ویتامین ها

In recent years, there has been a growing awareness of pediatric osteoporosis, a condition that can lead to weakened bones and a higher risk of fractures in children. It is essential for pediatricians to be knowledgeable about this issue so that they can identify and treat patients with osteoporosis or those at risk for it. Genetic factors and various disorders play a role in bone formation and quality. Osteogenesis imperfecta is the most common genetic condition linked to primary osteoporosis. Secondary osteoporosis can occur in children with chronic illnesses. X-rays can help diagnose the condition. Prevention is key in managing pediatric osteoporosis, as understanding normal bone development allows for early detection and treatment. Medications can help prevent bone loss in pediatric patients. The definition of pediatric osteoporosis involves low bone mass and significant fractures. Factors such as genes, medications, lack of movement, and corticosteroid use can contribute to osteoporosis in children. Treatment options for pediatric osteoporosis are limited, but anabolic agents and bisphosphonates may be used. Close monitoring and follow-up are crucial to prevent further fractures. It is important for pediatricians to understand the diagnosis and treatment of pediatric osteoporosis, as well as lifestyle factors and the effectiveness of treatment approaches.

Breast cancer is the most common cancer diagnosed in women. Epidemiological studies have led to the hypothesis that vitamin D may reduce the risk of breast cancer. This study aimed to investigate the association between vitamin D deficiency and breast cancer.

This case-control study was conducted on 59 patients referred to Khatam Al-Anbia Comprehensive Cancer Clinic in Jahrom city between May 2021 and March 2022. Thirty patients with pathologically confirmed ductal or lobular breast cancer in situ or invasive in one or both breasts, with no previous history of the disease and within two months of their breast cancer diagnosis, were considered as the case group. Thirty women without breast cancer who had been referred for breast screening examination were considered as the control group. Both groups were matched for demographic characteristics and age. The data collection tools in this study included demographic information and clinical history of the patients and serum vitamin D levels. Data analysis was performed using SPSS software, version 21 (IBM SPSS, Armonk, NY, USA) and descriptive statistics (mean, percentage, and standard deviation) and inferential statistical tests (logistic regression, Kolmogorov-Smirnov). The significance level was considered to be P<0.05.

The mean age of the patients participating in the case group was 52.17±10.6 and in the control group was 51.24±9.7. There was no statistically significant difference in age (P=0.654). There was also no significant difference between the two groups in terms of body mass index and different body index classifications, menopause age, and age of onset of menstruation. The number of months of breastfeeding in the control group was significantly higher than the case group (P=0.001). The results of logistic regression showed that, on the other hand, there was no significant relationship between the type of pathology of the disease and serum vitamin D levels.

The results of the present study showed that vitamin D deficiency can be a poor prognostic factor in the course of breast cancer.

Cardiovascular diseases are responsible for about one-third of deaths worldwide. Consequently, innovative strategies for the development and treatment of cardiovascular diseases are of great interest. Vitamin E is known for its unique and remarkable anti-oxidant and anti-inflammatory properties. The advantages of vitamin E in cardiovascular diseases have been investigated and the relationship between lower vitamin E levels and increased cardiovascular events supports this view. However, clinical trials reveal inconsistent and disappointing results in reducing cardiovascular events with vitamin E supplementation. The analysis of studies shows that in addition to the amount, duration of consumption, the type of vitamin E isoform, and its natural or synthetic source, factors such as genetic polymorphisms and the clinical status of users also affect the impact of vitamin E supplementation on cardiovascular events.

Patients with cardiovascular diseases, as well as those receiving preventive care for cardiovascular events or at risk of bleeding, should take Vitamin E only under medical supervision.  Considering that low concentrations of antioxidants such as alpha-tocopherol can lead to greater susceptibility to diseases related to oxidative stress and inflammation in the population, reviewing or reinterpreting the mechanisms of vitamin E effects in the cardiovascular process is essential for a better understanding of the relationship between Vitamin E and cardiovascular diseases. It is equally important to establish public health initiatives and strategies to encourage the intake of natural vitamin E sources and healthy fats.

Nephrolithiasis is one of the oldest known systemic diseases of kidney and urinary tract in children. This study aimed to compare the serum level of vitamin D in children with nephrolithiasis and healthy children.

The present descriptive-cross-sectional study was conducted from October 2017 to September 2019. 74 children with kidney stones and 63 healthy children referring to Afzalipour Hospital in Kerman were selected by simple sampling method. Healthy children who were considered as the control group were matched with the case group in terms of age and gender. All patients underwent kidney and urinary tract ultrasound. The diagnosis of kidney stones was based on the radiologist's opinion. Demographic characteristics of patients (age and sex) were recorded. Patients' blood tests were checked for vitamin D and calcium. Descriptive and analytical methods and SPSS software version 21 were used to analyze the data.

The average age of children with kidney stones and healthy children was 5.41±1.8 and 10.06±0.41 years old, respectively (P=0.971). The most number of patients were boys (58.1%). 29.7% of patients and 15.9% of healthy children had a family history of kidney stones (P=0.056). 71.6% of patients had unilateral kidney stones and 28% had bilateral kidney stones. The mean serum level of vitamin D was higher in healthy children (P=0.021). The average calcium was higher in children with kidney stones (P=0.001). The average calcium was higher in children with kidney stones who had a family history of kidney stones (P=0.018). Average calcium was higher in children with bilateral kidney stones (11.4±1.1) (P=0.033). The mean calcium was higher in children with kidney stones with vitamin D deficiency (P=0.001) and sufficient vitamin D levels (P=0.037).

The average level of vitamin D serum in healthy children was significantly higher than that of children with kidney stones, and the average level of calcium in children with kidney stones was significantly higher than that of healthy children. Larger studies with more patients are needed to investigate these relationships.

One of the most important social developments of the 21st century is older people struggling with problems such as muscle mass loss and vitamin D deficiency. The present study investigated the effect of combined exercises with and without blood flow restriction and vitamin D supplementation on serum alkaline phosphatase (ALP) levels in older women.

This study was conducted as a clinical trial on 40 older women in three intervention groups and a control group in the spring of 2021. The people in the intervention group were subjected to the exercise program for eight weeks, three sessions per week. Combined exercises included aerobic + resistance exercises (with an intensity of 80% 1 maximum repetition) and combined exercises with blood flow restriction (20%-30% 1 maximum repetition). In the supplement group, a 50000 mg vitamin D capsule was used once a week. ALP indices vitamin D supplement amount was measured in two stages before and after the test. Data analysis was done using analysis of covariance and paired t-test in SPSS software at a significance level of α=0.05. 

The present study showed that vitamin D supplementation had no significant effect on ALP levels (P˃0.05). While combined exercises with and without blood flow restriction significantly affected the target index (P˂0.05).

It seems that combined exercises with and without blood flow restriction have a positive effect on the level of ALP in older women, while taking vitamin D supplements alone in the short term cannot have beneficial effects on the level of ALP in older women.

Vitamin D deficiency is common among pregnant women and can lead to maternal and fetal complications during pregnancy. This study was conducted with the aim of investigating the relationship between the mother's vitamin D serum level and the infant's anthropometric indices and neurodevelopment.

This prospective cohort study was conducted on a group of pregnant women who visited Imam Khomeini Hospital in Tehran from September to March 2020. Demographic information and anthropometric characteristics of the newborn were collected using the medical record. Blood samples were collected at the time of delivery to evaluate the mother's vitamin D status, and serum vitamin D levels were measured using standard laboratory procedures. The neurodevelopment of infants was assessed at the age of 6 months through the Ages and Stages Questionnaires (ASQ). Data analysis included using descriptive statistics to summarize maternal and neonatal characteristics. The relationships between maternal serum vitamin D levels, neonatal anthropometric indicators, and neurodevelopmental outcomes were examined through Spearman's rank correlation and Mann-Whitney U tests.

In total, 123 pregnant women participated in this study, with a mean age of 31.41 years (±5.75). The mean birth weight, height, and head circumference of the neonates were 3208.33 grams (±706.05), 34.32 cm (±3.91), and 50.33 cm (±2.30), respectively. Statistical analysis showed no significant correlations between maternal serum vitamin D levels and the infants' weight (P=0.318), height (P=0.531), or head circumference (P=0.241). Furthermore, there was no significant association between maternal vitamin D levels and any of the assessed neurodevelopmental domains at six months (P > 0.05).

 While this study did not find a positive correlation between the mother's vitamin D serum level and the anthropometric indices and neurodevelopmental domains of infants at six months, it is important to interpret these results cautiously due to the study's limitations. Thus, it is advisable to conduct prospective cohort studies with large sample sizes in diverse demographics nationwide.

Obesity is associated with a decrease in antioxidants and an increase in inflammation, and vitamin D deficiency accelerates this process. New evidence has shown that vitamin D and exercise have anti-inflammatory and antioxidant effects. Therefore, in the present study, the effect of 8 weeks of intensive intermittent running with and without vitamin D consumption on the levels of total antioxidant capacity and eotaxin-1 in overweight women with vitamin D deficiency was investigated.

In this clinical trial study, 52 overweight women with vitamin D deficiency, after being selected by available sampling method, were randomly divided into three groups: control, exercise, exercise+vitamin (combined). The HIIRT was performed with the 12x1-min running bouts at 80-90% HRmax interspersed with 1-min active recovery at 50% HRmax in between bouts for 8 weeks and 3 times a week. Combined groups took vitamin D (50,000 IU) once a week. The data were analyzed using one-way ANOVA with repeated measures, one-way ANOVA and Kruskal-Wallis tests (P<0.05).

After 8 weeks, eotaxin-1 levels decreased and TAC values increased significantly in the exercise, and combined groups. However, the changes of eotaxin-1 and TAC levels in the combined intervention group were significantly higher in comparison with the exercise group (p<0.05).

It seems that HIIRT with and without vitamin D intake can help increase health in people with vitamin D deficiency, partly by increasing the antioxidant status and reducing eotaxin-1, and combined intervention is associated with the strengthening of these effects.

Considering the inconsistent data on the relationship between vitamin D (VD) and autoimmune thyroid diseases, we aimed to investigate associations of VD with anti-thyroid peroxidase antibody (TPOAb).

For this study, 695 subjects, including 369 women, were enrolled. TPOAb status was compared between different categories of VD deficiency (VDD), and correlations between TPOAb and VD were estimated. Multiple logistic regression analysis investigated the associations between VD status and TPOAb positivity.

The prevalence of VDD was 82%. There was no statistically significant difference in the prevalence of TPOAb positivity among different VD groups (p-value=0.18), a finding that did not change when TPOAb titer was considered a continuous variable. Multiple logistic regression analysis showed no significant relationships between VD status and TPOAb positivity. Regarding thyroid function, a weak negative correlation between 25(OH) D and TSH in men and a weak positive correlation between 25(OH) D and FT4 in women was demonstrated.

Our study in a population with a high prevalence of VDD revealed no statistically significant associations between serum VD levels and either TPOAb levels or TPOAb positivity.

The aim of this study was to investigate the relationship between vitamin D status and serum lipids in patients referred to Rafsanjan Salamat Clinic in 2021.

In this descriptive study, 112 people were investigated. After ten hours of fasting, serum levels of vitamin D, cholesterol, LDL, HDL, and triglyceride were measured. Data were analyzed using one-way analysis of variance and Pearson’s correlation coefficient.

There was a significant association between serum levels of vitamin D  and more favorable LDL, cholesterol, and HDL levels (p<0.05). In obese individuals, high levels of this vitamin were associated only with higher HDL levels. In vitamin D consumers, blood cholesterol level was significantly lower (p<0.05), but vitamin D supplementation did not show a statistically significant association with LDL and triglyceride levels (p=0.0456).

Blood levels of vitamin D are associated with more favorable levels of LDL and HDL and cholesterol, especially in women. More studies are suggested to investigate this relationship.

Vitamin D has been shown to reduce exercise-induced muscle damage and muscle soreness; however, further research is needed to establish definitive conclusions. The aim of this study was to investigate the effect of vitamin D supplementation on muscle soreness and recovery after exercise.

A systematic review and meta-analysis was conducted to evaluate the effects of vitamin D intake on muscle soreness and biochemical markers of muscle damage, including myoglobin (MB), creatine kinase (CK), lactate dehydrogenase (LDH), and inflammatory factors such as TNFα and IL-6. Data were sourced from PubMed, Scopus, and Web of Science databases up to February 2024. Analyses were performed to compare vitamin D with placebo, and weighted mean differences (WMD) were calculated.

A total of 11 studies involving 358 athletes and non-athletes were examined. Changes in muscle soreness immediately after exercise due to vitamin D intake were not statistically significant [P=0.70, WMD=-0.07]. However, vitamin D significantly reduced muscle soreness 24 hours after exercise [P=0.04, WMD=-0.40]. No significant changes were observed in CK [P=0.30, WMD=-3.22 U/L], LDH [P=0.30, WMD=-11.86 U/L], or MB [P=0.50, WMD=10.66 ng/ml] immediately after exercise.

Vitamin D may be effective in reducing muscle soreness 24 hours post-exercise, but it does not appear to significantly affect markers of muscle damage, including CK, MB, and LDH, in the timeframes studied. Further research in this area is recommended.

This systematic review and meta-analysis aimed to investigate the association between serum vitamin D levels and the prevalence of severe early childhood caries(S-ECC) in children under six years old.

A systematic search was conducted across multiple databases to identify relevant studies. Inclusion criteria encompassed case-control studies published between 2012 and 2023; caries outcomes expressed as prevalence of S-ECC among children under 6; and vitamin D levels assessed by laboratory analysis. Two authors selected studies, extracted data and assessed risk of bias independently. The quality of the studies was also assessed according to STROBE checklist. Selected studies were included in the meta-analysis.

Among the 235 identified studies, 10 studies were finally included in the meta-analysis, Meta-analysis results revealed a significant association between lower serum vitamin D levels and higher prevalence of S-ECC in children under six years old (mean difference: 12.73 nmol/L, CI: [-17.10, -8.35]).which indicates the existence of a relationship between low levels of vitamin D and the occurrence of S-ECC in children.

This systematic review and meta-analysis suggest a significant association between lower serum vitamin D levels and higher prevalence of S-ECC in young children. However, the cross-sectional nature of included studies and variations in methodologies highlight the need for further research to establish causality definitively. These findings underscore the importance of considering serum vitamin D levels in pediatric dental health strategies and advocate for more robust study designs in future research.

Nowadays, sleep disorders have become a growing concern in human societies, and it is very important to identify optimal and low-cost treatment methods to improve the quality of sleep. The present study was conducted to determine the effect of regular Pilates exercises along with vitamin D supplementation on the sleep quality of overweight men.

This clinical trial study was conducted on 50 overweight men in Qaimshahr city in 2022, who were randomly divided into control, exercise, vitamin D, and combined groups after being selected by an available sampling method. The exercise and combined groups performed 8 weeks of Pilates training with an intensity of 50-75% of their reserve heart rate, 3 sessions per week. Vitamin D was taken at a dose of 50,000 IU weekly. The Pittsburgh Sleep Quality Index was used to assess sleep quality, with a score higher than 5 indicating poor sleep quality. The data were analyzed using one-way ANOVA, Kruskal-Wallis, Mann–Whitney U, and paired t tests (p < 0.05).

Vitamin D status in subjects was lower than normal. Sleep quality significantly improved in the Pilates, vitamin D, and combined groups compared to the control group (p < 0.05). However, no significant difference was found between the effects of these interventions on changes in sleep quality (p > 0.05).

The results indicate the prevalence of unfavorable vitamin D status associated with low sleep quality in overweight men. Additionally, all three treatment methods—Pilates exercises, vitamin D supplementation, and a combination of Pilates exercises with vitamin D supplementation—can lead to improvements in sleep quality and aspects such as the duration of beneficial sleep, sleep efficiency, and the amount of sedative medication used in overweight individuals with lower-than-normal levels of vitamin D. Although the combined intervention has shown stronger effects on enhancing sleep quality compared to the other two interventions, no significant difference was observed between the effects of the interventions on changes in sleep quality. Based on the study's findings, using vitamin D supplements may be a suitable approach for regulating sleep.

Recent studies show a connection between serum vitamin D levels and the onset of asthma, as well as markers of disease severity in children with asthma. This study explores the relationship between serum vitamin D levels and the severity of asthma in children.

In this case-control study, 210 children aged 5 to 15 entered the study after obtaining informed consent from their parents. Participants were divided into three groups: healthy (control) = 70, moderate asthma (case) = 70, and severe asthma (case) = 70. The diagnosis of asthma and its severity were determined based on clinical signs and spirometry. At the same time, the serum levels of 25-hydroxyvitamin D were measured using a standard DIA source kit and the ELISA method.

The mean serum level of vitamin D in healthy individuals was 28.92 ± 9.54, which was higher than in those with asthma. On the other hand, the vitamin D level in patients with severe asthma was 13.24 ± 21.61, significantly lower than that in patients with non-severe (mild and moderate) asthma, who had levels of 28.44 ± 9.97. The results indicated a statistically significant difference in serum vitamin D levels among the study groups (P<0.001). Furthermore, there was a negative correlation between serum vitamin D levels and asthma severity among the subjects (r=-0.25), which was also statistically significant (P<0.05).

In conclusion, assessing vitamin D levels in patients with asthma is recommended. If a deficiency is identified, it is important to implement the necessary treatment.

Osteoporosis is a well-known problem in patients with spondyloarthropathy that may begin even in the early stages of the disease and cause debilitating complications. The aim of this study was to investigate the relationship between disease severity and low bone density in patients with axial spondyloarthropathy.

In this study, 65 patients with axial spondyloarthropathy were included in the study, and the data including age, gender, BMI, CRP, 25(OH) vit.D, HLAB27, MRI of the sacroiliac joint and bilateral hip, disease duration, disease activity and the last BMD test was extracted from their records and analyzed with statistical software.

Mean (and standard deviation) age, BMI, the duration of the disease, CRP, and ASDAS- CRP were 37.5±5/9 years, 24.7±1.8 kg/m2, 73.9±33.5 months, 14.2±3.2, and 2.2±0.5, respectively. 21.5% of patients had osteoporosis, 90/8% were HLAB27 positive, 78.5% had sacroiliac joint involvement and 66.2% had vitamin D deficiency. Gender (p=0.75), age (p=0.11), involvement of sacroiliac joints (p=0.13) and positive HLAB27 (p=0.75) were not significantly different in patients with and without osteoporosis. While, vitamin D deficiency (p<0.001), BMI (p<0.001), disease duration (p=0.01), CRP (p<0.001), and disease activity (p=0.004) were significantly higher in patients with osteoporosis.

The results of this study showed that disease activity, CRP, disease duration, BMI and vitamin D level are related to osteoporosis in these patients. Therefore, patients who have these risk factors should be prioritized to check bone density.

Glucose transporter4 (GLUT4) is the main glucose transporter in skeletal muscle. Impaired GLUT4 expression plays a role in the disorders of glycemic homeostasis. The aim of the present study was to investigate the combined effects of aerobic training and vitamin D3 supplementation on Glut4 protein levels and insulin resistance in the soleus muscle of diabetic rats with STZ and high-fat diet.

In 40 male Wistar rats type 2 diabetes was induced by 6 weeks high-fat diet followed by streptozotocin injection. Then rats were randomly divided into five groups: Healthy control (HC), Diabetic control (DC). Diabetes+Aerobic training (DAT), Diabetes+Vitamin D3 (DVD) and Diabetes+Aerobic training+ Vitamin D3 (DVDAT). The rats underwent eight weeks of aerobic training and vitamin D3 supplementation. 24h after last session of training and, the rats were anesthetized and soleus muscle was isolated for measurement of Glut4 protein concentrations and serum levels of insulin, glucose, vitamin D3 index were measured.

One-way ANOVA showed that GLUT4 protein levels in DC group was significantly lower than HC group (P<0.001), but in DVDAT group was significantly higher than DC group (P<0.04) and DVD group (P<0.005). Also in DAT group was significantly higher than DVD (P<0.018). The HOMA-IR index also in DVDAT, DAT and DVD groups was significantly lower than DC group (P<0.001).

It seems that Eight weeks of aerobic training with vitamin D3 supplementation improves glucose metabolism in diabetic rats via increasing Glut4 protein levels and improving insulin resistance index.

Hypocalcemia is a common complication of total thyroidectomy. It has many consequences for the health of patients and negatively affects the patient’s quality of life. The purpose of this study was to investigate the predictive role of vitamin D serum levels before total thyroidectomy in the occurrence of hypocalcemia.

This cross-sectional study was conducted on 82 patients who were candidates for total thyroidectomy surgery and referred to 5 Azar Hospital in Gorgan in 2022. Demographic information, laboratory variables, and clinical symptoms of hypocalcemia before surgery, and 24 hours and two weeks after surgery were collected using a checklist. Data were analyzed with SPSS18 software, independent t-tests, U-Man-Whitney, Wilcoxon, paired t-tests, and a Chi-square test at a significance level of 0.05.

The mean serum calcium level was significantly reduced 24 hours and two weeks after surgery. The average serum level of phosphorus also decreased significantly 24 hours after surgery. About 32.9% showed symptoms of hypocalcemia 24 hours after surgery. Hypocalcemia was not related to the serum vitamin D level. The mean serum calcium level was significantly lower in patients with hypocalcemic symptoms. The average parathyroid hormone one day after surgery was significantly higher in patients with normal calcium levels.

Vitamin D serum level before total thyroidectomy is not related to hypocalcemia after total thyroidectomy. Serum levels of parathyroid hormone and phosphorus are related to serum calcium changes after surgery.

Serum vitamin D levels before thyroidectomy cannot predict hypocalcemia after total thyroidectomy. Serum levels of parathyroid hormone and phosphorus are related to serum calcium changes after surgery. Therefore, long-term follow-up of calcium, vitamin D, parathyroid hormone, and phosphorus levels is recommended for these patients.

Extensive research is underway to find effective treatments for clinical manifestations of COVID-19. Given the proven effectiveness of certain micronutrients, such as vitamins, in antimicrobial activity and immune system modulation for treating or preventing infectious diseases, the potential role of vitamins in the treatment or prevention of COVID-19 should be considered. The present study aimed to assess the correlation between serum folate levels in patients hospitalized with COVID-19 and the severity of the disease, emphasizing the importance of relevant awareness regarding different folate levels.

In this cross-sectional study, folate levels were measured in 117 COVID-19-infected patients hospitalized from January 2020 to November 2020 at Sina Hospital, Hamadan. Patients were categorized based on disease severity into three groups: mild to moderate, severe, and critical. Group differences were statistically analyzed using appropriate tests.

Our study revealed a statistically significant difference in folate levels among the three examined groups. Logistic regression analyses demonstrated that for every one microgram per milliliter increase in folate, the probability of severe COVID-19 symptoms decreased by 23%. The large area under the ROC curve (0.864) indicates that mortality in COVID-19 patients can be well predicted based on folate levels.

As evidenced by the obtained results, it can be stated that a reduction in serum folate levels among hospitalized patients with COVID-19 is common and is recognized as a predictive factor for COVID-19-related mortality. Consequently, monitoring folate levels and considering supplementation, if necessary, should be considered for hospitalized COVID-19 patients.