Iskanje po repozitoriju

A+ | A- | | SLO | ENG

Povzetek: Background: Vitamin D status is influenced by season, age, and public health messaging. The COVID-19 pandemic was accompanied by heightened interest in vitamin D, but long-term national data from Central/Eastern Europe remain limited. We aimed to characterize 10-year trends, seasonal variation, and demographic determinants of serum 25-hydroxyvitamin D [25(OH)D] in Slovenia, with particular focus on changes during the COVID-19 period. Methods: We performed a retrospective cross-sectional analysis of all serum 25(OH)D measurements performed at the Slovenian national reference laboratory between January 2014 and December 2023. The core analytic cohort included 106,875 patients with valid 25(OH)D results, aged 0–100 years. Vitamin D status was classified as deficient (<30 nmol/L), insufficient (30–50 nmol/L), adequate (50–75 nmol/L), and optimal (>75 nmol/L). Temporal trends, seasonal patterns, and age- and sex-specific differences were assessed using non-parametric tests and Kendall’s τ. Results: Mean 25(OH)D concentration over the study period was 61.9 ± 34.2 nmol/L; 16.0% of patients were deficient and 22.8% insufficient. Annual mean 25(OH)D increased from 57.0 nmol/L in 2014 to 67.2 nmol/L in 2023, with a significant upward temporal trend and a 14.6% higher mean level during 2020–2023 compared with 2014–2019. Seasonal variation was pronounced (≈20% higher summer–autumn vs. winter–spring), and vitamin D status declined progressively with age, with the highest deficiency prevalence in patients ≥ 70 years. Females had slightly higher 25(OH)D than males, although absolute differences were small. Conclusions: This laboratory-based analysis of tested patients showed higher 25(OH)D concentrations during and after the COVID-19 period, superimposed on persistent seasonal and age-related gradients. These observations identify older adults and winter testing periods as important contexts for vitamin D optimization, but they should be interpreted as descriptive trends among tested individuals rather than as evidence of causal pandemic effects or population-wide prevalence changes.
Ključne besede: 25-hydroxyvitamin D, seasonal variation, deficiency, age factors, COVID-19 pandemic
Objavljeno v DiRROS: 24.04.2026; Ogledov: 344; Prenosov: 270
Celotno besedilo (1,54 MB)
Gradivo ima več datotek! Več...

Povzetek: Vitamin D deficiency is common in hospitalized COVID-19 patients and is associated with increased severity. However, single-biomarker approaches provide insufficient prognostic precision. We developed an integrative inflammatory-metabolic risk index combining vitamin D status, systemic inflammation, and coagulation activation. This is a prospective cohort study of 512 hospitalized COVID-19 patients (September 2022–December 2023) with serum 25(OH)D3 measurement at admission. The primary analysis (N = 301) included patients with complete data for VDIBS-Core components (CRP, ferritin, D-dimer, LDH). The Vitamin D Inflammatory Burden Score-Core (VDIBS-Core; range 0–7) integrated the following: (1) vitamin D tier (deficient < 30 nmol/L: 3 points; insufficient 30–50: 2; non-optimal 50–75: 1; sufficient > 75: 0), (2) inflammation score (CRP ≥ 100, ferritin ≥ 1000 each +1 point; 0–2 total), and (3) coagulation score (D-dimer ≥ 1000, LDH ≥ 3–6 or ≥ 6 each +0–2 points; 0–2 total). The IL-6 measurement (N = 48, 9.4%) was explored separately as VDIBS-Plus in the secondary analysis. The outcomes were severe COVID-19 (defined as the worst severity classification during hospitalization per WHO criteria), ICU admission, and mortality. The mean vitamin D was 63.4 ± 33.2 nmol/L (68.1% deficient). Among N = 301 with complete VDIBS-Core data, severe disease occurred in 221 (73.4%), ICU admission in 15 (5.0%), and mortality in 8 (2.7%). VDIBS-Core risk stratification showed the following: low-risk (VDIBS 0–2, n = 178) 8.4% severe; moderate-risk (VDIBS 3–5, n = 245) 45.7% severe; and high-risk (VDIBS 6–7, n = 89) 78.6% severe; χ2 = 142.3, p < 0.001. VDIBS-Core predicted severe disease with AUC 0.78 (95% CI 0.74–0.82), with excellent calibration (Hosmer–Lemeshow p = 0.40). When compared to complex multivariate models incorporating all seven individual biomarkers, VDIBS-Core demonstrated equivalent discrimination (AUC 0.82, Δ = 0.04, p = 0.08, not statistically significant) with superior clinical simplicity. Bootstrap internal validation confirmed modest optimism (optimism-corrected AUC 0.76). An incremental value analysis demonstrated that the vitamin D component contributes a significant additional predictive value compared to inflammation/coagulation biomarkers alone (LR test p = 0.004). VDIBS-Core provides bedside-implementable risk stratification using three simple components measurable in <5 min, integrating vitamin D-dependent immune regulation with systemic inflammation and coagulation activation. This composite approach offers a practical tool for treatment intensity escalation and monitoring frequency assignment in hospitalized COVID-19 patients. External validation in geographically diverse cohorts is required before widespread clinical implementation.
Ključne besede: vitamin D deficiency, COVID-19 severity, biomarker integration, risk stratification, immunometabolism
Objavljeno v DiRROS: 08.04.2026; Ogledov: 320; Prenosov: 264
Celotno besedilo (2,93 MB)
Gradivo ima več datotek! Več...

Ključne besede: rak rebušne slinavke, citopatologija, onkologija
Objavljeno v DiRROS: 25.02.2026; Ogledov: 460; Prenosov: 152
Celotno besedilo (84,57 KB)

Povzetek: Acute pancreatitis (AP) is primarily caused by inflammation and immunological responses, both of which are regulated by vitamin D. The purpose of this study was to examine the correlation between the severity of AP and vitamin D levels, including its total, free, and bioavailable forms. Eighty individuals with AP were enrolled in this study. Serum levels of free 25(OH)D3, bioavailable 25(OH)D3, and total 25-hydroxyvitamin D 25(OH)D3 were assessed. The severity of the disease course was assessed by scoring systems (Revised Atlanta classification, Ranson score, CTSI). Vitamin D deficiency was common in AP patients, with 31.3% being categorized as deficient (<50 nmol/L) and 27.5% having a severe deficiency (<30 nmol/L). Compared to patients with adequate vitamin D status, those with lower vitamin D levels had a significantly higher risk of developing moderate-to-severe AP (44.7% vs. 14.3%, p = 0.029). Patients with severe vitamin D insufficiency were the only ones who experienced severe AP. Clinical outcomes showed similar correlations: patients with significant vitamin D deficiency had longer hospital stays (mean of 12.1 ± 5.3 days vs. 7.8 ± 3.4 days, p = 0.018) and higher rates of ICU admission (31.8% vs. 8.0%, p = 0.007). Low levels of total, free, and bioavailable vitamin D were significantly associated with the severity of AP and ICU admission. Free, bioavailable, and total vitamin D were correlated with the severity of acute pancreatitis. All severe cases occurred in patients with severe vitamin D deficiency. Given the observational design, these associations require confirmation in interventional or mechanistic studies.
Ključne besede: vitamin D deficiency, acute pancreatitis severity, free and bioavailable vitamin D, inflammation and immune response, clinical outcomes
Objavljeno v DiRROS: 25.11.2025; Ogledov: 721; Prenosov: 489
Celotno besedilo (342,78 KB)
Gradivo ima več datotek! Več...

Ključne besede: abbreviated 13C-mixed triglyceride breath test, pancreatic exocrine insufficiency, gastrectomy, faecal elastase, gastric cancer
Objavljeno v DiRROS: 25.07.2024; Ogledov: 1619; Prenosov: 491
Celotno besedilo (429,37 KB)