates that one carbon metabolism and vitamin D deficiency can play a role in the aetiology of OCD.

Topics: Adolescent; Biomarkers; Child; Female; Folic Acid; Folic Acid Deficiency; Homocysteine; Humans; Obsessive-Compulsive Disorder; Psychiatric Status Rating Scales; Vitamin B 12; Vitamin D; Vitamin D Deficiency

Vitamins are known to be associated with immunity and nutrition. Moreover, vitamin deficiency can affect host immunity to various infectious diseases, including tuberculosis. Although patients with tuberculosis often have vitamin D deficiency, little is known about the levels of other vitamins. Here, we aimed to investigate the status of vitamins A, B. We performed a case-control study to investigate the serum vitamin concentrations in 152 patients with tuberculosis and 137 control subjects. The concentrations of vitamin A, vitamin D, vitamin E, homocysteine, and methylmalonic acid were measured using high-performance liquid chromatography (HPLC) or HPLC-tandem mass spectrometry. Patient demographic data and other biochemical parameters were also analyzed.. The serum concentrations of vitamins A, D, and E were significantly lower in patients with tuberculosis than in control subjects (1.4 vs. 2.0 μmol/L, P < 0.001; 10.6 vs. 19.3 ng/mL, P < 0.001; and 22.8 vs. 30.6 μmol/L, P < 0.001, respectively). In contrast, the methylmalonic acid levels were higher in patients with tuberculosis (134.9 vs. 110.8 nmol/L, P < 0.001). The prevalences of vitamin deficiencies were significantly higher in patients with tuberculosis. Moreover, multiple vitamin deficiencies were only observed in patients with tuberculosis (22.4% of all patients with tuberculosis vs. 0% of all control subjects). Positive correlations among vitamin A, D, and E concentrations were observed (vitamins A and D, r = 0.395; vitamins D and E, r = 0.342; and vitamins A and E, r = 0.427, P < 0.001). Body mass index, total cholesterol, low-density lipoprotein, iron, and total iron-binding capacity all showed positive correlations with vitamin A, D, and E concentrations.. Vitamin deficiencies are common in patients with tuberculosis. Further research investigating the clinical importance of vitamin and nutritional status in patients with tuberculosis is needed.

Topics: Adolescent; Adult; Aged; Avitaminosis; Case-Control Studies; Female; Humans; Male; Middle Aged; Nutritional Status; Tuberculosis, Pulmonary; Vitamin A; Vitamin B 12; Vitamin D; Vitamin D Deficiency; Vitamin E; Young Adult

Recent studies have demonstrated a relationship between poor vitamin D status and respiratory infections and diarrhea among young children. Acute lower respiratory infections (ALRI) and diarrhea are among the two most important causes of death in under-5 children. In this paper, we examined the extent to which vitamin-D deficiency (<10 ng/ml) predicts ALRI, clinical pneumonia and diarrhea among 6 to 30 months old children.. We used data from a randomized controlled trial (RCT) of daily folic acid and/or vitamin B12 supplementation for six months in 6 to 30 months old children conducted in Delhi, India. Generalized estimating equations (GEE) were used to examine the associations between vitamin-D deficiency and episodes of ALRI, clinical pneumonia and diarrhea.. Of the 960 subjects who had vitamin-D concentrations measured, 331(34.5%) were vitamin-D deficient. We found, after controlling for relevant potential confounders (age, sex, breastfeeding status, wasting, stunting, underweight, anemia status and season), that the risk of ALRI was significantly higher among vitamin-D deficient (OR 1.26; 95% CI: 1.03 to 1.55) compared to vitamin-D-replete children in the six months follow-up period. Vitamin-D status was not associated with episodes of diarrhea or clinical pneumonia.. Vitamin-D deficiency is common in young children in New Delhi and is associated with a higher risk of ALRI. The role of vitamin D in Indian children needs to be elucidated in further studies.

Topics: Child, Preschool; Diarrhea; Dietary Supplements; Female; Folic Acid; Humans; India; Infant; Luminescent Measurements; Male; Odds Ratio; Pneumonia; Respiratory Tract Infections; Seasons; Social Class; Vitamin B 12; Vitamin D; Vitamin D Deficiency

Old age and diabetes mellitus are risk factors for vitamin deficiencies, weakness and falls. Deficiencies of vitamin D, and possibly vitamin B12 and folate (which are associated with hyperhomocysteinaemia), contribute to sarcopenia. Determination of the physical effects of vitamin deficiencies in specific groups of people can help to guide public health policy with regard to vitamin supplementation.. A pilot cross-sectional study was conducted to determine the association of levels of vitamin D, vitamin B12, folate and homocysteine with muscle strength, gait and fall history in 56 patients >65 years old with diabetes mellitus in primary care in Singapore. Hand-grip and leg-quadriceps strength measures were obtained and divided by body mass index (BMI). The timed up-and-go and Tinetti tests were used to measure gait. A history of "at least one fall in the preceding year" was obtained.. Vitamin B12 deficiency (<150 pmol/l) was present in 43 % of patients, folate deficiency (<13.5 mmol/l) in 20 %, hyperhomocysteinaemia (≥15.0 μmol/l) in 52 % and vitamin D deficiency (<49.9 nmol/l) in 25 %. Levels of vitamin D, vitamin B12 and homocysteine did not significantly predict muscle strength in regression analyses. Folate (B = 0.010, P < 0.01) and gender (B = 0.356, P < 0.001) predicted average grip strength corrected for BMI (F(2,53) = 17.74, P < 0.001, R. The prevalence of vitamin deficiency was very high in our sample of patients >65 years old with diabetes mellitus. Folate levels were significantly correlated with grip and leg strength (with correction for BMI). Leg strength was positively correlated with gait measures and negatively correlated with a history of falls. The role of folate in muscle weakness and falls warrants further study.

Topics: Accidental Falls; Aged; Cross-Sectional Studies; Diabetes Mellitus; Female; Folic Acid; Folic Acid Deficiency; Gait; Hand Strength; Homocysteine; Humans; Hyperhomocysteinemia; Male; Muscle Strength; Pilot Projects; Primary Health Care; Risk Factors; Singapore; Vitamin B 12; Vitamin B 12 Deficiency; Vitamin D; Vitamin D Deficiency

To utilize complementary biochemical and dietary data collected before the initiation of national flour fortification to (i) identify micronutrient insufficiencies or deficiencies and dietary inadequacies in Palestinian women and children in vulnerable communities and (ii) assess the suitability of the current wheat flour fortification formula.. Quantitative dietary intake questionnaires were administered and fasting venous blood samples collected in randomly selected households in Gaza City and Hebron. The impact of fortification was simulated by estimating the additional micronutrient content of fortified wheat flour.. Households in Gaza City and Hebron that were not receiving food aid from social programmes.. Non-pregnant women (18-49 years) and children aged 36-83 months.. The micronutrients with highest prevalence of insufficiency were vitamin D in women (84-97 % with serum 25-hydroxyvitamin D <50 nmol/l) and vitamin B12 in women and children (43-82 % with serum B12 <221 pmol/l). Deficiencies of vitamin A, Fe and Zn were also of public health concern. Current levels of wheat flour fortificants were predicted to improve, but not eliminate, micronutrient intake inadequacies. Modification of fortificant concentrations of vitamin D, thiamin, vitamin B12, Zn and folic acid may be indicated.. Micronutrient insufficiencies or deficiencies and intake inadequacies were prevalent based on either biochemical or dietary intake criteria. Adjustments to the current fortification formula for wheat flour are necessary to better meet the nutrient needs of Palestinian women and children.

Topics: Adolescent; Adult; Arabs; Child; Child, Preschool; Diet; Fasting; Female; Flour; Folic Acid; Food Assistance; Food, Fortified; Humans; Iron, Dietary; Male; Micronutrients; Middle Aged; Surveys and Questionnaires; Triticum; Vitamin A; Vitamin A Deficiency; Vitamin B 12; Vitamin B 12 Deficiency; Vitamin D; Vitamin D Deficiency; Vulnerable Populations; Young Adult; Zinc

Falls and fractures constitute a major cause of morbidity and mortality among older adults. Although falls and fractures share similar risk factors, there is no integrated approach to identifying secondary causes of both entities. We report a cost-effective approach to identify metabolic causes of falls and fractures in the clinical setting.. Falls and fractures are a major cause of morbidity and mortality among older adults. Metabolic disorders contributing to the combined risk of falls and fractures are frequent but often go undetected. The most efficient and cost-effective laboratory screening strategy to unmask these disorders remains unknown. The purpose of this study was to identify the most cost-effective laboratory tests to detect undiagnosed metabolic contributors and to decide treatment of these disorders in older persons.. This is a cross-sectional study design, which included all participants attending the Falls & Fractures Clinic, Nepean Hospital (Penrith, Australia) between 2008 and 2013. Chemistry profile included 25(OH) vitamin D, parathyroid hormone (PTH), albumin, creatinine, calcium, phosphate, vitamin B-12, folate, and thyroid-stimulating hormone (TSH) for all patients, and serum testosterone in men. The number of new diagnoses identified and their cost-effectiveness (cost in US$ per patient screened and cost per new diagnosis) were calculated.. A total of 739 participants (mean age 79, 71 % female) were assessed. Among 233 participants with complete laboratory tests, previously undiagnosed disorders were identified in 148 (63.5 %). Vitamin D deficiency (27 %) and hyperparathyroidism (21.5 %) were the most frequent diagnoses. A testing strategy including serum vitamin D, calcium, PTH, creatinine/estimated glomerular filtration rate (eGFR), and TSH for all patients and serum testosterone in men would have been sufficient to identify secondary causes of falls and fractures in 94 % of patients at an estimated cost of $190.19 per patient screened and $257.64 per diagnosis.. The minimum cost-effective battery for occult metabolic disorders in older adults at risk of falls and fractures should include serum vitamin D, PTH, TSH, creatinine/eGFR, testosterone (in men), and calcium.

Topics: Accidental Falls; Aged; Aged, 80 and over; Australia; Blood Chemical Analysis; Calcium; Cost-Benefit Analysis; Creatinine; Cross-Sectional Studies; Female; Folic Acid; Fractures, Bone; Humans; Hyperparathyroidism; Male; Metabolic Diseases; Middle Aged; Parathyroid Hormone; Phosphates; Risk Factors; Serum Albumin; Testosterone; Thyrotropin; Vitamin B 12; Vitamin D; Vitamin D Deficiency

Nutritional deficiency anaemia in vegans is common and usually due to lack of vitamin B12, as this vitamin is found almost exclusively in animal-based food products. In this case report we present a 39-year-old male vegan with severe macrocytic anaemia due to vitamin B12 deficiency as well as secondary hyperparathyroidism due to severe vitamin D deficiency. We want to emphasize the importance of a detailed nutritional history for patients with anaemia, and the need for vitamin B12 and vitamin D supplements for people who comply with a vegan diet.

Topics: Adult; Anemia, Macrocytic; Diet, Vegan; Dietary Supplements; Humans; Hyperparathyroidism, Secondary; Male; Vitamin B 12; Vitamin B 12 Deficiency; Vitamin D; Vitamin D Deficiency

Low vitamin D status has been implicated in several chronic medical conditions and unfavorable health outcomes. Our goal was to investigate whether serum 25-hydroxyvitamin D (25OHD) levels are a potentially modifiable risk factor for anemia in a nationally representative cohort of community-dwelling individuals in the United States. We performed a cross-sectional study of 5456 individuals (≥17 years) from the National Health and Nutrition Examination Survey from 2001 to 2006. Locally weighted scatterplot smoothing (LOWESS) was used to graphically depict the relationship between serum 25OHD levels and the cumulative frequency of anemia. Multivariable logistic regression models were then used to assess the independent association of 25OHD levels with anemia, while controlling for age, sex, race, body mass index, chronic kidney disease, as well as serum levels of C-reactive protein, ferritin, iron, vitamin B12, and folic acid. The mean (standard error) 25OHD and hemoglobin levels in the analytic group were 23.5 (0.4) ng/mL and 14.4 (0.1) g/dL, respectively. Prevalence of anemia was 3.9%. Locally weighted scatterplot smoothing analysis demonstrated a near-linear relationship between vitamin D status and cumulative frequency of anemia up to 25OHD levels of approximately 20  ng/mL. With increasing 25OHD levels, the curve flattened out progressively. Multivariable regression analysis demonstrated an inverse association of 25OHD levels with the risk of anemia (adjusted odds ratio 0.97; 95% confidence interval 0.95-0.99 per 1  ng/mL change in 25OHD). Compared to individuals with ≥20  ng/mL, individuals with 25OHD levels <20  ng/mL were more likely to be anemic (adjusted odds ratio 1.64; 95% confidence interval 1.08-2.49). In a nationally representative sample of community-dwelling individuals in the United States, low 25OHD levels were associated with increased risk of anemia. Randomized controlled trials are needed to determine whether optimizing vitamin D status can reduce the burden of anemia in the general population.

Topics: Adult; Age Factors; Anemia; Body Mass Index; C-Reactive Protein; Cross-Sectional Studies; Female; Ferritins; Folic Acid; Humans; Iron; Male; Middle Aged; Nutrition Surveys; Risk Factors; Socioeconomic Factors; United States; Vitamin B 12; Vitamin D; Vitamin D Deficiency

Studies report frequent micronutrient deficiencies after bariatric surgery, but less is known about micronutrient levels of pregnant women after bariatric surgery.. To prospectively evaluate micronutrient levels and supplement intake in pregnancy following bariatric surgery.. A multicenter prospective cohort study including women with restrictive or malabsorptive types of bariatric surgery. Nutritional deficiencies, together with supplement intake, were screened during pregnancy.. The total population included 18 women in the restrictive and 31 in the malabsorptive group. Most micronutrients were depleted and declined significantly during pregnancy. The proportion of women with low vitamin A and B-1 levels increased to respectively 58 and 17% at delivery (P = 0.005 and 0.002). The proportion of women with vitamin D deficiency decreased from 14% at trimester 1 to 6% at delivery (P = 0.030). Mild anemia was found in respectively 22 and 40% of the women at trimester 1 and delivery. In the first trimester, most women took a multivitamin (57.1%). In the second and third trimester, the majority took additional supplements (69.4 and 73.5%). No associations were found between supplement intake and micronutrient deficiencies.. Pregnant women with bariatric surgery show frequent low micronutrient levels. Supplementation partially normalizes low levels of micronutrients.

Topics: Adolescent; Adult; Anemia; Bariatric Surgery; Cholecalciferol; Cohort Studies; Dietary Supplements; Female; Folic Acid; Humans; Micronutrients; Obesity; Pregnancy; Pregnancy Complications; Pregnancy Trimester, Third; Prospective Studies; Vitamin A; Vitamin B 12; Vitamin D Deficiency; Vitamins; Young Adult

Despite routine supplementation of vitamins and minerals after bariatric surgery, an important number of patients suffer from deficiencies. Little is still known about the novel restrictive procedure, sleeve gastrectomy.. A retrospective study of 30 morbidly obese patients undergoing a laparoscopic sleeve gastrectomy, between May 2008 and September 2010, was performed. Baseline albumin, ferritin, iron, zinc, calcium, vitamin D, parathormone (PTH), vitamin B12, and folic acid were obtained before operation and postoperative determinations 1, 3, 6, 9, 12, 18, and 24 months after surgery.. Before surgery, 96.7% of the patients presented vitamin D deficiency, 20% had elevated PTH, 3.3% hypoalbuminemia, and 3.3% folic acid deficiency. One year after surgery, only one patient (3.3%) presented vitamin D deficiency and had elevated PTH. The rest of parameters were within normal range. The second year after surgery, the results remain similar. A significant difference was obtained when comparing preoperative vitamin D values and postoperative determinations 12 months after surgery (increase of 51.9 ng/dl, 95% confidence interval (CI) (41.8-61.3); p < 0.001). A significant difference was determined when comparing preoperative PTH values and postoperative determinations 3 months after surgery (decrease of 16.6 pg/ml, 95% CI (2.6-30.6); p = 0.03). A significant inverse correlation was observed between weight loss and vitamin D increase at the third month after surgery (Pearson correlation coefficient -0.948; p = 0.033).. Postoperative values of vitamin D show a progressive increase, while PTH ones present a significant reduction, without any impact on serum calcium levels. We have demonstrated an inverse correlation between weight loss and vitamin D increase at the third month after surgery.

Topics: Adult; Calcium; Dietary Supplements; Female; Ferritins; Folic Acid; Gastroplasty; Humans; Iron; Middle Aged; Obesity, Morbid; Parathyroid Hormone; Postoperative Period; Retrospective Studies; Time Factors; Vitamin B 12; Vitamin D; Vitamin D Deficiency; Weight Loss; Young Adult

Biological markers for the status of vitamins B12 and D: the importance of some analytical aspects in relation to clinical interpretation of results When vitamin B12 deficiency is expressed clinically, the diagnostic performance of total cobalamin is identical to that of holotranscobalamin II. In subclinical B12 deficiency, the two aforementioned markers perform less well. Additional analysis of a second, functional marker (methylmalonate or homocysteine) is recommended. Different analytical approaches for 25-hydroxyvitamin D quantification, the marker of vitamin D deficiency, are not yet standardized. Measurement biases of up to +/- 20% compared with the original method used to establish threshold values are still observed.

Topics: Biomarkers; Homocysteine; Humans; Methylmalonic Acid; Transcobalamins; Vitamin B 12; Vitamin B 12 Deficiency; Vitamin D; Vitamin D Deficiency

Plasma vitamin B12 [cobalamin (Cbl)] concentrations are usually measured as a screening marker for vitamin B12 deficiency. Siemens Healthcare Diagnostics has introduced Cbl assays for various platforms, i.e., the immulite (IML) 2000 and 2500. In our laboratories, regular validation studies for the IML 2500 were conducted and showed acceptable quality specifications. After the introduction of the IML 2500 Cbl assay, clinicians in the department of internal medicine reported an increased frequency of patients with Cbl-concentrations less than 148 pmol/L.. In order to investigate this claim from the clinicians, we retrospectively analyzed the internal and external quality control (QC) of the Cbl assay. In addition, the monthly patient means for the Cbl assay were analyzed both before and after the introduction of the new Cbl assay.. No abnormalities were found in the internal and external QCs. However, the monthly patient means for the Cbl assay showed a statistically significant decrease in cobalamin concentrations. Siemens acknowledged the problems and formulated a new Cbl assay, which was subsequently validated in our laboratories and showed equivocal Cbl results when compared to the IML 2000 Cbl assay.. We report a flawed validation study conducted by the manufacturer that resulted in an undetected analytical problem in the IML 2500 Cbl assay, its subsequent introduction on the market, the final recognition of the poor performance of the assay by our clinicians, and the eventual resolution by the manufacturer. Hence, it emphasizes the utmost importance for thorough comparison between assays over the entire measurement range, even when both assays are produced by the same manufacturer.

Topics: Biomarkers; Humans; Immunoassay; Reproducibility of Results; Retrospective Studies; Vitamin B 12; Vitamin D Deficiency

Variations in the intake of folate are capable of modulating colorectal tumorigenesis; however, the outcome appears to be dependent on timing. This study sought to determine the effect of altering folate (and related B vitamin) availability during in-utero development and the suckling period on intestinal tumorigenesis.. Female wildtype mice were fed diets either mildly deficient, replete or supplemented with vitamins B(2), B(6), B(12) and folate for 4 weeks before mating to Apc(1638N) males. Females remained on their diet throughout pregnancy and until weaning. After weaning, all Apc(1638N) offspring were maintained on replete diets for 29 weeks.. At 8 months of age tumour incidence was markedly lower among offspring of supplemented mothers (21%) compared with those of replete (59%) and deficient (55%) mothers (p=0.03). Furthermore, tumours in pups born to deficient dams were most likely to be invasive (p=0.03). The expression of Apc, Sfrp1, Wif1 and Wnt5a--all of which are negative regulatory elements of the Wnt signalling cascade--in the normal small intestinal mucosa of pups decreased with decreasing maternal B vitamin intake, and for Sfrp1 this was inversely related to promoter methylation. β-Catenin protein was elevated in offspring of deficient dams.. These changes indicate a de-repression of the Wnt pathway in pups of deficient dams and form a plausible mechanism by which maternal B vitamin intake modulates tumorigenesis in offspring. These data indicate that maternal B vitamin supplementation suppresses, while deficiency promotes, intestinal tumorigenesis in Apc(1638N) offspring.

Topics: Animals; Animals, Newborn; Colorectal Neoplasms; Dietary Supplements; Disease Models, Animal; Female; Folic Acid; Humans; Male; Mice; Mice, Inbred C57BL; Mice, Mutant Strains; Pregnancy; Prenatal Exposure Delayed Effects; Riboflavin; Vitamin B 12; Vitamin B 6; Vitamin B Complex; Vitamin D Deficiency; Wnt Signaling Pathway

Vitamin D and holotranscobalamin (HTCII) deficiencies have been seen to demonstrate an association with various types of cancers. The objective of this study is to determine the frequency of vitamin D and HTCII deficiency in cancer patients. Our study investigated vitamin D, total B12, and HTCII levels in 70 cancer patients. Vitamin D status was measured as serum 25-hydroxyvitamin D [25(OH)D, Nichols Advantage assay], and serum B12 was measured as both total B12 and as the metabolically active HTCII (Immulite B12 assay followed by glass adsorption). Insufficiency of serum 25(OH)D levels for this study is defined based on differing literature standards of insufficiency and was selected to be either <50 or <75 nmol/l. When 25(OH)D insufficiency is defined as serum level of <75 nmol/l, 43 of 60 (72%) of cancer patients were found to be insufficient. At the lower definition of insufficiency, <50 nmol/l, 24 of 60 patients (40%) were insufficient. Of 52 patients, only 3 (6%) were found to have insufficient serum levels of total B12 (normal = >300 pg/ml), whereas 17 of 52 (34%) were found to be HTCII insufficient (normal = >69 pg/ml). Of these 17 patients, 14 (84.4%) had normal total B12 levels. Low serum levels of 25(OH)D strongly correlated with low serum HTCII. All 12 HTCII-deficient patients were vitamin D insufficient at the <75-nmol/l standard. Six of 12 HTCII-deficient patients (50%) were vitamin D deficient at the <50-nmol/l cutoff. The standard measurement of total serum B12 alone is inadequate for identifying patients with insufficient levels of metabolically active B12. Deficiency of vitamin D (72%) and HTCII (34%) is prevalent among newly diagnosed patients with cancer and could play a role in cancer development and host response to tumor and therapy. Possible explanations for combined HTCII and 25(OH)D deficiencies include patient age, presence of atrophic gastritis, and lack of sun exposure.

Topics: Adult; Age Factors; Aged; Aged, 80 and over; Biomarkers; Female; Humans; Male; Middle Aged; Neoplasms; Sunlight; Transcobalamins; Vitamin B 12; Vitamin B 12 Deficiency; Vitamin D; Vitamin D Deficiency; Vitamins

Topics: Ascorbic Acid; Ascorbic Acid Deficiency; Avitaminosis; Folic Acid; Folic Acid Deficiency; Humans; Pyridoxine; Vitamin B 12; Vitamin B 12 Deficiency; Vitamin B Deficiency; Vitamin D; Vitamin D Deficiency; Vitamin E; Vitamin E Deficiency; Vitamin K; Vitamin K Deficiency; Vitamins

In March, 1976, vitamin-D status was investigated in 256 thirteen-year-old school boys of Asian, West Indian, andEuropean origin in Birmingham. Serum-25-hydroxyvitamin-D3 (25-OHD3) concentrations in 78% of the 124 Asian boys resembled those found in rickets and osteomalacia. Serum-25-OHD3 concentrations were also low in a few West Indian and European children. Dietary intake of vitamin D and exposure to sunlight were similar in each group. Serum-parathormone concentrations were increased in many children with low serum-25-OHD3. Reinvestigation in October, 1976, of a group of children whose serum-25-OHD, concentration had been less than 8 microng/l in March, 1976, showed pronounced improvement in all, but some still had concentrations which indicated a possible deficiency. It is suggested that the high frequency of vitamin-D deficiency in Asian adolescents would be much reduced if 1 mg of vitamin D3 was given orally each school term during adolescence.

Topics: Adolescent; Alkaline Phosphatase; Asia; Body Constitution; Calcium; Cholecalciferol; England; Europe; Folic Acid; Hemoglobins; Humans; Hydroxycholecalciferols; Male; Parathyroid Hormone; Phosphates; Racial Groups; Seasons; Serum Albumin; Vitamin B 12; Vitamin D Deficiency; West Indies